Background and objectives Breast cancer patients are vulnerable to depression with prevalence varying between 11 and 86% in literature with direct and indirect impact on compliance to treatment, quality of life and response to therapeutic course. Our study aims to identifying the profile of patients with cancer breast whom symptoms exceed normal reactive sadness to depressive manifestation necessitating psychiatric and psychological intervention. Methods 100 female patients with breast cancer diagnosis were recruited from Alexandria Police Hospital after consenting they were subject to mammogram, laboratory investigations for calcium, alkaline phosphatase, renal, hepatic functions and complete blood picture and thyroid profile. Hamilton Rating Scale and structured demographic data questionnaire was to collect relevant data. Results The prevalence of moderate to severe depressive symptoms on HAM-D was 52%, Significant statistical association was found between patients with depressive manifestations and postmenopusal state (p<0.001), with widowed and divorced (p<0.001), family history of brease cancer (p<0.001), advanced cancer staging (p<0.001), presence of Infiltrative ductal carcinoma (p<0.001) and type of surgery whether lumbectomy or modifies radical mastectomy (p<0.05). However the presence of brain metastasis, adjuvant chemotherapy or presence of family history of psychiatric illness didn't show statistical difference. Conclusion Depression is a common illness among breast cancer patients with particular vulnerable group among those postmenopausal widowed and divorced with advanced stage having rather infiltrative ductal carcinoma.

Background and Objectives High incidence of osteoporosis and pathological fractures were observed in schizophrenic patients medicated by antipsychotics for long time. Hyperprolactinemia induced by antipsychotics may partially contribute to osteopenia. Though atypical antipsychotics cause less hyperprolactinemia than conventional antipsychotics, however, risperidone and amisulpride seem to have no advantage in this regard. Our study aims at assessing effect of long term use of antipsychotics on bone density. Methods 30 schizophrenic patients on antipsychotics for 2-10 yrs were recruited compared to control drug naïf schizophrenic group for bone mineral density Results: both groups were balanced for age and gender distribution. Significantly decreased bone mineral density was found among schizophrenic patients on long term use of antipsychotics (X 2 =3.25;p<0.05). This later had significantly higher serum prolactin (p<0.001) and lesser serum cortisol level (p<0.01). Conclusion Osteopenia and osteoporosis are common adverse effects among antipsychotics, though can easily be screened for, but it's often a forgotten side effect with impact on general health state.

Background. Differentiating between schizophrenia and major depression with psychotic features often reveals diagnostic dilemma. Both share psychotic features and severe impairment in occupational functions. Severe psychomotor retardation, not uncommon in psychotic depression, may simulate negative symptoms of schizophrenia. Our work aims at utilizing Wisconsin Card Sorting Test (WCST) performance as a potential differentiating neurocognitive tool. Subjects and Methods. 60 patients were recruited randomly from the outpatient service at Alexandria University Hospital: 30 patients with schizophrenia and 30 patients with chronic psychotic depression. They were subjected to Clinical Global Impression for Severity (CGI-S) scale and Wisconsin Card Sorting Test (WCST) 128 card computerized version. Results. Both groups were balanced in terms of gender distribution, severity and duration of illness. The study compared all parameters of WCST. Only perseverative errors showed mild significant difference (P < 0.05) that disappeared when applying Bonferroni adaptation, setting significance level at 0.01 instead of 0.05. Conclusion. Performance on WCST is similar in schizophrenia and severe depression with psychotic features in most of the measured parameters and hence could not serve as a supplementary tool differentiating between both diagnoses in our study.

-Background and Objectives: Dopaminergic neurotransmission is implicated in stress responses. The dopamine D2 receptor gene (DRD2) has been studied by the authors to assess its possible role as a predictor of those who are at a higher risk to develop PTSD after major psychological trauma.Methods: Over one year period 75 children and adolescents 6-18 yrs of age who had been exposed to moderate to severe burns were recruited from the burn unit at the Alexandria University Hospital for the study. Patients and their family were interviewed within the first 10 days of exposure. After signing a written consent form a 2 ml blood sample was obtained for genetic studies of the TaqA1/A2 polymorphism site of the DRD2 gene. Patients were reevaluated three and six months later for assessment of PTSD.Results: Among the 75 children recruited in the study, 26 died due to their burn injury, 19 dropped out as parents refused follow up and 30 continued the study follow up visits. Fourteen carried the A1A2 genotype. Of these 11 (78.6%) developed PTSD. Sixteen carried the A2A2 genotype. Of these only one child (6.3%) developed PTSD. The results were significant at p < 0.001 with a relative risk 12.5.Conclusions: Following exposure to severe stress, the presence of the Taq A1 allele of the DRD2 gene results in a significant increase in the risk of developing PTSD.

Post-traumatic stress disorder is a commonly overlooked psychiatric disorder due to the heterogeneity of symptoms that may simulate many other psychiatric disorders. Such heterogeneity of manifestations may be explained by the multifaceted nature of the different neurotransmitters, endocrinologic axis, and their genetic basis, that are implicated in the etiology. Although this disorder has been studied from many different perspectives, its etiology is still enigmatic. This minireview demonstrates, in brief, that different susceptibility genes are associated with post traumatic stress disorder.