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Background Early symptoms of dementia may not be apparent and are sometimes even concealed during short office visits initiated for other complaints. The aim of the study is to find out if the combined use of VF/CDT, VF/BNT, or CDT/BNT could improve the accuracy of detecting mild NCD in an outpatient setting, compared with either test used alone. Participants Community-dwelling older adults, attending the outpatient Geriatrics Clinic at Ain Shams University hospitals between June 1, 2017 and January 31, 2018. All participants received a comprehensive geriatric assessment (CGA) which included the mini-mental state examination test. Participants with a score of less than 24 and fulfil DSM5 criteria for mild neurocognitive disorder (NCD) are considered cognitively impaired otherwise are considered normal. Then participants were further examined by the Arabic versions of CDT, BNT, and VF animal category. Results We recruited 143 male and female participants mean age 67.17 ± 5.41, females are 56.6%, and 48.9% of all participants have mild NCD according to DSM5 criteria. AUC for individual neurocognitive tests in illiterates is 0.893 for clock drawing test, 0.907 for verbal fluency animal category, and 0.904 for Boston naming test, while AUC for neurocognitive test combinations in illiterates is 0.932 for VF + CDT, 0.917 for VF + BNT, and 0.932 for BNT + CDT. On the other hand, AUC for individual neurocognitive tests in educated participants is 0.925 for clock drawing test, 0.921 for verbal fluency animal category, and 0.907 for Boston naming test, whereas AUC for neurocognitive test combinations in educated participants is 0.958 for VF + CDT, 0.963 for VF + BNT, and 0.953 for BNT + CDT. Conclusion From the current study, we can conclude that any of the studied combinations have better diagnostic accuracy (although small) than individual test in both literate and illiterate older adults.

Background The diagnostic infant and preschool assessment (DIPA) was one of the fewest available instruments which have been developed to assess young children up to 6 years old. The present study translated, validated, and cross-culturally adapted the DIPA from English to Arabic. Forward translation, expert panel evaluation, and back translation of the DIPA were conducted and followed by assessment of cultural relevance and content validity. Results Validation was performed on a clinical sample of 30 children, through agreement between the diagnostic infant and preschool assessment (DIPA) and Arabic version of DSM-based Child Behavior Check List (CBCL). Validity of categorical variables of translated DIPA showed substantial kappa (0.61-0.80) for conduct disorder, moderate kappa (0.41-0.60) for depressive disorder, post-traumatic stress disorder, generalized anxiety disorder, oppositional defiant disorder, and sleep disorders; poor kappa (0-0.40) for separation anxiety disorder, attention deficit hyperactivity disorder and reactive attachment disorder. Test-retest reliability had almost perfect agreement for all disorders (kappa > 0.81). Conclusions The current study shows an encouraging psychometric property for a new Arabic translated and culturally validated assessment tool for psychiatric disorders in Egyptian young children. This instrument is useful in examining DSM-IV disorders for young children. Future studies are needed to include larger sample size, age younger than 1.5, and to include patients from specialty clinic.

Background A strong relationship between dementia caregiving and negative consequences on psychological health of caregivers has been established in numerous studies. A meticulous evaluation of caregiver mental status function is of utmost importance to gain better insight into daily caregiver functioning and to alleviate their high levels of burden. This study evaluated the prevalence of psychiatric morbidities and their sociodemographic and clinical correlates among a sample of dementia caregivers in Egypt. Twenty-five caregivers of patients with dementia were collected and compared with regard to their psychiatric morbidity with 25 careers of patients with chronic physical diseases. Patients were subjected to Mini-Mental State Examination (MMSE) and Arabic versions of activities of daily living (ADL) and instrumental activities of daily living (IADL), and caregivers were interviewed using the Arabic version of the General Health Questionnaire (GHQ), Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), and Zarit Burden Interview (ZBI). Results Caregiver’s burden was significantly higher among the dementia caregiver group than the non-dementia group. Moreover, dementia caregivers provided more aid with a higher total of ADLs and provided help for more IADLs than did the non-dementia caregivers. They also showed higher psychiatric morbidity. Such morbidity was found to be related to hours of caring, years of caring, GHQ, ZBI, ADL/IADL, BPSD, and MMSE. On the other hand, ADL, IADL, and GHQ scores had the highest predictive significance of caregiver’s burden in our study. Conclusions Caregivers of patients with dementia are subjected to more burden and vulnerability to psychiatric disorders than the other caregiver group. That should raise a flag to pay extra support and care for those people, which in turn will benefit both the patient and the health care authorities in terms of quality and cost of the care provided.

