Role of Islam in the management of Psychiatric disorders

Between Life and Death: How do Muslim Terminal Patients in Pakistan cope with Hepatitis C utilizing their Beliefs and Social Support?

Life-threatening events including terminal illness intensify the search for meaning and incite individuals to get closer to religion. Terminal patients can often find religious practices as helpful as medical therapy for bettering both physical and mental health. The present research aims to explain the interaction between religion, spirituality, and social support in coping with terminal illness among Muslim hepatitis C patients in Pakistan. A semi-structured open-ended interview guide was utilized to collect the data. Participants expressed that the deployment of religious and spiritual beliefs along with socio-emotional support during illness fostered medical therapy. Participants also revealed that belief in God provided them the strength to be steadfast during the terminal stage of the disease. Religious beliefs enabled terminal participants to accept death as an eventual reality and a normal part of their lives. Furthermore, participants put forward their longing for those kinds of religious practices that terminal diseases usually restrained them from receiving. The emotional support stemming from social relationships also improved resilience to cope with the terminal stage of illness. The study concludes that the interplay of religion, spirituality, and social support normalizes the fear of death, lessens pain, and improves resilience among Muslim hepatitis C patients in Pakistan.

Incidence and pattern of neurological emergencies in Ramadan

BACKGROUND

The impact of Ramadan fasting on various neurological emergencies remains relatively unexplored. This study aimed to clarify the incidence and pattern of the different neurological emergencies in Ramadan compared to Shaaban.

METHODS

In this cross-sectional study, all adult patients attending the emergency room at two Egyptian centers with neurological emergencies during Shaaban and Ramadan were evaluated. Clinical, laboratory, and radiological assessments were made on an individual basis upon which the diagnosis of neurological disorder was made. IBM SPSS Version 25 was used to analyze the data.

RESULTS

Seventy-twenty patients were included, 382 during Shaaban and 338 during Ramadan. Among causes of delirium, the frequency of dehydration was significantly higher, and the frequency of illicit drug abuse was significantly lower during Ramadan compared to Shaaban (P = 0.004, 0.030, respectively). The incidence of ICH was significantly reduced during Ramadan compared to Shaaban (10.8% vs 19.7%, P = 0.031). The incidence of cardioembolic strokes significantly increased during Ramadan than Shaaban (40.5% vs 26.4%, P = 0.014), whereas the incidence of small vessel disease (SVD) significantly decreased during Ramadan than Shaaban (21.6% vs. 42.1%, P < 0.001). The incidence of a single seizure was significantly higher in Ramadan than in Shaaban (69.4% vs. 34.6%, P = 0.007). The incidence of functional neurological disorders was significantly reduced in Ramadan than in Shaaban (P < 0.001).

CONCLUSION

The incidence of delirium caused by illicit drug abuse, ICH, SVD, and functional neurological disorders declined during Ramadan, while the incidence of delirium triggered by dehydration, cardioembolic strokes, and a single seizure increased during Ramadan.

Prevalence and risk factors associated with mental disorders among migrants in the MENA region: A systematic review and meta-analysis

BACKGROUND

The MENA region has experienced extraordinary events in recent years, resulting in an influx of refugees and displaced people who are vulnerable to mental disorders. Several previous studies have examined their prevalence, but none have focused on this region. This systematic review provided an estimate of the prevalence of mental illness and associated risk factors in the MENA region, and overcame the methodological limitations of individual studies.

METHODS

Thorough searches of the relevant databases were carried out to locate relevant published articles. Furthermore, cross-sectional studies were conducted to assess mental disorders in refugees, asylum seekers, migrants, or internally displaced people residing in the MENA region. Only studies meeting the aforementioned criteria were considered. For this purpose, RStudio software version 2023.12.0 + 369 with netmeta package was used for measurement and data analysis. JBI used to assess study quality.

RESULTS

The results, including 32 cross-sectional studies with a total of 21659 participants were obtained and discussed. The overall prevalence was 42% (95% CI; 30%, 54%) for depression, 43% (95% CI; 31%, 57%) for anxiety, 22% (95% CI; 11%, 39%) for stress, and 45% (95% CI; 36%, 53%) for PTSD. As a result, it was noted that being female was associated with depression, and being female and unemployed was associated with PTSD, however being married was protective against this later.

CONCLUSION

Compared to the rest of the globe, MENA has a greater rate of mental illness among refugees. Nevertheless, much effort should be devoted on listing causes associated, as well as their management and prevention.

Islamic Spiritual Care, Depression, and Quality of Life Among Patients With Heart Disease: A Systematic Review

Objectives: This study sought to identify the potential effect of Islamic-Spiritual care and how it is delivered in treating depression and improving the quality of life (QoL) of patients with heart disease. Methods: This systematic review is reported based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. We searched using relevant keywords through PubMed, CINAHL, Scopus, Springer Link, and Academic Search Complete. Articles with an experimental or cohort design were included, without date restrictions. The quality of evidence was assessed using the Joanna Briggs Institute critical appraisal checklist, and data synthesis used thematic analysis. Results: The analysis included 6 of the 47 identified studies. All studies were conducted in Iran, and a small number had a low risk of bias. The intervention was given through an Islamic teaching strategy, indicating the potential to reduce depression and improve QoL. Moreover, the learning core consists of belief and surrender in God's providence, strengthened meaning and life's purposes, worship, and skills to overcome obstacles. Conclusions: The interventions had the potential to treat depression and improve the QoL. However, a further study considering the risks of bias and involving a larger patient population with other Muslim backgrounds is necessary.

