Ibrahim Saleh Al-Busaidi

Poststroke Anxiety and Depression: Findings from Saudi Arabia

BACKGROUND Anxiety and depression are the two most frequent neuropsychiatric manifestations of stroke. In Saudi Arabia, there is a general lack of research into anxiety and depression in stroke patients when compared with physical complications. METHODS We assessed the prevalence of anxiety and depression in 76 stroke patients from Saudi Arabia using the Hospital Anxiety and Depression Scale (HADS). RESULTS In this study, 18.4% and 23.7% of the patients met the HADS criteria for moderate or severe anxiety and depression, respectively. Female gender was the only significant predictive factor associated with both anxiety (P = .03) and depression (P = .04), where longer duration since stroke was only associated with anxiety (P = .02) but not depression (P = .25). CONCLUSIONS These results suggest that anxiety and depression are commonplace in Saudi patients with stroke, a finding that has implications for clinical practice and future research.

Anxiety and depression in Parkinson's disease patients in Saudi Arabia Global neurology

Parkinsons disease is the most common movement disorder in Saudi Arabia. Among the most common non-motor symptoms of PD are anxiety and depression. Mental health disorders, however, still remain taboo subjects in the region. This brief article sheds light on a small study conducted on Saudi PD patients, and discusses current challenges for managing them in the region. Given the wider readership of JNSs Global Neurology, this piece is hoped to appeal to the appropriate audience. Classically a motor disorder, Parkinsons disease (PD) results in many non-motor symptoms, some of which have been recognised since the first description of the “shaking palsy” by James Parkinson [1]. Only recently, however, research on non-motor symptoms of PD has gainedmomentum [2–4]. The PRIAMO study evaluated 1072 Italian PD patients and observed that 98.6% of PD patients experienced such symptoms [5]. Psychological complaints were the most common, including anxiety in 56% and depression in 22.5% patients [5]. Sociocultural factors have been shown to influence the prevalence [6,7], perception [8] and even clinical presentation of anxiety and depression [9,10]. Large-scale epidemiological studies on mental health disorders are largely lacking in Saudi Arabia, as most studies involve selective patient samples (e.g. medical students or dialysis patients) [11–13]. In a cross-sectional study from South-eastern Saudi Arabia on general practice patients (n = 280), around 10% screened positively for depression [14]. Little is known about the prevalence and nature of anxiety and depression in PD patients in Saudi Arabia. In a clinical study [15] that alluded to non-motor symptoms in 54 PD patients in Saudi Arabia, depression was the second most prevalent symptom, exceeded only by constipation. The only available data on anxiety and depression come from a small cohort (n=18) of Saudi PD patients (Alamri, unpublished).When compared with another ageand sex-matched cohort from New Zealand (n = 30), Saudi PD patients scored significantly higher on the HADS depression subscale (mean 11.7 vs. 9.5, p = 0.004), but not anxiety subscale (4.7 vs. 5.6, p = 0.36) or the total HADS scores (11.7 vs. 9.5, p = 0.23).

Care of Patients with Diabetic Foot Disease in Oman

Diabetes mellitus is a major public health challenge and causes substantial morbidity and mortality worldwide. Diabetic foot disease is one of the most debilitating and costly complications of diabetes. While simple preventative foot care measures can reduce the risk of lower limb ulcerations and subsequent amputations by up to 85%, they are not always implemented. In Oman, foot care for patients with diabetes is mainly provided in primary and secondary care settings. Among all lower limb amputations performed in public hospitals in Oman between 2002-2013, 47.3% were performed on patients with diabetes. The quality of foot care among patients with diabetes in Oman has not been evaluated and unidentified gaps in care may exist. This article highlights challenges in the provision of adequate foot care to Omani patients with diabetes. It concludes with suggested strategies for an integrated national diabetic foot care programme in Oman.