People with diabetes need a lower cut-off than others for depression screening with PHQ-9

Aims: This study evaluated the psychometric characteristics of the Polish version of the PHQ-9 in detecting major depression (MDD) and ‘MDD and/or dysthymia’ in people with and without type 2 diabetes. Methods: Participants were randomly selected from a diabetes outpatient facility (N = 216) and from among patients admitted to a medical center and psychiatric hospital (N = 99). The participants completed the PHQ-9. The Hamilton Depression Rating Scale and the Mini International Neuropsychiatric Interview were used to identify the presence of psychiatric symptoms. The optimal cut-offs for PHQ-9 in people with and without type 2 diabetes were investigated based on two methods: 1) Youden’s index which identifies cut-off points useful in scientific research; 2) a second method of two-stage screening for depressive disorders to provide guidance for clinical practice. Results: The Polish version of the PHQ-9 is a reliable and valid screening tool for depression in people with and without type 2 diabetes. An optimal cut-off of ≥ 7 was indicated by Youden’s index and ≥ 5 by the two-stage method for screening for MDD and ‘MDD and/or dysthymia’ in the group with type 2 diabetes. A cut-off of ≥ 11 was optimal for screening for both MDD and ‘MDD and/or dysthymia’ among people without diabetes (Youden’s index). The two-stage approach suggested a ≥ 10 score for screening for MDD and ≥ 9 for screening for ‘MDD and/or dysthymia’ in people without diabetes. Conclusions: A lower cut-off score of the PHQ-9 is recommended for people with type 2 diabetes as compared to the general population

Psychosocial correlates of using faith healing services in Riyadh, Saudi Arabia: a comparative cross-sectional study

BACKGROUND: In this study, we compared the prevalence of psychiatric disorders and the characteristics of those who either use or do not use faith healers (FHs) services. We also assessed the independent factors of study subjects associated with using FHs. METHODS: This cross-sectional study compared those who use FHs (n = 383) with a control group of those who do not use them (i.e., shopping mall visitors, n = 424) using a survey of sociodemographic characteristics and a validated Arabic version of the Mini International Neuropsychiatric Interview (MINI 6.0). RESULTS: Participants who ranked higher among FH users included males, people who were either married, divorced, or widowed, those with less education, and those with lower income. They were more likely to report past medical and psychiatric history. Those with diagnosable psychiatric disorders were more likely to visit FHs, especially if the diagnosis was of psychotic and bipolar disorders. The prevalence of psychiatric disorders was higher among FH users, and depressive and anxiety disorders were the most prevalent. CONCLUSIONS: The study showed that having past psychiatric history and a current psychiatric disorder are risk factors for using FHs. Also, a high percentage of FH users had a diagnosable psychiatric disorder. Further research should assess how to facilitate their access to the mental health system

More anxious than depressed: prevalence and correlates in a 15-nation study of anxiety disorders in people with type 2 diabetes mellitus

Background Anxiety disorder, one of the highly disabling, prevalent and common mental disorders, is known to be more prevalent in persons with type 2 diabetes mellitus (T2DM) than the general population, and the comorbid presence of anxiety disorders is known to have an impact on the diabetes outcome and the quality of life. However, the information on the type of anxiety disorder and its prevalence in persons with T2DM is limited. Aims To assess the prevalence and correlates of anxiety disorder in people with type 2 diabetes in different countries. Methods People aged 18–65 years with diabetes and treated in outpatient settings were recruited in 15 countries and underwent a psychiatric interview with the Mini-International Neuropsychiatric Interview. Demographic and medical record data were collected. Results A total of 3170 people with type 2 diabetes (56.2% women; with mean (SD) duration of diabetes 10.01 (7.0) years) participated. The overall prevalence of anxiety disorders in type 2 diabetic persons was 18%; however, 2.8% of the study population had more than one type of anxiety disorder. The most prevalent anxiety disorders were generalised anxiety disorder (8.1%) and panic disorder (5.1%). Female gender, presence of diabetic complications, longer duration of diabetes and poorer glycaemic control (HbA1c levels) were significantly associated with comorbid anxiety disorder. A higher prevalence of anxiety disorders was observed in Ukraine, Saudi Arabia and Argentina with a lower prevalence in Bangladesh and India. Conclusions Our international study shows that people with type 2 diabetes have a high prevalence of anxiety disorders, especially women, those with diabetic complications, those with a longer duration of diabetes and poorer glycaemic control. Early identification and appropriate timely care of psychiatric problems of people with type 2 diabetes is warranted

Inborn errors of type I IFN immunity in patients with life-threatening COVID-19.

