Stress Levels and Coping Strategies of Families of Adults With Intellectual Disability and Challenging Behaviours During the COVID-19 Pandemic in Qatar.

This study investigated the perceived stress levels and coping strategies of caregivers of adults with intellectual disability and challenging behaviours during the COVID-19 pandemic in Qatar. A cross-sectional survey was conducted from June 7 to September 7, 2020 for caregivers of adults diagnosed with intellectual disability and challenging behaviours. Perceived stress levels and coping strategies were assessed using the Perceived Stress Scale and Brief Coping Orientation to Problems Experienced inventory. Results showed moderate to high perceived stress levels in most caregivers (69%). The most frequent coping strategy was religion, followed by acceptance and active coping. Substance use and self-blame were less frequently used. The study revealed that emotional support, informational support and venting coping strategies were significant predictors of perceived stress levels. Restrictions on physical activity and social mobility caused by pandemic-related lockdowns have placed tremendous pressure on caregivers. Appropriate supportive measures should be implemented for the caregivers.

Perceived stress and post-traumatic stress disorder symptoms among intensive care unit staff caring for severely ill coronavirus disease 2019 patients during the pandemic: a national study.

BACKGROUND: Intensive care unit (ICU) staff have faced unprecedented challenges during the coronavirus disease 2019 (COVID-19) pandemic, which could significantly affect their mental health and well-being. The present study aimed to investigate perceived stress and post-traumatic stress disorder (PTSD) symptoms reported by ICU staff working directly with COVID-19 patients. METHODS: The Perceived Stress Scale was used to assess perceived stress, the PTSD Diagnostic Scale for the Diagnostic and Statistical Manual of Mental Disorders (5th edition) was used to determine PTSD symptoms, and a sociodemographic questionnaire was used to record different sociodemographic variables. RESULTS: Altogether, 124 participants (57.2% of whom were men) were included in the analysis. The majority of participants perceived working in the ICU with COVID-19 patients as moderately to severely stressful. Moreover, 71.4% of doctors and 74.4% of nurses experienced moderate-to-severe perceived stress. The staff with previous ICU experience were less likely to have a probable diagnosis of PTSD than those without previous ICU experience. CONCLUSIONS: Assessing perceived stress levels and PTSD among ICU staff may enhance our understanding of COVID-19-induced mental health challenges. Specific strategies to enhance ICU staff's mental well-being during the COVID-19 pandemic should be employed and monitored regularly. Interventions aimed at alleviating sources of anxiety in a high-stress environment may reduce the likelihood of developing PTSD.

Chatbot features for anxiety and depression: A scoping review.

Chatbots can provide valuable support to patients in assessing and guiding management of various health problems particularly when human resources are scarce. Chatbots can be affordable and efficient on-demand virtual assistants for mental health conditions, including anxiety and depression. We review features of chatbots available for anxiety or depression. Six bibliographic databases were searched including backward and forwards reference list checking. The initial search returned 1302 citations. Post-filtering, 42 studies remained forming the final dataset for this scoping review. Most of the studies were from conference proceedings (62%, 26/42), followed by journal articles (26%, 11/42), reports (7%, 3/42), or book chapters (5%, 2/42). About half of the reviewed chatbots had functionality targeting both anxiety and depression (60%, 25/42), whereas 38% (16/42) targeted only depression, 38% (16/42) anxiety and the remaining addressed other mental health issues along with anxiety and depression. Avatars or fictional characters were rarely used in these studies only 26% (11/42) despite their increasing popularity. Mental health chatbots could benefit in helping patients with anxiety and depression and provide valuable support to mental healthcare workers, particularly when resources are scarce. Real-time personal virtual assistance fills in this gap. Their role in mental health care is expected to increase.

Dandy-Walker malformation and intermittent explosive disorder: A case report.

