Prevalence and correlates of depressive symptoms among professional drivers in Saudi Arabia: A cross-sectional study.

BACKGROUND: Professional drivers in Saudi Arabia may be at increased risk for mental illness because of their expatriate status, long driving hours, and unhealthy lifestyles. OBJECTIVE: To assess the prevalence and correlates of depressive symptoms among professional drivers in Saudi Arabia, most of whom are expatriates. METHODS: Professional drivers (n = 324) were interviewed after convenient sampling of transportation companies. The Depression Anxiety Stress Scale-21 (DASS-21) was used to screen for depressive symptoms. Correlates of depressive symptoms were identified using Cox regression with a fixed follow-up time. RESULTS: Of the drivers, 20.4% had moderate to severe depressive symptoms. Sleep quality was found to be a significant independent correlate of depressive symptoms. Drivers with poor and fair sleep quality had higher risk of depressive symptoms than drivers with excellent sleep quality (poor: OR = 5.8, CI: 1.95-17.11; fair: OR = 4.5, CI: 1.68-11.96). CONCLUSION: The frequency of depressive symptoms among professional drivers in Saudi Arabia is high (one out of five). Companies should consider screening for depressive symptoms and sleep disorders among employees and should provide referrals as needed.

Symptoms of depression and stress among migrant workers in Al Qassim, Saudi Arabia.

BACKGROUND: Migrant workers make up a third of the population of Saudi Arabia, approximately 13 million. Mental health disorders among this population are common, but very limited data exist currently. AIMS: To assess the prevalence of moderate to severe symptoms of depression and stress among a sample of migrant workers in Saudi Arabia. To identify whether migrant-specific factors, such as occupation, nationality, duration of migration, and work characteristics, are associated with depressive and stress symptoms. METHODS: A cross-sectional study of 2,123 migrants was conducted in Al Qassim, Saudi Arabia. Depressive and stress symptoms were assessed with the Depression, Anxiety, and Stress Scale (DASS-21). The outcomes were categorized into two levels (i.e. mild or no symptoms versus moderate to severe symptoms). Univariate and multivariate binary logistic regressions were used to assess the relationship with potential covariates. RESULTS: The prevalence of moderate to severe depressive and stress symptoms was 7.3% and 3.6%, respectively. These did not vary by the duration of stay in the country or weekly work hours. However, there was substantial variance in the symptoms by participants' nationality and occupation. Participants from Bangladesh were 3.8 (95% CI [1.50, 9.62]) times more likely, and hospital cleaners were 6.5 (95% CI [2.12, 20.07]) times more likely to have depressive symptoms. Similarly, auto-repair workers were 6.3 times more likely to have symptoms of stress (95% CI [1.55, 25.90]). CONCLUSION: The prevalence of depressive and stress symptoms varied significantly depending on occupation and country of origin. It would behoove employers to screen for these mental health conditions and refer employees to the relevant healthcare services. Future studies could examine the feasibility of mental health screening programs among migrant employees.

COVID-19 vaccine acceptance and COVID-19-induced income disruption among migrant workers in Saudi Arabia.

Background: Neither COVID-19 vaccine acceptance nor income changes among migrant workers during the pandemic has been assessed in Saudi Arabia. Aims: To assess the correlates of willingness to take the COVID-19 vaccine and a decrease in income during the pandemic among migrant workers in Saudi Arabia. Methods: An electronic questionnaire was administered to 2403 migrant workers from the Middle East and South Asia employed in agriculture, auto repair, construction, food service (restaurants), municipality, and poultry farms in Al-Qassim Province, Saudi Arabia. The interviews were conducted in the native languages of the workers in 2021. Chi-square was used to assess the associations, and a multiple logistic regression was used to generate the odds ratio. Data analysis was conducted using SPSS version 27. Results: South Asian workers were 2.30 [95% confidence interval (CI): 1.60-3.32] times more likely to accept the COVID-19 vaccine than those from the Middle East (reference group). Restaurant, agriculture and poultry workers were respectively 2.36 (95% CI: 1.41-3.95), 2.13 (95% CI: 1.29-3.51) and 14.56 (95% CI: 5.64-37.59) times more likely to accept the vaccine than construction workers (reference group). Older (≥ 56 years, reference group ≤ 25 years) workers were 2.23 (95% CI: 0.99-5.03) times, auto repair 6.75 (95% CI: 4.33-10.53) times, and restaurant workers 4.04 (95% CI: 2.61-6.25) times more likely to experience a reduction in income than construction workers. Conclusions: Workers from South Asia were more likely to accept the COVID-19 vaccine and less likely to experience an income reduction than those from the Middle East.

