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Background There is evidence supporting a pathophysiological role of oxytocin in attention deficit hyperactive disorder (ADHD) especially hyperactive and combined subtypes. It is known that children with ADHD show a high rate of social cognitive problems regarding emotion recognition. Oxytocin was assumed to play a role in the emergence of social cognition deficits in ADHD. Aim of this study is to assess social cognition (emotion recognition) deficits in relation to oxytocin level in different subtypes of ADHD among the study group. Forty male patients with ADHD were recruited from psychiatric outpatient clinic of Fayoum University Hospital, were diagnosed according to DSM-5, and were assessed using Conner’s parent rating scale–revised (L). Social cognition measured by CANTAB emotion recognition task (ERT) and the level of salivary oxytocin was measured by ELISA technique. Results Combined subtype had been lower in correctly detecting the emotions of fear and anger. Predominately, hyperactive impulsive ADHD subtype was more rapid while detecting the emotions of surprise and disgust. There was significant negative correlation between age of onset of ADHD and errors in detecting the emotion of anger and positive correlation between age of onset of ADHD and errors in detecting the emotion of surprise. Correct detection of the emotion of happiness was associated with increased oxytocin level but the correct detection of the emotion of fear was inversely related to oxytocin level. No statistically significant difference between different subtypes of ADHD regarding salivary oxytocin level. Conclusion Oxytocin may play a role in social cognitive deficits in ADHD. The presence of social cognitive deficits in ADHD prompts further investigations to focus on the specificity of these deficits and in turn identify ways of managing them. Studying oxytocin in this population and its relation to social cognitive deficits can support the notion that oxytocin is a biological marker for ADHD.

Objective The aim was to study the relation between plasma lipid severity of cognitive impairment in elderly patients with depression and dementia. Background Cognitive functions are related to changes in lipid profile. Materials and methods Two groups of participants were studied: group A (patient group) included 60 patients subdivided into two subgroups: 30 patients who currently have dementia as a whole without taking into consideration the different kinds of dementia, but after exclusion of vascular dementia, and 30 patients with depressive disorders. Group B (control group) included 30 normal participants selected from among volunteers matched to the patient group for age, sex, education, sociodemographic, and economic status. They were subjected to the following: a psychological assessment that included the geriatric depression scale, the Wechsler memory scale − revised short form, and plasma lipid concentration assessment (overnight fasting blood was collected from each participant by standard venipuncture). Results The results of the study clarified that dementia patients showed more statistically significant impairment in cognitive functions than depressed patients in terms of the Wechsler memory scale − revised. The mean values of the blood cholesterol level, low-density lipoprotein, and high-density lipoprotein in the depressed group were significantly higher than those of the dementia and control groups. Conclusion There is a relation between cognitive impairment in depressed and dementia patients and plasma lipid concentration.

Objectives To show the correlation between items of Callous Unemotional Inventory (CUI) and Conduct Disorder and to assess correlation between salivary cortisol and Conduct Disorder. Background Emerging evidence suggests that low levels of cortisol may act as a biological marker for the Callous Unemotional traits (CU Traits) subgroup of Conduct Disorder. Materials and methods The current study tested the presence of items of Callous Unemotional Inventory (CUI) and the salivary cortisol level among group of patients with Conduct Disorder (Forty patients from 12 to 16 years old, diagnosed according to criteria of DSM IV and recruited from Kasr El Aini Psychiatric hospital) and group of control (Forty healthy volunteers). Both groups were subjected to Callous Unemotional traits Inventory and salivary cortisol level was assessed using ELISA. Results Patient group showed high levels of CU traits compared to control group. Patient group showed significant difference in salivary cortisol level (mean is 3.188 ±1.1108) compared to control group (mean is 5.01±1.846).This study found correlation between Callous traits and severity of Conduct Disorder. Conclusion The current findings build upon recent research in suggesting that low cortisol level may be a biological marker for patients with Conduct Disorder and high levels of CU traits.

Background It is generally estimated that metabolic syndrome (MetS) is especially common in patients with severe mental illness, with a high prevalence ranging from 30 to 60% for schizophrenic and bipolar disorders, which predispose them to further medical complications up to premature death. Objective The aim of this study was to compare the prevalence of MetS in patients with major depressive disorder (MDD), schizophrenic patients, and healthy general individuals, and to assess the relation between cortisol levels and presence of MetS. Patients and methods The study included 120 participants (40 patients with drug-naive MDD, 40 patients with drug-naive schizophrenia, and 40 healthy individuals who served as the control group). Full history was taken. Blood pressure and waist circumference (WC) were measured and BMI was calculated. Laboratory investigations were carried out, including fasting blood glucose (FBG), serum triglycerides, serum high-density lipoprotein, and a morning level of serum cortisol. Results The study revealed a similar prevalence of MetS in the MDD and the schizophrenic group (27.5%) compared with a prevalence of 22.5% in the control group. The WC and the BMI were significantly higher in the MetS patients of the MDD and the schizophrenic group compared with those of the control group. FBG was significantly higher among MetS patients in the MDD group as compared with those in the schizophrenic and the control group. Cortisol level was significantly higher in MetS patients in the MDD and the schizophrenic group as compared with those in the control group. Conclusion The prevalence of MetS is higher in MDD and schizophrenic patients than in the general population, and is related to high WC, BMI, FBG, and serum cortisol. Hence, screening of such patients for metabolic disturbances is recommended.

