Obsessive-Compulsive Disorder During the COVID-19 Pandemic: Preliminary Findings From a Study in the United Arab Emirates.

Objective: To investigate the prevalence of obsessive-compulsive disorder (OCD) during the coronavirus disease 2019 (COVID-19) pandemic among the general population of the United Arab Emirates.Methods: An online survey of a convenience sample was conducted between October 2020 and January 2021. The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) was used to assess symptoms of OCD. The rate of OCD symptoms in those who had positive COVID-19 test results was compared with those who had no previous COVID-19 diagnosis.Results: The total number of participants was 702, including 371 males and 325 females (6 skipped the question regarding sex). Most participants reported no previous psychiatric history (84.3%). Previous psychiatric diagnoses were reported by 15.7% of participants (n = 110) and included generalized anxiety (27.3%), phobia (1.8%), depression (19.1%), bipolar mood disorder (1.8%), OCD (6.3%), and panic attacks (8.2%). There were 39 (5.6%) participants who had past psychiatric history but were unsure of the exact diagnosis. Presence of history of OCD for the total sample was reported by 7 (1%) participants. A family history of OCD was reported by 34 (4.8%) participants. A total of 218 (31.1%) participants scored mild, moderate, severe, or extreme OCD symptoms. Clinically significant OCD symptoms were reported by 75 participants (10.7% of the total sample). The mean (SD) score of the Y-BOCS was 6.63 (7.13) for the COVID-positive group and 4.9 (6.34) for the COVID-negative group, which was statistically significant (P = .0008).Conclusions: The study findings indicate an increased prevalence of OCD during the COVID-19 pandemic, which is significantly higher among people with positive COVID-19 infection compared to those with negative COVID-19 test results.

Attitudes of patients with psychiatric illness toward traditional healing.

BACKGROUND: The role of traditional healers in the community remains an issue of debate as they have a role in the community that could not be neglected. Traditional medicine can be a barrier for early intervention and treatment of psychiatric disorders. AIM: This study is a cross-sectional descriptive study that aims to evaluate the attitude of patients toward traditional healing in Khartoum teaching hospital in Sudan. METHOD: Patients who attended the outpatient clinic were asked about previous history of seeking treatment from traditional healers. A specific questionnaire was introduced to participants. Descriptive statistics was used to describe the data variables, and tabulated tables were used to calculate chi-square test for categorical data and the significance was set at p < .05. RESULTS: From a total of 131 subjects, there were 111 (84%) of patients who reported previous history of seeking traditional treatment for psychiatric illness. No significant difference was found between the two groups in terms of psychiatric diagnosis ( p = .559) or sociodemographic characteristics including age ( p = .740), gender ( p = .469) and educational level ( p = .226). The decision of seeking traditional treatment was mostly taken by families and the patients took the decision in only 27% of cases. The majority of participants (55.9%) believe that their psychiatric symptoms are due to evil eye, and 20.7% believe that the symptoms are due to magic. The type of traditional treatment was significantly related to gender ( p = .003) but not related to level of education ( p = .137). CONCLUSION: The vast majority of psychiatric patients have history of receiving traditional healing, and the decisions regarding treatment are taken by family in most of the cases. Further research is needed to evaluate future projects of providing psychoeducation to the community and to invite traditional healers to participate in channels of referral for cases that need early intervention with psychotropic medications.

Basal Ganglia Calcification in Psychiatric Inpatients: A Case-Control Study.

BACKGROUND AND OBJECTIVE: Several case reports have noted basal ganglia calcification (BGC) as an incidental radiologic finding in patients presenting with psychiatric manifestations. In this study, we examined the clinical correlates of mental disorders in two groups of psychiatric patients, one with BGC and one with normal radiologic studies. METHODS: In a retrospective cross-sectional case-control study of patients admitted to the psychiatric ward in Al Ain Hospital between January 2011 and December 2013, we compared all 15 patients diagnosed with BGC and 30 control patients who had normal radiologic findings. RESULTS: The BGC group's psychiatric symptoms began when they were aged in their 30s and 40s, later than the controls' 20s and 30s (P=0.001). More of the BGC group than the controls had cognitive symptoms (60% versus 6.7%, P=0.001). The BGC group was more likely to have chronic medical comorbidities (66.7% versus 20%, P=0.003). The BGC group's mean serum calcium was lower than the controls' (P=0.003) and the C-reactive protein was higher (P=0.049). We did not find significant differences between the groups in psychiatric diagnoses; five of the 15 patients with BGC had mood disorders and four of the 15 had psychotic disorders. CONCLUSIONS: Patients with BGC tend to develop psychiatric symptoms later in life than other psychiatric patients, and have higher rates of medical comorbidities. Many patients with BGC have cognitive symptoms, which can be concurrent with a mood or psychotic disorder.

Familial idiopathic basal ganglia calcification (Fahr`s disease).

