Parental Attitude Towards the Prescription of Psychotropic Medications for Mental Disorders in Children in a Tertiary Care University Hospital in Oman.

Objectives: This study aimed to investigate parental attitude towards psychotropic drugs' use for children's mental disorders. Methods: This cross-sectional study was conducted from December 2020 to March 2021 at the Department of Behavioural Medicine, Sultan Qaboos University Hospital, Muscat, Oman. A questionnaire was used to determine parents' opinions and attitudes about use of psychotropic medications on their children and, in a small proportion, other caregivers if the child attended with them. Risk factors associated with parents who preferred to consult a folk healer (FH) for children with mental disorders were identified by the logistic regression model. Results: A total of 299 parents participating in the study (response rate: 95.2%). Most (n = 244, 81.6%) agreed to give their child psychotropic medications if necessary, but 25.4% (n = 76) would consult an FH before a psychiatrist. Married parents were 14.5 times (P = 0.011) more likely than separated or divorced parents to consult an FH. Caregivers with a monthly income below 500 OMR and between 500 and 1,000 OMR were 2.5 (P = 0.016) and 3.2 times (P <0.001), respectively, more likely than those with more than 1,000 OMR to consult an FH. Parents who disagreed with giving their children psychotropic medications were 3.8 times (P <0.001) more likely to consult an FH than parents who agreed to give them if necessary. Conclusion: Most parents agreed to give their children psychotropic medications if necessary. However, a proportion of parents and caregivers preferred to consult an FH before accessing mental health services.

The Parental and Children Report of the Prevalence of Depressive Symptoms in Children and Adolescents Amid the COVID-19 Pandemic: A Cross-Sectional Study From Oman.

Objective: Studies from the past decades have shown that mood disorders are common during childhood and adolescence. This study aimed to estimate the point prevalence of depression in Omani children and adolescents during social distancing and lockdown and identify the risk factors for developing depressive symptoms during the COVID-19 pandemic. Methods: This is an analytical cross-sectional study conducted in May 2020, in which all young Omani people attending a mainstream school aged 8-18 years old were eligible to participate. Parents were asked to complete the online survey, which consisted of the parent version of the Mood and Feelings Questionnaire (MFQ-Parent). In addition, the option of a self-reported version (MFQ-Self) was provided in cases where children preferred to fill out the survey themselves. Logistic regression was used to identify the contributing socio-demographic variables associated with depressive symptoms. Results: A total of 445 participants completed the MFQ, out of which 72.1% were parents, and 27.9% were children, adolescents and young people. 13.9% of children and adolescents exhibited depressive symptoms during the COVID-19 pandemic in Oman. The presence of depressive symptoms was associated with increased food intake (OR 1.81, 95% CI 1.00-3.29, p-value <0.05), longer use of smartphones (OR 2.72, 95% CI 1.56-4.73, p-value <0.001), whereas additional entertainment activities during lockdown were protective against depression (OR 0.35 95% CI 0.19-0.64, p-value <0.001). Conclusion: This study from Oman concurs with recent reports of depression being common during the COVID-19 pandemic. Concerted efforts are needed to mitigate this trend and identify high-risk groups during the lockdown period.

Socio-Demographic and Clinical Profiles of Adult Attention Deficit Hyperactivity Disorder Patients in a University Hospital in Oman.

Objectives: Although attention deficit hyperactivity disorder (ADHD) is typically considered a condition affecting children, there is evidence that children diagnosed with ADHD continue to suffer from this condition after the age of 18. This study aimed to describe the socio-demographic and clinical characteristics of adult ADHD patients in Oman and evaluate their association with the disorder's different subtypes. Methods: This retrospective study included adult patients with ADHD from the outpatient clinic at Sultan Qaboos University Hospital, Muscat, Oman. Data from medical records from January 2018 to April 2020 were collected. Socio-demographic characteristics, clinical profiles and psychiatric comorbidities were examined. Results: This study included 100 adults who fulfilled the standard diagnosis of ADHD, with 54.0% (n = 54) and 46.0% (n = 46) from the inattentive and combined subtypes, respectively. It was found that ADHD was more prevalent among males (64.0%) than females (36.0%), with the inattentive subtype being more predominant among females. The ADHD patients with the inattentive subtype were associated with comorbid substance use disorders (odds ratio [OR] = 11.29; P = 0.049), personality disorders (OR = 7.96; P = 0.017) and major depressive disorder (OR = 15.94; P = 0.002) compared to patients predominantly with the combined subtype. Conclusion: This study echoes the findings from the current literature that adult patients with ADHD commonly have comorbid psychiatric disorders, leading to significant functional impairment. Psychiatric comorbidities must be identified and urgently treated for better clinical and functional outcomes in adult patients with ADHD.

