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Identifying the Knowledge and Attitudes Towards Suicidal Warning Signs Among University Students in the UAE
- Hamid Alhaj, Amal Ali, Hagar Abdulrahman, Mariam Rawashdeh, Omar Hamrawi, Tarek Zaki, Yazan Katroon
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- Journal:
- BJPsych Open / Volume 9 / Issue S1 / July 2023
- Published online by Cambridge University Press:
- 07 July 2023, pp. S43-S44
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Aims
One of the top causes of death and injury among adolescents and young adults is suicidal behaviour. Indeed, suicide is the second leading cause of death among individuals aged between 15 and 24 years worldwide. Studies on the prevalence of suicide among university students in the UAE are scarce. Importantly, the extent of awareness and experience of suicidality among this group is still unknown. We aimed to ascertain the knowledge and attitudes towards suicidal warning signs and symptoms amongst university students in the UAE.
MethodsAn online self-administered questionnaire platform was used to collect data from UAE university students in a quantitative cross-sectional study. In addition to demographics, experience regarding suicidal thoughts and behaviours, efficacy expectations, and outcome expectations and values were evaluated. Data were analysed using SPSS, setting a p-value of <0.05 as statistically significant.
ResultsA total of 392 participants completed the questionnaire, 233 (59.4%) were males and 159 (40.6%) were females. Based on the knowledge scale, only 35.3% of total participants were identified as knowledgeable of the warning signs of suicide. Expectedly, out of the knowledgeable group, a vast majoring of 83.3% were medical students. When they were asked about what they would do if a friend told them that they are thinking about ending their life, many of the students chose to talk to their friends without getting anyone else's help. There was no statistically significant correlation between being educated regarding suicide and being knowledgeable of suicidal signs and symptoms (P = 0.1). Surprisingly, the degree course students enrolled in was not found to play a significant role in their level of confidence regarding suicidal signs and symptoms.
ConclusionTo our knowledge this is the first study to investigate awareness and attitudes about suicidal thoughts and behaviours among university students in the UAE. Knowledge regarding suicidal signs and symptoms among university students in the UAE is notably low. According to the results, self-reported education did not play a major role in appropriately managing suicidal signs and symptoms. The nature of the education provided to students needs to be further investigated to explore the gaps in the knowledge provided.
Can Functional Visual Loss Occur in an Older Adult Patient With a History of Stroke: A Case Report
- Abdullah Aldweik, Kholod Haj Hussain, Hamid Alhaj
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- Journal:
- BJPsych Open / Volume 9 / Issue S1 / July 2023
- Published online by Cambridge University Press:
- 07 July 2023, p. S118
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Aims
Nonorganic visual loss, or functional blindness, is estimated to account for up to 5% of all presentations of blindness. This form of blindness can be ascribed to either a psychogenic aetiology or to malingering. Psychogenic blindness is often a manifestation of conversion disorder, in which a psychiatric condition impairs the normal physical functioning of the affected individual. This could lead to both motor and sensory defects, given that they are not better explained by an organic cause, which should be ruled out by investigations that prove an intact visual system. The individual would also commonly have an identifiable source of stress or trauma. Conversion disorders are less prevalent in older adults, and they may be missed where there are organic comorbidities.
MethodsA 67-year-old male with a recent history of stroke was diagnosed with a major depressive disorder, characterized by low mood, anhedonia, insomnia, fatigue, poor appetite, poor concentration, feelings of guilt, negative feelings about life, and hopelessness. Multiple social problems and family conflicts were identified as possible precipitating factors. Sertraline led to some good initial response, although it was later discontinued. A few months later, he developed severe depression with irritability and suicidal ideation, and he was repeatedly requesting euthanasia. At this point, there was a sudden loss of his vision. Following a thorough ophthalmology evaluation, neurological assessment, and investigations including MRI of the head, cortical blindness was ruled out. As a result, he was diagnosed with visual conversion disorder. After recommencing treatment for his depression with a psychotherapeutic approach as well as vortioxetine antidepressant medication, the visual loss resolved, and the issue has not recurred since then. There was also a significant improvement in his mood. He no longer feels suicidal and appears to be brighter and more socially interactive.
