Prevalence, Severity, and Correlates of Premenstrual Dysphoric Disorder Symptoms Among Women in the Arabian Peninsula.

OBJECTIVE: To study the prevalence of premenstrual dysphoric disorder (PMDD) symptom patterns among women in the United Arab Emirates and to measure the debilitating nature of PMDD symptoms and sociodemographic correlates. METHODS: This cross-sectional sample study used the Mini-International Neuropsychiatric Interview-Plus (MINI-Plus) and Premenstrual Symptoms Screening Tool (PSST) to screen for presence and severity of PMDD symptoms in Arab women attending ambulatory health services in Alain city, Emirate of Abu Dhabi, United Arab Emirates, for routine health care between May 2005 and September 2005. RESULTS: The study participants include 508 women (76% Emiratis, 15% Omanis, and 8% other Arabs) of childbearing age. In total, 94 women (18.6%) met MINI-Plus criteria for PMDD; of these, 21 (4.1%) met PSST criteria for severe symptoms, 29 (5.7%) for moderate symptoms, and 44 (8.7%) for mild or less symptoms. One woman (0.2%) with severe symptoms and 12 women (2.4%) with moderate symptoms had negative MINI-Plus scores. Presence of PMDD symptoms was significantly associated with higher education (P = .000), single marital status (P = .001), major life stressors (P = .001), and personal/family use of psychotropic medications (P = .000/P = .006), personal/family psychological problems (P = .000/P = .001), irregular/painful menses (P = .043/P = .001), and functional impairment on the Sheehan Disability Scale (P = .000). Multilogistic regression analysis showed higher education, major life stressor, personal use of psychotropic medications, personal/family psychological problem, and painful menses were independent predictors of PMDD symptoms. CONCLUSIONS: PMDD symptoms were common among the Arab women in our study. The cyclically triggered mood disturbances were clustered in women with personal/familial psychological problems, perhaps linking biologic constitution to genetic predisposition for the development of PMDD symptomatology.

Subjective life satisfaction and mental disorders among older adults in UAE in general population.

BACKGROUND: Life satisfaction is widely considered to be a central aspect of human welfare. Many have identified happiness with it, and some maintain that well-being consists largely or wholly in being satisfied with one's life. Empirical research on well-being relies heavily on life satisfaction studies. AIMS: The aim of this study was to examine the relationships of psychiatric disorders and physical disorders on life satisfaction among Arab older adults in general population. METHODS: Face-to-face interviews with Geriatric Mental State Interview (GMS-A3) were conducted with a nationwide sample of 2000 household in 2001. Total samples of 610 elders (above 60 years) were interviewed. RESULTS: There were 347 males (56.9%) and 263 females (43.1%). The mean age was 68.6 years (SD = 8.3). The commonest diagnoses were depression (20.2%), anxiety (5.6%), hypochondriasis (4.4%), and organic brain syndrome with or without dementia (3.6%). The findings suggest that having depressive disorder was significantly associated with less life satisfaction in the whole sample of older adults' people. In addition, anxiety, hypochondriacal disorders, and organic brain syndrome were significantly associated with low life satisfaction. Meanwhile, other psychiatric disorders e.g., phobia, Obsessive Compulsive disorder (OCD), schizophrenia were not significantly associated with life satisfaction. No significant relationship was found with any physical disorders alone. The data further reveal that low level of life satisfaction was especially significant in the age group above 85 years and people who live alone or only with wife/husband. CONCLUSIONS: The strong influence of psychiatric disorders e.g., depression, anxiety, organic brain syndrome, and hypochondriasis rather than physical disorders suggests that a lack of meaning and worries are more detrimental to life satisfaction than physical frailty. The findings underscore the need to develop interventions that help older people deal more effectively with psychiatric disorders and its comorbidities. Moreover, the results suggest that providing family support, by not allowing older adults to live alone, may be especially helpful for older adults.

Help-seeking behaviour of patients attending the psychiatric service in a sample of United Arab Emirates population.

