Patterns and sociodemographic characteristics of substance abuse in Al Qassim, Saudi Arabia: a retrospective study at a psychiatric rehabilitation center.

BACKGROUND: The problem of substance abuse is one of the top 20 risk factors for poor health worldwide. Though widely prevalent in the Middle East, there are few studies in Saudi Arabia. OBJECTIVE: Record the pattern of substances abuse and the sociodemographic characteristics of abusers attending the local rehabilitation center. DESIGN: Descriptive, retrospective medical record review. SETTING: Patients admitted to psychiatric rehabilitation center. METHODS: The sample included all patients admitted to a rehabilitation center during the period of January 2016-December 2016. Data was collected retrospectively from patient records. MAIN OUTCOME MEASURES: Descriptive epidemiological data and statistical comparisons. SAMPLE SIZE: 612 patients. RESULTS: The majority of patients (73%) were 21-40 years of age. Polysubstance abuse (60%) and amphetamine (24%) abuse were most predominant in the 20-40 year olds (45%) and high school dropouts (41%). The average number of drugs being used by polysubstance abusers was 2.5 (and the maximum was 6). There was no relationship of family history of drug abuse and mental illness. CONCLUSION: There was an increased use of polysubstances and amphetamine with a decreased abuse of prescription drugs when compared to previous studies reported in Saudi Arabia. There was a decreasing prevalence for heroin and alcohol. Substance abusers have certain epidemiological, social and drug patterns and we recommend that authorities and planners integrate their efforts to look for the reasons for substance abuse. LIMITATIONS: Females not included and prevalence of tobacco smoking not studied. CONFLICT OF INTEREST: None.

A multicentre randomised controlled trial of a carer supervised culturally adapted CBT (CaCBT) based self-help for depression in Pakistan.

BACKGROUND: Cognitive Behaviour Therapy (CBT) based self-help has been found to be effective for treating depression and anxiety. There is some evidence to suggest that CBT needs to be culturally adapted for it to be effective in non-Western cultures. CBT is not widely used in low and middle income countries and there is a need to test its effectiveness in different settings and formats, including self-help. METHODS: We describe a RCT of a Culturally adapted CBT (CaCBT) based self-help manual in Pakistan. The trial was conducted in psychiatry departments in three cities. Assessments were carried out at baseline and at 12 weeks, using Hospital Anxiety and Depression Scale, Bradford somatic Inventory and brief disability Questionnaire. RESULTS: At the end of the trial CaCBT based self-help was found to be effective against care as usual in reducing the symptoms of depression and anxiety, as well as somatic symptoms and disability. LIMITATIONS: This study was conducted only in secondary care and required either patient or a carer to be able to read and write. CONCLUSIONS: This is the first study outside West of a CBT based self-help intervention for depression. This study highlights the importance of using cost effective interventions in developing world in low intensity formats. Future studies should focus on trying these resources in different settings, like primary care, and with the use of audio/video or multimedia resources to improve compliance in patients with lower literacy.