Search

Background: Prevalence of posttraumatic stress disorder (PTSD) in refugees is reportedly higher in comparison to the general population. Refugee children specifically are often coping with trauma and loss and are at risk for mental health difficulties. With staggering numbers of people seeking refuge around the world and 50% being 18 years or younger, research examining the effects of trauma-focused therapies for refugee children with PTSD is highly needed. Both Eye Movement Desensitization and Reprocessing (EMDR) therapy and the child version of Narrative Exposure Therapy (KIDNET) have been used for refugees, although these treatment methods have not been systematically compared. The aim of the current study is to investigate the effectiveness of EMDR and KIDNET, compared to a waitlist control group and with each other, offered to refugee children.Methods: A randomized controlled three-arm trial has been designed. The primary outcome is PTSD diagnosis and symptom severity assessed with the Clinician-Administered PTSD Scale for Children DSM5 (CAPS-CA-5) at baseline (T1), 1 month post-treatment, or after 8 weeks of waiting (T2) and 3 months follow-up (T3). Additionally, instruments to assess posttraumatic stress symptoms, behavioral and emotional problems, and quality of life perception in children aged 8-18 are conducted at T1, T2, and T3.Discussion: This is the first RCT that examines the effectiveness of EMDR and KIDNET in refugee children aged 8-18 years specifically, compared to a waitlist control group intended to reduce PTSD diagnosis and severity of posttraumatic stress symptoms and comorbid complaints in a growing and challenging population.Trial Registration: Dutch Trial Register NL40769 . Retrospectively registered on June 16, 2021. [ABSTRACT FROM AUTHOR]

Previous studies suggest that refusals form the largest proportion of nonresponse for household surveys. As face-to-face household health surveys are uncommon in several countries, it might be advantageous for prospective surveys to preemptively tackle respondents' refusal to survey participation. Using contact history data from the Saudi National Mental Health Survey, we examined the relationship between social environmental factors, respondent characteristics, survey request concerns recorded by interviewers, and respondents' propensity to refuse to participate in the survey. Content analysis and logistic regressions were conducted. Our findings suggest that urbanicity, region, socioeconomic status, age, and gender are associated with refusal. Patriarchal gatekeepers and specific survey-related concerns are more likely to lead to temporary refusals compared to final refusals. These results have implications for survey researchers employing similar recruitment and data collection methods, for example in tailoring refusal conversion strategies for interviewers to address concerns expressed by Saudi and/or culturally similar respondents. [ABSTRACT FROM AUTHOR]

Objectives: To estimate 12‐month prevalence and severity of mental disorders in the Saudi National Mental Health Survey (SNMHS). Methods: The SNMHS is a face‐to‐face community epidemiological survey in a nationally representative household sample of citizens aged 15 to 65 in the Kingdom of Saudi Arabia (KSA) (n = 4,004). The World Health Organization (WHO) Composite International Diagnostic Interview (CIDI) was used to estimate 12‐month prevalence of common DSM‐IV mental disorders. Results: Twelve‐month prevalence of any DSM‐IV/CIDI disorder is 20.2%. Most common are anxiety disorders (12.3%) followed by mood (6.8%), disruptive behavior (5.4%), eating (3.2%), and substance use (1.9%) disorders. The proportion of 12‐month cases rated serious (39.0% of all cases) is high across virtually all disorders relative to the proportions found in CIDI surveys in other high‐income countries. Younger people have significantly elevated odds of mood and disruptive behavior disorders and serious disorders. Women have significantly elevated odds of anxiety and mood disorders and serious disorders. Previously married people have significantly elevated odds of most disorder classes and serious disorders. Conclusions: Both 12‐month prevalence and severity of DSM‐IV/CIDI disorders are high in Saudi Arabia compared to other high‐income countries that carried out comparable surveys. [ABSTRACT FROM AUTHOR]

Objectives: To present an overview of the survey and field procedures developed for the Saudi National Mental Health Survey (SNMHS). Methods: The SNMHS is a face‐to‐face community epidemiological survey of DSM‐IV mental disorders in a nationally representative sample of the household population in the Kingdom of Saudi Arabia (KSA) (n = 4,004). The SNMHS was implemented as part of the WHO World Mental Health (WMH) Survey Initiative. WMH carries out coordinated psychiatric epidemiological surveys in countries throughout the world using standardized procedures designed to provide valid cross‐national comparative data on prevalence and correlates of common mental disorders. However, these procedures need to be adapted to the unique experiences in each country. We focus here on the adaptations made for the SNMHS. Results: Modifications were needed to several interview sections and expansions were needed to address issues of special policy importance in KSA. Several special field implementation challenges also had to be addressed because of the need for female interviewers to travel with male escorts and for respondents to be interviewed by interviewers of the same gender. Conclusions: Thoughtful revisions led to a high‐quality field implementation in the SNMHS. [ABSTRACT FROM AUTHOR]

Objectives: The DSM‐IV diagnoses generated by the fully structured lay‐administered Composite International Diagnostic Interview Version 3.0 (CIDI 3.0) in the Saudi National Mental Health Survey (SNMHS) were compared to diagnoses based on blinded clinical reappraisal interviews. Methods: Telephone follow‐up interviews were administered using the clinician‐administered non‐patient edition of the Structured Clinical Interview for DSM‐IV (SCID) in separate sub‐samples of SNMHS respondents who screened positive for four disorders that are of special importance in Arab countries: obsessive–compulsive disorder, separation anxiety disorder, social phobia, and major depressive episode. Results: Initial diagnoses based on the CIDI were found to have higher prevalence than those based on the SCID for all four disorders. For reasons having to do with respondent denial of symptoms in the SCID reported in the CIDI, we interpreted these differences as due more to under‐diagnoses in the SCID than over‐diagnoses in the CIDI. Nonetheless, CIDI diagnostic thresholds for three of the four disorders were increased to make sure prevalence estimates based on the CIDI were conservative. The procedures used to implement these recalibrations are described in this paper. Conclusions: The CIDI interviews used in the SNMHS generated valid but conservative diagnoses of common mental disorders in the Saudi population. [ABSTRACT FROM AUTHOR]