The Development of a Novel Suicide Postvention Healing Model for Muslim Communities in the United States of America

Suicide among American Muslims is understudied, despite recent research  highlighting increased suicide attempts among this population. While suicide is forbidden in Islam, formal guidelines for addressing and responding to suicide within Muslim communities did not exist until recently. The Stanford Muslim Mental Health and Islamic Psychology Lab has responded to a number of suicides in Muslim communities across North America and implemented an original model for suicide response and community healing. This approach incorporates Islamic principles and values to create a culturally and religiously congruent response to suicide that can support loss survivors and steer impacted communities toward healing. The Muslim Postvention Community Healing session described in this paper aims to provide a safe space for individuals impacted by suicide to come together and process their emotions, while also using Islamic teachings to guide the healing process. This unique model has the potential to serve as a valuable resource for Muslim communities across North America, and beyond, in addressing and responding to suicide.

Majnūn or Mental Disorders: Between Cultural Traditions and Western Psychology in Jordan

Mental disorders or altered psychological states are prevalent in all populations, regardless of race or ethnic origin, while at the same time, culture also shapes the conceptions of mental disorders. Religion is deeply rooted in the daily life of the Muslim-majority countries, while Arab countries are affected by an ongoing modernization. Thus, how does the traditional religious conception of mental disorders interact with Western psychological conceptions in contemporary Arab-Muslim society? This study explores the conceptions of mental disorders and their causes among Muslims in contemporary Jordan. By employing cognitive anthropological method (free listing), forty participants were asked to provide three lists of (a) typical names of mental disorders, (b) causes of mental disorders and (c) determining features of mental disorders. Collected qualitative data have been quantitatively analysed and interpreted in the context of relevant ethnographic and interview data. While Western terms of mental disorders are well known among young and educated Jordanians, the study demonstrates that Jordanians employ cultural and religious notions alongside. This co-existence of different conceptions confirms an importance of Islamic notion in the modern rendering of mental health. As a result, despite rapid modernization, mental health is still highly stigmatized.

The effect of the holy Quran recitation and listening on anxiety, stress, and depression: A scoping review on outcomes

Background and Aim

Anxiety, stress, and depressive disorders as common mental health problems have adverse effects in different populations. Holy Quran recitation and listening can help reduce these disorders. Therefore, the aim of this study was to investigate the effect of the Holy Quran on anxiety, stress, and depression.

Materials and Methods

To retrieve eligible studies, we searched PubMed, Web of Science, and Scopus databases. The articles were screened and chosen by three researchers. The selection of studies and the data extraction from the studies were done by three researchers using the data collection form based on the inclusion and exclusion criteria. Disagreements were resolved by consulting the third and fourth researchers. To report scoping review, we used the PRISMA cheklist.

Results

A total of 174 articles were retrieved from three databases and after removing irrelevant and repetitive articles, 15 articles were included in the current review. All studies were performed in Asia countries. Most studies have examined the effect of Holy Quran recitation and listening on anxiety (45%), stress (30%), and then depression (25%), respectively. The Beck Depression Inventory was the most widely used tool to evaluate the effect of Holy Quran recitation and listening on reducing anxiety, depression and stress. "Reducing the level of anxiety, stress, and depression" and "Simple, affordable, practical and cost-effective treatment to reduce depression and anxiety" were the most important outcomes of holy Quran recitation.

Conclusions

Based on the results of this study, Quran recitation and listening can be applied as a useful nonpharmacological treatment to reduce anxiety, stress, and depression.

Sociodemographic predictors of depression and anxiety symptomatology among parents in rural Côte d'Ivoire

BACKGROUND

In Côte d'Ivoire, cocoa farming is a widespread practice in rural households, an occupation with increased risks of depression and anxiety exacerbated by economic instability. We used the Goldberg-18 Depression and Anxiety diagnostic tool to identify predictors of depressive and anxiety symptomatology among a sample of parents in rural cocoa farming communities.

METHODS

In a cross-sectional survey, the Goldberg-18 was administered to Ivorian parents (N = 2471). Confirmatory factor analysis (CFA) was conducted to confirm the factor structure of the assessment tool, and Ordinary Least Squares (OLS) regression with clustered standard errors was used to identify sociodemographic predictors of symptomatology.

RESULTS

CFA showed adequate fit statistics for a two-factor model measuring depressive and anxiety symptoms. Among respondents, 87 % screened positive for requiring further referral for clinical diagnosis. Sociodemographic predictors of depressive and anxiety symptoms were similar for males and females. For the total sample, higher monthly income, more years of education, and belonging to the Mandinka ethnic group predicted fewer depressive and anxiety symptoms. In contrast, higher depressive and anxiety symptomatology were associated with age. Single marital status predicted increased anxiety but not depressive symptoms for the full sample model and the female only sample, but not the male sample.

LIMITATIONS

This is a cross-sectional study.

CONCLUSIONS

The Goldberg-18 measures distinct domains of depressive and anxiety symptoms in a rural Ivorian sample. Age and single marital status are predictors of increased symptoms. Higher monthly income, higher education, and certain ethnic affiliations are protective factors.

