Mental health literacy in Arab states of the Gulf Cooperation Council: A systematic review

Efficacy of internet-based cognitive behavioral and interpersonal treatment for depression in Arabic speaking countries: A randomized controlled trial

BACKGROUND

Politically and economically unstable contexts have been associated with increased prevalence rates of depression. Despite high demand, the availability of mental health experts and care systems is limited in Arabic-speaking countries. Internet-based interventions might provide an opportunity to treat patients independently of location. Therefore, we investigated the efficacy of internet-based cognitive behavioral treatment (iCBT) and interpersonal treatment (iIPT) for depression in Arabic-speaking countries.

METHODS

In total, 743 Arabic-speaking adults with depression were randomly allocated to iCBT (n = 243), iIPT (n = 247), or waitlist (n = 253). Depressive, anxiety, and somatoform symptoms, perceived social support and quality of life (QoL) were assessed at pre-, and post-treatment and at three months follow-up. Multiple imputation was performed for missing data. Changes associated with treatment were analyzed using regression in the completer and intention-to-treat sample.

RESULTS

Participants in both treatment groups showed lower depressive and anxiety symptom severity, higher QoL, and perceived social support compared to the waitlist group (p < .001). Somatoform symptom severity was significantly lower in participants receiving iIPT compared to waitlist (p < .001). Differences between the two treatments in all outcomes were non-significant (p > .05). Three-month follow-up treatment effects regarding depressive symptoms were indicated.

LIMITATIONS

The sample mainly consists of educated, single, female adults. Three-month follow-up results rely on a small subsample and must be interpreted with caution.

CONCLUSIONS

This is the first randomized controlled trial to demonstrate the efficacy of iCBT and iIPT for depression in Arabic-speaking countries. It provides first indications that internet-based interventions might help specific individuals in this region.

Public perceptions of digital mental health awareness campaign in the Arab Gulf states: a qualitative thematic analysis

Mental illness is a significant public health concern and a leading cause of disability worldwide. Research shows a lack of mental health knowledge and inappropriate practices in the Gulf Cooperation Council (GCC) states. Our study aimed to evaluate individuals' perspectives on mental health by analyzing their responses to a digital campaign directed at GCC adolescents. We conducted a qualitative thematic analysis of comments in response to the Gulf Health Council's mental health campaign. The campaign content was shared on four social media platforms: TikTok, YouTube, Instagram, and X. A total of 2,146 comments were included in the analysis. There was a widespread denial of the existence of mental illness. The comments revealed a lack of understanding and insufficient support for individuals dealing with mental health issues. Stigma and discrimination against people with mental illness were evident in the comments. The general perception was that individuals have control over their mental health, often associating mental illness with weakness and lack of willpower. Mental illness was believed to be caused by religious and moral shortcomings, and religion was viewed as the solution. Some comments highlighted the need to acknowledge mental illness and urged the development of strategies to promote mental health. Our research shows a lack of awareness, stigma, and inadequate resources for individuals dealing with mental health issues. It highlights the importance of addressing barriers to mental healthcare and increasing access to support. Interventions focusing on stigma reduction and promoting acceptance of mental health disorders are crucial and require collaborative efforts from various stakeholders.

Knowledge and Perception Towards Psychotropic Drugs Among the General Population in Saudi Arabia

Background

Mental health is crucial to overall well-being. Despite an increase in mental disorders over the past few decades, public awareness remains slow-growing, and stigmatization towards psychotropic medications persists. Therefore, this study aimed to identify knowledge and perceptions of psychotropic drugs among the general population in the Makkah Region, Saudi Arabia.

Methods

A questionnaire-based cross-sectional study was conducted among adults aged 18 years old and older, living in the Makkah Region, Saudi Arabia, from 1 January to 30 April 2024. Descriptive statistics were used to describe participants' characteristics, and categorical variables were reported as frequencies and percentages. A Chi-square test was used to examine the relationships between variables.

