Open Access Case Report

Acute Non-communicating Hydrocephalus Developed within 48 Hours in a Patient with Systemic Lupus Erythematosus

Baha Eldin Adam, M. Emin Eminoğlu, Mehmet Erşahin, Abdulkadır Koçer

International Neuropsychiatric Disease Journal, Page 1-6
DOI: 10.9734/INDJ/2016/31801

Hydrocephaly is a rare manifestation of systemic lupus erythematosus [SLE], and the pathogenesis is still unclear. Some studies suggest cerebral venous thrombosis, immune complex deposition within the arachnoid villi, or direct post-inflammatory lesions of the central nervous system [CNS] as possible causes, but these remain unproven. We report a case of acute non-communicating hydrocephalus secondary to stenosis of the aqueduct of Sylvius. The condition developed within a 48-hour period as the result of cerebrovascular accident in a 40-year-old man with previously diagnosed SLE. The pathophysiologic mechanism of hydrocephalus in SLE is subject to various arguments and remains a dilemma facing researchers.

Open Access Case Study

Ischemic Stroke: A Complication of Tuberculous Meningitis

Muhammad Azharuddin, Ishan Lalani, Doantrang Du, Wael Ghali

International Neuropsychiatric Disease Journal, Page 1-6
DOI: 10.9734/INDJ/2016/29820

We report a case of a 45-year old Hispanic male who was diagnosed with tuberculous meningitis (TBM) presented to the emergency department (ED) with altered mental status, confusion, and violent behavior. Computed tomography (CT) scan of the head was normal and repeated lumbar puncture (LP) did not yield new findings. Magnetic resonance imaging (MRI) of head showed multiple ischemic infarcts. Non-tPA stroke protocol was followed and anti-TB medicines were continued. With continuous cardiac monitoring, echocardiogram (ECHO) was normal so arrhythmia was less likely. Soon he was more responsive and alert with no further episodes of agitation and behavioral changes. Then, he was able to walk with assistance and was discharged to acute rehabilitation facility.

Open Access Original Research Article

Comparison between the Electronic Version and Traditional Methods of a Test for Dyslexia: A Cost-benefit Analysis

Tong Fu, Fang Tong

International Neuropsychiatric Disease Journal, Page 1-9
DOI: 10.9734/INDJ/2016/25365

Background: The psycholinguistic ability testing of phonological and orthographic skills is one of the assessment tools to measure children’s learning development. The traditional method to administer the test has been face to face with a scale box. Continuing advancements in reducing the test burden are expected to provide new methods of network evaluation for medical assessment.

Aims: To compare the electronic version with a net work evaluation and the face-to-face version of a psycholinguistic test and to conduct a cost-benefit analysis.

Study Design: To calculate and compare the cost and benefit of two possible methods using the data from a cost survey when administering the traditional psycholinguistic test in a sample of outpatient children from the Chinese Capital Institute of Pediatrics as well as to predict the cost of the electronic version at similar consumption levels.

Methodology: We sought to calculate the average cost per hour according to the average incomes of 283 parents of thousands of outpatients by counting the sub-costs of time and materials for a single test administered using both methods. We compared the numbers of cases that could be performed if the initial investments of the two versions were similar as well as the sub-costs inside and outside the family, the time and materials. We generated equations after Bayes’ discrimination with two groups with the test methods and used Fisher’s coefficient analysis as the number of cases increased. The Pareto chart demonstrated the ‘useful many’ and ‘vital few’ of the two methods.

Results: The initial costs were assumed to be same for the production, design, data and platform needed for the electronic method and the reference norm constructed beforehand using the traditional method. The cumulative cost curves were typically U-shaped when the subsequent cases increased exponentially. The former method could analyze 5000 cases and the latter only 1000 cases given the balanced U-shaped curve. The sub-costs of the methods were compared with Bayes’ discrimination, and Fisher’s coefficient could form a common trend equation showing a 20/80% phenomenon by classification. Therefore a Pareto chart was subsequently generated. The highest sub-cost was ‘in the family’ with the electronic online method; the traditional assessment method gave priority to ‘time consumption’ with the lowest sub-cost of materials greater than the highest consumption with the electronic method. The results showed that the network evaluation method was far favorable to the face to face format, especially as the scale matured, and its use became more widespread.