Impact of the COVID-19 pandemic on the psychological status of undergraduate medical students in Saudi Arabia: A cross-sectional double-scale study.

The COVID-19 pandemic is a major health care catastrophe that affects people's physical and mental well-being worldwide. Medical students are at an increased risk of mental health hazards during the COVID-19 pandemic. Sulaiman Al Rajhi University (SRU), the site of our study, is located in Qassim province in the Kingdom of Saudi Arabia. We conducted this study to assess the prevalence of depression, stress and anxiety symptoms among SRU medical students during the quarantine and while learning online shortly after the announcement of documented COVID-19 cases in Kingdom of Saudi Arabia. In this cross-sectional study, an online questionnaire was sent to all medical students of SRU; 278 students responded (71%). We collected participants' demographic, socioeconomic, and academic data. The Depression, Anxiety, and Stress scale and the Fear of COVID-19 Scale were used as the validated mental health assessment tools. Depression, anxiety and stress symptoms were found in 23%, 11%, and 6% of students, respectively. Females were more likely to have anxiety (P = .03) than males. Students who had close contact with COVID-19 cases, those whose lives were affected by COVID-19, and those with poor socioeconomic status had significantly higher levels of stress, anxiety, and depression compared to their counterparts (P = .004, .01, .01, respectively). Students from high-viral-load areas, unmarried students, and those who did not live with their families were more stressed (P = .06, .01, .01, respectively). The Fear of COVID-19 Scale was positively correlated with all Depression, Anxiety, and Stress components (depression: r = 0.36, anxiety: r = 0.45, and stress: r = 0.39, P < .001 for all). Medical students, especially female students, are at an increased risk of developing depression, anxiety, and stress symptoms with increased COVID-19 fear during the pandemic. The study highlights the importance of mental health screening for female students, students of low socioeconomic status, and relatives of COVID-19 cases. Our findings could help institutions adjust mental health services in the future amid such pandemics.

Central Corneal Thickness of a Saudi Population in Relation to Age, Gender, Refractive Errors, and Corneal Curvature.

Background In this study, we aimed to investigate the relationship between central corneal thickness (CCT) and age, gender, refractive errors, and corneal curvature in a Saudi population. Methodology In this randomized, hospital-based, retrospective study, data were collected from Dr. Sulaiman Al Habib Hospital and Imam Medical Center, Riyadh. A total of 1,005 eyes were included and recruited from patients referred to the refractive surgery clinic for Lasik assessment. The study included patients aged between 17 and 57 years with no history of any ocular pathology, eye surgeries, and systemic disease, as well as all groups with stable refractions. The identifying data were the age and gender of the patients, as well as their CCT, refraction, and corneal curvature. CCT and corneal curvature were measured by ultrasound pachymeter Pentacam. Results The distribution of CCT was 543.81 ± 34.47 µm. A significant difference in the mean CCT was observed across different refractive errors (p = 0.004). Patients with astigmatism had the lowest CCT, followed by myopic and hyperopic patients. An association between the spherical equivalent of patients with myopia and CCT (p = 0.001) was noted. Conclusions In the Saudi population, we found no significant association between mean corneal curvature and CCT in all three groups. Spherical equivalent in myopic patients was significantly associated with CCT. A significant difference in the mean CCT was observed across different refractive errors. There was a significant negative and weak correlation between age in myopic and astigmatism patients and CCT. Gender was significantly associated with CCT in patients with astigmatism.

