Background: Traditional healers are considered one of the important stages in the pathway to care of schizophrenia patients because of the confidence in the system, affordability and accessibility of the service, exposing patients to hazardous management, delay in seeking psychiatric help and bad prognosis. Aim: To assess the pathway to care of schizophrenia patients and role of traditional healers into it, the sociodemographic and clinical correlates of those patients. Methods: We assessed 232 patients with schizophrenia after confirmation of diagnosis with Structured Clinical Interview for DSM-IV Axis I Disorder (SCID-I) research version using a questionnaire designed by authors to assess help seeking behavior in schizophrenia patients and its sociodemographic and clinical correlates. Positive and Negative Syndrome Scale to identify the presence and severity of symptoms. Results: A total of 41.8% sought traditional healers first, 58.1% sought a psychiatric consultation first, main symptoms related to traditional healers seeking were hallucinations in 51.5%, delusions 29.9%, 9.28% bizarre behavior and 9.28% formal though disorder. Main causes of traditional healers’ preference were society acceptance 30.39%, affordability 24.74% and accessibility 16.49%. Conclusion: This study shows that a significant percentage of the patients suffering from schizophrenia prefer to approach faith healers first due to their own beliefs, society acceptance, affordability and easy accessibility.
Objectives:Tramadol addiction is one of the major addiction problems in growing countries, especially in Egypt. Moreover, there is a strong relation between suicidality and addiction even after exclusion of personality disorders; the burden of suicide adds to the burden of substance abuse in those individuals and their families. Materials and Methods:A cross-sectional descriptive study was conducted on 72 tramadol-dependent patients who were recruited randomly in this study from the addiction outpatient clinic of Okasha Institute of Psychiatry of Ain Shams University, after obtaining an informed consent. They are assessed by ( 1) Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, 4th Edition Axis I Disorders for diagnosis of substance use disorder, (2) Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, 4th Edition Axis II Disorders for exclusion of personality disorders, (3) suicide probability scale, and (4) Addiction Severity Index. Results:Regarding suicidal probability, 44.44% of the sample showed risk of suicide, which was severe among 19.44%, moderate among 11.11%, and mild among 13.89% of the sample. Regarding "Addiction Severity Index," most patients had no real medical problem. In the employment domain, 38.89% had a slight problem. In the drug use domain, 80.56% had a moderate problem.There is a significant relation between the degree of medical, drug use, and legal problem and the severity of suicidal risk. Moreover, the longer duration of addiction and the advanced age of patients are risk factors for suicidal probability. Conclusions:There is a suicide probability among tramadol addicts. The duration of tramadol use could be considered a strong risk factor for suicide, as the longer the duration of tramadol, the higher the suicidal risk.
Objectives: Various studies have proven the presence of disturbances in emotional processing among patients with substance abuse. In the current study, we aimed to examine the relationship between emotional intelligence (EI), tramadol dependence, and comorbid personality disorders. Methods: Thirty adult male patients with tramadol dependence and 30 healthy controls were enrolled in the current study. Participants were assessed by the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Axis I diagnosis (SCID-I) and the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Axis-II Personality Disorders (SCID-II). EI was assessed using the Schutte Self-Report Emotional Intelligence Test. Results: With respect to the Schutte Self-Report Emotional Intelligence Test score, there was a statistically significant difference between patients with tramadol dependence and the control group in all domains of EI (P<0.001). With respect to the SCID-II, the most common personality disorders reported among patients with tramadol dependence were borderline personality disorder (13, 43.3%), followed by depressive personality disorder (12, 40%) and narcissistic personality disorder (10, 33.3%). There was no statistically significant difference between common personality disorders and all domains of EI. Conclusion: The susceptibility to tramadol dependence is most likely to underlie disturbances in EI, suggesting that treatment strategies targeting the management of emotions would reduce this risk.
Children of addicted parents exhibit depression, anxiety, and elevated rates of psychiatric disorders more frequently than do children from nonaddicted families.Hence, we conducted this research to illustrate the psychiatric illness of children of substance-dependent parents. Materials and Methods:The study included 50 children [25 with a parent diagnosed with substance use disorder according Diagnostic and Statistical Manual of Mental Disorders-4th edition criteria (group A), and 25 whose parents had no psychiatric diagnosis according to general health questionnaire (group B)]. The subjects were recruited from the Heliopolis Psychiatric Hospital, which is a Ministry of Health Hospital. They were assessed using the Mini-International Neuropsychiatric Interview for Children and Adolescents (MINI KID) scale.We, furthermore, assessed the relation between the Addiction Severity Index, type of substance used by group A parents, and the MINI KID scale. Results:Group A showed more significant diagnosis than group B (P = 0.037) by the MINI KID scale (major depressive disorder, dysthymia, panic disorder, agoraphobia, and separation anxiety disorder) (P = 0.018, 0.037, 0.042, 0.021, and 0.004, respectively). Hence, the substance abuse parent has a detrimental effect on their children's well-being.As regards the relation between addiction severity and result of MINI KID scale in group A, only "employment" was significant (P = 0.025). Surprisingly, neither the severity of substance abused nor the type of substance abused by the parent had significant relation with the diagnosed psychiatric disorders in their children. Conclusions:Our study found that the prevalence of psychiatric disorders in children increases when their parents have substance use disorder. Moreover, the variation of the severity of parent addiction does not affect the risk for having psychiatric disorders in their children.
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