Diabetes and mental health problems are closely linked, yet evidence examining this relationship among international labour migrants in the Gulf region is limited. Labour migrants are exposed to distinct occupational and psychosocial stressors that may increase vulnerability to depression and anxiety, particularly in the context of chronic diseases such as diabetes.

This study examined the prevalence and correlates of depressive and anxiety symptoms among male migrant workers with type 2 diabetes attending out-patient services in Qatar.

A clinic-based, cross-sectional study was conducted among adult male migrants receiving care at endocrinology out-patient clinics in Qatar. Symptoms of depression and anxiety were assessed using Patient Health Questionnaire 9 and Generalized Anxiety Disorder 7. Sociodemographic and clinical variables were collected using structured questionnaires and electronic medical records. Associations between clinical and sociodemographic factors and mental health outcomes were examined using chi-square tests and logistic regression analyses.

A total of 339 participants were included, predominantly of South Asian origin. Clinically significant depressive symptoms were identified in 21.3% of participants, with 14.8% reporting clinically significant anxiety symptoms. Depression severity was significantly associated with diabetes treatment modality and past psychiatric history. Anxiety severity was significantly associated with ethnicity and past psychiatric history. In multivariate analysis, past psychiatric illness independently predicted anxiety symptoms (odds ratio 6.24, 95% CI: 1.91–20.38, p = 0.002). No significant associations were observed between mental health outcomes and glycaemic control or duration of diabetes.

Lower-skilled male labour migrants with diabetes experience a substantial burden of depressive and anxiety symptoms, highlighting a clinically important but often overlooked dimension of diabetes care in this population. Past psychiatric illness and more complex diabetes treatment regimens were associated with poorer mental health outcomes. These findings support the need for integration of mental health assessment and targeted support within routine diabetes services for migrant worker populations.

Autism Spectrum Disorder (ASD)-related catatonia presents a significant diagnostic and management challenge, due to the overlap between catatonic features and core autistic traits. Adolescents with ASD appear to be at increased risk of catatonic deterioration often triggered by psychosocial stressors and underlying neurobiological factors. This case describes a 16-year-old female adolescent whose catatonia was primarily driven by underlying autism, illustrating the crucial role of ASD-related mechanisms in both her deterioration and recurrence. Current literature review reveals a small number of documented adolescent catatonia cases indicating limited clinical and research consideration to this population.

A multidisciplinary treatment approach integrating pharmacological, psychological, and environmental strategies was implemented. Pharmacological management included Lorazepam (1 mg BD) targeting motor symptoms, alongside Olanzapine (5 mg ON) and Sertraline (150mg OD) to address comorbid anxiety, emotional dysregulation, and behavioural rigidity. Regular physical health monitoring remained unremarkable throughout. Additionally, the adapted for children version of the Bush Francis catatonia scaled was utilised to measure symptoms. Psychological interventions focused on anxiety reduction, restoration of independence, and development of structured daily routines. Environmentally, a low-arousal setting was prioritised with consistent 1:1 support as part of Level 3 observations. This provided containment, predictability, relational stability and reduced sensory overload. Collaborative multidisciplinary working and graded Section 17 leave facilitated a smooth transition back to the community.

A clinical decline was observed when Lorazepam was tapered and observation levels reduced to Level 2 (15-minute checks). Catatonic features including behavioural “stuckness,” delayed motor initiation, increased ritualistic behaviour, and reduced self-care re-emerged. Marked improvement was observed following the reintroduction of 1:1 support as part of Level 3 observations and an increased Lorazepam dose. This clear temporal association emphasises that environmental structure and sustained relational support are as critical as pharmacological treatment.

This case highlights the importance of recognising catatonia as a treatable manifestation of ASD. The clinical course established how ASD specific neurobiological vulnerabilities impacted to the initial deterioration and subsequent relapse. Recovery was dependent not only on benzodiazepine responsiveness but also on maintaining consistency, predictability, and therapeutic connection. A formulation driven, multidisciplinary approach balancing pharmacological, psychological, and environmental interventions is essential for sustaining improvement and preventing relapse in autistic adolescents with catatonia.

