Dual burden of chronic physical conditions and mental disorders: Findings from the Saudi National Mental Health Survey.

Introduction: Comorbidities of mental disorders and chronic physical conditions are a common medical burden reported among Western countries. National estimates of such comorbidities among the general population of Arab countries like Saudi Arabia are unknown. This study examined the prevalence of lifetime chronic physical conditions among the Saudi general population with DSM-IV 12-month mental disorders, and the associations with disability in the Kingdom of Saudi Arabia (KSA). Methods: The Saudi National Mental Health Survey, a cross-sectional household study - part of the World Mental Health (WMH) Survey Consortium - was conducted between 2013-2016 in the KSA, with 4,001 Saudi citizens aged 15-65 (response rate 61%). The World Health Organization Composite International Diagnostic Interview 3.0 was used to assess prevalence of lifetime chronic physical conditions and 12-month mental disorders; disability was measured in terms of days out of role. Results: The prevalence of any comorbid 12-month mental disorder among those with chronic physical conditions was 24%. Major depressive disorder, social phobia, and adult separation anxiety disorder were the most common comorbid mental disorders across all chronic physical conditions. Gender, education, income, urbanicity, region, and employment were associated with the presence of any chronic physical condition. Respondents with mental / physical comorbidities had 2.97 days out of role (on average) in the last 30 days. Conclusion: Comorbidities of mental disorders and chronic physical conditions are common among Saudis. National efforts are needed to increase awareness of such comorbidities among the general population, and develop prevention and treatment services tailored to the needs of individuals at-risk for comorbidities.

Assessment of Insulin Therapy as a Risk Factor for Hirsutism Among Diabetic Females in Saudi Arabia.

Introduction Hirsutism is defined as a condition in which women develop excessive body hair in androgen-dependent areas, which include lips, chin, chest, abdomen, back, and femoral region. The link between hyperandrogenism and insulin resistance and/or hyperinsulinemia is well established. Polycystic ovary syndrome, as a form of hyperandrogenism, has been linked to several diseases, including type 2 diabetes mellitus and hirsutism. However, it is unknown how common hyperandrogenic problems are in women who receive exogenous insulin. Therefore, this study aims to assess the effect of insulin intake and other sociodemographic factors on the development of hirsutism among diabetic females. Methods This case-control study was conducted in six regions of Saudi Arabia, including Al-Ahsa, Dammam, Qatif, Riyadh, Abha, and Jeddah, during the year 2022. The population was Saudi females who were diabetic, between the age of 18 and 65 years, and living in Saudi Arabia. The sample size was 186 participants. Of the participants, 48 had considerable hirsutism whereas 138 did not. The degree of hirsutism has been determined using the Ferriman and Gallwey scoring tool. Results A total of 186 diabetic females were included in the study. Among the females, 97 (52.2%) were on insulin therapy and 89 (47.8%) were on non-insulin therapies. Only hair distribution on the chin showed a significant difference between the study groups where 4.1% of cases on insulin showed complete cover with light or heavy hair on the chin compared to 3.4% of controls (P = 0.049). There was no significant difference regarding hirsutism score among the study patients according to insulin intake where the mean score was 5.4 ± 5.1 among cases on insulin versus 4.7 ± 5.1 for controls (P = 0.978). Adjusted logistic regression models showed an insignificant association between diabetic female hirsutism and insulin intake (OR = 1.1 and 1.0, respectively; P > 0.05). Conclusion Many factors were examined to reveal their associations with hirsutism in diabetic females. Neither the type of diabetes nor insulin intake was significantly correlated with the development of hirsutism. On the other hand, age was found to be significantly associated with the development of hirsutism among age groups (<30, 30-49, and 50+; P = 0.49). It seemed that the prevalence of hirsutism decreases as age advances.