Beyond antipsychotics: the role of medication and nonmedication factors in female sexual dysfunctions in schizophrenia.

To date, few studies have investigated male sexual dysfunctions (FSDs) in schizophrenia in non-Western countries, with most studies focusing on the sexual side effects of antipsychotic medications. Therefore, we aimed to screen for FSD in a sample of Egyptian females with schizophrenia, compare them to controls and to investigate demographic and clinical parameters associated with FSD. We conducted a cross-sectional study of 72 medicated and unmedicated females with schizophrenia (27 unmedicated and 45 medicated) and 24 controls. They were assessed using the Female Sexual Function Index (FSFI) and data were collected for demographic and clinical parameters. We found that females with schizophrenia had significantly lower scores on the FSFI compared to controls and that 93.1% of females with schizophrenia reached the threshold for FSD (FSFI score ≤26), compared to 87.5% of controls. Medicated and unmedicated subjects did not differ significantly in most domains of the FSFI. Age, duration of illness, positive and negative syndrome Scale total, positive and negative symptom scores correlated significantly with the majority of domains of the FSFI. Rates of FSD are very high in both schizophrenia and controls and correlate in schizophrenia with a number of demographic and clinical parameters, suggesting that FSDs are not restricted to the side effects of medications. There is a need to screen for sexual function in routine practice, and for developing active strategies to tackle sexual dysfunctions.

Single episode brief psychotic disorder versus bipolar disorder: A diffusion tensor imaging and executive functions study.

BACKGROUND: Despite fast progress in neuroscientific approaches, the neurobiological continuum links psychotic spectrum, and affective disorder is obscure. White matter WM abnormalities found utilizing Diffusion Tensor Imaging (DTI) showing impaired communication in both disorders have been consistently demonstrated; however, direct comparisons of findings between them are scarce. This study aims to study WM abnormalities in single episode bipolar I disorder, and single episode brief psychotic disorder related to healthy control with the association of executive function. METHODS: A cross-sectional case-control study was used to assess 60 subjects divided into 20 patients with single episode bipolar I disorder, 20 individuals with single episode brief psychotic disorder (both groups of patients were in remission), and 20 healthy controls. The present study examined the superior longitudinal fasciculus (SLF), and cingulum bundle fractional anisotropy (FA) determined from DTI images symmetrically and connected these results with cognitive functions as assessed by the trail making test (TMT) and Wisconsin card sorting test (WCST). RESULTS: DTI data indicated that the psychotic group had a significant decrease in FA of the right SLF (p-value less than 0.001), left SLF (p-value less than 0.001), and left cingulum (p-value less than 0.001) than the bipolar I group. In terms of executive functioning, the psychotic group performed significantly worse than the bipolar I group on the TMT part B (p-value less than 0.001), the WCST (number of classifications fulfilled) (p-value less than 0.001), and perseverative errors (p-value less than 0.001). CONCLUSION: Even after clinical remission, individuals with single episode brief psychotic disorder had more pronounced white matter impairments and executive function deficiencies than individuals with single episode bipolar I disorder.

Screening for ADHD in a Sample of Egyptian Adolescent School Students.

OBJECTIVE: To screen for ADHD in a sample of Egyptian adolescent students, and study the distribution of different subtypes of ADHD, associated comorbidities, and sociodemographic correlates. METHOD: A total of 925 adolescents were randomly selected and screened by the Conners-Wells' Adolescent Self-Report Scale-Short form (CASS:S), and potential cases were further assessed by the Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime versions (K-SADS-PL). RESULTS: A total of 87 students (9.4%) had potential ADHD diagnosis with evident preponderance in boys (13.8%, n = 58) than in girls (5.8%, n = 29) with a ratio of 2:1 ( p = .000, χ2 = 17.328). The hyperactive-impulsive subtype comprised the majority of cases (54.7%, n = 41). Psychiatric comorbidity was invariably present (85.1%, n = 74). Nearly half the cases had poor academic achievement (43.7%, n = 34). Positive correlates included family history of psychiatric disorders, the order of birth, and parental disharmony. CONCLUSION: ADHD is prevalent in Egyptian adolescents and is associated with high psychiatric comorbidity and a pronounced effect on academic performance.

Frequency of occurrence of specific reading disorder and associated psychiatric comorbidity in a sample of Egyptian primary school students.

