Omer E. F. El-Rufaie

Reliability, Validity, and Factor Structure of the Arabic Version of the 12-Item General Health Questionnaire:

The aim was to examine the psychometric properties of the Arabic 12-item General Health Questionnaire in a sample of university students. A sample of 157 university students was screened using this questionnaire and the Hopkins Symptom Checklist-90. A standardized clinical interview using SCID was conducted on a subset of screened students. Reliability, validity, and factor analysis of the questionnaire were evaluated. Using factor score discrimination between cases and noncases was also evaluated. The Arabic version of the GHQ-12 proved to be reliable as indicated by Cronbach alpha of .86. The best balance between sensitivity and specificity was found at the General Health Questionnaire cut-off point of 15/16: at this threshold, sensitivity was .88 and was paired with a specificity of .84. Principal component analysis with varimax rotation identified three factors, namely, Factor A (general dysphoria), Factor B (lack of enjoyment), and Factor C (social dysfunction). Factors A and C discriminated between clinically distressed and clinically nondistressed subjects. The General Health Questionnaire-12 as a whole is a reliable and valid screening tool in university settings.

Somatized mental disorder among primary care Arab patients: I. Prevalence and clinical and sociodemographic characteristics.

The aims of this study were to estimate the prevalence of somatized mental disorder (SMD) in comparison to psychologized mental disorder (PMD) among a sample of primary health care (PHC) Arab patients, and to investigate the clinical and sociodemographic characteristics of SMD. The first stage of study was conducted by general practitioners (GPs), using the 12-item General Health Questionnaire (GHQ-12). The second stage was carried out by a psychiatrist using the Clinical Interview Schedule (CIS) and an inquiry schedule. Specific operational criteria were used to identify SMD and PMD. The estimated prevalence rate of SMD among the total screened sample was 12%. SMD patients constituted 48% of the psychiatric patients identified, whereas, for the PMD group, this figure was 42%. Educational level was significantly lower in the SMD group. Headache, backache, and abdominal pain were the most commonly presented somatic symptoms. The symptoms pursued a chronic and persistent course and most patients experienced multiple symptoms. The most common ICD-10 psychiatric diagnoses among both SMD and PMD patients were mixed anxiety and depressive disorder, generalized anxiety disorder, and mood and adjustment disorders. Recurrent depressive disorder and dysthymia were significantly more prevalent in the PMD group. The severity of psychiatric illness identified was greater among psychologizers than the somatizers of mental disorder.

Pediatric injuries in an Arabian Gulf country.

OBJECTIVE: To determine the common types of injuries among children (0-14 years) in Al-Ain, United Arab Emirates (UAE). DESIGN: A retrospective descriptive hospital based study. SETTING: Al-Ain Medical District, Al-Ain Teaching Hospital, UAE. SUBJECTS: All patients aged 0-14 years seen at Al-Ain Teaching Hospital for injuries during 1994. RESULTS: The number of children with an injury who attended the emergency room was 16,518 (69.9% boys; 30.1% girls). Injury rates were higher among non-UAE nationals. The most frequent reason for hospital admission was poisoning (41%). In the age group < 5 years, the most common causes were falls, blunt trauma, and burns or scalds, while in the 5-9 year and in 10-14 year groups the most frequent cause was road traffic accidents (RTAs). Fights and sporting injuries were also seen frequently in children aged 10-14 years. CONCLUSION: Injury rates were higher in boys and RTAs mostly occurred in children over 10 years. The majority of cases (56%) occurred among non-UAE nationals, who are usually of lower socio-economic status. RECOMMENDATION: Injuries can be prevented by developing strategies to substantially increase the profile of health education to parents and children, by educating policy makers and health professionals, and by environmental modification, legislation, and enforcement. The UAE government can play an important part by establishing and supporting injury prevention programs with these goals.

SEXUAL DYSFUNCTION AMONG TYPE II DIABETIC MEN: A CONTROLLED STUDY

This was a primary health care (PHC) study aiming at the investigation of the prevalence and nature of sexual dysfunction among a sample of type II diabetic men, in comparison with the control groups of hypertensive men and apparently healthy men with no chronic medical illness. Subjects were assessed by PHC physicians using a sexual dysfunction semistructured questionnaire and a questionnaire designed for medical history and sociodemographic data. Clinical assessments for peripheral vascular disease and peripheral neuropathy were carried out for the diabetic group only. The estimated high prevalence rate of sexual dysfunction among the diabetic group (89.2%) was significantly greater than the hypertensive group (43.6%), and the apparently healthy group (16.7%). The commonest clinical presentations of sexual dysfunction among the diabetic men were impaired morning and spontaneous erections, erectile weakness, and ejaculatory disturbances. Lesser common presentations were reduced sexual interest and complete erectile failure. There were no significant associations between the sexual dysfunction and clinically obvious physical complications of diabetes, or factors that might affect sexual functioning (i.e., alcohol or drug misuse or marital disharmony). However, the validity of these results is questioned due to the small numbers used for statistical analysis.