Social Determinants of Rural Household Food Insecurity under the Taliban Regime

Despite the severity of food insecurity in Afghanistan, little is known about the factors contributing to household food insecurity (HFI) under the Taliban regime. Therefore, this paper investigated the social determinants of severe HFI in rural areas of Afghanistan. We used the fifth-round survey of 6019 rural households from 25 provinces, collected between July and August 2022 by the Food and Agriculture Organization. We used binary logistic regression to examine the association between household characteristics and HFI. The majority of household heads were male (97.8%) with no education (62.8%). The findings showed that female-headed households had significantly higher odds of severe HFI. Household heads with any level of formal education had significantly reduced odds of severe HFI, while the odds of severe HFI was not different among those with religious/informal household-head education compared to those with no education. Likewise, engagement in any type of agricultural activity decreased the odds of severe HFI. Additionally, household income per member was negatively, while household size was positively associated with severe HFI. In summary, interventions to alleviate HFI among rural households should prioritize income-generating opportunities and skills targeting households with female heads, low levels of household-head education, larger size, no agricultural activities, and low income.

The Relationship Between Intolerance of Uncertainty and Spiritual Well-Being Levels of COVID-19 Among Elderly: A Cross Sectional and Correlational Study

The aim of this research is to relationship between intolerance of uncertainty and spiritual well-being levels during Covid-19 among elderly. This study was conducted with cross-sectional and corrational design. The research was conducted between January and June 2021 in Turkey's Eastern Anatolia Region. Introductory Information Form, Intolerance of Uncertainty Scale-Short Form (IUS), and Spirituality Index of Well-Being (SIWB) were used to collect data. The research was completed with 302 volunteers who met the following inclusion criteria. All participants belong to the Muslims. A negative significant correlation was found between IUS and SIWB; that is as the spirituality of the elderly individuals increased, the levels of intolerance of uncertainty decreased. It is recommended to identify the fears and intolerances of elderly individuals. For uncertainty, it is necessary to refine their spirituality. For this, it is recommended to organize spiritual education programs.

Integrating Cognitive Behavioural and Islamic Principles in Psychology and Psychotherapy: A Narrative Review

Standardisation of knowledge has become a by-product of globalisation, and western-based models are often seen as the ultimate answer to expertise and development. In light of this, some professionals have debated the feasibility of employing cognitive behavioural therapy (CBT) with Muslim communities. Debates have focused on CBT's secular roots and its compatibility with a world where Islam permeates most aspects of life. This article highlights some of the theoretical dilemmas of integration and suggests ways to bridge the existing gap between secular and Islamic literature and avoid alienating those individuals who might feel uncomfortable with secular CBT teachings.

Thematic analysis of the raters' experiences administering scales to assess depression and suicide in Arab schizophrenia patients

BACKGROUND

This study aimed to enhance the cultural adaptation and training on administering the Arabic versions of the Calgary Depression Scale in Schizophrenia (CDSS) and The International Scale for Suicidal Thinking (ISST) to Arab schizophrenia patients in Doha, Qatar.

METHODS

We applied the qualitative thematic analysis of the focus group discussions with clinical research coordinators (CRCs). Five CRCs met with the principal investigator for two sessions; we transcribed the conversations and analyzed the content.

RESULTS

This study revealed one set of themes related to the scales themselves, like the role of the clinician-patient relationship during administration, the semantic variations in Arabic dialects, and the design of scales to assess suicide and differentiate between negative symptoms and depression. The other set of themes is relevant to the sociocultural domains of Muslim Arabs, covering religion, families' roles, and stigma. It also covered the approaches to culturally sensitive issues like suicide, taboos in Islam, and the gender roles in Arab countries and their impact on the patients' reports of their symptoms.

CONCLUSIONS

Our results highlight several cultural and religious aspects to tackle when approaching schizophrenia patients through in-depth discussions and training to improve the validity of the assessment tools and treatment services.

Can mental healthcare for Muslim patients be person-centred without consideration of religious identity? A concurrent analysis

BACKGROUND

Muslims constitute the largest, fastest growing religious minority in the UK. Globally, nurses are legally, morally and ethically obliged to provide non-discriminatory, person-centred, culturally sensitive care. This obligation includes supporting people with their religious needs where appropriate, but there is evidence this is not always happening, particularly for Muslims in mental health care.

AIMS

This paper reviewed primary research to address the question: Can mental healthcare for Muslims be person-centred without consideration of religious identity?

METHODS

Narrative synthesis and concurrent analysis. Searches were conducted post 2000 in MEDLINE, CINAHL, SAGE, PsychINFO and ASA with terms: 'Muslim', 'Islam* ', 'mental health', 'nurs* ', 'person-cent* ', 'religio* '. Narrative data were analysed for commonalities and themes.

FINDINGS

Seven studies of sufficient quality were analysed. Unconscious religious bias was the overarching theme linking the findings that healthcare staff felt ill-prepared and lacked necessary knowledge and experience to work with diverse patient groups. Unconscious racial bias contributed to limited cultural/ religious competence in treatment and care.

CONCLUSION

Religious identity is core for Muslim patients, so this group may not be receiving the person-centred care they deserve. Nurses need cultural and religious competence to deliver person-centred, holistic care to diverse patient populations, yet the importance of religious practice can be overlooked by staff, with harmful consequences for patient's mental and spiritual welfare. This paper introduces a welcome pack that could help staff support the religious observance of those Muslim patients/service-users wishing to practice their faith during their stay in health services.

Development of Culturally Informed Trauma Therapy Approach for Muslim Refugee Families

Refugees from predominantly Muslim countries have been exposed to severe traumatic experiences in their country of origin. Further their stress continues during the resettlement process in the host country. Although the number of Muslim refugees is increasing in the U.S. and Europe, the existing literature is not adequate to derive a conclusion on treatment efficacy for specifically traumatized Muslim refugee families. An inadequate treatment approach for this population may result in negative/ineffective therapy outcomes. Thus, the aim of this study is to develop a culturally responsive treatment model. For this purpose, this study offers an integrated family-based therapy approach, which is influenced by narrative, art, and narrative exposure approaches for refugee families. This integrated family therapy model consists of 12 weekly sessions and includes 4 phases: a) diagnostic interview, b) narration of the life story, c) exposure to the trauma, and d) re-narrate and reprocessing of the traumatic events. Future studies should test the feasibility and effectiveness of the integrated model using the randomized controlled trials, as the acquisition of such treatment models is essential to the development of a culturally sensitive treatment model for Muslim refugees.

