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The objective of this study was to examine the relationship between legal status and guardedness in patients who attempted suicide in Abu Dhabi, United Arab Emirates. The consultation-liaison team assessed 355 patients admitted for suicidal/self-injurious behavior, recording their guardedness before knowing whether they were legally charged. Patients who were legally charged for the suicidal act (n = 139) were 1.6 times (p = .03) more guarded in volunteering information than patients who were not legally charged. Legally charging suicide attempters might have a negative impact on risk assessment and psychiatric care.
Assuntos
Tentativa de Suicídio/legislação & jurisprudência , Tentativa de Suicídio/psicologia , Revelação da Verdade , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Tentativa de Suicídio/estatística & dados numéricos , Emirados Árabes Unidos , Adulto JovemRESUMO
PURPOSE: to investigate potential factors impacting HRQOL among PWE at a medical facility in the UAE. METHODS: Depression, anxiety, and health-related quality of life were assessed in 160 adult patients with epilepsy from September 2014 to January 2015 at Sheikh Khalifa Medical City (SKMC). The World Health Organization Quality of Life abbreviated scale (WHOQOL-BREF), the Patient Health Questionnaire nine-item (PHQ-9) depression scale, and Generalized Anxiety Disorder seven-item (GAD-7) scale were administered. Demographic details including psychosocial factors were also obtained. Clinical details including seizure freedom, epilepsy type, epilepsy duration, and magnetic resonance imaging (MRI) results were recorded. Multivariate analysis was used to look at significant variables associated with HRQOL. RESULTS: Depression, anxiety, seizure freedom, and the use of anti-depressants had significant positive correlation with HRQOL in univariate analysis. However, depression, followed by seizure freedom, had the strongest association with HRQOL in a multivariate regression analysis. CONCLUSION: Depression and seizure freedom, followed by anxiety and anti-depressants use, were significantly correlated with HRQOL. These results underscore the importance of screening for psychiatric comorbidities in patients with epilepsy. IMPLICATIONS: Screening for comorbid psychiatric disorders should be an essential component of the standard of care, and incorporated in the treatment plan for all patients with epilepsy. Factors contributing to psychiatric symptoms among PWE, such as maladaptive illness perceptions, non-adherence to anti-epileptic drugs (AED), and social stigma should be carefully addressed to achieve an optimal health-care plan.
Assuntos
Ansiedade/diagnóstico , Depressão/diagnóstico , Epilepsia/psicologia , Qualidade de Vida/psicologia , Adulto , Ansiedade/epidemiologia , Comorbidade , Depressão/epidemiologia , Epilepsia/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ambulatório Hospitalar/estatística & dados numéricos , Emirados Árabes Unidos/epidemiologiaRESUMO
To study the impact of depression and anxiety on health-related quality of life (HRQOL) in patients with multiple sclerosis (pwMS) in the UAE. All consecutive patients attending the MS clinic over a fourmonth period, October 2014 through February 2015, at Sheikh Khalifa Medical city (SKMC) were asked to complete The World Health Organization quality of life abbreviated scale (WHOQOL-BREF), the Patient Health Questionnaire nine-item (PHQ-9) depression scale, and Generalized Anxiety Disorder seven-item (GAD-7) scale. These last two scales were used to screen for depression and anxiety disorders respectively. The study looked at significant variables associated with HRQOL, using multivariate analysis. Eighty patients were enrolled in the study. Both anxiety and depression had a strong positive correlation with HRQOL in univariate analysis. However, depression was the strongest predictor of HRQOL in the patients using linear multi-regression analysis. Screening and timely treatment of both anxiety and depression in MS patients should be a recommended policy when managing pwMS to improve their optimal care and ensure better quality of life.
RESUMO
Behavioral symptoms are known side effects of levetiracetam. Previous case series in children and adolescents have demonstrated the potential effect of pyridoxine in ameliorating these symptoms. We retrospectively reviewed the charts of 51 patients treated with pyridoxine to control agitation and irritability following the introduction of levetiracetam. These symptoms were relieved in 34 patients (66.6%). Seventeen patients did not appear to benefit from this supplementation. This preliminary study suggests that pyridoxine might be an effective option across all ages for patients suffering from levetiracetam-induced behavioral side effects.
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Depression and anxiety are highly prevalent in patients with epilepsy (PWE), with prevalence rates ranging from 20% to 55%. The cause of this increased rate is multifactorial. Depression and epilepsy are thought to share the same pathogenic mechanism. Anxiety, on the other hand, seems to have a prevalence rate among PWE comparable to, or even higher than, those reported for depression, and it is closely linked to epilepsy. To test this hypothesis, we screened for depression and anxiety 186 and 160 patients attending the epilepsy and MS clinics, respectively, using standardized screening tools to determine the rates of both depression and anxiety, comparing these rates to 186 age, sex matched controls. Among the three groups, only patients with epilepsy were at increased risk of having depression (OR = 1.9), whereas anxiety was not. This finding could point to the shared pathogenic mechanisms hypothesis between depression and epilepsy.
