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Background Childhood obesity is a major global health concern. Weight-management camps involving delivery of a program of physical activity, health education, and healthy eating are an effective treatment, although post-intervention weight-management is less well understood. Our objective was to assess the effectiveness of a weight-management camp followed by a community intervention in supporting weight-management for overweight children and children with obesity. Methods Participants were overweight Qatari schoolchildren or schoolchildren with obesity, ages 8–14 years, (n = 300) recruited over a three-year period across 14 randomly selected schools in the Doha area. They attended a two-week weight management camp, then a 10-week program of weekly lifestyle education and physical activity sessions, which also included behavior change techniques. The programme was cognitive behavioural therapy (CBT)-focused with a strong element of behavioural economics blended in. Results Participants saw a significant BMI SDS reduction as a result of the entire intervention (camp + education and activity sessions) both at the individual (p p = 0.0002) levels, and weight loss occurred during each intervention stage separately for the camp (p p p = 0.0220 at the individual and cluster/school levels, respectively). Conclusions Weekly lifestyle education and activity sessions which include behavior change techniques may be useful in promoting continued weight management in the period following intensive, immersive childhood obesity interventions. Trial registration ClinicalTrials.gov NCT02972164, November 23, 2016.

Background: Understanding the prescription pattern of medications in a population can help reveal the potential usage scenarios, including off-label prescriptions, and the need for precision medicine implementation. Therefore, the aim of this study was to assess the prescription pattern and off-label use of antipsychotics in the Qatari population.Methods: We performed a cross-sectional study of Qatari patients who received antipsychotic prescriptions from the major healthcare providers in the country during the 2-year period between June 2018 and May 2020. The number of patients, prescriptions dispensed, and clinical indications were collected and statistical analysis using chi-square test was conducted.Results: Among the 9,349 Qatari patients prescribed with antipsychotics during the study period, the majority were female (57%; p < 0.001) and were in the age categories 20–39 and 30–39 years (both 22%; p < 0.001). Among the 35,938 antipsychotic prescriptions dispensed, second-generation antipsychotics were the most highly prescribed (59%), specifically, quetiapine (16%) and olanzapine (12%), but the first-generation antipsychotic prochlorperazine (13%) was also highly prescribed. Most of the indications of antipsychotics (69%) were for off-label use such as for controlling chronic diseases, sleeping disorders, benign paroxysmal positional vertigo and irritable bowel syndrome.Conclusion: Non-mental health and off-label prescriptions of several antipsychotics were observed. Integration of this data with pharmacogenomic and clinical outcome data will help in determining the course of action for implementing personalized and precision medicine in the country and beyond.

Although mental disorders are a leading cause of disability in the Arab region, which includes 5·54% of the global population, Arab countries produce only 1·0% of the global output of peer-reviewed publications in mental health research. Various stakeholders, including Arab mental health researchers, institutional and funding agency officials, and international research collaborators, convened to identify challenges faced by Arab mental health researchers and propose an evidence-informed call for action. Challenges identified include prevalent stigma and low awareness, conflict and war, scarce institutional and funding resources, inadequate publishing opportunities, insufficient training in mental health research, and shortage of reliable and valid assessment tools. The proposed action plan includes ways of addressing stigma and spreading awareness, increasing collaborative efforts, building research infrastructure, strengthening the mental health workforce, and translating research findings into a call to action on societal and governmental levels. The proposed action plan could provide a roadmap for Arab mental health researchers and research institutions, which might ultimately increase research productivity in the Arab region and close the gap between Arab countries and the rest of the world.

Studying the prescription pattern of medications will help in understanding potential unnecessary prescriptions, due to the trial-and-error method of prescribing, and the need for personalized medicine in a population. Therefore, in this study, our aim was to explore the prescribing pattern and off-label use of antidepressants in the Qatari population. We conducted a retrospective study of Qatari patients who received prescriptions for antidepressants from the major healthcare providers in Qatar, for a period of 24 months between June 2018 and May 2020. The number of patients, prescriptions, and diagnostic indications were analyzed. The chi-square test was used for identifying statistically significant association of the number of individuals prescribed with age category or gender. Of the 14,601 Qatari patients who were prescribed antidepressants, the majority were female (61%, p &lt, 2.2 × 10−16), and were at or above 60 years of age (27%, p &lt, 2.2 × 10−16). More numbers of selective serotonin reuptake inhibitors (SSRIs) (22,085 out of 48,031, 46%), were dispensed than other classes of antidepressants, with escitalopram (26%) at the top of the list. Preponderance of prescription of antidepressants for non-mental health diseases was observed. Population-level prescription trends, as we reported here, when combined with patient genetic variability and outcome data, will have the power to predict the potential for treatment failures and adverse effects of these medications in the population. We also recommend educating non-mental health prescribers about the adherence to evidence and guidelines to ensure patient safety while prescribing antidepressants.

