Welcome message from President of the Conference

2nd Annual Kasr Al Ainy International Psychiatry Conference Cairo 17th -19th February, 2009 Pyramisa Hotel, Giza

P PS SY YC CH HIIA AT TR RY YA AC CR RO OS SS ST TH HE E LLIIFFE EC CY YLLC CE E Under the Patronage of

Prof. Hossam Kamel Chancellor, Cairo University and

Prof. Ahmed Sameh Farid Dean, Faculty of Medicine In Collaboration With

The Egyptian Psychiatric Association The Egyptian Association of Evolutionary Psychiatry Middle East Division, Royal College of Psychiatrists Conference President Prof. Emad Hamdi Ghoz Head, Department of Psychiatry

WELCOME MESSAGE From the Conference President

Dear Colleagues We are encouraged by the success of our 1st annual conference to invite you yet again to Cairo for a rich and rewarding scientific experience. This year we are especially honoured by the attendance of distinguished scientists from abroad who I am confident will make your attendance worthwhile. At Kasr Al-Ainy we remain committed to the cause of mental health service development in Egypt, and would like to continue a national and international debate for its benefit especially in the area of management of mental disorders This year we concentrate on the theme of “Psychiatry Across the Life Cycle” in order to clarify the commonalities and differences in psychiatric practice at different stages of life. We also like to hope that the practice of emergency psychiatry, adolescent psychiatry, liaison psychiatry, problem-specific psychotherapy, and community management of substance misuse become core aspects of psychiatric management at Kasr El-Ainy and all over Egypt’s mental health service. Egypt is a country that offers a rich heritage to contemplate and a colourful present to debate. We promise you will find a warm welcome, a platform for scientific exchange, and opportunities for collaboration in teaching, clinical care, and research

Emad Hamdi Ghoz Head, Department of Psychiatry Kasr Al Ainy Faculty of Medicine, Cairo University

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CONTENTS Conference President

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Honorary Presidents

4

Advisory Committee

8

Egyptian Psychiatric Association

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Sponsoring Pharmaceutical Companies

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General Information

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P Program at a Glance

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Conference Program Tuesday 17th February

17

Wednesday 18th February

28

Thursday 19t February

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Biosketch of Distinguished Guests

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Abstracts of Oral Presentations

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Conference President Prof. Emad Hamdi, Ghoz Head, Department of Psychiatry Kasr Al Ainy Faculty of Medicine, Cairo University

Honorary Presidents 1- Prof. Mahmoud Samy Abdel-Gawad. Emeritus Prof. of Psychiatry, Cairo University 2- Prof. Yehia El-Rakhawy Emeritus Prof. of Psychiatry, Cairo University 3- Prof. Ahmed Okasha Emeritus Prof of Psychiatry, Ain Shams University Head, WHO Collaborating Centre Ain Shams Institute of Psychiatry

Vice Presidents Prof. Magdy Arafa Prof. Momtaz Abdel Wahab

Conference Coordinator Prof. Lamis El-Raey

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Scientific Committee Chairperson : Prof. Ahmed Abdel Latif Members: Prof. Azza El-Bakry Prof. Tarek A. Gawad Prof. Ola Shaheen Prof. Suaad Moussa Assis. Prof. Noha Sabry Assis. Prof. Dalal Amer Assis. Prof. Mohamed Nasr Assis. Prof. Hanan El-Shinnawy Dr. Nahed Khairy

Secretary to Scientific Committee

Dr. Heba Fathy ([email protected])

Organizing Committee Chairperson: Prof. Mohsen Askar Deputy Chairperson: Prof Samir Abou El Magd Members: Prof. Mustafa Shaheen Assis. Prof. Mona El-Rakhawy Assis. Prof. Salwa Erfan Assis. Prof. Aref Khoweiled Assis. Prof. Tamer Goueili Assis. Prof. Mohamed Ezzat Dr. Mohammed Abd Al-Fattah ([email protected])

Secretary to Organizing Committee

Dr. Osama Refaat ([email protected])

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Distinguished Guest Speakers 1- Prof. Timothy Crow (UK) Prof. of Psychiatry, Honorary Director of the Prince of Wales SANE Research Centre, Oxford University 2- Prof. Tom Craig (UK) Prof. of Community Psychiatry, Institute of Psychiatry, King's College, London 3- Prof. Robert Howard (UK) Prof of Old Age Psychiatry, Consultant Old Age Psychiatrist, South London and Maudsley NHS Trust Dean, The Royal College of Psychiatrists 4- Prof. David Shaffer (USA) Prof. of Child Psychiatry, University of Columbia, New York 5- Prof. Trevor Young (Canada) Prof and Head, Department of Psychiatry, University of British Columbia, Vancouver 6. Prof. Richard A. Rawson (USA) Associate Director of UCLA Integrated Substance Abuse Programs 7. Prof. Rafia Ghubash, (UAE and Bahrain) President, Arabian Gulf University, Bahrain 8. Dr. Lancelot Patrick (Canada) Consultant and Clinical Director, Vancvouver Health Authority

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9. Prof. Rick Procyschen (Canada) Prof. of Pharmacology, University of British Columbia, Canada 10. Dr. George Tadros (UK) Consultant Psychiatrist, Queen Elizabeth Psychiatric Hospital Birmingham Honorary Senior Clinical Lecturer and Course Director, Birmingham University, UK 11. Dr. Yousreya Amin (UK) Consultant Psychiatrist , Kent NHS and Social Care Partnership Trust, UK 12. Dr. Francis Harvey (UK) Consultant Clinical Psychologist, Kent NHS and Social Care Partnership Trust, UK 13. Dr. Mohamed Abdel Fattah (Canada) Consultant Psychiatrist, West Vancouver Health Authority, Vancouver 14. Dr. Amani El-Rashidi (France) Consultant Psychiatrist, and Head of inpatient service, Rennes

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Advisory Board (in alphabetical order) Prof. Abdel- Shafi Khashaba Prof. Abdo Dod Prof. Adel Sheshae Prof. Adel Medany Prof. Ahmed Shawki El-Akabawy Prof. Ehsan Fahmy Prof. El Sayed Gad Prof. Fatma Moussa Prof. Hoda Salama Prof. Ismail Youssef Prof. Khadiga Ragheb Prof. Magda Fahmi Prof. Mahmoud Hammouda Prof. Mohamed Al Atrouny Prof. Mohamed Ghanem Prof. Mohamed Hadhoud Prof. Mohamed Khater Prof. Mounir Fawzi Dr. Nasser Loza Prof. Naglaa El Mahalawy Prof. Osama El Boraey Prof. Refaat Mahfouz Prof. Said Abdel Azim Prof. Safia Effat Prof. Samia Abdel Rahman Prof. Sanaa Ahmed Prof. Seham Rashed Prof. Tarandil El Guindy Prof. Victor Sami Prof. Yousry Abdel Mohsen Prof. Zeinab Sarhan

Zagazig University Tanta University Alexandria University Al Azhar University Al-Azhar University Banha University Tanta University Cairo University Alexandria University Suez Canal University Al Azhar University Suez Canal University Al Azhar University Mansoura University Ain Shams University Assiut University Mansoura University Zagazig University Ministry of Health Ain Shams University Mansoura University El Menia University Cairo University Ain Shams University Cairo University Cairo University Alexandria University Cairo University Banha University Cairo University Cairo University 8

Egyptian Psychiatric Association President: Vice President: Secretary General: Treasurer:

Prof. Ahmed Okasha Dr. Hussein Morsy Prof. Moustafa Shaheen Dr. Mostafa Fahmy

Executive Board Prof. Said Abdel Azim Prof. Yousry Abdel Mohsen Prof. Ahmed Shawki El-Akabawy Prof. Emad Hamdi Ghoz Prof. Momtaz Abdel Wahab Prof. Ismail Youssef Prof. Mohamed Ghanem Prof. Ahmed Abdel Latif Prof. Tarek Asaad Prof. Tarek Okasha Assis. Prof. Aref Khoweiled Official Conference Agent SERVO EGYPT: Dr. Mohamed Saad (And Team) SERVO Tel: ( +202 ) 22678336 / 22678338 Fax: ( +202 ) 22678338 P.O. box 5570 Heliopolis west, Cairo - Egypt E-mail:[email protected]

Secretarial Support

Mr. Youssef Mohamed Mohamady Mrs. Ragaa Mohamed Mrs. Roquaya Ahmed

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Sponsoring Pharmaceutical Companies

The Department of Psychiatry, Cairo University gratefully acknowledges the financial and practical sponsorship offered by the Pharmaceutical Industry in Egypt. The department especially acknowledges that such support to Kasr El-Ainy International Psychiatry conference has been forthcoming without any pressure as to the direction or content of the scientific programme. We are especially thankful to the following companies (listed in alphabetical order):

Adwia Al-Hikmah Pharmacy Andalus Apex Astra Zeneca Copad Delta Pharmaceuticals Eli-Lilly Genesis GlaxoSmithKline Janssen Cilag Lundbeck Pfizer Ranebexy Sanofi Aventis Servier Solvay Duphar Utsuka Wyeth Egypt

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GENERAL INFORMATION Date and Venue: 17-19, February, 2009 Pyramisa, Giza, Egypt Language The official languages of the conference are Arabic and English with no simultaneous translation. Prepaid Full time registration includes: Your package includes conference materials, coffee breaks, and lunch on 17-19 February 2009. Registration Fees cover: Participation at all Scientific activities Conference Certificate Conference Bags and scientific materials Daily Lunch and Coffee Break Conference Speakers are exempt from registration fees Services on site On site registration desk Secretariat Information Business center Press Center: Press conferences will be held throughout the conference Name Badges The conference badge will be received upon registration and should be worn during all conference events. Groups are distinguished by badge color label: Green: Full Registration Red: Organizing committee Yellow: Scientific Registration Blue: Speaker Audiovisual Facilities Corner Slide preview and submission facilities are available from 7:30 am to 6:00 pm daily in the slide delivery corner. All speakers making presentations are requested to try their presentation at least two hours before the session starts. Video films should be submitted to the Video Desk at least four hours before the session of their presentation. Exhibits Days / Time 10 am to 5 pm An exhibition of pharmaceutical firms will be held during the conference. You are kindly requested to visit the exhibition and have the opportunity to know the new development of drugs in the field of psychiatry.