ResultsUncertainty regarding aetiology might initially arise if the patient has a history of trauma or a pathological condition that could cause blindness, such as diabetic retinopathy or stroke, both of which would have been differential diagnoses in the patient in this case had they not been debunked by further investigations, which included neuro-ophthalmic assessments and radiographic studies. The patient's improvement with antidepressants and counselling further supports the diagnosis of visual conversion disorder.
ConclusionFunctional blindness, which is an aspect of conversion disorder, may be a representation of how detrimental undiagnosed and untreated depression could be.
The Prevalence of OCD Like Symptoms Among UAE Residents During COVID-19 Pandemic
- Hamid Alhaj, Amena Ali, Hamid Askari, Hend Ibrahim, Leena Mohamed Ali, Leen Kassasand, Noura Al Nasere
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- Journal:
- BJPsych Open / Volume 8 / Issue S1 / June 2022
- Published online by Cambridge University Press:
- 20 June 2022, p. S2
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Obsessive-compulsive disorder (OCD) is a psychiatric disorder characterised by repetitive, undesirable thoughts or acts. With the pandemic being on the rise, public health authorities have urged people to take proper health measures, specifically around hand washing and social distancing. It is hypothesised that such sudden change would cause excessive hygiene habits in people predisposed to OCD. Our study aimed to measure how COVID-19 pandemic affected the prevalence of OCD-like symptoms among the UAE population. Furthermore, we explored the correlation between these symptoms and demographic factors.
MethodsThis was a quantitative cross-sectional study that used an online survey platform to collect responses from male and female adult UAE residents (aged between 18 and 60 years). The self-administered questionnaire included Yale-Brown Obsessive compulsive scale (YBCOS) to test the severity of obsessions and compulsions, in addition to demographic questions. People with a previous diagnosis of obsessive-compulsive disorder were excluded. Data were analysed using SPSS 23. A bivariate analysis to examine the correlation between the severity of the reported symptoms and sociodemographic characteristics, age, and ethnicity was conducted. A p-value <0.05 was considered statistically significant.
ResultsA total of 343 questionnaires were completed and used for analysis; 244 of which were females and 99 were males. 63.5% of females had no symptoms of OCD, 24.6% had mild symptoms, 9% had moderate symptoms, 2.5% had severe symptoms, and 0.4% had extreme OCD symptoms. In males, 75.8% had no OCD symptoms, 18.2% had mild OCD, 6.1% had moderate OCD, and 0% had severe or extreme OCD. A significant correlation was found between the Emirate of residence and the severity of OCD-like-symptoms (P = 0.042). The most significant scores of OCD symptoms were in Sharjah, with 10 people out of 108 displaying moderate to extreme symptoms, Abu Dhabi with 9 out of 115 and Fujairah with 7 out of 56. Level of education, occupation and age had no significant role in the exhibition of the symptoms.
ConclusionTo our knowledge this is the first study to investigate the prevalence of OCD-like symptoms within the UAE residents during COVID-19 pandemic. The symptoms of potential clinical significance of OCD are high, especially in females compared to the global prevalence studies prior to COVID-19, although a within-subject comparison is not possible. Further research is warranted to investigate the long-term effect of COVID-19 on OCD-like and other neuropsychiatric symptoms and elucidate possible mechanisms.
In memory of Professor Iain Wilkinson: cognitive and neuroimaging endophenotypes in a consanguineous schizophrenia multiplex family
- Iain D. Wilkinson, Tariq Mahmood, Sophia Faye Yasmin, Anneka Tomlinson, Jamshid Nazari, Hamid Alhaj, Soumaya Nasser el din, Joanna Neill, Chhaya Pandit, Shahzad Ashraf, Alastair G. Cardno, Steven J. Clapcote, Chris F. Inglehearn, Peter W. Woodruff
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- Psychological Medicine / Volume 53 / Issue 7 / May 2023
- Published online by Cambridge University Press:
- 07 February 2022, pp. 3178-3186
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Background
Schizophrenia endophenotypes may help elucidate functional effects of genetic risk variants in multiply affected consanguineous families that segregate recessive risk alleles of large effect size. We studied the association between a schizophrenia risk locus involving a 6.1Mb homozygous region on chromosome 13q22–31 in a consanguineous multiplex family and cognitive functioning, haemodynamic response and white matter integrity using neuroimaging.
