Mohammad A. Seleem

The longitudinal course of sleep timing and circadian preferences in adults with bipolar disorder.

To study the longitudinal course of sleep timing and circadian preferences in individuals with bipolar disorder (BP) compared to individuals with non‐BP psychopathology and healthy controls.

Psychosocial profile of a sample of Egyptian children with rheumatic heart disease

ObjectivesEarly-onset physical morbidity is likely to affect the emotional balance and behavioral adaptation of children and adolescents. Few published studies have investigated psychological morbidity in children with rheumatic heart diseases (RHD). Our work aims to explore the psychiatric symptoms in addition to total competence and quality of life in a sample of Egyptian children with RHD in comparison with those with no RHD and with healthy controls. Participants and methodsChildren (age 6–18 years) with RHD (n=24), those with congenital or other heart diseases (non-RHD) (n=23), and healthy control children (n=28) were recruited. The Arabic version of the Child Behavior Checklist was completed by parents. ResultsAfter adjustment for different socioeconomic statuses, all children with heart diseases were found to show more internalizing problems and post-traumatic stress compared with healthy children. Non-RHD children showed more generalized and social anxiety, whereas those with RHD showed higher levels of obsessive–compulsive problems. ConclusionChildren with heart diseases suffer from high internalizing psychological stress. More effort needs to be made for the early identification and management of psychological morbidity in children with RHD, especially for anxiety and obsessive compulsive symptoms.

Primary monosymptomatic nocturnal enuresis: an etiological study

BackgroundNocturnal enuresis (NE) is a very common chronic pediatric problem with bad psychological consequences.MethodsForty primary monosymptomatic nocturnal enuresis (MNE) children and 20 healthy controls were recruited in the study and subjected to history taking, neurological and urological examinations, and psychological assessment using the Arabic-translated and validated version of child behavior checklist, sleep architecture studying through one-night polysomnography (PSG), and vasopressin levels determination both diurnal and nocturnal.ResultsEnuretic children had positive family history of NE in 42.5%, inverted vasopressin circadian rhythm in 52.5% and PSG changes in the form of increased N3 deep sleep % of total sleep time (TST), sleep stage transition index (SSTI), periodic limb movement index (PLMI), and snore index. Enuretic children PSG showed decreased deep sleep latency, N1% of TST, N2% of TST, and REM % of TST. The child behavior checklist showed higher anxious depressed symptoms, social problem, attention problems, and internalizing problems in enuretic children than control subjects.ConclusionsMNE is a heterogeneous disorder with multiple factors interplay in its pathogenesis. So, the management must be tailored patient by patient according to the dominating etiology.

Suicidal Ideation in an Egyptian Sample of Hospitalized Patients with Acute Psychosis

BACKGROUND Suicide mortality is 12 times higher in psychotic patients compared to the general population. Identifying characteristic of suicidal patients among this group might help in preventing such behavior. AIMS To assess the predictors of suicidal risk in patients hospitalized due to acute psychosis. METHODS One hundred and fifty patients (age 18 - 60 years) admitted with acute psychotic features were recruited. Patients were evaluated clinically by The Arabic version of Mini International Neuropsychiatric Interview (M.I.N.I.). Suicidal ideation was assessed using the Scale for Suicide Ideation (SSI). RESULTS Forty four out of 150 patients (29.33%) reported having current and/or previous history of suicidal ideation. Patients with major depression showed the highest suicidal tendencies followed by delusional disorder then bipolar disorder, psychosis related to substance abuse and schizophrenia. The more severe the psychotic symptoms, the more suicidal tendencies shown by patients. Predictors for suicidal ideations included diagnostic category, severity of psychotic features, unemployement and younger age CONCLUSION: Patients with psychosis that require admission to the hospital carry a high risk of suicidal ideation and behavior. Factors like unemployment, young age and psychiatric diagnosis and severity of psychosis could be predicting factors.

