Perceived Awareness of Clozapine associated with Socio- Demographic status, clinical, and side effect profile among patients from Mental Health Hospital, Taif, Saudi Arabia

Background: The main objective was to investigate the Socio-demographic, clinical, and side effect profile of patients on clozapine from Mental Health Hospital, Taif, Saudi Arabia. This article reports on an observational study. Clozapine is a second-generation atypical antipsychotic used as the drug of choice for the treatment resistant psychosis. It is supposed to be a baseline study from which we will get and understand rate of clinical, and side effect profile of the clozapine taking patients. Physicians, particularly psychiatrists are not only ignoring but also not aware, alert, so they always need to be watchful to the fatality of the drug, and take appropriate therapeutic measures. The aim was to study the socio-demographic status, clinical profile, comorbidity, side effects and outcome of patients treated with clozapine. Methodology: We reviewed all the indoor psychiatric patients of Mental Health Hospital, Taif, Saudi Arabia, from the period of one year between January 2021 to January 2022 (N=29). Our study design focused on prospective and observational studies. Descriptive statistical analysis was explored, and presented as frequencies, and percentages. We also determined crude rates for all adverse outcomes of clozapine. Results: We did a nearly mean follow-up of one year. The majority of patients were male (n=26; 89.65%), with a maximum being unmarried (n=16; 55.17%). Most patients belong to nuclear families due to cultural restrictions in this country (n=23; 79.31%). Among the literacy rate illiterate were (n=2; 6.89%, and unemployed (n=23; 79.31%). Among the study populations, the majority of respondents were found to have treatment-resistant schizophrenia (n=18; 62.06%), and around 79.31% of patients took more than two antipsychotics in adequate doses. Among side effect profiles most of the patients suffered hyper-salivation (n=19; 65.51%), sedation (n=12; 41.37%), and rarely suffered from agranulocytosis. Conclusion: Socio-demographic, clinical, and side effect profiles were the significant indicators of clozapine. Clozapine has been used for treatment-resistant psychosis, but due to fatal side effect profile we used it cautiously. In our study, we found that myocarditis, hematemesis, and leukocytosis, and neutropenia are fatal side effects of clozapine. We also found hyponatremia-induced seizure. The prevalence of blood dyscrasias in our study is rarely seen. Hyper-salivation is the most common side effect reported. Majority of the patients in our study were male, and treatment resistant Schizophrenia was the most common diagnosis. Myocarditis is life-threatening side effect seen in our study

Factitious Disorder - Patient Pretending To Long Stay At Hospital

Factitious disorder (FD) is a psychiatric disorder where patients intentionally create false physical or psychological symptoms or exaggerate the already existing ones consciously in the absence of clear external motive. Patients feigned for the sole purpose of assuming the patient's role and to stay lifelong at hospital. Here we present a case of 61 years old Saudi patient presenting with so many various complaints and wasting valuable time and resources of doctors and wants potentially long hospital stays, which affects both the patient and the healthcare system.

Recidivism Rate among Patients discharged from long care unit in forensic psychiatry program at Mental Health Hospital, Taif, Saudi Arabia

Background: This article reports on an observational study of rate and violent recidivism after discharge from a Long-Term Forensic care unit, in mental Health Hospital, Taif, Saudi Arabia. It is an attempt to examine current state of the service provided and its outcomes. It is supposed to be a base line study on which further efforts are to be directed to understanding the risk factors, effective rehabilitation programs and the necessary community-based follow up strategies that would lead to the best outcome possible towards maximizing the benefits of long-term psychiatric care hospitalization on criminal behaviour. Methodology: We reviewed all psychiatric patients who were admitted to, then discharged from the chronic forensic rehabilitation ward from Mental Health Hospital, Taif, Saudi Arabia, between 2005 and 2020 (N=66). Our study focused exclusively on observational studies. We counted number of times of reconviction after the first Mental Health Hospital admission, and also counted for the number of readmissions. Descriptive statistical analysis was explored and presented as frequencies and percentages. We determined crude rates for all adverse outcomes. Results: We did nearly mean follow up of 15 years, 15.15 percent patients died after discharge with average age of death of 31-40 years, 68.18 percent were hospitalized due to relapse of illness and 16.66 percent violently offended after discharge associated with violent crime. The association between psychiatric diagnosis and outcome varied such as substance use disorder as a primary diagnosis was associated with highest risk of mortality and re-hospitalization, on which personality disorder was linked with the highest risk of violent offending. Furthermore, comorbid substance use disorder typically increased risk of adverse outcomes. Conclusion: Long term unit, although might mitigate the risk of high risk patient group. However, that is not enough and they still in a way or another, and for reasons to be looked at and investigated, pose risk to the public safety

Shared Psychotic Disorder: A case of “Folie a deux” with a delusion of pregnancy

Shared psychotic disorder (Folie a deux), is a rarely seen and poorly understood psychiatric disorder. It ischaracterized by the transfer of delusional belief from one primary patient, who already suffering from apsychotic disorder, to another, the secondary patient. Here we present a case, of daughter of schizophrenicmother who has shared psychotic disorder with belief delusion of pregnancy. It was easily diagnosed but abigger challenge for management purpose.