Dual diagnosis and suicide probability in poly-drug users

Objective: To determine the frequency of suicidal thoughts and suicidal probability among poly-substance abusers in Saudi population, and to examine the relation between dual diagnosis and suicidal thoughts

Study Design: Case control study

Place and Duration of Study: Al-Baha Psychiatric Hospital, Saudi Arabia, from May 2011 to June 2012

Methodology: Participants were 239 subjects, aged 18 - 45 years. We reviewed 122 individuals who fulfilled the DSM-IV-TR criteria of substance abuse for two or more substances, and their data were compared with that collected from 117 control persons

Results: Suicidal cases were highly present among poly-substance abusers 64.75%. Amphetamine and cannabis were the most abused substances, [87.7% and 70.49%, respectively]. A statistically significant association with suicidality was found with longer duration of substance abuse [p < 0.001], using alcohol [p=0.001], amphetamine [p=0.007], volatile substances [p=0.034], presence of comorbid psychiatric disorders [dual diagnosis] as substance induced mood disorder [p=0.001], schizo-affective disorder [p=0.017], major depressive disorders [p=0.001], antisocial [p=0.016] and borderline [p=0.005] personality disorder. Suicidal cases showed significant higher scores [p < 0.001] of suicide probability scale and higher scores in Beck depressive inventory [p < 0.001]

Conclusion: Abusing certain substances for long duration, in addition to comorbid psychiatric disorders especially with disturbed-mood element, may trigger suicidal thoughts in poly-substance abusers. Depression and suicide probability is common consequences of substance abuse

Family physicians ability versus other specialty physicians in breaking bad news skills to patients in Suez canal university and family practice centers

To assess family physicians ability to break bad news to the patient versus the ability of physicians from other specialties in the same skill. A cross sectional study was carried out in family practice centers and Suez canal university hospital that are affiliated to faculty of medicine Suez canal university to compare the performance of family physicians in breaking bad news skill versus the performance of physicians from other specialties in this skill using a Breaking Bad News Assessment Schedule [BAS] which was a method of evaluating how well a physician is breaking bad news to the patient. The family physician working in family practice centers and physicians from other specialty such as internal medicine, pediatric, oncology and obstetric and gynecology departments, they were chosen because they all share the same conditions that include breaking bad news such as chronic diseases, cancers, congenital anomalies, and infertility. The used tool BAS, was administered as self assessment, after explanation of the aim of the study to the studied groups. The study found that the two studied groups had similar sociodemographic and job characteristics; the only statistically significant difference was in attending postgraduate courses in breaking bad news which was higher in the family physician group. The majority of physicians in both groups expressed their need for more training courses in breaking ad news skill but the need was statistically higher in other specialty group. Statistically significant moderate positive correlations were detected between scores of performance and physician's qualifications and experience years. The independent predictors of the score of the performance of the skill of breaking bad news were being a family physician, with longer experience years, having broken bad news to patients more frequently, and having attended postgraduate courses in breaking bad news. The mean total skill score in the family physician group [78 +/- 10.8] was statistically significantly higher than that of the other specialties group [6 1 +/- 12.4] and the majority [91.7%] of the family physicians group were satisfied by their ability to break bad news, compared to [43.3%] of the other specialties physicians. The total performance of breaking bad news skill in the family physician group was higher than in the other specialties group, and they also feel more satisfied with performance, compared to the other specialties

Psychiatric morbidity among attendants of internal medicine out-patient clinic in Ismalia general hospital

Cross sectional survey was done to identify the extent to psychiatric disorders among the attendants of Internal Medicine Clinic. A total of 252 patients were taken by systemic random sample. Two stages screening design was adapted in this study. In the first stage, the total sample was screened for the presence or absence of psychological disorders by the General Health Questionnaire [GHQ]. In the second stage, the GHQ positive [+ ve] [probable cases] were interviewed using a Psychiatric Assessment Schedule [PAS]. One hundred and four patients had scored above the cute-off point [41.27%] and they were statistically significant in females, adult period, married persons. Mood disorders were the commonest disorders [35.57%] followed by anxiety disorders [28.84%] and adjustment disorders were 15.38%. The most common physical symptoms associated with psychiatric disorders were abdominal pain, headache, dyspnea, drowsiness, chest pain, backache and palpitations. The importance of secondary prevention was discussed