Stigma impacts persons with mental illness (PWMI), their families and network of friends, the public and health care professionals. Stigma is a major barrier for PWMI to seeking treatment, which contributes to the burden of disease, disability, and mortality. Research on stigma is relatively scant in the Middle East region and particularly in Qatar. To address stigma effectively in each culture, it is essential to study its nature in the context where the PWMI experience stigma. The purpose of this study was to assess the prevalence of internalized stigma in PWMI in Qatar. A cross-sectional study of PWMI receiving outpatient mental health services in Qatar was done. We interviewed 417 PWMI using a modified 18-item version of the short form of the Internalized Stigma of Mental Illness (ISMI) Scale. Descriptive and regression models were used to analyze the data. The Cronbach alpha for the modified 18-items ISMI was 0.87. Participants' average score on this scale was 2.07 ± 0.38 with 41 (9.8%) of them scoring more than 2.5 which is considered “high” stigma score. In multivariate logistic regression, high stigma (modified ISMI score >2.5) was significantly higher among PWMI with no formal education and among those who reported lower levels of social support. The reported levels of internalized stigma in this vulnerable population of Qatar fall at the lower spectrum reported worldwide. An anti-stigma education program designed for the context of Qatar emphasizing on education and support for PWMI may be conducive to creating an all-inclusive society.

Reem Jawad Al-Sulaiman,1 Abdulbari Bener,2,3 Lisa Doodson,4 Salha Bujassoum Al Bader,1 Suhaila Ghuloum,5 Alain Lemaux,1 Hekmat Bugrein,1 Reena Alassam,1 Aisha Karim1 1Department of Medical Oncology, National Center of Cancer Care and Research, Doha, Qatar; 2Istanbul Medipol University, International School of Medicine, Istanbul, Turkey; 3Department of Biostatistics and Medical Informatics, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey; 4Department of Psychotherapy and Counseling Studies, Regent’s University London, London, UK; 5Department of Psychiatry, Hamad Medical Corporation, Doha, Qatar Background: An insufficient number of studies have been carried out in the Middle East to evaluate the role of structured psychotherapeutic interventions in enhancing breast cancer patients’ psychological well-being, quality of life and treatment compliance. This study has been designed to address this limitation by exploring the benefit of two structured psychotherapeutic interventions, crisis counseling and psychoeducation, in enhancing breast cancer patients’ psychological well-being, quality of life and treatment compliance in Qatar. Methods: A total of 201 women with early-stage breast cancer from the state of Qatar were recruited and randomized into either the control group or one of the treatment groups (crisis counseling or psychoeducation). Each of the two treatment interventions consisted of a total of six 60- to 90-minute sessions, which were provided over a period of 12 weeks. The short- and long-term benefits of the crisis counseling and psychoeducation interventions were evaluated in terms of improving patients’ psychological well-being, quality of life and treatment compliance by asking all the patients to complete the Depression, Anxiety and Stress Scale, 21 item version (DASS-21) and European Organization for Research and Treatment of Cancer Quality of Life scale (QLQ-C30) instruments at different points in time and by monitoring their compliance to chemotherapy and radiotherapy treatment. Results: This study revealed that both of the study interventions, crisis counseling and psychoeducation, were effective in improving women’s psychological well-being and quality of life over time in comparison to the control group, but had no significant impact on patients’ compliance with treatment. In addition, the study showed that psychoeducation conferred a greater advantage than did the crisis counseling model, especially in improving women’s psychological well-being over time. Conclusion: This study is considered the first of its kind in Qatar to provide evidence on the benefit of crisis counseling and psychoeducation interventions in improving the psychological well-being and quality of life of women with early-stage breast cancer in Qatar. In addition, this study has provided innovative research that can be used as evidence to propose changes to the psychotherapy services for breast cancer patients in Qatar. This research study aims to provide a first step toward further research in the future, which will hopefully lead to a better health care system for cancer patients in Qatar. Keywords: breast cancer, DASS-21, QLQ-C30, crisis counseling, psychoeducation, NCCCR, Qatar, psycho-oncology, psychotherapy, cancer, psychological wellbeing

The aim of this study was to measure advanced glycation end products (AGEs) among participants maintained on antipsychotics using the AGE Reader and to compare them with controls from the general population. Participants maintained on antipsychotics for at least 6 months were recruited from the Psychiatry Department at Rumailah Hospital, Doha, Qatar. Healthy controls were recruited from the primary healthcare centers in Doha, Qatar. AGEs of a total of 86 participants (48 patients and 38 controls) were recorded. Among the group maintained on antipsychotics, women, smokers, and Arabs had significantly higher AGEs levels compared with men, nonsmokers, and non-Arabs, respectively (P

Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity. The multifaceted intertwined nature of optimal health, mental health, and well-being requires operational, sustainable interdisciplinary partnerships in order to improve personal and global well-being and happiness. The initial step must be the assessment of the nature and magnitude of local problems in the global context. The WHO annual reports may be an adequate departure point as they can demonstrate the global nature of stressful situations and their association with physical and mental stress-related disorders. Therein, mental health professionals should spearhead change and progress. Attitudes need to be pro-active and partnerships are essential. Pertinent data should be evaluated by local experts who will determine the needs and how best to face them and achieve solutions. Hopefully, common regional denominators will lead to the formation of Regional Interdisciplinary Collaborative Alliances (RICAs) who will share needed resources and focus particularly on vulnerable populations. The RICAs would be supported by experts and technological facilities located in developed economy centers. The long-term goal is to turn the concept of pursuit of happiness into a well-perceived reality.

