Anxiety related disorders in adolescents in the United Arab Emirates: a population based cross-sectional study

Global Prevalence of Social Anxiety Disorder in Children, Adolescents and Youth: A Systematic Review and Meta-analysis

Social anxiety disorder is a prevalent mental health condition that significantly impairs social interactions, academic performance, and professional functioning in children, adolescents, and youth. This study aimed to investigate the global prevalence of social anxiety disorder across these developmental stages. Six electronic databases (PubMed, Scopus, Web of Science, Embase, ScienceDirect and Google Scholar) were systematically searched for studies related to the prevalence of social anxiety disorder in children, adolescents and youth. Random-effects models were employed for data analysis and Comprehensive Meta-Analysis Version 2.0. Heterogeneity was assessed using the I2 index. A total of 38 studies were included in the final analysis. The global prevalence of social anxiety disorder was estimated to be 4.7% in children, 8.3% in adolescents, and 17% in youth. These findings suggest a progressive increase in the prevalence of SAD across these developmental stages. Considering the prevalence of social anxiety disorder in this study, policymakers can use the findings of this study to inform and develop effective prevention strategies for individuals and communities most susceptible to this disorder.

Adolescents' electronic devices use during the COVID-19 pandemic and its relationship to anxiety and depression levels: a cross-sectional study

BACKGROUND

The aim of this study is to assess the prevalence of anxiety and depression symptoms among adolescent students in the West Bank region of Palestine, with a particular focus on the impact of electronic device usage on their mental well-being.

METHODS

This cross-sectional study included a representative sample of 1,140 adolescents enrolled in governmental secondary schools. We targeted schools located in Nablus, Ramallah, and Hebron districts, which, respectively, represent the northern, central, and southern regions of the West Bank. We collected data on their sociodemographic characteristics, patterns of electronic device usage, scores from the Beck Depression Inventory-II, and the 7-item Generalized Anxiety Disorder scale, all gathered through a self-administered online questionnaire. To explore the independent relationship between anxiety, depression, and various factors, we calculated odds ratios and their corresponding 95% CI using a binary logistic regression model.

RESULTS

The study revealed a prevalence of moderate to severe anxiety at 35.4% [95% CI: 32.7-38.3%] and moderate to severe depression at 23.9% [95% CI: 21.4-26.4%]. Notably, anxiety scores were significantly higher among females [OR = 3.8, 95% CI: 2.5-5.9], individuals with lower academic performance [OR = 3.4, 95% CI: 2.1-5.4], and smokers [OR = 1.9, 95% CI: 1.1-3.0]. Similarly, significantly elevated depressive scores were observed among females [OR = 2.0, 95% CI: 1.3-3.1], those with lower academic performance [OR = 3.4, 95% CI: 2.1-5.4], and smokers [OR = 1.9, 95% CI: 1.3-2.8]. Conversely, students who used electronic devices for shorter durations were less likely to experience depression [OR = 0.49, 95% CI: 0.32-0.76] or anxiety [OR = 0.47, 95% CI: 0.32-0.69].

CONCLUSION

Considering the alarming rates of anxiety and depression in adolescents, along with their connection to the time spent using electronic devices, we strongly recommend the creation of initiatives and support networks to alleviate this issue's impact. Encouraging healthier lifestyles, such as reducing screen time and increasing physical activity, could potentially enhance the mental well-being of adolescents.

Prevalence and predictors of social anxiety disorders among Malaysian secondary school students during the COVID-19 pandemic: Exploring the influence of internet gaming disorder and impulsivity