Effectiveness and Adverse Effects of Risperidone in Children with Autism Spectrum Disorder in a Naturalistic Clinical Setting at a University Hospital in Oman.

OBJECTIVE: This study aimed at examining the effectiveness of treating children with autism spectrum disorder (ASD) who present with irritability, aggression, and disruptive behavior at the Sultan Qaboos University Hospital (SQUH) in Muscat, Oman, with risperidone, and to note any sex-based differences among this cohort. METHOD: This was a retrospective study conducted at the Department of Behavioral Medicine at SQUH over two years from January 2017 to December 2018. This study included all children aged 3 to 18 years attending the Child and Adolescent Mental Health Service (CAMHS) outpatient clinic with a diagnosis of ASD, based on the DSM-5 criteria, and comorbid disruptive behavior, who had been prescribed risperidone. RESULT: This study identified 95 ASD patients (72 males). Male patients' BMI score after 12 months of risperidone treatment showed an increase by 0.62 (1.57 SD; P=0.001); however, there was no significant change among female patients. Somnolence was noted in 69.6% of female patients as compared to 34.7% of males (P=0.003). Among those with a family history of ASD, 5 out of 17 patients had treatment success (29.4%), whereas 70 out of 78 patients (90.0%) who did not have a similar history had successful treatment. CONCLUSION: In conclusion, low-dose risperidone monotherapy is effective and well tolerated among some children with ASD who present with disruptive behavior in a naturalistic clinical setting. However, we found that some of the side effects, such as weight gain and somnolence, were concerning.

Depressive Symptoms and Its Correlate Among Children with Epilepsy at Single-center Study in Oman.

OBJECTIVES: Epilepsy is the most common neurological disorder in children and comorbid depression is common. This study aimed to assess the frequency of depressive symptoms along with demographic and clinical factors in children diagnosed with epilepsy in a tertiary care institution in Oman. METHODS: This cross-sectional study was conducted between June 2016 and August 2018 and included children (n = 75) aged 6-12 years old attending the epilepsy clinic at Sultan Qaboos University Hospital, Oman. The cohort constituted of children with epilepsy (CWE) following up at a dedicated unit. We used the Center for Epidemiologic Studies Depression Scale for Children to assess the presence of depressive symptoms. Associated factors, including history of seizure in the last three months, compliance with antiepileptic medications, and type of epilepsy were also examined. RESULTS: Depressive symptoms were endorsed in 52.0% of CWE and 96.0% were compliant to medications. Recurrent seizures were present in the last three months among 48.0% of the CWE. The type of epilepsy was significantly associated with the presence of depressive symptoms. CONCLUSIONS: Depression is prevalent among Omani CWE. Certain clinical factors appeared to increase the risk of depression among this population. The findings of this study fill a gap in the existing literature and call for further work aiming to explore possible tailored recognition and CWE.

School Dropout and Associated Factors Among Omani Children with Attention-Deficit Hyperactivity Disorder: A Cross-Sectional Study.

OBJECTIVE: Despite the rising incidence of attention-deficit hyperactivity disorder (ADHD), there is a dearth of studies examining the rate of school dropout and its correlates in non-Western populations. METHODS: Medical records were scrutinized to identify Omani children diagnosed with ADHD from 2006 to 2014 in a tertiary care hospital in Oman. The persistence of ADHD symptoms, school performance and dropout, as well as sociodemographic characteristics were examined. RESULTS: Three hundred sixty-seven children fulfilled the diagnosis of ADHD based on Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) (DSM-IV) criteria and 16.6% of them had dropped out of school. School dropout was associated with poor school performance, comorbid conduct disorder, and parental divorce. CONCLUSION: This study from Oman concurs with existing literature that school dropout is common among children with ADHD. Concerted efforts are needed to mitigate this trend. Management strategies should incorporate the treatment of comorbid conduct disorder.