To examine the prescribing patterns of antidepressants among a sample of psychiatrists working in Oman and to compare these practices to the current evidence for prescribing specific antidepressant ...in particular clinical situations.
This retrospective cross sectional study. Massachusetts General Hospital Psychopharmacology Questionnaire, a 10-item questionnaire listing factors that might have influenced the choice of antidepressant medication, was sent to 83 psychiatrists working in governmental health sectors in Oman. The study was done from March to July 2019.
A total number of 78 psychiatrists responded to the questionnaire. Of these, 44 of the psychiatrists (56.4%) believed that one type of antidepressant is more efficacious than others, while 74 psychiatrists (94.9%) indicated that selective serotonin reuptake inhibitors (SSRIs) were their first-line treatment preference. Mirtazapine was chosen as the most likely antidepressant to cause weight gain by two-thirds of the participants. For the treatment of anxious depression and depression with melancholic feature, SSRIs were the first choice of treatment for 64.1% and 7% of respondents, respectively. For depression with atypical features, 42.3% indicated that a monoamine oxidase inhibitor would be their first option.
There is a discrepancy between the current antidepressant prescribing practices in Oman and empirical antidepressant-prescribing evidence, and this finding is consistent with previous studies.
The current literature, mostly Euro-American based, indicates that the presence of meaning in life (MIL) improves resilience and lowers stress. However, the differential mediating roles of resilience ...in the relationship between the search for and presence of MIL, and stress have not been explored. This study aimed to investigate the differential mediating roles of resilience in the relationship between the presence of and search for MIL, and stress among Omani college students amid the COVID-19 pandemic. This cross-sectional study consisted of the Brief Resilience Scale, Perceived Stress Scale 4, and Meaning in Life Questionnaire, as well as socio-demographic questions. A path analysis model was used to examine the hypothesis. A total of 970 Omani college students responded to the questionnaire. Findings indicate that searching for MIL was significantly associated with a high level of stress directly (β = 0.023; p < 0.001) and indirectly, through a negative effect on resilience (β = 0.006; p < 0.001). Conversely, the presence of MIL was significantly associated with a decreased level of stress directly (β = - 0.045; p < 0.001) and indirectly via a positive effect on resilience (β = - 0.151; p < 0.001). In keeping with the proposed hypothesis, this study contributes to the current knowledge, by extrapolating the effect of searching for MIL on resilience and stress, and culturally re-contextualizing MIL research. University counseling centers could adopt meaning-based strategies to mitigate stress by promoting meaningful living and resilience.
Reports from different parts of the world suggest that the COVID-19 pandemic and the resultant lockdown and social distancing measures have heralded unprecedented mental health challenges among ...children and adolescents. To date, there is a dearth of studies emerging from the Arabian Gulf, where the majority of its population are children and adolescents. The study aims to examine the prevalence of anxiety-related symptoms and their covariates among children and adolescents in an Arabian Gulf country, Oman. This is a cross-sectional analytic study carried out over two weeks (1st to 15th of August 2020) during the COVID-19 pandemic across Oman. Parents were asked to complete the online survey, which consisted of the parent version of the Screen for Child Anxiety Related Emotional Disorders (SCARED) instrument and questions regarding basic socio-demographic information. Logistic regression was used to identify the contributing variables associated with anxiety-related symptoms. A total of 790 valid responses were received. Among the 790 children, 33.3% (n = 263) were diagnosed with anxiety-related symptoms by the SCARED instrument. Logistic regression analysis suggested that anxiety-related symptoms in children and adolescents were significantly associated with three demographic variables. The model shows that children with divorced or separated parents were 1.9 times more likely to have anxiety-related symptoms than children of married couples (OR = 1.93, p = 0.035). Children living in families with an income below USD 1000/month, were 1.8 times more likely to have anxiety-related symptoms than a family with an income of USD 4000/month (OR = 1.833, p = 0.018). Children in grades 3-6 were 1.8 times more likely to have anxiety-related symptoms than those in grades 1-2 (OR = 1.79, p = 0.024). Anxiety-related symptoms are common among Omani children and adolescents. They are more likely to be reported in middle scholastic grade levels and children from families with marital discord and low socioeconomic status. It is not clear whether the presently observed rates of anxiety exceed the prevalence that would have been observed prior to the COVID-19 pandemic. More studies are therefore warranted using children and adolescents' self-reported scales.