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Certificates of attendance Complete the Global Evaluation Form inside your bag. Deliver the evaluation form and print your name on the certificate at the Registration Desk. Please, do not forget your recommendations, which are very important to us to plan next meeting. Smoking policy There will be no smoking in scientific sessions or exhibit halls. Messages and Notices Please check the "conference Message Board" for last minute changes in the program. Participants can post their messages directly or ask the help of the Information Desk. Climate The average temperature during the conference is between 15°C - 30°C. Currency The Egyptian currency is the Egyptian Pound (L.E.), One US Dollar = 5.5 LE (approximately) to date. Electricity 220 volts. 50 HZ, AC. The wall plugs are the round two prongs (European type). Official Conference Agent SERVO Tel: (+202) 22678336 / 22678338 Fax: (+202) 22678338 P.O. box 5570 Heliopolis west, Cairo - Egypt E-mail : [email protected] www.servoegypt.com

MEETING AND FUNCTION ROOMS On All Days of the Conference Hall A Hall B Hall C

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CONFERENCE PROGRAM AT A GLANCE Tuesday 17th February, 2009

Time

Event

8.00- 10:00

REGISTRATION

10:00-11:00

OPENING CEREMONY

11:00-11:30

Coffee Break Plenary 1

11:30-12:15

Genetics of Psychosis and the Speciation Event

Workshop 1

Integrated Approach to Stress Management

Workshop 2

12:15-13:45

Management Algorithm for the Child with Disruptive Behavior

Oral Presentation 1

General Adult Psychiatry I

Plenary 2

13:45-14:30 14:30-15:30

Child and Adolescent Suicidality, Is It Different? Lunch

Hall

A

A A B C A

Plenary 3

15:30-16:15

16:15- 17:45

Managing Psychosis: A care pathway approach

A

Expert Corner I

A

Oral Presentation 2

General Adult Psychiatry II

Symposium1

Addiction Services

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B C

CONFERENCE PROGRAM AT A GLANCE Wednesday 18th February, 2009 Time

Event Oral Presentation 3

Addiction Psychiatry

Hall A

Workshop 3

09:30-11:00

Short-Term, Intensive Psychotherapeutic Intervention for In-Patients with A Psychotic Disorder

Workshop 4

Asperger's Syndrome: Clinical and Management Implications

B

C

Plenary 4

11:00-11:45 11:45-12:15

How to Achieve Academic and Research Excellence. “An Egyptian Perspective “ Coffee Break

Expert Corner II Symposium 2

12:15-14:00

Ethical Practice in Psychiatry

14:00-15:00

Do You Think You Can Present? Lunch

Oral Presentation 4 Plenary 5

15:00-15:45

Advances in the Drug Treatment of Patients with Dementia

Symposium3

New Perspectives in Dementia 15:45-17:30

Expert Corner III Workshop 5

Application of Cognitive Behavioral Therapy Skills in Addiction Treatment

A

A B C

A A B C

Workshop 6

17:30-19:00

Practical Therapy for the Borderline Personality Patient, with A Focus on Group Strategies

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C

CONFERENCE PROGRAM AT A GLANCE Thursday 19th February, 2009 Time

Event Symposium 4

Integrative Group Psychotherapy, A Local Experience 09:30-11:00

Symposium 5

Exercise, Sports and Psychiatry

Oral Presentation 5

Child and Adolescent Psychiatry

Plenary 6

11:00-11:45

Is Schizophrenia Objectively Real?

11:45 -12:15

Coffee Break

Workshop 7 Too Many Duties, Too Few Rights:

Ethical Considerations Highlighting Psychiatrists' Rights 12:15 - 14:00

Debate

15:45 - 17:15

C A

A

Obstacles for Drug Therapy in Psychiatry Lunch

C

Refining the Molecular and Cellular Targets of Mood Stabilizing Drugs

A

Expert Corner IV Symposium 7

A

Human Sexuality and Comorbid Medical Conditions

B

Patient Placement Criteria in Egypt: Does it fit?

C

Closing Ceremony

A

Workshop 8

17:30-18:00

B

B

Plenary 7

15:00 - 15:45

A

Cosmetic Surgery for Adolescents: Yes or No?

Symposium 6

14:00 - 15:00

Hall

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PROGRAM DETAILS

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Tuesday 17th February, 2009

10:00-11:00

Hall A

OPENING CEREMONY Welcome Words: Prof. Ahmed Sameh Farid

Dean, Kasr Al Ainy Faculty of Medicine, Cairo University

Prof. Rafia Ghubash

President of Arabian Gulf University

Prof. Hossam Kamel

Chancellor, Cairo University

Prof. Emad Hamdi Ghoz

Head, Department of Psychiatry, Cairo University President of the conference

Opening Talk Psychiatry Across the Life Cycle

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11:30-12:15

Hall A

PLENARY 1 Genetics of Psychosis and the Speciation Event Prof. Timothy Crow Professor of Psychiatry, SANE Prince of Wales International Centre, Warneford Hospital, Oxford University, UK

Chairpersons: Prof. Yehia El-Rakhawy

Prof. Ahmed Okasha

Cairo University

Ain Shams University

Abstract: The nuclear symptoms of “schizophrenia” occur with approximately the same age- and sex-specific incidence in all human populations. No environmental precipitants have been identified. The variation must be intrinsic and therefore genetic although associated with a substantial fecundity disadvantage. It is argued that its persistence is the price that

Homo sapiens pay for the species-defining characteristic (“mate recognition system”) of language. Schizophrenic “illnesses” are associated with deviations in structural and functional features that differentiate the hemispheres in Man.

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12:15-13:45

Hall A

Workshop 1 Integrated Approach to Stress Management Chairperson:

Prof. Magdi Arafa

Cairo University

Coordinator:

Assis.Prof. Mona El-Rakhawy

Cairo University

Trainers: (Cairo University) (Cairo University) (Cairo University) (Cairo University) (Cairo University)

Assis.Prof. Noha Assis.Prof. Mona El-Rakhawy Assis.Prof. Aref Khoweiled Assis.Prof. Tamer Goueli Assis.Prof. Hanan El-Shinnawy

Workshop description:

The aim of this workshop is to elaborate the concept of stress and the use of specific techniques of management of different forms of stress reactions. The workshop will be directed to professionals and trainees who encounter cases that require stress management skills. Audience will participate in workgroups.

Objectives:

1-Define the diverse forms of stress. 2- Recognize the different reactions to stress. 3- Apply simple techniques of stress management.

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12:15-13:45

Hall B

Workshop 2 Management Algorithm for the Child with Disruptive Behavior Chairpersons: Prof. Azza El-Bakry

Prof. Suaad Moussa

Cairo University

Coordinator:

Cairo University

Assis. Prof. Omnia Raafat

Cairo University Presenter Dina Yousry Adly El Sheikh Hisham Salah Maha Emad

Post Institution Resident in Psychiatry Cairo University Resident in Psychiatry Cairo University Clinical Demonstrator in Psychiatry Bani-Sueif University Lecturer of Psychiatry Bani-Sueif University

Target audience:

Professionals dealing with the mental health of children including psychiatrists, psychologists, social workers, nurses, pediatricians and teachers

Topics:

1- General guidelines for therapy in children. 2- Overview of different lines of therapy for disruptive behavior disorder. 3- Constructing Algorithms for ADHD ODD and CD.

Objectives:

 General guidelines for constructing an algorithm.  Construct a blue print for an algorithm suiting our Egyptian culture for: ADHD, ODD & CD.

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12:15-13:45

Hall C

Oral presentation 1 General Adult Psychiatry I Chairpersons: Prof. Samia Abdel Rahman

Cairo University

Prof. Ehsan Fahmy

Banha University

Coordinator:

Assis. Prof. Dalal Amer

Cairo University

Speakers: Behavioral pathology in Alzheimer's disease patients: cognitive correlates: analysis from a database.

Dr. Nahed Khairy (Cairo University)

Psychosocial adaptation and quality of life differences between pacemaker and implantable cardiovertor-defibrillators (ICDs) in a sample of Egyptian patients.

Assis. Prof. Mohamed Nasreldin (Cairo University)

Psychological aspects in a sample of vitiligo patients.

Dr.Sherine Abd El-Mawella (Cairo University)

A current debate in France regarding hospitalisation of psychiatric patients : therapy or security ?

Dr. Amany El-Rashidy (France)

Psychiatry in the Neuroscience Era: Integrating Knowledge and Concepts.

Prof. Wafaa Haggag (Suez Canal University)

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13:45-14:30

Hall A

Plenary 2 Child and Adolescent Suicidality: Is it different? Prof. David Shaffer Prof. of Psychiatry, Columbia University, USA

Chairpersons: Prof. Suaad Moussa

Prof. Naglaa El Mahalawy

Cairo Universit


Abstract:

There are some similarities between youth and adult suicidal behavior but there are also striking differences that can be overlooked. The epidemiology of suicide ideation, attempts and completions in different age groups will be described. The possible causes of these including differences in risk factors; susceptibility to imitation and contagion and the assumption that some repeated but benign self injurious behaviors are suicide equivalents will be considered. The implications of these differences for the Black Box warnings attached to SSRI's and other medications will be discussed and methods of assessment in the young that can provide a rational approach to treatment will be proposed.

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15:30-16:15

Hall A

Plenary 3 Managing Psychosis: A care pathway approach Prof. Tom Craig

Prof. of Community Psychiatry,Section of Social Psychiatry, Health Service and Population Research Department David Goldberg Centre, Institute of Psychiatry, UK

Chairpersons: Prof. Emad Hamdi

Cairo University

Prof. Afaf Hamed


Abstract:

There is now a fairly compelling argument for early intervention (EI) in psychosis both in terms of reducing the duration of untreated psychosis (DUP) and of limiting the impact of illness on the persons social and occupational developent. Intervening early in the course of illness leads to better engagement with services, improved compliance with treatment, reduced use of coercion and of institutional care. But schizophrenia and other psychoses have life-long consequences while EI services typically remain involved with patients for only the first 2 to 3 years. Such evidence as currently exists suggests that significant numbers of people require care long beyond the treatment „window‟ of the EI service and that the long-term impact of these services may be modest at best. This presentation reviews the evidence for short and long-term efficacy of EI and describes an approach that links EI to specialised continuing care interventions for those who need them, targeted at key functional outcomes such as employment, socialisation and community participation.

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16:15- 17:45

Hall A

Expert Corner I Chairpersons: Prof. Ahmed Shawki El-Akabawy

Al-Azhar University

Prof. Momtaz Abdel Wahab

Cairo University

Moderator:

Assis. Prof. Hanan El-Shinnawy

Cairo University

Experts: Clozapine, Serum Lipids and Clinical Efficacy. Prof. Ric Procyshyn (Psychopharmacologist, BC Mental Health & Addictions Research Institute, Canada) Abstract When drugs enter the blood, they often form complexes with plasma protein molecules that are present in abundance. These drug-protein complexes, which primarily involve albumin, can affect the pharmacokinetic characteristics of the involved drug. Unfortunately, it is not as widely recognized that drugs can also form complexes with other plasma proteins including lipoproteins. In this regard, plasma lipoproteins have also been shown to modify the pharmacokinetics, tissue distribution, and pharmacological activity of lipophilic compounds. Knowing that clozapine is hydrophobic and is associated with hypertriglyeridemia compelled us to examine what effect dyslipidemia may have on its plasma distribution and in turn its clinical

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effectiveness/efficacy. Combining our basic science data with clinical observation and data from a randomized control trial, this presentation will address the hypothesis that an increase in serum lipids in clozapine treated patients is associated with improvement in the symptoms of schizophrenia.