Results

A total of 717 participants were involved in the study: (52%) were from Jeddah, (25.9%) were from Taif, and (22%) were from Makkah. The mean age was 33.9 years, and 67.1% were females. Among the participants, (20.8%) had experienced a psychiatric illness, (41.7%) had a member of the family who suffered from a psychiatric illness, (39.5%) had a family member who used a psychiatric drug, and only 25 (7%) had a child suffering from a psychiatric illness. Specifically, 20.8% of those with a psychiatric illness demonstrated good knowledge (P=0.001), 16.1% of those with a family history of psychiatric illness had good knowledge (P=0.007), 16.3% with family use of psychiatric drugs had good knowledge (P=0.006), and 24.5% of those who used psychiatric drugs had high knowledge (P=0.001). Overall, (40.6%) of participants had a low level of knowledge and perception about psychotropic drugs, (47.8%) had a moderate knowledge and perception level, and only (11.6%) had high knowledge and perception.

Conclusion

Psychological well-being is crucial for health, but misconceptions persist, acting as barriers that impede people from seeking and accepting necessary psychiatric care. The findings highlight the need for targeted public education and healthcare professional training to improve Confirmed understanding and reduce stigma around psychotropic drugs in Saudi Arabia. A multifaceted approach involving policy development, community outreach, and ongoing research is essential for enhancing mental health outcomes and treatment accessibility.

An internet-based cognitive behavioural intervention for adults with depression in Arabic-speaking countries: A randomized controlled trial

Internet-based interventions have proven to be effective for the treatment of depression in different samples, but evidence from the Middle East and North Africa (MENA) region is scarce. The aim of this study was to investigate the acceptance and efficacy of an internet-based cognitive behavioural writing intervention for Arabic-speaking participants with depression living in the MENA region. A total of 259 participants (167 female, age in years: M = 25.58, SD = 6.39) with depressive symptoms indicative of clinical relevance were randomly allocated to a treatment group (TG; nTG = 128) or a waitlist control group (WG; nWG = 131). The TG received an internet-based intervention over a 6-week period. The primary outcome was depressive symptoms, and secondary outcomes were anxiety and quality of life (QoL). T-tests with change scores from pre- to post-treatment were used for data analyses. Intention-to-treat (ITT) as well as completer analyses were calculated. The ITT analysis revealed significant differences between the TG and WG in depression (T257 = -4.89, p < 0.001, d = 0.70) and QoL (T257 = 3.39, p < 0.001, d = 0.47). Significant differences regarding anxiety symptoms (T257 = 3.25, p < 0.05, d = 0.53) were identified for the completer sample. The general dropout rate was 39.9%. The results indicate the feasibility and efficacy of an internet-based cognitive behavioural writing intervention in adults from Arabic-speaking countries. The development and implementation of such interventions can be used to improve access to psychological help and adequate treatment.

Revealing the Obscurity of Attitudes Towards Mental Health Conditions: A Cross-Sectional Study of Attitudes Among the General Population of Iraq

BACKGROUND

Mental health conditions cause a huge burden on individuals and healthcare systems. According to the World Health Organization, around 970 million individuals worldwide had a mental disorder in 2019.

AIM/QUESTION

To explore the attitudes towards mental health conditions among the Iraqi community and determine factors influencing such attitudes.

METHODS

A cross-sectional survey was conducted on 1394 individuals of the Iraqi general population between December 2022 and February 2023 using a self-administered online questionnaire in Arabic, utilising convenience and snowball sampling. The data were analysed using R Statistical Software.

RESULTS

In total, 763 (54.73%) individuals had positive attitudes towards mental health conditions. The multivariate regression analysis revealed the males and age group of 46 years, and more were significantly associated with negative attitudes (p = 0.001, p = 0.045 respectively).

DISCUSSION

Individuals with mental health conditions experience stigmatising attitudes as in the Middle East jeopardising their treatment and recovery. This is the first study to address the Iraqi population's attitudes towards mental health conditions indicating overall positive attitudes.