Aim
To explore the prevalence and correlates of depressive symptoms among parents/primary care providers of children with autism spectrum disorder (ASD).
Design and Methods
A cross‐sectional ...analytical study was conducted among a systematic random sample of parents/caregivers of children with diagnosis of ASD in Muscat, Oman. Depressive symptoms were quantified using the
Patient Health Questionnaire‐9.
Findings
The response rate was at 86% (n = 80) and the prevalence of depressive symptoms, at 71.3% (95% confidence interval, 60.5‐80.1). Logistic regression analyses indicated that unemployment and being the sole parent/caregiver in the family were both significant correlates of depressive symptoms.
Practice Implications
With an increase in the number of children being diagnosed with ASD, multidimensional preventive and remedial service programs for parents/caregivers will be essential.
We appreciate the comments from Al-Mendalawi on our case report, and on the merit of exploring cytokine and immunosuppression in the context of psychosis. In our case report, we overlooked the ...literature suggesting the potential role of cytokine and immunosuppression in the development of psychosis despite emerging evidence that cytokine profile might be critically associated with COVID-19 and its severity. In line with Al-Mendalawi's assertion, infection by SARS-CoV-2 virus has been widely established to trigger activation of central and peripheral cytokine which may result in cytokine storms and weakening of the blood-brain barrier. Such pathological processes compromise the integrity of the brain circuits leading to consequences such as the onset of obscured consciousness and conditions resembling psychosis. Along with this, the occurrence of overt neurological events as a result of COVID-19 has been observed including triggering of acute and ischemic strokes. The hallmarks of encephalopathy or encephalitis via brain scans have been documented.
As part of the globalization of medical education, residency programs in Oman have adopted competency-based standards by the Accreditation Council for Graduate Medical Education International ...(ACGME-I). Correctly perceiving the emotions of others and managing one's own emotions are essential to high-quality patient care.
We tested the reliability and construct validity of the Trait Emotional Intelligence Questionnaire-Short Form (TEIQue-SF), and assessed trait Emotional Intelligence (EI) in Oman Medical Specialty Board (OMSB) residents in multiple specialties. We explored for correlations with trainees' sociodemographic background data.
We conducted a cross-sectional, observational study between February and August 2017. Participants were OMSB residents. We administered the TEIQue-SF and collected sociodemographic data from participants. Multiple linear regression analysis was conducted to identify independent predictors of trait EI.
The present cohort scored high in the trait EI subscale of Well-being, followed by Sociability, Self-control, and Emotionality. Among sociodemographic factors, female gender and high income were significant predictors of TEIQue-SF's Well-being subscale and high income and living in a rented home were significant predictors of the Sociability subscale.
This is the first study conducted among medical residents in Oman regarding trait EI and its correlates. Our findings of overall high EI and several socioeconomic predictors echo the literature on the assessment of EI in trainees. The findings add to the evidence of cross-cultural applicability of instruments to measure trait EI, and use assessments of EI in resident selection and education.
Objectives: Medical professionals are exposed to many job stressors everyday, which can lead to psychological disturbances as well as burnout syndrome. We sought to assess the level of burnout among ...primary care physicians (PCPs) in Oman and explore risk factors for its development.
Methods: We conducted a cross-sectional, analytical study among a random cluster sample of 190 PCP working in Muscat, Oman. Indices of burnout (emotional exhaustion (EE), depersonalization (DP) and personal accomplishment (PA)) were noted using the Maslach Burnout Inventory-Human Services Survey (MBIHSS). We also used a questionnaire to obtain sociodemographic and job characteristics data. We used a binary logistic regression model and both unadjusted and adjusted odds ratios for statistical analysis.
Results: The prevalence of burnout in all three dimensions was 6.3%. High levels of MBI-HSS subscales were reported on EE, DP and PA with 17.8%, 38.2%, and 21.5%, respectively. Logistic regression analysis revealed that working over 40 hours per week was the most important risk factor for burnout among PCPs.
Conclusions: A total of 6.3% of PCPs working in urban areas in Oman suffered burnout. Long working hours was strongly associated with high occupational burnout. Solutions to eliminate or decrease the rate of burnout involve institutional changes, primarily respecting weekly working hours, and in more severe cases psychotherapy help is very important.
Objective:
Studies from the past decades have shown that mood disorders are common during childhood and adolescence. This study aimed to estimate the point prevalence of depression in Omani children ...and adolescents during social distancing and lockdown and identify the risk factors for developing depressive symptoms during the COVID-19 pandemic.