The Dispute between a Man and his Ba: does it reveal the knowledge of the Ancient Egyptian about the psycholpathology of Suicide. Dr. George Tadross (Elizabeth Psychiatric Hospital Birmingham, UK) Introduction: Suicide as a form of human behaviour is probably as ancient as man himself. Therefore, a historical approach makes it possible to understand the meaning of suicide to people from different backgrounds, generations and experiences. Aim: To study one of the oldest written documents about suicide that is “The dispute of a man and his Ba” which was written as a poem by an unnamed Egyptian writer between 2000- 1740 B.C. on papyrus in hieroglyphics. The study attempts to find out how much the ancient Egyptians knew about the psychopathology of suicide. Method: A qualitative analysis of the poem was carried out using conceptual analysis. The authors used, ATLAS-ti programme, special software for qualitative analysis. Results: The poet gave a detailed description of negative thoughts, hopelessness and helplessness. He also described depressive mood and its associated negative cognitive schema. The poet gave a unique illustration of magical thinking which is frequently associated with suicide. He gave a detailed account of the feeling of suicide as approaching death. However, he also offered a solution of reconciliation to resolve the conflict. Conclusion: The document included a fine description for the psychopathology of suicide. Possibly, it is the oldest description of suicidal thoughts and its associated depressive cognition. It appears that the Ancient Egyptians had a significant grasp of suicide psychopathology.

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16:15- 17:45

Hall B

Oral Presentation 2 General Adult Psychiatry II Chairperson: Prof. Fatma Moussa

Cairo University

Prof. Abdel Shafi Khashaba

Zagazig University

Coordinator:

Assis. Prof. Mohamed Ezzat

Cairo University

Speakers:

Does Bipolar Disorder in Females Contribute to Domestic Violence?

Assis. Prof. Noha Sabry (Cairo University)

Depression and C-reactive protein: A possible inflammatory mechanism for the increased Risk of Ischaemic Heart Disease (IHD) in Depression.

Assis. Prof. Hisham Ramy (Ain Shams University) A System Approach to A Community Survey on the First National Anti-Stigma Campaign in Cairo, Egypt.

Dr.Nahed Khairy (Cairo University)

A Brief 10-Week Skills Based Group Therapy for Patients with Borderline Personality Disorder: and Traits: Preliminary Report.

Dr. Anoop Sankaranarayanan (Maitland Hospital, Australia)

Clinical and Neurocognitive Correlates of Insight.

Dr.Hala Sayaah (Beni Suef University)

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16:15- 17:45

Hall C

Symposium1 Addiction Services Chairpersons: Prof. Tarek A. Gawad

Cairo University

Prof. Hashim Bahry

Al-Azhar University

Coordinator:

Assis. Prof. Salwa Erfan

Cairo University

Speaker: Implementing New Strategy for Addiction Services in Egypt.

Prof. Tarek A.Gawad (Cairo University)

The US System of Care for Substance Abuse Treatment: What is it and What is it Supposed to Do?

Prof. Richard Rawson (UCLA School of Medicine, USA)

Outcome of Combined Methadone Treatment and the Matrix Model for Heroin Dependent Patients, an International Experience

Dr. Mansour Shawky (Assiut University)

Life Time Prevelance of Substance misuse in Egypt.

Prof. Emad Hamdi (Cairo University) Dr. Albert Sedrak (Ministry of Health)

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Wednesday 18th February, 2009

09:30-11:00

Hall A

Oral presentation 3 Addiction Psychiatry Chairpersons: Prof. Samir Abou El Magd

Cairo University

Prof. Amany Haroun


Coordinator:

Assis. Prof. Mohamed Nasreldin

Cairo University

Speakers: What Type of Ego Are We Dealing with, Here? Ego Functions in a Group of Substance Abusers: A MetaAnalysis.

Assis. Prof. Salwa Erfan (Cairo University)

Special Issues in Addiction Treatment: Addressing the Unique Needs of Addict Women in a Recovery Process in Arab Countries.

Dr. Rania Mamdouh (Cairo University)

Spirituality in Relation to Addiction Recovery.

Prof. Maha Mobasher (Cairo University)

The Relation between Childhood Abuse and the Severity of Substance Abuse Disorder. Dr. Moustafa El Rakhawy (Cairo University) Profile of Blood Born Disease among Substance Abusers.

Dr. Wael Mansour (Matar Psychiatric Hospital) 28


09:30-11:00

Hall B

Workshop 3 Short-Term, Intensive Psychotherapeutic Intervention for In-Patients with A Psychotic Disorder Chairpersons: Prof. Magdy Arafa

Cairo University

Dr. Amany El-Rashidy

France

Trainers: Dr. Ahmad Dobea & Dr. Maged Abd El-Kader

(Agiad Hospital - Mansoura)

Background:

The response to treatment of psychiatric patients varies widely, some patients respond in a linear manner and some improve dramatically in a short period of time. Other patients either do not respond or may even deteriorate in the in-patient setting. This workshop considers nonresponse to be a temporary state that can be overcome by specific interventions.

Aim of Workshop:

1- To demonstrate different forms of treatment resistance in in-patients with psychotic disorders encountered in clinical practice. 2- To display several techniques used for the purpose of by-passing these obstacles to improvement.

Target Audience:

Junior workers in the psychiatric field particularly who are interested in treating psychotics especially in-patient ones.

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09:30-11:00

Hall C

Workshop 4 Asperger's Syndrome: Clinical and Management Implications Chairpersons: Prof. Yousreya Amin Kent University, UK

Dr. Francis Harvey

Kent NHS & social care, UK

Background: The aim of the workshop is to familiarise clinicians with the concept of Asperger's syndrome in adult patients. Though adult Asperger's syndrome is well recognised, the diagnosis remains controversial. The difficulty is possibly due to the lack of characteristic symptoms. The clinician needs to learn to read through wide variations of behaviour to reach for the essence of the syndrome. Taking a comprehensive and reliable developmental history appears to be essential in the assessment. Recent research studies on the aetiology of Asperger's syndrome are reviewed. Different lines of management are explored with particular reference to CBT and behaviour therapy. Management is challenging because of the usual chronicity of the problem.

Aim of Workshop:

By the end of the workshop, the participants should be: 1. Familiar with the concept of adult Asperger's syndrome. 2. Able to make a diagnosis. 3. Capable of helping patients with adult Asperger's syndrome.

Target Audience:

Clinicians dealing with adult patients with mental health problems.

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11:00-11:45

Hall A

Plenary 4 How to Achieve Academic and Research Excellence. “An Egyptian Perspective “ Prof. Ahmed Okasha

Emeritus Prof. of Psychiatry, Ain Shams University

Chairpersons: Prof. Mohammed Ghanem

Prof. Adel Sheshae


Alexandria University

Abstract: It is harder to do worthwhile research in psychiatry than in most other medical disciplines. In future as in the recent past the most important advances and the development of new concepts are going to be made by neuroscientists, geneneticists, psychologists…etc. and our role will be a junior partner. We shall lead in research on efficacy of treatment. Outcome studies, comorbidity..etc. The creeping devaluation of medicine will damage the standing and understanding of psychiatry. The presentation will discuss the limitation of research: In Egypt especially in academic departments and the personality requirements for research. A short academic and clinical autobiography will be alluded to. Lastly the question whether we have evidence based psychiatry like evidence based medicine and the difference between value based versus evidence based psychiatry will be discussed.

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12:15 - 14:00

Hall A

Expert Corner II Middle East Division of the Royal College of Psychiatrists

Chairpersons: Prof. Emad Hamdi Cairo University

Dr. Nasser Loza

Mental Health Secretariat

Coordinator: Assis. Prof. Amany Abdou

Cairo University

Experts: The nuclear symptoms of schizophrenia reveal the four quadrant structure of language and its deictic frame. Abstract

Prof. Timothy Crow (Oxford University, UK)

The “torque” constitutes a bias across the antero-posterior axis such that dorsolateral prefrontal cortex (DLPFC) on the right is thinner and wider than that on the left side, and occipito-parieto-temporal cortex (OPTC) is thinner and wider on the left than the right. Thus the human brain is distinguished from that of all other mammals by having 4 quadrants of association cortex – left and right motor and right and left sensory. This has the consequences that i) each primary sensory or motor engram has an alternate form compatible with De Saussure‟s separation of the signifieds from the signifiers and ii) conceptual-intentional compartments associated with “meaning” and “thought” respectively are separated in the non-dominant hemisphere from articulatory-perceptual compartments in the dominant hemisphere.

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The nuclear symptoms of schizophrenia tell us what happens when the distinction between compartments (the deictic frame) breaks down. Thought, the precursor of speech loses its characteristic autonomy – thoughts are inserted into or removed from the individual‟s mind. Conversely auditory hallucinations such as thoughts spoken aloud represent self-generated neural activity that activates phonological engrams normally only activated by speech from another individual. Thus schizophrenic symptoms are the key to the evolution of the human brain.

Developments in Postgraduate Training in Psychiatry

Prof. Robert Howard (Institute of Psychiatry, London, UK)

The UK government‟s Modernising Medical Careers agenda has revolutionised the organisation of training in Psychiatry and the Royal College of Psychiatrists has fought hard to protect those features of training that are important and to maintain standards. A new examinations format, development of workplace-based assessments and an updated curriculum have been the most important components of this process. Psychiatry, perhaps more than any other large specialty, suffers from an erosion of standards – both in the quality of those entering training and the training process itself. My challenge, as Dean of the College, is to increase the quality of trainees entering our specialty and to make sure that the training they receive delivers competent and happy psychiatrists.

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12:15 - 14:00

Hall B

Symposium 2 Ethical Practice in Psychiatry Chairpersons: Prof. Ahmed Okasha


Prof. Mostafa Kamel


Coordinator: Prof. Mohamed Ghanem


The Madrid Declaration will be highlighted with emphasis on HOW TO AVOID BOUNDARY VIOLATIONS Prof. Ahmed Okasha (Ain Shams University)

Two case Vignettes will be presented and discussed.

