Criteria for a good referral system for psychiatric patients: the view from Saudi Arabia.

The development and implementation of quality referral systems reflects sound national health planning. This review appraised the data on referral systems, in particular psychiatric referrals, with special reference to Saudi Arabia. A computer search was made of relevant literature in the past 2 decades. The rate and process of referring patients through referral letters varies globally across practice settings and is initiated by an array of factors linked with health consumers, health providers and delivery systems. Referral systems, including consultation-liaison services, are an essential component of any health care organization for offering a complete range of good quality, specialized health services.

Criteria for a good referral system for psychiatric patients: the view from Saudi Arabia

The development and implementation of quality referral systems reflects sound national health planning. This review appraised the data on referral systems, in particular psychiatric referrals, with special reference to Saudi Arabia. A computer search was made of relevant literature in the past 2 decades. The rate and process of referring patients through referral letters varies globally across practice settings and is initiated by an array of factors linked with health consumers, health providers and delivery systems. Referral systems, including consultation-liaison services, are an essential component of any health care organization for offering a complete range of good quality, specialized health services

Smoking patterns among primary health care attendees, Al-Qassim region, Saudi Arabia.

Prevalence, sociodemographic patterns and medical co-morbidity of smoking among a cross-section of primary health care (PHC) clients in Saudi Arabia were examined. We used a 44-item semistructured questionnaire to collect data from 1752 patients at 25 randomly selected PHC centres. Percentage of smoking was 52.3%. Although 85% were adult smokers, 8.6% began smoking before age 12. Smokers gave overlapping reasons to smoke including peer pressure; non-smokers gave religious and health logics against smoking. Of all smokers, 92.8% wanted to learn cessation strategies, 11.8% were ignorant of hazards and 32.4% reported manifestations of nicotine withdrawal. Besides alcohol use (13.4%), 81.8% had co-morbid physical disease.

Smoking patterns among primary health care attendees, Al-Qassim region, Saudi Arabia

Prevalence, sociodemographic patterns and medical co-morbidity of smoking among a cross-section of primary health care [PHC] clients in Saudi Arabia were examined. We used a 44-item semistructured questionnaire to collect data from 1752 patients at 25 randomly selected PHC centres. Percentage of smoking was 52.3%. Although 85% were adult smokers, 8.6% began smoking before age 12. Smokers gave overlapping reasons to smoke including peer pressure; non-smokers gave religious and health logics against smoking. Of all smokers, 92.8% wanted to learn cessation strategies, 11.8% were ignorant of hazards and 32.4% reported manifestations of nicotine withdrawal. Besides alcohol use [13.4%], 81.8% had co-morbid physical disease

Psychiatric referrals. In primary care and general hospitals in Qassim Region, Saudi Arabia.

OBJECTIVE: From different perspectives, psychiatric symptoms have special significance in psychiatry. This study comparatively describes the psychopathological symptoms as noted in primary care (402) and general hospital (138) referrals. METHODS: Five hundred and forty psychiatric referrals, retrieved randomly, were reviewed extensively for collecting relevant data. RESULTS: Both hospital and primary care referrals were observed to have a variety of psychological and somatic symptoms of variable frequencies, which were suggestive of several psychopathological domains. Functional psychotic (19.5% versus 10%), mood (27.5% versus 23%) and psychosomatic (7% versus 2%) symptoms were significantly noted in hospital referrals as compared to primary care referrals while the later were observed to have significantly more somatic (34.5% versus 22.5%) and neurological (8% versus 4%) symptoms. Only a small proportion of primary care referrals (33/402, 8%] have symptoms of childhood psychiatric disorders. CONCLUSION: Psychiatric symptomatology differs in primary care and general hospital referrals. Both the general practitioners and clinicians are expected to record psychiatric symptoms in a comprehensive manner. Hence, they need condensed training courses on psychiatric symptomatology.

Psychiatric co-morbidity in primary care and hospital referrals, Saudi Arabia.

Psychiatric and physical morbidities among patients referred from primary health care (PHC) centres and general hospitals (GH) in Al-Qassim region were compared. Thus, 540 psychiatric referrals (GH = 138; PHC = 402) were selected randomly. Fifteen GH patients but no PHC patients were referred for admission. Psychiatrists made more diagnoses of dementia, affective and anxiety disorders, mixed anxiety-depression and somatoform disorders than clinicians and general practitioners (GPs). Clinicians made significantly more diagnoses of acute psychoses and somatoform disorders than GPs. Physical morbidity was noted in 38.4% and 17.2% of GH and PHC referrals respectively.

Psychiatric co-morbidity in primary care and hospital referrals, Saudi Arabia

Psychiatric and physical morbidities among patients referred from primary health care [PHC] centres and general hospitals [GH] in Al-Qassim region were compared. Thus, 540 psychiatric referrals [GH = 138; PHC = 402] were selected randomly. Fifteen GH patients but no PHC patients were referred for admission. Psychiatrists made more diagnoses of dementia, affective and anxiety disorders, mixed anxiety-depression and somatoform disorders than clinicians and general practitioners [GPs]. Clinicians made significantly more diagnoses of acute psychoses and somatoform disorders than GPs. Physical morbidity was noted in 38.4% and 17.2% of GH and PHC referrals respectively

Smoking among male psychiatric outpatients in Saudi Arabia.

