A prospective study of the effect of COVID-19 on psychiatric symptoms and sleep problems from infection to 9-month follow-up.

Diverse psychological consequences of the COVID-19 pandemic have been reported for 6 months after infection. We conducted a prospective study to evaluate the psychological impact of COVID-19 infection in newly diagnosed cases that were followed up at 1, 6, and 9 months after infection. 137 people were recruited and divided into four groups based on the COVID-19 Treatment Guidelines. They were evaluated using the Pittsburgh Sleep Quality Index (PSQI), Post-traumatic stress disorder Checklist for DSM-5 (PCL-5), and Symptom Checklist 90 (SCL-90). We found that 9 months after infection, patients continued to report poor sleep (74.5%), PTSD (78.3%), somatization (17%), anxiety (17%), aggression (5.7%), phobic anxiety (4.7%), psychoticism (1.9%), paranoid (3.8%), and obsessive-compulsive (9.4%) symptoms, as well as depression and interpersonal sensitivity. The most significant risk factors for psychiatric complications were older age, level of education, smoking, hospitalization duration, hypertension, and critical severity. The negative mental health effects of COVID-19 persist after hospital discharge, and many patients continue to experience moderate-to-severe issues that may endure for 9 months. Notably, there was a progressive improvement in these symptoms over that time.

Prevalence and predictors of depressive symptoms among married Egyptian women: a multicenter primary healthcare study.

BACKGROUND: Depression affects about 3.8% of the world's population. Although marriage may contribute to subjective well-being, some marital variables could increase women's risk for depression. This study aimed to determine the prevalence of depressive symptoms and their correlates among married females attending primary healthcare facilities. METHODS: A cross-sectional study was conducted on a purposive sample of 371 married women at the primary healthcare centers, Assiut Governorate, Upper Egypt. In this study, an interviewer-administered questionnaire was used for data collection. Depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9) and marital satisfaction using the ENRICH Marital Satisfaction Scale (EMS). Standardized measurements of weight and height were performed. RESULTS: According to the PHQ-9 diagnostic criteria, the prevalence of depressive symptoms among the studied married females was 30.2%. The significant predictors of depressive symptoms were advanced husbands' ages, living with an extended family, exposure to spousal verbal violence, high body weight, and low marital satisfaction levels. CONCLUSIONS: Approximately one-third of married Egyptian women experienced depressive symptoms. In addition to high body weight, some social and marital factors contributed to the increase in women's vulnerability to depressive symptoms. Egyptian primary healthcare physicians should be trained to identify females with depressive symptoms and refer them to specialists if need be. To combat depression in women, it may be helpful to construct qualified marital counseling centers. This may improve marital satisfaction, decrease the negative consequences of spousal violence, and ensure the value of independence for new families.

Worry from contracting COVID-19 infection and its stigma among Egyptian health care providers.

BACKGROUNDS: Healthcare providers (HCPs) in COVID-19 epidemic face stressful workload of disease management, shortage of protective equipment and high risk of infection and mortality. These stressors affect greatly their mental health. The aim is to identify working conditions among Egyptian HCPs during COVID-19 epidemic as well as stigma and worry perceptions from contracting COVID-19 infection and their predictors. METHODS: A cross-sectional study was conducted among 565 HCPs. Data was collected through Google online self-administered questionnaire comprised seven parts: demographics characteristics, knowledge and attitude of COVID-19, working condition, worry of contracting COVID-19 at work, discrimination intention at work for COVID-19 patients, stigma assessment using impact stigma, and internalized shame scales. RESULTS: The vast majority of HCPs (94.7%) were worried from contracting COVID-19 at work. Risk factors for perceiving severe worry from contracting COVID-19 were expecting infection as a severe illness, believing that infection will not be successfully controlled, improbability to continue working during the pandemic even if in a well/fit health, high discrimination intention and impact stigma scales. Significantly high impact stigma scores were detected among those aged < 30 years, females, workers primarily in sites susceptible for contracting COVID-19 infection, those had severe worry from contracting infection at work, and high internalized shame scale. The risk factors for perceiving higher internalized shame scores were not having a previous experience in working during a pandemic, high discrimination intention towards COVID-19 patients and high impact stigma scale. CONCLUSIONS: Considerable levels of worry and stigma were detected among Egyptian HCPs during COVID-19 outbreak. The psychological aspect of health care providers should not be overlooked during epidemic; appropriate institutional mental health support should be provided especially for young HCPs, those without previous work experience in epidemic and those who work in high-risk units. Raising the community awareness about contribution of HCPs in fighting the epidemic might decrease stigmatization action toward HCPs.