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12:15 - 14:00

Hall C

Expert Corner III Chairpersons: Prof. Yousry Abdel Mohsen

Prof. Lamis Al-Raey

Cairo University

Cairo University

Experts:

Considerations of Child Disorders in DSM V. Prof. David Shaffer (Columbia University, USA)

Description of the broad goals intended for the new system and some of the disorders that are currently being considered for revision including Pediatric Biolar Disorder; ADHD subtypes; Oppositional Defiant Disorder; CD subtypes; PTSD; Suicidal behavior; Non suicidal self injury; Bipolar disorder; Autism and Aspergers syndrome.

Positive Mental Health Prof. Rafia Ghubash (President, Arabian Gulf University, Bahrain)

Reforms of Promotion Processes for Academics in Psychiatry in Egypt Prof. Mounir Fawzi (Zagazig University) In Egypt, new changes are in progress as regard promotion processes for academics in the Assistant Professor and Professor Grades, in psychiatry as well as in all other disciplines. One objective of these changes is to raise the level of scientific research. Another objective is to ensure an assessment of the applicants by unbiased, objective and efficient „Permanent Scientific Committee‟ and Assessors, both national

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and international. Announced reforms will be fully employed in the very near future. Currently, however, there is a transitory stage in which the newly selected Scientific Committee and Assessors are working mostly under earlier regulations. There are wide differences between the two types of regulations. According to the system in use, for example, applicants are required to submit a total of 8 research papers for Assistant Professor Grade, and 9 papers for Professor Grade, whereas under the new regulations to be implemented it will be sufficient to submit only 4 papers. Nevertheless, it is argued that the new system is much tougher. This author hopes to get from audience an enriching discussion of a timely topic that concerns all of us as academics in Egypt, whether we are candidates going to apply for an Assistant Professor or a Professor post, or we are or will be their assessors. Colleagues from other countries should be most helpful through exchange of experiences and views. Indeed, reforms which will be discussed in this presentation appear to be both exciting and challenging.

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15:00 - 15:45

Hall A

Plenary 5 Advances in the Drug Treatments of Patients with Dementia Prof. Robert Howard Professor of Old Age Psychiatry and Psychopathology, Consultant Old Age Psychiatrist, South London and Maudsley NHS Trust, Institute of Psychiatry, London, UK Dean, The Royal College of Psychiatrists

Chairpersons: Prof. Ahmed Abdel Latif

Prof. Mohsen Askar Cairo University

Cairo University

Abstract As the number of older people in society increases so does the total number of cases of dementia which are estimated to double worldwide in the next 25 years. Drug treatments for cognitive symptoms are already available with modest efficacy but the evidence-base for the drug treatment of behavioural and psychological symptoms is weak. Atypical neuroleptics are probably the best treatment for non-cognitive symptoms, but their use is associated with a number of side-effects, including stroke. The advent of drugs that can slow down the disease course in dementia is still awaited and a number of promising compounds have recently failed at the Phase III trial stage.

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15:45 - 17:30

Hall A

Symposium3 New Perspectives in Dementia Chairpersons:

Prof. Yousry Abdel Mohsen

Prof. Hoda Salama

Cairo University

Alexandria University

Speakers: Clarifications on Alzheimer’s Dementia.

Dr. Soha Abdel Latif (Alexandria University)

The UK Dementia Strategy: Does Egypt Need To Develop Its Own Dementia Strategy? Dr. George Tadros (Queen Elizabeth Psychiatric Hospital Birmingham, UK)

Clinical and Polysomnographic Study of the Sleep Pattern in Patients with Alzheimer’s, Vascular and Parkinson’s Dementias. Dr.Osama Elkhouli (Alexandria University)

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15:45 - 17:30

Hall B

Oral presentation 4 Do You Think You Can Present? Chairpersons:

Prof. Azza El-Bakry

Cairo University

Judges:

Prof.Mounir Fawzy Zagazig University

Assis. Prof. Noha Sabry

Cairo University

Dr.Yousreya Amin Kent University,UK

Prof.Tom Craig Institute of Psychiatry

Presenters: Neurological Soft Signs in Obsessive Compulsive Disorder.

Dr. Mohammed Abd Al-Fattah (Cairo University)

Depressive Disorders among Egyptian Elderly Patients on A Medical Ward.

Dr. Alia Adel (Cairo University)

Parenting Styles and Personality Features in Children with Externalizing and Internalizing Disorders.

Dr. Walaa Amin (Cairo University)

A Comparative Study of Dynamic Dimensions in Egyptian Patients with Anxiety and Depressive Disorders.

Dr. Hoda Abdou (Cairo University)

Psychobiological Aspects of Suicidality in Relation to Serum Lipid Levels in Adult Patients with Major Depression .

Dr. Dalia Shawarbi (Cairo University) 39


15:45 - 17:30

Hall C

Workshop 5 Application of Cognitive Behavioral Therapy Skills in Addiction Treatment Chairpersons:

Prof. Richard Rawson

UCLA School of Medicine, USA

Trainer:

Prof. Tarek A. Gawad

Cairo University


Background: One of the most widely used of the TREATMENT training modules is the set of materials produced on the topic of cognitive behavioral therapy (CBT). TREATNET Trainers who have trained therapists with this module have reported that trainees have found this material to be very helpful and practical in their day to day practice. The 2 hour workshop will describe the rationale for the CBT approach and will demonstrate the use of a number of CBT treatment strategies.

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15:45 - 17:30

Hall C

Workshop 6 Practical Therapy for the BorderlinePersonalityPatient, with a Focus on Group Strategies Chairpersons:

Prof. Samir Abou El Magd

Cairo University

Dr.Mohamed Abdel Fattah

West Vancouver Health Authority, Canada

Trainer: Dr. Lancelot Patrick

Consultant, West Vancouver Health Authority, Canada

Goals/Purpose of the workshop Can we develop a suggested framework for managing borderline personality patients within available resources? We will examine if there is a role for cost effective group therapy in your treatment delivery system and present a group strategy that has the potential to limit self-damaging behaviors. Target audience Front-line therapists seeking ways to maximize the service delivery. Psychiatry administrators interested in system design options. Format The workshop starts with a group brainstorming session. Small groups will then strategically analyze the treatment resources available in their own home community and present to each other. Objectives: 1 Identify personality dimensions and comorbidities that guide therapy. 2 Adapt cognitive strategies to encourage healthy attitudes 3 Facilitate patient acquisition of key interpersonal skills.

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Thursday 19th February, 2009

09:30-11:00

Hall A

Symposium 4 Integrative Group Psychotherapy A Local Experience Chairpersons: Prof. Zeinab Sarhan

Cairo University

Coordinator: Background:

Prof. Refaat Mahfouz

El Menia University

Assis. Prof. Aref Khoweiled

Cairo University

El-Menia Group Psychotherapy Training Program (MGPTP) has been established 8 years ago as the first group therapy training program in Upper Egypt. It has adopted an integrative approach for psychotherapy practice, training and research.

Speakers:

Object Relations as the Core Constituent of the MGPTP.

Dr. Amr Makram (El Menia University)

Gestalt Games & the Hierarchy of Therapeutic Human Growth in MGPTP. Dr. Mohamed Taha (El Menia University) Existential and Spiritual Elements in MGPTP.

Dr. Mohamed Ayman (El Menia University)

Principles of Cognitive Psychotherapy as Integrated & Practiced in MGPTP. Dr. Ahmed Kamal (El Menia University) Socio-Cultural Influence on Group Therapy Leadership Style in MGPTP (A Comparison with British Group Analysis).

Dr. Mohamed Taha (El Menia University)

Neurobiological Concerns of the MGPTP.

Dr. Nashaat Adel (El Menia University)

Psychotherapy as a Creative Process: Getting it altogether.

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09:30-11:00

Hall B

Symposium 5 Exercise, Sports and Psychiatry Chairpersons: Prof. Adel Medany

Prof. Mahmoud Hammouda

Al-Azhar University

Al-Azhar University

Speakers: Relation of Sports and Exercise to Mental Health.

Prof. Said Abdel Azim (Cairo University)

Drug Abuse and Sports.

Prof. Samir Abou El Magd (Cairo University)

Dance Movement Therapy.

Dr. Radwa Said (Cairo University)

Psychotherapeutic Benefits of Exercise for Geriatric Age Group” A Review of Literature.

Dr. Tarun Amalnerkar (Masterskill University of Health Sciences)

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09:30-11:00

Hall C

Oral presentation 5 Child and Adolescent Psychiatry Chairpersons: Prof. Ola Shaheen

Cairo University

Prof. Zeinab El-Bishry Ain Shams University

Coordinator:

Assis. Prof. Mona El Rakhawy

Cairo University

Speakers: Dermorphin Peptide Action in Autistic Children: Is It Real?

Assis. Prof. Omnia Raafat (Cairo University)

Psychiatric Adjustment in Children and Adolescents with Chronic Fatigue Syndrome.

Dr. Fadia Zyada (Cairo University)

Masturbatory Behavior in Preschool Children (0-5 years): A Descriptive Egyptian study.

Dr. Ghada El Khouly (Ain Shams University)

Psychodynamic Profile of Diabetic Adolescent Patients.

Assis.Prof.Hani Hamed (Bani-Sueif University)

Gender Differences in Personality Characteristics and Cognitive Abilities in Adolescents Admitted in Correctional Institute in Egypt.

Assis. Prof. Amany Abdou (Cairo University) 44


11:00-11:45

Hall A

Plenary 6 Is Schizophrenia Objectively Real? (Disorganization-Deterioration Ultimatum: Underlying all other Psychiatric Disorders) Prof. Yehia El-Rakhawy

Emeritus Professor of Psychiatry, Cairo University

Chairpersons:

Prof. Sanaa Ahmed

Cairo University

Prof. Timothy Crow

Oxford University

Background:

All psychiatric disorders (except chaotic organic ones caused directly by infection, degeneration or neoplasm - or the like) are hierarchical defenses against disorganization, deterioration and ultimate psychic or actual death. The patient escapes the more serious disorder by defenses using the less serious ones. Accordingly, such disorders could be arranged in a devolutionary order corresponding to the stages of growth. Neuroses (and personality disorders) are defenses against depression. Depression is a defense against paranoid disorders and mania. Paranoid disorders are defenses against schizophrenic disorganization and ultimate deterioration. This, of course, could take any possible alternatives along the evolutionary-devolutionary scale).

Practical clinical benefits making use of such hypothesis could be achieved by considering the latent covert disorder while dealing with the overt manifest one. The hypothesis could also be useful in certain preventive considerations to prevent or abort more serious disorders.

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12:15 - 14:00

Hall A

Workshop 7 Too Many Duties, Too Few Rights: Ethical Considerations Highlighting Psychiatrists' Rights Chairpersons: Coordinator: Trainers:

Prof. Emad Hamdi

Cairo University

Dr. Nahed Khairy

Cairo University

Assis. Prof. Dalal Amer Assis. Prof. Mohamed Nasreldin Assis. Prof. Hani Hamed Dr. Nahed Khairy

(Cairo University) (Cairo University) (Bani-Sueif University) (Cairo University)

Topics:

 Patients exploiting doctors: balancing duties with rights.  Colleagues potentially undermining the profession: Best practices in whistle blowing in both clinical practice and research.  The Media: reciprocal benefits, potential harms  The industry: Conflicts AND interests.

