Metabolic profile in first episode drug naïve patients with psychosis and its relation to cognitive functions and social cognition: a case control study

1st episode drug naïve patients with psychosis might be at higher risk for cardiometabolic disturbances which could affect the different cognitive, and executive functions and domains of social cognition. This study aimed to study the metabolic parameters in 1st episode drug naïve patients with psychosis, to evaluate the relation of these cardiometabolic domains to the cognitive, executive functions, and social cognition. Socio-demographic characteristics of 150 first episode drug naïve patients with psychosis and 120 matched healthy control groups were collected. The current study also assessed the cardiometabolic profile and cognitive functions in both groups. Social cognition was examined by Edinburgh Social Cognition Test. The study revealed a statistically significant difference in parameters of metabolic profile among the studied groups (p < 0.001*), the scores of cognitive and executive tests were statistically significantly different (p < 0.001*). In addition, the patient's group has lowered scores of domains of social cognition (p < 0.001*). Also, the mean affective theory of mind was negatively correlated with the conflict cost of the Flanker test (r = -.185* p value = .023). The total cholesterol level (r = - 0.241**, p value = .003) and level of triglycerides (r = - 0.241**, p value = 0.003) were negatively correlated with the interpersonal domain of social cognition, the total cholesterol level is positively correlated to the total score of social cognition (r = 0.202*, p value = 0.013). Patients with 1st episode drug naïve psychosis showed disturbed cardiometabolic parameters which have deleterious effects on cognitive functions and social cognition.

Role of DSM5 anxious distress specifier interview in acute manic episode: sociodemographic characteristics, clinical presentation and quality of life

Background

DSM 5 anxious distress specifier is one of the newly added specifiers for bipolar and related disorders. It may have impacts on the symptoms severity, insight, impulsivity, and different domains of quality of life of acute manic episodes of bipolar disorders. The current study aimed to study the effects of DSM 5 anxious distress specifier in acute manic episodes and its relation to sociodemographic data, clinical characteristics, and quality of life. 380 patients with the diagnosis of acute manic episode were recruited in the study, sociodemographic data, clinical features, DSM 5 anxious distress specifier interview, attitude and insight of the disorder, impulsivity and different aspects of quality of life were also evaluated in those patients.

Results

The studied patients were divided into 2 subgroups according to the presence of high DSM5 anxious distress specifier interview score. The duration of a manic episode (P < 0.001), the severity of the manic episode (P < 0.001), and the presence of psychotic features (P = 0.002) were more common in the subgroup with high DSM 5 anxious distress. DSM 5 anxious distress specifier was severe (P < 0.001) and more frequent (P < 0.001) in the 1st subgroup than the 2nd one. There was a statistically significant difference regarding the attentional facet of the Barratt impulsiveness scale between the studied groups (P = 0.002). In addition, there was a statistically significant difference regarding the mean score (P < 0.001) and severe impairment (P < 0.001) domains of work and social adjustment scale between the 2 subgroups.

Conclusions

DSM 5 anxious distress specifier interview is a very crucial parameter of evaluation the patients with acute manic episodes which may have implications on the clinical presentations, symptoms severity, impulsivity, and variable aspects of quality of life in those patients. All these implications might change the course, prognosis, and outcomes of an acute manic episode of bipolar disorder.

Procalcitonin as new inflammatory mediator in cases of 1st episode drug naive major depressive disorder: a case-control study

Introduction

Procalcitonin (PCT) is the prohormone of calcitonin.Whereas calcitonin is only produced in the C cells of thethyroid gland as a result of hormonal stimulus, PCT is secreted by different cells from numerous organs in response to proinflammatory stimulation, particularly bacterial overactivity,also procalcitonin level might be elevated during the depressive episode as a result of inflammatory theory.PCT assessment is not fully studied in different psychaiatric disorders and particularly in major depressive disorder.