The Association Between Dry Eye and Sleep Quality Among the Adult Population of Saudi Arabia.

Background and objective Dry eye disease (DED) is one of the most prevalent ocular diseases worldwide. DED symptoms can result from disturbances to the homeostasis of the middle tear film layer (aqueous layer), including inflammation, pain, and eye discomfort, which can have a negative impact on individuals' quality of life and daily activities. Sleep disorders are highly prevalent among patients with DED, and the incidence of sleep disturbances in DED patients has been reported to be as high as 40%. Decreased sleep quality can aggravate dry eye symptoms by increasing tear osmolarity and decreasing tear production. In this study, we aimed to investigate the association between DED and sleep quality in the adult population of Saudi Arabia. Methods This cross-sectional study was conducted among adult patients aged 18 years and above in Saudi Arabia in August 2021. A validated Arabic version of the Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep quality, and the Ocular Surface Disease Index (OSDI) questionnaire was employed to diagnose DED. Data collection and analysis were performed using the SPSS Statistics software (IBM, Armonk, NY). Results A total of 234 subjects were analyzed, and 59.8% of the participants were women. Our tool suggested that 71.4% of the included participants had severe DED, 15% had moderate DED, and 13.7% had mild DED. However, 40.6% of the participants reported that they had not been diagnosed with DED previously and 34.6% had no previous DED symptoms. The mean total PSQI score was 8.63 ±2.23, with the highest score recorded for component 2: sleep latency (1.73) and the lowest score recorded for component 4: habitual sleep efficiency (0.20). Poor sleep quality as assessed by PSQI showed a significant positive correlation with the severity of DED as assessed by OSDI. Conclusion The significant positive correlation between poor sleep quality and DED indicated that patients with DED had a higher risk of poor sleep quality compared to healthy patients. Patients with DED should be educated about the steps and techniques to improve their sleep patterns.

Knowledge of and attitude toward venous thromboembolism among professional drivers in Saudi Arabia.

Evidence suggests that professional drivers are at risk for venous thromboembolism (VTE), a life-threatening yet preventable disease. Awareness of VTE among this population has not been assessed in the Middle East. The study aimed to assess professional drivers' awareness of VTE and attitudes toward VTE preventive measures. We used a validated VTE awareness questionnaire to interview 324 drivers in Saudi Arabia during February-March 2020. Knowledge about VTE was the lowest compared to other medical conditions. Less than a third (31.8%) of the drivers were aware of VTE. Only 15.7% of those with prior awareness correctly identified all four deep vein thrombosis symptoms, and only 7.4% correctly identified all five pulmonary embolism symptoms. A significant proportion believed in unrelated practices for VTE prevention. Health promotion campaigns are urgently needed to raise awareness and to promote healthy behaviors.

Gain in growth after surgical repair of congenital heart disease among children with Down syndrome.

Down syndrome (DS) is a common genetic disorder among Saudi children, for which limited data is available on growth for those who undergo surgery for congenital heart disease (CHD). We assessed the magnitude of growth over time following surgery and the factors associated with growth change. Eighty-eight children with DS and CHD who underwent surgery between 2009 and 2017 at the tertiary children's hospital in Al-Qassim, Saudi Arabia, were eligible. Information on gender, height, and weight (at surgery, 6 and 12 months), age at surgery, and type of CHD were abstracted from the medical records. Repeated measure analysis of variance (ANOVA) was used for data analysis. The sample's mean age (SD) was 16.2 months (20.1); 47% were male. Height, weight, and body mass index (BMI) increased significantly at both follow-up points. There was a significant interaction between age at surgery, type of heart disease, and time for all three physical indices (p-values <0.001). The increase in height, weight, and BMI was significantly greater for children ≤8 months old with acyanotic CHD compared to children >8 months with cyanotic CHD. Overall, the gain in growth was greater for the children with DS who had had surgery at a younger age.