Objectives: By the end of the workshop, the participants will be able to:

 Contribute in the brainstorming of violated rights through personal experience according to stage of training or practice and setting  Realize their role in protecting their rights without falling into defensive practice  Reach a consensus about the guidelines of best practice to enforce their rights.  Participate in the initiation of the online discussion forum creating a continuous platform for ongoing challenges.

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12:15 - 14:00

Hall B

Debate Cosmetic Surgery for Adolescents.. Yes or No? Chairpersons: Prof. Ahmed A. Latif

Cairo University

Coordinator: Speakers :

Prof. Magda Fahmy

Suez Canal University

Dr. Heba Fathy

Cairo University

Prof. Lamis El Raey

(Prof. of Psychiatry,Cairo University, Head of Adolescent Unit)

Vs.

Prof. Amr Mabrouk

(Prof. of Plastic Surgery, Ain Shams University)

Background:

Cosmetic surgery for adolescents is a debatable issue. Many dimensions are to be taken into consideration, surgical, psychological, ethical and medicolegal. The bodies of adolescents are still growing, their decision making is still evolving, their social skills are forming, and some of them may have a psychiatric trouble as well. Who is to take the decision of the operation: the surgeon, the parents, or the adolescent himself who is influenced by the media or searching for more social acceptance? Is it ethical to do such surgeries for adolescents or they are too young? The plastic surgeon have their point of view, also the psychiatrists have their own opinion. The debate aims also at clarifying the various cultural aspects of this issue, especially in Egypt.

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12:15 - 14:00

Hall C

Symposium 6 Obstacles for Drug Therapy in Psychiatry Chairpersons:

Prof. Tarandil El-Guindy

Cairo University

Coordinator:

Prof. Osama El Boraey

Mansoura University

Assis. Prof. Hani Hamed

Bani-Sueif University

Speakers: Psychiatric Disorders Associated with Interferon Treatment for Chronic Hepatitis.

Prof. El-Sayed El-Naggar (Mansoura University)

Compliance or Alliance and Adherence.

Assis. Prof. Mohamed Ezzat (Mansoura University)

Impact of Clinical Variables versus Family Attitudes on the Compliance of Psychotic Patients: A Clinical Study in Mansoura Locality.

Prof. Wafaa El-Bahaey (Mansoura University)

Factors Predicting Response in Therapy for Major Depressive Episodes.

Assis. Prof. Hala El-Borae (Mansoura University) & Prof. Hani El-Ameen (Zagazig University)

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Assis.


15:00 - 15:45

Hall A

Plenary 7 Refining the Molecular and Cellular Targets of Mood Stabilizing Drugs Prof. Trevor Young

Professor and Head of the Department of Psychiatry, University of British Columbia, Canada

Chairpersons: Prof. Mostafa Shaheen

Cairo University

Prof. Tarek Okasha


Background:

The chronic course of bipolar disorder, with multiple episodes, persistent symptoms and decreasing function over time has focused attention on specific targets of mood stabilizers. Of increasing interest are those targets with long term effects and those located intracellularly. Multiple effects of these agents on signal transduction pathways have been well established and modulation of these pathways leads to up regulation of several neuroprotective factors. Microarray studies have elaborated these mechanisms include targets involved in energy metabolism such as mitochondrial function and reducing oxidative stress. These targets appear relevant in patients with bipolar disorder since cell loss in prefrontal cortical and limbic regions has been shown in a number of samples of postmortem brain tissue with rather remarkable consistency. There may be subtle changes in the volume of these regions in addition to their function as evidenced by brain imaging studies. Together these data suggest that intracellular targets further refine models of pathophysiology. Findings may lead to the development of novel treatments for bipolar disorder based on unidentified mechanisms.

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15:45 - 17:15

Hall A

Expert Corner IV Chairpersons:

Prof. Momtaz Abdel Wahab

Cairo University

Dr. Lancelot Patrick

Vancvouver Health Authority, Canada

Coordinator:

Assis. Prof. Mohammed Nasreldin

Cairo University

Experts: Essentials of Diagnosis and Treatment of Adult ADHD.

Dr. Mohamed Abdel Fattah (Lions Gate Hospital, Canada) Abstract Attention deficit-hyperactivity disorder is a heterogeneous disorder. It is estimated that about 3% to 5% of school-age children suffers from ADHD and an estimated 30% to 70% of those will maintain the disorder into adulthood. Impairments in daily functioning are prominent and are directly and indirectly linked to ADHD. Comorbidity and other life circumstances must be taken in consideration in the treatment and management of ADHD patients.

Antipsychotics Associated Drug Interactions.

Prof. Ric Procyshyn (Psychopharmacologist, BC Mental Health & Addictions Research Institute, Canada)

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15:45 - 17:15

Hall B

Symposium 7 Human Sexuality and Comorbid Medical Conditions Chairpersons:

Prof. Ismail Youssef

Prof. Victor Samy

Suez Canal University

Coordinator:

Banha University

Dr.Osama Refaat Cairo University

Speakers: Antidepressants and Sexual Dysfunctions. Prof. Said Abdel Azim (Cairo University)

Drug Abuse, Addiction and Human Sexuality. Prof. Tarek A. Gawad (Cairo University)

Evidence Based Medicine in the Management of Erectile Dysfunctional.

Prof. Hussien Ghanem (Prof. of Andrology, Cairo University)

Oncological Conditions and Sexual Behavior. Prof. Mahmoud El-Batrawy (Cairo University)

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15:45 - 17:15

Hall C

Workshop 8 Patient Placement Criteria in Egypt: Does it fit? Trainers:

Assis. Prof. Salwa Erfan Dr. Rania Mamdouh

(Cairo University) (Cairo University)

Introduction:

The estimated number of substance dependence in Egypt is 1.2 % drug addicts for cannabinoids, sedatives, alcohol and opiates. There is inadequate monitoring and supervision mechanisms on drug abuse treatment guidelines. A major change in the substance abuse field is the growing acceptance of training substance abuse treatment professionals, including physicians, social workers, nurses, and counselors, and to have access to scientifically validated screening, assessment, diagnostic and treatment tools.

Objectives: 1-Increase the attendants understanding on the ASAM Patient Placement Criteria. 2-Train the attendants on the different levels of care defined by The Placement Criteria and the decision making skill required for each patient. 3-Train the attendants on how to answer the questions for substance dependence treatment planning such as: What are the patients needs? Which assessment for which patient? Where to place the patient?

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Biosketch of Distinguished Guests (In alphabetical order)

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Prof. Ahmed Okasha

MD, PhD, FRCP, FRCPsych, FACP(Hon.) -Founder and Honorary Chairman Institute of Psychiatry.-Professor and Director of WHO Collaborating Center for Training and Research in Mental Health, Institute of Psychiatry – Ain Shams University, Cairo. -Member Expert Advisory Panel in Mental Health (WHO) Geneva. -President Egyptian Psychiatric Association. -President Arab Federation of Psychiatrists. -Past President WPA (2002 – 2005). -Council member WPA. -President of the Egyptian Society of Biological Psychiatry, of WFSBP. -Chairman of Ethics' Committee of WPA (1993 – 1999). -Editorial Advisory Board of 20 International Scientific Journals. -Honorary Fellowship of the American College of Psychiatrists (2002). -Fellow of Royal College of Psychiatrists (London, 1973). -Fellow of Royal College of Physicians (Edinburgh, 1973). -Honorary Fellow of WPA (2005), international fellow of APA. -Presidential Commendation of APA (2006). -Published More Than 220 Original Articles in National and International Journals. -Editor and contributor of 47 books in the field of psychiatry and psychology in both the Arabic and English languages. -The Egyptian State Merit award in creativity in Science 2000. -The Egyptian State Merit Prize for Medical Sciences 2008.

Prof. David Shaffer FIELD OF SPECIALIZATION Child Psychiatry DEGREES AND QUALIFICATIONS 1985 Fellow of Royal College of Physicians (London) 1981 Fellow of the Royal College of Psychiatrists (London) 1973 Member of the Royal College of Psychiatrists (London) 1969 Academic Diploma in Psychological Medicine (Univ. of London) 1964 Member of the Royal College of Physicians (London) 1961 M.B., B.S. (Univ. of London) Board Certifications: F.R.C.P., F.R.C.Psych.

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APPOINTMENTS 1987–present Irving Philips Professor of Child Psychiatry, Professor of Psychiatry and Pediatrics, Columbia University College of Physicians and Surgeons, New York 1979–present Attending Psychiatrist, Presbyterian Hospital in the City of New York PREVIOUS APPOINTMENTS 1977–2008 Director, Department of Pediatric Psychiatry, Babies Hospital, Columbia-Presbyterian Medical Center 1977–2008 Director, Division of Child Psychiatry, New York State Psychiatric Institute, New York 1980–1986 Consulting Psychiatrist, Blythedale Children‟s Hospital, Valhalla, New York 1980–1985 Professor of Clinical Psychiatry and Pediatrics, Columbia University College of Physicians and Surgeons, New York 1979–1980 Clinical Professor of Psychiatry and Pediatrics, Columbia University College of Physicians and Surgeons, New York Address: Lawrence C. Kolb Research Building Room 263A Unit/Box:78 40 Haven Avenue New York, NY 10032

[email protected]

Prof. Emad Hamdi M.D., Ph.D, MRCPsych Dr. Hamdi is Head, Department of Psychiatry, Faculty of Medicine, Cairo University and Director, Mental Health Research Unit, Ministry of Health, Egypt. He held honorary Senior Lecturer appointments with Kent Institute of Medicine and Health Sciences, University of Kent, and Kings College, London. Dr. Hamdi obtained his M.B. B.Ch (1973) with Honors, his M. Sc. in Psychiatry and Neurology (1977); and his M.D., in psychiatry (1982) all from the Faculty of Medicine, Cairo University. He obtained his MRCPsych in 2001. Dr. Hamdi did a 10 month fellowship at the Adult Psychiatry Branch, National Institute of Mental Health, in 19831984: Clinical training, Behavioral Neurology Clinic, Adult Psychiatry Branch, NIMH, at St. Elizabeth‟s Hospital, Washington DC (Dr. Daniel Weinberger). The clinic was a highly specialized teaching and management clinic for neuropsychiatric and neurological conditions. In

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1995 he was a visiting fellow Mental Health Clinical Research Centre, University of Iowa Hospitals and Clinics (Dr Nancy Andreasen). The visit covered orientation and methods of research in brain imaging with MRI and PET. He is the Lead Researcher of collaborative research with the World Health Organization (WHO) regional office (EMRO), and United Nations Office of Drugs and Crime, Member of The National Supervisory Council for detention of mentally abnormal offenders and is on the Executive Board, Egyptian Membership Degree Program, and PI of the National Addiction Research Program in Egypt. Dr. Hamdi supervised 10 M.D. theses, 7 M.Sc students and currently supervises 2 M.Sc and MD Students. Dr. Hamdi has 54 publications in national and international peer-reviewed journals.