Objectives

1-To study the level of Procalcitonin level in 1st episode drug naive major depressive disorder. 2-To investigate the relation between procalcitonin level and cognitive dysfunctions in these patients 3-To illustrate the role of PCT in psychopathology of Major depressive disorder

Methods

1-Socio-demographic data of the target group of patients 2-Psychiatric evaluation using DSM 5 diagnostic criteria 3-Hamilton rating scale of Depression 4-Laboratory assessment of Procalcitonin level (PCT) using VIDAS® B·R·A·H·M·S PCT™ 5-Cogintive evaluation using novel battery of THINC-IT

Results

1-Elevated level of Procalcitonin(PCT) in the targeted patients in comparison to control group 2-The level of PCT is positively associated with the cognitive dysfuctions reported in these patients. 3-The severity of depressive psychopathology is related positively to the elevated level of PCT

Conclusions

Procalcitonin (PCT) assessment played an importnat role in the etiopathogenesis of 1st episode drug naive major depressive disorder,also it has a crucial role in the cognitive dysfunctions commonly reported in these patients

Disclosure

No significant relationships.

Role of DSM5 Anxious Distress Specifier Interview in symptoms severity and medication adherence in 1st episode mania

Introduction

-Anxious Distress Specifier is one of the newly added specifier in diagnosis and managment of bipolar disorder.This unique item may paly a role in not only the symptoms severity but also the degree of adherence to the psychotropics. -DSM5 Anxious distress specifier is not well studied in the 1st manic episode of bipolar disorder.

Objectives

1-To study the role of DSM5 Anxious Distress Specifier in the symptoms severity of 1st diagnosed manic episode 2-To investigate its role in medication adherence in thses patients

Methods

1-DSM 5 Anxious distress specifier interview which includes 5 items : a- Keyed up or tense b-Restlessness c-Impaired concentration. d-Sense of foreboding e-Loss of control 2-The Young Mania Rating Scale (YMRS) is one of the most frequently utilized rating scales to assess manic symptoms. The scale has 11 items and is based on the patient’s subjective report of his or her clinical condition 3-Drug Attitude Inventory:consists of a questionnaire that is completed by the patient, pertaining to various aspects of the patient’s perceptions and experiences of treatment.

Results

1-There is a positive correlation between the mean score of Young mania Rating scale in 1st episode manic patients and the mean score of DSM5 Anxious Distress specifier Interview 2-The presence of high score of DSM5 Anxious Distress Specifier Interview is positively correlated to the mean score of Drug Attitude Inventory during the follow up visits after controlling the 1st episode mania

Conclusions

The presence of high levels of Anxious Distress in the 1st episde mania affected the symptoms severity and medication adherence

Disclosure

No significant relationships.

A novel Arabic tool of cognitive assessment in patients with mild cognitive impairment

Introduction

Mild cognitive impairment is one of the commonly reported disorders nowadays in old age individuals,it might represent the prodroma of definite dementia.There is a novel Arabic tool now which could help in the evaluation of cognitive functions in these patients.

Objectives

1-To study the cognitive functions in mild cognitive impairment by a novel Thinc-it tool (Arabic version) 2-To compare between Mini Mental Status Examination ( Standard test) and the novel Thinc-it battery ( Arabic version ) in detection of cognitive dysfunctions in these patients.

Methods

1-The Mini Mental State Examination (MMSE) is a tool that can be used to systematically and thoroughly assess mental status. It is an 11-question measure that tests five areas of cognitive function: orientation, registration, attention and calculation, recall, and language. The maximum score is 30. A score of 23 or lower is indicative of cognitive impairment. The MMSE takes only 5-10 minutes to administer and is therefore practical to use repeatedly and routinely 2-Thinc-it THINC-it® is a screening tool designed to measure cognition and provides important data for an overall evaluation of whether cognitive functioning is impaired,it includes the folloowing tests:

PDQ-5D Subjective Questionnaire

“Spotter” – CRT game

“Symbol Check” – Nback game

“CodeBreaker” – DSST game

Trails – TMT game

Results

The results of Thinc-it (Arabic version) is statistically correlated to the mean score of Mini Mental state Examination,this means this Arabic version is a valid novel tool for assessment of Cognitive dysfunctions .

Conclusions

Arabic version of Thinc-it can be used in cognitive evaluation

Disclosure

No significant relationships.

