Feasibility of using Arabic Hospital Anxiety and Depression Scale (HADS) to assess anxiety and depression among patients attending accident and emergency at a University Hospital setting in Riyadh, Saudi Arabia

Objective: To evaluate the feasibility of using Arabic Hospital Anxiety and Depression Scale [HADS] to assess depression and anxiety among patients attending accident and emergency [A and E] at a University Hospital setting in Riyadh, Saudi Arabia

Methods: In this prospective observational study translated questionnaire of HADS was used for patients aged 18 years or above who presented to A and E at King Khalid University Hospital in Riyadh, Saudi Arabia. The study included 257 patients as per an agreed inclusion criteria. The study quantified depression and anxiety and its association with demographic and or illness related variables using SPSS

Results: Out of 257 participants, the dominant age group, ranged between 18-30 years [40.9%] with female participants [55.3%] outweigh the male among all. The overall occurrence of depression was 27.2% [95% Confidence Interval [CI]: 21.8% to 32.6%] and anxiety was 23% [17.8% to 28.2%CI]. Marital, educational and economic status of participants, were statistically significantly associated [p<0.05] with the levels of anxiety whereas age, marital, education, economic and employment status were associated [p<0.05] with the levels of depression

Conclusion: In the A and E setting at University Hospital in Saudi Arabia, comorbid depression and anxiety is not uncommon as enumerated by using HADS. The identified cases could then be sent for appropriate psychiatric treatment promptly not only to improve quality of individual care but also to reduce the overall health care costs in local context

Child sexual abuse

Child sexual abuse with significant impact on victim's physical, mental and social health has now been recognized as existing on an appreciable scale worldwide. Diversity of opinions exist about the concept, types, prevalence and repercussions along with a paucity of systematic and scientific work in the developing world including Pakistan. This paper aims at reviewing the literature for clarification of concept, update of estimates and correlates, and to identify lines for future research. The literature was searched through BMJ-Medline for international data, supplemented by local data through CPSP-MEDLIP service. The search term [child sexual abuse] with associated sub-heads were used. No constraint of time period, publication type or source applied except [English Language version]. Wide variations identified in conceptual boundaries with consequent impact on prevalence estimates. Agreement found for its existence as an international problem with rates ranging from 7 percent - 36 percent for women and 3 percent - 29 percent for men. Female abused 1.5-3 times more than male with exponential high rates in age group 3-6 years and 8-11 years. In 2/3 cases the perpetrator identified belonged to nuclear or extended family. Significant association exists with early onset of psychiatric ailments like substance abuse, eating disorders, personality disorders, dissociative disorders and depression. The need for extensive research studies is immense in developing countries like Pakistan where environmental circumstances suggest its presence at rates higher than the identified elsewhere. In addition to facilitate awareness and perhaps to clarify the concept as well as the prevalence of child sexual abuse researchers need to select methodologies and instruments with international comparison in mind