IMPLICATIONS FOR PRACTICE

Health promotions must be conducted by educators, healthcare workers and universities to dispel the myths. Future studies with extensive sampling will help clarify the obscurity of mental health conditions in Iraq.

Knowledge of and attitude towards depression among urban and rural residents in Beijing: a cross-sectional study

OBJECTIVES

To compare the level of knowledge of depression, recognition ability and attitudes towards depression among urban and rural residents in Beijing.

DESIGN

A cross-sectional study.

SETTING

Six districts in Beijing, China, 2021.

PARTICIPANTS

A total of 6463 participants aged 18 years and above who had lived for more than 6 months over the last year in Beijing were selected in this study.

OUTCOME

The awareness and recognition of depression and the views of residents towards people with depression.

RESULTS

A total of 2554 urban and 2043 rural residents completed the survey. Urban residents of Beijing exhibited a higher average total score on the Depression Knowledge Questionnaire [(20.4±3.3) vs (18.7±3.5), p<0.001] and a higher rate of correctly identifying individuals with depression (47.9% vs 36.6%, p<0.001) than their counterparts in rural areas. Residents who correctly identified people with depression had higher scores on the Depression Knowledge Questionnaire. Depression knowledge varied significantly among urban and rural residents. The multivariate linear regression analysis revealed that rural residents scored significantly lower on measures of depression knowledge compared with urban residents (B=-0.83, 95%CI=-1.03 to -0.63, p<0.001). Older individuals (aged 50+) showed lower understanding compared with the 18-49 age group, with significant negative regression coefficients (Urban: B=-1.06, Rural: B=-1.35, both p<0.001). Higher educational levels were positively associated with greater depression knowledge (Urban: B=1.40, Rural: B=1.21, both p<0.001). Employment was linked to higher knowledge levels than unemployment (Urban: B=-0.60, Rural: B=-0.58, both p=0.00). A monthly income of 8000 yuan or more correlated with better depression understanding than lower incomes (Urban: B=0.81, Rural: B=1.04, both p<0.001). Additionally, in urban areas, unmarried residents scored higher in depression knowledge than those divorced (B=-0.55, p=0.04). Residents in urban areas had relatively positive attitudes towards individuals with depression.

CONCLUSIONS

Rural residents of Beijing had lower levels of knowledge and recognition of depression and more negative attitudes towards individuals with depression than those from urban areas. The health authority needs to focus on the poor level of knowledge and increase mental health resources in rural areas as a priority site for future psychological popularisation efforts.

Assessing mental health literacy in Jordan: a factor analysis and Rasch analysis study

Background

Mental health literacy (MHL) research in Jordan is sparse and validated MHL measures are lacking. The present study validated a Jordanian version of the Mental Health Literacy Scale (MHLS) and examined Jordanian individuals' MHL.

Method

A Google Forms survey was designed, and the link was shared through various Jordanian social media platforms. Factor analysis and Rasch analysis were performed to validate the Jordanian version of the MHLS. Binary logistic regression was performed to assess variables associated with MHL.

Results

The Jordanian MHLS was administered to 974 participants (74.4% females; median age 27 years). The mean MHL score of the participants was 71.1% indicating average literacy levels. The factor analysis indicated that 27 items distributed across four factors had the best model fit. The Rasch analysis confirmed item separation reliability and person reliability. The regression showed a correlation between educational attainment, income, marital status and MHL level. These findings emphasize the role of educational attainment in MHL, pointing to the necessity of integrating mental health education into formal curricula to enhance MHL across all societal levels. Stigma and limited-service availability act as barriers to mental health service and access, which compound the challenge of improving MHL. Targeted educational interventions and policy reforms may help improve MHL, thereby contributing to improving mental health outcomes in Jordan and potentially other similar settings.