Effects of transcranial magnetic stimulation on sleep quality in fibromyalgia: A double-blind randomized clinical trial.

OBJECTIVES: The aim of the current study was to assess the therapeutic impact of repeated low frequency repetitive transcranial magnetic stimulation (rTMS) over the right dorsolateral prefrontal cortex (rDLPFC) on sleep problems in patients with fibromyalgia. METHODS: Forty two patients with fibromyalgia who had sleep difficulties were randomly assigned to receive either real or sham rTMS treatment. Patients received 20 treatment sessions (5 sessions per week) in which 1200 rTMS pulses were applied over the rDLPFC using a frequency of 1 Hz and an intensity of 120 % of the resting motor threshold. All participants were evaluated at baseline, and then 1 month and 3 months after treatment using the Fibromyalgia Impact Questionnaire (FIQ), Pittsburgh Sleep Quality Index (PSQI), Medical Outcomes Study Sleep Scale (MOS-SS) and polysomnography (PSG). RESULTS: There were significant time (pre, 1month, and 3 months)X group (real versus sham group) interactions in all 3 clinical rating scales; FIQ (Df = 1.425, F = 237.645, P = 0.001), PSQI (Df = 2, F = 64.005, P = 0.001), MOS-SS (Df = 2, F = 28.938, P = 0.001) due to the fact that the real group improved significantly more over time than the sham group. Similarly, the real group improved more on the PSG parameters than the sham group. The effect sizes were large both in the rating scales and PSG, indicating a substantial clinical improvement. Correlation as an exploratory analysis between the changes (pre - post 3 months) in MOS-SS and PLMs index (/h) showed significant negative correlation (r = -0.643, P = 0.002). CONCLUSIONS: 20 sessions of LF-rTMS over rDLPFC can improve sleep quality in both subjective (PSQI and MOSS) as well as objective (PSG) rating scales.

Short-Term Therapeutic Effect of Repetitive Transcranial Magnetic Stimulations of Sleep Disorders in Parkinson's Disease: A Randomized Clinical Trial (Pilot Study).

This study aimed to evaluate the efficacy of rTMS in treating sleep disorders in PD. It included 24 patients with PD who had sleep disorders. Group allocations (active or sham with a ratio of 2:1) were placed in serially numbered closed envelopes. Each patient was evaluated with the following: MDS-UPDRS, Parkinson's Disease Sleep Scale (PDSS), Beck Depression Inventory (BDI), and polysomnography (PSG) before and 10 days after the treatment sessions. Each session consisted of 10 trains, 20 Hz, 10 sec for each, over the parietal cortex (bilaterally). Scores of UPDRS, BDI, and PDSS improved significantly in the active group but not in the sham group. The PSG data showed that sleep onset and rapid eye movement (REM) latencies (min), REM duration, and time spent awake (both as %TST) were improved after rTMS in the active group compared with the sham group. The number of awakenings, the wake-after-sleep onset index, the arousal index, and periodic leg movements (PLMs) were all significantly reduced in the active group but not in the sham group. Ten sessions of 20 Hz rTMS over parietal cortexes improved sleep quality and PLMs in patients with PD. The improvement in PSG and PDSS were correlated with improvements in UPDRS and BDI scores.