Dr. George Tadros

MB ChB, PG.Dip, MRCPsych, MD Sub specialties: Old Age Psychiatry. Experience: Memory disorders. Neuropsychiatry. Medico-legal Psychiatry. Research: Around 40 publications in a range of peer reviewed journals, original papers, letters, abstracts and chapters in books. Current posts: 1. Consultant Psychiatrist, Queen Elizabeth Psychiatric Hospital Birmingham. 2. Honorary Senior Clinical Lecturer and Course Director, Birmingham University. Current Memberships/Professional Bodies: Royal College of Psychiatrists. Contact Details: Direct Telephone: 01214 273388/ 07811 338055 Email address: [email protected]

Prof. Rafia Ghubash

President, Arab Gulf University Professor Rafia Obaid Ghubash is President of the Arabian Gulf University (AGU) in Bahrain. She studied at Cairo University to gain her Bachelor of Medicine degree and went on to receive a Ph.D. in community and epidemiological psychiatry from the University of London. As well as her role at the AGU she is also President of the

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Arab Network for Women in Science and Technology, a network to help women scientists attain leadership positions and to attract more women into science. She takes a strong interest in the education of Arab women in particular and received the "Middle East Women's Educational Achievement" award in 2002 for her work in this field.


Ph.D. Richard A. Rawson, Ph.D., is an Associate Director of UCLA Integrated Substance Abuse Programs and Professor-in-Residence at the UCLA Department of Psychiatry, in which he has been a member for more than 20 years. He received a Ph.D. in experimental psychology from the University of Vermont in 1974. Dr. Rawson oversees clinical trials on pharmacological and psychosocial addiction treatments. He is principal investigator of the Los Angeles County Evaluation System Program (LACES) and the California Outcome System Monitoring Program (CalOMS). He has led addiction research and training projects for the United Nations, the World Health Organization, and the U.S. State Department, exporting science-based knowledge to many parts of the world. Dr. Rawson has published 2 books, 27 book chapters, and over 150 peer-reviewed articles and has conducted over 1,000 workshops, paper presentations, and training sessions. Specialties Methamphetamine Behavioral Treatment Research Medication Research Treatment System Evaluation International Addiction Research Addiction Training Contact Details: UCLA Integrated Substance Abuse Programs 1640 S. Sepulveda Blvd., Suite 200 Los Angeles, CA 90025 [email protected]

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Prof. Ric M. Procyshyn

B.Sc.(Pharm.), M.Sc., Pharm.D., Ph.D. Psychopharmacologist, BC Mental Health and Addictions Services, An Agency of the Provincial Health Services Authority Position: Research Scientist NEXUS Lead Investigator Research Focus: Smoking in the context of mental health Antipsychotic polypharmacy Antipsychotic associated metabolic disorders Mechanism of antipsychotic action Pharmacoeconomics Current Research Projects: Examining the patterns of antipsychotic utilization in community mental health teams (Ric Procyshyn [PI], Joy Johnson [Co-PI], Alasdair Barr, Sean McIsac, Tony Wu, William Honer Examining the cellular metabolic and cardiovascular effects of the atypical antipsychotics (Ric Procyshyn [PI], Alasdair Barr [Co-PI]) Investigating the role of serum lipids on clozapine‟s therapeutic activity (Ric Procyshyn [PI], Kishor Wasan, Alasdair Barr, William Honer) Contact Details: BC Mental Health and Addictions Services An Agency of the Provincial Health Services Authority Riverview Hospital Administration Building – Office #128 2601 Lougheed Highway, Coquitlam, BC V3C 4J2

Prof. Robert Howard

MD MRCPsych Professor of Old Age Psychiatry and Psychopathology Consultant Old Age Psychiatrist, South London and Maudsley NHS Trust Biography After undergraduate education at Cambridge (BA Zoology 1982) and St Bartholomews Hospital (MB BS 1985) and a couple of years in general medicine, Robert Howard came to the Maudsley Hospital as an SHO in 1988 and has never been able to work out how to leave. Work with Raymond Levy on late life psychosis led to a more general interest in

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brain imaging - in particular MRI-based structural and functional imaging in psychosis and dementia. He is Chief Investigator on the MRC CALM-AD and DOMINO trials. As well as working to provide an independent evidence base to support the use of drugs in old age psychiatry, he is interested in applications of functional brain imaging that can increase our understanding of the processes involved in the pathophysiology of neuropsychiatric disorders and their treatment. Clinically, Robert Howard is an inpatient consultant in the Southwark Mental Health for Older Adults Service within SLAM and has an interest in forensic and other medicolegal issues in old age; in particular disputed testamentary capacity. He was a defence expert witness in the War Crimes trial of Szymon Serafinowicz in 1996 and was Amnesty Internationals expert witness in the Pinochet extradition hearings in 1999. Interested in postgraduate training in psychiatry he was SHO tutor at the Maudsley from 1995-2004 and is currently Dean of the Royal College of Psychiatrists. Contact Details: Tel: 020 7848 0545/0550 Fax: 0632 Address: Institute of Psychiatry Box P070, De Crespigny Park, London United Kingdom, SE5 8AF Location: M1.13 Main Wing Departments: MRC Centre for Neurodegeneration Research Neurodegeneration and Brain Injury Psychological Medicine and Psychiatry also Old Age Psychiatry

Prof. Timothy Crow

PhD, FRCP, FRCPsych, FMedSci Affiliation:SANE Prince of Wales International Centre Clinical Interests: Schizophrenia, Bipolar disorder Research Focus: Brain imaging, Cell biology, Neurodevelopment, Neuropathology, Pharamacology, Epidemiology, Genetics, evolution, speciation, Animal models, Molecular and Cell biology, Neuroanatomy/Systems Neuroscience, Clinical trials, Neurotransmission, Electrophysiology, Protein structure/chemistry, Glia/myelin Reasearcher Bio :

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Tim Crow is a research psychiatrist who is a member of the External Scientific staff of the Medical Research Council and Honorary Director of the Prince of Wales SANE Research Centre. He qualified at the Royal London Hospital in 1964 and obtained a PhD in the University of Aberdeen in 1970. He is a fellow of the Royal Colleges of Physicians and Psychiatrists and the Academy of Medical Sciences. Before moving to Oxford in 1994 Dr Crow was for twenty years Head of the Division of Psychiatry of the MRC Clinical Research Centre at Northwick Park. Tim Crow‟s long term research interests are in the nature and causation of the major psychoses. These illnesses are characterised by the presence of delusions and hallucinations and disorders of thinking and generally have an onset in early and middle adult life. Encompassing schizophrenia and manic-depressive psychosis these disorders are common, affecting around 2% of the population in the course of a lifetime. Contact Details: Street Address 1: Warneford Hospital, Street Address 2: Roosevelt Drive City: Oxford Zip/Postal Code: OX£ 7JX Country/Territory: United Kingdom Phone:0044 1865 455917 Fax: 0044 1865 455922

Prof. Tom Craig Professor Tom Craig leads the Social Psychiatry team and other members include emeritus Professor George Brown and Dr Tirril Harris, both of whom are based at St Thomas‟ Hospital. Tom Craig is a Professor of Community and Social Psychiatry. His research has included studies of mental illness in homeless young people and other disadvantaged people in inner cities, and more recently he has evaluated the success of early intervention services for people with first episode psychosis. Professor Craig‟s clinical activities focus on developing innovative community-based psychiatric services to supplement and enhance care. Contact Details: Section of Social Psychiatry, PO33 Health Service and Population Research Department David Goldberg Centre Institute of Psychiatry

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De Crespigny Park London SE5 8AF [email protected] Phone: 020 7848 0736 Fax: 0207 277 1462 Fax: 604-524-7800

Prof. Trevor Young MD, PhD, FRCPC Trevor Young is currently the Professor and Head of the Department of Psychiatry, University of British Columbia. He was previously Professor and the Cameron Wilson Chair in Depression Studies in the Department of Psychiatry at the University of Toronto as well as Physician-in-Chief of the Centre for Addiction and Mental Health in Toronto, Ontario, Canada. He is also Adjunct Faculty at Rockefeller University in New York, New York, USA. Dr. Young earned his medical degree from the University of Manitoba School of Medicine and his PhD from the University of Toronto Institute of Medical Sciences. He completed an internship at McGill University in Montreal and training in Internal Medicine and Psychiatry at the University of Toronto. Dr. Young also completed research fellowships in the Department of Psychiatry at the University of Toronto and in the Department of Radiology at Johns Hopkins School of Medicine in Baltimore, Maryland. A Distinguished Fellow of the American Psychiatric Association, Dr. Young is a member of the Society for Biological Psychiatry, the American Psychiatric Association and the Collegium Internationale Neuro-Psychopharmacologicum. He has won numerous awards for his work, including the American Psychiatric Association‟s Psychiatric Services Gold Achievement Award, the Douglas Utting Award for Outstanding Contributions to the Field of Mood Disorders and the Heinz Lehmann Award from the Canadian College of Neuropsychopharmacology.

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Prof. Yehia El-Rakhawy Emeritus Professor of Psychiatry, Faculty of Medicine, Cairo University Member of Egyptian Association of Mental Health (1960-). Foundation member and fellow of Royal College of Psychiatrists , FRC Psych President, Association of Evolutionary Psychiatry and Group Work. Editor, Egyptian Journal of Psychiatry (December,1978 - ). Editor-in-Chief, Journal of "Man and Evolution" (January, 1980-). Official Journal of the Association of Evolutionary Psychiatry and Group Work. Member of the Medico legal Consultant for Egyptian and Arab Courts (Sudan 1980, Saudirabia 1980 &1981) Visiting Professor Shahar Mental Hospital, El-Taief, Saudi Arabia, 1980 - 1981 (In the program arranged by WHO then). Head of the Scientific Committee of the Egyptian Psychiatric Association (October,1991-October1996) Executive Member of the Egyptian Association of Literary Criticism (1990 -1991 ). Head of Psychiatric Department Kasr El-Eini Faculty of Medicine Cairo University 1990-1994. Senior examiner of post graduate degrees in the specialty: 1-El-Mansoura University, Faculty of Medicine (1962- 1972) 2-Ain-Shams University, Faculty of Arts: [Psychological Medicine and Physiological Psychology for Psychologists] (1972 - 1977) 3-Nursing schools and the High Institute of Nursing, Cairo University: (More or less part of the official duties all through). 4-National Center of Judicial Researches: Medico legal Psychiatry a-Representatives of the Prosecution : 1982 - 1988. b-Military Magistrates: 1987-1989. c- Medico legal Practitioners : 1986-1988. 5- Member of the Permanent Committee of Assessment of Legibility for the degree of Professorship in Internal Medicine Specialties [Egyptian Universities] ( 1982-1989) (1990-2004). 6-Chair of Examination committee of Arab Board of Psychiatry (19901998).