Determinants of Depression among Malay Single Mothers Living in Community in Perak, Malaysia

Background

Being a single mother is challenging. Many single mothers developed depression, but some managed to survive. This study aimed to determine the proportion of depression among single mothers living in community and its associated factors.

Methods

This cross-sectional study involved conveniently sampled 213 Malay single mothers living in community in Perak, Malaysia. A Malay version of Patient Health Questionnaire (PHQ)-9 was used to determine significant depression at a cut-off point of 10. Malay version of Multidimensional Scale of Perceived Social Support (MSPSS-M) and Brief-Coping with Problems Experienced (COPE) scales were used to assess support and coping strategies.

Results

The proportion of depression among Malay single mothers in this study was 20.2% (95% CI: 15.0, 26.2). Previous history of depression (adjusted odds ratio [aOR]: 10.27; 95% CI: 2.18, 48.35; P = 0.003) and coping by using self-blame (aOR: 2.00; 95% CI: 1.45, 2.77; P < 0.001) increased the risk of depression. Active coping (aOR: 0.66; 95% CI: 0.46, 0.96; P = 0.027) and use of emotional support (aOR: 0.61; 95% CI: 0.44, 0.84; P = 0.002) is protective of depression.

Conclusion

There was a high proportion of depression among Malay single mothers living in the community. Personal history of depression and type of coping strategies used significantly influenced the occurrence of depression among these single mothers. Providing guidance to acquire adaptive coping strategies is a crucial preventive measure.

Impact of Religious Activities on Quality of Life and Cognitive Function Among Elderly

Religiosity and spirituality have previously been found to have significant effects on mental and physical health. This study aimed to compare elderly people utilizing different types of religious activities in their daily routine and the effects upon their quality of life and cognitive function. A cross-sectional study was conducted among elderly people dwelling in suburban areas of Malaysia. The Malay version of Short Form (36) Health Survey (SF-36), Geriatric Depression Scale (GDS-15), Older Americans Resources and Services's Instrumental Activities of Daily Living (OARS's IADL), and the Montreal Cognitive Assessment (MoCA) questionnaires were used in this study. Independent t test was utilized to determine the difference in the quality of life and the cognitive function between groups of elderly people that were categorized based on their level of participation in different religious activities. The study involved 432 participants. The mean score for all domain of SF-36 was significantly higher among those who engaged in the religious activities as compared to those elderly who were either less engaged or did not practice religious activities. The mean score of GDS-15, OARS's IADL, and MoCA was also significantly higher among those who participated in religious activities. There was a significant impact on the quality of life and cognitive function among elderly people practicing religious activities. This study proved the importance of practicing religious activities among the elderly in achieving healthy aging.

"I Need Presence and a Listening Ear": Perspectives of Spirituality and Spiritual Care Among Healthcare Providers in a Hospice Setting in Pakistan

This paper aims to describe how healthcare providers perceived spirituality and spiritual care while caring for dying patients and their families in a hospice setting in Karachi, Pakistan. Using a qualitative interpretive description design, individual in-depth interviews were conducted among healthcare providers. Thematic analysis approach was used for data analysis. Spirituality and spiritual care were perceived as shared human connections, relating to each other, acts of compassion, showing mutual respect while maintaining dignity in care and empowering patients and families. Developing spiritual competency, self-awareness, training and education, and self-care strategies for healthcare providers are essential components promoting spiritual care in a hospice setting.

Risk perceptions, fear, depression, anxiety, stress and coping among Saudi nursing students during the COVID-19 pandemic

BACKGROUND

The COVID-19 pandemic has seriously impacted various aspects of the society on a global scale. Schools and universities provide rich resources for adolescents and young adults to develop significant coping mechanisms.

AIM

This study assessed the perceptions of risk, fear, mental health status, and coping strategies among Saudi student nurses amid the COVID-19 pandemic.

METHODS

Using an online survey, the mental health of the students was assessed by the Depression, Anxiety and Stress Scale short form version, whereas the coping was assessed by the Brief-Coping Orientation of Problem Experienced scale.

RESULTS

The students had modest risk perception and fear of contracting COVID-19. "Religion" was reported as the most frequently used coping strategy. Approximately 43.3%, 37.2%, and 30.9% of the respondents manifested some degree of depression, anxiety, and stress, respectively. Poor COVID-19 knowledge, perceived seriousness of COVID-19 in Saudi Arabia, perceived risk of COVID-19 infection, and the use of some coping strategies were predictors of fear. Knowing someone infected with COVID-19, fear, and several coping strategies predicted students' mental health.

CONCLUSION

This study provides data that can be used to create educational and health policies that focus on the mental health of university students, specifically nursing students.

