Abdelmaksoud, R., M. E. Rakhawy, D. Amer, and H. Kotb, Suicidality and depression in female patients with Systemic lupus Erythrematosus, , Cairo, Kasr AlAiny, 2012. Abstract

Objective: To evaluate the presence of suicidal behavior and depressive symptoms and the factors contributing to them in female patients with systemic lupus erythematosus (SLE).
Method: Forty female patients attending the Rheumatology and Rehabilitation department in Kasr Al Aini for treatment of SLE where patients fulfilled the Modified 1997 American College of Rheumatology criteria for the classification of SLE. They were assessed using psychiatric assessment, Rheumatology sheet including SLE Disease Activity Index (SLEDAI) and psychometric tools; Suicide probability scale (SPS) (Arabic version), Patient Health Questionnaire (PHO-9) for assessment of depression, MiniMental State Examination(MMSE) for assessment of cognitive ability and Pain Visual Analogue Scale.
Results: 52.5% of the patients of the sample were depressed, 25% of the sample fulfilled the criteria of major depressive disorder (MDD) according to DSM-IV while the other 27.5% patients were diagnosed as depressive disorder NOS, 90% of the sample had SLE disease activity, 70% of the sample had a suicide probability and 17.5% of the sample had severe suicide probability and 82.5% had a pain score of 5 or more on the pain visual analogue scale.
Suicide probability is related to pain intensity, disfigurement and physical disability but not related to disease activity. SPS and the hostility subscale are predicted by the increased depression (P=0.000) the higher cognitive ability (P=0.028) and the presence of disability/ disfigurement. SLE disease activity is related to depression but not to suicide probability.
Conclusion: Depression and suicide are significant problems in SLE. Pain is a predictor of depression. Younger age with higher cognitive abilities and presence of physical disability/ disfigurement predict suicide. Psychiatric assessment for SLE female patients should be considered as part of their clinical assessment.
Key Words: Systemic lupus erythematosus- depression- suicide.

Abdelmaksoud, R., Abdel Wahab M.M, S. A. E. Magd, C. E. Grella, and D. Enaba, Characteristics of Tramadol-dependent Patients Compared to Heroin- dependent Patients, , Cairo, Kasr AlAiny, 2016. Abstract

Objective: To evaluate the clinical characteristics of patients with current tramadol dependence disorder compared to heroin dependence disorder, examine association between sociodemographic variables and dependence disorder of each substance, identify the risk factors correlated to dependence disorder of each substance and correlate the quality of life to severity of dependence of each substance in addition to other characteristics.
Method: A cross sectional observational study including 100 treatment seeking patients with either tramadol or heroin as a primary substance of dependence. Recruited from patients attending Kasr Alainy hospital addiction department (inpatient and outpatient) and Maadi private hospitals for treatment of addiction Psychometric assessment included: Psychiatric assessment using MINI, Addiction severity index (ASI),assessment of Quality of life using WHO QoL BREF, motives of initial and continued substance use and history of traumatic life events.
Results: Tramadol patients had lower educational level, more manual work, initiated any substance at older age, less previous treatment trials (including inpatient admission), more seizures, less legal complications, better environmental QoL, more childhood trauma and less number of lifetime trauma. Kasr AlAiny received less education, had manual work, started cigarette smoking and the use of any substance at younger age. The inpatient groups had worse medical condition, longer addiction treatment history, seizures, more deterioration in occupational, drug and psychiatric domains of ASI, more co-morbid mood disorders, ADHD and substance induced psychiatric disorders and were exposed to multiple lifetime trauma. In the regression models, heroin use predicted worse environmental and social quality of life. Being KA inpatient predicted more lifetime trauma and childhood trauma. Both heroin and KA inpatient predicted worse medical condition.
Conclusion: Heroin patients are worse in most of the aspects of medical, psychiatric, social and legal domains. Tramadol are more likely to suffer from seizures. There is a difference based on recruitment site, inpatient/outpatient.
Key Words: Tramadol- Heroin- Egypt- Mood- Quality of life- Motives- Trauma.

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