Psychological profile among chronically ill adolescents

Background: Chronic illness [CI] presents considerable burden at dtferent life stages especially childhood, so its concern is raised and need greater attention. The psychological influences of C1 are currently less well understood and consequently the elements of its care may be overlooked if its importance is not stressed by appropriate definition and classification

Objective: To assess psychological profile [PP] and psychological impacts [PI] of CI among adolescents, and to demonstrate the determinants of the psychological reactions [PR]

Methods: A case control design was adopted in this study. The index cases [n = 150] were those attending the clinics at Alexandria Students' School Hospital and suffering from CI namely; Diabetes Mellitus [DM], Rheumatic heart [RH], and Bronchial asthma [BA]. A similar number of controls who attended for minor conditions, matched by age and sex, were chosen from the same hospital. Data about adolescents' characters [age, sex, birth order, level of education, family size and the crowding index] and PI [Adolescents' perception of their illness, Family response and School support to the chronically ill adolescents] were obtained by an interviewing questionnaire. Additionally, psychological assessment was done by using Middle Sex Test [MST]

Results: Hysteria, obsession, depression and psychosomatic constituted the highly prevalent neurotic traits in the Present study. Asthmatic adolescents stated that their illness is incurable and restrict their activity. Mothers [initially] and siblings [late] of rheumatics are more likely to have negative attitudes. Teachers' care of absence is More mentioned by the diabetics. The significant factors contributing to the psychological disturbance are the birth Order, family responses, school support and the effect of CI on activity and attendance

Conclusion: It could be concluded that Cl affects the adolescents' psychological status and exerts impacts on the Idolescent himself, his family and school members. CI of adolescents expose them to peer rejection through their Isolation and avoidance of activity, prolonged absence from school besides the decrease of self confidence due to independency that results from overprotective and sympathetic parents. Lack of social support and communication islike a sixth sense without which you cannot make a complete use of the other five. The chronically ill adolescents and their families are in need for team providing comprehensive care [medical and psychosocial], support and education

Predictors of clinical outcome among adolescents with first episode schizophrenia in Alexandria.

Evidence was emerging that the early phase following the onset of a first psychotic illness could be conceived of as a critical period, influencing the long-term course of the illness. Effective intervention at this stage might alter the subsequent course of the illness. Psychosis may be developed as the action of social or psychological stressors acting on the vulnerable individuals. The present study aimed at providing data about potential sociodemographic and family risk factors related to development of first episode schizophrenia [FES], identifying clinical profile of FES among adolescents, providing baseline assessment of patients with FES as well as changes in assessment domains during five months follow up period, and finally identifying significant contributing factors related to clinical outcome of FES among adolescents. A clinic-based case control study was carried out. Cases were recruited from Psychiatric Consultation Clinic for school children in Alexandria. The trained investigators themselves collected the data using precoded structured questionnaire. A structured clinical interview format was used for assessing five domains. The majority of cases [88.7%] claimed that illness was precipitated by stressful life events. Source of referral was the physician in 66.2% of instances. The most commonly cited reason for referral was aggression and violence [39.4%]. More than one-fifth of cases [21.1%] visited faith healer before referral and 19.7% did not seek any medical care. Just less than two-thirds of family members [60.6%] had negative attitude towards the illness. Nearly three-quarter of cases [73.2%] reported progressive course of illness. Significant risk factors for FES in logistic regression model were: positive family history of mental disorders [Adjusted OR=6.47, 95% Cl=1.29-9.61], unskilled fathers' occupation [Adjusted OR=1.34, 95% Cl=1.22-3.03], low mothers' educational level [Adjusted OR=4.92, 95% Cl=2.42-9.71], and negative parental rearing style [Adjusted OR=2.51, 95% Cl=1.67-4.471. The estimated remission rate following the follow up period was 86.3%. Positive symptoms improved in 87.3% of cases while negative symptoms improved in 83.1% of cases. Moreover, 73.2% of cases experienced improvement in psychopathological symptoms. Social functioning had improved in 76.1% of cases. Compliance to medication and family support were the only significant predictors for clinical improvement in patients with FES [Adjusted OR=3.15, 95% Cl=2.64-6.83, P<0.001, and 2.63, 95% Cl=1.89-5.72, P=0.0081. The present work concluded that the best strategy is to early diagnose and treat patients suffering from first episode psychosis. This includes appropriate medical diagnosis, neurocognitive and psychological assessment, and appropriate medication. The support and necessary education were needed for family members to be helpful

Outcome of care in two burn units in Alexandria

The outcome of care in a special care burn unit and a traditional burn ward in the Main University Hospital in Alexandria was assessed in terms of length of hospital stay, psychoneurotic status, and satisfaction of patients. The study population comprised 38 consecutive admissions to the traditional ward and 37 consecutive admissions to the special care unit. Results indicated that the outcome of care was more favourable for patients treated in the special care unit. The length of hospital stay was significantly shorter for the special care unit group. Based on the Middlesex Hospital Questionnaire, the levels of anxiety, phobia, psychosomatic complaints, depression and hysteria were significantly higher for the traditional ward group.The level of overall satisfaction, as well as the levels of satisfaction with physical conditions, staff responsiveness, and visiting regulations were significantly higher for the special care unit group