Lifetime prevalence, risk, and treatment of mood and anxiety disorders in Qatar's national mental health study.

OBJECTIVES: To estimate lifetime prevalence, risk, and treatment for mental disorders and their correlates in Qatar's general population for the first time. METHODS: We conducted a national phone survey of 5,195 Qatari and Arab residents in Qatar (2019-2022) using the Composite International Diagnostic Interview Version 3.3 and estimated lifetime mood and anxiety defined diagnoses. Survival-based discrete time models, lifetime morbid risk, and treatment projections were estimated. RESULTS: Lifetime prevalence of any disorder was 28.0% and was associated with younger cohorts, females, and migrants, but lower formal education. Treatment contact in the year of disorder onset were 13.5%. The median delay in receiving treatment was 5 years (IQR = 2-13). Lifetime treatment among those with a lifetime disorder were 59.9% for non-healthcare and 63.5% for healthcare; it was 68.1% for any anxiety and 80.1% for any mood disorder after 50 years of onset. Younger cohorts and later age of onset were significantly predictors of treatment. CONCLUSIONS: Lifetime prevalence of mental disorders in Qatar is comparable to other countries. Treatment is significantly delayed and delivered largely in non-healthcare sectors thus the need for increased literacy of mental illness to reduce stigma and improve earlier help-seeking in healthcare settings.

Influencing factors of non-suicidal self-injury according to DSM-5 in adolescents admitted to the psychiatric department: a cross-sectional study.

Background: Non-suicidal self-injury (NSSI) is being increasingly recognized as a prominent mental health concern, especially among adolescents. In psychiatric clinical samples, its incidence is high and difficult to identify. However, few studies have explored the NSSI behavior of psychiatric hospitalized adolescents. This study aimed to explore the influencing factors of NSSI according to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) in adolescents admitted to the psychiatric department. Methods: In this cross-sectional study, by convenient sampling, a total of 505 psychiatric adolescent inpatients aged 10-19 years completed questionnaires to record details of sociodemographic characteristics, the NSSI questionnaire, the Child Psychological Abuse and Neglect Scale (CPANS), the self-report version of the Strengths and Difficulties Questionnaire (self-report SDQ), the Coping Style Scale for Middle School Students (CSSMSS), which were compared between NSSI inpatients and non-NSSI inpatients. This study used the diagnostic criteria for NSSI disorder in DSM-5: adolescent patients who have NSSI behaviors for more than 5 times in the past 1 year are called NSSI. A multiple logistic regression model was built to explore the relationships among general information, CPANS, SDQ, CSSMSS, and NSSI. Risk for NSSI is quantified by odds ratio (OR) with 95% confidence interval (CI). Results: The results showed that 77.82% (n=393) of adolescent inpatients had NSSI, and 80.0% were female (n=404). NSSI adolescent inpatients experienced more family scolding, psychological abuse, and neglect and showed more positive attitudes toward NSSI than non-NSSI adolescent inpatients. However, after controlling for covariables, the difference disappeared. NSSI behavior was significantly associated with female (OR =2.391, 95% CI: 1.396-4.097, P=0.002), younger age (10-14 years old) (OR =1.876, 95% CI: 1.154-3.049, P=0.011), have close friends (OR =0.355, 95% CI: 0.164-0.768, P=0.008), peer discussion about self-injury (OR =1.977, 95% CI: 1.047-3.734, P=0.036), emotional and behavioral difficulties (OR =1.853, 95% CI: 1.054-3.258, P=0.032), problem-oriented coping styles (OR =0.968, 95% CI: 0.945-0.991, P=0.007), emotion-oriented coping styles (OR =1.035, 95% CI: 1.006-41.064, P=0.016). Conclusions: Measures should be taken to prevent and reduce the occurrence of NSSI behaviors among hospitalized adolescents in psychiatric department, which include improving adolescents' attitude towards NSSI, reducing adolescents' gathering behavior in the ward, preventing adolescents from discussing NSSI through social media, improving their coping style when facing difficulties, and reasonably regulating their abnormal emotions and behaviors.

Impact of modification to DSM-5 criterion A for hypomania/mania in newly diagnosed bipolar patients: findings from the prospective BIO study.

BACKGROUND: DSM-IV states that criterion A for diagnosing hypomania/mania is mood change. The revised DSM-5 now states that increased energy or activity must be present alongside mood changes to diagnose hypomania/mania, thus raising energy/activity to criterion A. We set out to investigate how the change in criterion A affects the diagnosis of hypomanic/manic visits in patients with a newly diagnosed bipolar disorder. RESULTS: In this prospective cohort study, 373 patients were included (median age = 32; IQR, 27-40). Women constituted 66% (n = 245) of the cohort and 68% of the cohort (n = 253) met criteria for bipolar type II, the remaining patients were diagnosed bipolar type I. Median number of contributed visits was 2 per subject (IQR, 1-3) and median follow-up time was 3 years (IQR, 2-4). During follow-up, 127 patients had at least one visit with fulfilled DSM-IV criterion A. Applying DSM-5 criterion A reduced the number of patients experiencing a hypomanic/manic visit by 62% at baseline and by 50% during longitudinal follow-up, compared with DSM-IV criterion A. Fulfilling DSM-5 criterion A during follow-up was associated with higher modified young mania rating scale score (OR = 1.51, CL [1.34, 1.71], p < 0.0001) and increased number of visits contributed (OR = 1.86, CL [1.52, 2.29], p < 0.0001). CONCLUSION: Applying the stricter DSM-5 criterion A in a cohort of newly diagnosed bipolar patients reduced the number of patients experiencing a hypomanic/manic visit substantially, and was associated with higher overall young mania rating scale scores, compared with DSM-IV criterion A. Consequently, fewer hypomanic/manic visits may be detected in newly diagnosed bipolar patients with applied DSM-5 criterion A, and the upcoming ICD-11, which may possibly result in longer diagnostic delay of BD as compared with the DSM-IV.