Catatonia is a neuropsychiatric condition that is frequently under-recognised in children and adolescents and may co-occur with a range of psychiatric and neurodevelopmental disorders, including autism spectrum disorder (ASD). Diagnosis is often challenging due to symptom overlap with neurological and psychotic conditions. In individuals with ASD, catatonia may be precipitated or exacerbated by environmental stressors and disruption to established routines. This case report aims to describe the presentation, diagnostic process, treatment, and longer-term management of catatonia in an adolescent with ASD, with particular emphasis on pharmacological treatment, electroconvulsive therapy (ECT), and psycho-ecological interventions.

We report the case of a 16-year-old female who presented with a five-month history of mutism, immobility, unsteady gait, and markedly reduced oral intake, resulting in significant weight loss, nasogastric feeding, and hospital admission. Extensive investigations, including CT and MRI brain imaging, EEG, autoimmune encephalitis screening, metabolic testing, chromosomal microarray, and whole genome sequencing, were unremarkable. A lorazepam challenge produced a marginally positive reaction, thus supporting the catatonia diagnosis. The lorazepam dosage was escalated to 12 mg per day, which yielded partial improvement, though this was limited by sedation. Due to the inadequate response, electroconvulsive therapy (ECT) was commenced.

The first six ECT sessions did not produce any improvement; however, from the seventh session onwards, a substantial and sustained recovery was noted, marked by the resumption of speech, mobility, and functional autonomy. Rehabilitation strategies incorporated structured physical activity and social engagement. Despite the initial progress, symptoms later recurred, including psychomotor retardation and confusion. Fluoxetine and quetiapine were subsequently introduced based on collateral history, resulting in partial improvement. A subsequent neurodevelopmental assessment confirmed a diagnosis of ASD, along with learning difficulties.

Following discharge, a relapse occurred several months later, which was linked to stopping lorazepam and less social interaction. When the patient was readmitted, a psycho-ecological approach was emphasised. This approach focused on organising the environment, managing sensory input, establishing predictable schedules, and helping the patient reintegrate socially. All psychotropic medications were stopped due to low efficacy, except lorazepam. Gradual improvement was seen, along with increased involvement in psychosocial activities.

This case highlights the importance of catatonia as a significant but treatable condition in adolescents with ASD. Although lorazepam and ECT were effective for quickly controlling symptoms, lasting recovery depended on psycho-ecological approach with consistent environment, structured routines, family involvement, and ongoing social interaction.

Prolonged armed conflict profoundly impacts children’s mental health. This study investigated elevated rates of post-traumatic stress disorder (PTSD) symptoms among displaced Palestinian youth residing in Qatar. A cross-sectional study included 350 Palestinian children and adolescents aged 8–18 years displaced from Gaza. The Child PTSD Symptom Scale – Self-Report Version for DSM-5 (CPSS-5) and a Demographic and Resilience Questionnaire were used. Descriptive statistics and multiple linear regression identified factors associated with PTSD symptoms.

It was found that 54.9% of participants met the threshold for probable PTSD (CPSS-5 score ≥31). Intrusion and arousal symptoms had the highest average severity scores. Factors associated with higher PTSD severity included formal education, physical injury during the war and witnessing death, particularly that of close relatives.

The findings emphasise the urgent need for accessible, culturally appropriate and sustained mental health interventions. Longitudinal research is needed to understand long-term trajectories and inform comprehensive support systems.

Multidrug-resistant organisms (MDROs) such as carbapenem-resistant Enterobacterales (CRE) are a significant public health threat. Patients colonized with MDROs are at higher risk of severe outcomes and can serve as a source of spread to others. The public health impact of a hypothetical agent that reduces MDRO load (i.e., pathogen reduction), including in the gastrointestinal tract, has not been described.

Compartmental models of CRE transmission in healthcare facilities were used to estimate the impact of a hypothetical pathogen reduction agent on CRE bloodstream infections (BSIs) and deaths.

The agent was assumed to reduce the time to pathogen clearance with effectiveness varying from 25–100% across simulations. Interventions were modeled in acute care hospitals (ACHs), critical access hospitals, long-term acute care hospitals (LTACHs), skilled nursing facilities, and ventilator-capable skilled nursing facilities (vSNFs). Direct effects (among patients who received the agent) and indirect effects (among patients who did not receive the agent) were estimated at the national healthcare network level.