BackgroundEating disorders are common in adolescents. Data on occurrence rates, sociodemographic correlates, and risk factors in Egyptian population are needed along with better screening tools to inform future research and service development. We aimed to estimate the occurrence of eating disorders in a representative sample of Egyptian adolescent students and to examine the sociodemographic and clinical risk factors associated with eating disorders. So, a multistage random selection of 407 adolescent students from public and private secondary schools in Eastern Tanta, Egypt, was carried out. All participants were subjected to screening using the Eating Attitude Test (EAT) and the eating disorders section of the clinician version of the Structured Clinical Interview for DSM-IV axis-I disordersResultsOccurrence estimates of anorexia nervosa and bulimia nervosa were 6.1% and 3.2%, respectively. Being female, overweight (BMI = 25–29.9 kg/m2), low self-esteem, and high body shape preoccupation were significantly associated with eating disorders risk among adolescents.ConclusionsEating disorders are prevalent in the general adolescent population. The unmet treatment needs in the adolescent population place these disorders as important public health concerns.

Background Mental and neurocognitive disorders are the leading cause of disabilities amongst the older adult populace worldwide. The population of the older adult in Egypt is fast growing. The national census in 2017 revealed a 2.56% increase in the older adult population from the 2006 census, and these figures are expected to double by year 2031. This study aims to review current evidence about the prevalence of mental and neurocognitive disorders amongst older adult population in Egypt. Results A systematic review was carried out, and 16 studies met the inclusion criteria outlined in this study. Four main mental and neurocognitive disorders were identified: depression, anxiety, cognitive impairment and dementia. The reported prevalence of depression, anxiety, dementia and cognitive impairment are 23.7–74.5%, 14.2–72%, 3.66–39.2% and 1.74–51.4%, respectively. Anxiety and depression were positively correlated with the female gender, increasing age and lower educational status. Also, cognitive impairment and dementia were positively correlated with age, illiteracy or low education. However, there appears to be inconsistencies in the diagnostic tools used. Conclusion Egypt aging population is growing, and this research brings to forefront the scale of mental and neurocognitive disorders amongst the older adult population. This may help ensure evidence-based initiatives are put in place and priority is given to resource allocation for geriatric mental and neurocognitive disorders in Egypt. Systematic review registration PROSPERO CRD42018114831

Background Vitamin D is involved in many brain processes including neurological immune process, regulation of neurological factors, and neuroplasticity. Some studies have linked low serum vitamin D to major depressive disorder (MDD) and schizophrenia, while others have not shown any relationship. The study aimed to assess vitamin D level in patients with depression and those with schizophrenia. Sixty participants were recruited from outpatient clinics of the Institute of Psychiatry, Ain Shams University, Cairo, Egypt. The sample was divided into three groups: group A, 20 patients with MDD; group B, 20 patients with schizophrenia, and group C, 20 healthy control subjects. Ain Shams Psychiatry Clinical Interview was used to gather demographic data, and Structured Clinical interview (SCID-I) and laboratory vitamin D serum levels (ELISA) were applied to subjects. Results Eighty-five percent of patients with MDD and 80% of patients with schizophrenia had below normal vitamin D serum level. Compared to controls, vitamin D serum concentration in patients with MDD was statistically significantly lower than controls, while schizophrenia had vitamin D level lower than did control group but higher level than patients with MDD. However, vitamin D level failed to differentiate between patients diagnosed with schizophrenia and those with MDD. Conclusions Patients with MDD and those with schizophrenia demonstrated lower vitamin D level compared with health controls. There was no statistically significant difference in vitamin D level between patients with MDD and those with schizophrenia.