Objective Even though all guidelines recommend generally against antipsychotic polypharmacy, antipsychotic polypharmacy appears to be a very common practice across the globe. This study aimed to examine the prescription patterns of antipsychotics in Qatar, in comparison with the international guidelines, and to scrutinize the sociodemographic and clinical features associated with antipsychotic polypharmacy. Methods All the medical records of all the inpatients and outpatients treated by antipsychotics at the Department of Psychiatry–Hamad Medical Corporation (HMC) in Doha, Qatar (between October 2012 and April 2014) were retrospectively analyzed. We retrieved the available sociodemographic data, psychiatric features, and details on the medication history. Results Our sample consisted of 537 individuals on antipsychotics (2/3 were male; mean age 33.8±10.2 years), prescribed for a psychotic disorder in 57%, a mood disorder in 9.3%, and various other diagnoses in 33.7%. About 55.9% received one antipsychotic, 29.6% received two antipsychotics, and 14.5% received more than two antipsychotics. Polypharmacy was associated with younger age (p = 0.025), being single (p Conclusions Antipsychotic polypharmacy appears to be quite common in Qatar, as it is the case in many other countries, in contrast with most international recommendations. Studies are needed to explore the reasons behind this disparity.

This article explores predictors of job satisfaction and stress among clinicians and administrative staff at the public health sector in the State of Qatar. This is a rapidly growing sector, aiming for excellence in service, education and research. The vast majority of the staff are expatriates with different cultural backgrounds, and varying qualifications. After obtaining ethical approvals to conduct the study, the target population were asked to complete an anonymous online survey, that included sociodemographic data followed by the National Institute for Occupational Safety and Health (NIOSH) generic Job Stress questionnaire. Total number included in the analysis is 1260, female, married with children. Role ambiguity, conflict, skill underutilization and workload were associated with job dissatisfaction. Role and job future ambiguity were significantly associated with depression.

Background Metabolic abnormalities are common in patients maintained on antipsychotics. These abnormalities increase the risk of cardiovascular diseases and mortality in this population. The aim of this study is to assess the prevalence of metabolic syndrome (MetS) in subjects maintained on antipsychotics relative to controls in Qatar, and to assess the factors contributing to the development of MetS. Methods A cross sectional design was used to collect data and fasting blood samples from subjects maintained on antipsychotics for at least six months (n = 112) and from a control group (n = 114). The groups were compared in regard to prevalence of MetS, and multiple regression analysis was used to determine the risk factors in each group. Results The two groups (antipsychotics vs. control) were similar in regard to age (35.73 ± 10.28 vs. 35.73 ± 8.16 years) and gender ratio. The MetS was higher among the subjects on antipsychotics, but this difference did not reach statistical significance. Blood pressure (BP) was significantly higher in the antipsychotics group and BMI was the major risk factor to develop MetS in this group. Conclusions The prevalence of MetS in both groups is high and mostly attributed to obesity and high BP. Public health interventions are needed to address this major health problem overall. Larger studies are needed to further assess the impact of antipsychotics and mental illness on the development of MetS.

Adequate sleep and physical activity have been linked to the overall well-being of both medical and psychiatric patients. Patients with schizophrenia have shown abnormal sleep patterns and decreased physical activity that were linked to their psychopathology and physical health. These phenomena are not studied yet in Arab patients with schizophrenia. The purpose of this study is to study the sleep and exercise patterns in Arab patients with schizophrenia compared with those of healthy controls.A total of 99 patients with schizophrenia and 101 controls were recruited. Arabic versions of sleep, exercise, socio-demographic, and clinical questionnaires were administered as well as the validated scales to measure psychopathology, depression, and suicidality in these participants.The majority of patients with schizophrenia slept more than 8 h per day and exercised less when compared with controls. Sleep quality was worse in those with higher depression score and higher suicidality scores were seen in patients with lower sleep duration. Multinomial regression showed that patients with schizophrenia have higher odds of sleeping more than 8 h even after controlling for the intake of antipsychotics, age, gender, smoking status, and other confounding factors.Our results showed that Arab patients with schizophrenia are at increased risk of having longer sleep duration with inadequate physical activity, which are correlating with worsening of depressive symptoms and suicidality. Thus, more attention should be paid to the changes in sleep patterns and level of exercise when treating Arab patients with schizophrenia.

Background Patients with schizophrenia commonly show both depressive and negative symptoms that can differentially affect the prognosis and course of treatment. The Calgary Depression Scale for Schizophrenia (CDSS) was designed to distinguish between depression and negative symptoms in patients with schizophrenia. The purpose of this study is to validate an Arabic version of the CDSS among patients with schizophrenia. Methods The diagnosis of schizophrenia was confirmed using the Arabic Mini International Neuropsychiatric Interview 6 (MINI 6). A standardized translation back-translation process was adopted. One rater administered the Arabic CDSS to subjects with schizophrenia as well as to a control group who should not have any psychiatric disorder except for depression. Another rater, blinded to the results administered the already validated Arabic version of Beck Depression Inventory-II (BDI-II). Results We recruited 102 patients and 102 controls subjects. The CDSS showed good internal consistency in the active group (Cronbach’s alpha = 0.82). The Intraclass Coefficient correlations (ICC) for the inter-rater reliability (n = 21) was 0.90, p