One of the core components of the TRAPD (Translation, Review, Adjudication, Pretesting and Documentation) team approach to translation in survey research is pretesting. Cognitive interviewing is increasingly being used for pretesting survey questionnaires adapted to different populations. Exploring the issue of question sensitivity is particularly relevant when adapting a questionnaire to a population different than the one for which it was designed. However, little guidance exists on the use of cognitive interviewing, and specifically, the types of verbal probes, to elicit respondent feedback on question sensitivity. In preparation for the Saudi National Mental Health Survey, cognitive interviewing was carried out to pretest the Arabic version of the World Mental Health survey instrument (CIDI 3.0). Different types of cognitive probes: proactive direct, proactive indirect and general probes were randomly assigned to survey questions to investigate differences in the feedback elicited by each type of probe. Findings suggest that different types of cognitive probes that are designed to explore perceived sensitivity of the survey questions elicit different amounts and types of feedback. An indirect cognitive probe identified a topic to be sensitive in more instances than a direct probe or a general probe. A general probe, on the other hand, elicited more non-codable feedback especially when paired with a survey question that asks about a more abstract concept such as the respondent's feelings. [ABSTRACT FROM AUTHOR]

Background: The World Mental Health surveys have been known to apply high standards of quality control, but few studies have been published to document this. Furthermore, the effectiveness of quality control has rarely been reported in the Middle East. Case presentation: The focus of this paper was to highlight the implementation of quality control procedures in the Saudi National Mental Health Survey under the World Mental Health Survey Consortium. The paper summarizes the guidelines implemented for the various phases of survey quality control--the quality assurance procedures, the quality control procedures and the quality control appraisal components--as per previously prescribed recommendations in literature. Conclusions: Survey quality management is a process and not reducible to a single event. Midstream corrections are warranted by detecting problems and intervening appropriately. The Saudi National Mental Health Survey implemented such procedures through continuous quality improvement. [ABSTRACT FROM AUTHOR]

Several challenges exist in carrying out nation-wide epidemiological surveys in the Kingdom of Saudi Arabia (KSA) due to the unique characteristics of its population. The objectives of this report are to review these challenges and the lessons learnt about best practices in meeting these challenges from the extensive piloting of the Saudi National Mental Health Survey (SNMHS), which is being carried out as part of the World Mental Health (WMH) Survey Initiative. We focus on challenges involving sample design, instrumentation, and data collection procedures. The SNMHS will ultimately provide crucial data for health policy-makers and mental health specialists in KSA. [ABSTRACT FROM AUTHOR]

Background: With the growth of information technology, there is a need for the evaluation of cost-effective means of monitoring and support of field workers involved in large epidemiological surveys. Aim: The aim of this research was to measure the performance of a survey help desk that used knowledge management tools to improve its productivity and efficiency. Knowledge management tools are based on information technologies that improve the creation, sharing, and use of different types of knowledge that are critical for effective decision-making. Methods: The Saudi National Mental Health Survey's help desk developed and used specific knowledge management tools including a computer file system, feedback from experts and a call ticketing system. Results are based on the analyses of call records recorded by help desk agents in the call ticketing system using descriptive analysis, Wilcoxon rank-sum test (p < 0.01) and Goodman and Kruscal test (gamma). The call records were divided into two phases and included details such as types of calls, priority level and resolution time. Results: The average time to resolve a reported problem decreased overall, decreased at each priority level and led to increased first contact resolution. Conclusion: This study is the first of its kind to show how the use of knowledge management tools lead to a more efficient and productive help desk within a health survey environment in Saudi Arabia. Further research on help desk performance, particularly within health survey environments and the Middle Eastern region is needed to support this conclusion. [ABSTRACT FROM AUTHOR]

Background: The World Mental Health-Composite International Diagnostic Interview (CIDI) 3.0, originally in English, is a fully-structured interview designed for the assessment of mental disorders. Although Arabic translations of CIDI from countries like Lebanon and Iraq exist, a Modern Standard Arabic translation was developed to suit the Saudi population. While the translation model used in the present paper has been used to translate instruments in Asian and European languages, there is no study to the best of our knowledge which has used this specific model to translate a validated instrument from English to Arabic. Case presentation: This paper describes the Saudi adaptation of CIDI 3.0. The TRAPD team translation model—comprising of translation, review, adjudication, pretesting and documentation—was implemented to carry out the Saudi adaptation of CIDI 3.0. Pretests involving cognitive interviewing and pilot study led to translation revisions which consequently confirmed that Saudi respondents had a good understanding of various items of the instrument. The adaptation procedures for the Saudi CIDI 3.0 were well documented and the instrument was linguistically validated with the Saudi population. Conclusion: The TRAPD model was successfully implemented to adapt the CIDI 3.0 to be used as the main survey instrument for the Saudi National Mental Health Survey, findings of which will provide health policy makers mental health indicators for health decision making and planning. [ABSTRACT FROM AUTHOR]