BACKGROUND: The prevalence rate of smoking among psychiatric patients has been shown to be higher than that among the general population, and this may have several neuropsychiatric implications. This cross-sectional study examines the prevalence, sociodemographic variables and pattern of smoking among psychiatric outpatients in Saudi Arabia. PATIENTS AND METHODS: Over a period of 18 months (January 1996 to June 1997), 505 outpatients from five different hospitals were randomly selected to participate in the study. RESULTS: It was observed that 292 patients (57.83%) were current smokers, 199 (39.4%) were nonsmokers and 14 patients (2.77%) were ex-smokers. Besides revealing certain attitudes towards smoking and religious antismoking notions, it was observed that unemployment, low education status, rural background, and drug abuse were significantly associated with smoking. CONCLUSION: The prevalence rate of smoking revealed in this study is consistent with international data, and probably has implications similar to those reported in other studies. This study also found certain patterns of tobacco use in psychiatric outpatients characterized by certain sociodemographic variables and drug abuse.

Drug addiction: a general review of new concepts and future challenges.

Relevant papers published in peer reviewed journals in the past 2 decades were identified and screened to abstract pertinent information. Substance dependence/addiction, involving both a common brain reward mechanism and longer-lasting molecular and cellular changes, is a preventable chronic, relapsing brain disease and as such a public health problem. Physical and psychological dependence, characterized by withdrawal syndrome, are now given less weight compared with compulsive behaviour and uncontrolled use of drugs in the comprehension of addiction. The challenging components of drug addictions, including counteradaptation, sensitization, abstinence, craving and relapse need further neurobiological and non-neurobiological exploration and understanding, which may be possible through the use of advanced imaging and genetic techniques and animal models of drug addiction together with relevant human studies.

Drug addiction: a general review of new concepts and future challenges

Relevant papers published in peer reviewed journals in the past 2 decades were identified and screened to abstract pertinent information. Substance dependence/addiction, involving both a common brain reward mechanism and longer-lasting molecular and cellular changes, is a preventable chronic, relapsing brain disease and as such a public health problem. Physical and psychological dependence, characterized by withdrawal syndrome, are now given less weight compared with compulsive behaviour and uncontrolled use of drugs in the comprehension of addiction. The challenging components of drug addictions, including counteradaptation, sensitization, abstinence, craving and relapse need further neurobiological and non-neurobiological exploration and understanding, which may be possible through the use of advanced imaging and genetic techniques and animal models of drug addiction together with relevant human studies

Psychotropic drugs prescriptions in Al-Qassim region, Saudi Arabia.

Psychotropic drugs prescriptions for patients attending psychiatric outpatient clinics were studied. Of the 52,168 prescriptions written in 1996, 18,265 were systematically, randomly selected and evaluated. Incomplete prescriptions were found; the data missing included duration of treatment (18.75%), sex (9.25%), age (8.75%) and diagnosis (7.50%). Antipsychotics (33.1%), antidepressants (23.2%), anticholinergics (22.0%) and anticonvulsants (12.9%) were the most frequently prescribed drugs. Polypharmacy (85%) was the predominant mode of practice. The most common diagnoses were mood (23.1%), anxiety (17.7%) and schizophrenic (16.2%) disorders. Medical education and quality monitoring programmes are suggested to improve the quality of psychotropic prescriptions and modify multiple pharmacotherapy practice.

Factitious disorder in saudi arabia: a report of two cases.

Factitious disorders are characterized by physical or psychological manifestations that are intentionally produced or feigned with no apparent external incentives in order to assume the sick role. These disorders are rarely reported or may be under-reported in Saudi patients. We describe here two male and female Saudi cases of such disorders. Both presented predominantly with features of Munchausen's syndrome. Like most psychiatric patients both had sought help from traditional healers prior to their reporting to the hospitals. Inspite of the socio-cultural factors, it is clear that doctors' awareness and acceptance of the possibility of factitious disorders is a prerequisite to making the diagnosis.

Datura induced delirium: A report of two cases.

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Psychotropic drugs prescriptions in Al-Qassim Region, Saudi Arabia

Psychotropic drugs prescriptions for patients attending psychiatric outpatient clinics were studied. Of the 52,168 prescriptions written in 1996, 18,265 were systematically, randomly selected and evaluated. Incomplete prescriptions were found; the data missing included duration of treatment [18.75%], sex [9.25%], age [8.75%] and diagnosis [7.50%]. Antipsychotics [33.1%], antidepressants [23.2%], anticholinergics [22.0%] and anticonvulsants [12.9%] were the most frequently prescribed drugs. Polypharmacy [85%] was the predominant mode of practice. The most common diagnoses were mood [23.1%], anxiety [17.7%] and schizophrenic [16.2%] disorders. Medical education and quality monitoring programmes are suggested to improve the quality of psychotropic prescriptions and modify multiple pharmacotherapy practice

Hysteria: A clinical and sociodemographic profile of 40 patients admitted to a Teaching Hospital, 1985-1995.

This is a retrospective clinical study of 40 inpatients diagnosed as suffering from hysteria, as defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM III-R), admitted to King Khalid University Hospital at Riyadh over a period of 10 years (1985-95). The female:male ratio was 3:1, 80% were less than 30 years of age and 60% were single. Hysterical conversion was the most common type (95%), whereas hysterical dissociation was rare (2.5%). A stressful situation preceded the onset of symptoms in 62.5% of the cases. Twenty-five percent of the patients were clinically depressed. The typical histrionic personality was rare.