Open Access Case Study

Twenty Year and Still Isolated Form of Restless Arm with Hypometabolism of Brain in Caudate Bilaterally

Koçer Abdulkadir, Varoğlu Asuman, Sanlısoy Buket, Özcan Muhammed Emin, Varoğlu Erhan

International Neuropsychiatric Disease Journal, Page 1-3
DOI: 10.9734/INDJ/2016/25810

We reported a patient with restless arm but without any other extremity involvement during 20 year period. There was hypometabolism of brain in caudate bilaterally. Interestingly, the restlessness had not progressed to involve other hand or his legs during this long time period. Only restless arm syndrome (RAS) is very rare. In describing the patient, we hope to raise awareness about RAS and avoid misdiagnoses and inappropriate investigations.

Open Access Original Research Article

Alcohol, Substance Use and Psychosocial Competence of Adolescents in Selected Secondary Schools in Uganda: A Cross Sectional Survey

Catherine Abbo, Elialilia S. Okello, Wilson Muhwezi, Grace Akello, Emilio Ovuga

International Neuropsychiatric Disease Journal, Page 1-14
DOI: 10.9734/INDJ/2016/25387

Aims: 1) To determine the nature and extent of alcohol and substance use and 2) To describe the relationship between alcohol use and psychosocial competence among secondary school youths in Northern and Central Uganda.

Study Design: This was a cross-sectional study.

Place and Duration of study: Departments of Mental Health, Gulu University (Northern Uganda) and Department of Psychiatry, Makerere University College of Health Sciences (Central Uganda) between September 2011 and April 2012.

Methodology: Four (4) and eight (8) secondary schools located in the rural and urban areas of Gulu and Kampala districts respectively were randomly selected to participate in the survey. A total of 3,200 students aged 12 to 24 years were recruited by proportionate multistage sampling. Data was collected using a socio-demographic questionnaire that included questions about nature and frequency of alcohol and substance use. A pre-tested self-administered survey questionnaire with scales to measure components of psychosocial competence (PSC) was administered. Data was entered in Epidata, and exported to SPSS version 16.0 for analysis. Psychosocial competence was classified as high or low depending on the responses in the sub-scales of decision making, self efficacy, empathy, emotional awareness, coping with stress and emotions, and accurate self-assessment and self-confidence.

Results: A total of 2,902 questionnaires comprising of 2,502, (86.2%) from Kampala district and 400 (13.8%)) from Gulu district were analyzed. Male to female ratio was 1:1 with an age range of 12 to 24 years and a mean of 16.5. About 70.1% had ever used alcohol and substances. Only 39.1% used substances regularly. The commonest substance used was alcohol (23.3%), followed by kuber (10.8%), khat (10.5%), aviation fuel (10.1%), cannabis (9.2%) and cigarettes (5.9%). Respondents from the Gulu district were twice more likely to use all substances. Users and regular users from the North Northern Uganda had lower psychosocial competence. Factors significantly associated with non-use of alcohol were high levels of self-confidence, non-use of cannabis and kuber and age. In the alcohol user groups, a high level of coping was associated with discontinued and experimental use of drugs of abuse.

Conclusion: More than two-thirds (70.1%) of young people in this study had ever used substances of abuse only once and slightly over a third had used it regularly. From the perspectives of service provision, mental health promotion and prevention of illicit substance use, school mental health programmes that target both non-users and users are recommended.

Open Access Original Research Article

Examining the Impact of Patient-Reported Hope for Improvement and Patient Satisfaction with Clinician/Treatment on the Outcome of Major Depressive Disorder Treatment

Waguih William IsHak, Jennice Vilhauer, Richard Kwock, Fan Wu, Sherif Gohar, Katherine Collison, Shannon Nicole Thomas, Lancer Naghdechi, David Elashoff

International Neuropsychiatric Disease Journal, Page 1-10
DOI: 10.9734/INDJ/2016/26203

Aims: This analysis aims at examining if patient-reported variables such as hope for improvement and patient satisfaction with clinician/treatment could influence the outcome major depressive disorder (MDD) treatment, namely depression remission, in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial.

