AJP-Vol. 9. No. 1, May (1998)

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THE ARAB JOURNAL OF PSYCHIATRY Vol. 9. No. 1, May (1998) E.mail: takriti@nol.com.jo

q CONTENTS / SOMMAIRE / فهرس الموضوعات
q Education: § The Contribution of psychiatry to the Undergraduate Medical Curriculum:. The Liverpool Experience / M. T Abou-Saleh q Papers: § Self-Reported Depressive Symptoms Among Male Adolescents in the UAE / Harith Swadi § Depressive symptoms in a community sample of UAE Teenage Girls / Harith Swadi, Mona Issa § Contracting with deliberate Self-harm Patients Attending A Psychiatric Emergency Center / Hani R- Khouzam, Nashaat N Boutros, Ismail Youssef § Effectiveness of Social Skills Training Program for Children with Conduct Problems:. Skill Acquisition / Ahmed Al-Ansari, Ahmed Hafeedh § Panic disorder Among Patients Presenting to Endocrine Clinic with Thyrotoxic Like Symptoms / A- Khawaldeh, F Haddad, O. Malkawi, T Ahmad, M. AI-Shobaki q Brief Report: § Mental Health Law in Tunisia.: Its Context, Its Characteristics and Its Repercussions on the Psychiatrics Hospitalization / N. Ayadi, A. Jaoua .
q SUMMARY / RESUMES / ملخصات
q Education: § The Contribution of psychiatry to the Undergraduate Medical Curriculum:. The Liverpool Experience / M. T Abou-Saleh *ABSTRACT :* This article deals with the teaching experiences that had been delivered to undergraduate medical students. They included behavioral sciences, psychiatry, clinical interview and medical ethics. In addition, psychotherapy psychogeriatrics, learning disability forensic, child psychiatry and drug abuse it also deals with evaluation of students and future developments. Return in high q Papers: § Self-Reported Depressive Symptoms Among Male Adolescents in the UAE / Harith Swadi *ABSTRACT :* To test the feasibility of screening for depression in teenagers, self-reports of depressive symptoms were obtained from a community sample of teenage boys in Al Ain City, UAE. The sample, which consisted of 446 boys provided self-reports using a translated version of the Mood and Feelings Questionnaire. Utilizing various cut-off points the sample reported significant depressive symptoms varying between 9,9% and 30,7%. These rates were comparable to, or slightly higher than those reported elsewhere in the world. The most recent official census statistics show that young people under the age of 18 form the largest group in the population of the UAE. The population of the UAE in 1994 was 2,3 million, of which 34% were under the age of 15 and 57% were under the age of 45. Males represent just under 60% of the population. Expatriates consist of the total population. In an attempt to plan the development of psychiatric services for young people, including adolescents, we needed to obtain an idea of the extent of a number of psychiatric conditions among this population. Depression among young people had a very high priority, but little has been done to estimate the prevalence of depression in community samples of young people (particularly boys) in the UAE or the Arabian Gulf area. However there are a couple of exceptions. A sample of female secondary school students in Al Ain City, United Arab Emirates was screened using the Depression Self-Rating Scale and a 5-item Dysfunction Related Scale to estimate the prevalence of significant symptoms of depression, and their personal and social concomitants. Of 505 female students aged between 13 and 18 years, 79 (15,6%) scored above a cut-off point of 14 and reported depressive symptoms which were associated with significant personal dysfunction 3. In another study the prevalence of depression among 1981 middle-school students (995 boys and 986 girls) in Kuwait was estimated to be 3,7% in boys and 4,8% in girls. The ideal method to estimate the prevalence of depression in a community is a two-stage design (screening followed by interviews of samples of high scorers and low scorers). However, this was not the objective of this study. The primary objective trial to answer a basic question. Does depression among adolescents in this community justify investigating ? For this reason it was decided to carry out a screening exercise. This paper reports the main findings of that investigation. Return in high § Depressive symptoms in a community sample of UAE Teenage Girls / Harith Swadi, Mona Issa *ABSTRACT :* A sample of female secondary school students in Al Ain City, United Arab Emirates, were screened using the Birleson Depression Self-Report Scale and a 5-item Dysfunction Related Scale to estimate the prevalence of significant symptoms of depression, and their personal and social concomitants. Of 505 female students aged between 13 and 18 years, 79 (15,6%) scored above a cut-off point of 14 and reported depressive symptoms which were associated with significant personal dysfunction. Overall 23% reported significant suicidal ideation. Depression was significantly associated with mixed nationality marriage, but not with family income, life events or parental loss. The results indicate that depression among teenage UAE females is not uncommon and that socio-environmental factors are less relevant aetiological factors. Young people under the age of 18 form the largest group of the population in the UAE according to the most recent official census statistics released to the press, but not yet officially published. In an attempt to plan the development of psychiatric services for young people , including adolescents, we needed to establish the prevalence of a number of psychiatric conditions among this population. Depression among young people had a very high priority. Until now no definite study has been undertaken in the UAE or in the Arabian Gulf area. Many studies in the same field have been performed in the western world and do indicate that feelings of misery, unhappiness