Dandy-Walker malformation is a group of brain malformations that sometimes present with psychotic features, violent and impulsive behavior, or mood symptoms. Here, we present a case report of a patient with Dandy-Walker malformation who presented with intermittent explosive disorder. A young man, aged 18 years, was brought to the author's hospital [Hamad Medical Corporation] with anger outbursts, irritable mood, and violent behavior. His magnetic resonance imaging scans showed typical alterations of Dandy-Walker malformation. He also had mild intellectual disabilities and epilepsy. After a few weeks of treatment with sodium valproate 1000 mg/day and risperidone 2 mg/day, his condition improved, and his violent behavior was significantly reduced in 3 months, 6 months, and 1 year of follow-up. There is broad consensus that Dandy-Walker malformation is associated with psychosis and other behavioral abnormalities because of a possible disruption in the prefrontal, thalamic, and cerebellar circuits. The link between Dandy-Walker malformation and intermittent explosive disorder may help us understand this type of brain malformation as a potential psychiatric comorbidity.

Burnout and job satisfaction among psychiatrists in the Mental Health Service, Hamad Medical Corporation, Qatar.

BACKGROUND: Job satisfaction is a critical concern among medical staff and directly affects patient safety and quality of health care services. Burnout has been reported to be correlated with job satisfaction. AIMS: This study aimed to determine the prevalence of burnout and level of job satisfaction among psychiatrists working in the Mental Health Service, Hamad Medical Corporation, Qatar, and examine correlations among socio-demographic variables, burnout, and job satisfaction. METHOD: A cross-sectional survey was conducted using a socio-demographic questionnaire, the Maslach Burnout Inventory (MBI), and the Job Descriptive Index (JDI). RESULTS: One-third of psychiatrists reported high levels of emotional exhaustion, with a similar proportion describing low levels of personal accomplishment. Less than 20 % demonstrated high levels of depersonalization. Trainees were more burned out than senior psychiatrists. Opportunities for promotion was the only factor with which the majority of psychiatrists were not satisfied. CONCLUSIONS: The prevalence of high burnout in psychiatrists remains lower in Qatar than in other countries. Lower levels of satisfaction with co-workers, work, supervision, opportunities for promotion, and the job in general increased emotional exhaustion and depersonalization. Interestingly, satisfaction with salary did not have a significant effect on burnout.

Risk Perception and Psychological Impact of COVID-19 Pandemic Among Healthcare Workers in Primary and Secondary Healthcare Settings in Qatar: A National Study.

INTRODUCTION: During the coronavirus disease 2019 (COVID-19) pandemic, primary and secondary healthcare workers (HCWs) have faced unprecedented stress, jeopardizing their mental well-being. AIMS: To compare risk perception and psychological distress between primary and secondary HCWs. METHOD: A cross-sectional web-based survey was conducted with HCWs in Qatar from April 5 to July 5, 2020. Psychological distress and risk perception were assessed using the Kessler Psychological Distress Scale, a perceived COVID-19 risk questionnaire, and a sociodemographic questionnaire. RESULTS: Of the 4417 participating HCWs, 3421 (90.3%) felt that their job increased their risk of COVID-19 exposure, 3759 (90.9%) accepted this as part of their job, and 3440 worried that this also increased the risk of exposure to their families. Moreover, 2911 (84.8%) believed that their employer would look after their needs if they contracted COVID-19. Moderate to severe psychological distress was present in 1346 (30.5%) HCWs. Primary HCWs were less likely to experience moderate to severe psychological distress than secondary HCWs (adjusted OR, 0.48; 95% CI 0.29-0.77, P = .003). Secondary HCWs who worked in COVID-19 designated areas had greater psychological distress. CONCLUSIONS: HCWs' exposure to outbreaks has various psychological effects, which may have long-term consequences and affect their decision-making capacity. Strategies to enhance the mental well-being of HCWs exposed to COVID-19 should be introduced immediately.

Early-onset dementia: diagnostic challenges.

