Said Yousef

Attention Deficit Hyperactivity Disorder and Environmental Toxic Metal Exposure in the United Arab Emirates

No systematic studies have been carried out on the effects of toxic metals on childhood behavior in the Gulf Region including the UAE. The relationship between blood levels of heavy metals and Attention Deficit Hyperactivity disorder (ADHD) were explored in school-aged children of UAE and it was found that increased blood concentrations of lead (Pb), manganese (Mn) and zinc (Zn) were significantly associated with ADHD. The findings suggest that monitoring for exposure to heavy metal levels and education on potential child health hazards related to them are indicated.

Help-seeking behaviour of patients attending the psychiatric service in a sample of United Arab Emirates population.

Background: Many patients suffering from psychiatric disorders seek non-professional care before attending specialized services. Aims: To study the help-seeking behaviour of patients referred to the psychiatric department of Al-Ain Hospital, which is the main university teaching hospital in UAE. Methods: This study was a descriptive cross-sectional epidemiological survey. All new patients attending the psychiatry out-patient clinic at Al-Ain Hospital were screened for nine consecutive months from March to November 2003 inclusive. Results: The sample consisted of 106 patients (52 male; 54 female). Prior to presenting to the psychiatric service, 44.8% consulted faith healers, 31% of whom had had a previous experience with them; 45% reported some improvement but their symptoms recurred later, while 47% reported no improvement. In 8% their symptoms worsened for the current episode. Treatments received were herbal (29.8%) and prayer (70.2%). Of the sample, 43.4% consulted a primary care physician before presenting to the secondary psychiatric care. Conclusion: In this sample a sizable number of patients sought alternative methods of treatment before attending the specialized psychiatric services.

Behavioral correlation with television watching and videogame playing among children in the United Arab Emirates

Abstract Objective. Television viewing and videogame use (TV/VG) appear to be associated with some childhood behavioral problems. There are no studies addressing this problem in the United Arab Emirates. Methods. One hundred ninety-seven school children (mean age, 8.7 ± 2.1 years) were assessed. Child Behavior Checklist (CBCL) subscale scores and socio-demographic characteristics were compared between children who were involved with TV/VG more than 2 hours/day and those involved less than 2 hours/day (the recommended upper limit by The American Academy of Pediatrics). Results. Thirty-seven percent of children who were involved with TV/VG time of more than 2 hours/day scored significantly higher on CBCL syndrome scales of withdrawn, social problems, attention problems, delinquent behavior, aggressive behavior, internalizing problems, externalizing problems and the CBCL total scores compared with their counterparts. Moreover, these children were younger in birth order and had fewer siblings. After controlling for these confounders using logistic regression, we found that TV/VG time more than 2 hours/day was positively associated with withdrawn (p = 0.008), attention problem (p = 0.037), externalizing problems (p = 0.007), and CBCL total (p = 0.014). Conclusion. Involvement with TV/VG for more than 2 hours/day is associated with more childhood behavioral problems. Counteracting negative effects of the over-involvement with TV/VG in children requires increased parental awareness.

Learning disorder and blood concentration of heavy metals in the United Arab Emirates

Children are frequently exposed to toxic metals in the environment, and their developing central nervous system is particularly vulnerable to their effects. This study examined the blood level of heavy metals in children with learning disorder (LD) as compared to children without LD in the United Arab Emirates (UAE). Significantly high blood concentrations of seven heavy metals were found in children with LD. Further analysis using forward stepwise logistic regression showed that molybdenum levels and family history of developmental problems were the best predictors of LD. Our findings suggest the need for monitoring for toxic metals in the environment.

Suicidal Behavior and Attitudes Among Medical Students in the United Arab Emirates

BACKGROUND Few studies have investigated suicidal behavior and attitudes of medical students. We are not aware of any previous reports emerging from the Arab world. AIMS To investigate suicidal behavior and attitudes among medical students in the United Arab Emirates (UAE). METHOD The prevalence of suicidal ideation and attempts as well as attitudes toward suicide and reactions to a hypothetical suicidal friend were assessed using a self-report survey. Furthermore, the survey included the self-assessment of the current mood and religiosity, and socio-demographic information. RESULTS A group of 115 medical students (mean age 20.7 years, 59.1% female) participated in the survey. The prevalence of lifetime suicidal ideation was 17.5% and of suicide attempts 1.8%. In general, students showed very low acceptability of suicide, strong beliefs in the punishment after death, and highly endorsed communicating problems with parents. Moreover, high acceptance of and support for a suicidal friend were found. Sadness was associated with higher acceptability of suicide and fewer beliefs in punishment after death. Religiosity was associated with less acceptability of suicide, seeing suicide in context of mental illness, communicating problems with parents, and greater support for a suicidal friend. CONCLUSIONS The prevalence of suicidal ideation and attempts among medical students in the UAE was in the lower range in international comparison. Negative attitudes toward suicide were accompanied by a strong support for a suicidal friend, and both were related to religiosity.

Suicide rates in the national and expatriate population in Dubai, United Arab Emirates

Background: Reports on suicide from the Gulf region are scarce. Dubai is a city with a large expatriate population. However, total and gender-specific suicide rates for the national and expatriate populations are not known. Aims: To investigate total and gender-specific suicide rates in the national and expatriate population in Dubai and to elicit socio-demographic characteristics of suicide victims. Methods: Registered suicides in Dubai from 2003 to 2009, and aggregated socio-demographic data of suicide victims were analysed. Suicide rates per 100,000 population were calculated. Results: Suicide rate among expatriates (6.3/100,000) was seven times higher than the rate among the nationals (0.9/100,000). In both groups, male suicide rate was more than three times higher than the female rate. Approximately three out of four expatriate suicides were committed by Indians. The majority of suicide victims were male, older than 30 years, expatriate, single and employed, with an education of secondary school level and below. Conclusion: Further research on risk factors for and protective factors against suicide, particularly among the expatriate population, is needed. Epidemiological monitoring of suicide trends at the national level and improvement of UAE suicide statistics would provide useful information for developing suicide prevention strategies.