Dementia and revivalist Islam: New perspectives to understanding dementia and tackling stigma

The notion of stigma and its influence on the understanding of dementia has commonly been recognized as a great challenge to seeking healthcare services for South Asians in England. The aim of this commentary is to examine how Muslims view, understand and tackle dementia stigma in the context of revivalist Islam, especially among Bangladeshi Muslims within their British communities. This article reflects on the interrelationship between dementia and revivalist Islam among Bangladeshi family caregivers and addresses the question of how revivalist Islam is a significant source of understanding dementia and tackling stigma. Bangladeshi caregivers show a practical attitude toward dementia which is generally acknowledged as a medical symptom, and for which family caregivers voluntarily seek healthcare support. This piece highlights underlying principles of caregivers religious beliefs in the acceptance of dementia as a disease, and in help-seeking which is influenced by Qur'anic verses and Prophetic traditions. Bangladeshi caregivers' religious beliefs intertwine with their knowledge, perception, and attitudes toward caregiving for their relatives with dementia. Revivalist Islam offers family caregivers an opportunity to explore their inner wisdom through the challenging journey of caregiving for their family members with dementia.

Understanding the Perceptions of Omani Women Regarding Life After a Breast Cancer Diagnosis

Objectives

There is a rising burden of breast cancer (BC) in the Eastern Mediterranean Region (EMR), and its sociopsychological impact is a quickly growing health concern in this region. Because understanding cancer patients’ perceptions of life is integral to their treatment, they are also a concern for healthcare providers. This qualitative study, therefore, explored changes in Omani women’s perceptions of life after a BC diagnosis.

Methods

Semi-structured interviews were conducted individually with 21 Omani women undergoing treatment for BC at the Oncology Ward of Muscat’s Royal Hospital from March to May 2017. The collected data were subjected to qualitative content analysis.

Results

After their cancer diagnosis, the women appeared to pass through three main stages in their coping processes. First, they passed through a stage of severe psychosocial distress and diminishment in personal identity. Next, they evolved strategies for coping based on cultural, religious and family resources. Finally, the women experienced acceptance and submission to the reality of the cancer as God’s will with changes in attitudes and perceptions of the meaning of life.

Conclusion

A BC diagnosis impacts Omani women severely, affecting their lives dramatically. They adopt coping strategies based on cultural, religious and spiritual beliefs. Healthcare providers need to acknowledge and facilitate women’s spiritual and cultural coping strategies as an integral part of their treatment which holds potential to improve their prognosis. Such strategies should be individualised to suit each woman’s experiences, perceptions and needs.

Well-being and needs of Malay carers of people with mental illness in Singapore

Despite the importance of carers supporting the lives of people with mental illness, there are limited studies investigating the well-being and needs of Malay carers in multicultural Singapore. The Malays consist of 13.4% of Singapore's population. A mixed methods qualitative dominant research approach was used to explore the well-being and needs of Malay carers in a voluntary welfare organisation. The Kessler-10, Friendship Scale and Carers' and Users' Expectations of Services-Carer version were used to assess the needs and well-being of 17 Malay carers. Findings show that Malay carers experienced poor well-being and had numerous unmet needs. Four main themes were found: (a) Concerns related to relatives with mental illness, (b) Mental health practices related to carers, (c) Holistic support for carers and (d) Preference for greater spiritual support in mental health. Recovery-oriented mental health practice implications are discussed. Spirituality of Malay carers needs to be given greater consideration in recovery-oriented mental health services.

Primary caregivers experience of anti-psychotic medication: A qualitative study

BACKGROUND

Management of schizophrenia is now shifted to the community setting and family caregivers are the primary caregivers. Managing medications is a complex responsibility of family caregivers caring for patients with mental illness. Medication compliance contributes to improve health outcomes and reduced hospitalization for the care service users; however, little is known about attitudes and perception of family caregivers.

AIMS AND OBJECTIVES

To explore family caregivers experience towards antipsychotic medications.

METHODS

A purposeful sampling of 21 family caregivers was included in the study. Semi-structured interview was employed to collect data from the participants between May and October 2015. Thematic analysis approach was used to identify the common pattern in the data.

RESULTS

Four main themes emerged from the study: insight into illness (poor understanding of illness), treatment factor (thinking about medication, poor guidance for medication compliance), resources and support (availability of medication and cost of medication), health care provider factors (communication gap and poor assessment with follow-up, social dysfunction (social isolation, disruption in life routine) of the primary caregivers.

CONCLUSIONS

Responsibility for providing care for patients with mental illness are taken place in the community setting and cared by family caregivers. More information resources are required for this role, which requires specific medication management skills and knowledge.

Coping Through Religiosity, Spirituality and Social Support Among Muslim Chronic Hepatitis Patients

Academics acknowledge religiosity, spirituality and social support as socio-behavioral factors that influence patients' ability to deal with chronic illness. This study has attempted to describe empirical reality of how these factors influence patients. The sample of this study was 500 chronically ill hepatitis patients and was selected through the multistage sampling techniques. Through structured interview schedule, data were collected during the period of September 2016 to March 2017 from five most populated cities of Punjab (Pakistan). Data were analyzed through descriptive (frequency and percentage) and inferential statistics (Cronbach's alpha, Pearson correlation, and structural equation modeling). The study suggests some recommendations and suggestions to policy makers regarding the significance of religiosity, spirituality and social support as coping strategies during chronic illness. The findings illustrate that social support has more association with coping than religiosity and spirituality of the patients.

Improving the mental wellbeing of Arabic speaking refugees: an evaluation of a mental health promotion program

BACKGROUND

Refugee populations have particularly high rates of mental health problems, including Posttraumatic Stress Disorder (PTSD) and depression. However, uptake of mental health care may be low even when severe depression and PTSD symptoms are present in individuals following resettlement. This is likely due, at least in part, to cultural influences on refugees' knowledge and beliefs about mental health problems and their treatment. We sought to provide preliminary evidence for the effectiveness of a culturally tailored mental health promotion program for Arabic-speaking refugees.