At baseline without intervention, an estimated 2,086 CRE BSIs and 622 associated deaths occurred annually nationwide. Use of a pathogen reduction agent in LTACHs and vSNFs averted 69–75% of CRE BSIs nationally, with greater reductions when expanded to all facility types. Approximately 90% of averted CRE BSIs would have occurred in patients who were not administered the agent.

An effective pathogen reduction agent might substantially reduce MDRO infections and deaths among patients in U.S. healthcare facilities. New and expanded efforts are needed to accelerate the development of such products.

Children displaced by armed conflict are at high risk of experiencing psychological distress. The ongoing war in Gaza has resulted in widespread trauma among Palestinian youth, yet limited data exist on their mental health following displacement. This study assessed the prevalence and correlates of anxiety and depressive symptoms among war-displaced Palestinian refugee children and adolescents resettled in Qatar.

To estimate the prevalence of clinically significant anxiety and depressive symptoms and to identify psychosocial and trauma-related factors associated with symptom severity in this population.

A cross-sectional study was conducted among 350 Palestinian children (aged 8–17 years) residing in a residential compound in Qatar. Symptoms of anxiety and depression were measured using the Screen for Child Anxiety Related Emotional Disorders-Child Version and the Short Mood and Feelings Questionnaire-Child Version, respectively. A Resilience and Demographic Questionnaire was devised to assess trauma exposure and psychosocial variables. Multiple linear regression identified factors associated with symptom severity.

Clinically significant anxiety and depressive symptoms were found in 70.9 and 46.0% of participants, respectively. Separation anxiety was the most common subtype. Female gender, witnessing death, physical injury and disrupted caregiving were significantly associated with worse outcomes.

This study highlights the urgent need for trauma-informed, culturally sensitive mental health services for displaced Palestinian children and young people. While clinical interventions are vital, a sustainable resolution to the conflict is essential to mitigate further psychological harm.

Prolonged antibiotic therapy is associated with an increased risk of antimicrobial resistance and adverse events. We evaluated the implementation of a multifaceted antimicrobial stewardship (ASP) initiative aimed at reducing antibiotic duration for respiratory tract infections (RTIs) in outpatient settings.

Quasi-experimental study.

Academic medical center in Riyadh, Saudi Arabia.

Patient with RTIs in outpatient settings

A multifaceted ASP intervention—including a clinical decision support tool and an educational session—was implemented to guide physicians in prescribing the shortest effective duration of oral antibiotics. We compared antibiotic utilization and adherence to evidence-based duration prescribing in a preintervention phase (June 2021–December 2021) and a postintervention phase (January 2022–June 2022) .

We included 2320 patients in our study, of which 1359 were in the preintervention period and 961 in the postintervention period. Following implementation of the multifaceted stewardship initiative, the days of therapy (DOT) per 1,000 outpatient visits decreased from 131 to 50 and the mean duration of antibiotic therapy declined from 6.4 to 6.0 days (p < 0.001). Adherence to the recommended duration improved, with the percentage of prescriptions meeting recommended duration increasing from 49.7% to 56.3% (p = 0.002).

The multifaceted ASP initiative can reduce unnecessary antibiotic exposure and improve the adherence to the recommended duration.

The formative years of childhood and adolescence shape the course of future mental health. The COVID-19 pandemic has been associated with increased mental health problems in young people. This study aimed to examine changes in referrals and clinical activity in a child and adolescent mental health service (CAMHS) in Qatar following the pandemic.

To explore changes in referral trends and clinical activity in CAMHS, including referral numbers, reasons, sources, demographics, urgency and multidisciplinary team (MDT) allocation, comparing pre-pandemic (2019) with post-pandemic periods (2021, 2022).

A retrospective analysis of referral data from CAMHS was conducted. Data were collected from the administrative paper data archived in the relevant department for the years 2019, 2021 and 2022. Referral data included: source, reason, urgency, patient demographics and outcome. Chi-square analysis was employed to compare referral trends and patient characteristics across the 3 years. Binary logistic regression was used to identify factors associated with urgent referrals.

A significant increase in referrals was observed post-pandemic, with notable changes in referral reasons (increased mood and anxiety disorders), sources (increased referrals from public and private hospitals) and urgency (higher proportion of urgent referrals). MDT allocation shifted towards psychiatrists, with a decrease in joint assessments.