The aim of this study was to assess the prevalence of anxiety and depressive disorders in a Qatari population who attend the primary health care settings and examine their symptom patterns and comorbidity. This is a prospective cross-sectional study conducted during the period from July 2009 to December 2009. Primary Health Care Center and the Supreme Council of Health in the State of Qatar. A total of 2,080 Qatari subjects aged 18–65 years were approached and 1,660 (79.8%) patients participated in this study. The study was based on a face-to-face interview with a designed diagnostic screening questionnaire, which consisted of 14 items for anxiety and depression disorders. Socio-demographic characteristics, comorbidity factors, and medical history of patients were collected. The Hospital Anxiety and Depression Rating Scale (HADS), which consisted of seven items for anxiety (HADS-A) and seven for depression (HADS-D), was used. The items are scored on a 4-point scale from zero (not present) to 3 (considerable). The HADS-A had an optimal cut-off ≥8 (sensitivity 0.87 and specificity 0.78), and the HADS-D had an optimal cut-off ≥8 (sensitivity 0.82 and specificity 0.86). The HADS scales generally used the cut-off score ≥8 to identify respondents with the possible presence of anxiety or depression. Of the studied Qatari subjects, 46.2% were males and 53.8% were females. The mean HADS-A anxiety symptom scores were 4.1 ± 3.6 for males and 4.9 ± 3.7 for females (p = 0.048) and with a prevalence of 18.7% among males and 24.6% among females (p = 0.017). The mean HADS-D depressive symptom scores were 8.0 ± 6.3 for males and 10.8 ± 7.5 for females (p = 0.041) and with a prevalence of 26.6% among males and 30.1% among females (p = 0.219). Qatari women were at higher risk for depression (53.1 vs. 46.9%) and anxiety disorder (56.7 vs. 43.3%) as compared to men. More than half of the sufferers with anxiety (56.7%) and depression (53.1%) were Qatari women with a higher frequency in the age group 18–34 years. There were significant differences between men and women with depression in terms of age group (p = 0.004), marital status (p = 0.04), occupation (p

Background: Mental disorders are common in all countries and cause immense suffering. Both gender and low socioeconomic status have been related to depression and other common mental disorders, but their possible relationship to mental health literacy remains uncertain. Aim: The aim of this study was to determine the gender differences in knowledge, attitudes and practices towards mental illness in a sample of Qatari and other Arab expatriates residing in the State of Qatar. Design: This is a cross-sectional survey. Setting: Primary healthcare centres in the State of Qatar. Subjects: A multi-stage sampling design was used and a representative sample of 3,300 Qatari and other Arab expatriates above 20 years of age were surveyed during the period from October 2008 to June 2009. Of the study sample of 3,300, 2,514 subjects (76.2%) expressed their consent to participate. Methods: A questionnaire was designed to assess the gender difference in knowledge, attitudes and practice towards mental illness.This questionnaire was administered to the Arab adult population above 20 years of age who were attending primary healthcare centres for various reasons other than mental illness. Face-to-face interviews were based on this questionnaire, which included variables on socio-demographic characteristics, knowledge, attitude and practice towards mental illness. Results: Of the study sample, 49.2% were men and 50.8% were women. Overall, the studied women held more to the cultural beliefs related to some aspects of mental illness. For example, more women than men believed that mental illness is due to possession by evil spirits. Also, nearly half of the women thought traditional healers can treat mental illness; this belief was significantly lower in men. Some of the women considered people with mental illness as dangerous; a belief also significantly lower in men. Men had a better attitude towards mental illness than women. Men were more willing to visit a psychiatrist for their emotional problems, while women preferred a traditional healer. Women were more afraid than men to talk to the mentally ill. Knowledge of common mental illnesses was generally poor, and it seemed to be lower among women. Men obtained more information than women from the media; women favoured healthcare staff more than men did. Conclusion: The study reveals that men had better knowledge, beliefs and attitudes towards mental illness than women. Most of the women were afraid and not willing to keep friendships with the mentally ill. The results of this study underline the importance of information in changing people’s attitude towards mental illness. Recognition of common mental disorders was very poor in men and women.

The aim of this study was to examine the knowledge, attitudes, and practices concerning mental illness among Qatari and other Arab expatriates. Method: This is a cross-sectional survey conducted from October 2008 to March 2009. A questionnaire was designed to assess knowledge, attitude, and practice regarding mental illness. Results: Of 2254 subjects surveyed, 49.6% were Qataris, 50.4% other Arab expatriates, 54.8% males, and 45.2% females. A majority of the respondents thought that substance abuse like alcohol or drugs could result in mental illness (84.7%). Fewer than half of the subjects believed that mentally ill people are mentally retarded (40.6%). 48.3% believed that mental illness could result from punishment from God. The most common information source on mental illness was media (64.2%). Recognition of common mental disorders in the studied population was poor (72.5%). Conclusion: Knowledge of mental illness among the Arabic-speaking population of Qatar was quite poor.

