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.

Serum interleukin-23 levels: relation to depression, anxiety, and disease activity in psoriatic arthritis patients.

OBJECTIVES: Assessment of serum levels of IL-23 in PsA patients and its correlation with depression, anxiety, and disease activity. METHODS: Eighty psoriatic arthritis (PsA) patients and eighty healthy volunteers matched for age and gender were included in this observational case-control study. All participants suspected to detailed history, clinical assessment, PsA activity using Disease Activity Index for Psoriatic Arthritis (DAPSA) score, the severity and extent of psoriasis was assessed by the Psoriasis Area and Severity Index (PASI), and ultrasonographic assessments of the entheses were examined according to the Madrid Sonographic Enthesitis Index (MASEI). Depression and anxiety were assessed by Hospital Anxiety and Depression Scale (HADS). Serum IL-23 was measured and correlated with disease activity, depression, and anxiety. RESULTS: There was no significant difference between patients and controls regarding demographic data. Thirty-six PsA patients (45%) had anxiety and 28 patients (35%) had depression, while in the control group, 16 persons (20%) had anxiety and 12 (15%) had depression, with significant differences between the 2 groups (p < 0.0001). There were significant differences in HADS anxiety and depression scores between patients and controls with significant positive correlations between HADS depression, anxiety scores and IL-23, DAPSA, PASI, and MASEI scores (p < 0.05). IL-23 was positively correlated with DAPSA, PASI, and HADS scores; we observed that interleukin 23, higher DAPSA, and PASI were independently associated with depression and anxiety. CONCLUSION: Serum interleukin-23 levels were elevated in PsA patients and were found to be correlated with depression, anxiety, and disease activity. Key Points • Psoriatic arthritis is a multidimensional disorder with psychiatric drawbacks. • Interleukin-23 is a proinflammatory cytokines that was correlated with depression and anxiety in PsA patients. • Interleukin-23 was correlated with disease activity in PsA. • Depression and anxiety were positively correlated with disease activity in PsA.

An international study on psychological coping during COVID-19: Towards a meaning-centered coping style.

BACKGROUND/OBJECTIVE: This study examined the role of different psychological coping mechanisms in mental and physical health during the initial phases of the COVID-19 crisis with an emphasis on meaning-centered coping. METHOD: A total of 11,227 people from 30 countries across all continents participated in the study and completed measures of psychological distress (depression, stress, and anxiety), loneliness, well-being, and physical health, together with measures of problem-focused and emotion-focused coping, and a measure called the Meaning-centered Coping Scale (MCCS) that was developed in the present study. Validation analyses of the MCCS were performed in all countries, and data were assessed by multilevel modeling (MLM). RESULTS: The MCCS showed a robust one-factor structure in 30 countries with good test-retest, concurrent and divergent validity results. MLM analyses showed mixed results regarding emotion and problem-focused coping strategies. However, the MCCS was the strongest positive predictor of physical and mental health among all coping strategies, independently of demographic characteristics and country-level variables. CONCLUSIONS: The findings suggest that the MCCS is a valid measure to assess meaning-centered coping. The results also call for policies promoting effective coping to mitigate collective suffering during the pandemic.

ANTECEDENTES/OBJETIVO: Este estudio examinó el papel de diferentes estrategias de afrontamiento psicológico en la salud mental y física durante las fases iniciales de la crisis de COVID-19. MÉTODO: 11,227 personas de 30 países representando todos los continentes participaron en el estudio y completaron medidas de malestar psicológico (depresión, estrés y ansiedad), soledad, bienestar, salud física, medidas de afrontamiento centrado en el problema y en la emoción, y una medida denominada Escala del Afrontamiento Centrado en el Sentido (MCCS) que fue desarrollada en este estudio. El análisis de validación de la MCCS se realizó en todos los países, y los datos se evaluaron mediante un modelo multinivel. RESULTADOS: La MCCS mostró una estructura unifactorial en 30 países con buenos resultados de validez test-retest, concurrente y divergente. Los análisis mostraron resultados mixtos en cuanto a las estrategias de afrontamiento centradas en la emoción y en el problema. La MCCS fue el predictor positivo más fuerte de salud física y mental, independientemente de las características demográficas y las variables a nivel de país. CONCLUSIONES: Los resultados sugieren que la MCCS es un insrumento fiable para medir afrontamiento centrado en el sentido. Estos resultados pueden servir para dirigir políticas que promuevan un afrontamiento eficaz con el fin de mitigar el sufrimiento colectivo durante la pandemia.

Demographic & clinical correlates of admission into a specialized psychiatric inpatient service for children and adolescents in Egypt: An observational retrospective study.