Background Little is known regarding the standardized neuropsychological tests available in Arabic. The aim is to determine the diagnostic performance and the best cutoff value for the clock drawing test (CDT), animal category test of semantic verbal fluency (VF), and the short form of the Boston Naming Test (BNT) in identifying patients with mild and major neurocognitive disorders among community-dwelling educated Egyptian older adults using Arabic versions of those tests. Community-dwelling educated male and female older adults aged 60 years or older. Successive patients were attending the outpatient geriatrics clinic at the Ain Shams University Hospital during a 12-month study period from January to December 2016. The study was approved by the ethics committee of the Faculty of Medicine, Ain Shams University, Cairo, Egypt. Informed consent to participate in the study was received from each participant and/or his/her next of kin. Patients and/or their next of kin who declined to participate were excluded, as were those who refused to complete the assessment. A two-step protocol was followed. Step 1: Participants were divided into three groups according to DSM-V diagnostic criteria for neurocognitive disorders. The assessment of cognitive function included Mini-Mental State Examination (MMSE), Clinical Dementia Rating Scale (CDR), patient’s current functional status regarding basic and instrumental activities of daily living by the Blessed Dementia Scale (BDS), and patient detailed history and examination based on protocol five of the CERAD assessment packet. Step 2: The application of the Arabic versions of ELokl et al. 2001 VF test, the BNT, and the CD by a clinical psychologist blinded to the initial assessment results. Results In current study, AUC for CD, VF, and BN are 0.807, 0.77, and 0.753 respectively for mild NCD and 0.884, 0.877, and 0.839 respectively for major NCD while cutoff values for CD, VF, and BN are 2, 12, and 14 respectively for mild NCD and 2, 9, and 13 respectively for major NCD. Conclusion Verbal fluency, clock drawing, and Boston naming showed reasonable diagnostic performance in educated Egyptian elderly and should be considered separately or in combination for the assessment of cognitive function. Further research is warranted.

Background The problem of substance use is becoming one of the most serious and rapidly growing phenomena all over the world. Efficient and well-designed prevalence studies for mental illnesses including substance use problems need to be regularly updated, in order to rearrange the prevention and management plans on a scientific basis. The aim of the study is to detect the prevalence of substance use and dependence among secondary school students, as they are one of the high-risk populations for drug use, targeting a representative sample of 10,648 of students. Results The most commonly used substance was nicotine during lifetime (9%), last 12 months (4.9%), and last month (2.4%). After the exclusion of nicotine, benzodiazepines was the commonest substance abused (5.1%) followed by alcohol (3.3%) and organic solvents (3.1%). The most commonly used during the last 12 months was alcohol (2.9%) followed by organic solvents (2.7%) and cannabis (2.6%). The prevalence of the regular use of any substance was 1.5%, while the prevalence of the dependence syndrome was 0.9% (excluding nicotine dependence). The prevalence of intake, regular use, and dependence were all higher among males. Conclusion The results of this study attract attention towards the substance abuse problem among adolescents in Egypt. Tobacco is the most commonly used substance followed by benzodiazepines which seemed to be used on a regular basis. Alcohol, organic solvents, and cannabis are also commonly used. Preventive services should be directed towards youth to combat these phenomena.

BackgroundHeavy training rotations load looms over medical residents because of spending long working hours in a stressful environment, the demands of which might exceed their adapting capacity and could affect their psychological and endocrinal functions. The main objective of this research was to

BackgroundRecent preliminarily evidence suggests that types and severity of cognitive dysfunctions may differ between bipolar disorder I and II (BD-I and BD-II). However, available data are scarce and inconsistent.AimWe aimed to investigate the differences in cognitive deficits between BD-I and BD-I