The COVID-19 pandemic had a substantial impact on CAMHS referrals and clinical activity in Qatar. The observed changes highlight the urgent need for additional resources and services. Adapting service delivery models and strengthening collaboration between healthcare sectors are crucial to addressing the evolving mental health needs of children and adolescents effectively.

Helplines and crisis lines are a standard component of a public health approach which appear to be intuitively supportive and useful to a population in acute distress and prevent severely adverse outcomes i.e., suicide. These services exist in different formats throughout the world. They have the advantage of being widely accessible, approachable, and bypass the waiting times and bureaucracies of referral systems for accessing secondary mental health services. The authors set out to study the range of outcomes used to evaluate mental health helplines and crisis lines. The focus was not simply to explore whether mental health helplines were effective or not. Rather the authors wanted to investigate what outcomes were being considered as evidence.

The authors aimed to conduct a systematic review of evidence for mental health outcomes of service users of helplines and crisis lines.

The research question was, ‘What outcomes are evidenced in published literature for mental health helplines and/or crisis lines in terms of efficacy, effectiveness or efficiency?’

This was a systematic review of literature using the PRISMA-2020 statement. Literature searches of Web of Science, Ovid (PsycINFO, Medline, EMBASE), PubMed and Scopus were conducted in December 2022. Relevant information from eligible studies was extracted by using a structured data extraction form. Mixed Methods Appraisal Tool (MMAT) was used to assess quality of the included studies. While the heterogeneity of studies prevented a meta-analysis, it provided a rich landscape for exploring the topic through a thematic analysis.

Eighteen studies finally met the inclusion and exclusion criteria. The projects studied used both trained professionals and volunteers trained to offer crisis intervention. Both qualitative and quantitative outcomes were evaluated across the studies. Outcomes were frequently subjective assessments of service users and/or the personnel delivering the intervention. Studies evaluated outcomes in various ways. Anonymity of the callers made long-term follow-up difficult in most cases, though it is understandable that anonymity might have contributed to the helpline being more accessible and less intimidating to the callers. MMAT scores showed the papers have a range of methodological soundness.

There is lack of consensus and uniformity regarding what outcomes can evidence the efficacy, efficiency, and effectiveness of mental health helplines. Before more investment in helplines, there needs to be discussion, planning and understanding among policy makers and service developers in deciding what they want to achieve from a mental health helpline. This will help researchers focus on relevant outcomes to evaluate mental health helplines. Services need clarity regarding what difference they are trying to make when such helplines are set up.

The COVID-19 pandemic may disproportionately affect the mental health of healthcare professionals (HCPs), especially patient-facing HCPs.

To longitudinally examine mental health in HCPs versus non-HCPs, and patient-facing HCPs versus non-patient-facing HCPs.

Online surveys were distributed to a cohort at three phases (baseline, July to September 2020; phase 2, 6 weeks post-baseline; phase 3, 4 months post-baseline). Each survey contained validated assessments for depression, anxiety, insomnia, burnout and well-being. For each outcome, we conducted mixed-effects logistic regression models (adjusted for a priori confounders) comparing the risk in different groups at each phase.

A total of 1574 HCPs and 147 non-HCPs completed the baseline survey. Although there were generally higher rates of various probable mental health issues among HCPs versus non-HCPs at each phase, there was no significant difference, except that HCPs had 2.5-fold increased risk of burnout at phase 2 (emotional exhaustion: odds ratio 2.50, 95% CI 1.15–5.46, P = 0.021), which increased at phase 3 (emotional exhaustion: odds ratio 3.32, 95% CI 1.40–7.87, P = 0.006; depersonalisation: odds ratio 3.29, 95% CI 1.12–9.71, P = 0.031). At baseline, patient-facing HCPs (versus non-patient-facing HCPs) had a five-fold increased risk of depersonalisation (odds ratio 5.02, 95% CI 1.65–15.26, P = 0.004), with no significant difference in the risk for other outcomes. The difference in depersonalisation reduced over time, but patient-facing HCPs still had a 2.7-fold increased risk of emotional exhaustion (odds ratio 2.74, 95% CI 1.28–5.85, P = 0.009) by phase 3.

The COVID-19 pandemic had a huge impact on the mental health and well-being of both HCPs and non-HCPs, but there is disproportionately higher burnout among HCPs, particularly patient-facing HCPs.