Assuntos
Ansiedade/epidemiologia , Depressão/epidemiologia , Epilepsia/epidemiologia , Esclerose Múltipla/epidemiologia , Adolescente , Adulto , Idoso , Comorbidade , Feminino , Humanos , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , Prevalência , Risco , Emirados Árabes Unidos/epidemiologia , Adulto JovemRESUMO
Depression and anxiety are highly prevalent in patients with epilepsy (PWE), with prevalence rates ranging from 20% to 55%. Unfortunately, the rates, patterns, and risk factors have not been well studied in the Middle East and, to our knowledge, have not been studied at all in the UAE. We screened 186 patients attending an epilepsy clinic using standardized screening tools to determine the rates of both depression and anxiety and compared these rates with that of age- and sex-matched controls. Almost one-third of our patients scored in the depression and anxiety ranges, which was significantly higher compared with the age- and sex-matched controls. Using a multiregression model, none of the studied variables were associated with an increased risk of having either disorder. Depression or anxiety symptoms independently and significantly increased the risk of association with the other disorder. Almost two-thirds of patients with depression and anxiety were not prescribed antidepressant or antianxiety medications.
Assuntos
Ansiedade/epidemiologia , Depressão/epidemiologia , Epilepsia/complicações , Epilepsia/psicologia , Adolescente , Adulto , Idoso , Anticonvulsivantes/uso terapêutico , Ansiedade/etiologia , Ansiedade/psicologia , Estudos Transversais , Depressão/etiologia , Depressão/psicologia , Egito/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Escalas de Graduação Psiquiátrica , Risco , Fatores de Risco , Convulsões/epidemiologia , Fatores Socioeconômicos , Inquéritos e Questionários , Adulto JovemRESUMO
Depression and anxiety are reported to be prevalent in patients with MS, with prevalence rates ranging from 20% to 50%. Unfortunately, the rates, patterns, and risk factors are not well studied in our Middle East region, and, to our knowledge, not at all in UAE. Using standardized screening tools, we observed that 17% and 20% of 80 patients seen in MS clinic had scores consistent with major depression and anxiety disorders, respectively, at a rate that was not statistically different when compared to age and sex matched controls. None of the studied variables including duration of the disease, EDSS scores, age, gender, and the level of education had any significant correlation with the rates of both disorders. Almost two-thirds of the patients with scores consistent with major depression and anxiety were not on antidepressant and antianxiety medications.
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The corpus callosum has been proposed as a mechanism of interhemispheric inhibition that allows language dominance to develop [1]. Callosal agenesis or dysgenesis provides a test of this hypothesis, as patients lacking a normal corpus callosum should also lack normal language lateralization [2]. We report pre- and postoperative functional magnetic resonance imaging (fMRI) and neuropsychological testing in a patient with partial callosal agenesis who underwent a right temporal lobectomy for medically refractory seizures.
RESUMO
Drug-induced seizures are rare causes of hospital admissions (Coleman, 2004). Various classes of drugs are reported to induce seizures either directly, due to their epileptogenic potential or due to drug withdrawal effect, or indirectly, due to systemic and CNS-related side effects (Thundiyil et al., 2011). Midwakh is commonly used among young Emiratis. However, its CNS-related adverse effects are not well studied. We report seven consecutive patients with a history of seizures provoked by smoking midwakh and a negative workup for epilepsy. Six of these patients had no further seizures after they had agreed to discontinue smoking midwakh.
Assuntos
Convulsões/induzido quimicamente , Fumar/efeitos adversos , Adolescente , Adulto , Humanos , Masculino , Emirados Árabes Unidos , Adulto JovemRESUMO
OBJECTIVE: To measure the stigma of psychiatric illness in a general hospital setting, and to test the connection between common ideas people have of patients with psychiatric illness (personal responsibility, and dangerousness), and the generation of discriminatory behavior. METHODS: A cross-sectional survey through internal mail was carried out in all the hospital staff of King Abdulaziz Hospital in Al-Ahsa, Kingdom of Saudi Arabia. The questionnaire was distributed on the 1st of February, and the study was finished on the 12th of March 2008. The sample size of 860 staff members was included for the study. This study was approved by the Eastern Region National Guard's Health Affairs Research and Ethical Committee. RESULTS: Hospital staff had high scores (6.8/9) for caring attitude for patients with psychiatric illness. They had medium scores for fear (4/9), avoidance (4.8/9), and dangerousness (4.3/9). They had low scores (3.1/9) for anger feelings toward these patients. Discriminatory behavior was found to be the result of feeling that these patients are dangerous, but not because they were held responsible for their illness. CONCLUSION: Our staff had a caring attitude towards patients with psychiatric illness. The idea that the patients with psychiatric illness are to blame for their illness did not hold, while the idea that these patients are dangerous showed positive relationship with discriminatory behavior.