WHAT IS KNOWN ON THE SUBJECT: Admitting children and adolescents in psychiatric inpatient units is a relatively new and still debatable practice in Egyptian society and in the entire Arab world. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE: Egyptian young people diagnosed with complex behavioural problems, such as in other parts of the world, desperately need and do get benefit from inpatient psychiatric service. The demographic and clinical characteristics of children in need for such service are not clearly different from those reported in other parts of the world. WHAT ARE THE IMPLICATIONS FOR PRACTICE: More should be done to spread awareness, remove obstacles, and develop more specialized inpatient units, with trained child psychiatrists and psychiatric nurses to provide best care for children and adolescents diagnosed with severe emotional and behavioural problems in Egypt, the Arab world and other developing countries in the world. ABSTRACT: Background To our knowledge, this is the first study that aims to investigate the demographic and clinical correlates of admission into a specialized inpatient psychiatric unit for children and adolescents in Egypt and the Arab world. Methods The files of all service users who presented for care in the outpatient service for children and adolescents in Tanta University between July 2017 and December 2019 were reviewed. Of the 1,195 files reviewed, 100 patients were admitted to the inpatient unit for 133 admission episodes with an average duration of 18.5 days per episode. Results The most common diagnosis among admitted children and adolescents was disruptive behaviour disorder. Having a diagnosis of bipolar disorder, eating disorder, or trauma-related disorders powerfully predicted admission. Both physical and sexual abuse also predicted admission, readmission and longer duration of admission. Conclusions The need for admission into specialized psychiatric inpatient units for children and adolescents is comparable to that in other parts of the world. There is an urgent necessity to develop such therapeutic units across the entire Arab world with subsequent need to establish suitable training programs for mental health workers to deal with children and adolescents diagnosed with severe psychiatric disorders in inpatient setting.

Micro RNA 146a gene variant / TNF-α / IL-6 / IL-1 ß; A cross-link axis inbetween oxidative stress, endothelial dysfunction and neuro-inflammation in acute ischemic stroke and chronic schizophrenic patients.

This work was purposed to speculate the possible association of rs2910164hsa-miR-146a C>G gene single nucleotide polymorphism in the pathogenesis of schizophrenia and subsequently their relevance to neuro-inflammatory, vascular and oxidative stress pathways as acute ischemic stroke (AIS) risk factors in chronic schizophrenic patients. 450 subjects, 150 healthy controls (group I), 150 chronic schizophrenic patients without any evidences of stroke (group II) and 150 chronic schizophrenic patients with AIS (group III) were included. Genotypes (CC, CG&GG) for hsa-mir-146a gene polymorphism were identified using polymerase chain reaction-restriction fragment length polymorphism PCR-RFLP technique. Tumor necrosis factor-alpha (TNF-α), interleukin 6 (IL-6), interleukin 1ß (IL-1 ß), plasminogen activator-inhibitor 1 (PAI-1), thrombomodulin (TM) and 8-Hydroxy-2-deoxyguanosine (8-OHdG) serum levels were immunoassayed. Complete lipid profile was estimated. The CG and GG hsa-miR-146a genotypes were associated with increased risk of both schizophrenia and AIS in schizophrenic patients with thrombomodulin levels decrement in group II& III. On the other side, the risk genotypes were associated significantly with positive and negative syndrome scale PANSS scores, TNF-α, IL-6, IL-1 ß, PAI-1, and 8-OHdG increment levels in both groups II & III. By contrast, the CG and GG hsa-miR-146a genotypes did not affect the neuro-inflammatory and oxidative stress markers in healthy controls. These findings illustrate a new mechanism strengthening the occurrence of oxidative stress and DNA damage as a result of the neuro-inflammatory and endothelial dysfunction status originated from the hsa-miR-146a C>G gene single nucleotide polymorphism, thus, confirming their role in the pathogenesis of schizophrenia and its AIS risk.

Demographic and clinical characteristics of children seeking psychiatric services in the Nile Delta region: an observational retrospective study.

BACKGROUND: Epidemiological studies, describing both community and clinical samples of youth in need for psychiatric help, are rare in the middle east. To our knowledge, this is the first study that aims to investigate the demographic and clinical characteristics of a sample of children suffering from emotional and behavioral problems seeking psychiatric services in the Nile Delta region and the largest clinical sample to date in Egypt. METHODS: The files of all new cases who presented for care in the outpatient service for children and adolescents between August 2016 and July 2018 were reviewed. Ninety-six files were excluded due to missing data while another 18 files were found to be for adults (ages > 18 years old), so the sample included 886 cases. RESULTS: The ages of our sample (n = 886) ranged from 18 months to 18 years with an average of 7.5 (± 3.8) years. Most of our cases were male, school aged children, living within low-income households and predominantly coming from rural areas. The most common diagnoses were attention deficit hyperactivity disorder (ADHD) (22.6%), intellectual disability (ID) (13.7%), depressive disorders (13.3%), and disruptive behavior disorders (DBD) (12.3%). Strong protective effects were found for family integrity and stability. Corporal punishment and physical and sexual abuse were noted to be significant risk factors for internalizing and externalizing disorders in children and adolescents. CONCLUSIONS: Except for males being a majority in our sample of children seeking psychiatric consultation, demographic patterns and prevalence of psychiatric disorders are comparable to other tertiary clinical samples in other parts of the world.