Rheumatoid arthritis: a psychosomatic and somatopsychic dialogue

A number of 46 patients, 76.1% females and 23.9% males, aged 33.4 + 20.8 years, with acute [15.2%] and chronic [84.8%] rheumatoid arthritis, were assessed for their previous mental adjustment present mental state, and social attitudes, in comparison to two control groups of organic pain and peptic ulcer subjects, to roll-out those having psychiatric disorders and need additional help. Using E.P.Q., the study could identify indistinguishable personality characteristics in rheumatoid patients, compared to controls. Clinical evaluation, with the aid of applied General Health Questionnaire. Taylor-manifest anxiety, and Beck-depressive state scales instilled that psychiatric disorders were manifested in 69.6% of study sample, as mood disorders [71.9%], anxiety disorders [25%], and interrelations problems [3.1%], which were not statistically different from controls. An attempt to determine whether these disorders are an organic manifestation of the disease, a toxic effect of treatment, or a psychological reaction to illness, inferred that a combination of the three might exist. It is particular with this group of patients that the value of liaison seminars, rather than formal written referrals was recommended. The interplay of physical and psychological factors necessitates the availability of a liaison psychiatrist with a special interest in field of rheumatology to all such units i.e. a host, and not a guest

Clobazam as adjunctive therapy in drug-resistant seizures: clinical, EEG and psychological study

The anticonvulsant effect of clobazam in refractory epileptics of all types in different age groups was studied. Subjects were kept on their basic monotherapy antiepileptic regimens with phenytoin, valproic acid or carbamazepine [to which the response was unsatisfactory], in addition to 0.5-1 mg clobazam/kg/day for 6 months. Clinical, EGG and psychological assessments were carried out at the start, 3 months and at the end of the study. An improvement [50% reduction of seizure frequency or more] was noticed in 24 patients, but with no statistical significance. None of the subjects in this study developed tolerance. There was no correlation between the degree of the effect and serum levels of phenytoin and carbamazepine; while valproic acid was positively correlated, but without statistical significance. Normal EEG patterns were obtained in two patients. Although the present study was populated by negative sample of problem patients, the results were encouraging to recommend inclusion of clobazam in unproblematic cases with expected greater success rates than have been observed so far