BACKGROUND: Specific reading disorder (dyslexia) is common in primary school students. Data on prevalence rates in Egypt are needed along with better screening tools to guide future research. We aimed to estimate the frequency of dyslexia in a sample of fourth and fifth graders. METHOD: A cross-sectional study was conducted in Eastern Cairo through multistage random selection of students from three governmental primary schools. A total of 586 students were recruited. Only 567 students fulfilled the inclusion criteria; they were subjected to screening by Goodenough Draw-a-Man test for intellectual quotient (IQ), the Reading Disability Test of Nasra Gilgil (RDT) to identify dyslexic children, Wechsler Children Intelligence Scale for thorough detection of IQ, and the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS-PL) to detect psychiatric comorbidity. RESULTS: The frequency of occurrence of specific reading disorder (dyslexia) was 11.3% among the studied sample of Egyptian primary school students. The gender ratio was nearly 1.3:1 boys to girls. Comorbidity with other psychiatric disorders was found in 57.8% of the sample. Attention deficit hyperactivity disorder (ADHD) was present in 33%, generalized anxiety disorder in 21.6%, and major depressive disorder in 16.2% of patients. CONCLUSION: Dyslexia was prevalent in fourth and fifth graders. A meaningful presence of ADHD, anxiety, and depressed mood was detected in students. There is a need for better screening and awareness for early intervention and service provision. The cross-sectional design, lack of collateral information, and records precluded inference of casualty. The lack of rural comparator and samples from other governorates limit generalization of results.

Cognitive functions in euthymic Egyptian patients with bipolar disorder: are they different from healthy controls?

BACKGROUND: There is marked interest to research neurocognitive functions in bipolar disorder during euthymia. Consequently we aimed to study cognitive functions in euthymic bipolar patients and factors affecting them. METHODS: It is a cross sectional case-control study of 60 euthymic bipolar patients and 30 matched healthy controls. They were subjected to: Structured Clinical Interview for DSM-IV disorders, (SCID-I) to ascertain clinical diagnosis, Young Mania Rating Scale (YMRS), Hamilton Rating Scale for Depression (HRSD) to validate euthymia. Wechsler Adult Intelligence Scale (WAIS) for general intellectual abilities, Wechsler Memory Scale-Revised (WMS-R) for memory, Wisconsin Card Sorting Test (WCST) for executive functions, Continuous Performance Test (CPT) for attention and impulsivity, and an information sheet gathering patient data. RESULTS: Bipolar patients had statistically significant lower mean IQ scores in all WAIS subscales (p=0.000), significantly lower memory abilities especially digit span and visual memory, higher impulsivity and inattention (p=0.000) but no significant difference in response time by CPT. They displayed significantly lower executive performance on WCST. Patients' years of education correlated positively with IQ. Hospital admission, number, type of episodes and total number of episodes affected memory functions. Hospital admission and number of hypomanic episodes correlated with attention and impulsivity. Previous hospitalization correlated with executive functions. CONCLUSIONS: Euthymic bipolar patients exhibit cognitive deficits, which correlated with clinical variables as number, type of episodes and previous hospitalization, this knowledge could help minimize cognitive impairments for future patients. LIMITATIONS: The small sample size, cross sectional design and lack of premorbid cognitive assessment limit generalization of findings.

Impact of personality temperaments and characters on academic performance and specialty selection among a group of Egyptian medical graduates.

BACKGROUND: The relationship between personality temperaments, academic achievement and specialty interest is important because of its implications in career counseling. AIM: To assess the effect of personality on academic performance and career selection and to study the impact of some sociodemographic factors on academic achievement and career choice of medical graduates. METHODOLOGY: A total of 436 medical graduates of Ain Shams medical school were approached, out of which 331 participated. They were given a sociodemographic questionnaire, and the Temperament and Character Inventory-Revised (TCI-R; 240) for personality construct; they had to answer questions about academic achievement, ranking, scores and choice of medical specialty. RESULTS: Novelty seeking (NS1, NS2 and NS3) and self-transcendence (ST1 and ST2) were correlated with graduation ranking, (r = .2, p = .00; r = .15, p = .009; r = .16, p = .005; r = .12, p = .003; r = .14, p = .02; r = .17, p = .004; r = .13, p = .03, respectively), that is, lower NS and ST had better academic outcome. Only high school score was associated with better achievement (p = .00). In specialty selection, females were significantly overrepresented in pediatrics and clinical pathology, whereas males were significantly predominating surgical specialties except for obstetrics and gynecology (p = .00). Students choosing patient-centered specialties had higher reward dependence (RD), persistence (PS) and cooperativeness (C); those choosing clinical pathology had highest harm avoidance (HA), whereas those choosing radiology had lowest HA and those choosing surgery had significantly higher self-directedness (SD3). CONCLUSION: Personality impacts academic achievement and specialty choice with other factors as gender and previous scholastic performance.