Psychiatric morbidity among sentenced male prisoners in Dubai: Transcultural perspectives

Abstract The aim of this study was to investigate the prevalence and nature of psychiatric morbidity among sentenced male prisoners in Dubai, United Arab Emirates (UAE). Sociodemographic data were collected from 142 UAE national prisoners. All were interviewed by a psychiatrist who administered the CIS and the CAGE questionnaires, documented self-reported substance misuse, previous seizures and deliberate self-harm and, finally, made a clinical ICD-10 diagnosis when appropriate. A psychiatric diagnosis was made in 25% of the sample, problematic drinking was identified in 28% and drug and volatile substance misuse in 63%. Evidence for both problematic drinking and history of drug withdrawal phenomena was demonstrated in 16% of the sample. Previous seizures were reported by 13% and self-harm by 32%. These results are suggestive of higher rates of substance misuse compared to other relevant studies. Among other explanations, this is most likely related to the strict rules prohibiting such substances: their u...

The rationale, development and reliability of a new screening psychiatric instrument

AbstractBackground: This paper describes the rationale, development, reliability and validity of a new screening psychiatric instrument. Method: The instrument comprises 26 items that tap the cardinal features of main psychiatric categories as defined by ICD-10 and DSM-IV. These items were adapted from various structured and semi-structured diagnostic interviews that yield ICD-10 and DSM-IV psychiatric diagnoses. After a training course, 12 trainees and the trainer rated blindly the 26 items on 45 subjects (22 with psychopathology and 23 without). Inter-rater reliability coefficient (Kappa) was estimated between trainees and the trainer on each item of the instrument. The total score on the new instrument was then correlated with the total score on the Arabic Self Reporting Questionnaire (SRQ-20) and the Arabic version of the General Health Questionnaire (GHQ) in a random sample from the general population (n=365). Logistic regression was utilised to estimate the power of the total score on the new instrument in discriminating between cases and non-cases as classified by the SRQ-20. Results: Excellent levels of agreement (Kappa > 0.80) were found for all items except for obsession (Kappa = 0.65) and for depressed mood (Kappa = 0.70). Moderate correlations were found between the total score on the new instrument and total score on SRQ-20 (r = 0.69) and the total score on the Arabic GHQ (r = 0.7). The new instrument correctly classified 89% of subjects into cases and non-cases. Conclusions: The results of this study indicate that the new instrument is a highly reliable and valid screening instrument. The authors are now investigating its test-retest reliability and its procedural validity.

The diagnostic stability of ICD-10 psychiatric diagnoses in clinical practice

This study examines the stability of ICD-10 diagnoses of patients admitted to Al Ain (United Arab Emirates) inpatients psychiatric unit during the period from November 1993 to August 1995. Diagnostic stability is a measure of the degree to which diagnoses remained unchanged at a later hospital admission. One hundred and seven patients were admitted more than once during this period, accounting for 168 readmissions. High levels of diagnostic stability were found for ICD-10 Fl-psychiatric disorders (100%), F2-schizophrenia (87%), F3-bipolar disorders (87%) and F3-depressive disorders (73%). A poor level of stability was found for patients with neurotic, stress related and adjustment disorders (F4), ranging from zero for somatoform disorders to 50% for generalized anxiety and panic disorders. Poor levels of stability were also found for other psychoses (excluding schizophrenia and affective psychoses) and personality disorders. We conclude that the introduction of ICD-10 as a formal diagnostic system has greatly improved the temporal stability of the most commonly encountered psychiatric disorders (ICD-10 Fl to F3 disorders), confirming the construct validity of those psychiatric disorders. Further investigations are required to evaluate the diagnostic stability of neurotic and other psychotic disorders.

Predictors of length of hospital stay

The purpose of this study was to determine whether diagnostic, clinical, and demographic variables would adequately predict variation in length of hospital stay in an acute-care psychiatric unit. Three hundred and ten patients with first-ever admissions were recorded to have been admitted to the unit during the period from November 1993 to August 1995. The following independent factors were tested for their predictiveness in explaining variation in length of hospital stay: sex, marital status, nationality, ICD-10 Axis 1 diagnosis, “receipt” of electroconvulsive therapy, type of medication received, number of medications received, associated disabilities on admission, and employment status. Demographic variables were found to be poor predictors of length of hospital stay. The rest of the variables explained in total about 50% of variation in the dependent variable. Stepwise regression analysis showed that the best subset of the independent variables explained about 27% of the variation. The significance of...

Personality profile among primary care patients: experimenting with the Arabic IPDE ICD-10

Objective: To estimate the prevalence of personality disorder (PD) among primary health care (PHC) patients, and to investigate the characteristic features of the International Personality Disorder Examination, the ICD‐10 module (IPDE ICD‐10).

Psychiatric morbidity among hypertensive men: A controlled study

A study group of 39 hypertensive male patients and 36 healthy male control patients were recruited for this study, done in a primary health care (PHC) centre in Al Ain, United Arab Emirates. The aim was to determine the prevalence and nature of psychiatric morbidity among the hypertensive group compared with the control group. A preliminary interview for recording medical history and sociodemographic data was carried out by PHC physicians. This was followed by a psychiatric interview by a psychiatrist using the Clinical Interview Schedule (CIS). Psychiatric diagnoses for identified cases were recorded in accordance with ICD-10 criteria. There was no significant difference in the prevalence of psychiatric morbidity between the hypertensive group (17.9%) and the healthy group (5.6%). This is against the hypothesis that chronic medical illnesses are associated with higher psychiatric morbidity. The psychiatric morbidity identified consisted mainly of generalized anxiety disorder, depressive episode, and mixe...