the aim of this study was to provide evidence that DMSA detoxification treatments cause a reduction of the heavy metal burden in the autistic, and that this reduction lessens neurological symptoms associated with ASD (Autistic Spectrum Disorder).The participants were 44 children, age 3 to 9 years of age, with Autistic Spectrum Disorder (ASD) according to Diagnostic and Statistical Manual of Mental Disorders 4t Edition, (DMS-IV). The severity of the autistics symptomatologiy had been measured by the Childhood Autism Rating Scale (SCARS). We collected urine samples before and after the DMSA challenge test, comparing urine metal output. We also compared the results of the DMSA detoxification(=the urine challenge test) with behavioral effects, typical for ASD.The DMSA challenge test increased the urine metal output for a number of potentially toxic metals. Statistically significant difference were noted between the baseline urine and DMSA challenge test regarding the level of cadmium, mercury, and lead (P=0.006, P=0.049, and P=0.008 respectively). We also noted that behavioral effects, typical for ASD (autism spectrum disorders) were reduced with this method of detoxification. A comparison between CARS Subscales and Total Score before and after a 6-month chelation program showed greatest improvements for Verbal and nonverbal communication (P0.001), Taste, Smell and Touch (P 0.001) and Relating to People (P 0.005). Other improvements were noted for Adaptation to Change and Improvement.DMSA chelation increased the urinary output of toxic and neurotoxic metals. Our data supports evidence that detoxification treatment with oral DMSA has beneficial effect on ASD patients.

The objective of this study was to assess the levels of ten toxic metals and essential elements in hair samples of children with autism, and to correlate the level of these elements with the severity of autism.The participants were 44 children, age 3 to 9 years, with Autistic Spectrum Disorder (ASD) according to Diagnostic and Statistical Manual of Mental Disorders 4th Edition, (DSM-IV). The severity of autistic symptomatology was measured by the Childhood Autism Rating Scale (CARS). Hair analysis was performed to evaluate the long term metal exposure and mineral level.By comparing hair concentration of autistic vs nonautistic children, elevated hair concentrations were noted for aluminum, arsenic, cadmium, mercury, antimony, nickel, lead, and vanadium. Hair levels of calcium, iron, iodine, magnesium, manganese, molybdenum, zinc, and selenium were considered deficient. There was a significant positive correlation between leadverbal communication (p = 0.020) and general impression (p = 0.008). In addition, there was a significant negative correlation between zincfear and nervousness (p = 0.022).Our data supports the historic evidence that heavy metals play a role in the development of ASD. In combination with an inadequate nutritional status the toxic effect of metals increase along with the severity of symptoms.

Background Mental health is an important component of overall health and mental disorders that can cause suffering, disability, and, rarely, even death. Pediatric-psychiatric liaison programs have evolved to enable the staff pediatricians to receive adequate training to assess emotional, behavioral, and family problems that may be an integral part of the patient's symptoms. Objectives The aim of the current study is to assess the prevalence of psychiatric symptoms among physically ill children ranging in age from 16 to 18 years attending the pediatric outpatient clinic in Beni Suef University Hospital and to compare the differences in psychiatric symptoms in relation to sex and the nature of physical illness among these patients. Participants and methods This survey study is a cross-sectional, observational, and comparative study. The study was carried out in the Pediatric outpatient clinic of Beni Suef University Hospital. A random sample of 300 Egyptian children with acute and chronic illness aged between 6 and 18 years, fulfilling the inclusion and exclusion criteria, participated in this study over an 8-month duration starting from May 2011 to December 2011. All participants of the study, both patients and informants, were subjected to a screening test using 'the Child Behavior Checklist for ages 6-18,' and intelligence quotient (IQ) was assessed for all sharing patients using the 'Stanford-Binet Intelligence Scale.' Results One hundred and seventy (56.7%) of the 300 selected patients were females and 130 (43.3%) were males; 260 of these patients attended regular schools. Out of the total number of patients, 155 (51.67%) presented with acute illness, whereas 145 (48.33%) had chronic illnesses. The mean IQ score was 79.8 ± 15.2 and only 22.3% of the sample (67 patients) had an 'average' IQ. Sex-based comparison of IQ results showed that female patients had significantly higher IQ scores (82.2 ± 13.6 with P = 0.035). However, Child Behavior Checklist 6-18 scores showed that 223 out of 300 patients had diagnosable Internalizing disorders with internalizing T -scores above 70; 118 (52.9%) of these were females compared with 105(47.1%) males, with a statistically significant difference ( P = 0.026). Meanwhile, 203 patients had diagnosable externalizing disorders with externalizing T -scores above 70; 104 (51.2%) of these were females. IQ scores differed significantly, being higher in acute illnesses (82.3 ± 13.6 vs. 77.8 ± 15.9 and P = 0.025). Another significant difference between patients with acute illnesses and those with chronic illnesses was clear in the internalizing T -score and the externalizing T- score (higher in acute illnesses, P = 0.028 and 0.034, respectively). Conclusion The current status of psychiatric problems in pediatric physically ill patients calls for mandatory cooperation in pediatric consultation-liaison services in the Beni Suef Governorate.