Familial idiopathic basal ganglia calcification (Fahr`s disease) is a rare neurodegenerative disorder characterized by symmetrical and bilateral calcification of the basal ganglia. Calcifications may also occur in other brain regions such as dentate nucleus, thalamus, and cerebral cortex. Both familial and non-familial cases of Fahr`s disease have been reported, predominantly with autosomal-dominant fashion. The disease has a wide range of clinical presentations, predominantly with neuropsychiatric features and movement disorders. Psychiatric features reported in the literature include: cognitive impairment, depression, hallucinations, delusions, manic symptoms, anxiety, schizophrenia-like psychosis, and personality change. Other clinical features include: Parkinsonism, ataxia, headache, seizures, vertigo, stroke-like events, orthostatic hypotension, tremor, dysarthria, and paresis. Fahr`s disease should be considered in the differential diagnosis of psychiatric symptoms, particularly when associated with movement disorder. The disease should be differentiated from other conditions that can cause intracranial calcification. No specific treatment is currently available. Further research is needed to bridge the gap existing in our current knowledge of the prevalence, etiology, symptoms, and treatment of Fahr`s disease.

A case of Gorlin-Goltz syndrome presented with psychiatric features.

We report a case of a 34-year-old male who presented with an acute onset of pleomorphic psychiatric features. Upon examination we later diagnosed him with Gorlin-Goltz syndrome based on clinical and radiological findings that are characteristic for this rare autosomal dominant syndrome. His psychiatric manifestations included irritability, aggressive behavior, labile mood, hallucinations, paranoid delusions, and transient cognitive impairment. His past history indicated surgical excision of pigmented lesion in the left lower eyelid which turned out to be a basal cell carcinoma. His past visits to dermatology clinics indicated pitted keratosis involving hands, callosities, and seborrheic dermatitis. There were numerous palmar pits, and Brain CT Head scan revealed extensive calcification along falx cerebri and around the cerebellar vermis. He had low (20 ng/L) vitamin D level and high parathyroid hormone level. The patient improved using antipsychotic medications and vitamin D supplementations for symptomatic management and was discharged with a plan for multispecialty outpatient follow-up. This case highlights the importance of considering rare organic etiologies in the differential diagnosis of patients presenting with psychiatric symptoms. This is of vital importance for early intervention to prevent complications and for better outcomes of the coexistent diseases.

Community mental health services in Al Ain Hospital, United Arab Emirates.

This paper evaluates a model of community mental health service (CMHS) in Al Ain in the United Arab Emirates. The hospital records were reviewed and the total number of patient admissions and duration of in-patient care before and after enrolment in the CMHS were documented. Patient satisfaction with the CMHS was assessed using a questionnaire. The total number of admissions and the number of days that the patient spent in hospital per year were significantly reduced by the CMHS. Patients had high satisfaction rates with the information and advice they received, with their relationships with CMHS workers, with their access to mental health services and with their drug treatment.

A review of body dysmorphic disorder and its presentation in different clinical settings.

OBJECTIVE: Body dysmorphic disorder (BDD) is a relatively common psychiatric disorder characterized by preoccupations with perceived defects in physical appearance. This review aimed to explore epidemiology, clinical features, comorbidities, and treatment options for BDD in different clinical settings. DATA SOURCE AND STUDY SELECTION: A search of the literature from 1970 to 2011 was performed using the MEDLINE search engine. English-language articles, with no restriction regarding the type of articles, were identified using the search terms body dysmorphic disorder, body dysmorphic disorder clinical settings, body dysmorphic disorder treatment, and body dysmorphic disorder & psychodermatology. RESULTS: BDD occurs in 0.7% to 2.4% of community samples and 13% of psychiatric inpatients. Etiology is multifactorial, with recent findings indicating deficits in visual information processing. There is considerable overlap between BDD and obsessive-compulsive disorder (OCD) in symptom etiology and response to treatment, which has led to suggestions that BDD can be classified with anxiety disorders and OCD. A recent finding indicated genetic overlap between BDD and OCD. Over 60% of patients with BDD had a lifetime anxiety disorder, and 38% had social phobia, which tends to predate the onset of BDD. Studies reported a high level of comorbidity with depression and social phobia occurring in > 70% of patients with BDD. Individuals with BDD present frequently to dermatologists (about 9%-14% of dermatologic patients have BDD). BDD co-occurs with pathological skin picking in 26%-45% of cases. BDD currently has 2 variants: delusional and nondelusional, and both variants respond similarly to serotonin reuptake inhibitors (SRIs), which may have effect on obsessive thoughts and rituals. Cognitive-behavioral therapy has the best established treatment results. CONCLUSIONS: A considerable overlap exists between BDD and other psychiatric disorders such as OCD, anxiety, and delusional disorder, and this comorbidity should be considered in evaluation, management, and long-term follow-up of the disorder. Individuals with BDD usually consult dermatologists and cosmetic surgeons rather than psychiatrists. Collaboration between different specialties (such as primary care, dermatology, cosmetic surgery, and psychiatry) is required for better treatment outcome.