Clinical outcome upon infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ranges from silent infection to lethal coronavirus disease 2019 (COVID-19). We have found an enrichment in rare variants predicted to be loss-of-function (LOF) at the 13 human loci known to govern Toll-like receptor 3 (TLR3)- and interferon regulatory factor 7 (IRF7)-dependent type I interferon (IFN) immunity to influenza virus in 659 patients with life-threatening COVID-19 pneumonia relative to 534 subjects with asymptomatic or benign infection. By testing these and other rare variants at these 13 loci, we experimentally defined LOF variants underlying autosomal-recessive or autosomal-dominant deficiencies in 23 patients (3.5%) 17 to 77 years of age. We show that human fibroblasts with mutations affecting this circuit are vulnerable to SARS-CoV-2. Inborn errors of TLR3- and IRF7-dependent type I IFN immunity can underlie life-threatening COVID-19 pneumonia in patients with no prior severe infection

Knowledge and attitude towards dentist-industry relationship and their association with own behavior among dentists working in Saudi Arabia

Objectives: To examine the knowledge and attitude towards dentist-industry relationship including accepting gifts, influence on decisions, and accuracy of given information among dentists working in Saudi Arabia. In addition, to examine the association of such knowledge and attitude of dentists' behavior with industry, including sorts of interaction and accepting industrial gifts. Methods: A cross-sectional study was conducted among dental practitioners working in the private and governmental hospitals located in the various regions of Saudi Arabia. A self-administrated questionnaire was developed and distributed to all participants. Fourteen questions assessed the socio-demographic, economic, and occupational characteristics of the participants including age, gender, nationality, monthly revenue, income satisfaction, hospital setting, job rank, specialty, and patients' socio- economic status. Seventeen questions assessed the interaction with DSRs, acceptance and characteristics of gifts and opinion of dentists regarding gift acceptance in dental practice. One-Way ANOVA and t-test was used to examine differences in transformed scores by socio-demographic, occupations and outcome characteristics. All P-values were two-tailed. P-value < 0.05 was considered as significant. Results: Total of 672 participants responded to general questions related to the knowledge and attitude. The mean of the overall knowledge and attitude score was 64.3 ± 7.2, general questions score was 63.1 ± 8.6 and interaction questions score was 66.9 ± 8.0. Approximately, 40% of participants disagreed that accepting industrial gifts can affect their own decisions but slightly lower proportion (25%) disagreed that accepting industrial gifts can affect decisions of other dentists. Only 25% of participants thought it is ethical to accept industrial gifts and even fewer proportions (20%) believed that dental supply representatives (DSRs) always provide accurate information about their new materials. Almost two-thirds of participants trusted information from other sources than from DSRs. On the other hand, 40% of the participants were against banning industrial gifts to dentists and approximately 50% were against informing the patients about the industrial gifts given to their dentist by dental companies. Conclusions: There was insufficient knowledge and an overall positive attitude towards the dental industry among the sample of dentists in Saudi Arabia. Well-designed ethical education programs should be implemented to enhance knowledge and attitudes about the interactions with dental industry. Keywords: Dentist-industry, Knowledge, Attitude, Industrial gift

Association of help-seeking behavior with depression and anxiety disorders among gastroenterological patients in Saudi Arabia

Background/Aims: There is a high prevalence of depression and anxiety disorders among gastroenterological outpatients. Relatively few studies have been done on the help-seeking behavior among those who suffer from gastrointestinal symptoms with or without psychiatric disorders. We aimed to characterize the help-seeking behavior of gastroenterological outpatients and to evaluate if this behavior is linked to the presence of depression and anxiety. Patients and Methods: A cross-sectional study was carried out in gastroenterology clinics in four hospitals in Riyadh between February and September 2013. A self-administrated questionnaire was developed and administered to patients. Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder (GAD-7) questionnaires were used to diagnose depression and anxiety, respectively. Results: A total of 440 patients completed the study questionnaire. The average age was 36.0 ± 12.8 years and 69% of the patients were males. Complaints included abdominal pain (58%), heartburn (29%), diarrhea or constipation (25%), appetite or weight changes (22%), and nausea or vomiting (16%). Depression was diagnosed in 36%, while anxiety was diagnosed in 28% of the patients. The first intervention was use of medications (68%) and undergoing endoscopy (16%), while few patients initially used herbs or Islamic incantation (7.5%). This first intervention was done primarily (59%) in private sector hospitals rather than government sector hospitals (36%). The rates of depression and anxiety in our patients were higher among those who suffered from multiple complaints for longer durations and with less satisfaction with the offered services. Conclusion: Depression and anxiety are common comorbidities in gastroenterological outpatient population, especially those who have a chronic course of multiple gastrointestinal complaints

Bipolar Disorders in Saudi Arabia: What Do We Know So Far?

Bipolar disorders (BP) are prevalent neuropsychiatric illnesses affecting 1%–5% of the global population and about 3% of the Saudi population. They are associated with significant comorbidities and negative consequences. Despite being common mental health conditions in Saudi Arabia, stigma persists, with weak character, supernatural beliefs, and weak faith considered as causes. In addition, Saudi patients with BP have been reported to seek help from non-psychiatric healthcare professionals and faith healers. More data are required on BP from Saudi Arabia, including the genetic aspects and their treatment approaches. This narrative review paper explores the epidemiology and clinical manifestations, etiology and biological mechanisms, public knowledge and awareness of the illnesses, and treatment of BP in Saudi Arabia