Ziad A. J. Zaidan

The ineffectiveness of the Hospital Anxiety and Depression Scale for diagnosis in an Omani traumatic brain injured population.

Background: The rehabilitation of the traumatic brain injury (TBI) patient is especially challenging in non-western populations as the phenotypic indicators as well as the neurobehavioral assessments for the survivors of brain injury are limited. Objective: The study screened for the prevalence of anxiety and depressive states among patients with TBI and examined the validity of the Hospital Anxiety and Depression Scale (HADS) to identify TBI patients with comorbid affective dysfunctions, specifically anxiety and depressive disorders, in an Omani population. Methods: Sixty-eight survivors of TBI were screened with the semi-structured, Composite International Diagnostic Interview (CIDI) and the HADS. A receiver operating characteristics (ROC) curve was calculated to discriminate the power of the HADS for every possible threshold score. Results: The semi-structured interview revealed the prevalence rate of 57.4% for depressive disorder and 50% for anxiety disorder. The sensitivity (53.8%) and specificity 75.9%, gave the best compromise using the cut-off score of 4, suggesting HADS is not a useful screening tool for this particular population. Conclusions: Phenotypic indicators as detected by CIDI revealed that prevalence of affective dysfunctionality is common among this TBI population. Although the HADS is the most widely used screening instrument in other clinical populations, it does not appear to be a reliable resource in identifying depression and anxiety in people with traumatic brain injury in Oman.

Deliberate self-poisoning in Oman

OBJECTIVE  To describe the demographics, precipitating factors, substances and methods used for deliberate self‐harm in Oman.

Dissociative disorders in the sultanate of Oman

Objective: To study the clinical manifestations and psychosocial aspects of dissociative (conversion) disorders (DD) in the Sultanate of Oman.

Hazardous and Harmful Alcohol Consumption Among Non-Psychotic Psychiatric Clinic Attendees in Oman

Although interest in substance abuse in psychiatric patients has received increasing attention, there is scant study of hazardous and harmful drinking patterns in Arab/Islamic societies where socio-cultural patterning imposes total abstinence on drinking. However recent globalization has eroded such prescription. An aim of this study is to examine the severity of harmful and hazardous drinking in Oman. From Omani nationals seeking psychiatric consultation, an assessment of alcohol dependence or hazardous or harmful drinking was elicited using the World Health Organization’s assessment measure, the Alcohol Use Disorders Identification Test (AUDIT). Clinical interviews were also conducted to ascertain the severity of alcohol dependence. The results from this convenience sample of patients suggest the presence of hazardous and harmful alcohol consumption among non-psychotic attendees seeking psychiatric consultation. The clinical interview revealed that 49 patients of the consenting patients (n = 56) have persistent and clinically significant alcohol intoxication. Fifty patients scored in the pathological range of indices of harmful and hazardous alcohol consumption. There was no relationship between the socio-demographic variables and indices of AUDIT. The result is discussed in terms of the speculated increase in harmful and hazardous drinking among Omanis and the inherent limitation of undertaking a study where the topic of interest is socio-culturally abhorred.

Characteristics of ADHD Among Omani Schoolchildren Using DSM-IV: Descriptive Study

Background: There is a dearth of studies describing the characteristics of ADHD among schoolchildren attending child psychiatry clinics in the Arab world. Most of the previous quests have focused on community surveys or themes that hampered international comparison. Aim: This study screened for the presence of ADHD as well as investigates the psychosocial and educational history relevant for the diagnosis of ADHD among children. Method: Consecutive schoolchildren attending child psychiatric consultations were screened for the presence of ADHD according to the Diagnostic and Statistical Manual for Mental disorders (DSM) criteria. Result: A total of 221 schoolchildren suffering from ADHD were identified according to the DSM. The year incidence was 0.16. Males constituted the majority presenting with ADHD. The contribution of consanguinity and a history of acquired brain injury were common features. The majority were attending mainstream education as pharmacotherapy is the only option available for managing ADHD. Conclusion: This study is one of the few from this part of the world using DSM criteria to diagnose ADHD. The implications of the present findings are discussed in the context of the available literature and the specific situation in Oman. (J. of Att. Dis. 2011; 15(2) 139-146)

A case of bilateral ptosis with unsteady gait : Suggestibility and culture in conversion disorder

We report a case of a 14-year-old girl who presented, following a sudden onset, with bilateral ptosis, gait disturbance, difficulty swallowing and loss of appetite, right hypochondriacal pain, and frontal headache. Protracted neurological and medical examinations were unremarkable; neither was precipitating psychological stresses evident. The condition, which manifest as typical conversion disorder, lasted for one year. “Treatment” involving electrical stimulation of both eyes muscles and legs with positive reassurance resolved the symptom. This case supports the view that conversion disorder, not only involves a strong element of suggestion, but also incorporates socio-cultural sanctioned prescription.

Neurocognitive functioning in women presenting with undifferentiated somatoform disorders in Oman

Aim:  There is a dearth of research from non‐Western populations focusing on neurocognitive functioning in patients presenting with undifferentiated somatoform disorders. The aim of the present quest is to examine the presence of cognitive impairment and other health‐related parameters among attendees at psychiatric settings in Oman, an Arab/Islamic country, with a diagnosis of undifferentiated somatoform disorder.

Clinical and Demographic Profile of Attendees at Baghdad's Walk-in Psychiatric Clinic

OBJECTIVE Few studies have examined clinical and demographic profile of attendees of a walk-in psychiatric clinic in countries ravaged by wars. The aim of this study is to quantify the characteristics of attendees of an open walk-in psychiatric clinic in a general hospital in Baghdad and the suburb towns of Iraq in the year 2010. METHODS As part of a retrospective survey, information on specific variables (socio-demographic background, clinical characteristics and attendance rate) were sought from medical records in the year 2010 (January to December). RESULTS Despite the shortcomings expected from a country coming out of the ravage of war, the survey included 2,979 attendees (1,864 [63%] males and 1,115 [37%] females) of a walk-in psychiatric clinic who fulfilled the inclusion criteria. The profile of attendees indicated that a majority of the cohort was self-referred with a predominance of employed males, aged 19 to 49 years, residing in Baghdad City. Depression and psychosis were the most common diagnosis given. CONCLUSION The observed patterns are discussed within the available literature relevant to consultation liaison psychiatry, and specific to situations in Iraq and Arab/Islamic cultural patterning.

Two-phase survey to determine social anxiety and gender differences in Omani adolescents.

There is a lack of studies examining the effectiveness of some of the commonly used instruments to elicit the presence of social anxiety disorder (SAD) in Arab‐speaking populations, such as those in Oman. The aim of this study was to establish the influence of social anxiety and the role of gender among Omani adolescents.