Gender Differences in Sleep and Mental Health among Saudi Adolescents.

Among adolescents, mental health issues (i.e., stress and depressive symptoms) negatively affect sleep. We assessed whether the association between mental health and sleep varied between genders among Saudi adolescents. A total of 2206 school students (grades 7-12) from 40 randomly selected schools in four cities of Al-Qassim province in Saudi Arabia participated in this cross-sectional study. The survey assessed demography, lifestyle, sleep (12-item Medical Outcomes Study Sleep Scale), depression (Depression, Anxiety, Stress Scale (DASS-21)) and stress (10-item Perceived Stress Scale). Adjusted associations with sleep were tested with linear and logistic regressions. Of the sample, 55% were girls, and their average sleep score was lower than that of the boys (58.7 vs. 63.4, p < 0.001). Girls had worse mental health than boys; the proportion of girls with both severe stress and severe depressive symptoms was three times higher than that of the boys (12% vs. 4%, p < 0.001). For both boys and girls, those with severe depressive symptoms only or both severe depressive symptoms and severe stress had significantly lower sleep scores than those who had neither of the two conditions (reference group). On the other hand, among those who had severe stress only, the sleep score was significantly lower for the girls (p = 0.002) than for the boys (p = 0.19). Overall, girls had a significantly lower sleep score and worse mental health than boys. The association between mental health and sleep significantly differed between the sexes. Severe stress was negatively associated with sleep in girls but not in boys.

Internet addiction in Gulf countries: A systematic review and meta-analysis.

BACKGROUND AND AIMS: The prevalence of internet addiction (IA) varies widely in the Gulf Cooperation Council (GCC) countries (4%-82.6%). We aimed to assess the quality of IA studies from the GCC and pool their data to get an accurate estimate of the problem of IA in the region. METHODS: A systematic review of available studies was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. PubMed, Embase, and Cochrane Controlled Register of Trials were systematically searched; studies conducted in GCC countries (i.e., Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates) with a validated instrument for internet addiction assessment were eligible. Ten studies were eligible for the systematic review, all of which were included in the meta-analysis. The Newcastle Ottawa Scale was used for quality assessment. RESULTS: Nine out of ten of the included studies had either adolescent and/or young adult participants (age < 25). Two studies were of 'good' quality, six were of 'satisfactory' quality, and two were of 'unsatisfactory' quality. The pooled internet addiction prevalence was 33%; it was significantly higher among females than males (male = 24%, female = 48%, P = 0.05) and has significantly increased over time (P < 0.05). DISCUSSION AND CONCLUSIONS: One in every three individuals in GCC countries was deemed to be addicted to the internet, according to Young's Internet Addiction Test. A root cause analysis focusing on family structure, environment, and religious practices is needed to identify modifiable risk factors.

The associations of religiosity and family atmosphere with lifestyle among Saudi adolescents.

There have been gradual sociocultural changes in Saudi Arabia due to globalization. This allows a unique opportunity to examine religiosity and family atmosphere in relation to lifestyle among Saudi adolescents. In this cross-sectional study, 2067 school students (grades 7-12) from 32 randomly selected schools in Al-Qassim, Saudi Arabia were enrolled. Perceived religiosity, family atmosphere, lifestyle (e.g., physical activity, diet, screen time, obesity, and smoking), demography, parental attributes, and religious practices were assessed with validated scales and questions. A risk profile was created from the lifestyle variables (none, one, two, or ≥ three), and the students were grouped into low versus high religiosity and low versus high family atmosphere using a median split. Multinomial regressions were used to model the lifestyle risk profile. The mean age ±standard deviation was 15.5 years ±1.7, and 35% were girls; 28% had no risk factors, 32% had one, 25% had two, and 15% had ≥3. After adjustment, both low religiosity and low family atmosphere were significant correlates of the lifestyle risk profile (e.g., ≥3 risk factors: religiosity OR = 2.9, 95% CI: 2.1, 4.0; family atmosphere OR = 2.0, 95% CI: 1.5, 2.8). Those with both low religiosity and low family atmosphere were more likely to have a higher lifestyle risk profile than those who scored high in religiosity and better in family atmosphere (e.g., ≥3 risk factors: OR = 5.9, 95% CI: 3.7, 9.5). Hence, higher religiosity and better family atmosphere are associated with less risky lifestyles among Saudi adolescents.