Perceptions of mental disorder causes, treatments, and prevention among the general population in Saudi Arabia

This study investigates the community's perception of mental health in Saudi Arabia, emphasizing its influence on attitudes toward the causes, treatment, and prevention of mental health issues. This understanding is vital for creating evidence-based mental health interventions. A cross-sectional national mental health screening was conducted in 2023, utilizing proportional quota sampling for age, gender, and regional representation among 4547 Saudi participants aged 18-90, randomly selected from national databases. Data were gathered using the ZDataCloud system. The study covered all 13 administrative regions of Saudi Arabia: Riyadh, Makkah, Madinah, Qassim, Eastern Province, Asir, Tabuk, Hail, Northern Borders, Jazan, Najran, Baha, and Al-Jouf. The majority (86.5%) had no personal history of mental health diagnosis or treatment. Key findings identified psychological trauma (78.36%) and substance abuse (72.88%) as primary perceived causes of mental disorders. Preferred treatments included non-pharmacological psychotherapies (74.97%) and pharmacological methods (71.08%). Prevention strategies focused on raising awareness of mental illness (80.4%) and enhancing positive relationships (70.6%). A multivariate logistic regression analysis revealed significant associations between demographic variables and perceptions of mental disorder causes, treatments, and prevention strategies. Females were more likely than males to perceive psychological trauma, drug and alcohol abuse, and domestic violence and sexual harassment as causes of mental disorders. Regarding treatments, females and those with personal or close connections to mental health issues were more likely to endorse non-pharmacological psychotherapy and Roquia in the Qur'an. For prevention strategies, females, those with a mental health diagnosis, and those living with someone diagnosed with a mental disorder were more likely to endorse increasing awareness, positive social relationships, and physical activity. The study suggests integrating religious and social beliefs into mental health programs to enhance community engagement and effectiveness.

Cultural adaptations of third-wave psychotherapies in Gulf Cooperation Council countries: A systematic review

The effectiveness of third-wave psychotherapies has been demonstrated in a range of mental and physical health conditions in Western cultures. However, little is known about the cultural appropriateness and effectiveness of third-wave psychotherapies for Gulf Cooperation Council (GCC) populations. This review aimed to critically evaluate cultural adaptations to third-wave psychotherapies and explored the effectiveness of these interventions on physical and mental health outcomes in GCC populations. Five bibliographic databases and grey literature were searched; both English and Arabic studies conducted in the GCC were included. Mental and physical health-related outcomes were included. Eleven studies were identified. The overall degree of cultural adaptation ranged from 2 to 5, based on Bernal et al.'s cultural adaptation framework. Language and assessment tools were most frequently adapted. Several studies incorporated goal, method, and context adaptations, whereas metaphor and content were least frequently adapted. None of the studies incorporated person or concept adaptations. Culturally adapted third-wave psychotherapies were associated with improvement in numerous mental health outcomes, including psychological distress, well-being, and psychological traits. No physical health outcomes were identified. Although findings are promising with respect to the effectiveness of third-wave psychotherapies for GCC populations, they should be interpreted with caution due to the small number of studies conducted, cultural adaptation evaluations relying on explicit reporting in studies, and the weak methodological quality of studies. Future rigorous research is needed in the evaluation of culturally adapted third-wave psychotherapies in GCC populations, with more comprehensive reporting of cultural considerations.

Mental health literacy among Arab men living in high-income Western countries: A systematic review and narrative synthesis

