Background and Purpose Abnormal excitability of the central nervous system, both spinal and supraspinal, has previously been described as a pathophysiological plastic mechanism for chronic pain syndromes. Primary fibromyalgia (FM) as one extreme of this spectrum of diseases. This case-control study aimed to determine the changes in the spinal excitability by investigating the Hoffman reflex (H-reflex) in patients with FM. Methods Thirty-eight patients with FM and 30 healthy controls participated in this case-control study. We measured the H-reflex bilaterally in the upper limbs (flexor carpi radialis) and the lower limbs (gastrocnemius and soleus). Moreover, pain-related variables were measured, including pain severity (using a visual analogue scale), pain duration, Widespread Pain Index, and the score on the Symptom Severity Scale. Various psychiatric comorbidities and quality-of-life parameters were measured for each patient, including scores on the Hamilton Depression Rating Scale, Taylor's Manifest Anxiety Scale, and the Revised Fibromyalgia Impact Questionnaire. Results A significant increase in the ratio of the maximum baseline-to-peak amplitudes of H and M waves (H max /M max ) but not in the H-wave minimum latency was found in patients with FM compared with healthy controls. There were no significant correlations between this ratio in both muscles and the various pain-related measures, psychiatric comorbidity, and quality of life in patients with FM. Patients with FM suffered more depression and anxiety than did the controls. Conclusions We found increased spinal excitability in patients with FM, which was not confined to the site of maximum pain. This information may help in the diagnosis of FM and supports the hypothesis of central sensitization.

Background Type 1 diabetes mellitus is a chronic disease mainly diagnosed in children and adolescents. It has multiple psychiatric comorbidities. Our aim in this study was to determine the prevalence of psychological and behavioral problems in children and adolescents diagnosed with type 1 diabetes and to find if there is a strong correlation between these problems and different epidemiological- and disease-related factors such as age of the child, duration of diabetes, and other risk factors. We conducted a cross-sectional study and compared between 564 children diagnosed with diabetes mellitus type 1 (who attended Specialized Health Insurance Clinic in Sohag City, Upper Egypt, during the year 2018/2020) and 564 non-diabetic children matched with the diabetic children for age, sex, and socio-economic status. We used “Strengths and Difficulties Questionnaire (SDQ)” to screen for behavioral, social, and emotional problems in diabetic and control children. “SDQ” is a 25-item brief behavioral screening questionnaire that consists of five subscales which are emotional problems, hyperactivity-inattention problems, conduct problems, peer problems, and prosocial behavior subscales. It generates total score and individual score for each subscale. Results In our study, we found that diabetic children had significantly higher prevalence of emotional and behavioral problems than control children (92.37% of diabetic children versus 20.2% of control children had abnormal total SDQ score with P value < 0.001). All subscales of SDQ except prosocial subscale were significantly affected in children with type 1 diabetes mellitus than control children with P value < 0.001. Certain factors were significantly associated with impaired subscales of SDQ scale. We found a positive correlation between age and emotional, hyperactivity and conduct problems as these problems were more frequent in older children. Female children had more hyperactivity and conduct problems than male children (68.6%, 71.7% vs. 58.0%, 62.0%, P 0.002 and 0.003, respectively) while male children were more affected by emotional problems than female children (68% vs. 57.4%, P 0.003). Peer problems were more prevalent in children of parents with higher educational level. Children with positive family history of diabetes were less affected by emotional problems than children with negative family history (50% vs.64.3%, P 0.04). Longer duration of disease was associated with increased prevalence of peer and emotional problems. Poor control of diabetes increased the prevalence of conduct and emotional problems (P 0.007 and 0.022, respectively). Conclusion Children with type 1 diabetes mellitus have more emotional, hyperactivity, conduct, and peer problems than non-diabetic children. These findings indicate a need to screen diabetic children and adolescents for behavioral and emotional problems and treat these problems if found.

Background Internet addiction (IA) is a growing issue with multiple impacts on psychological functions, including sleep. Consequently, the present study aimed to assess the correlation between IA as well as the quality of sleep among medical students. A total of 525 students from Sohag University were included in the study. Young Internet Addiction Test (YIAT) was utilized in order to evaluate IA. Demographic information, university-related factors, and Internet usage patterns of the participants were documented. Pittsburgh Sleep Quality Index was utilized so as to evaluate the quality of sleep. Results The prevalence of IA was 4.95% for severe addiction and 39.62% for moderate addiction. About 81.62% of subjects who suffer from IA significantly had poor quality of sleep. Young age, male gender, low academic performance, computer presence at home, Internet presence at home, using the Internet for chatting and gaming, and poor sleep quality are strong predictors of Internet addiction. Conclusions The prevalence of IA and its impact on the quality of sleep have been found to be substantial among medical students. There is a need for programs to raise awareness towards IA as well as its impact on sleep among university medical students.

Background Stigma among psychiatric patients is pervasive all over the world. Our aim in this study was to investigate risk factors for stigma related to psychiatric disorders and to demonstrate the major consequences of mental stigma for patients who experience mental illness. We conducted a cross-sectional study and applied a stigma scale to 573 patients with psychiatric disorders who attended our outpatient psychiatry clinic. Participants were divided into two groups, group I (no.262) with low stigma score and group II (no.311) with high stigma score. The two groups were compared in term of socio-demographic characteristics (age, gender, level of education, residency, marital status, employment and socioeconomic level), factors related to the psychiatric disorder (duration of illness, number of psychiatric hospital admission and diagnosis) and impact of psychiatric illness (follow-up visits, adherence to medications and suicidal thoughts or attempts). Results The mean age of patients with high stigma score (group II) was 29 ± 6 years. High stigma score was more common in females (53.7%), illiterate (11.9%), living in rural areas (58.2%), single (22.83%), unemployed (44.37%) and low socioeconomic class (59.49%). Patients with a high stigma score showed longer duration of psychiatric disorder (43 ± 8 months), more frequent number of psychiatric hospital admission (4.3 ± 0.5) and schizophrenia ((11.25%) and other psychotic disorders (6.49%) were common diagnoses. Patients with a high stigma score show poor adherence to medication (47.91%) and follow-up (44.05%) and a high frequency of suicidal ideation or attempt (47.91%). Significant risk factors predicting high mental stigma were level of education (explaining about 23% of the risk, P = 0.03), duration of mental illness (explaining about 25% of the risk, P = 0.019), number of hospital admissions (explaining about 22.7% of the risk, P = 0.032), diagnosis of mental illness (explaining about 27.7% of the risk, P = 0.01). Conclusion Mental stigma is more prevalent among young aged individuals, females, single, unemployed, living in rural areas and those with lower educational and socioeconomic level. Mental stigma has a parallel correlation with psychiatric disorder duration, number of psychiatric hospital admissions, as well as diagnosis of psychotic disorder. The stigma of mental illness from the viewpoint of the patient may lead to delaying the access to care as well as poor adherence to medications and follow-up. Anti-stigma measures can contribute to diminishing the psychiatric illness effect.

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