Methods:
This is an analytical cross-sectional study conducted in May 2020, in which all young Omani people attending a mainstream school aged 8–18 years old were eligible to participate. Parents were asked to complete the online survey, which consisted of the parent version of the Mood and Feelings Questionnaire (MFQ-Parent). In addition, the option of a self-reported version (MFQ-Self) was provided in cases where children preferred to fill out the survey themselves. Logistic regression was used to identify the contributing socio-demographic variables associated with depressive symptoms.
Results:
A total of 445 participants completed the MFQ, out of which 72.1% were parents, and 27.9% were children, adolescents and young people. 13.9% of children and adolescents exhibited depressive symptoms during the COVID-19 pandemic in Oman. The presence of depressive symptoms was associated with increased food intake (OR 1.81, 95% CI 1.00–3.29,
p
-value <0.05), longer use of smartphones (OR 2.72, 95% CI 1.56–4.73,
p
-value <0.001), whereas additional entertainment activities during lockdown were protective against depression (OR 0.35 95% CI 0.19–0.64,
p
-value <0.001).
Conclusion:
This study from Oman concurs with recent reports of depression being common during the COVID-19 pandemic. Concerted efforts are needed to mitigate this trend and identify high-risk groups during the lockdown period.
Most documented cases of menstrual psychosis have been from Euro-American populations with reports from cross-cultural populations being only a few. A primary aim was to determine whether the ...cyclical/episodic nature of menstrual psychosis among case series observed at a tertiary care unit in Oman fulfills the diagnostic criteria of the International Classification of Diseases (ICD-10) and diverge into Brockington's sub-types (World Psychiatry. 2005;4(1):9-17). Related aims were to solicit measures of psychometric functioning of those with menstrual psychosis and associated idioms of distress.
A series of consecutive patients seeking psychiatric consultation from January 2016 to December 2017 were screened via structured interview-Composite-International Diagnostic Interview (CIDI) and Brockington's sub-types. The identified patients (n = 4) also underwent psychometric evaluation including examination of affective functioning, intellectual capacity and neuropsychological functioning (i.e.attention and concentration, learning and remembering, executive function, processing speed and speech and language). The analysis of outcome measures was via an idiographic approach.
The spectrum of distress among people with menstrual psychosis does not fit existing psychiatric nosology. Evaluations revealed that a majority of the participants displayed something akin to morbid phenomena relating to manic and psychotic symptoms. In the parlance of traditional Omani society, this would be termed "spirit possession". In terms of classification by timing within the menstrual cycle as expounded by Brockington, the present case series in Oman fulfilled the definition of catamenial psychosis and paramenstrual psychosis. With regard to psychometric function, all participants performed adequately on indices of intellectual functioning but appeared to have impairments in neuropsychological functioning, including the dimensions of processing speed, episodic memory, and executive functioning. Within the given society, the periodicity of mind alteration has been attributed to spirit possession.
This is one of the first case series of its kind in the country elucidating whether the manifestation of menstrual psychosis among individuals in Oman fulfills the subtypes postulated by Brockington. The present case series suggests that menstrual psychosis is marked with neuropsychological impairments that were previously observed in other phasic manic episodes or brief psychotic disorders.
Depressive illnesses in non-Western societies are often masked by somatic attributes that are sometimes impervious to pharmacological agents. This study explores the effectiveness of repetitive ...transcranial magnetic stimulation (rTMS) for people experiencing treatment-resistant depression (TRD) accompanied by physical symptoms. Data were obtained from a prospective study conducted among patients with TRD and some somatic manifestations who underwent 20 sessions of rTMS intervention from January to June 2020. The Hamilton Rating Scale for Depression (HAMD) was used for clinical evaluation. Data were analysed using descriptive and inferential techniques (multiple logistic regression) in SPSS. Among the 49 participants (mean age: 42.5 ± 13.3), there was a significant reduction in posttreatment HAMD scores compared to baseline (t = 10.819, p < 0.0001, and 95% CI = 8.574–12.488), indicating a clinical response. Approximately 37% of the patients responded to treatment, with higher response rates among men and those who remained in urban areas, had a history of alcohol use, and were subjected to the standard 10 HZ protocol. After adjusting for all extraneous variables, the rTMS protocol emerged as the only significant predictor of response to the rTMS intervention. To our knowledge, this is the first study to examine the effectiveness of rTMS in the treatment of somatic depression.
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