MethodsWe performed CANTAB neuropsychological testing on four affected family members (all homozygous for the risk locus), ten unaffected family members (seven homozygous and three heterozygous) and ten healthy volunteers, and tested neuronal responses on fMRI during an n-back working memory task, and white matter integrity on diffusion tensor imaging (DTI) on four affected and six unaffected family members (four homozygous and two heterozygous) and three healthy volunteers. For cognitive comparisons we used a linear mixed model (Kruskal–Wallis) test, followed by posthoc Dunn's pairwise tests with a Bonferroni adjustment. For fMRI analysis, we counted voxels exceeding the p < 0.05 corrected threshold. DTI analysis was observational.
ResultsFamily members with schizophrenia and unaffected family members homozygous for the risk haplotype showed attention (p < 0.01) and working memory deficits (p < 0.01) compared with healthy controls; a neural activation laterality bias towards the right prefrontal cortex (voxels reaching p < 0.05, corrected) and observed lower fractional anisotropy in the anterior cingulate cortex and left dorsolateral prefrontal cortex.
ConclusionsIn this family, homozygosity at the 13q risk locus was associated with impaired cognition, white matter integrity, and altered laterality of neural activation.
An innovative method of expanding the support for doctors returning to training in psychiatry after a period of extended leave: the Sheffield Mindful Support Programme
- Helen Linnington, Hamid Alhaj
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- Journal:
- BJPsych Open / Volume 7 / Issue S1 / June 2021
- Published online by Cambridge University Press:
- 18 June 2021, p. S145
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Aims
To offer regular continuous professional development opportunities covering both clinical and non-clinical skills to trainees and trainers and enhance their experience and skills to increase their wellbeing and resilience.
BackgroundThere are approximately 50,000 doctors undertaking postgraduate training in England. Of these, 10% (5000) are taking approved time out of training at any time. A 2017 HEE survey revealed that doctors returning to work reported numerous concerns. Based on these and with the backdrop of the Bawa-Gaba case HEE's Supported return to Training programme (SuppoRTT) was developed.
We at Sheffield Health and Social Care NHS Foundation Trust devised a unique “Mindful SuppoRTT” initiative and were successful in securing funding from HEE. Part of which was the organisation of a conference aimed at various groups of doctors including those who have previously had time out of training, are currently out of training and those considering time out.
The Sheffield Mindful SuppoRTT Programme not only aimed to provide a structured and systematic process for planning and returning from absence, but also focussed on enhancing performance through promoting the wellbeing of participants and supporting them with important clinical and non-clinical skills.
Method2-day twice yearly conferences, which covered training on speciality specific as well as non-technical skills were organised. The clinical workshops covered interactive sessions of common and emergency clinical scenarios. A wide range of non-technical skills such as an introduction to mindfulness, tai chi, resilience, team-working and leadership, “Thinking Environment” and meditation were introduced and developed using bespoke training. Feedback was collected at the end of each conference day. The attendees were asked to use a 5-point Likert scale (5 being the highest) to rate their satisfaction with the day and to highlight which sessions they found most and least useful.
ResultThe attendee satisfaction rate was high. The first conference had ratings of 56% of attendees scoring 5 (excellent) and the remainder scoring 4 (very good). The second conference achieved even higher satisfaction ratings with 94% of attendees scoring 5 and the remainder scoring 4.
ConclusionThe conference had high attendee satisfaction. The hope is to expand on its success and open it up to delegates from all specialities within HEE South Yorkshire and the Humber. Evaluation of the long-term impact of this programme is also warranted.
More than just the mental health act – foundation-specific teaching to inspire psychiatrists
- Robert Heminway, Lauren Fitzmaurice, Hamid Alhaj, Edward Fearnley
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- Journal:
- BJPsych Open / Volume 7 / Issue S1 / June 2021
- Published online by Cambridge University Press:
- 18 June 2021, pp. S139-S140
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This project aimed to further develop a teaching programme for Foundation Doctors attached to a psychiatry rotation. The purpose was threefold – to educate foundation doctors about important psychiatric topics; to encourage them to think about wider impacts of psychiatry; and to inspire them to consider psychiatric training in the longer term.