This study aimed to investigate the prevalence of social anxiety disorder (SAD) among Malaysian secondary school students during the COVID-19 pandemic and to explore its correlations with demographic variables, impulsivity behavior, and internet gaming disorder (IGD). A total of 1574 participants from 12 government secondary schools across five Malaysian states, comprising 569 males and 1005 females, completed an online questionnaire containing validated Malay versions of the Social Interaction Anxiety Scale, Barratt Impulsiveness Scale, and Internet Gaming Disorder Scale - Short Form. The findings revealed a notable SAD prevalence rate of 40.53% among Malaysian adolescents. Logistic regression analysis unveiled significant associations between SAD and factors such as attention impulsiveness (OR = 2.58, p < .001), motor impulsiveness (OR = 1.47, p = .03), female gender (OR = 2, p < .001), Malay ethnicity, and IGD (OR = 1.08, p < .001). In conclusion, this study provides valuable insights into the extent of social anxiety experienced by Malaysian secondary school students during the pandemic, shedding light on the demographic and psychosocial factors linked to its emergence. Furthermore, the research underscores a robust link between IGD and SAD, emphasizing the need for comprehensive interventions addressing both issues concurrently. By recognizing the multifaceted nature of these associations, future interventions can be tailored to provide holistic support for adolescents' mental well-being.

Phone addiction, cyberbullying, and mental health amongst young adults in the United Arab Emirates: a cross-sectional study

BACKGROUND

Smartphone addiction is a common phenomenon worldwide and within the UAE. It is related to many factors, including gender and ethnicity, and can lead to mental health disorders, such as anxiety and depression. This study investigates these factors concerning smartphone addiction among young adults in the UAE.

METHODS

421 participants answered a questionnaire of validated and reliable scales measuring smartphone addiction, cyberbullying experiences, mental health, and demographic information. The average age of the participants was 21 years, and the age groups were divided into two groups. Group 1 consists of participants who are 20 years or younger, and group 2 consists of participants aged 21 or older.

RESULTS

There was a positive correlation between smartphone addiction with both anxiety and depression. A positive correlation was also found between cyberbullying victims, anxiety, and depression. Females were found to have higher levels of anxiety and smartphone addiction in comparison to males.

CONCLUSION

Smartphone addiction is a problem that connects to disorders like anxiety and depression. Conversely, cyberbullying is not directly related to smartphone addiction but is also strongly related to anxiety and depression.

Validation of the Arabic version of the resilience scale for adolescents (READ)

INTRODUCTION

Adolescents react differently to challenging negative life events. Resilience, a dynamic characteristic of individuals, was studied to be a protective factor against such events. In order to study the resilience among Arabic-speaking adolescent populations, age-appropriate measures that are fully apprehended by younger respondents are needed. In this context, the present study aimed to examine the psychometric properties of an Arabic translation of the Resilience Scale for Adolescents (READ) in a community sample of native Arabic-speaking adolescents aged 13-18 years.

METHODS

A sample of 546 community Arabic-speaking adolescents from Lebanon was recruited (n = 328 females, with a mean age of 15.76 ± 1.65 years). Through an online questionnaire, participants were requested to complete the READ, Depression, Anxiety and Stress Scale (DASS-8) and the 13-item Children's Impact of Event Scale (CRIES-13).

RESULTS

Following the exploratory and confirmatory factor analysis (EFA-to-CFA) strategy, a unidimensional model of the Arabic version of the READ was met after 10 items were removed from the scale, and showed strong internal consistency (Cronbach's alpha of 0.943). Additionally, the one-factor solution of the Arabic version of the READ was identical across male and female adolescents at the three levels of invariance (Configural, Metric and Scalar). Finally, higher resilience scores were significantly correlated with lower levels of psychopathology, namely depression, anxiety, stress and PTSD, thus attesting to the concurrent validity of the Arabic READ.

CONCLUSION

Findings lend support to the psychometric reliability and validity of the Arabic version of the READ, and therefore its suitability for use among Arabic-speaking adolescents. The availability of this tool facilitates the implementation of interventions that foster resilience, especially in adolescents who have faced a number of negative life events.

Cardiovascular health research priorities in the United Arab Emirates

Background

Cardiovascular diseases (CVDs) are a leading cause of morbidity and mortality in the United Arab Emirates (UAE) and have been prioritized for intervention by healthcare authorities and clinicians.

Aim

To identify clinically relevant research priorities for the treatment and prevention of CVDs in the UAE.

Methods

This study used the nominal group technique to identify CVD-related research priorities. Participants were 37 experts from UAE hospitals, academic and research institutions, CVD associations, and paramedical organizations.