While interest in mental health literacy (MHL) is growing rapidly, cross-cultural research focusing on MHL is developing more slowly. This inaugural systematic review explored the recognition and beliefs about the causes of mental health disorders amongst Arab men living in high income Western countries (HIWC), their help-seeking beliefs, behaviors, and sources of help, as well as barriers and facilitators to help-seeking. Six electronic database searches were conducted using Medline, Embase, ProQuest Dissertations & Theses Global, PsycINFO, Scopus, and Web of Science. These searches yielded a total of 9,460 citations. After applying inclusion criteria through both database and manual hand searches, 46 studies were identified. The findings corresponded with four of the socioecological model's five factors: intrapersonal, interpersonal, societal, and institutional. Intrapersonal factors included attributing mental health illness to life and migration stressors, and religious reasons. Interpersonal and societal factors included men favoring informal help-seeking sources as stigma was a barrier to formal help-seeking. Institutional factors around the perceived cultural competence of healthcare professionals and access difficulties were obstacles to seeking formal help. The growth in Arab migration to HIWC highlights the need for culturally tailored care. Research is needed to understand the perspectives of healthcare providers working with Arab men in addition to how men's stigmatizing attitudes are an obstacle to formal help-seeking. Interventions should be designed to address the unique mental health needs of Arab men, recognizing that some explanatory beliefs may not align with current Western models of mental health. Moreover, efforts should be made to integrate men's informal sources of support into treatment planning.

Self and public stigma towards mental illnesses and its predictors among university students in 11 Arabic-speaking countries: A multi-site study

This study aimed to explore self and public stigma towards mental illness and associated factors among university students from 11 Arabic-speaking countries. This cross-sectional study included 4241 university students recruited from Oman, Saudi Arabia, the United Arab Emirates (UAE), Syria, Sudan, Bahrain, Iraq, Jordan, Lebanon, Palestine and Egypt. The participants completed three self-administrative online questionnaires-Demographic Proforma (age, gender, family income, etc.), Peer Mental Health Stigmatization Scale and Mental Health Knowledge Questionnaire. There was a significant difference in the average mean between the 11 countries (p < 0.01) based on stigma agreement (self) and stigma awareness (public). The mean stigma agreement towards mental illnesses among university students was 19.7 (SD = 6.0), with the lowest in Lebanon, 15.9 (SD = 5.1) and the highest in UAE, 24.1 (SD = 5.6). The factors associated with stigma agreement included poor knowledge, being male, high family income, age, weak cumulative grade point average (cGPA), mothers with primary education, an unemployed parent, students in scientific colleges and fathers who completed secondary or university degrees. Furthermore, the factors associated with stigma awareness included good knowledge, acceptable cGPA and having a father who has a low income and is illiterate. Stigma towards mental illness varies among university students across Arabic-speaking countries. There is a need to sensitize youngsters to the need for a humanitarian approach in society to individuals affected by mental health concerns. Major governmental reforms must be initiated for the provision of mental health services for individuals with mental illnesses.

The lived experience of Omani adolescents and young adults with mental illness: A qualitative study

There is currently limited knowledge about the firsthand experiences of adolescents and young adults with mental health problems and the meanings they ascribe to these experiences, particularly within Arab countries. This study, therefore, aimed to explore the lived experience of Omani adolescents and young adults with a mental health problem. A sample of 15 participants aged 13-22 diagnosed with a range of mental health problems took part in the study. A qualitative interview guide consisting of open-ended questions was used to allow participants to speak in-depth about their experiences. Using the thematic analysis approach to uncover patterns in the data, three major themes emerged: "living in darkness", "perilous journey" and "uncertain future". Results show that the progress of adolescents and young adults with mental health problems is characterized by several challenges; the most significant of which is having insufficient knowledge about their illness, leading to unnecessary delays in their treatment. These findings shed light on the breadth and depth of the experience of adolescents and young adults with mental health problems and lay the groundwork for further examinations. Implications lie in the development of approaches for preventing or mitigating difficulties faced by adolescents and young adults with mental health problems.

Prevalence and determinants of health literacy among the adult population of Qatar

Introduction

Health literacy (HL) is both a direct determinant and a mediator of health outcomes. Research on the prevalence and determinants of HL in terms of its functional, communicative, and critical domains is scarce in the state of Qatar and its surrounding regions. Thus, this study aims to fill the knowledge gap in this area, estimate the levels of functional, communicative, and critical health literacy among the general adult population, and identify its determinants in the state of Qatar.