Sleep in COVID-19 recovery period and its impacts on Quality Of Life

Introduction

According to the World Health Organization (WHO), the COVID-19 infection became a worldwide devastating health issue starting in December 2019 in China and then gradually was a global pandemic. PTSD after recovery from COVID-19 has been correlated to sleep problems, high anxiety level and depressive manifestations. These sleep problems have their drastic effect on the recovered patients’ quality of life including physical, psychological and social domains.

Objectives

1-To investigate the sleep in the post Coronavirus -19 period 2-If has an impact on the different items of patients’ quality of life.

Methods

1-Socio-demographic characteristics of 500 recovered COVID-19 patients 2-Insomnia Severity index a brief scale evaluating the patient’s insomnia. The ISI evaluates the subjective complaints and results of insomnia as well as the level of dysfunctions from these sleep disturbances 3-Pittsburgh sleep quality index (PSQI):The Pittsburgh Sleep Quality Index (PSQI) is a scale that study the subjective sleep quality and different domains of sleep over a period of 1-month 4-Quality Of Life (QOL) by the SF36 Health Survey is a 36-item -report survey that evaluate eight domains of physical and mental wellbeing ranging from 0 to 100.

Results

The mean score of insomnia severity index was 13.01±4.9.Regarding Pittsburgh sleep quality index ,Sum of seven component scores was 15.37±4.43.Also QOL SF36 showed higher scores of the 8 domains including physical and mental

Conclusions

High score of insomnia and sleep disturbances during the recovery period of COVID-19 infection which affecting the Quality Of Life

Disclosure

No significant relationships.

Pandemic Grief Scale in detection of grief reaction among physicians in COVID-19 era

Background

Physicians are considered one of the most vulnerable groups who might develop pandemic grief during this critical time of COVID-19 infection, and this grief reaction might have deleterious effects on their life. This cross-sectional observational online study aimed to investigate the pandemic grief reaction among physicians and its burden on their aspects of life.

Results

Socio-demographic characteristics of 900 physicians were collected. The Pandemic Grief Scale (PGS) was used to detect the grief reaction among them and also Patient Health Depression Questionnaire-9 (PHQ-9) was used to evaluate the depressive manifestations. Sheehan Disability Scale was considered to investigate the burden of this grief on different aspects of life. The study revealed high mean score of Pandemic Grief Scale: 11.12 ± 2.34; the mean score of Sheehan Disability Scale was 17.63 ± 5.17, and the mean score of Patient Health Depression Questionnaire-9 was 19.89 ± 4.27.

Conclusion

Pandemic grief is commonly experienced by the physicians during this COVID-19 era due to sudden loss of loved one or the cases themselves. This pandemic grief has drastic effect on domains of physicians’ life.

Sleep in post-COVID-19 recovery period and its impact on different domains of quality of life

BACKGROUND

COVID-19 pandemic became a global health problem affecting the life of millions of people all over the world. The effects of this pandemic were not only on the physical and medical aspects but also on the psychological issues including anxiety disorders, depressive manifestations, sleep problems and others. Sleep disorders were very commonly reported during the novel Coronavirus-19 pandemic either in the acute phase of COVID-19 infection or after recovery. These sleep problems might have a drastic burden on the recovered patients' life. This study aimed to investigate the sleep in the post-Coronavirus-19 period and if has an impact on the different items of patients' quality of life. This cross-sectional observational study investigated the sleep problems in 500 patients in the post recovery period using Insomnia Severity Index and Pittsburgh sleep quality index (PSQI), their relation to this critical period and their impact on different domains of Quality of Life which was assessed by the SF36 Health Survey.

RESULTS

Socio-demographic characteristics of 500 post-Coronavirus-19 patients were collected; the insomnia severity index and Pittsburgh sleep quality index evaluated the sleep pattern. The quality of life was investigated using Short Form 36 scale. The study revealed high scores of insomnia severity index (13.01 ± 4.9), Pittsburgh sleep quality index (15.37 ± 4.43), also high scores of different items of scale of quality of life in the studied group.

CONCLUSION

Post-COVID-19 sleep disturbances were commonly reported in the recovery period, also these sleep deficits had an impact on the physical and mental aspects of quality of life, so these sleep problems must be managed properly especially in this critical pandemic era.