Results

Initially, 138 research topics were suggested by participating experts. These topics were then refined to identify the most important research priorities related to CVD prevention and treatment. The top research priority areas were: development of evidence-based, customized algorithms for CVD prevention and in-hospital emergency interventions; the availability, accessibility, and affordability of CVD treatment and rehabilitation; identification of relationships between CVDs, lifestyle factors, and mental health; efficacy and constraints in the management of cardiac emergencies; and epidemiological studies that trace CVD in the UAE.

Conclusion

The identified research priorities will guide a more informed research program for CVD treatment and prevention in the UAE. Funding opportunities and support for researchers should be prioritized for these identified research areas.

Burden and risk factors of anxiety disorders among Arabic pediatric population: A systematic review

<b>Aim:</b> In the general population, where 6 to 20% of individuals experience anxiety disorders, children also experience a higher burden of anxiety. We undertook a systematic review In order to examine and summarize the results from studies that estimated the prevalence of anxiety and/or its associated risk factors in the pediatric populations of Arab nations, primarily the gulf countries.<br /> <b>Methods:</b> Any study that focused on the pediatric population and completed in Arab nations to determine the incidence of anxiety and/or its risk factors among children under the age of 18. The review had 13 articles were included.<br /> <b>Results:</b> The results of the systematic review found that there was a wide variation in the prevalence of anxiety among children. At least 30.2% of the children were found to suffer from anxiety and the prevalence could go up to 60% in some countries with a higher prevalence among girls than boys. Associated factors of anxiety were diverse including exposure to environmental tobacco smoke, parenting style, living with parents suffering from mental disorders, school type, and being female.<br /> <b>Conclusion:</b> The findings of the review demonstrate the higher prevalence of anxiety among children as almost at least one-third of children suffer from anxiety in the Gulf countries. The program managers and the respective government of these Arab countries need to devise some strategies and interventions that not only focus on the children but also their environment.

Impact of COVID-19 pandemic on the mental health of university students in the United Arab Emirates: a cross-sectional study

BACKGROUND

The COVID-19 pandemic had a significant impact on the mental well-being of students worldwide. There is a scarcity of information on the mental health impact of the COVID-19 pandemic on university students in the United Arab Emirates (UAE). This study aimed to investigate the mental health impact of the COVID-19, including depression, anxiety and resilience among a sample of university students in the UAE.

METHODS

A cross-sectional study using an online survey was conducted from September to November 2021. The patient health questionnaire (PHQ-9), generalized anxiety disorder-7 (GAD-7) and Connor-Davidson Resilience Scale (CD-RISC-10) were used to assess depression, anxiety, and resilience. The COVID-19 impact was assessed using a list of questions.

RESULTS

Only, 798 students completed the survey and were analyzed for this study. Overall, 74.8% of the students were females, 91.2% were never married, and 66.3% were UAE-nationals. Based on PHQ-9 and GAD-7 cut-off scores (≥ 10), four out of ten of the students self-reported moderate to severe depression (40.9%) and anxiety (39.1%). Significantly higher mean PHQ-9 and GAD-7 scores were found among students who were impacted by COVID-19 than those non-impacted (mean PHQ-9 = 9.51 ± 6.39 and 6.80 ± 6.34; p = 0.001, respectively) and (mean GAD-7 = 9.03 ± 6.00 and 8.54 ± 6.02; respectively, p < 0.001). Female students who were impacted by COVID-19 had statistically significant higher depression and anxiety scores (mean PHQ-9 of 9.14 ± 5.86 vs. 6.83 ± 6.25, respectively; p < 0.001) than the non-impacted females (mean GAD-7 of 9.57 ± 6.32 vs. 5.15 ± 3.88, respectively; p = 0.005). Never married students had significantly higher PHQ-9 and GAD-7 scores than ever-married (9.31 ± 6.37 vs. 6.93 ± 5.47, P = 0.003) and (8.89 ± 6.11 vs. 7.13 ± 5.49, respectively; p = 0.017).

CONCLUSIONS

The results of this study demonstrate that the COVID-19 pandemic has negatively impacted the mental health of this sample of university students in terms of depression and anxiety. The results highlight the need to adopt culturally appropriate interventions for university students and focus on vulnerable groups.

