A Comparison of Knowledge, Attitude, and Practice (KAP) Between Private- and Government-Sector Pharmacists With Regard to Psychotropic Medications in Riyadh City.

Background Pharmacists play a significant role in patient care, and many patients consider them to be their primary source of information regarding medications. Therefore, pharmacists must have an adequate level of knowledge about psychotropic medications. This study aims to assess and compare the levels of knowledge, attitudes, and practices regarding psychotropic medications in governmental and private-sector pharmacists in Riyadh, Saudi Arabia. Methods An observational cross-sectional study was conducted, which included 355 pharmacists (governmental and private sector pharmacists). Each pharmacist was interviewed and asked to answer a structured questionnaire that consisted of four sections: demographic data, knowledge, attitude, and practice regarding psychotropic medications. Results Our findings indicate that the overall knowledge regarding psychotropic medications among private and government-sector pharmacists is insufficient. While 282 (79.4%) had insufficient knowledge, 20.6% of pharmacists had adequate knowledge regarding psychotropic medications, and good knowledge was detected among 29.1% of government-sector pharmacists compared to 18.1% of private-sector pharmacists (P = .033). Our results also revealed that 31.5% of the pharmacists felt comfortable with their knowledge of psychotropic agents. In addition, 18.9% of the pharmacists reported that they received adequate training on psychotropic medications (12.7% of the governmental group versus 20.7% of the private-sector group; P =.048). Conclusion The insufficient knowledge among pharmacists regarding psychotropic medications highlights the importance of providing more training programs and educational courses to improve pharmacists' knowledge about psychotropic medications in Saudi Arabia.

Challenges in the Clinical Diagnosis of Lithium Toxicity: A Case Report.

Lithium, a medication commonly used to treat bipolar disorders, has a narrow therapeutic index, putting patients at risk of lithium toxicity. Such toxicity could entail neurological-related complications and could be precipitated by several factors. In this paper, the authors discuss a case of a middle-aged woman taking lithium for bipolar disorder who presented to the emergency department with altered mental status, tremors, generalized weakness, and dysarthria. Multiple differential diagnoses were considered during her hospitalization, which included an admission to the intensive care unit. This case highlights the variability of lithium toxicity presentations and its management challenges. Further research is needed to understand such manifestations, potential precipitating factors, differential diagnoses, and effective detection and management.

Perceptions and Attitudes of Mental Health Professionals toward the Mental Health Care Law in Saudi Arabia.

The Saudi Mental Health Care Law (SMHL) was established in 2014; however, no prior study has evaluated mental health professionals' perceptions or attitudes toward it. This cross-sectional study examines these aspects and their associated factors among psychiatrists, psychologists, social workers, and psychiatric nurses in Saudi Arabia (SA). The data were collected from 432 participants using an online electronic survey consisting of four sections, including the Mental Health Legislation Attitudes Scale (MHLAS). Psychiatrists comprised most participants (46.06%), followed by psychologists (36.34%). Most participants were 40 years of age or younger (83.10%). Of the 432 participants, 226 (52.31%) were females. Overall, 28.70% were unaware of the existence of the SMHL. A total of 172 (66.67%) out of 258 participants agreed that the legislation operates well in ensuring treatment for persons who require involuntary admission. There was a statistically significant association between specialty and opinions of treatment efficacy and care benefits of the SMHL (p = 0.031 and p < 0.001, respectively). Official implementation of SMHL in participants' facilities resulted in high MHLAS scores (p = 0.007). Reading or attending lectures and workshops related to the SMHL resulted in high MHLAS scores (p = 0.044 and p = 0.021, respectively). Negative opinions and uncertainty regarding the effect of SMHL on confidentiality were associated with low total MHLAS scores (p < 0.001). This study highlights the need to increase awareness of the SMHL among Saudi Arabian healthcare workers.

The impact of low self-esteem on academic achievement and the behaviors related to it among medical students in Saudi Arabia.

OBJECTIVES: To measure the prevalence of low self-esteem among medical students in Saudi Arabia and determine its impact on their behaviors and academic achievement. METHODS: We hypothesized that the level of self-esteem reflected on the student's academic performance and linked to some of their behaviors. A cross-sectional study was carried out among students of the medical colleges in Saudi Arabia. A self-administered questionnaire was distributed electronically using social media platforms, socio-demographic data, Rosenberg's self-esteem scale, and a questionnaire about self-esteem-related behaviors. RESULTS: Of 1099 participants (55.9% females and 50% males), 24.1% showed low self-esteem. Independent significant predictors of low self-esteem were female gender and diagnosis with mental illness. Increasing GPA was associated with better self-esteem. Participating in students' study groups and attending self-development programs were estimated to be the protective factors against low self-esteem. CONCLUSION: One-quarter of medical students are assumed to have low self-esteem. Improved GPA ratings positively influence self-esteem, while attending students' study groups and self-development programs were identified as protective factors for low self-esteem. Further studies are needed to shed more light on this important topic.

The Prevalence of Depression and Anxiety in Heart Failure Patients in Saudi Arabia: An Original Study.

