Background: Living donor liver transplantation is an effective line of therapy for patients with end-stage liver disease. While there are various psychiatric complications that affect donors, only a few studies investigated such complications among Egyptian living donors. Results: The study showed psychiatric morbidity in 15% of donors, especially anxiety disorders and major depression. Donors had high mean scores on psychoticism, neuroticism, impulsivity, and extraversion subscales of the EPQ. Female gender, younger age group, low educational level, managerial work, being the sibs of the recipients, and obtaining high scores in the EPQ were found to be independent risk factors correlated with the development of psychiatric morbidity in liver donors. Conclusion: The increased frequency of psychiatric morbidity among liver donors raises the need for thorough pre-and postoperative psychiatric assessment and monitoring. It is mandatory to investigate the donors' personality traits preoperatively to assess the decision-making process for donation and postoperatively to plan appropriate protective and treatment programs.
Schizophrenia is a chronic mental illness which poses a tremendous burden on the families, caregivers and the society. The purpose of this paper is to provide an updated review of the epidemiology of schizophrenia with a special attention to the clinically important risk factors such as drug abuse, hormonal factors and the new advances in genetic research. The authors reviewed the literature with a special focus to the recent papers published from January 1970 to present. The prevalence of schizophrenia varied by ten-fold and the incidence of schizophrenia varied by five-fold among different studies. Significant advances in genetic research and DNA technology have been achieved over the past two decades and suggested substantial genetic etiology of schizophrenia. Extensive studies have been done with many variations in the prevalence, incidence and risk factors of schizophrenia among different studies.
BackgroundMedication non-adherence presents a considerable problem in patients with schizophrenia. Cognitive and executive functions can affect adherence. The association between medication non-adherence and cognitive impairment in schizophrenia is under investigated with limited and conflicting research data.Purpose of the studyTo prospectively assess the rate of drug adherence among a sample of patients with schizophrenia and to compare the cognitive and executive functions between adherent and non-adherent patients.Subjects and methodsOne hundred and nine patients with schizophrenia diagnosed according to the DSM-IV classification were initially assessed by the Wechsler Adult Intelligence Scale (WAIS), Wechsler Memory Scale-Revised (WMS-R) and Wisconsin Card Sorting Test (WCST) and six months later by the Brief Adherence Rating Scale (BARS).ResultsAmong the patients, 68.8% were non-adherent to their antipsychotic medication. Adherent patients (31.2%) had significantly higher mean scores for the total, verbal and performance IQ. Moreover, they had significantly higher mean scores in most of WMS subtests (orientation, information, verbal paired association, digit span, visual memory span), and higher mean scores for; total correct, conceptual level response, percentage and categories completed on the WSCT subscales (P < 0.0001). Whereas the non-adherent group had higher mean scores in; trials administered, total errors, perseverative responses, and perseverative errors (P < 0.0001). In a step regression analysis, digit span, conceptualization, total and percentage of errors were putative predictors of non-adherence to antipsychotic medications.ConclusionCognitive deficits, especially verbal memory and executive functions were the strongest patients’ related factors associated with non-adherence to medication. Psychiatrists should consider possible cognitive factors influencing adherence to enable offering proper interventions.Disclosure of interestThe author has not supplied his declaration of competing interest.
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