Cognitive impairment and electroencephalographic changes in patients with obsessive compulsive disorder

ObjectiveObsessive compulsive disorder (OCD) is a common psychiatric illness. It has been suggested that certain alterations in executive functioning and information processing might play a primary role in the pathogenesis of OCD. An association between electroencephalogram (EEG) changes and alterations in cognitive functions in OCD was suggested. This work aimed at examining the different aspects of the cognitive impairment among patients with OCD and its relation with EEG changes. Patients and methodsThe sample included 30 OCD patients and 15 healthy individuals as controls. Their ages ranged from 18 to 45 years. The Yale–Brown Obsessive Compulsive Scale was utilized to assess the severity of obsessive compulsive symptoms in patients. The Wisconsin Card Sorting Test (WCST) and the Wechsler Memory Scale – 3rd ed. – Abbreviated (WMS-III-Abbreviated) were utilized to assess cognitive functioning. EEG (10/20 system) was performed for both patients and controls. ResultsCompared with the control group, patients with OCD committed significantly more perseverative and total errors with less total correct trials in the WCST. They also showed significantly less efficient performance in all subscales of the WMS with the exception of information and orientation subscales. Three subscales of the WMS negatively correlated with both severity and duration of OCD. The difference between the two groups as regards EEG changes did not reach statistical significance. OCD patients with EEG abnormalities showed no clear differences compared with OCD patient without EEG abnormalities with regard to duration or severity of OCD and performance on the WCST or the WMS. ConclusionOur sample of Egyptian patients with OCD had significantly lower cognitive performance on several parameters compared with healthy controls, an impairment that positively correlates with both the severity and duration of the illness. Our results did not support a significant role of EEG in the pathogenesis of OCD or its related cognitive impairments.

Self-concept and psychiatric comorbidity in a sample of Egyptian adolescents with secondary nocturnal enuresis

Objective Enuresis is a common problem in children and adolescents that can be troubling for them and their families. The potential effect of enuresis on the synthesis of identity and self-concept in children and adolescents is still poorly understood. This study aimed to evaluate the probable impact of secondary nocturnal enuresis on the self-concept of Egyptian adolescents. Participants and methods Forty patients aged 10-18 years with a diagnosis of secondary enuresis and 40 control children of the same age range were recruited. A validated Arabic version of the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID) in addition to the Child Behavior Check List (CBCL) and an Arabic-translated and validated version of the Piers-Harris Children′s Self-Concept Scale were applied to evaluate the sample. Results After statistical adjustment for differences in intelligence quotient and socioeconomic status, youth with enuresis showed lower school, social, and total competence scores on CBCL but higher scores in all CBCL problem parameters. Adolescents with enuresis scored lower than control adolescents in all six subscales of the Piers-Harris Children′s Self-Concept Scale in addition to the total score. Linear regression was used to adjust the results for significant differences between the two groups regarding intelligence quotient, socioeconomic status, CBCL school competence, CBCL total problems, and diagnosis of attention-deficit hyperactivity disorder and conduct disorder according to the MINI-KID interview. Differences in three subscales - behavior, intellect, and physical appearance - in addition to the total score were still significant after adjustment. Comparison between youth with nocturnal enuresis versus those with combined-type enuresis yielded no significant differences. Conclusion Older children and adolescents with enuresis suffer from high internalizing and externalizing problems, and low competence levels. They also suffer from low self-esteem that is most probably the result of enuresis itself and not due to low competence levels or behavioral problems. Further research is needed to determine the effect of treatment on the self-concept of these children.

Role of the serotonin transporter gene in susceptibility to mood disorders in children of depressed parents

Objective The aim of the study was to explore psychological and behavioral disturbances in a sample of Egyptian children with depressed parents and investigate the potential role of the short (s) alleles of the serotonin transporter-linked polymorphic region in developing depressive symptoms in both parents and their offspring. Subjects and methods The study included 20 families with depressed parents and their offspring (age 6-18 years), who were compared with 20 control families with healthy parents. The Child Behavior Check List was filled by parents for children to detect syndromal and subsyndromal symptoms of mood disorders and other psychiatric disorders in the offspring. Blood samples were drawn from all groups and PCR analysis was conducted to investigate the polymorphism of interest. Results The children of depressed parents scored higher than the children of control parents in almost all Child Behavior Check List internalizing and externalizing problem parameters. A significantly higher percentage of depressed parents (70%) were found to carry the risk allele (s) compared with control parents (35%) (P = 0.03). A similar, but nonsignificant, pattern of asymmetric allele distribution was also found among the offspring of the two groups (77.3 vs. 50%). Conclusion Parental depression must be recognized as a major risk factor of psychiatric morbidity in children. Greater emphasis should be placed on developing large-scale effective preventive interventions for families with parental depression.