Methods

An analytical cross-sectional study with a disproportionate stratified random sampling technique was conducted in 2022. A representative sample of phone numbers was obtained from the Cerner database at Hamad Medical Corporation and approached via well-trained data collectors. A socio-demographic and health-relevant factor questionnaire and the validated All Aspects of Health Literacy scale (AAHLS) were used to collect the data on functional, communicative, and critical HL and their determinants. Descriptive analysis, independent sample t-test, ANOVA, and linear regression were used and yielded the outcomes on HL levels as low, adequate, and high in percentages and the HL determinants.

Results

A total of 770 participants were included. The study found that 41.5%, 29.3%, and 29.2% of them have adequate, high, and low overall HL levels consecutively. People who participated in the study are older adult, are of Arabic ethnicity, are of Qatari ethnicity, have a lower level of education, have close relatives with a lower level of education, have a lower income, are non-migrants, are not living within a family, sought medical care within the last week, and who do not know if they have a chronic disease or do not have lower overall HL levels compared to the other groups. After linear regression analysis, only the participant's level of education and "last time sought medical care within last week" variable predict the overall HL score.

Conclusion

Almost half of Qatar's adult population has an adequate HL level, comparable to the HL levels in other regions, despite the limitation in comparison due to variation in context and the HL measurement tools used. The possible determinants are amenable factors to focus on while designing HL interventions and providing healthcare.

Policy and legislation for the treatment of mental health and substance use disorders in Qatar

There is a marked paucity of publications on the policy and legislation of mental health, and substance use disorders in the public domain in Qatar. Qatar National Vision provides a framework for national strategies and the State of Qatar has developed policies and legislation dedicated to mental health and substance use. In doing so, Qatar has adopted international guidance to shape its mental health services and relevant policy and legislation. This article is a narrative description of the evolution of the mental health and substance use policy and legislation in Qatar.

Prevalence and Characteristics of Health and Wellness Programs for Arab Hospitals' Employees: A Cross-Sectional Study

Background

Compared to the general workforce, hospital staff has a greater incidence of chronic diseases and mental health illnesses. Wellness programs have been shown to improve the health and well-being of hospital employees by reducing risk factors and promoting healthy behaviors. In the Arab World, there are no available studies on the number, nature, or impact of wellness services provided to healthcare workers.

Objective

The study aims to assess the prevalence, characteristics, and components of health and wellness programs targeting hospital employees in Arab countries. It also aims to test the association of hospitals' characteristics and the challenges faced by these hospitals with the availability of such programs.

Methods

A cross-sectional study was conducted through an online questionnaire in English and Arabic emailed to directors of Arab hospitals registered in the Arab Hospital Federation.

Results

Only 39.5% of the hospitals in the Arab region have an established wellness program. No significant association was found between hospital characteristics and the availability of these wellness programs. The most provided services for hospital staff are Flu vaccine (90.7%), pre-employment medical exam (79.1%), healthy food options (65.1%), and health risk assessment (60.5%), while the least common provided services are mental health (20.9%) and stress management (23.3%). The most common challenges facing wellness services (scale: 0-10) are financial restriction (5.95), creating a culture of health (5.88), and motivating employees (5.56). Only 4.7% of hospitals provide incentives to participate in their wellness programs.

Conclusion

In general, Arab hospitals lack a wellness culture, and more investment is needed in essential wellness services such as mental health, weight reduction, stress management, and smoking cessation.

Mental health literacy among primary healthcare workers in South Africa and Zambia

BACKGROUND

In developing countries, mental health literacy (MHL) still needs to be improved due to the high prevalence of mental disorders. It is widely recognized that MHL can improve health outcomes for both individuals and populations. Healthcare professionals' development in MHL is crucial to the prevention of mental disorders. The aim of this study was to assess MHL of primary healthcare (PHC) workers in South Africa (SA) and Zambia and determinants thereof. Limited evidence is available on the levels of MHL among PHC workers in the sub-Saharan Africa region, which faces a large burden of mental disorders.

METHODS

The study population for this cross-sectional survey comprised PHC workers (n = 250) in five provinces of SA and Zambia. MHL was measured with the Mental Health Literacy Scale (MHLS). We conducted a multivariate analysis to explore determinants of MHL.