BACKGROUND: Many patients suffering from psychiatric disorders seek non-professional care before attending specialized services. AIMS: To study the help-seeking behaviour of patients referred to the psychiatric department of Al-Ain Hospital, which is the main university teaching hospital in UAE. METHODS: This study was a descriptive cross-sectional epidemiological survey. All new patients attending the psychiatry out-patient clinic at Al-Ain Hospital were screened for nine consecutive months from March to November 2003 inclusive. RESULTS: The sample consisted of 106 patients (52 male; 54 female). Prior to presenting to the psychiatric service, 44.8% consulted faith healers, 31% of whom had had a previous experience with them; 45% reported some improvement but their symptoms recurred later, while 47% reported no improvement. In 8% their symptoms worsened for the current episode. Treatments received were herbal (29.8%) and prayer (70.2%). Of the sample, 43.4% consulted a primary care physician before presenting to the secondary psychiatric care. CONCLUSION: In this sample a sizable number of patients sought alternative methods of treatment before attending the specialized psychiatric services.

Prevalence of diabetes mellitus and its complications in a population-based sample in Al Ain, United Arab Emirates.

AIMS: To determine the prevalence of diabetes mellitus (DM) and its complications in the adult population of the United Arab Emirates (UAE) and assess the degree of metabolic control in subjects with diagnosed DM. METHODS: A random sample of houses of Emirati citizens living in Al Ain, UAE was surveyed. Fasting blood glucose was determined by glucose meter and an oral glucose tolerance test (OGTT) was conducted if blood sugar was <7 mmol/l. DM was defined according to the WHO criteria. Pre-diabetes status was based on fasting venous blood glucose concentration of 5.6-6.9 mmol/l or 2h post-OGTT venous blood glucose level of 7.8-11.0 mmol/l. RESULTS: There were 2455 adults (>18) living in the 452 surveyed houses of which 10.2% reported having the diagnosis of DM. A total of 373 men and non-pregnant women underwent testing, and after adjustment for factors affecting participation probability the prevalence of diagnosed DM, undiagnosed DM and pre-diabetes was 10.5, 6.6 and 20.2%, respectively. Age-standardized rates for DM (diagnosed and undiagnosed) and pre-diabetes among 30-64 years old were 29.0 and 24.2%, respectively. Logistic regression analysis showed that only age and body mass index (BMI) were significantly independently related to undiagnosed DM. In patients with diagnosed DM, the prevalence rates for retinopathy, neuropathy, nephropathy, peripheral vascular disease and coronary heart disease were 54.2, 34.7, 40.8, 11.1 and 10.5%, respectively. A significant proportion of subjects with undiagnosed DM and pre-diabetes also had micro- and macro-vascular complications. The proportion of subjects with diagnosed DM who achieved internationally recognized targets for HbA1c (<7%), LDL-C (<2.6 mmol/l) and blood pressure (<130/80 mmHg) was 33.3, 30.8 and 42.1%, respectively. CONCLUSION: This study confirms the previously reported high prevalence of DM in the UAE. Diabetic complications were highly prevalent among subjects with diagnosed and undiagnosed DM. Metabolic control was suboptimal in most subjects with diagnosed DM. Greater efforts are urgently needed to screen early and effectively treat DM in the UAE in order to prevent long-term complications.

Low IGF-1 levels are associated with cardiovascular risk factors in haemodialysis patients.

Cardiovascular diseases (CVD) constitute a significant risk and may, in part, explain the high morbidity and mortality rates among haemodialysis (HD) patients. Several studies have implicated reduced insulin like growth factor (IGF-1) levels in the development of CVD. However, it is not clear whether IGF-1, and its relationship with other hormones such as leptin, insulin, and growth hormone (GH), as well as anthropometric variables may explain the high incidence of vascular complications in chronic kidney disease (CKD) patients. This study was designed to measure total serum IGF-1, leptin, insulin and GH levels in CKD patients and in age-matched control subjects and to elucidate the relationship between IGF-1 and GH, leptin, and insulin as well as other known aetiological risk factors for CVD including blood pressure, body mass index (BMI), and age. The study consisted of 50 CKD patients [36 M and 14 F; mean age; 41.8 +/- 10.3 years) on maintenance haemodialysis and 50 healthy control subjects (36 M and 14 F; mean age 41.6 +/- 10.2 years) matched for age and sex. None of the subject among patients and controls reported either smoking or history of diabetes mellitus. The circulating levels of IGF-1 were significantly lower (P < 0.001) in both male and female patients compared to the control subjects. Moreover, IGF-1 was strongly and inversely correlated with both systolic blood pressure (SBP) (r = -0.360; P < 0.01) and diastolic blood pressure (DBP) (r = -0.512; P < 0.001) in the CKD group, and when the two groups were combined SBP (r = -0.396; P < 0.001) and DBP (r = -0.296; P < 0.01). When adjusted for age, the correlation was more significant, however, when adjusted for BMI no significant correlation was observed between IGF-1 and blood pressure. IGF-1 was inversely correlated with age (r = -0.367; P < 0.01) and BMI (r = -0.310; P < 0.05) in the control group, but not the patient group. In controls and patients, respectively, a positive correlation between leptin and BMI (r = 0.358; P < 0.01; r = 0.640, P < 0.001) was observed. The results show that circulating levels of IGF-1 were significantly lower in CKD patients as compared to healthy normal subjects and were inversely correlated with SBP and DBP independent of age, but not BMI indicative of a strong relationship between cardiovascular risk factors and low IGF-1 levels. Although, the data do not clearly indicate low IGF-1 levels as a cause or an effect of these cardiovascular risk factors, they do point to an interesting relationship between low IGF-1 levels and increased cardiovascular risk factors among CKD patients as compared to age-matched healthy control subjects.