Objective: The main aim of the study was to examine the impact of patients' ethnic diversity on the patient satisfaction level to psychiatry care and explores the satisfaction domains with mental health care. Design: This is a prospective cross sectional study. Setting: Psychiatry department of the Hamad Medical Corporation. Subjects: The study sample was Qatari and other Arab nationals aged 18 to 65 years who visited the psychiatry department during the study period; April 2009 to August 2009. A total of 1300 adult patients were approached and 1054 (81.1%) expressed their consent to participate in this study. Method: A standard forward-backward procedure was applied to translate the English version of the PDRQ to Arabic. PDRQ was administered by pre-trained nurses among the psychiatry patients. The main outcome measures of the study were 13-item patient doctor relationship questionnaire (PDRQ) score and other 11 items assessing what patients need from psychiatrists. Also, Socio-demographic data of the patients was collected. Results: Of the studied patients, there were 479 Qataris (45.4%) and 575 other Arabs (54.6%). There was a significant differences found between Qatari and Arab expatriate patients in marital status (p=0.036), level of education (p

Obesity and overweight continue to raise in Qatar due to a confluence of factors such as genetics, overeating, inactivity, tradition of food-centered social events, convenience, and advertising of energy-dense fast foods, and hot climate making outdoor activities impractical most of the year. Estimates by experts within and outside Qatar point to an extremely high rate of obesity and overweight in Qatar, with the World Health Organization placing the rate at 78%. This places Qatar among the top of countries worldwide in the overall prevalence of obesity and overweight. Childhood obesity in particular has also been rapidly increasing with the combined rate of obesity and overweight hovering around 40%, up from below 30% less than ten years ago. This trend is alarming due to the increased risks for obesity-related conditions such as diabetes, coronary heart diseases, and lower quality of living. Hence, comprehensive obesity prevention interventions are needed to stem the rise of obesity among Qatari children. This study was conducted to evaluate the effectiveness of an integrated weight loss intervention incorporating lifestyle education, physical activity, and behavioral psychology nudges among Qatari school children. The intervention was designed to integrate family and school support and fit within Qatari school system calendar and schedule. The study was branded Agdar/أقدر and conducted by an interdisciplinary team of collaborators from Qatar (Qatar University, Supreme Education Council, Aspire, Hamad Medical Corporation) and external partners (Imperial College, Leeds Metropolitan University/MoreLife, UK).In the first year of a three-year intervention study, four randomly chosen schools in Qatar participated in the intervention with a total of 941 Qatari children (316 girls and 625 boys) between 9 to 12 years of age of whom 430 children were qualified to participate in the study. A group of four other randomly chosen schools served as control. Out of 430 qualified children, one hundred children (50 boys and 50 girls) with BMI in the 95th percentile from the intervention schools were enrolled in a two phase weight loss intervention. Phase 1 consisted of an intensive weight loss camp with a highly structured set of activity which combined a range of physical activity, lifestyle learning, dietary control, behavioral nudge techniques, and social activity. The second phase consisted of a ten week after school sessions on lifestyle education and weight management for those children who successfully completed camp. These after school/community clubs were run on school premises to facilitate integration in school schedule. The two phases were designed to be complementary: the camp helps children lose weight and introduces them healthy lifestyle behavior, whereas the after school phase embeds/consolidates the knowledge already learnt and helps in long term weight management. During the camp, children participated in a range of structured interactive and skill based activities including a mixture of water based activity, contact games and electives, where the children were able to choose from a range of physical activities. At camp, participants were subjected to a series of assessments including anthropometric (Weight, Height, BMI, Waist Circumference, Blood pressure), Lifestyle and Physical Activity Questionnaires (diet and physical activity), and Psychometric assessment (self-esteem and subjective well-being). During the clubs, only anthropometric measurements took place to ensure the children get the most out of the sessions focusing on reward and recognition and celebrating success regardless of the magnitude of the health improvement. This phase was designed to provide children and parents with the tools, know-how, and the confidence to carry on with the new healthy lifestyle at home as means to ensure durable weight management.Data show that out of the 941 children in intervention schools, 430 children or 45.7% were either overweight or obese, having BMI in the top 95th centile by age. This rate is higher than the 42% we observed in a pilot study conducted by our team in 2014 and the 40% prevalence of overweight and obesity among children reported by other studies.A total of 100 children aged 9–12 completed the camp with a significant reduction in percent BMI SDS of 12.5% (p These improvements in percent BMI SDS reduction (weight loss) and self-esteem occurred in a group that reported an unhealthy lifestyle profile with respect to physical activity and diet. In fact, participant responses painted a profile characterized by little or no physical activity (1 to 2 times/week) with two thirds of participants reporting fewer than 3 occasions of physical activity in their previous week. Participants' diet was characterized by low intake of fruits and vegetables and high intake of calorie-dense foods including sweets, soft drinks, and fast foods. Girls reported eating more fruits than boys but they seem to indulge more frequently in sweets.As the camp phase resulted in a significant weight loss among all participants (100% of participant lost weight at variable levels), particularly girls who were more serious in participation, the clubs were found to help participants in weight management. After an initial weight gain during a 3 week period between camp and club phases (percent BMI SDS reduction down to 10%), participants were able to recover and maintain their post camp levels of BMI SDS reduction. Correlations on data suggest that the more clubs participants (particularly boys) attended, the more likely they were to lose weight during the club phase (p = .028).In summary, the intervention camp was effective in significantly reducing the weight of all participants, despite its short duration of 11 days. After school clubs showed effectiveness in maintaining or further enhancing weight loss achieved in the camp and in engaging parents. The synergistic effect of the camp and after school/community clubs suggests promising potential for successful incorporation of this integrated intervention into the school curriculum, especially since the camp occurs during mid-year school break and the after school clubs during school days. The succeeding cohorts will provide further data for validation of this potential. The one year follow up data are being collected to assess the durability of weight changes and the stickiness of behavioral changes induced by the different phases of this intervention.