Contact Lens Practices and Knowledge of Complications and its Association With Refractive Error in Saudi Arabia.

Introduction For optical, cosmetic, or therapeutic purposes, contact lenses (CLs) are temporary prostheses positioned on the eye. CLs do not only improve the quality of life by correcting, but also providing a better appearance and less activity restriction. Patients' failure to comply with the hygienic practices prescribed in using CLs is often considered an important risk factor for eye complications and it is not often clarified to CLs consumers at the time of dispensation. Aim The objective of this study was to assess the knowledge and practices towards the use of CLs in a sample of the Saudi population in Riyadh. Methods A cross-sectional study was performed using an online questionnaire among adult residents in Riyadh, Saudi Arabia from April to May of 2020. The statistical analysis was performed using R v 3.6.2 (R Foundation for Statistical Computing, Vienna, Austria). Ordinal (Likert-scale) variables were summarized using mean ± standard deviation, or median and interquartile range (IQR) as needed. Results The majority of current users of CLs had no sight problem (P < 0.001). Using CLs was thought to be harmful in non-users (12.4%) versus CL users (2.93%) (P < 0.001). The main reason for using CLs in all groups was the emulation of others. Dryness was a well-known complication in current users (P < 0.05) and evening discomfort was a well-known one in previous users (P < 0.05). Social circle was the main source of information in 40% of users. High monthly income has a significant association with knowledge regarding the complications of CLs compared with low income (B = 0.94, P < 0.05). Education has a major effect on the users' knowledge regarding the increase of refractive error and infection by CLs (P < 0.05). Conclusions Knowledge and practice were less than desired among CLs users. Many use CLs without prescription and solely for cosmetic purposes. More education is needed to lessen eye complications among CLs users.

The SARS-CoV-2 pandemic course in Saudi Arabia: A dynamic epidemiological model.

OBJECTIVE: Saudi Arabia ranks second in the number of coronavirus disease 2019 (COVID-19) cases in the Eastern Mediterranean region. It houses the two most sacred religious places for Muslims: Mecca and Medina. It is important to know what the trend in case numbers will be in the next 4-6 months, especially during the Hajj pilgrimage season. METHODS: Epidemiological data on COVID-19 were obtained from the Saudi Arabian Ministry of Health. A susceptible-exposed-infectious-recovered (SEIR) prediction model was constructed to predict the trend in COVID-19 in Saudi Arabia in the next 6 months. FINDINGS: The model predicts that the number of active cases will peak by 22 May 2020. The cumulative infected cases are predicted to reach 70,321 at that time. The total number of infected individuals is estimated reach to 114,580 by the end of the pandemic. CONCLUSION: Our estimates show that by the time the Hajj season commences in Saudi Arabia, the pandemic will be in the midst of its deceleration phase (phase 3). This information will likely be useful to policymakers in their management of the outbreak.

Substance use disorders in Saudi Arabia: a scoping review.