Case report: Avoidant/restrictive food intake disorder after tonsillectomy.

Background: Avoidant Restrictive Food Intake Disorder (ARFID) is a newly classified eating disorder that requires further understanding of its presentation. There is no previous report of ARFID in a child post-tonsillectomy. ARFID may be a potential negative outcome for children following oropharyngeal surgery. Case presentation: A female child aged 10 years and 2 months presented with ARFID associated with depression, anxiety and nutritional deficiency following tonsillectomy. She had more difficulty in swallowing solids than fluids and had repeated vomiting and spitting food after chewing it. She became dehydrated and malnourished with a BMI of 10.5 and was misdiagnosed with myasthenic gravis. Conclusions: To our knowledge, this is the first case report of ARFID in a child post-tonsillectomy. We discuss the pathophysiology of ARFID, which remains elusive, and recommend psychiatric assessment when evaluating children post operative tonsillectomy.

Impact of Repetitive Transcranial Magnetic Stimulation on Cognitive and Psychiatric Dysfunction in Patients with Fibromyalgia: A Double-Blinded, Randomized Clinical Trial.

Few randomized controlled trials have reported that repetitive transcranial magnetic stimulation (rTMS) has controversial results for managing multiple domains of fibromyalgia-related symptoms. This work aimed to evaluate the effect of low-frequency rTMS over the right dorsolateral prefrontal area (DLPFC) on the Fibromyalgia Impact Questionnaire (FIQ) concerning psychiatric and cognitive disorders. Forty-two eligible patients with fibromyalgia (FM) were randomized to have 20 sessions of active or sham rTMS (1 Hz, 120% of resting motor threshold with a total of 1200 pules/session) over the right DLPFC. All participants were evaluated at baseline, post sessions, and 3 months after sessions with the FIQ, Hamilton depression, and anxiety rating scales (HDRS and HARS), Montreal Cognitive Assessment (MoCA), Rey Auditory Verbal Learning Test (RAVLT), Tower of London test (TOL), the Trail Making, and Digit Span Tests. Both groups showed improvement in most rating scales at 1 and 3 months follow-up, with greater improvement in the active group, with significant correlation between FIQ cognitive rating scales, including RAVLT and TOL. Twenty sessions of low-frequency rTMS over the right DLPFC can improve FIQ scores regarding the psychiatric and cognitive symptoms of medicated patients with FM to a greater extent than sham. Changes in RAVLT and TOL correlated with changes in FIQ results.

Predictors of long-term health-related quality of life in Guillain-Barré syndrome: A hospital-based study.

OBJECTIVE: This study aimed to determine the impact of patients' baseline clinical, neurophysiological data, and management plan of Guillain-Barré syndrome (GBS) on long-term quality of life (QoL) and to identify its potential predictors. METHODS: Seventy-nine GBS patients were recruited. On admission, participants were evaluated using the Medical Research Council (MRC) sumscore, GBS disability scale (GDS), and Erasmus GBS Respiratory Insufficiency Score (EGRIS). Neurophysiological data were collected, and a management plan was devised. MRC sumscore was repeated at nadir. MRC, GDS and Short Form Survey (SF-36) were assessed at first-year follow-up. RESULTS: The mean age was 37.84 ± 17.26 years, with 43 male patients (54.4%). QoL at one year correlated significantly with baseline clinical variables (age, number of days between weakness and admission, MRC sumscore at onset and nadir, high GDS, and EGRIS scores). Antecedent events, especially diarrhoea, neck muscle weakness, autonomic dysfunction, cranial nerve involvement, and mechanical ventilation (MV), associated with worse QoL. Axonal GBS patients had lower QoL than AIDP patients, and PE patients exhibited lower QoL than IVIG patients. Multiple regression analysis showed that older age, diarrhoea, number of days between weakness and admission, neck muscle weakness, cranial nerve involvement, autonomic dysfunction, early MV, and MRC at onset and nadir and high GDS could predict poor QoL. CONCLUSION: Older age, more days between weakness and admission, neck muscle weakness, cranial nerve involvement, autonomic dysfunction, early MV, diarrhoea, low MRC at onset and nadir, high GDS at onset, axonal type, and PE treatment were potential predictors of poor QoL in GBS.