Study Design: Retrospective cohort study.

Place and Duration of Study: The STAR*D study was conducted at 18 primary care and 23 psychiatric care settings in the United States from 2001-2007 and was funded by the National Institute of Mental health (NIMH). The analysis contained in this manuscript was conceptualized at the Cedars-Sinai Department of Psychiatry and Behavioral Neurosciences and performed at the UCLA School of Public Health.

Methodology: Using data from STAR*D, the current study used logistic regression and survival analyses to examine the relationship between depressive symptoms remission and two sets of self-reported factors: Hope for improvement and, Patient satisfaction with treatment/clinician.

Results: First, more than 90% of STAR*D patients reported having high hope for improvement (agree or strongly agree) and more than 66% endorsed high satisfaction with clinicians and more than 50% expressed high satisfaction with treatments (very or mostly satisfied). Second, hope for improvement was predictive of depression remission (p<0.05). Third, satisfaction with clinician/treatment, did not predict remission.

Conclusion: This study shows the impact that patients’ subjective hope for improvement can have on predicting depression remission in contrast to satisfaction with clinician/treatment. Future studies should prospectively incorporate patients’ subjective attitudes regarding hope for improvement and satisfaction with clinicians and treatments as mediators and moderators of MDD treatment success.

Open Access Original Research Article

Depression and Disability in Chronic Kidney Disease in Nigeria: A Case-Control Study

Joachim Azegbeobor, Victor Olufolahan Lasebikan

International Neuropsychiatric Disease Journal, Page 1-13
DOI: 10.9734/INDJ/2016/26218

Aim: The main purpose of this study was to determine the prevalence of depression and disability in Chronic Kidney Disease (CKD) patients and to determine any association between stage of CKD and depression in the University College Hospital, Ibadan.

Methods: One hundred and sixty CKD patients were matched by age and gender with 160 subjects from the General Outpatient Department (GOPD). CKD patients were staged according to the study center criteria.

The Mini International Neuropsychiatry Interview was used to elicit the diagnosis of depression, and the WHODAS 2.0 to assess disability. The Mann-Whitney U test and the independent t test/ANOVA to compare median and mean WHODAS scores respectively, the Chi square statistics were used in comparing WHODAS scores between the CKD group and the control group and the Wilcoxon test for within group comparisons. All analyses were carried out using (SPSS version 16.0).

Results: Prevalence of depression was 17.5% in CKD and 4.4% in control group. There was no significant difference between stages of CKD and depression. Predictors of disability were stages 3 and 4 of CKD OR = 1.9, 95% CI (1-3-3.0), P = .001 and depression OR = 8.5, 95% CI (1.8-38.5), P < .01, after model adjustment.

Conclusion: There is a need for effective consultation liaison work in the general medical department in order to assist in early detection and treatment of patients with depression in CKD.

Open Access Review Article

Alzheimer’s Disease Management: Current Therapy and Recent Drug Development

Mohammad Yaseen Abbasi, Md. Shamshir Alam

International Neuropsychiatric Disease Journal, Page 1-19
DOI: 10.9734/INDJ/2016/24771

Alzheimer’s disease is an age-related central nervous disorder that has created daunting challenges for the treating physicians, the families and the society. Alzheimer’s disease, a leading neurodegenerative disorder worldwide, is a major cause of dementia in the developed and developing countries around the globe. While, there is no definitive cure for Alzheimer’s disease and no treatment is available to reverse or halt its progression. Currently Food Drug Administration approved acetylcholinesterase inhibitors and memantine, a N-methyl-D-aspartate receptor antagonist for the treatment of Alzheimer’s disease. Moreover, new therapeutic approaches, including those more closely targeted to the pathogenesis of the disease, are being developed. This potentially disease-modifying therapeutics includes both beta and gamma secretase inhibitors, cholesterol-lowering drugs, amyloid-beta immunotherapy, non-steroidal anti-inflammatory drugs, hormonal modulation and the use of antioxidants. In this current review we summarize the available evidences on the newer therapeutic approaches for the treatment of Alzheimer’s disease.