s of Theses Approved for the MSc and PhD Degrees at the Faculty of Medicine, Health Sciences Centre, Kuwait University, Kuwait IL-8 levels and the IL-8/IL-10 ratio promise to be good indicators of irreversible pulpitis. An important and potentially very useful outcome of this study is the demonstration that cytokine estimation in pulpal blood may help in the diagnosis of pulpal inflammation. Supported by a Fellowship from the College of Graduate Studies. Raj Raghupathy (Supervisor) Kefah Barrieshi (Co-Supervisor)

Levels of overweight and obesity have reached alarming proportions in Qatar and other Gulf nations. In Qatar, the need to establish national strategies for the prevention and treatment of obesity was recognized in the National Health Strategy 2011-2016, which stresses the need for prevention. The treatment and prevention of childhood obesity is largely through lifestyle changes- encouraging health eating and physical activity. However, changing such behaviors is complex and requires integrated approaches to tackle such a multifaceted problem. In this study, we sought to implement and evaluate a novel weight management program for Qatari school children at the vulnerable age of 9-12 years. The program uses a cognitive-behavioral approach that involves developing social and emotional competences, promotion healthy dietary habits, and development of physical literacy, while enlisting family involvement in an attempt to maintain long term weight loss. This study also sought to take things further by integrating cutting edge insights from behavioral economics. The pilot study was conducted by an interdisciplinary team of collaborators from Qatar (Qatar University, Supreme Education Council, Aspire, Hamad Medical Corporation) and external partners (Imperial College and Leeds Metropolitan University/MoreLife, UK). The study was branded Agdar/???? and involved development of intervention materials, questionnaires, neuropsychological measures, and other study components such as training manuals and virtual world program. A sample of 100 overweight or obese Qatari children (age 9-12) from 5 independent schools participated in the intervention along with a control group. The intervention was conducted in Arabic and consisted of three phases (1) intensive weight loss camps, (2) after-school clubs as consolidation phase, and (3) a maintenance phase using virtual world program. Variables measured included anthropometric (BMI, Fat composition, and Waist circumference, and Blood pressure), Lifestyle (Physical Activity and Dietary questionnaires), and Psychometric assessments (Self-esteem, Subjective well-being, and Impulsivity, including heart monitoring). Overall, 100% of children who participated in the camp lost weight with a significant reduction BMI-SDS (p

Background : Mental Disorders, particularly Depression, are recognised as one of the biggest burden of disease worldwide. Two of the top three burdens of disease in Qatar are mental health related. Yet, this is scarcity of lifetime prevalence data available to understand the impact in this country. Aim : This study uses the WHO Composite International Diagnostic Interview (WHO-CIDI), to measure the lifetime prevalence of the most presenting mental disorders in the adult Qatari population, aged 18-65, and examine their symptom patterns and co-morbidity. Design : This is a cross sectional study conducted during the period from April 2010 to October 2011. Setting : Five Primary Health Care (PHC) Centres distributed around the country. Subjects : A total of 1,500 Qatari subjects aged 18 to 65 years were approached; 1,063 (70.8%) gave consent and participated in this study. Methods : Four field supervisors from Qatar were trained and certified as trainers by IDRAAC, the education and training centre responsible for the Arabic translation and validation of CIDI. Variations in Arabic dialect were reported to IDRAAC for verification and approval. In line with the World Health Organization (WHO) World Mental Health (WMH) Survey Initiative, a nationally representative psychiatric epidemiological survey was carried out in Qatar. Prevalence and severity of ICD-10 disorders were assessed with the WHO Composite International Diagnostic Interview (CIDI, Version 3.0). Results : Of the studied 1063 subjects, 50.1% were males and 49.9% were females. Most of the respondents were in the age group 18-34 years (46.1%), followed by 35-49 years (34.1%), then 50-65 years (19.8%). The most common ICD-10 disorders were specific generalized anxiety disorders (20.4)%, and major depression (19.1%), with a higher prevalence in women. 20.6% of the sample had chronic physical conditions. There were high levels of statistically significant differences between age groups and gender regarding Generalized Anxiety Disorders, Social phobia, specific phobia, major depression, and personality disorders screen. Women performed significantly worse as assessed by the 30 day functioning screen (p < 0.001). Conclusion : The findings of this study in lifetime prevalence of mental disorders in Qatar are comparable with international figures. Women were more likely than men to have mental illness. Overall, Generalized Anxiety Disorders; Social phobia, specific phobia, major depression, and personality disorders were the commonest disorders.

