Nada, M. A. F., S. A. M. El-Mawella, H. A. Bayoumy, and M. N. E. I. Sirafy, "Personality Trait and Coping Strategies in Multiple Sclerosis: Neuropsychological and Radiological Correlation", The Egyptian Journal of Neurology, Psychiatry and Neurosurgery, vol. 48, issue 1, pp. 71-78, 2011. Abstract

Background: Personality trait represents one of the major factors influencing different aspects in quality of life and treatment compliance in multiple sclerosis. Objective: Explore personality changes and coping strategies and detect their relation with subcortical brain atrophy in multiple sclerosis. Methods: Forty multiple sclerosis patients, compared to 20 healthy matched controls, were evaluated by Mini-mental State Examination, Quality of life questionnaire, the Eysenck Personality Questionnaire, Hospital Anxiety and Depression Scale and Coping Processes Scale. Bicaudate ratio was measured from MRI FLAIR images to measure subcortical brain atrophy. Results: Progressive MS patients were older (39.39±6.94 vs. 29.23±7.72; P<0.01), and more disabled than remitting relapsing subjects (mean EDSS 5.9±1.2 versus 4.3±0.8). A highly statistically significant difference (p<0.01) was found between MS and control groups as regards coping mechanisms dealing with problem source where patients showed low score in exercite restrain (37.5%) compared to control group (6.7%). There was a statistically significant difference (p<0.05) in positive reinterpretation being higher in MS group (37.5%) compared to control group (10%). Psychoticism was more frequent in patients when compared to control. Bicaudate ratio was positively correlated with age, disease duration, severity and type of multiple sclerosis while it was inversely correlated with progression index. No correlation was detected between bicaudate ratio and personality trait. Conclusion: It is important to move from medical focus alone to include personality trait rehabilitation and programs with more problem-focused coping strategies with MS to help patients adjust to their illness. [Egypt J Neurol Psychiat Neurosurg. 2011; 48(1): 71-78]

Key Words: Multiple sclerosis; Personality trait; Coping strategies; Bicaudate ratio.

el mawella, S. M. 0hamed A., H. A. Hussein, and M. Ezzat, "Eating disorders in a sample of Egyptian women with bipolar I disorder ", Egyptian Journal of Psychiatry, vol. 33, issue 2, pp. 97-101, 2012. Abstract

Introduction: Eating disorders are relatively common among patients with bipolar disorder. Overweight, obesity, and extreme obesity were common in this patient group. Eating disorders in these patients not only increase the risk for further episodes but also do damage to the body and eventually prove fatal if left untreated. Aim of the study: to assess eating disorders in female bipolar patients and the relation between eating disorders and both of obesity and disturbed body image in these patients. Subject and methods: A case-control cross sectional study; where 60 female bipolar patients were recruited from the psychiatric department and clinic of Kasr al Aini hospital and compared to 60 female healthy controls. Psychometric procedure: Hamilton Depression Rating Scale, Young Mania Rating Scale, Eating Disorder Test, Body Image Scale and body mass index. Results: there is statistically significant difference between cases and the control group as regard eating disorders as 80% of the cases are suffering from eating disorders compared with only 16.1% of the control group (P=.000). The eating disorders are most frequent during manic episode (100%), followed by mixed episode (92.9), depressive episode (90.9%), and lastly euthymia (41.4%). there is also statistically significant difference between cases and the control group regarding disturbed body image as cases are complaining more from disturbed body image(P=.000). There is no statistically significant difference between cases and the control group regarding obesity but we found positive correlation between obesity and disturbed body image in cases group. Conclusion: Eating disorder are more frequent in female bipolar disorder patients especially during manic episode, also obesity is common among the patients especially who take atypical antipsychotic and body image is more disturbed in these obese patients.
Key word: female bipolar, eating disorder, obesity, body image.
 