Antidepressant and anti-suicidal effects of ketamine in treatment-resistant depression associated with psychiatric and personality comorbidities: A double-blind randomized trial.

OBJECTIVE: To evaluate the effects of ketamine treatment on depression and suicidal ideation in treatment resistant depression (TRD) and to determine whether they are influenced by other psychiatric and personality comorbidities. METHODS: A randomized double-blind parallel-arm controlled study on 36 patients with TRD. Patients were divided into two treatment groups: ketamine (K group) and placebo (P group). Patients in the K and P groups received one infusion of medicine per week for two weeks. All participants were assessed using the Structured Interview for the Five-Factor Personality Model (SIFFM), Hamilton Depression Rating Scale (HDRS), Suicide Probability Scale (SPS), and Symptom Checklist 90 (SCL 90). RESULTS: After treatment, there was a significant decrease in the total HDRS and SPS scores in the K group compared to the P group, but the magnitude of response was not influenced by the presence of other psychiatric symptoms. Regression model, only receive ketamine treatment was significant factor for improve suicide and depression scores. LIMITATIONS: lack of data on other outcomes that are important to patients (e.g., quality of life, cognition) and need for a larger sample size. CONCLUSIONS: Ketamine infusions in TRD reduce suicidal ideation and depression despite the presence other psychiatric and personality disorders.

The relationship between alexithymia, emotion regulation, and sleep problems in school-aged children: A multicentric study.

OBJECTIVES: Alexithymia, mood dysregulation, and sleep quality have complicated effects on children's development. The current study aimed to investigate the relationship between alexithymia, emotion regulation, psychiatric problems, and sleep problems among Egyptian school-aged children. METHODS: A total of 564 Egyptian children, aged 6 to 14, were divided into two groups based on their total Children's Sleep Habits Questionnaire abbreviated score: group 1 (N = 300) with sleep problems and group 2 (N = 264) with non-sleep problems. Their parents completed the Strengths and Difficulties Questionnaire (SDQ) and subjectively assessed the children's emotions using the Children's Alexithymia Measure (CAM) and the Clinical Evaluation of Emotional Regulation-9 (CEER-9). RESULTS: Males were more proportional in the sleep problems group than others. The sleep problem group was significantly younger and had a longer daily sleep duration than the non-sleep problem group. Alexithymia and emotion dysregulation had the highest mean in the sleep problem group. Furthermore, alexithymia, emotion dysregulation, emotion difficulty, conduct, and prosocial problems were the most significant contributing factors and risk factors for sleep problems in children. CONCLUSION: Sleep problems in children were associated with younger male children with lengthy daily sleep duration and emotional, behavioural, and prosocial difficulties. Furthermore, alexithymia and emotion dysregulation are significant contributors and risk factors for sleep problems in school-aged children.

Prevalence of school bullying and its relationship with attention deficit-hyperactivity disorder and conduct disorder: a cross-sectional study.

Background: School bullying is the most widespread form of violence among adolescents. It has been identified as a critical problem for students and has evolved into a public health issue and global crisis. The study aims to assess the prevalence of school bullying among primary school students and its relationship with attention deficit hyperactive disorder (ADHD) and conduct disorders. Among the 280 primary school students those aged 10-12 years were recruited. All participants were assessed by parent interview, the Arabic version of the bullying behavior scale for children and adolescents and the Arabic version of the Conners' Teacher Rating Scale-28. Results: We found that the prevalence rate of bullying behavior was 12.5% among students. In bullying students' group, males were higher percentage (15.8%) than females (9%). Also, they had the highest mean scores regarding verbal bullying and social bullying, followed by psychological and physical bullying. Regarding Conners', the higher mean scores of conduct problem, passive-inattentive, and hyperactivity index were associated with bullying students in compared to students without bullying. Conclusions: The prevalence of school bullying among primary school students was 12.5%. Also, there was significant association between bullying students and having attention deficit hyperactive disorder (ADHD) and/or conduct disorder.

