The Psychological Impact and Suicidal Behaviour in the Context of the COVID-19 Pandemic: Four Case Reports From Oman.

During the COVID-19 pandemic, quarantine has caused disruptions to daily social and economic activities. Many people have felt trapped and alone, experiencing rising levels of worry and financial hardships. Numerous studies have demonstrated that the COVID-19 pandemic increases depression and anxiety symptoms, as well as suicidal ideas and attempts, particularly in vulnerable individuals. We report four cases of suicidal attempts during the COVID-19 outbreak due to the lockdown and related financial difficulties. Those cases were admitted to a general hospital from April 2020 to June 2020. The patients were all male, had negative coronavirus tests, and committed violent suicides by hanging and slitting their throats. After receiving the appropriate treatment, all cases were discharged from the hospital. The COVID-19 pandemic and its economic and social impacts could result in significant consequences for vulnerable persons. Screening and early intervention play a role in averting the pandemic's mental health consequences.

Psychiatric, cognitive functioning and socio-cultural views of menstrual psychosis in Oman: an idiographic approach.

BACKGROUND: Most documented cases of menstrual psychosis have been from Euro-American populations with reports from cross-cultural populations being only a few. A primary aim was to determine whether the cyclical/episodic nature of menstrual psychosis among case series observed at a tertiary care unit in Oman fulfills the diagnostic criteria of the International Classification of Diseases (ICD-10) and diverge into Brockington's sub-types (World Psychiatry. 2005;4(1):9-17). Related aims were to solicit measures of psychometric functioning of those with menstrual psychosis and associated idioms of distress. METHODS: A series of consecutive patients seeking psychiatric consultation from January 2016 to December 2017 were screened via structured interview-Composite-International Diagnostic Interview (CIDI) and Brockington's sub-types. The identified patients (n = 4) also underwent psychometric evaluation including examination of affective functioning, intellectual capacity and neuropsychological functioning (i.e.attention and concentration, learning and remembering, executive function, processing speed and speech and language). The analysis of outcome measures was via an idiographic approach. RESULTS: The spectrum of distress among people with menstrual psychosis does not fit existing psychiatric nosology. Evaluations revealed that a majority of the participants displayed something akin to morbid phenomena relating to manic and psychotic symptoms. In the parlance of traditional Omani society, this would be termed "spirit possession". In terms of classification by timing within the menstrual cycle as expounded by Brockington, the present case series in Oman fulfilled the definition of catamenial psychosis and paramenstrual psychosis. With regard to psychometric function, all participants performed adequately on indices of intellectual functioning but appeared to have impairments in neuropsychological functioning, including the dimensions of processing speed, episodic memory, and executive functioning. Within the given society, the periodicity of mind alteration has been attributed to spirit possession. CONCLUSIONS: This is one of the first case series of its kind in the country elucidating whether the manifestation of menstrual psychosis among individuals in Oman fulfills the subtypes postulated by Brockington. The present case series suggests that menstrual psychosis is marked with neuropsychological impairments that were previously observed in other phasic manic episodes or brief psychotic disorders.

Rate of Tobacco Smoking Among Psychiatric Outpatients Attending a Tertiary Care Hospital in Oman: A Cross-sectional Study.

OBJECTIVES: Tobacco smoking is the single most avoidable cause of morbidity and mortality around the world. Patients with psychiatric disorders tend to smoke tobacco at a higher rate than the general population, with significant adverse health consequences. This study aimed to determine the rate of tobacco smoking among psychiatric outpatients attending Sultan Qaboos University Hospital, a tertiary care hospital in Muscat, Oman. METHODS: We conducted a cross-sectional study among psychiatric outpatients attending a psychiatric clinic from 1 January to 1 August 2017. The patients' demographic information, history of smoking, previous hospitalizations, and the number of and specific psychotropics used during treatment was documented. The degree of dependence on tobacco smoking was measured using the Fagerstrom test for nicotine dependence. RESULTS: A total of 272 patients were included in this study. The overall rate of smoking among psychiatric patients was 13.6%. Patients with schizophrenia had the highest rate of smoking (22.2%), followed by those with bipolar (13.1%), and anxiety disorders (11.1%). Patients who smoked tobacco were more likely to be admitted to the psychiatric ward than non-smokers (p < 0.050). CONCLUSIONS: Tobacco smoking is common among psychiatric patients, a finding consistent with similar studies conducted in different parts of the world. Assessment of smoking status and its associated adverse health associations among patients with mental disorders is of paramount importance.

Surviving a Suicide Attempt.

Suicide is a global phenomenon in all regions of the world affecting people of all age groups. It has detrimental consequences on patients, their families, and the community as a whole. There have been numerous risk factors described for suicide including mental illness, stressful life situations, loss of social support, and general despair. The association of suicide with Islam has not been extensively studied. The common impression from clinical practice is that being a practicing Muslim reduces the risk of suicide. Another factor associated with suicide is starting a patient on antidepressants. However, this has been questioned recently. This report describes a middle-aged man with depression and multiple social stressors who survived a serious suicide attempt. The discussion will focus on the factors that lead him to want to end his life and the impact of the assumed protective factors such as religious belief and family support on this act of self-harm. Such patients can be on the edge when there is an imbalance between risk factors (such as depression, insomnia, and psychosocial stressors) and protective factors (like religious affiliation and family support). All physicians are advised to assess the suicide risk thoroughly in patients with depression regardless of any presumed protective factor.