Associations between Dietary Intake of Vitamin D, Sun Exposure, and Generalized Anxiety among College Women

Vitamin D insufficiency impacts about half of the population worldwide. Almost one billion individuals across all ages and ethnicities suffer from vitamin D deficiency. Hypovitaminosis D is mainly related to lifestyle choices and habits, such as outdoor activities and food intake. Several studies have demonstrated a correlation between vitamin D status and anxiety symptoms. The main purpose of this study was to investigate the correlation between anxiety and factors including age, vitamin D deficiency, citizens, dietary and supplementary vitamin D intake, along with sun exposure, among a sample of female college students in the United Arab Emirates. A descriptive questionnaire, including a short version of the generalized anxiety disorder scale, food frequency questionnaire, and sun avoidance inventory, was used to assess the relationship between the dietary intake of vitamin D-rich foods and supplements, along with sun avoidance/exposure and generalized anxiety, among a total of 386 female participants aged 18 and above. The findings showed clear evidence that sun avoidance behaviors are strongly associated with an elevated risk of generalized anxiety disorder among adult females in the United Arab Emirates.

Geographic, Socio-Demographic and School Type Variation in Adolescent Wellbeing and Mental Health and Links with Academic Competence in the United Arab Emirates

Interest in adolescents' wellbeing and mental health is growing worldwide, but little research in this area has been conducted in certain world regions and countries such as the United Arab Emirates (UAE). Geographic, socio-demographic and school type differences in adolescent wellbeing and mental health are commonly observed in the field, and the UAE is a diverse country where these types of differences have been found for other outcomes (notably, academic). Yet, no prior national study has explored these differences in terms of wellbeing and mental health in the nation. We address this gap by investigating differences across emirates, gender, socio-economic status, immigrant status, school sector and school curriculum for overall life satisfaction, positive affect, negative affect, meaning and purpose in life, and internalizing difficulties. We use linear regression to analyse cross-sectional data from the Programme for International Student Assessment (PISA) study from 2015 and 2018. We find substantial geographic, socio-demographic and school type differences in levels (2018) of wellbeing and mental health -which vary across distinct domains- and declines (2015-2018) of wellbeing. Better wellbeing and mental health are observed in the northern emirates and among boys. Better wellbeing and poorer mental health are observed among nationals (compared to expatriates) and in public schools (compared to private schools). Despite presenting the best academic outcomes, British schools present the worst wellbeing and mental health outcomes. However, results show the absence of a trade-off between academic competence and wellbeing and mental health, with evidence of a small positive association with wellbeing.

Child and adolescent mental health disorders in the GCC: A systematic review and meta-analysis

Background

The Gulf Cooperation Council (GCC), with a predominant ‘youth bulge’ among its 54 million people, has witnessed an exponential increase in research pertinent to child and adolescent mental health (CAMH). Aside from a few narrative reviews, to date, no critical appraisal examining the magnitude of CAMH has emerged from this region.

Aims

This study aimed to report the prevalence rates of CAMH disorders in the GCC through a systematic review of the existing literature followed by a meta-analysis.

Methods

A systematic review of the literature from the six GCC countries (Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates) was conducted. The databases used included Scopus, ProQuest, Pubmed, and a final check was performed on Google Scholar to account for any remaining studies that may have still been under review. Meta analytic techniques were then used to estimate prevalence rates of each specific mental disorder, i.e. ADHD, depression, anxiety, stress, eating disorders, and tobacco use disorder.

Results

A total of 33 studies from the six countries were included. The pooled prevalence of ADHD as per the Vanderbilt ADHD Diagnostic Rating Scale (VADHDDRS), clinical judgments, Attention Deficit Disorders Evaluation Scale (ADDES), and the Strengths and Difficulties Questionnaire (SDQ) was found to be 13.125%, 13.38%, 26.135%, and 12.83%, respectively. The pooled prevalence of depressive symptoms solicited by the Patient Health Questionnaire (PHQ-9), Depression, Anxiety, and Stress Scale (DASS), and Mini-International Neuropsychiatric Interview for Children and Adolescents (MINI Kid) was 44.684%, 45.09%, and 26.12%, respectively. The pooled prevalence of anxiety according to the DASS and the MINI Kid was 57.04% and 17.27%, respectively, while the pooled prevalence of stress as per the DASS was found to be 43.15%. The pooled prevalence of disordered eating solicited by the Eating Attitudes Test (EAT-26) was 31.55%. Lastly, the pooled prevalence of tobacco use disorder per the Global Youth Tobacco Survey was 19.39%.