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7- Member of Scientific Culuture Community (High Institute of litter Egypt. 1992-). Consultant of Forensic Psychiatry in Sudan and Saudi Arabia (1980, 1981). Member of Egyptian Writers Union (1987). Member of Supreme Council of Culture (1993). Editor of more than 34 books in psychiatry and literature. Editor and co-editor in 68 articles in psychiatry (English). Editor and co-editor in 91 articles in psychiatry (Arabic). Supervision on more than 30 theses in Psychiatry and Psychology.

Contact details:

www.rakhawy.org

Dr. Yousreya Amin

Graduated from Faculty of Medicine, Cairo University 1974 and qualified for Msc and MD in 1978 and 1983. Dr. Amin spent 1 year training at the Service Universetaire, Centre Hospitalier Sainte Ann, Paris, France. She subsequently worked in UAE as a consultant psychiatrist between 1989 and 1997. She has been working as a consultant psychiatrist with the National Health Service, West Kent, Uk ever since where she became a member of Royal College of Psychiatrists. Dr. Amin has around 40 publications in peer reviewed journals. She is currently director of psychiatry training with the Kent Surrey and Sussex deanery; she is also program director for the University of Kent Msc in psychiatry. Her main research interests are psychiatric training and education. Her current post: Consultant psychiatrist, Kent NHS and social care partnership trust. e-mail: [email protected]

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ABSTRACTS of Research Paper Presentations (In alphabetical order of presenting authors)

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A Brief 10-week Skills Based Group Therapy for patients with Borderline Personality Disorder: and Traits: Preliminary Report Dr. Anoop Sankaranarayanan, Maitland Hospital, Australia

Introduction: Borderline Personality Disorder is associated with substantial medical morbidity, functional impairment, impaired quality of life (QOL), and increased healthcare utilization. Most available psychological techniques require high level of expertise and skill-base, and commitment, is often labor –intensive and long-term. Objective: To describe a locally developed psychological technique along the principles of Dialectical Behavior Therapy that is offered in a group setting for patients with Borderline Personality Disorder who either cannot commit for the full DBT or are unsuitable for the program. Results: The structure and approach of the treatment program will be described with de-identified case-vignettes that highlight some of the benefits and advantages of this program, particularly for a rural based mental health service with resource constraints.

Psychiatric Adjustment in Children and Adolescent with Chronic Fatigue Syndrome

Prof. Said Abdel Azim, Prof. Ola Omar Shaheen, Dr. Hala S. E.Talaat , Dr. Fadia Zyada Objective: The aim of our work to detect the possibility of comorbid psychiatric disorders associated with chronic fatigue syndrome patients, assessment of associated psychosocial stressors. Subjects and Methods: Comparative study between children and adolescence suffering from chronic fatigue syndrome (n= 40), organic (collagen disease) patients (n=30) and healthy children (n=35), who were recruited from the Pediatric Collagen Outpatient Clinic of Abo El Rish university hospital. Who were subjected to Stanford Binet Test, The Achenbach's Child Behavior Checklist (CBCL), Child Depression Inventory (CDI), Anxiety Scale For Children and Lowa Fatigue Severity Scale For Children and adolescence (IFS) while their parents were subjected to Parental Attitude Inventory, Quality Of Life Scale, Social Score to Calculate Social Standards of Families, Social Readjustment Rating scale (SRRS) and Eysenck Personality Questionnaire (EPQ). Results: There was statistically significant difference was found between the CFS and the organic group as regard schizoid, obsessive traits. and phobia.There was statistically significant difference between CFS and the organic group as regard family history of psychiatric disorders. Also, Half of CFS and organic patients have depression while 7.5% of CFS and 16.6%

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among organic have mixed (anxiety and depression) with no significant differences. the mean of externalizing subscale (aggressiveness and delinquency) among CFS higher than the mean of internalizing subscale (anxiety, depression, and withdrawal) regarding (CBCL). The parents of CFS reported physical aggression and negligence compared to organic group. The highest score was Neuroticism (N) as regard (EPQ)while they showed more problems in thinking followed by mood and economic problems regarding Quality Of Life Scale. Conclusion: Children and adolescents with CFS were at high risk of psychiatric disorders and behavioral problems.

Masturbatory behavior in preschool children (0-5 years): A descriptive Egyptian study El Khouly GH, El Farghaly O G, and Hasnaa Abou Seif

Masturbation is the act of a person touching their own sexual organs. In the human lifespan, there is no time peak for the masturbatory behavior. It is not uncommon to observe genital play in the pre pubertal children even in the preschool phase. Parents' reactions to masturbation pose the greatest danger for kids with lots of people grow up with conflicting feelings about sex. However, the scientific contribution in this area is very poor. This work aimed to study the masturbatory behavior in a sample of Egyptian preschool kids with determination of its psychosocial and clinical correlates. Methodology: we interviewed all children‟s mothers and/or fathers attend the pediatric general outpatient clinic for three months from June to September 2008. We screened them with yes/no question about the presence or absence of the masturbatory behavior in the child. If yes we proceed in a designed questionnaire to denote the correlates of this behavior and parental attitude to it. We exclude the child if he/she has past &/or current history of mental sub normality, psychiatric disorder, chronic physical illness and/or acute debilitating illness. A comparison between children with positive masturbatory behavior with those without Results: The prevalence of masturbatory behavior in our sample is common. Parents‟ attitudes and behavior related to masturbation is not appropriate. Positive shaping of child‟s non-masturbatory time is not found. Conclusion: awareness of families about the sexual development of the child is poor and need a concern from the mental health professionals.

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CLINICAL AND NEUROCOGNITIVE CORRELATES OF INSIGHT Dr. Hala El Said Sayyah, Dr. Hanan Azzam, Assis. Prof. Abeer Eissa

Background: Insight has been identified as an important clinical outcome measure in schizophrenia with nearly 60% of patients with schizophrenia evidencing moderate to severe unawareness of having a mental disorder. Explanations of the correlates and attributes of lack of insight are purely hypothetical and pending clarification. Thus the aim of this study is to examine the clinical and cognitive correlates of lack of insight in schizophrenia. Subjects and methods: A sample of 30 schizophrenic patients diagnosed as schizophrenia according to the DSM-IV. Positive and Negative Symptom Scale (PANSS) were applied to assess symptom severity ; Scale of Unawareness of Mental Illness (SUMD); Schedule for the Assessment of Insight (SAI) and Beck Cognitive Insight Scale (BCIS) were used to assess clinical and cognitive insight. Wisconsin Card Sorting Test is used as a measure of executive functions and Wechsler Memory Scale is used to assess attention verbal and visual memory. Results: Visual memory was correlated to insight; there were a tendency to a significant correlation between clinical insight (assessed by SUMD and SAI) and visual attention (p0.08). There was no correlation between any of the insight dimensions and any of the symptom domains measured by (PANSS). Conclusion: Insight is a multidimensional phenomena correlated to some cognitive functions more than to clinical variables of the disease.

Psychodynamic Profile of Diabetic Adolescent Patients Prof. Sanaa Ahmed,Prof. Aza Elbakry,Assis.Prof. Hani Hamed, Dr. Maha Emad

Objective: To investigate the effect of psychosocial factors as self-esteem, body image, coping strategies and family factors on diabetes selfmanagement behavior and subsequent glycemic control in diabetic adolescents. Also, to assess the effect of cognitive and emotional response to disease and treatment on diabetes self-management behavior. Method: cross-sectional study which includes 37 controlled and 30 uncontrolled diabetic adolescents recruited from Abou El-Rich Hospital, All participants were subjected to Semi structured interview, Personal Models of Diabetes Questionnaire, Summary of Diabetes Self-Care Activity, Strengths & Difficulties Questionnaire, Coopersmith Self Esteem Inventory, Body Image Scale, Taxonomy of Children's Coping Strategies and Assessment of Glycosylated Hemoglobin. Results: The group of uncontrolled diabetes shows statistically significant higher emotional problems (p=0.003), higher peer problems (p=0.012) and higher total difficulties scores (p=0.023) compared to the group of controlled

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diabetes. Higher self-esteem in the group of controlled diabetes (14.91 + 3.43) compared to the group of uncontrolled diabetes (10.33+ 4.74). There was highly statistical significant difference regarding Coopersmith SelfEsteem Inventory (p 0.05). Conclusion: Bipolar disorders don't make significant difference in occurrence of domestic violence.

Dermorphin Peptide Action in autistic children: Is it real? Assis. Prof. Omnia Raafat Amin, Cairo University

Introduction: The Dermorphin peptide hypothesis of autism suggests that autism is the consequence of the incomplete breakdown and excessive absorption of peptides with opioid activity (derived from foods which contain gluten and casein), causing disruption to biochemical and neuroregulatory processes. Recently dermorphin, an another opioid similar to betacasomorphin is thought to be one of the cause affecting brain neurons. This

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neuropeptide is 30-40 times more potent than morphin and its endogenous bio-source in humans is still a mystery. It is hypothesized that there is bloodbrain barrier for this peptide causing mental illness disorder in autistic spectrum children.. Biochemical evidence has indicated the presence of increased levels of peptides in the urine of people with autism. Aim: to find the relation between autistic symptoms and dermorphin peptide action in autistic children. To detect the effect of diet elimination (gluten and casein) in symptoms of dermorphin positive autistic children. Subjects and Methods: The participants were 42 autistic children according to DSM IV criteria between the age of 3 and 6 year old and the control group was 18 normal children with the same age. The whole sample was subjected to full clinical child psychiatric sheet, The Childhood Autism Rating Scale, Blood sampling for detection of Dermorphin peptide action. Results: There was no significant difference in severity of autistic criteria in both dermorphin positive and negative autistic children. Improvement of severity of autistic criteria in both opioid positive and negative autistic children after 6 months of casein and gluten elimination. There was no significant difference in the mean of dermorphin blood level between autistic and control group. Conclusion: There was no significant difference in the mean of dermorphin blood level between autistic and control group.