Secondary association of PDLIM5 with paranoid schizophrenia in Emirati patients.

Schizophrenia is a clinically and genetically heterogeneous disorder of unknown etiology. PDLIM5 variants have been linked to schizophrenia and other related neuropsychiatric disorders and upregulated in the brain of schizophrenia patients suggesting a possible pathogenic role in disease progression. The aim of this study is to examine the potential association of schizophrenia in Emirati patients with previously reported variants in PDLIM5, PICK1, NRG3 or DISC1 genes. Consequently, we found a secondary association between PDLIM5 variants and the paranoid subtype of schizophrenia in Emirati Arabs suggesting that PDLIM5 may represent a determinate/marker for schizophrenia subtype specification. However, no associations were found with variants in PICK1, NRG3 or DISC1 genes.

Prevalence of and factors associated with burnout among health care professionals in Arab countries: a systematic review

BackgroundBurnout among healthcare professionals is one of the key challenges affecting health care practice and quality of care. This systematic review aims to (1) estimate the prevalence of burnout among health care professionals (HCP) in Arab countries; and (2) explore individual and work-related factors associated with burnout in this population.MethodsMultiple electronic databases were searched for studies published in English or Arabic from January 1980 to November 2014 assessing burnout (using the Maslach Burnout Inventory; MBI) amongst health care professionals (HCP) in Arab countries.ResultsNineteen studies (N = 4108; 49.3% females) conducted on HCP in Bahrain, Egypt, Jordan, Lebanon, Palestine, Saudi Arabia and Yemen were included in this review. There was a wide range of prevalence estimates for the three MBI subscales, high Emotional Exhaustion (20.0–81.0%), high Depersonalization (9.2–80.0%), and low Personal Accomplishment (13.3–85.8%). Gender, nationality, service duration, working hours, and shift patterns were all significantly associated with burnout.ConclusionsWithin the constraints of the study and the range of quality papers available, our review revealed moderate-to-high estimates of self-reported burnout among HCP in Arab countries that are similar to prevalence estimates in non-Arabic speaking westernized developed countries. In order to develop culturally appropriate interventions, further research using longitudinal designs is needed to confirm the risk factors for burnout in specific HCP settings and specialties in Arab countries.

Associations Between the Order of Drug Use Initiation and the Development of Opioid Dependence Among Egyptian Adults: Cannabis as a Gateway and Culture-specific Drug

Aim: The primary aim of this study was to study, for the first time to our knowledge in Egypt, the relationship of initial use of cannabis as a gateway drug to later dependency on opioid among Egyptian adults. Methods: Forty-eight patients were recruited from outpatient psychiatric attendees at a psychiatric hospital, Cairo, Egypt. A semistructured interview was conducted to assess the relationship of initiating cannabis abuse to later opioid dependence, and its relationship to demographic and clinical variables. Results: The most frequent age group at the time of presentation of the sample was 15 to 25 years (47.9%). The mean age of starting abuse of drugs was 15.8 years (SD=2.6; 11 to 25 y): 42 individuals (87.5%) started with cannabis and 4 (8.3%) started with alcohol. The entire group was dependent on opioid and 46 (95.5%) were dependent on cannabis at the same time; 19 (39.6%) were dependent on alcohol. The significant predictors of being dependent on opioid were being single (r2=0.650, P=0.001), having a Vocational Education and Training qualification (r2=0.329, P=0.02), an early age of onset of use (r2=0.327, P=0.02), cannabis as the initial drug used (r2=0.487, P=0.001), and the use of cough medicine (r2=0.516, P=0.001) or tramadol (r2=0.363, P=0.01) currently. Conclusions: The results of this study indicate that the typical pattern of drug abuse among Egyptians starts with cannabis but not alcohol, as alcohol is completely forbidden in Islam, which is not the case with cannabis.

The association of depression and anxiety with unhealthy lifestyle among United Arab Emirates adults

Dear Editor The prevalence of mental health disorders in the United Arab Emirates (UAE) has increased over the past several decades (Abou-Saleh et al. 2001). According to local estimates, approximately between 55% and 73% of patients attending primary care in the UAE suffer mental disorders (El-Rufaie & Absood, 1993). The commonest diagnoses were depressive disorders 55%, mixed anxiety-depression 13% and anxiety disorders 12%. Worldwide research showed that depression and anxiety are major causes of morbidity and mortality (Harter et al. 2003; Chapman et al. 2005; Amaddeo & Tansella, 2010) and are associated with impaired health-related quality of life and social functioning, as well as with increased risk for disability (Kivimakl et al. 2009). Recent research indicates that people with major depression or anxiety disorders particularly panic disorder, have a higher prevalence of regular smoking than those without such conditions (McCabe et al. 2004). Obesity has been associated with increased life time risk for major depression and panic disorder or agoraphobia, particularly among females (Baumeister & Harter, 2007; Carpiniello et al. 2009), and physical inactivity has been associated with depression (Allgower et al. 2001). In the meantime, exercise has been found to be an effective adjunct to the usual forms of treatment for depression, anxiety and has even a protective effect against suicide (Dunn et al. 2005; Muller et al. 2009). In this study, we examined the extent to which depression and anxiety were associated with smoking, physical inactivity and obesity among UAE adults using data from the population-based UAE health and life survey 2000 (UAEHALS 2000). To our knowledge, this is the first large population-based study to examine these associations using the Hospital Anxiety and Depression Scale (HADS; Zigmond & Snaith, 1983).