A 56-year-old man was brought to our hospital by his family, seeking medical treatment for the patient's long-standing progressive word-finding difficulties, forgetfulness, agitation and social withdrawal. After multiple previous physician consultations, the patient was mistakenly diagnosed with epilepsy and prescribed multiple anticonvulsants, to which his above mentioned symptoms were unresponsive. His condition progressed over the next 10 years, resulting in severe cognitive impairments and a complete dysfunctionality. An electroencephalogram (EEG) assessment revealed persistent spike and wave activity in the left temporal lobe. Brain MRI revealed multiple small bright T2 and fluid attenuated inversion recovery (FLAIR) foci within the white matter of both cerebral hemispheres surrounding the ventricular system, as well as some widening of extra-axial cerebrospinal fluid spaces. The patient was finally diagnosed with early-onset dementia and temporal lobe epileptiform abnormalities. This case emphasises the need for diagnostic consideration of dementia in cognitively impaired patients, even when they are not of an advanced age.

Sociodemographic and clinical characteristics of patients with recurrent psychiatric readmissions in Qatar.

OBJECTIVE: To examine the sociodemographic and clinical characteristics of psychiatric patients with recurrent psychiatric readmissions (RPR). METHODS: A retrospective study was conducted at Hamad General Hospital in Qatar on psychiatric patients with recurrent readmissions from August 2018 to January 2019. RESULTS: Of 380 psychiatric patients admitted during the study period, 40 (10.5%) were readmitted within 30 days of discharge. Most of the patients who were readmitted were single, male and unemployed. Psychotic spectrum disorder was the most frequent psychiatric condition and was diagnosed in 18 (45%) patients. A total of 30% of the patients were receiving treatment with anti-psychotics, and a similar number received more than one medication. Most patients showed poor or no compliance. Only 12.5% of patients stayed in the hospital for more than 5 weeks in their last admission during the study period. CONCLUSIONS: Poor compliance, male sex and single status were the most common demographic and clinical features of patients with RPR. Post-discharge psychiatric care should be tailored to meet the requirements of patients prone to RPR.

Isotretinoin-induced psychotic episode in a 17-year-old adolescent male.

Isotretinoin, a synthetic vitamin A derivative, is primarily used in the management of severe nodulocystic acne. Since its introduction, isotretinoin has been linked with various psychiatric side effects. In particular, depression and suicidality have been extensively reported as side effects. This case report features a young male who developed a first psychotic episode within 3 months of starting isotretinoin therapy. The patient was hospitalized, and organic pathologies and use of psychoactive substances that could explain his presentation were ruled out. After stopping isotretinoin and starting olanzapine 10 mg, the psychotic symptoms remitted completely within 2 weeks. This case highlights the need for increased vigilance toward psychiatric manifestations of isotretinoin. In addition, it suggests that secondary psychosis should be considered as a differential diagnosis by clinicians, especially in patients with no past psychiatric history or family history of mental illness.

Atypical presentation of progressive young onset dementia.

We present the case of a 34-year-old Jordanian woman who was referred to mainstream mental health services because of irritability, agitation, loss of appetite, withdrawal from family activities and sleeping difficulties. She was initially diagnosed with major depressive disorder but subsequently showed very poor response to antidepressant therapy. Her presentation gradually and dramatically progressed into full blown dementia within couple of years. Brain MRI showed atrophic cortical changes and subcortical white matter alterations consistent with Alzheimer's dementia. Brain PET scan revealed reduction in cerebral glucose metabolism in temporoparietal areas bilaterally most consistent with Alzheimer's dementia. There was a strong family history of early-onset dementia. A final diagnosis of young onset dementia was made, and unfortunately, she passed away at the age of 44 years.

Distal trisomy 10q syndrome, report of a patient with duplicated q24.31 - qter, autism spectrum disorder and unusual features.

KEY CLINICAL MESSAGE: We report on a patient with distal trisomy 10q syndrome presenting with a few previously undescribed physical features, as well as, autism spectrum disorder (ASD). We recommend that patients with distal trisomy 10q syndrome should have a behavioral evaluation for ASD for the early institution of therapy.