Conclusions: Dyslexia is a chronic, non-medicinally treated brain disorder. An electronic method for screening would save more time and money for family assessments in Chinese cities.

Open Access Original Research Article

Pattern of Psychoactive Substance Use among Long Distance Commercial Drivers in Calabar, Nigeria

Chidi J. Okafor, Owoidoho Udofia, Theophilus Onyuku

International Neuropsychiatric Disease Journal, Page 1-9
DOI: 10.9734/INDJ/2016/29676

Background: The abuse of psychoactive substances has become a global menace that threatens the entire society because of its dire consequences. It has been observed that driving a vehicle under the influence of psychoactive substances is a growing cause of fatal road traffic accidents. In Nigeria, road transportation is a major means of movement of persons and goods, and long distance commercial drivers play a crucial role in this regards. These drivers sometimes use psychoactive substances to remain energetic and alert.

Aims: To examine the pattern of psychoactive substance use among long distance commercial drivers in Calabar with the view of obtaining information that may be useful for social monitoring and planning preventive strategies.

Methodology: A two-stage cross-sectional survey which lasted for three weeks, involving one hundred randomly selected (using table of random number) long distance commercial drivers drawn from the seven major motor parks in Calabar. These drivers had CAGE-AID and Socio-demographic questionnaires administered on them at the first stage of the study. Those that scored 1 and above on the CAGE-AID questionnaire were further interviewed using the computerized version of drug and alcohol module of the Schedule for Clinical Assessment in Neuropsychiatry (SCAN) in order to generate psychiatric diagnoses.

Results: The mean age of the respondents was 36.43 (SD 8.01). The most commonly used substance was alcohol (by 82% of the respondents) while the least commonly used was cocaine (used by 5% of the respondents). Some of the respondents use combination of substances. The most commonly used combination was alcohol/tobacco (used by 66%). Forty-three respondents (43%) reported using “combine” which is a mixture of cannabis leaves and seeds in local gin.

Hired drivers were significantly more likely (than owner drivers) to use cannabis (P=.04), alcohol (P=.02), tobacco (P=.01) and “combine” (P=.04).

The study recorded road traffic accident rate of 19% with some occurring under the influence of psychoactive substances.

Following the SCAN interview, Thirty two (76.2%) out of the 42 respondents that scored 1 or above on the CAGE-AID questionnaire had psychiatric diagnoses. The commonest of these diagnoses were alcohol and cannabis related disorders.

Conclusion: There is a wide spread use of psychoactive substances by long distance commercial drivers and this is associated with road traffic accidents as well as diagnosable psychiatric disorders. This calls for urgent interventions by relevant agencies of government.

Open Access Original Research Article

Physical Body, Imaginary Body, Symbolic Body: Investigating the Latent Dimensions of Change

Lony Schiltz, Anna Brytek-Matera

International Neuropsychiatric Disease Journal, Page 1-10
DOI: 10.9734/INDJ/2016/31113

Background and Objectives: We present a pilot study of arts psychotherapy proposed in combination with cognitive restructuring techniques to N=13 adult women affected by a disturbed body image, low self-esteem and depressive tendencies in relationship with obesity. 

Methods: The methodology of evaluation is based on a psychometric scale (SVF 78), projective tests (Rotter’s Sentences Blank and TAT), a semi-structured self-evaluation form for the patients and an evaluation questionnaire (FBB) for the therapist. Original rating scales were constructed for the projective tests. 

Results: The results of the study show a positive evolution on coping strategies with stress and anxiety, self-esteem, emotional stability and autonomy in social relations.  With the help of the Non Linear Principal Components Analysis (PRINCALS) applied on the Delta values of different tests, the latent dimensions of change could be explored.

Limitations: This exploratory study does not aim at statistical generalization but at demonstrating new treatment and evaluation options, opening tracks for future research.

Conclusions: In the context of a sequential design, the application of Optimal Scaling procedures on Delta values seems very promising for the evaluation of psychotherapies in general.