METHODS

A total of 33 Arabic-speaking refugees resettled in South Western Sydney were recruited and completed intervention which consisted of weekly three-hour sessions for 4 weeks delivered in Arabic. Key aspects of mental health literacy, help-seeking intentions and levels of general psychological distress were assessed, by means of a self-report survey, pre-intervention, (immediately) post-intervention and 3 months following intervention.

RESULTS

Of the 33 participants that completed the intervention, 31 completed the immediate post-intervention survey and 29 completed the 3 months follow-up survey. Improvements in most aspects of mental health literacy assessed were found immediately post-intervention and at follow-up, although only changes relating to stigmatising attitudes were statistically significant. Additionally, a statistically significant decrease in participants' levels of general psychological distress was observed immediately following the intervention, and this decrease was sustained at follow-up.

CONCLUSION

While further research employing a more rigorous study design and larger sample size will be needed, results of this initial trial suggest that a culturally tailored mental health promotion program targeting key aspects of mental health literacy can improve the mental health of Arabic-speaking refugees resettled in a Western nation.

Causes and risk factors for common mental illnesses: the beliefs of paediatric hospital staff in the United Arab Emirates

Background

Children and adolescents with chronic physical health conditions are vulnerable to poor mental health outcomes. The measurement of mental health literacy of health professionals working with such populations is important because of their role in promoting early and appropriate help-seeking. This study sought to determine the beliefs regarding the causes of and risks factors for three types of mental illnesses amongst health professionals in United Arab Emirates.

Method

A culturally validated mental health literacy survey presenting three vignettes of fictional characters meeting diagnostic criteria for posttraumatic stress disorder, depression with suicidal thoughts and psychosis was distributed. The survey measured health care professionals’ beliefs regarding the causes of and risk factors for these disorders.

Results

A total of 317 health care professional (> 90% nurses) were surveyed from across the UAE. Although 43.8% correctly endorsed exposure to a ‘traumatic event’ as the most likely cause for developing posttraumatic stress disorder, there was a more limited understanding of the contribution of biopsychosocial factors to the development of the mental illness, particularly for psychosis. Participant socio-demographic variables were associated with attributions of religious or spiritual beliefs and personal weakness as causal and/or vulnerability factors in the development of depression with suicidal thoughts and psychosis.

Conclusions

Efforts to improve mental health systems and health care providers in UAE and other similar Middle Eastern countries requires targeted mental health literacy programs that seek to integrate biopsychosocial models of mental illness and their treatment with the positive aspects of religious and cultural beliefs that are dominant in this region.

The state of mental digi-therapeutics: A systematic assessment of depression and anxiety apps available for Arabic speakers

BACKGROUND

Mental disorders are a major public health problem leading to premature mortality, homelessness, addiction problems, poor physical health, and suicide. The prevalence of mental disorders in Arab countries, is high. The proliferation and ubiquity of smartphones and their apps in the Arab world may be the long-awaited for digital therapeutic for mental health disorders. However, the evidence about the availability and characteristics of mental health apps available to Arabic speakers remains poor.

OBJECTIVE

To conduct a systematic assessment of the features of depression and anxiety mobile apps available for Arabic speakers.

METHODS

A critical review of all the currently available depression and anxiety apps, available free of charge to Arabic speakers. The apps are evaluated using the Mobile App Rating Scale (MARS). Further, a categorization of apps' main functions, inspired by the mhGAP guidelines, is developed to classify the apps based on their main functions.

RESULTS

A total of 23 apps are identified with far more apps available on the Google Play Store (n = 21) versus only two apps on the iOS App Store. The majority of the apps (n = 16) provide general information about either anxiety, depression, or both. Six apps are of spiritual nature mainly referring to the Islamic faith and the Holy Quran, with one app referring to the Christian faith. Another five apps provide advice on alternative treatments, mainly concerning herbal medicine recipes. Only two apps provided utilities for users, specifically about medication reminders.

CONCLUSIONS

Mental health digi-threaputics have huge potentials to transform mental health care delivery. However, more empirical studies are needed to assure their quality and efficacy. The results of this study clearly highlight the current gaps to address the needs of Arabic speakers; only 23 apps were identified in this study, mostly with low app quality scores. There is a need to involve expert healthcare professionals in the development of mental health apps and for healthcare providers to empower patients through discussing apps that are useful and discern them from those that can potentially cause harm.

Cross-cultural adaptation of the Arabic Positive and Negative Syndrome Scale in schizophrenia: Qualitative analysis of a focus group

As part of a project to translate and validate scales used in the diagnosis and treatment of Arab patients with schizophrenia, this study aimed to explore the experience of clinical research coordinators (CRCs) while administering the Arabic version of the Positive and Negative Syndrome Scale (PANSS) on Arab schizophrenia patients. We previously reported that the Arabic version of PANSS is a valid and reliable tool to assess Arab patients with schizophrenia. Five CRCs and the principal investigator attended focus group discussions on cultural issues in administering the PANSS. A thematic analysis approach was utilized for data coding and analysis. The results identified issues related to the translation of the instrument, the structure of the interview, the cultural sensitivity of some questions, and the procedures for rating items of the PANSS. Qualitative analysis also identified four main themes relevant to clinical assessment of patients from Middle Eastern cultures: religion, beliefs and values, gender, and semantic expressions. In conclusion, researchers or clinicians administering the PANSS scale interview in Arabic should be trained to consider the roles of local dialects, familiarity with abstract thinking, religion, and social constructs when assessing psychosis.