Sociodemographic and clinical characteristics of patients with dissociative disorders in an Arabian society.

OBJECTIVE: The aim of the study was to determine the sociodemographic and clinical characteristics of patients with dissociative disorders among psychiatric patients in the population of the United Arab Emirates. SUBJECTS AND METHODS: Six hundred inpatients with dissociative disorders were approached during the period 1997-2003, and 468 agreed to participate in the study. These patients were recruited from Al-Ain and Tawam Teaching Hospitals and Al-Jahili Primary Health Care Centers in Al-Ain, United Arab Emirates. The study is based on a questionnaire that included sociodemographic and clinical variables. Dissociative disorders were diagnosed according to the classification set forth in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) and the International Classification of Diseases (ICD-10) of the World Health Organization. RESULTS: Of the 468 patients studied, the majority (67.9%) were young, under the age of 25 years; 55% were UAE nationals, 59.4% female and 40.6% male. Disorganized movement was significantly lower among females (34.2%) than males (44.2%, p < 0.03). Disapproving of the key relative behaviour was higher in females (24.1%) compared to males (13.2%); comorbid anxiety was higher in females (37.4%) vs. males (25.3%). Disturbed relationships were more common in females (40.3%) while precipitating factors, such as intolerable stressful events, were significantly higher in males (42.6%, p < 0.01). Furthermore, males (20.5%) had a significantly higher history of similar episodes and other psychiatric illnesses (7.5%) than females. Finally, females (41%) showed more statistically significant improvements compared to males (29.5%, p < 0.001). CONCLUSION: Patients under 25 years of age suffered more from dissociative disorders with no correlation to educational level as a predisposing factor. The most common symptoms were fits or unorganized movements.

Prevalence and psychosocial correlates of global developmental delay in 3-year-old children in the United Arab Emirates.

OBJECTIVE: Developmental disabilities are lifelong conditions with considerable public health impact, incurring substantial financial and societal costs. Data on prevalence and associated factors can provide the basis for setting priorities and designing interventions. METHODS: A representative random sample of 694 United Arab Emirates national children aged 3 years were evaluated in a two-stage epidemiological study. RESULTS: Stage 1 screening using the Denver Developmental Screening Test found that 8.4% [confidence interval (CI): 6.4-10.7] had global developmental delay (GDD). Using clinical diagnostic interview in Stage 2, the weighted prevalence for clinically significant developmental disability was estimated to be 2.44% (CI: 1.28-3.56). GDD was associated with pregnancy and birth complications, poor maternal education, family history of developmental problems, and major traumatic life events, as well as behavioral problems in children. CONCLUSION: Our findings suggest the need for comprehensive and early screening programs for developmental problems, and the importance of training medical and child care professionals accordingly.

Parental consanguinity and risk of breast cancer: a population-based case-control study.