Fathy, H., S. M. A. El-Mawella, H. Abdou, A. Adel, and A. Abdou, "Methyl tetrahydrofolate reductase gene polymorphism , folic acid, B12 in a sample of patients with depressive and anxiety symptoms", MECPsych, vol. 18, issue 2, pp. 118-125, 2011. Abstract

Introduction: Both anxiety and depression are common symptoms or disorders with a major impact on public health. There are several theories concerning potential associations between depression and levels of vitamin B12 and folate. Vitamin B12 and folate are connected with the synthesis of monoamines and are involved in single carbon transfer methylation reactions connected with the production of monoamine neurotransmitters.
Aim of the study: To investigate the relationship between depression and other components of 1-carbon metabolism such as vitamin B12, folate, and the methylenetetrahydrofolate reductase 677C T polymorphism. To compare the associations between folate, vitamin B12, and the methylenetetrahydrofolate reductase 677C T polymorphism, in anxiety and depression.
Subjects and methods: After taking consent from ethical committee in kasr El Eini hospital, 90 subjects were randomly selected in a comparative cross sectional study. The sample consists of three groups: a group of depressive disorders without psychotic symptoms (n=30), a group of anxiety disorders (n=30) and control group (n=30). The patients were recruited from psychiatric out- patient clinic. Patients were diagnosed by lecturer of psychiatry according to DSMIV (APA, 1994) criteria. Psychometric procedure: Beck depression Inventory for severity of depression, Hamilton rating scale of depression (HRSD), Hamilton rating scale of anxiety (HRSA). Laboratory: Simultaneous assay of vitamin B12 and folic acid by Radio-immune assay technique and analysis of SNP of MTHFR (C677T) by means of PCR and RFLP.
Results: Both anxiety and depression groups has the same percentage of gene mutation (33.3%). Folic acid and Vitamin B 12 mean values were highest in control group followed by the anxiety group then the least was in depression. Within the depression group there is a negative correlation between the severity of depression and folic acid. Within the depression group, patients with mutant gene have lower level of both Folic acid and Vitamin B12 than patients with non mutant gene. Within the Anxiety group, patients with mutant gene have lower level of both Folic acid and Vitamin B12 than patients with non mutant gene. Conclusion: Folic acid and Vitamin B12 were lower than normal in both anxiety and depression patients and this was combined with gene mutation.
Key Words: Vitamin B12, Folic acid, Depression, anxiety
Eating disorders in a sample of Egyptian women with bipolar I disorder

El-Mawella, A. S., H. Fathy, H. Abdou, and M. M. Fawzi, "Psychodynamic aspects in a sample of Egyptian vitiligo patients", Egyptian Journal of Psychiatry, vol. 30, issue 1, pp. 31-37, 2010. Abstract

Introduction: Vitiligo is a skin condition resulting from loss of pigmentation, which produces white patches (macules) on the skin. Both men and women are equally vulnerable to vitiligo. Patients with vitiligo are very sensitive to the way others look at them and they often remain withdrawn, anticipating rejection. In general, young adults with severe vitiligo, and those for whom appearance is very important have more difficulty coping with the disease. Vitiligo can affect a person's emotional and psychological well-being and may create difficulty in social adjustment. Objective: To study the quality of life, body image and most common defense mechanisms used by patients to cope with their illness putting into consideration the gender difference and to asses the effect of site of lesion on the quality of life, body image. Subjects and Methods: 90 subjects were randomly selected in a comparative cross sectional study. The sample consists of two groups: a group of vitiligo (n=45), and control group (n=45). The patients were recruited from dermatological out patient clinic after being approved by the ethical committee of dermatological department in Kasr El Eini hospital. The patients were assessed using Defense Style Questionnaire, General Health Questionnaire, Quality of life scale and Body image scale. Results: Body image was disturbed in 57.8% of cases and 8.9 % of control and this difference was statistically significant and it was disturbed in females (72%) more than males (40%). Quality of life scales were lower in the cases than the control and better in male than female in all the scales and these differences reached a statistically significant difference. Mature and neurotic defenses were higher in the control group than the cases while the immature defenses as a whole were higher in the cases group but the difference were not significant except in the projection, autistic fantasy, denial, displacement and somatization Conclusion: There are impairment in body image and quality of life, in patients group more than the controlled group and in females more than males.
key words:,vitilligo, defense styles, quality of life,body image, gender difference 

Hussein, H. A., H. Fathy, S. M. A. Mawla, F. Zyada, and R. A. E. Hadidy, "Shyness and sociability in a sample of Egyptian schizophrenic patients and its relation to resting frontal EEG", MECPsych, vol. 18, issue 4, pp. 226-230, 2011. Abstract

Introduction:
One of the most disabling features and consequences of schizophrenia is marked impairment of social skills.
Aim of the work:
The aim of this study is to study the relationship between pre-morbid shyness and negative symptoms and resting frontal quantitative EEG alpha activity in schizophrenic patients.
Methodology:
Forty Schizophrenic patients were selected successively in a cross sectional study. The patients were assessed using The Structured Clinical Interview for DSM Axis of Disorders, Positive and Negative Syndrome Scale, The Revised Cheek and Buss Shyness and Sociability Scale. Quantitative EEG was done and assessed for frontal alpha asymmetry.
Results:
Ninety seven percent of patients showed asymmetrical frontal alpha EEG activity and 85% of them showed right resting frontal alpha EEG asymmetry. Patients with right frontal asymmetry showed higher scores in PANSS Negative and Shyness scores than left asymmetry.
Conclusion:
Negative symptoms of schizophrenia and pre-morbid shyness could be related to Right frontal resting alpha EEG asymmetry.
Key Words: Shyness, Negative symptoms, Schizophrenia, QEEG alpha asymmetry.
 