Clinical and Polysomnographic Study of the Sleep Pattern in Patients with Alzheimer’s, Vascular and Parkinson’s Dementias Dr. Osama Elkhouli, Prof. Hoda Salama, Prof. Tarek Assad, Prof. Tarek Molokhia, Dr. Mohamed Hamdy

The aim of the present study was to investigate the sleep architecture and disorders in patients with different types of dementia in comparison with agematched elderly. We aimed to use sleep characteristics as biological marker to differentiate between different types of dementia. The comparison was made between 15 subjects with Alzheimer‟s dementia (AD), 15 subjects with vascular dementia (VD), and 15 subjects with Parkinson‟s dementia (PD) in comparison with 15 age-matched controls (ND) All subjects were assessed by the Pittsburgh Sleep Quality Index (PSQI) and Polysomnography.

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Special Issues in Addiction Treatment: Addressing the Unique Needs of Addict Women in A Recovery Process in Arab Countries. Dr. Rania Mamdouh, Cairo University

Objectives: Designing and implementing a culturally sensitive and specific education and relapse prevention messages that meet the needs for addict women in an Egyptian recovery process. To contribute to upgrading their skills and self assertion, approaching their unique problems and helping their empowerment. Methodology: 25 polysubstance abuse women (24 Egyptian and 1 Arab) joined a therapeutic community rehabilitation program, where the following was assessed: Addiction severity, impulsivity, sexual orientation, lesbianism, co morbidity, medical complications of addiction, effect of social taboo and stigma, psychodynamic correlates and skills assessment. Cognitive therapy, art therapy, life skills training and vocational training in the form of10 group therapy sessions\week and one individual dynamic psychotherapy sessionweek were provided by two psychiatrists, one social worker, 4 females ex addicts counselors and two males ex addicts counselors. Outcomes: Emphasis on skills to overcome socio-cultural challenges were found to be accompanied by favorable outcome than only stressing on classic relapse prevention techniques. Conclusion: It was found that Women from special cultural subgroups can face strong taboos about disclosing family secrets, especially around interpersonal violence. Women can fear abandonment if they violate cultural norms. Those disclosing sexual violations can risk severe devaluation within or expulsion from their community, and they can lack the hope for improvement that could propel them past this barrier. Gender disparities in the society was found also affecting the management outcome.

The US System of Care for Substance Abuse Treatment: What is it, What is it Supposed to Do? Prof. Richard A Rawson, Ph.D. Professor, UCLA School of Medicine

In the United States, the treatment of substance use disorders has developed over the past 40 years in a somewhat patchwork and poorly planned response to a variety of drug abuse epidemics and the ongoing challenges of treating alcohol use disorders. The resulting "treatment system" is not really a "system" at all. It is a collection of treatment organizations, delivering services to substance abusers with a combination of medicines, therapies and self help approaches which are funded at a level of between 3 to 5 billions of dollars per year. Recently taxpayers have begun to ask the question: "What are we getting for this money?" It has led to a very large effort to describe

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and define the "system of care" and to determine how to evaluate the benefits of treatment.

What type of Ego are we dealing with, here? Ego functions in a group of Substanc Abusers: A Metanalysis Prof. Amani El Rasheedy, Assis.Prof. Salwa Erfan, Dr. Moustafa El Rakhawy, Dr. Nahed Khairy

Sustainable recovery is the cornerstone of rehabilitation programs. The Ego is the agency recruited in this process: it is the ego that will work with the challenges, filter distracters, and resist falling back to old learned habits of dealing with stress, cues and new material. It is the choice for change: the volition to achieve recovery that renders recovery possible. Objective: to identify which of the 12 Ego Functions are most likely to be impaired in Substance Abusers. Methodology: The Egyptian studies that attempted to assess Substance abusers from the perspective of Ego functions using Bellack's Clinical Assessment of Ego Functions are being presented in this metanlysis. Searching for these studis was conducted by word of mouth, on a national database as well as through experts in the field. Results: Each study conducted its research from a different perspective: eg; anxiety, abuse, personality...etc. Recommendation: The use of Ego function assessment is of paramount value for the purpose of management. Assessing them should be a routine measure in this very challenging population.

Psychological aspects in a sample of vitiligo patients

Dr. Sherine Abd El-Mawella, Dr. Heba Fathy, Dr. Huda Abdou Hussen, Dr. Marwa Mohamed Fawezy Introduction: Vitiligo is a skin condition resulting from loss of pigmentation, which produces white patches (macules) on the skin. Both men and women are equally vulnerable to vitiligo. Stressful life events or physical trauma can often precipitate the onset of the disease . Patients with vitiligo are very sensitive to the way others look at them and they often remain withdrawn, anticipating rejection. In general, young adults with severe vitiligo, and those for whom appearance is very important have more difficulty coping with the disease. Particularly in teenagers, mood disturbances including irritability and depression are common. Vitiligo can affect a person's emotional and psychological well-being and may create difficulty in social adjustment. Objective: To study the quality of life, body image and most common defenses mechanisms used by these patients to cope with their illness, and to assess the gender difference.

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Subjects and Methods: 90 subjects were randomly selected in a comparative cross sectional study. The sample consists of two groups: a group of vitilligo (n=45), and control group (n=45). The patients were recruited from dermatological out patient clinic. After taken a consent from ethical committee of dermatological department in kasr Aini hospital. The patients were assessed using Defense style Questionnaire, General Health Questionnaire, Quality of life scale and Body image scale. Results: Body image was disturbed in 57.8% of cases and 8.9 % of control and this difference was statistically significant and it was disturbed in females (72%) more than males( 40%) . Quality of life scales were lower in the cases than the control and better in male than female in all the scales and these differences reached a statistically significant difference. Mature and neurotic defences were higher in the control group than the cases while the immature defences as a whole were higher in the cases group but the difference were not significant unless in the projection, autistic fantasy, denial, displacement and somatization.

Clarifications on Alzheimer’s Dementia

Dr. Soha Abdel Latif, Lecturer of Psychiatry, Faculty of Medicine, Alexandria University. Dementia of the Alzheimer‟s type (DAT) increases in prevalence with increasing age. The classic course is an onset in the patient‟s 50s or 60s , with gradual deterioration over 5-20 years and an average survival expectation approximately 8 years. Until now no definite curative treatment has been put forth for this catastrophic disorder. Without a real understanding of the attributable etiological factors of DAT, we can never reach satisfactory treatment for this irreversible condition. Therefore, an attempt to clarify recent etiological data for DAT will be made, opening up possible new therapies for DAT‟s patients.

Implementing New Strategy for Addiction Services in Egypt Prof. Tarek A.Gawad, Cairo University The 3rd Egyptian National Strategy for Combating & Treatment of Addiction were launched on October 2007 and based mainly on reducing availability and demand on drugs of addiction. One of the main seven components of the strategy is Treatment Services of which Harm Reduction was cautiously introduced as a result of the WHO recommendation. During the 1st year of implementation a strong epidemiological data was obtained regarding patterns and trends also medical complications mainly blood borne infections. In one month upon implementing the screening for newly admitted to the

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service the rate of HCV reported were 54% and 5% were reported as HIV serological positive of those admitted to the main addiction hospital in Cairo. This presentation will highlight the cons & pros also the data obtained during this year.

Psychotherapeutic Benefits of The Exercise for Geriatric Age Group” A Review of Literature. Mr. Tarun Amalnerkar, Masterskill University of Health Sciences

Purpose of the study: The purpose of the reviews is to determine the physiotherapy role in treatment of the “geriatric‟s associated psycho morbidity” that is psychotherapeutic interventions of exercises and are being used clinically. Methodology: A systematic review was performed to establish specific efficacy of physiotherapy in reducing old age related psychological disorders. “Relevant studies and information collected from the sciencedirect, cochrane library, pubmed, and pedro databases embase, amed, mantis, cinhal. Loneliness, relative lack of social interaction augments awareness of age related physiological alteration and causes depression and various cardiovascular, respiratory abnormalities. Result : It tranquillize and unruffled patients by plummeting muscle spasm, regularizing cardiovascular abnormality by regularizing cardiac cycle by regulating ventricular contraction and improving peripheral circulation at the same time perk up respiratory system by reducing the use accessory muscle of respiration, reduces anxiety associated bronchospasm so alveolar functioning. Conclusion: Assorted studies revels sturdily the impact of exercises in treatment of psychological disorders. However its applicability in rehabilitation of geriatrics is still needs more detailed and evidence based researches, in future we can develop proper protocols and techniques specific in intensity & duration to the different old age group suffering with psychiatric conditions.

Psychiatry in the Neuroscience Era, Integrating knowledge and concepts. Prof. Wafaa L. Haggag, Suez Canal University

The Our hope in the 21st century should be for the scientific maturation of psychiatry that will allow us to use and integrate knowledge with the new concepts that address the complex multilevel phenomena of psychiatric disorders. We need a new scientific foundation for psychiatry which would consider the disorders commonly treated by psychiatrists in terms of the physiological baseline from which they depart, much as the heart disease is understood as deviation from normal cardiac function.

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Currently the relevant physiological focus of psychiatry is the social brain. The social brain concept allows psychiatry to utilize pathogenesis in a manner parallel to practices in the other specialties. Cognitive, Social and Moral neuroscience are new fields of study concerned with identifying the neural processes underlying cognitive, social and moral behavior.

Case Vignette 1 A male consultant in general psychiatry is persuaded to see a troubled female nurse in the same team „as a friend‟. They meet after hours in an empty outpatient department to avoid any embarrassment to the nurse. She asks that no official notes are kept for fear that colleagues may see them and it would be a „black mark‟ on her file in the eyes of management. The consultant, for the same reason, speaks to no one about the arrangement. At the end of the 1st session, the nurse is in tears and the consultant gives her a „friendly hug‟ - during which a cleaner barges into the room. The consultant takes the nurse home in his car because he considers she is too distressed to drive. He stays for a cup of tee and tries to comfort her further by telling her about his own marital separation and his subsequent recovery. In the following weeks, the nurse becomes increasingly demanding and sends a number of passionate letters. When the consultant tries to distance himself, she threatens to „expose‟ his seduction of her, citing evidence from the cleaner. Pitfalls Good practice  

Case Vignette 2

A male consultant child psychiatrist is contracted by the staff of a residential young people‟s home about one of his patients, a 15 year-old girl in the care of the local authority. She is extremely upset but will not talk to anyone. The consultant is unable to attend immediately but agrees to visit the home after work. By the time he gets to the residential home it is 8 p.m. The young girl has barricaded herself in her room and agrees to let only the consultant in. He sees her on his own in her room. After half an hour he finds that the young girl is much more settled. She describes the staff as being too authoritarian and says she has no freedom. On his way out the consultant has a fleeting conversation with the staff and recommends that the patient be left alone. Several weeks later the girl in question accuses the consultant of sexual harassment and abuse while visiting her in the residential room. Pitfalls Good practice  

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