Aims: The aim of the study was to determine the extent of compliance and noncompliance with treatment of psychiatric patients and examine the factors affecting compliance and non-compliance with treatment. Study Design: Hospital based prospective descriptive study. Place and Duration of Study: The study was carried out from September 2010 to May 2011 in Qatari population aged above 16 years at the Psychiatry Department of the Hamad Medical Corporation, Qatar. Methodology: The study included 628 patients aged 16-77 years who were hospitalized with psychiatric disorders and treated in the outpatient clinics of the Psychiatry department. The diagnostic classification of definite psychotic disorders was according to Original Research Article British Journal of Medicine & Medical Research, 4(2): 785-796, 2014 786 the International Classification of Disease, Tenth revision (ICD-10). Results: Of the 628 patients studied, 62.4% of them were compliant with treatment and 37.6% were non-compliant. High compliance was significantly more in patients in the age group (16 20) years old (84.4%), retired (70.2%) and housewives (70%) (P

The aim of this study was to examine the gender differences in the prevalence of somatoform disorders among a sample of Qatari patients who were visiting primary health care centers and to investigate the severity of diagnostic categories and the most frequent somatic symptoms in these patients. The first stage of the study was conducted with the help of general practitioners, using the somatic symptom module of the Patient Health Questionnaire 12-item General Health Questionnaire. Overall, 2320 subjects were approached, and a total of 1689 patients, of whom 892 were men and 797 were women, agreed to participate in the study. The prevalence rate of somatoform disorders among the total screened sample was 23.9%. The prevalence rate was slightly higher in Qatari women (24.2%) than in Qatari men (23.7%). Housewives (43.5%) and men in administrative posts (37.9%) reported higher somatic symptoms compared to other professions. Prolonged depressive reaction was significantly higher in women compared to men ( P = .003). There was a significant gender difference in certain psychiatric diagnostic categories such as depressive episode, recurrent depressive disorder, dysthymia, and brief depressive reaction. Backache was the most common reported symptom in men, whereas headache was more common in women. The present study revealed that the prevalence of somatoform disorders in Qatar is as high as the overall prevalence reported in prior studies done in other primary care settings. The prevalence of somatoform disorders was slightly higher in Qatari women than in men.

AIM: To examine the possible association between gastrointestinal symptoms and anxiety and depression in type 2 diabetes mellitus (T2DM). METHODS: The study was a matched case-control study based on a face to face interview with designed diagnostic screening questionnaires for gastrointestinal (GI) symptoms and T2DM, Patient Health Questionnaire (PHQ-9) for depression and General Anxiety Disorders (GAD-7) for anxiety. The questionnaire consisted of questions about symptoms and signs of anxiety and depression disorders. Also, socio-demographic characteristics, life style habits and the family history of patients were collected. It was carried out from June 2010 to May 2011 among Qatari and other Arab nationals over 20 years of age at Primary Health Care Centers of the Supreme Council of Health, Qatar, including patients with diabetes mellitus and healthy subjects over 20 years of age. RESULTS: In the studied sample, most of the studied T2DM patients with GI symptoms (39.3%) and healthy subjects (33.3%) were in the age group 45-54 years (P < 0.001). The prevalence of severe depression (9.5% vs 4.4%, P < 0.001) and anxiety (26.3% vs 13.7%, P < 0.001) was significantly higher in T2DM patients with GI symptoms than in general population. Obesity (35.7% vs 31.2%) and being overweight (47.9% vs 42.8%) were significantly higher in T2DM patients with GI symptoms than in healthy subjects (P = 0.001). Mental health severity score was higher in T2DM patients with GI symptoms than in healthy subjects; depression (8.2 ± 3.7 vs 6.0 ± 3.6) and anxiety (7.6 ± 3.3 vs 6.0 ± 3.7). The most significant GI symptom which was considerably different from controls was early satiety [odds ratio (OR) = 10.8, P = 0.009] in depressed T2DM patients and loose/watery stools (OR = 2.79, P = 0.029) for severe anxiety. Anxiety was observed more than depression in T2DM patients with GI symptoms. CONCLUSION: Gastrointestinal symptoms were significantly associated with depression and anxiety in T2DM patients, especially anxiety disorders.

The aim of this study is to systematically review the literature that explored the association between smoking and suicidal risk among those with serious mental illness and to estimate the risk of suicidal behaviors attributable to smoking among this patient group. Multiple databases (CINAHL, PsycINFO, EMBASE, Informit Health Collection and the Cochrane Library databases) were searched from 1 January 1975 through 15 January 2014, along with references from relevant articles for observational studies that ascertained the association between smoking and suicidal behaviors among patients with psychotic disorders conducted in adult patients. Thirteen studies involving 6813 patients with severe mental illness were included. We found that smoking was significantly associated with suicidality in psychosis with an Odds Ratio of 2.12 (95% CI 1.67-2.7). Smoking is associated with suicidal risk amongst individuals with a severe mental illness; however, it is still unclear whether this represents a true risk factor or a confounder or a mediator via mechanisms, hitherto unknown, needs to be studied further.

The aim of this study is to systematically review the literature that explored the association between smoking and suicidal risk among those with serious mental illness and to estimate the risk of suicidal behaviors attributable to smoking among this patient group. Multiple databases (CINAHL, PsycINFO, EMBASE, Informit Health Collection and the Cochrane Library databases) were searched from 1 January 1975 through 15 January 2014, along with references from relevant articles for observational studies that ascertained the association between smoking and suicidal behaviors among patients with psychotic disorders conducted in adult patients. Thirteen studies involving 6813 patients with severe mental illness were included. We found that smoking was significantly associated with suicidality in psychosis with an Odds Ratio of 2.12 (95% CI 1.67-2.7). Smoking is associated with suicidal risk amongst individuals with a severe mental illness; however, it is still unclear whether this represents a true risk factor or a confounder or a mediator via mechanisms, hitherto unknown, needs to be studied further.

