Background: Substance abuse is one of the major health and social problems that seriously impairs people's selfcontrol and social adjustment. The study's goal was to assess the impact of an expressed emotion management programme on self-control and social adjustment in substance abusers. To achieve the study's goal, a quasi experimental design (pre and posttest) was used. The study was carried out at the Addiction Treatment Center and Addiction Clinic at the Psychiatric Mental Health Hospital in Benha City, Qalubia Governorate, which is affiliated with the general secretariat. Subjects: For this study, a convenience sample of 40 substance abusers was used. For data collection, three tools were used. To collect data, tool 1 was a structured interview questionnaire. was used to collect information about the studied sample's sociodemographic and clinical characteristics. To assess self-control, the Tool 2-Self Control Scale was used. To assess social adjustment, use Tool 3: Social Adjustment Scale. The study found that there was a significant improvement in self-control and social adjustment among substance abusers after the programme compared to before it, and there was a high significant statistical positive correlation between total self-control and total social adjustment among the studied subjects after programme implementation. Conclusion: The expressed emotion management programme had a positive effect on substance abusers' self-control and social adjustment. Recommendations: A selfcontrol and social adjustment expressed emotion management programme should be implemented in addiction clinics and treatment centres For those who are addicted to drugs or alcohol. for substance abusers to cover a broader spectrum.

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Background: Rheumatoid arthritis is a systemic inflammatory disease that can involve other tissues and organs as well as synovial joints. It is characterized by destructive polyarthritis and extra-articular organ involvement, including skin, eye, heart, lung, renal, central and peripheral nervous system and gastrointestinal tract. The extra-articular manifestations of RA can occur at any age. Objectives of this study are to evaluate extra articular manifestations in Egyptian rheumatoid arthritis patients, its relation to the disease activity score (DAS28) and Anti-Cyclic Citrullinated Peptide (ACPA). Methods: This study was conducted on 50 patients they were diagnosed as RA by fulfilling the American College of Rheumatology (ACR) criteria of RA. Their age (mean±SD) is 45.78±13.26 years. Forty four (88%) of them were females, 6 (12%) were males. They were subjected to full medical history and examination, laboratory investigations were done, calculation of DAS28 score, measurement of plasma Anti-Cyclic Citrullinated Peptide (ACPA). RA patients were classified according to DAS 28 into three groups. Results: RA group 1 (mild disease activity) includes 12 (24%) patients with mean±SD of DAS 28 was 2.5±0.55, group II (moderate disease activity) includes 28 (56%) patients with mean±SD of DAS 28 was 3.9±0.55 and group III (severe disease activity) includes 10 (20%) patients with mean±SD of DAS 28 was 5.35±0.238. There was highly significant increase in mean±SD of ACPA titer in group III (sever activity), 90.31±40.78 IU/ml than that of group II 56.48±27.62 IU/ml, (p=0.000) and group1; 36.74±18.95 IU /ml also mean ACPA in group II increased significantly than that of group I, (P=0.000). Fifty (100%) RA patients had extra articular manifestations (ExRA); 37 (74%) had respiratory system disorders, 35 (70%) had hematological manifestations. CVS manifestations were found in 23 (46%). Eye manifestations present in 23 (46%) RA patients. Twelve (24%) RA patients had skin manifestations. GIT manifestations occur in 11 (22%) patients, 5 (10%) RA patients had renal manifestations. Four (8%) RA patients had neurological manifestations. The most common ExRA respiratory disorders was found in 8/12 (66.6%) patients in group I while it affect 22/28 (78.5%) patients in group II and 7/10 (70%) patients in group III (P = 0.000) with highly significant changes. Conclusion: This study showed that the ExRA are a common feature in Egyptian RA patients and they are related to the disease activity. [Egypt J Rheumatology & Clinical Immunology, 2014; 2(1): 71-79]