and low mood are quite common amongst adolescents. The question of how many would actually show a depressive syndrome has yielded highly variable rates. The Isle of Wight study showed that among 14-45 year olds about 42% of boys and 48% of girls reported significant depressive feelings, while the prevalence of depressive disorder was about 2%.A more recent UK based study of depressive symptoms among 140 secondary school students (male & female) aged 12-16 years reported that 5,8% had a clinical diagnosis of depression. Another UK community study of 1,072 adolescent girls (11-16 years) showed that the prevalence for current major depression (within one month) was 3,6% in previous years being 6,0%. For partial syndrome the corresponding rates were 8,9% and 20,7% respectively. The current study aimed at evaluating the prevalence of significant depressive symptomatology among a community sample of UAE teenage girls. This, apart from its epidemiological value had the added interest of looking at depressive symptomatology in an affluent community which is often described as free of economically determined adverse social circumstances. Return in high § Contracting with deliberate Self-harm Patients Attending A Psychiatric Emergency Center / Hani R- Khouzam, Nashaat N Boutros, Ismail Youssef *ABSTRACT :* OBJECTIVE : To determine the effects of pre-admission contracts in preventing deliberate self-harm in patients attending a psychiatric emergency unit. METHOD : Three case studies are described to illustrate examples of pre-admission contracts in patients with deliberate self-harm. RESULTS : The initiation and maintenance of pre-admission contracts did decrease the frequency of deliberate self-harm. CONCLUSION : The difficulty in managing deliberate self-harm can be minimized by the initiation of preadmission contracts. To further prove the efficiency of such contracts more controlled studies are needed. Return in high § Effectiveness of Social Skills Training Program for Children with Conduct Problems:. Skill Acquisition / Ahmed Al-Ansari, Ahmed Hafeedh *ABSTRACT :* The Social Skills Training Program (SST) for children with behavioral problems attending an inpatient/day care program were assessed in terms of skill acquisition. Eight boys, aged from 10-14, of whom three were attending the inpatient program and five the day care program, were exposed to 11 sessions of skills training twice weekly for 6 weeks. The sessions included topics related to classroom behavior, effective communication, problem solving and coping with stress. The subjects performance of these skills were measured by parents and teachers before and after the training period. Both parents and teachers reported a significant increase in the frequency of use of these skills. The generalization of these learned skills should be assessed in the future using a larger control sample. Return in high § Panic disorder Among Patients Presenting to Endocrine Clinic with Thyrotoxic Like Symptoms / A- Khawaldeh, F Haddad, O. Malkawi, T Ahmad, M. AI-Shobaki *ABSTRACT :* A considerable number of patients who may present with panic like symptoms as part of anxiety disorders in out patient medical clinics have no organic basis for their complaints, but it has been established that such patients are suffering from different types of anxiety and mood disorders. OBJECTIVE : The aim of this study is to identify panic disorder among patients presenting with thyrotoxic like symptoms at endocrine clinics. METHOD : A comparative prospective study was conducted at the Endocrine. Clinic at the King Hussein Medical Center (KHMC). A study group of sixty patients (45 females and 15 males) mean age 32,2 years (17-45), and 40 subjects as a control group (31 females and 9 males) mean age 33,8 years were seen, evaluated and examined at the King Hussein Medical Center (LHMC) ; test included thyroid ultrasound, thyroid function tests and test for phaeochromocytoma were negative in all patients included. These patients were assessed by the same specialist psychiatrist using the Arabic Version of Panic Scale which is derived from Diagnostic and Statistical Manual of Mental Disorder (IV edition). RESULTS: Fifty out of sixty patients (83,3%) were found to have panic disorder in the study group vs. 16(40%), in the control group (z static = 4,2438 ; p< 0,0003), the majority being females 75% (p< 0,05). The most frequent presenting symptoms were shortness of breath in both group (80%, 40% respectively) , followed by palpitation in study group 73,3%, trembling (71,7%) and sweating (63%). Lower frequencies were obtained in the control group. The most severe symptoms were fear of dying, palpitation, trembling and sweating in the study group, while chills or hot flushes, shortness of breath and numbness predominated in the control group. CONCLUSION : This study concludes that panic disorder is rather common in patients presenting to endocrine clinics and therefore such patients can receive more appropriate diagnosis and management if collaborative efforts are made by physicians and psychiatrists. Return in high q Brief Report: § Mental Health Law in Tunisia.: Its Context, Its Characteristics and Its Repercussions on the Psychiatrics Hospitalization / N. Ayadi, A. Jaoua . *ABSTRACT :* The act 92/83 which is concerned with mental health and the conditions of hospitalization have come about after a long absence of legislation which lasted for 36 years following independence. In this article we will be studying the historical, sociological, political and health factors that influenced the evolution of such an act. Finally, we will examine the important sections of it and evaluate the impact of such acts on the practice of psychiatry and patterns of hospitalization. Return in high
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