Discussion

To date, this is the first systematic review and meta-analysis of its kind from the GCC. The prevalence rate of CAMH disorders appears to be in the upper range of international trends. The higher rates could be attributed to the existing studies using suboptimal methodological approaches and instruments to solicit the presence of CAMH.

The psychological impact of the COVID-19 pandemic on adults and children in the United Arab Emirates: a nationwide cross-sectional study

BACKGROUND

The psychosocial impact of previous infectious disease outbreaks in adults has been well documented, however, there is limited information on the mental health impact of the COVID-19 pandemic on adults and children in the United Arab Emirate (UAE) community. The aim of this study was to explore anxiety levels among adults and children in the UAE and to identify potential risk and protective factors for well-being during the COVID-19 pandemic.

METHODS

Using a web-based cross-sectional survey we collected data from 2200 self-selected, assessed volunteers and their children. Demographic information, knowledge and beliefs about COVID-19, generalized anxiety disorder (GAD) using the (GAD-7) scale, emotional problems in children using the strengths and difficulties questionnaire (SDQ), worry and fear about COVID-19, coping mechanisms and general health information were collected. Descriptive analysis was carried out to summarize demographic and participant characteristics, Chi-square analysis to explore associations between categorical variables and anxiety levels and multivariable binary logistic regression analysis to determine predictors of anxiety levels in adults and emotional problems in children.

RESULTS

The overall prevalence of GAD in the general population was 71% with younger people (59.8%) and females (51.7%) reporting highest levels of anxiety. Parents who were teachers reported the highest percentage of emotional problems in children (26.7%). Adjusted multivariable logistic regression for GAD-7 scores showed that being female, high levels of worry associated with COVID-19, intention to take the COVID-19 vaccine and smoking were associated with higher levels of anxiety. Adjusted multivariable logistic regression for SDQ showed that higher emotional problems were reported for children in lower and higher secondary education, and parents who had severe anxiety were seven times more likely to report emotional problems in their children.

CONCLUSIONS

This study reports the psychological impact of COVID-19 among adults and children in the UAE and highlights the significant association between parental and child anxiety. Findings suggest the urgency for policy makers to develop effective screening and coping strategies for parents and especially children.

Characterizing individuals accessing mental health services in the UAE: a focus on youth living in Dubai

Background

Most mental health issues develop during adolescence, therefore identifying youth mental health needs and pathways to care is critical to improve prevention. To date, studies have typically focused on Western samples, while the impact of cultural diversity on perception of health and illness, and pathways to care, remain poorly understood. To address the shortage of studies conducted in the Arab world, and particularly in the United Arab Emirates (UAE), the present investigation aims to identify the characteristics of youth accessing mental health services in Dubai.

Methods

Data was collected retrospectively from patients’ records at Rashid Hospital Child Psychiatry Service. Information collected included demographics, life stressors, symptoms duration, main diagnosis, and presence/absence of psychotic features in patients’ symptomatology. The relationship between demographic and clinical variables was explored using Chi-square tests and negative binomial regression models.

Results

The sample included 99 treatment-seeking young patients (mean age 15.3; SD = 1.7); 47.5 % were Emirati (UAE national) and 52.5 % were non-Emirati patients. In our treatment-seeking youth sample Depressive disorders represented the most frequent diagnosis, followed by Bipolar and related disorders, Anxiety and stress related disorders, and Schizophrenia and psychotic disorders. Compared to Emirati patients, non-Emirati patients were more likely to report relationships with friends as a source of stress. Female help-seekers, compared to males, were more likely to report stressful relationships with family members, and to receive a diagnosis of Depressive disorders. The duration of symptoms before seeking help was significantly predicted by family stress, gender, self-harm behavior, a symptomatology with psychotic features, and a diagnosis of Anxiety disorders.