Relation between internet gaming addiction and comorbid psychiatric disorders and emotion avoidance among adolescents: A cross-sectional study.

INTRODUCTION: Internet Gaming Disorder has been a controversial subject. Even though internet addiction has been studied among adolescents, there is a lack of evidence regarding Internet Gaming Disorder. The purpose of this study was to assess the prevalence rate of Internet Gaming Disorder and the relationship between Internet Gaming Disorder, comorbid psychiatric disorders, and emotion avoidance among adolescents. METHODS: Four hundred seven adolescents aged 11 to 18 years old were recruited. Participants were divided into two groups based on the internet gaming addiction scale-Adolescents with IGA (N = 40) and adolescents without IGA (N = 367). All participants were evaluated for demographic data, the Strengths and Difficulties Questionnaire (SDQ), socioeconomic scale, and the Emotional Avoidance Strategy Inventory for Adolescents (EASI-A). RESULTS: The adolescent with IGA had a higher mean of the number of hours and devices using Internet gaming apps than an adolescent without IGA. Regarding SDQ, adolescents with IGA had a significantly higher mean value for all subscales of SDQ except the prosocial scale and all subscales of EASI-A compared with adolescents without IGA. CONCLUSIONS: Adolescents with IGA had more hours and devices using Internet gaming apps; more comorbid psychiatric disorders and problems in emotional expression inform of using avoidance techniques than adolescents without IGA.

Alteration of Gut Microbiota in Alzheimer's Disease and Their Relation to the Cognitive Impairment.

BACKGROUND: Dysbiosis of gut microbiota has been reported to be enrolled in the pathogenesis of Alzheimer's disease (AD). However, there is a lack of relevant studies on this topic in Egyptian patients with AD. OBJECTIVE: To investigate different species of gut microbiota in Egyptian patients with AD and correlate microbiota bacterial abundance with clinical data. METHODS: The study included 25 patients with AD and 25 healthy volunteers as age and sex-matched controls. Clinical data was taken for each patient, including medical history and examination; Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) were assessed for each participant. Bacterial DNA was extracted from stool, and abundance quantified via qPCR using 16S rRNA group-specific primers. RESULTS: Akkermansia, Enterobacteria, Bacteroidetes, Bacillus cereus, Prevotella, and Clostridium cluster IV were more abundant in the AD group than in the control group, although there was significantly less abundance of Bifidobacterium spp., Firmicutes, and Actinobacteria in patients with AD than in controls, whereas no such significance was found for lactic acid bacteria between both groups. Lactic acid bacteria and Prevotella abundance was negatively correlated with cognitive impairment (p = 0.03 with MMSE, and p = 0.03 with MoCA). Prevotella abundance was positively correlated with age of onset and duration of illness and negatively correlated with smoking and coronary heart disease (p = 0.007, p = 0.03, p = 0.035, and p = 0.047, respectively). CONCLUSION: The current work highlighted a significant relationship between AD and gut microbiota dysbiosis. A higher abundance of Prevotella species and lactic acid bacteria was correlated with cognition.

Prevalence and determinants of Internet Addiction among medical students and its association with depression.

