Management of suicide and self-harm risk by the National Mental Health Helpline in the State of Qatar.

BACKGROUND: Suicide is a serious public health problem. AIMS: To investigate the sociodemographic and clinical features of callers (patients) classed by the Qatar National Mental Health Helpline (NMHH) as moderate to high priority based on the risk of self-harm or suicide during the COVID-19 pandemic. METHOD: The study design was a retrospective chart review of patients who contacted the helpline in the first 12 months, starting 1 April 2020. Data of those classed as moderate to high priority based on risk to self were collected using a specifically designed form. Absolute and relative frequencies for each of the studied categorical variables were determined. RESULTS: Four hundred and ninety-eight patients were included. More than half were female. The mean age was 32 years (range 8-85 years). Two-thirds of patients were from Arab countries and more than half of all patients had contacted mental health services for the first time. The most common symptoms elicited included suicidal thoughts, depressed mood and disturbed sleep. The most common psychiatric disorders were depression and generalised anxiety disorder. Most patients were seen within 4 h and received psychiatric interventions. Virtually all patients received non-pharmacological interventions; only 38.5% received pharmacological interventions. The majority had follow-up appointments arranged with mental health services. CONCLUSIONS: People from the Indian subcontinent and males proportionally approached services less, which may reflect stigma. The NMHH improved access to care for patients considered at risk to self and prevented hospital admissions. The NMHH offers a valuable additional choice to patients and assists in prevention and management of suicidal behaviour and other mental health difficulties.

Emergency department presentations of alcohol and other substance misuse: first cross-sectional national study in Qatar.

OBJECTIVES: This study attempts the first in a series of investigations into the misuse of alcohol and substances in Qatar. This study explores the emergency presentations of alcohol and substance abuse to all the state funded emergency departments (EDs) in the country which serve around 90% of the population over a 22-month period. Due to legal penalties for alcohol and substance use, and lack of subsidised community-based facilities, ED presentations are a good starting point to explore this burden. DESIGN AND PARTICIPANTS: A retrospective population-based, cross-sectional study, analysing electronic patient records of all state funded EDs spanning a period of 22 months, from 1 January 2019 to 31 October 2020 was carried out. The study included all eligible individuals aged 18 or over. Primary reason/diagnosis for presentation containing any of the alcohol or substance use key words were included in the study using composite data capture forms by trained clinicians. RESULTS: An overwhelming majority (95.5%) of the total 1495 cases presenting to the EDs with substance abuse were using alcohol. Only 2.1% of the cases were females. Those of Asian (non-Arab) constituted 70% of this group. Qatari citizens presented with highest proportion of substance abuse other than alcohol (23%). Overall, 2.26% of all presentations to the EDs were related to alcohol and substance abuse and this amounted to 3 ED visits per 10 000 of population per year. 56.6% of the cases presented over the weekend. Less than 1% were referred to psychiatry and no other meaningful rehabilitative interventions were offered to others. CONCLUSION: As Qatar moves towards establishing community-based rehabilitative resources for alcohol and substances abuse, the findings from this study will help in shaping these developments. These can include ED-based routine screening for alcohol abuse and referral to rehabilitation services without fear of legal penalties.

Sleep-related eating disorder with mirtazapine.

Sleep-related eating disorder (SRED) is classified within parasomnia and is characterised by recurrent episodes of abnormal, dysfunctional eating during sleep. This report describes a case of SRED in a 19-year-old woman admitted to the psychiatric ward with worsening anxiety, low mood and suicidal ideation. She was started on low-dose mirtazapine for mood stabilisation and, following an incremental increase to 30 mg, she developed nocturnal binge eating of which she retained only partial memory on waking. She developed adverse health consequences as a result of these recurrent episodes. The subject's symptoms were relieved rapidly following reduction of the dose of mirtazapine back to 15 mg.