BackgroundThe Royal College of Psychiatrists’ mission statement includes actively promoting psychiatry as a career and improving knowledge of mental health, including its interactions with people's physical and social backgrounds. Targeting foundation doctors rotating into psychiatry posts is a good opportunity to achieve these objectives, as they will be the cross-speciality doctors of the future, and have specific learning needs given their unique rotations and new medical careers.
MethodOn one Wednesday morning per month Foundation Doctors had a specific teaching session for them. The sessions consisted of four 30-minute teaching blocks which, crucially, were given by foundation doctors. They were facilitated by a core psychiatry trainee, and the topics were decided by the doctor teaching each 30-minute block. The foundation doctors were able teach on any topic related to psychiatry that interested them. Feedback forms were developed and provided at the end of each session for the foundation doctors, as well as at the end of each recent foundation rotation, to get feedback on the overall quality of the course delivered.
ResultThe programme has now had 6 complete cohorts of foundation doctors. We have built a varied topic bank from past sessions, including the Mental Health Act, dementia, the Mind-Body Problem, psychiatry in video games and sociology of psychiatric illness, amongst other topics. All foundation doctors questioned have agreed or strongly agreed that the sessions were helpful for their psychiatric rotation and general medical training. Particularly praised aspects were the ability to discuss psychiatric topics that weren't normally discussed in an academic environment, being able to take ownership over learning and practicing giving teaching. Vitally, core trainee facilitators also found the sessions inspiring for their training.
ConclusionThe Foundation Teaching Programme has increased doctors’ knowledge of a range of psychiatric topics, the breadth of which and agency in choosing topics has increased engagement with psychiatry, regardless of planned medical training speciality. Areas to explore in the future include potentially opening attendance to medical students and physician associate students, and to other regions of the deanery. Evaluating the long-term impact of this training is also warranted.
Attitudes and decision-making processes of Midwakh smoking among adult males in UAE
- Hamid Alhaj, Rahaf Abughosh, Batool Aldaher, Asma Elhewairis, Ahmed Ali, Fatima Alnaqbi, Shaikha Alzaabi, Basema Saddik
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- BJPsych Open / Volume 7 / Issue S1 / June 2021
- Published online by Cambridge University Press:
- 18 June 2021, p. S233
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Midwakh, which involves smoking an Arabian tobacco blend typically mixed with herbs and spices, has recently become a major health concern due to a spreading popularity among adolescents and young adults in the United Arab Emirates (UAE). It is known to contain a higher nicotine content than cigarettes, potentially increasing the risk of addiction, despite contrary popular belief among young smokers. Yet, little is known about attitudes and decision-making processes involving this emerging smoking behaviour. The aim of this study was to ascertain the knowledge, attitudes and practices of Midwakh use among adult males in the UAE.
MethodA cross sectional study was conducted among male adults in Abu Dhabi, Dubai and Sharjah. A total of 500 participants completed self-administered validated questionnaires, which consisted of 30 questions that targeted the public's understanding, perception and use of Midwakh. Data were analysed using SPSS 23. Percentages and means were calculated for demographic data and Chi-Square was utilised to measure relations between categorical variables. Odds Ratio (OR) was used to estimate how strongly a predictor was associated to an outcome. A p-value less than 0.05 was considered statistically significant.
ResultThe prevalence of smoking Midwakh was 34.8% among the study sample. Males between ages 26 to 35 were found to be 4.48 times (95% CI: 1.59–12.66) more likely to be current Midwakh smokers than any other age groups (P = 0.01). Emiratis in the study were 5.92 times (95% CI: 2.83–12.35) more likely to smoke Midwakh than expats. 65% of respondents reported willingness to smoke Midwakh if it was offered to them. Adults with 3-4 close friends who smoke Midwakh were 6.8 times (95% CI: 2.08–22.41) more likely to smoke Midwakh themselves. Knowledge of being unsafe was cited in 62% of the participants as a cause of quitting Midwakh within two years.
ConclusionOur results demonstrate a significant impact of peer pressure on the decision-making process of Midwakh smoking. The high prevalence among young male residents warrants a multi-agency public health approach to tackle the issue. Culturally sensitive campaigns raising awareness to the harmful effect of Midwakh including its addictiveness appear to be essential. Further research investigating the effects of a targeted Midwakh-smoking cessation approaches is warranted.