Efficacy of a multi-component psychosocial intervention program for caregivers of persons living with neurocognitive disorders, Alexandria, Egypt: A randomized controlled trial.

BACKGROUND: Unlike other chronic diseases, dementia caregiving is associated with enormous psychological burden, which stresses the need for caregivers-directed psychosocial interventions. Aim: This randomized controlled trial (RCT) was conducted to evaluate the short-term efficacy of a multi-component psychosocial intervention program for informal caregivers of persons with neurocognitive disorders in Alexandria, Egypt. METHODS: Informal caregivers (120) were randomly assigned into intervention and control groups. The intervention group (60) participated in a multi-component program of 8 sessions, including psycho-education, group cognitive-behavioral therapy, and group social support. Program primary outcomes were assessed after program termination (post-1), and three months later (post-2). Measured outcomes included caregivers' knowledge, depression and anxiety symptoms, and perceived burden. RESULTS: Caregivers' depression, anxiety, and perceived burden demonstrated significant drop at post-1, and post-2 compared to the control group (P< 0.001). The intervention group showed significant negative absolute change on depression, anxiety, and perceived burden measures, while on the dementia-related knowledge measure, a significant positive absolute change was found at post-1, and post-2 (P< 0.001), in comparison to controls. All outcome measures recorded a large effect size; the highest was for knowledge (partial eta2 = 0.98), and the least was for perceived burden (partial eta2 = 0.71). CONCLUSION: A multi-component psychosocial intervention for caregivers of persons with neurocognitive disorders demonstrated a short-term efficacy in reducing their burden, depression, and anxiety, as well as improving caregivers' knowledge. However, further research is needed to investigate long-term efficacy of the intervention.

The relationship between the BMI and the emotional status of Alexandria University students, Egypt.

BACKGROUND: Although the relationship between obesity and depression has been researched extensively, the relation of the wide range of body-weight problems, as indicated by the BMI, to emotional health problems has received little attention. OBJECTIVES: To assess the rate of concomitant co-occurrence of emotional health and weight problems in Alexandria University students, and to investigate the relationship between their BMI and emotional status. PARTICIPANTS AND METHODS: A cross-sectional study was carried out on 842 university students (17-27 years), enrolled in four faculties of Alexandria University, Egypt, during the academic year 2012-2013. Participants of both sexes were interviewed to collect sociodemographic data. Weight and height were measured, and then the BMI was calculated and classified into underweight, normal weight, overweight, and obese according to age-corresponding and sex-corresponding standards. The Arabic version of Depression Anxiety Stress Scales was used to assess the emotional status of students. The curve of fit was used to test the statistical quadratic trend. RESULTS: Co-occurrence of depression, anxiety, or stress with any weight problem was prevalent among 7.4, 6.7, and 9.6% of the students, respectively. Obese and underweight students recorded higher rates of emotional problems compared with normal and overweight students, revealing a U-shaped relationship between the BMI and emotional states (R=0.01). This relationship was significant only for anxiety and stress (P<0.05). A significant relationship (P<0.05) was found with the three emotional states among male participants (R=0.02), but only for anxiety among female participants (R=0.01). After controlling for age and sex, only being underweight increased the risk of anxiety and stress (odds ratio=2.95, P<0.001 and odds ratio=2.18, P=0.01, respectively). CONCLUSIONS AND RECOMMENDATIONS: Findings revealed a U-shaped relationship between the BMI and the emotional status of university students, where sex differences were evident. University preventive strategies and treatment services should address such alarming coexisting problems among youth.

Efficacy of a psychosocial intervention for parents of children with attention deficit hyperactivity disorder, Alexandria, Egypt.

BACKGROUND: Childhood attention deficit hyperactivity disorder (ADHD) is a chronic disorder that carries an immense amount of suffering for its victims, their families, and communities. The efficacy of behavioral parent training in the treatment of ADHD has been supported in several studies. OBJECTIVE: To evaluate the efficacy of a predesigned culturally sensitive psychosocial intervention program for parents of ADHD children in Alexandria, Egypt. PARTICIPANTS AND METHODS: A pretest-post-test intervention study was carried out at the Child Mental Health Clinic for School Students affiliated to the Health Insurance Organization, Alexandria. The intervention aimed at improving parents' knowledge of ADHD, building their skills in effective parenting, stress management and problem-solving, as well as providing social support. All the participants (50 parents) were assigned to groups, each of five to eight parents. They received a total of eight sessions on a weekly basis. The program was evaluated immediately after completion and 2 months later using the Arabic Version of Conners' Rating Scale to identify ADHD and to assess its severity, Home Situations Questionnaire, Parenting Scale, the Arabic Version of Depression Anxiety Stress Scales (DASS), and parental ADHD-related knowledge questionnaire were used. RESULTS: There was a statistically significant decrease in the mean total scores recorded by parents on Conners' Rating Scale (P<0.001), Home Situations Questionnaire (P<0.05), Parenting Scale (P<0.001), and DASS (P<0.001) immediately after program completion and 2 months later compared with that reported before program initiation. The total scores of participants on the ADHD-related knowledge questionnaire increased significantly after attending the program (P<0.001). CONCLUSION AND RECOMMENDATIONS: Provision of a psychosocial intervention program for parents of ADHD children proved to be effective in reducing perceived severity of the symptoms and problem situations, as well as improving parents' knowledge, discipline practices, and psychological well-being.

Predictors of personality disorders among Alexandria University students.

Personality disorders (PDs) represent a common and serious public health problem. The aim of the present work was to determine the prevalence of different PDs among first grade students of Alexandria University and to investigate some ecological factors of the problem. A cross-sectional study was carried out and included 1086 students. The Arabic Version of Personality Diagnostic Questionnaire-4+(PDQ-4+) was applied. Results revealed that more than one quarter of the studied sample had at least one PD (26.1%). Cluster C was the most frequently occurring (24.9%). The commonest subtypes recorded were avoidant PD (20.4%) and obsessive-compulsive PD (20.2%) followed by paranoid PD (15.0%). Significant predictors of PD delineated on the logistic regression analysis were mainly psychosocial factors including parental inconsistent discipline, intrafamilial conflicts, parental rejection and control, decreased familial and friends' social support, and sexual abuse. A positive history of conduct disorder, chronic medical illness or psychiatric problem also significantly predicted the occurrence of PD. Lack of freedom in college selection and smoking emerged as recent events that predicted the PD status of students.