BACKGROUND: An estimated 600 million people in the world have consanguineous parents. The effect of consanguinity on the risk of breast cancer is uncertain. The objective of this case-control study was to examine whether parental consanguinity and different levels of inbreeding affect the risk and pathology characteristics of breast cancer. MATERIAL/METHODS: Over a 36-month period, consecutive female breast cancer patients were recruited in the main cancer hospital in the United Arab Emirates. All were locally born Arabs with a tissue diagnosis of breast cancer. The controls were locally born Arabs without breast cancer matched to cases by sex, age, and residence. The coefficient of inbreeding (F) of both groups was determined from information they provided about their parents' kinship. RESULTS: The mean age of the 72 patients and 187 controls was 48.6 years (range: 25-86) and 48.5 years (range: 25-82), respectively (P = 0.46). Consanguinity rates of the patients and controls were 29.2% and 28.9% (P = 0.96) and the coefficients of inbreeding were 0.0117 and 0.0167 (P = 0.21), respectively. More closely inbred women (F > or = 0.0625) were less frequent among patients than controls, but the difference was not statistically significant (P = 0.12). The rates of pathological stage of disease, tumor histologies, and tumor grades were similar between more and less inbred patients. CONCLUSIONS: Parental consanguinity in Arabs, even when a marriage is between first cousins or double first cousins, was not associated with an altered risk of breast cancer.

Child psychiatric disorders in a primary care Arab population.

OBJECTIVES: Physical and psychiatric comorbidity is relatively common in general practice but there have been few systematic studies using clinical interviews of children attending the primary care services in the Arab population, and none from the Gulf countries. This study was undertaken to determine the prevalence and nature of child psychiatric morbidity in primary care in the United Arab Emirates (UAE). METHOD: Systematic psychiatric evaluations were carried out on consecutive children aged 6 to 18 years visiting their primary care doctors in Al Ain. The sample consisted of 141 (50.7%) boys and 137 (49.3%) girls. RESULTS: Forty-three percent of the 278 children received a DSM-IV diagnosis. Of these, 46 (38%) were males and 74 (62%) were females. However, only 1.1% (3/120) of the patients consulted general practitioners for a primary psychiatric symptom. The most common diagnosis was anxiety disorder followed by depression. Obsessive compulsive disorder was present in 11%, conduct disorder in 7%, and attention deficit hyperactivity disorder in 3% of those with a diagnosis. A statistically significant association was found between DSM-IV caseness and female gender, higher number of children in the household, relationship problems in the family, physical illness and family history of psychiatric disorder. Other factors that did not show any significant association were age, nationality, socioeconomic status, parental education or occupation, scholastic performance or developmental delay in the child, or parental consanguinity. CONCLUSION: Our findings suggest that psychiatric disorders are common among young people of Arab origin attending primary care facilities, and that doctors need to be vigilant about this possibility.

Profile of mental disorders among the elderly United Arab Emirates population: sociodemographic correlates.

OBJECTIVES: To investigate the prevalence, nature and sociodemographic correlates of mental disorders among the elderly United Arab Emirates (UAE) population. STUDY SUBJECTS AND SAMPLE: UAE nationals aged 60 years or more, were recruited from within a random sample of households representing the UAE national population, irrespective of the age of individuals in each household. RESEARCH INSTRUMENTS: (i) Geriatric Mental State Interview (GMS-A3): an Arabic version, using the AGECAT for analysis; (ii) A short questionnaire for relevant sociodemographic data. PROCEDURE: Purposely trained, Arabic speaking interviewers visited the targeted sample households to interview study subjects at their homes. RESULTS: The total number of screened subjects was 610: 166 (27.2%) in Al-Ain; 286 (46.9%) in Dubai and 158 (25.9%) in Ras Al-Khaimah. There were 347 (56.9%) male subjects and 263 (43.1%) female subjects. The mean age of the interviewed subjects was 68.6 (SD 8.3). The commonest diagnostic entities at the AGECAT syndrome case level were depression (20.2%), anxiety (5.6%), hypochondriasis (4.4%) and organic, mostly cognitive impairment with or without dementia (3.6%). Organic syndrome caseness, as an independent entity, showed significant correlation only to older age, while the rest of the mental disorders showed significant correlation with female gender, insufficient income and being single, separated, divorced or widowed. CONCLUSION: The GMS-AGECAT package proved to be a useful tool for psychiatric assessment among the elderly in this Arabian culture. The prevalence rates of mental disorders among the elderly UAE population were, more or less, within the same range reported by other comparable worldwide studies.