Muraqaba as a Mindfulness-Based Therapy in Islamic Psychotherapy

This article first describes Sufism, the mystical/spiritual tradition of Islam then move to define Islamic psychotherapy and the various aspects of muraqaba by providing an overview of the Sufi literature. I will also highlight how the techniques used in muraqaba can be adapted and used as mindfulness-based stress reduction, mindfulness-based cognitive therapy, meditation, transcendental meditation, mind-body techniques (meditation, relaxation), and body-mind techniques. Although muraqaba might not be effective for all mental health issues, I suggest a possible value of muraqaba for treating symptomatic anxiety, depression, and pain. Furthermore, Muslim clinicians must be properly trained in classical Sufi traditions before using muraqaba techniques in their clinical practice.

Efficacy of Surah Al-Rehman in Managing Depression in Muslim Women

The study empirically investigated the idea that Quranic verses (Surah Al-Rehman) can help manage depression. Abdullah Ibn Mas'ud (radiAllahu anhu) reported that the Prophet (salAllahu alayhi wasalam) said, "Everything has an adornment, and the adornment of the Qur'an is Surah Al-Rehman." Surah Al-Rehman is the most rhythmic surah of the Quran, so it was used for our experimental study. The idea of the study was drawn from the premise that music therapy helps reduce depression. The objective of the present study was to investigate the efficacy of Surah Al-Rehman for managing depression in Muslim women admitted for treatment of major depressive disorder in a psychiatry ward of a government hospital. It was hypothesized that women diagnosed with severe depression in the treatment group will have reduced level of depression as compared to control group at post-assessment level. It was further hypothesized that the amount of decrease in depression in treatment group at the post-assessment level will be greater as compared to the control group. A purposive sample of 12 female patients diagnosed with depression was randomly assigned to the treatment group (n = 6) and control group (n = 6). Assessment was done at pre- and post-level by using Beck Depression Inventory-II. Both groups did not significantly differ on pre-assessment depression scores. Twelve structured group sessions of 22 min, two times a day, were conducted for a period of 4 weeks with the groups. Treatment group was made to listen to Surah Al-Rehman recited by Qari Abdul Basit, and control group was exposed to music used for relaxation and treatment of depression. Wilcoxon signed ranks test was used to find the within-group differences between pre- and post-assessment scores. Both groups had decreased level of depression at post-assessment level, so it was important to assess if there was any difference in level of decrease. Mann-Whitney U test for comparison of groups on level of decrease at the post-assessment level endorsed that treatment group had significantly greater decrease than control group on depression. Our study highlights the efficacy of Surah Al-Rehman as a remedy to reduce depression. The Holy Quran intones, "This sacred book is 'shifa' for its followers." Hence, we recommend that researchers should focus on finding remedies for other psychological and physical diseases from Quranic verses. An exploration of possible mechanism (such as activated cognitions or associated emotions while listening to Quran) through which effects of recitation are reached, can also be subject of investigation for forthcoming studies.

Discrete Effects of Religiosity and Spirituality on Gay Identity and Self-Esteem

Previous research has indicated that although spirituality may bolster development of a positive gay identity, religiosity may prove detrimental. Because the majority of this research confounds these constructs, there is little evidence as to the discrete roles religiosity and spirituality may play in LGB identity development. The present study endeavored to tease apart the unique effects of religion and spirituality on positive and negative gay identity and self-esteem. A sample of 376 self-identified sexual minority adults were given measures of religiosity, spirituality, LGB identity, and self-esteem. Models were built to evaluate the effects of religiosity (independent of spirituality) and spirituality (independent of religiosity), understanding that the constructs are greatly overlapped, on identity and self-esteem. Results included a positive association between spirituality and identity affirmation, identity superiority, and self-esteem. Religiosity was negatively associated with identity affirmation and self-esteem and positively associated with internalized homonegativity and heteronormativity. Limitations and implications are discussed.

Integration Between Mental Health-Care Providers and Traditional Spiritual Healers: Contextualising Islam in the Twenty-First Century

In the United Arab Emirates, neuropsychiatric disorders are estimated to contribute to one-fifth of the global burden of disease. Studies show that the UAE citizens' apathy towards seeking professional mental health services is associated with the 'religious viewpoints' on the issue, societal stigma, lack of awareness of mental health and lack of confidence in mental health-care providers. Mental health expenditures by the UAE government health ministry are not available exclusively. The majority of primary health-care doctors and nurses have not received official in-service training on mental health within the last 5 years. Efforts are to be made at deconstructing the position of mental illness and its treatments in the light of Islamic Jurisprudence; drafting culturally sensitive and relevant models of mental health care for Emirati citizens; liaising between Imams of mosques and professional mental health service providers; launching small-scale pilot programs in collaboration with specialist institutions; facilitating mentoring in line with Science, Technology, Engineering and Math (STEM) outreach programmes for senior school Emirati students concerning mental health; and promoting mental health awareness in the wider community through participation in events open to public.

Beliefs and knowledge about post-traumatic stress disorder amongst resettled Afghan refugees in Australia

Background

Resettled refugees are at high risk of trauma-related mental health problems, yet there is low uptake of mental health care in this population. Evidence suggests poor ‘mental health literacy’ (MHL) may be a major factor influencing help-seeking behaviour among individuals with mental health problems. This study sought to examine the MHL of resettled Afghan refugees in Adelaide, South Australia.