Background Depression is a severe comorbidity that is often detected in patients with chronic diseases. Poor prognosis may eventuate high mortality risk. Up to 30% of heart failure patients have been documented with depression and the majority upholds depression-related symptoms that may have serious clinical implications, such as hospital readmissions and fatalities. To mitigate depression-induced harms among heart failure patients, studies are being conducted to determine the prevalence, risk factors, and interventions. Objectives The current investigation is envisioned to examine the prevalence of depression and anxiety among the Saudi heart failure population. Also, it will help to explore the risk factors that will subsequently facilitate the analysis of preventive measures. Methodology The cross-sectional epidemiologic research was conducted at King Khalid University, Hospital with the recruitment of 205 participants. Each participant underwent a 30-question screening for depression, anxiety, and related risk factors. The "Hospital, Anxiety, and Depression Scale" (HADS score) was used to score subjects for the assessment of both comorbidities. The data points were subsequently analyzed by descriptive statistics and regression analysis. Results Among 205 participants, 137 (66.82%) were male and 68 (33.17%) were female with a mean age of 59.71 years. Our sample reflects a prevalence of 52.7% depression and 56.9% anxiety in Saudi heart failure patients. High depression scores were positively related to age, female gender, hospital readmissions, and pre-existing comorbidities in heart failure patients. Conclusion The study manifested high depression scores among the Saudi heart failure cohort compared to the previous survey. In addition, a substantial interrelationship of depression and categorical variables has been identified that accentuates predominating risks that can potentially promote depression and anxiety in heart failure patients.

Postpartum Depression at a Tertiary Care Hospital in Saudi Arabia: Prevalence and Associated Factors.

Objectives Postpartum depression (PPD) is a significant health concern associated with several risk factors. This study aims to assess the prevalence of PPD and its related factors in a tertiary care hospital in Riyadh, Saudi Arabia, specifically King Khalid University Hospital (KKUH). Methods A cross-sectional study was conducted of 187 females aged 18 to 50 years old who gave birth at KKUH. Data were collected from the same participants at two stages using the same questionnaire, which consisted of the Edinburgh Postnatal Depression Scale (EPDS) and demographic questions. In the first stage, the participants were selected randomly. The second stage included participants who scored less than 9 on the EPDS in the first stage and were asked to retake the questionnaire four weeks later. Results The prevalence of PPD found in this study was 50.3%, which is higher than in other studies that have been conducted in the country. Furthermore, factors such as sleep disturbances (p = 0.005), loss of interest in daily activities (p = 0.031), mood swings (p = 0.021), frequent bouts of sadness (p < 0.0001), and frustration or worry (p < 0.0001) were all found to significantly increase the risk of PPD. Conclusion This study demonstrates a high prevalence of PPD in women who delivered at KKUH. More studies with a more rigorous methodology are warranted.

Adjustment disorder among first year medical students at King Saud University, Riyadh, Saudi Arabia, in 2020.

BACKGROUND: The general health and well-being of medical students has become a matter of concern, as medical students have higher levels of stress than their nonmedical peers. Long-standing stress may lead to serious outcomes, such as depression, anxiety, poor quality of life, or adjustment disorders. This study aimed to estimate the proportion of first year medical students who have adjustment disorder and explore possible risk factors. MATERIALS AND METHODS: This cross-sectional study was conducted among all first-year medical students at King Saud University, College of Medicine, Saudi Arabia. The adjustment disorder-new model 20 (ADNM-20) was used to assess adjustment disorder with the stressor and item lists. The item list scores were summed and a cutoff point >47.5 was designated as a high risk of developing the disorder. Descriptive analysis included computing mean and standard deviation for continuous variable while frequency and percentages for categorical variables. Chi-square test and logistic regression analysis determined risk factors for having an adjustment disorder and the stress of attending a medical school. RESULTS: The study enrolled 267 students but only 128 completed the ADNM-20 survey. Out of 267 students, the most commonly reported recent stressor was too much/too little work, and 52.8% reported having difficulty in meeting deadlines. The most common core symptom expressed by the medical students was avoidance behavior with a mean score of 10.91 ± 3.12, followed by preoccupation with stressors with a mean score of 10.66 ± 3.10. The factors significantly associated with having adjustment disorder were being female, younger age, recent illness of a loved one, having family conflicts, and having too much or too little work. CONCLUSION: First year medical students are at increased risk of adjustment disorder. Screening and awareness programs may be considered for preventing adjustment disorder. Increased student-staff interactions may provide support to adapt to their new environment and help reduce social adjustment difficulties.

Stigma Toward Mental Illness Among Saudi Medical Students: Pre and Post Psychiatry Course Comparison.

ABSTRACT: This cross-sectional study aims to compare pre- versus post-psychiatry course stigma levels toward mental illnesses among King Saud University medical students and identify which factors could affect stigma degree. The sample included 384 randomly chosen students. The overall scores of the used scale, the 15-item Opening Minds Scale for Healthcare Providers (OMS-HC-15), indicated no statistically significant difference between the before- and the after-psychiatry-course groups. The univariate analysis for differences in OMS-HC-15 score according to the sociodemographic characteristics of the pre psychiatry course group indicated that the factors associated with the total OMS-HC-15 score were sex ( p < 0.001), being diagnosed with mental illness ( p < 0.001), and having a relative diagnosed with mental illness ( p = 0.005). Among the post psychiatry course group, the univariate analysis indicated that the same factors, namely, sex ( p = 0.001), being diagnosed with mental illness ( p = 0.006), and having a relative diagnosed with mental illness ( p = 0.007), were associated with the total OMS-HC-15 score. Further studies at a larger scale to confirm generalizability of the results are warranted.