BACKGROUND: Substance use disorders (SUD) are mental health conditions that arise from chronic drug use. There is an increased recognition of this problem in Saudi Arabia. OBJECTIVE: Conduct a comprehensive review of published literature on SUD to identify knowledge gaps and to guide future research. METHODS: PubMed, Embase and Cochrane databases were searched with suitable keywords for SUD publications up to June 10, 2019. Eligible studies (primary research conducted in Saudi Arabia) were organized into three broad domains: (1) risk (or protective) factors of SUD, (2) perspectives on drug use of people who use drugs, and (3) impact on family. The quality of the included studies was assessed with the Newcastle-Ottawa Scale. RESULTS: Of the 113 search records, 23 were eligible for analysis (19 cross-sectional and 4 case-control). All studies were conducted in clinical settings; all but two included males only. There were 4 studies about SUD risk factors, 6 studies about the perspectives of people who use drugs, and none about family impact. None of the cross-sectional studies (0%) and 25% of case-control studies were of good quality. CONCLUSIONS: The available studies were few in number, weak in methodology, and poor in quality. Quantitative as well as qualitative studies about SUD are warranted in each domain and should represent both genders.

Gaming addiction and perceived stress among Saudi adolescents.

INTRODUCTION: Adolescents (age: 10-19 years) make up 15% of the Saudi population and have easy access to electronic gadgets and the Internet, yet data on gaming addiction among adolescents are negligible. We aimed to determine the prevalence of gaming addiction and its association with stress among Saudi school students. METHODS: In this cross-sectional survey, 2675 school students (grades 7-12) from 40 randomly selected schools in four main cities of Al-Qassim province in Saudi Arabia participated. The questionnaire inquired about demography, lifestyle, gaming addiction (7-item Game Addiction Scale), and stress (10-item Perceived Stress Scale). Multinomial logistic regression assessed the association between gaming addiction (yes, no) and stress (high, moderate, low). RESULTS: Participants' mean age was 16.1 (SD = 1.6) years; 50% were female; 64% reported >3 h of daily screen time; 5% were addicted to gaming; 11.4% had high-level stress. Addiction to gaming was strongly associated with stress in the adjusted analysis (moderate OR = 6.7, 95% CI = 2.9-15.5; high OR = 11.9, 95% CI = 4.7-30.1). Additionally, those who were older, female, had poor grades, unhealthy dietary habits, an inactive lifestyle, and smoked were more likely to experience high stress. CONCLUSIONS: Gaming addiction is strongly associated with stress among Saudi adolescents.

Job insecurity, fear of litigation, and mental health among expatriate nurses.

The objective was to assess whether job insecurity and fear of litigation were correlates of depression, anxiety, and stress among expatriate nurses in Saudi Arabia. The participants included 977 expatriate nurses working in Al-Qassim, Saudi Arabia who completed an online survey that assessed depression, anxiety, and stress (using DASS-21) as well as demography, lifestyle, and job characteristics. Mean age was 32 years and 60% of nurses were from India/Pakistan. Twenty-four percent of nurses reported job insecurity, and 18% reported a fear of litigation. Severe depression, anxiety, and stress were significantly higher among nurses who always felt insecure about their job (compared to never) and among those who always feared litigation (compared to never). We concluded that job insecurity and fear of litigation were significant correlates of severe depression, anxiety, and stress among expatriate nurses.

Mental Health Status of Expatriate Nurses in Northcentral Saudi Arabia.

Mental health status may vary by nationality among expatriate workers; no conclusive data is available in Saudi Arabia. We invited expatriate nurses employed in governmental hospitals in Al-Qassim, Saudi Arabia to fill out an electronic survey that contained questions on demography (including nationality), lifestyle, job, depression, anxiety, and stress (assessed with DASS-21 scale). We categorized each outcome into normal, mild to moderate, and severe, and used adjusted multinomial logistic regressions for analyses. Nurses (n = 999) were from India (54.1%), the Philippines/Indonesia (37.0%), Pakistan (4.9%) and Arab countries (4.0%). Indian nurses were three times (OR = 2.93; 95% CI 1.84, 4.67), Pakistani nurses were 2.5 times (OR = 2.54; 95% CI 1.07, 6.00), and Arab nurses were five times (OR = 5.65; 95% CI 2.40-13.31) more likely to suffer from severe depression compared to Filipino/Indonesian nurses (reference group). Results were similar for stress. Depression and stress varied significantly by nationality among expatriate nurses.