Introduction

Some research suggests that mental health problems can be brought on by the stress of having unexplained symptom. In non-western cultures especially, psychological distress is often communicated through multiple somatic complaints . The biopsychosocial model takes into consideration all factors affecting health and disease , supporting the integration of biological, psychological and social factors in the assessment and treatment .

Objectives

In our study we assess prevalence of alexithymia as a potential psychopathological attribute manifesting as unexplained somatic symptoms

Methods

196 patients aged 18 to 60 with unexplained physical symptoms for at least three months, after collection of demographic data, medical and psychiatric history, were subject to Arabic version of the following scales : patient health questionnaire PHQ-15 to assess severity of somatic symptoms, patient health questionnaire PHQ-9 to assess depressive symptoms, generalized anaxiety disorder GAD-7 to assess general anxiety disorder symptoms and Toronto Alexithymia scale TAS to assess alexithymia

Results

90% of ours ample were female patients, 49,5% showed alexithymia, 27,6% were borderline alexithymic and 23% had no alexithymia. Patients with unexplained physical symptoms showed moderate to high depressive symptoms in 81,1% of the sample, moderate to severe anxiety symptoms in 73,5%. Severity of somatic symptoms as assessed by PHQ-15 were significantly highly correlated to scores for Alexithymia (TAS), depressive symptoms (PHQ-9) and anxiety symptoms (GAD-7) p<0,001

Conclusions

Alexithymia is prevalent among patients with unexplained physical symptoms. This later population has high prevalence of depressive and anxiety symptoms that go with the severity of somatic manifestations

Introduction

Protracted abstinence syndrome represent group of attenuated psyc that lead to a persistant sense of discomfort among misuse patients after detoxification and may last for some months.Poor sleep in terms of duration and quality is one of the major symptoms of protracted abstinence syndrome

Objectives

to assess polysomnography parameters as potential risk for relapse over six months

Methods

60 male patients with heroin misuse according to DSM V have been recruited immediately after detoxification phase, they were not receiving other psychactive substances or medications, polysomnography was done in the second week after detoxification to allow washout of medications used during detoxification and then a monthly sleep assessment through sleep diary and daytime sleepiness using visual analogue scale. Relapse was prooved through urine test.

Results

Sample contained 60 male patients with heroin misuse disorder , detoxified successfully with a mean age 35.47±7.32 and addiction severity index total score 3.21±0.22 , polysomnography was done to all sample patients one week after detoxification, 20% relapsed by the third month , rising to 30% by the six month. NREM stages I and II, both limb movement and arousal indices showed significant differnce between relapsed and non-relapsed patients.

Conclusions

Sleep disturbance is common among detoxified heroin misuse patients. Polysomnographic parameters such as percentage of NREM I and I, arousal index and limb mouvement index can potentially predict future relpase over six month follow up period.

Introduction

Couple therapy continues to gain in stature as a vital component of mental health services. The linkage of relationship distress to disruption of individual emotional and physical well-being emphasizes the importance of improving and extending empirically based strategies for treating couple distress

Objectives

To evaluate the efficacy of dialectical behavior therapy "DBT" in outpatients couples with emotional dysregulation

Methods

Twenty couples presented with marital distress and at least one of them suffers from emotional dysregulation assigned at their convenience or according to immediate availability of treatment slot to a couple DBT group. Arabic version of DERS was used for assessment of emotional dysregulation before and after intervention. Dyadic Adjustment Scale was used for assessment of marital adjustment

Results

Both male and female partners showed significant improvement in marital adjustment and

emotional regulation. Female partner showed significant higher change amplitude in both scales.

Female partners showed significant improvement in all DERS subscales except for (GOALS) subscale (significant decrease), while male partners showed significant improvement in (IMPULSE), (AWARNESS), (STRATEGIES) and (CLARITY) subscales

Conclusions

Dialectical behavioral therapy for couples is an effective approach to couples with emotional dysregulation in one or both partners

Introduction

Care givers of patients with severe mental disorders have been shown to be under heavy stress burden that reflect itself through various heterogenous psychiatric symptoms that may mimic PTSD with associated negative impact on interpersonal relations and work performance

Objectives

to assess the prevalence of PTSD symptoms among care givers of patients with severe mental illness

Methods

70 patients care givers of sevely mentally ill patients compred to control 70 care giver of patients with chronic debilitating medical illness were recruited from outpatient of the university hospital outpatient facilities, random selection. Severe mental illness was defined by Global assessment of function GAF score above 50 and duration exceeding 2 years. Both groups were subject to Zarit burden interview to assess stress burden and post traumatic stress diagnostic scale PDS to assess PTSD symptomats

Results

43% of care givers of severly mentally patients showed moderate to severe burden on the Zarit scale compared to only 10% among care givers of medically ill patients , this difference was statistically significant (p<0,001) . Among care givers of severly mental patients showed moderate to severe score on post traumatic stress diagnostic scale compared to 0% among those taking care of medically ill patients. this difference was statistically significant (p<0,001)

Conclusions

Stress burden among care givers of patients with severe mental illness is high and may manifest symptoms of post traumatic disorder. This highlight the importance of particular psychological support and assessment among care givers of patients with sever mental illness