Psychiatric morbidity among housemaids in Kuwait. a. prevalence of psychiatric disorders in the hospitalized group of housemaids

Objectives: To determine the first hospital admission rates and the nature of psychiatric disorders among housemaids and compare them with the Kuwaiti female patients

Subjects and Methods: Based on the International Classification of Diseases [10[th] revision; ICD-10] symptom checklist, a semi-structured interview was administered to all the housemaids and the Kuwaiti female patients hospitalized during the 2-year study period

Results: The hospital admission rates were 1.86 times higher in housemaids than in the Kuwaiti female patients and the nature of psychiatric disorders was also different in the two groups. The stress-related disorders were more common among housemaids while schizophrenia was the commonest disorder among Kuwaiti patients. Duration of hospital stay was significantly shorter for housemaids, and four fifths of them were repatriated on mental health grounds

Conclusions: The psychiatric morbidity is higher among housemaids than Kuwaiti females and a substantial number of them are prematurely repatriated on health grounds. Further studies are needed to explore the possible pre-immigration risk, and post-immigration precipitating factors, to prevent this 'expatriate failure'

Effect of 8-hour variable shift-work schedules on quality of sleep, work performance and general health

Data collected by combined self-administered questionnaires from 200 Kuwaiti males on variable shift-work and an equal number of males on straight one-shift-work at the Kuwait Oil Company [KOC] were studied over a 9-month period. Compared to men working a non-variable work schedule, those working variable shifts exhibited higher [P<0.0001] rates of heavy smoking, coffee/tea consumption, job stress and emotional problems. Variable shift-workers reported a significantly [P<0.0001] more persistent sleep disturbance of all dimensions, digestive complaints, decreased work performance and disruptive social life than did straight one-shift-workers. Forty-One percent complained of fatigue and 34% of poor concentration. They were also more prone to errors and accidents at work. The underlying psychophysiological factors are discussed. The need for a better occupational health system is emphasized

Noncompliance with treatments among psychiatric patients in Kuwait

One hundred and twenty psychiatric patients were discharged for outpatient treatment, of which 55% had prematurely discontinued their medications. Clinically, these patients were characterized as being young, single male individuals with diagnoses of schizophrenia and mania. Previous multiple hospital admissions were strongly associated with noncompliance. Fear of drug dependence, complex treatment regimen and social 'stigma' were the main reasons given by the patients for their noncompliance. The need for improved doctor-patient relationship and greater efforts toward public education is emphasized

Medical students' attitucle to psychiatry

A survey of attitudes to psychiatry was conducted on a group of 92 Kuwaiti senior medical students before and after a 6-week clerkship in psychiatry. A significant attitudinal change was observed in 4 of 18 items in a positive direction, while one item moved in an unfavorable direction. The percentage of students interested in a career in psychiatry rose from 2.2% prior to training to 8.7% after training. Poor working conditions, social stigma attached to mental illness, and low professional status were the main reasons given by students against specializing in psychiatry. Students' reasons for or against this subject are discussed

Wilson's disease with catatonic features

A case of Wilson's disease [Hepato-Lenticular Degeneration] in a 14 year old girl, was diagnosed on clinical grounds as Catatonic Schizophrenia. Psychiatric symptoms with motor abnormalities masquerading as Wilson's Syndrome are discussed. A screening test for Wilson's disease in psychiatric patients below the age of 40 presenting with neurological symptoms is strongly recommended

Polypharmacy among psychiatric patients in Kuwait

Prescriptions for 116 psychiatric inpatients were studied. About a third of the patients had received three psychotropic drugs and more than half had a combination of four or more. Neuroleptic drugs were prescribed for all patients regardless of the diagnoses. Anticholinergic drugs were prescribed in excess, without providing information on side effects or the duration of neuroleptic treatment. Half of the patients treated with antidepressants had diagnoses other than affective disorders. Most of the p.r.n. medications were administered on nurses' requests, without medical indications. Some underlying technical and administrative aspects of polypharmacy are discussed. Ways to improve prescribing habits are suggested

Effective reactions to breast cancer diagnosis among arab women

The psychiatric profiles of 40 women with early breast cancer [experimental sample] and a cancer sample of 40 women with other medical conditions [medical sample] were examined over a 6-month period. The breast cancer patients had a significantly higher affective reaction than patients with other medical conditions. They were also considerably less likely to have received adequate information about their illness. The underlying sociocultural factors are discussed. Means to promote communication between physicians and cancer sufferers are suggested. The need for an oncology liaison psychiatric service is emphasized