BACKGROUND: Internet addiction has been a topic of discussion in the academic literature for many years. As of April 2020, about 60 % of the world's population (nearly 4.6 billion people) were active internet user in their early adulthood. The prevalence among adolescent and college students ranged from 0.9 % to 33 %. The current study aimed to explore internet addiction's prevalence and correlates among undergraduate medical students at an Egyptian university. Also, to assess the relationship between internet addiction, depression symptoms, and socioeconomic status. METHODS: A cross-sectional study of 321 undergraduate medical students at Assiut University using the Internet Addiction Scale, Patient Health Questionnaire, and Family Affluence Scale. RESULTS: About 9 % of the study participants screened positive for internet addiction. The most important determinants among medical students were sex, mother's employment status, family affluence, depressive symptoms, and unmonitored internet access. LIMITATIONS: We did not investigate another psychiatric disease, daily time of internet usage, most frequent time of usage, type of internet usage, and cost of use. CONCLUSIONS: Internet Addiction is an important psychological problem affecting about 9 % of Assiut university medical students during their undergraduate stage, which may interfere with their lives and studies. Students with lower Internet addiction rates were female students whose mothers were employed, lived in a low affluence family, had fewer depressive symptoms, and had unmonitored internet privacy.

Correlation between psychiatric impact of COVID-19 during pregnancy and fetal outcomes in Egyptian women.

The prevalence of depression, anxiety, and post-traumatic stress disorder (PTSD) was examined in 238 pregnant women with (n = 146) and without (n = 92) coronavirus disease 2019 (COVID-19) using the State-Trait Anxiety Inventory (STAI), Edinburgh Postnatal Depression Scale (EPDS), and PTSD Checklist for DSM-5 (PCL-5). Fetal outcomes in the same groups were evaluated using the Apgar score. Anxiety and depression scores were significantly higher in women with COVID-19 but PTSD scores were similar in both groups. Infection with COVID-19 was associated with a higher number of fetal deaths or an Apgar score <7. During the COVID-19 pandemic, approximately 46.6% of pregnant women had depression, 5.5% had PTSD, 64.3% had state anxiety, and 60.9% had trait anxiety. Except for PTSD, psychiatric problems and poor fetal outcomes were higher in women with COVID-19 than in those without COVID-19. Lastly, women with COVID-19 were more prone to have a fetus who died or had an Apgar score of <7.

Relationship between time spent playing internet gaming apps and behavioral problems, sleep problems, alexithymia, and emotion dysregulations in children: a multicentre study.

BACKGROUND: Internet gaming addiction (IGA) is a serious condition that can significantly impact personal and social functioning. Many studies of IGA have been conducted in adolescents and young adults, but there are limited data available in children. We investigated the time spent using internet gaming apps in children and its association with behavioral problems, sleep problems, alexithymia, and emotional regulation. METHODS: The research populations (N = 564) were categorized based on the number of hours spent using online gaming applications. The Strengths and Difficulties Questionnaire, the Children's Sleep Habits Questionnaire Abbreviated, the Children's Alexithymia Measure (CAM), and the Clinical Evaluation of Emotional Regulation-9 were used to assess all participants. RESULTS: Compared to other groups, children who used internet gaming applications for more than 6 h had a higher proportion of abnormal responses on the emotional symptoms and hyperactivity scales. Children who used internet gaming applications for more than 6 h had the poorest sleep quality (75%), while children who used internet gaming applications for 1-2 h had the best (36.7%). Participants who used internet gaming apps for 1-2 h had significantly lower mean total scores on the emotional regulation scale and total CAM, whereas those using internet gaming apps for more than 6 h had the highest mean scores in the CAM. CONCLUSIONS: Excessive use of internet gaming apps during childhood may be associated with hyperactivity, peer problems, high socioeconomic level, alexithymia concerns, shorter daytime sleep duration, and a delayed morning wake-up.

Case Report: Catatonia Associated With Post-traumatic Stress Disorder.

