ABSTRACT
Background: Obesity is a chronic medical illness with a higher risk of physical and mental cascade. People who seek obesity treatment were reported to have some psychiatric disorders affecting their disease and selection of management. Aims of the Study: This study aims to estimate the prevalence of depressive and anxiety disorders in obese patients seeking obesity management and explore the relationship between common psychiatric disorders (depression and anxiety disorders) and selection of the type of obesity management (surgical or non-surgical). Methods: Patients were recruited from Alazhar Universityhospitals, Egypt, and the total number completing the study was 1115 patients. All subjects underwent psychiatric interview through Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (SCID-5 for DSM-5) for diagnosis of psychiatric disorders and completed two questionnaires, Hamilton Rating Scale for Depression (HRSD) and Hamilton Rating Scale for Anxiety (HRSA). Results: The prevalences of depressive and anxiety disorders were 29.23% and 25.56%, respectively, in all subjects. The most prevalent diagnoses were dysthymic disorder (20.7%), general anxiety disorder (16.95%), major depressive disorder (13.04%), and social phobia (12.4%). Our sample was divided into two groups (surgical and non-surgical). Dysthymia was more common in the surgical group (21.4% versus 19.8% P = 0.560), whereas major depressive disorder was more common in the non-surgical group (7.4% versus 5.4 P = 0.593); also, the non-surgical group was more likely to have "anxiety disorders" (29.23% versus 22.4%, P = 0.840), but severity of anxiety was higher in the surgical group according to HRSA score with a highly significant difference. Conclusions: A high prevalence of depression and anxiety disorders was found among patients who sought obesity treatment. Severity of anxiety was higher in the surgical group according to HRSA score with a highly significant difference, which may affect selection of treatment, so psychiatric evaluation and management are needed before and after obesity management to improve the outcome.
ABSTRACT
BACKGROUND AND AIM: Liver transplantation (LT) is the only curative treatment for patients with the end-stage liver disease. Amongst the complications post-LT, the neurological complications (NC) are particularly relevant. Our aim is to assess the incidence, risk factors and clinical presentation of NC in recipients after living donor liver transplantation. METHODS: Between November 2011 and December 2013, 149 patients were admitted to ICU in 3 different centres in Egypt after LDLT and were evaluated by full clinical examination, laboratory investigations, neuroimaging and the NC were observed over one month. This study was approved by the ethical committee of the National Research Center. RESULTS: 46 recipients (30.9%) developed neurological complications. The most common neurological complication was Encephalopathy (14.1%) while the least were both central pontine myelinolysis and meningoencephalitis (0.7%). In addition, 7 patients developed cerebrovascular events (either ischemic or hemorrhagic strokes). Patients were then classified into uncomplicated and complicated subgroups according to the highest percentage of neurological complication symptoms. These were encephalopathy, delirium with agitation, hallucinations, and delusions. CONCLUSION: A high incidence of neurological complications (30.9%) after LDLT was recorded, prolonging patient hospital stays. The most common complications were encephalopathy, delirium, hallucinations, delusions, and seizures some of which were drug related.