RESULTS

Results showed moderate MHL among PHC professionals, but with a wide range from low to high MHL. Knowledge-related items had a greater dispersion than other attributes of MHL. PHC workers with more education showed a greater ability to recognize mental health-related disorders. Those who had experience in the use of mental health-related assessment scales or screening tools reported a higher total MHL. The results confirmed strong internal consistency for the MHLS.

CONCLUSION

The results highlighted varying mental health perceptions and knowledge in PHC. Implementation of specifically developed formal training programs and interventions to improve MHL in PHC workers to strengthen their competence may help bridge the treatment gap.

Prevalence and Predictive Factors of Masked Depression and Anxiety among Jordanian and Palestinian Couples: A Cross-Sectional Study

Although anxiety and depression are among the most prevalent mental disorders worldwide, they continue to gain less attention than their physical counterparts in terms of health care provision and population mentalisation. This cross-sectional study explores and compares the national prevalence of depression and anxiety signs/symptoms and well as identifying associated socio-demographic factors among Jordanian and Palestinian fertile couples. Four-hundred and sixty-nine participants were eligible for inclusion and agreed to participate in the study. The mean score for HAM-A and BDI-II were 12.3 ± 8.2 and 15.30 ± 10.0, respectively. According to the grading of HAM-A and BDI-II, the majority of the participants have graded themselves to be mildly anxious (N = 323, 68.9%) and around one third of participants (N = 148, 31.6%) moderately to severe depressed. The suicidal intent was remarkable and of concern where around 18.6% of participants had suicidal thoughts and wishes. There was a significant correlation between both HAM-score and BDI-II score and age [p = 0.01, p = 0.011, respectively], body weight [p = 0.01, p = 0.006, respectively], and total monthly income [p < 0.001, p < 0.001, respectively]. Our findings ought to alert healthcare professionals and other interested parties that there is a high burden of anxiety and depression symptoms among Jordanian and Palestinian couples. To support Jordanian and Palestinian couples’ mental health, healthcare professionals, researchers, and educators favoured to concentrate on creating efficient and culturally relevant education, preventive, and intervention procedures utilising evidence-based guidelines.

Genetic etiology of hereditary hearing loss in the Gulf Cooperation Council countries

The past 30 years have seen an exponential growth concerning the identification of genes and variants responsible for hereditary hearing loss (HL) worldwide. This has led to a huge gain in our understanding of molecular mechanisms of hearing and deafness, which improved diagnosis for populations with hereditary HL. Many communities around the world, especially in the Middle East and North Africa, have a high prevalence of consanguineous marriages. Congenital monogenic conditions, such as recessive HL, are more common in these populations due to high consanguinity rates. Many studies have shown that high rates of consanguinity, endogamy, and first cousin marriages were observed in the six countries of the Gulf Cooperation Council (GCC). The intent of this study is to investigate the etiology of HL in the GCC region. A deep literature review of genes and variants responsible for HL in this region revealed 89 recessive DNA pathogenic variants reported in 138 cases/familial cases. A total of 21 genes responsible for non-syndromic hearing loss (NSHL) and 17 genes associated with syndromic hearing loss (SHL) were reported in cases from the GCC region. Out of 156 reported affected cases, 112 showed HL only, and 44 showed HL associated with other clinical manifestations. This data suggests that in the GCC region 72% of HL forms are non-syndromic and 28% are syndromic. For individuals with NSHL, 66% of variants were detected in four genes (GJB2, OTOF, TMC1 and CDH23), with a predominance of variants located in the GJB2 gene (37.5%). However, among SHL, Usher syndrome was the more frequent as it has been observed in 41% of the reported syndromic GCC cases. Finally, our analysis showed that HL genetics testing and research in the GCC region took advantage of the next generation sequencing (NGS)-based techniques, as approximately 58% of reported variants were identified using this technology.