We report here about a 12-year-old female patient who had two life-threatening accidents that led to post-traumatic stress disorder associated with catatonia. She had closed eyes, had urinary and fecal incontinence, and had been in an abnormal position for one and half month. Moreover, she had complications such as dehydration, malunion of the fractured arm, and deformities in hand and foot. After detailed psychiatric examination, neurological assessment, and laboratory investigation, the patient received successful treatment in the form of benzodiazepine injections, intravenous fluid, oral antidepressants, and six sessions of electroconvulsive therapy (ECT). We discuss the pathophysiology of catatonia, which remains elusive, and recommend evaluating catatonic children for any possible trauma during psychiatry assessment.

Impact of duration of untreated illness in bipolar I disorder (manic episodes) on clinical outcome, socioecnomic burden in Egyptian population.

INTRODUCTION: Bipolar disorder (BD) is a serious and chronic mental illness that may result in disability. We evaluated effect of the duration of untreated of bipolar (DUB) (manic episodes) on clinical outcomes, including episode severity, residual symptoms, duration of hospitalization, and suicide attempts, and on socioeconomic status of patients. METHODS: A total of 216 participants who had bipolar I disorder (manic state) recruited from November 2017-December 2019 from an inpatient psychiatric unit. Patients divided into 2 groups based on DUB: Group A, with DUB < 4 months; and Group B, with DUB ≥4 months. All participants had evaluation for demographic and clinical features, Socioeconomic scale, Young mania rating scale (YMRS) at admission and discharge. RESULTS: Group A participants were more often male, urban residents, married, literate and educated, professionally employed. Group A had a younger age of onset, less duration of illness, less frequency of episode, less suicide attempts, less duration in hospital, high mean of socioeconomic, lower mean of YMRS at admission and discharge in compared to Group B. CONCLUSION: A longer DUB (manic episodes)was associated with negative clinical outcomes (more frequent episode, more symptoms severity, longer hospital admission, more suicide severity, more residual symptoms) and low socioeconomic state of patients with BDI (manic episodes).

Evaluation of psychiatric comorbidity in attention-deficit hyperactivity disorder with epilepsy: A case-control study.

OBJECTIVE: Attention deficit/hyperactivity disorder (ADHD) is a developmental disorder caused by structural and functional brain abnormalities as well as genetic and environmental factors. ADHD symptoms are commonly observed in individuals with epilepsy. A few studies have reported a pattern of behavioral problems in children with combined epilepsy and ADHD. We aimed to evaluate comorbid behavioral problems and mental health concerns among children with epilepsy with ADHD and without ADHD including autism spectrum disorder, anxiety, depression, somatic problems, oppositional defiant disorder, and conduct disorder. METHODS: A total of 100 children aged between 6 and 11 years were recruited and categorized into 1 of 5 groups (20 child/group): (1) epilepsy, (2) epilepsy with ADHD, (3) ADHD with electroencephalogram (EEG) changes, (4) ADHD without EEG changes, and (5) healthy control. The scales used in our study included the Childhood Autism Spectrum Test (CAST) to screen autism spectrum conditions and related social and communication conditions, Conners' Parent Rating Scale (CPRS) to assess ADHD and other comorbid behavioral and social-emotional difficulties, and Children Behavior Checklist (CBCL) to evaluate behavior problems. RESULTS: The CAST scale score showed no significant difference among the studied groups. Regarding the Conners-3 scale, the combined type of ADHD was predominant in the ADHD with EEG changes group and the ADHD with epilepsy group, while hyperactive ADHD was predominant in the ADHD without EEG changes group. The ADHD with EEG changes group and the ADHD with epilepsy group had equally high clinical rating scores for CBCL in internalizing and externalizing problems. There was a significant difference in the profile of all Diagnostic and Statistical Manual of Mental Disorders (DSM-5) scales of CBCL among the studied groups. CONCLUSION: This is the first study to use EEG in patients with ADHD in comparison with epilepsy. ADHD with epilepsy is closely related to ADHD with EEG changes regarding psychiatric comorbidity in terms of anxiety, depression, somatic problems, oppositional defiance problems, and conduct problems.