Fathy, H., S. M. A. El-Mawella, H. Abdou, and A. Abdou, "The Role of the Brain Derived Neurotrophic Factors in progression of Bipolar Disorders", Egyptian Journal of Psychiatry, vol. 33, issue 1, pp. 15-18, 2012. Abstract

Introduction:Bipolar Disorder (BPD) is considered from the most prevalent psychiatric conditions, and is also among the most severe and debilitating. It was suggested that the brain-derived neurotrophic factor (BDNF) plays an important role in the pathophysiology of mood disorders. BDNF appears to be an unspecific biomarker of neuropsychiatric disorders characterized by neurodegenerative changes Aim of the study: To investigate the association between brain derived neurotrophic factors and progression of bipolar disorders. Subjects and methods: After taking approval from ethical committee in kasr El Eini hospital, 80 subjects were randomly selected in a comparative cross sectional study. The sample consists of two groups: a group of bipolar disorders (n=40) including patients with manic, depressive, mixed episode or in remission and control group (n=40). The patients were recruited from psychiatric out- patient clinic. Patients were diagnosed by lecturer of psychiatry according to DSMIV criteria. Psychometric procedure: Hamilton rating scale of depression, Young Mania Rating Scale: Laboratory: assay of Brain Derived Neurotrophic Factors by ELISA. Results: Fifty five percent of the bipolar group had three or more episodes. There is a statistical significant difference between the cases and control in the level of brain derived neurotrophic factor. There were a negative correlation between the BDNF and number of episodes (p= 0.000) and there were also a negative correlation between BDNF and disease duration (P= 0.000). There were no correlation between BDNF and the diagnosis of Bipolar Disorder (P = 0.3). Conclusion: Brain derived neurotrophic factor was lower than normal in bipolar patients and this was correlated with number of episodes and disease duration.
Key Words: BDNF, Bipolar disorder
Abbreviations: (BDNF ) Brain-Derived Neurotrophic Factor, (BPD)Bipolar Disorder,
 

Abdou, H., S. Mohamed, M. A. F. Nada, and H. Helmy, "Emotional Intelligence in Patients with Temporal Lobe Epilepsy vs Patients with Extra Temporal Lobe Epilepsy: Clinical and Radiological Study ", The Egyptian Journal of Neurology, Psychiatry and Neurosurgery, vol. 50, issue 2, pp. 121-126, 2013. Abstract

ABSTRACT

Background: Medial temporal lobe structures especially amygdala have been hypothesized to be important in emotional intelligence. There is some evidence associating temporal lobe epilepsy with impairment in emotional intelligence. Objective: compare emotional intelligence and other psychosocial abilities in patients with temporal lobe epilepsy and patients with extra- temporal lobe epilepsy and correlate the findings with electroencephalogram and magnetic resonance imaging in two patients groups. Methods: Forty patients with temporal lobe epilepsy, thirty patients with extra temporal lobe epilepsy and thirty healthy subjects were studied for emotional intelligence scale, general health questionnaire and social readjustment rating scale. EEG and brain MRI were done for patients groups only. Results: We couldn’t find any significant difference between both epileptic groups regarding emotional intelligence. A highly statistically significant difference was found when comparing emotional intelligence between control subjects and temporal lobe epileptic patients (p<.00) and also between control subjects and extra-temporal lobe epileptic patients (p<.00). There is significant negative correlation between emotional intelligence and social stressors in both epileptic groups. Conclusion: emotional intelligence was impaired in both epileptic groups and was associated with marked stressors. This may lead us to the conclusion that the two patients groups are exposed to the same CNS dysfunction and to the same psychosocial stressors however the paucity of mesial temporal lobe sclerosis in our patients with temporal lobe epilepsy can also explained these results.
Key words: emotional intelligence, temporal lobe epilepsy, extra temporal lobe epilepsy

 

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