Prevalence and associated factors of alexithymia among medical students: A cross-sectional study from Saudi Arabia.

OBJECTIVES: To assess the prevalence of alexithymia and its associated factors among medical students at King Saud University (KSU), Riyadh, Kingdom of Saudi Arabia. METHODS: A cross-sectional study was conducted at KSU, including 420 medical students from all years of medical college (i.e., first to the fifth year), by using an electronic questionnaire distributed during August 2021. The questionnaire consisted of sociodemographic-related questions and the 20-item Toronto alexithymia scale (a validated scale in the literature). RESULTS: The prevalence of alexithymia among the participants was found to be 26.9%. A statistically significant association between alexithymia and gender (p=0.013) was found. A diagnosis with any psychiatric condition (p=0.026), history of abuse during childhood (p=0.006), and lack of physical activity were associated with alexithymia. CONCLUSION: The prevalence of alexithymia among medical students at KSU was significantly higher than general population in literatures. It was indicated in the results that being female, having a psychiatric condition or history of childhood abuse, and lack of physical activity were all associated with alexithymia. We recommend increasing awareness of and screening for alexithymia and its associated factors among medical students.

Impact of Virtual Learning on Mothers With Children in Elementary School: A Psychosocial Viewpoint.

Background Measuring the impact of virtual learning (VL), specifically psychosocially, and its consequences have been poorly studied because VL has never been implemented in this way before worldwide. To our knowledge, no studies in Saudi Arabia have addressed this topic, with very limited available literature internationally. This study aims to evaluate the psychosocial effects of VL on mothers of children in elementary school and its relation to psychosocial factors. Methodology Using an anonymous online questionnaire posted on social media, a quantitative, observational, cross-sectional study was conducted from May through December 2021 in Riyadh, Kingdom of Saudi Arabia. A total of 460 mothers consented to complete the study questionnaire. The questionnaire consisted of a socioeconomic section and collected information on perceived stress via the Perceived Stress Scale (PSS-14). Results The overall PSS-14 score showed a moderate stress level. Our results showed that as age groups tended to rise, stress scores tended to decline. Diabetes was a significant variable contributing to high stress. Verbal abuse toward a child essentially reflects an increase in stress. Mothers with familial conflicts were more prone to high stress. Conclusions The consequences of VL on mothers and the whole family are alarming. Stress, verbal and physical abuse, and unhealthy family dynamics are strongly associated with such a way of learning. The impact of emotional and behavioral changes among this group of individuals needs to be further investigated.

Woodhouse-Sakati Syndrome Presenting With Psychotic Features After Starting Trihexyphenidyl: A Case Report.

Woodhouse-Sakati syndrome is a rare, autosomal recessive, multisystemic disorder first identified as a constellation of hypogonadism, mental retardation, diabetes, alopecia, deafness, and electrocardiogram abnormalities.  We report a case of a 33-year-old woman who was born to consanguineous parents. She is suffering from hypergonadotropic hypogonadism, extrapyramidal symptoms, hypothyroidism, alopecia, and sensorineural hearing loss. Her MRI showed iron depositions in globus pallidus bilaterally. She underwent genetic testing and was diagnosed with Woodhouse-Sakati syndrome. She was started on trihexyphenidyl to treat her extrapyramidal symptoms. A few months later, she started to have psychotic symptoms in the form of auditory hallucinations and delusions of persecution.  Although she exhibited psychotic symptoms after starting trihexyphenidyl, it is less likely to be causing her symptoms since the symptoms started a few months after taking the medication and she was not on high doses. Thus, it is more likely to be a part of Woodhouse-Sakati syndrome.

Knowledge and attitudes of physicians toward forensic psychiatry in Saudi Arabia.

OBJECTIVES: To assess the knowledge and attitudes of physicians of different specialties, including psychiatrists, regarding forensic psychiatry to determine whether further modification or training is needed in the psychiatry residency program. METHODS: This cross-sectional study was carried out using a 3-page, 3-section questionnaire containing 21 questions disseminated randomly online via Google forms using social media platforms. The 482 participants were residents, specialists, and consultants of various specialties. The study was conducted between September 2020 and August 2021 in various tertiary hospitals across Saudi Arabia. RESULTS: A total of 482 physicians were recruited. The most common age group was 25-35 years, comprising mostly Saudis (62.4%). Based on the results, "poor" and "good" knowledge of forensic psychiatry was identified in 89% and 11% of the physicians, while "negative" and "positive" attitudes were identified in 16.4% and 83.6% of the physicians. CONCLUSION: Although the perspective of physicians regarding forensic psychiatry was found to be positive, their knowledge of the topic seems to be lacking.