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.

Introduction The department of Psychiatry at Hamad Medical Corporation (HMC) in Qatar, and guided by the national mental health plan, initiated a plan for suicide registry for the country. Objectives Collect information on the patients presenting with self-harm and suicidal behaviors to the Emergency Department (ED), the primary emergency facility in Qatar. Aims Collection of data on the characteristics of the patients presenting to ED with intentional or accidental self-harm. Methods Retrospective chart review of all the cases presented to ED with self-harm, suicide attempts or committed suicide during the period between July 2011 and July 2012. Questionnaires were developed to collect the socio-demographic and clinical data available. Results A total of 470 cases were identified (48 completed suicide, 165 admitted/suicide attempts, 105 intentional self-harm/not admitted and 152 accidental self harm). The majority of completed suicide were males, expatriates, in their mid 30s and died by hanging. In the admitted suicide attempters, the method was overdose; the male/female ratio was equal, mostly single, employed expatriates, and no past psychiatric diagnosis, substance abuse or previous suicide attempts. The majority of accidental self-harm were secondary to intake of high doses of non-opiate painkillers. Data on many variables were missing. More comparisons will be presented in relation to the demographics in Qatar. Conclusions The data suggest that the single male immigrants in Qatar should receive more support and more screening. More prospective data are needed with adequate collection of data to improve the quality of the registry and thus design better prevention programs.

Background: Recognizing patient satisfaction and expectation is considered as important components of assessing quality of care.Aim: The aim of this study was to determine the gender difference on the patient satisfaction with psychiatrists and explore their expectation from physicians to mental health care needs.Design: This is a prospective cross sectional study conducted during the period from April 2009 to July 2009.Setting: Psychiatry hospital of the Hamad Medical Corporation.Subjects: A total of 1300 psychiatry patients aged 18 to 65 years were approached and 1054 (81.1%) patient’s participated in this study. The study sample included only Qatari and other Arab nationals.Materials and Methods: The study was based on a face to face interview with a designed Patient Doctor Relationship Questionnaire (PDRQ). A standard forward-backward procedure was applied to translate the English version of the PDRQ to Arabic. The main outcome measures of the study were 13-item patient doctor relationship questionnaire (PDRQ) score and other 11 items assessing what patients need from psychiatrists. Also, Socio-demographic data of the patients were collected. PDRQ was administered by qualified nurses among the psychiatry patients.Results: Of the studied patients, 50.9% were males and 49.1% were females. Male patients (55.5%) were more satisfied with the treatment of psychiatrists than females (44.5%). A significant association was observed between male and female patients in terms of marital status (P = 0.02), number of children (P < 0.001), education level (P = 0.001) and monthly household income (P = 0.03). The satisfaction level significantly increased with higher education in both the groups (P = 0.001). The satisfaction level of male patients was significantly higher than female patients in most of the satisfaction areas (P ≤ 0.001). Male patients had significantly high expectations from psychiatrists than females (P < 0.001). Both the groups had different attitude in assessing mental health needs.Conclusion: The study findings revealed that in general, psychiatry patients were quite satisfied with the services provided by the psychiatrists and the study found a gender difference in their satisfaction level with the mental health care. Male patients had significantly greater expectations from psychiatrists than females. The individuals of lower socio-economic status and less education tend to be less satisfied with the mental health care.Key words: Gender, mental health, PDRQ, Satisfaction

Aim The aim of this study was to assess the prevalence of anxiety and depressive disorders in a Qatari population who attend the primary health care settings and examine their symptom patterns and comorbidity.

Background: Medically unexplained somatic complaints are among the most common clinical presentations in primary care in developing countries and they are considerable burden for patients and health care system. Objectives: The aim of this study was to determine the prevalence of somatisation in comparison to psychologisation among a sample of Qatari patients who were visiting primary health care (PHC) centres and to investigate the clinical and socio-demographic characteristics of somatisers (STs) and psychologisers (PGs). Method: The survey was conducted among PHC Qatari patients during the period from January to July 2007. About 2,320 patients were approached, of whom 1,689 agreed to participate and responded to the questionnaire. Among the studied Qatari patients, 404 patients were identified for clinical interview. The first stage of the study was conducted with the help of general practitioners, using the 12-item General Health Questionnaire. The second stage was carried out by a consultant using the Clinical Interview Schedule. A specific operational criterion was used to identify STs and PGs. Results: The prevalence rate of STs among the total studied sample was 12.4%, while the PGs were 11.5%. Among the identified psychiatric cases, the proportion of STs (52%) was higher than PGs (48%). Most of the diagnostic categories were more prevalent among PGs. The dissatisfaction at work and stressful life events within 12 months before the onset of the presenting symptoms were the three postulated determinants which were significantly more among STs than PGs. Conclusion: The prevalence of somatised mental disorder was little higher than the psychologised mental disorder. The prevalence of somatisation and psychologisation is comparable with other reported studies from the Middle-East and Western countries. Dissatisfaction at work and stressful life events were significantly higher among STs than PGs. Keywords: somatisers; psychologisers; primary health care; determinants; Arab culture (Published: 16 June 2010) Citation: Libyan J Med 2010, 5: 5266 - DOI: 10.3402/ljm.v5i0.5266