Sufyan Sabri

Child Psychiatric Disorders in a Primary Care Arab Population

Objectives: Physical and psychiatric comorbidity is relatively common in general practice but there have been few systematic studies using clinical interviews of children attending the primary care services in the Arab population, and none from the Gulf countries. This study was undertaken to determine the prevalence and nature of child psychiatric morbidity in primary care in the United Arab Emirates (UAE). Method: Systematic psychiatric evaluations were carried out on consecutive children aged 6 to 18 years visiting their primary care doctors in Al Ain. The sample consisted of 141 (50.7%) boys and 137 (49.3%) girls. Results: Forty-three percent of the 278 children received a DSM-IV diagnosis. Of these, 46 (38%) were males and 74 (62%) were females. However, only 1.1% (3/120) of the patients consulted general practitioners for a primary psychiatric symptom. The most common diagnosis was anxiety disorder followed by depression. Obsessive compulsive disorder was present in 11%, conduct disorder in 7%, and attention deficit hyperactivity disorder in 3% of those with a diagnosis. A statistically significant association was found between DSM-IV caseness and female gender, higher number of children in the household, relationship problems in the family, physical illness and family history of psychiatric disorder. Other factors that did not show any significant association were age, nationality, socioeconomic status, parental education or occupation, scholastic performance or developmental delay in the child, or parental consanguinity. Conclusion: Our findings suggest that psychiatric disorders are common among young people of Arab origin attending primary care facilities, and that doctors need to be vigilant about this possibility.

Subjective life satisfaction and mental disorders among older adults in UAE in general population

Life satisfaction is widely considered to be a central aspect of human welfare. Many have identified happiness with it, and some maintain that well‐being consists largely or wholly in being satisfied with ones life. Empirical research on well‐being relies heavily on life satisfaction studies.

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.

Familial Predictors of Childhood Shyness: A Study of the United Arab Emirates Population

Objectives: Phobic anxiety disorders generally breed true. In this regard, family studies have suggested an association between childhood shyness and maternal social phobia. In this study, the relationship between childhood shyness and maternal social anxiety was examined. Subjects andMethods: 203 5-year-old children from an Arabian Gulf community and their mothers were evaluated. The children were assessed in stage 1 using the shyness scale of Stevenson-Hinde and Glover and the Preschool Behavior Checklist (PBCL), while mothers completed the Liebowitz Social Anxiety Scale. In the second stage, blind clinical interviews were carried out to ascertain the diagnosis of psychiatric diagnoses, if any, using DSM-IV criteria. Results: 27% of the children were identified as shy using the shyness scale of Stevenson-Hinde and Glover and 19% scored above the cutoff for behavioral disturbance on the PBCL. Child shyness was associated with female gender and maternal social anxiety as indicated by scores on the Liebowitz Social Anxiety Scale, while an inverse relationship was noted with behavioral disturbance. The odds of the child having a high shyness score was increased if the mother had social anxiety (odds ratio = 2.14) and the child lived in a family that was ‘not socially active’ (odds ratio = 1.42). Conclusion: Our initial findings suggest that there may be a complex interaction between maternal social anxiety and family sociability in childhood shyness. Prospective longitudinal work is indicated.

Epidemiological Study of Attention Deficit Hyperactivity Disorder Among School Children in the United Arab Emirates

Background: While extensive research data is available on Attention Deficit Hyperactivity Disorder (ADHD) from industrialized countries, very few studies have been undertaken in the developing countries including the Arab world. Methods: A representative random sample of school children aged 5 to 16 years was evaluated for the prevalence of ADHD using the Conner Parent and Teacher Scale in Dubai, Al-Ain and Ras Al- Khaima to represent the urban, semi-urban and rural population of UAE. Results: The rate of ADHD was 4.1% as per the parent report and 3.4% as per the teacher report. Children with ADHD were noted to have a range of psychiatric co-morbidity. Conclusion: Our findings suggest the importance of comprehensive and early screening program for ADHD and we hope that this data on the prevalence and associated factors can provide the basis for setting priorities and designing interventions.

Sociodemographic and Clinical Characteristics of Patients with Dissociative Disorders in an Arabian Society

Objective: The aim of the study was to determine the sociodemographic and clinical characteristics of patients with dissociative disorders among psychiatric patients in the population of the United Arab Emirates. Subjects and Methods: Six hundred inpatients with dissociative disorders were approached during the period 1997–2003, and 468 agreed to participate in the study. These patients were recruited from Al-Ain and Tawam Teaching Hospitals and Al-Jahili Primary Health Care Centers in Al-Ain, United Arab Emirates. The study is based on a questionnaire that included sociodemographic and clinical variables. Dissociative disorders were diagnosed according to the classification set forth in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) and the International Classification of Diseases (ICD-10) of the World Health Organization. Results: Of the 468 patients studied, the majority (67.9%) were young, under the age of 25 years; 55% were UAE nationals, 59.4% female and 40.6% male. Disorganized movement was significantly lower among females (34.2%) than males (44.2%, p < 0.03). Disapproving of the key relative behaviour was higher in females (24.1%) compared to males (13.2%); comorbid anxiety was higher in females (37.4%) vs. males (25.3%). Disturbed relationships were more common in females (40.3%) while precipitating factors, such as intolerable stressful events, were significantly higher in males (42.6%, p < 0.01). Furthermore, males (20.5%) had a significantly higher history of similar episodes and other psychiatric illnesses (7.5%) than females. Finally, females (41%) showed more statistically significant improvements compared to males (29.5%, p < 0.001). Conclusion: Patients under 25 years of age suffered more from dissociative disorders with no correlation to educational level as a predisposing factor. The most common symptoms were fits or unorganized movements.

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).

Prevalence, Severity, and Correlates of Premenstrual Dysphoric Disorder Symptoms Among Women in the Arabian Peninsula

Objective To study the prevalence of premenstrual dysphoric disorder (PMDD) symptom patterns among women in the United Arab Emirates and to measure the debilitating nature of PMDD symptoms and sociodemographic correlates. Methods This cross-sectional sample study used the Mini-International Neuropsychiatric Interview-Plus (MINI-Plus) and Premenstrual Symptoms Screening Tool (PSST) to screen for presence and severity of PMDD symptoms in Arab women attending ambulatory health services in Alain city, Emirate of Abu Dhabi, United Arab Emirates, for routine health care between May 2005 and September 2005. Results The study participants include 508 women (76% Emiratis, 15% Omanis, and 8% other Arabs) of childbearing age. In total, 94 women (18.6%) met MINI-Plus criteria for PMDD; of these, 21 (4.1%) met PSST criteria for severe symptoms, 29 (5.7%) for moderate symptoms, and 44 (8.7%) for mild or less symptoms. One woman (0.2%) with severe symptoms and 12 women (2.4%) with moderate symptoms had negative MINI-Plus scores. Presence of PMDD symptoms was significantly associated with higher education (P = .000), single marital status (P = .001), major life stressors (P = .001), and personal/family use of psychotropic medications (P = .000/P = .006), personal/family psychological problems (P = .000/P = .001), irregular/painful menses (P = .043/P = .001), and functional impairment on the Sheehan Disability Scale (P = .000). Multilogistic regression analysis showed higher education, major life stressor, personal use of psychotropic medications, personal/family psychological problem, and painful menses were independent predictors of PMDD symptoms. Conclusions PMDD symptoms were common among the Arab women in our study. The cyclically triggered mood disturbances were clustered in women with personal/familial psychological problems, perhaps linking biologic constitution to genetic predisposition for the development of PMDD symptomatology.