Methods

Interviews were completed with 150 (74 males; mean age 32.8 years, SD = 12.2) resettled Afghan refugees living in Adelaide, South Australia. A convenience sampling method was employed and participants were comprised of volunteers from the Afghan community residing in the northern suburbs of Adelaide. Following informed consent participants were presented a culturally appropriate vignette describing a fictional person suffering from posttraumatic stress disorder (PTSD). This was followed by a series of questions addressing participants’ knowledge and understanding of the nature and treatment of the problem described. Self-report measures of PTSD symptoms and co-morbid psychopathology were also administered.

Results

Thirty-one per cent of the respondents identified the problem depicted in the vignette as being PTSD, while 26 per cent believed that the main problem was ‘fear’. Eighteen per cent of participants believed that ‘getting out and about more/finding some new hobbies’ would be the most helpful form of treatment for the problem described, followed by ‘improving their diet’ and ‘getting more exercise’ (16 %).

Conclusion

The results of this study demonstrate aspects of MHL that appear to be specific to Afghan refugees who have resettled in Australia. They indicate the need for health promotion and early intervention programs, and mental health services, to recognise that variation in MHL may be a function of both the cultural origin of a refugee population and their resettlement country. Such recognition is needed in order to bridge the gap between Western, biomedical models for mental health care and the knowledge and beliefs of resettled refugee populations.

Electronic supplementary material

The online version of this article (doi:10.1186/s13033-016-0065-7) contains supplementary material, which is available to authorized users.

Role of traditional healers in the pathway to care of patients with bipolar disorder in Egypt

BACKGROUND

A large number of mentally ill patients prefer to visit non-medical practitioners such as traditional healers because of the confidence in the system, affordability and accessibility of the service. This may lead to delay in seeking psychiatric services and has prognostic impact.

AIM

To assess the rate of bipolar affective disorder (BAD) patients seeking traditional healers, the sociodemographic and clinical correlates of those patients.

METHODS

We assessed 350 patients with BAD after confirmation of diagnosis with Structured Clinical Interview for DSM-IV Axis I Disorder (SCID-I) research version and assessment of functioning with Global Assessment of Functioning scale. They were assessed for percent, rate and timing of seeking traditional healers.

RESULTS

In all, 40.8% sought traditional healers, with 34.9% more than four times. Of those, 62.2% were before seeking psychiatric services and 37.8% after. Lower educational level, less impairment of functioning and presence of hallucinations were significant correlates.

CONCLUSION

This study shows that most of the patients suffering from mental illness prefer to approach faith healers first, which may delay entry to psychiatric care and thereby negatively impact the prognosis of BAD. This highlights the importance of mental health education and developing a positive collaborative relationship with traditional healers.

Does religious coping and spirituality have a moderating role on depression and anxiety in patients with spinal cord injury? A study from Iran

OBJECTIVES

We evaluate the level of anxiety and depression among patients with spinal cord injury (SCI) in relation with their religious coping and spiritual health.

SETTING

Brain and Spinal Cord Injury Repair Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.

METHODS

A sample of patients with SCI participated in this cross-sectional study. They completed a sociodemographic questionnaire, the Hospital Anxiety and Depression Scale, the Brief Religious Coping Questionnaire and the Spiritual Well-being Scale. Then, the association between anxiety, depression and independent variables was examined.

RESULTS

In all, 213 patients with SCI were studied. Of these, 64 (30%) have had anxiety and 32 (15%) have had depression. Multiple logistic regression analyses revealed that gender (odds ratio (OR) for female=3.34, 95% confidence interval (CI)=1.31-8.51, P=0.011), employment (OR for unemployed=5.71, 95% CI=1.17-27.78, P=0.031), negative religious coping (OR=1.15, 95% CI=1.04-1.28, P=0.006) and existential spiritual well-being (OR=0.93, 95% CI=0.89-0.97, P=0.003) were significant contributing factors to anxiety (Table 3), whereas negative religious coping (OR=1.21, 95% CI=1.06-1.37, P=0.004) and existential spiritual well-being (OR=0.90, 95% CI=0.84-0.96, P=0.001) were significant contributing factors to depression.

CONCLUSION

The findings indicated that depression and anxiety are two psychologically important side effects after SCI. The findings also indicated that religion and spiritual well-being have a moderating role on occurrence of depression and anxiety.

Attitudes and beliefs of patients with chronic depression toward antidepressants and depression

BACKGROUND

Many patients have erroneous views with regard to depression and its management, and it was noted that these attitudes and beliefs significantly affected their adherence rates.

OBJECTIVES

The primary aim of this study was to determine the attitudes and beliefs of patients with depression toward depression and antidepressants. A secondary aim was to assess the influence of ethnicity on patients' attitudes and beliefs.

PATIENTS AND METHODS

The study involved patients with chronic depression being followed up at an outpatient clinic at a government-run hospital in Malaysia. Patients' attitudes and beliefs were assessed using the Antidepressant Compliance Questionnaire.

RESULTS

A total of 104 patients of Malay, Chinese, and Indian ethnic groups met the selection criteria. Chinese patients had significantly negative attitudes and beliefs toward depression and antidepressants compared to Malays and Indians (b=-8.96, t 103=-3.22; P<0.05). Component analysis revealed that 59% of patients believed that antidepressants can cause a person to have less control over their thoughts and feelings, while 67% believed that antidepressants could alter one's personality; 60% believed it was okay to take fewer tablets on days when they felt better, while 66% believed that antidepressants helped solve their emotional problems and helped them worry less.

CONCLUSION

Patients had an overall positive view as to the benefits of antidepressants, but the majority had incorrect views as to the acceptable dosing of antidepressants and had concerns about the safety of the medication. Assessing patients' attitudes and beliefs, as well as the impact of their respective cultures, can be used in tailoring psychoeducation sessions accordingly.