Conclusions

The present study contributes to characterizing youth accessing mental health services at Rashid Hospital’s Child Psychiatry service in Dubai. An overall prevalence of poor family functioning among help-seeking youth, and the importance of peer support for expatriate youth were highlighted. Gender differences in perceived stressors, diagnoses and help-seeking behavior suggest the need to promote help-seeking among young boys. While presentation with psychotic features seems to lead to quicker access to medical care, self-harm and anxiety appear to delay help-seeking. The potential implications of our results for promoting youth wellbeing in the region are discussed.

Screening for depression, anxiety, and obsessive-compulsive disorders among secondary school students in Al-Hasa Region, Saudi Arabia

BACKGROUND

The purpose of this study was to determine the prevalence of anxiety, depression, and obsessive-compulsive disorder (OCD) and assess their severity in both male and female secondary school students.

MATERIALS AND METHODS

This cross-sectional study was conducted among secondary school students in Al Hasa region. A sample of student was selected using multi-stage sampling technique. Data were collected using valid self administered questionnaires (Patient Health Questionnaire 9, Anxiety Disorder 7, and Yale-Brown Obsessive-Compulsive scale). Study was approved by institutional ethical review committee, and informed consent was obtained from each participant. SPSS used for data entry and analysis. Chi-square test was used to test for statistical significance.

RESULTS

A total of 1783 of students, 930 males and 853 females, were enrolled in the study. The prevalence of depression, anxiety, and OCD was 76.2%, 49.9%, and 61.6%, respectively. Most of the diagnosed students had mild forms of the diseases, fewer had moderate form, and very few had severe forms. The most significant risk factor was gender, but other risk factors were significant for some of the diseases.

CONCLUSION

The prevalence of the three diseases is high and significantly associated with gender. Further work is needed to evaluate this high prevalence and assess the severity of the diseases and other risk factors.

Prevalence and associated factors of psychological distress among a national sample of in-school adolescents in Morocco

BACKGROUND

The goal of the study was to estimate the prevalence and correlates of psychological distress among adolescent school children in Morocco.

METHODS

Nationally representative cross-sectional data were analysed from 6745 adolescents (15 years median age) that responded to questions on a two-item measure of psychological distress from "2016 Morocco Global School-Based Student Health Survey (GSHS)."

RESULTS

The prevalence of psychological distress was 23.3, 18.0% among males and 29.2% among females. In adjusted logistic regression analysis, female sex, older age, bullying victimization, infrequently physically attacked, frequent participation in physical fights, having no close friends, frequent experience of hunger, parental emotional neglect, parental disrespect of privacy, school truancy, sedentary behaviour and having sustained a single or multiple serious injuries (past year) were associated with psychological distress. In addition, in unadjusted analysis, low peer support, parents never check homework, exposure to passive smoking, substance use (current tobacco use, current cannabis use and ever used amphetamine), frequent soft drink and frequent fast food consumption were positively and fruit and vegetable intake was negatively associated with psychological distress.

CONCLUSION

Almost one in four students reported psychological distress and several associated factors were identified which can aid prevention and control strategies.

Trends in the prevalence of twenty health indicators among adolescents in United Arab Emirates: cross-sectional national school surveys from 2005, 2010 and 2016

BACKGROUND

The aim of this study was to assess the trends in the prevalence of various health indicators among adolescents in United Arab Emirates (UAE).

METHODS

Nationally representative data were analysed from 24,220 in-school adolescents (median age = 14 years) that took part in three cross-sectional surveys (2005, 2010 and 2016) of the "UAE Global School-Based Student Health Survey (GSHS)".

RESULTS

Significant improvements were identified among both girls and boys in the reduction of being physically attacked, inadequate fruit intake, inadequate vegetable consumption, loneliness, and among girls only poor oral hygiene (< 2 times tooth brushing/day) and among boys only, experiencing hunger and in physical fight. Significant rises were identified among both girls and boys in the prevalence of bullying victimization, overweight or obesity, leisure-time sedentary behaviour, injury and inconsistent washing hands prior to eating, and among boys only obesity and among girls only inadequate physical activity, and school truancy.

CONCLUSIONS

Several reductions but even more increases of poor health indicators were identified over three cross-sectional surveys during a period of 11 years emphasizing the need for enhanced health promotion activities in this adolescent school population.