It is clinically hard to differentiate primary from secondary-to-schizophrenia depression, especially in the absence of obvious psychotic symptoms. However, the classical symptoms of depression like subjective depressed mood, anhedonia, reduced energy and pathological guilt are more prominent in the primary depression.
Objectives: A number of studies have shown variations in the rate of alcohol and substance use disorders among different occupations, but no study till now stressed on such a variation in Iraq. The present study aimed to study variations in the rate of alcohol and substance use disorders between journalists and some other occupations in Erbil city. Methods: 200 journalists and 486 of other professionals were interviewed between the period of September to November 2008 by a structured interview (M.I.N.I.) for the detection of alcohol and substance use disorders. Results: Among the journalists, 34.5% were alcohol dependents, 7.5% were alcohol abusers, 1% was substance dependent, and another 1% was substance abuser. Among the non-journalists, 7.6% were alcohol dependents, 2.26% were alcohol abusers, 1.44% was substance dependents, and 1.02% was substance abusers. Most of the substances, other than alcohol, used by both groups were the prescription pills. 50% of journalists and 75% of non-journalists, who were either substance dependents or abusers, were alcohol dependents or abusers at the same time. Male gender and those who achieve higher educational levels were more affected in both groups. Conclusion: The present study concluded that occupation is an important determinant for alcohol and substance use disorders in Iraq. Working as a journalist, is a risk factor particularly for alcohol dependence. Gender is an important determinant within each occupation as well.
An item bank of 17 items may be useful in computer adaptive testing and nine or even four items may be used to develop a simplified screening tool for DSM-V major depressive disorder (MDD). Further examination of this item bank should be conducted in different cultural settings.
Indigenous healing is commonly practiced in Middle East. Little is known about trends of indigenous therapies among patients with psychiatric disorders in Iraq. To determine and compare rates and predictors of indigenous healings by individuals with psychiatric disorders, and the practiced rituals among Arabic and Kurdish ethnicities in Iraq, patients aged 18 year and older attending outpatients in Erbil and Najaf were assessed for their prior contacts with indigenous healers. About 48.9 % had indigenous healer's consultations before visiting their psychiatrists; the figure was three times higher among Arabs than Kurds. Higher consultation rate was detected among younger and less formally educated patients. Fourteen types of religious therapeutic rituals have been practiced. Indigenous healing is widespread in Iraq. It is more common among Arabs, younger and less educated people with psychiatric disorders. Participants consider indigenous healing for their psychiatric more than non-psychiatric disorders.
We aimed to find the depression rating scale with the greatest accuracy when applied by psychiatrists in Iraqi Kurdistan. We recruited 200 patients with primary depression and 200 controls living in the Kurdistan region of Iraq. The Mini International Neuropsychiatry Inventory (MINI) was used as a gold standard for DSM-IV depression. We also used: the two-item and the nine-item versions of the Patient Health Questionnaire (PHQ2, PHQ9), the Hospital Anxiety and Depression Scale (HADS), the Calgary Depression Scale for Schizophrenia (CDSS) and the Centre for Epidemiological Studies Depression (CES-D) scale. Interviews were performed by psychiatrists who also rated their clinical judgement using the Clinical Global Impression (CGI) scale and other mental health practitioners. All scales and tools performed with high accuracy and reliability. The least accurate tool was the PHQ2; however, with only two items it was efficient. Sensitivity and specificity for all tools were above 90%. Clinicians using the CGI were accurate in their clinical judgement. The CDSS appeared to be the most accurate scale for DSM-IV major depression and the PHQ2 the most efficient. However, only the CDSS appeared to offer an advantage over psychiatrists' judgement.
The objective of this study is to determine the rates and predictors of consulting faith healers by patients with schizophrenia, and therapeutic rituals practiced by therapists in Najaf province/Iraq. 70 patients, aged 18 year and older who attended the psychiatric out-patient unit in Najaf were invited to assess their previous contacts with faith healers. Our data demonstrated that prior faith healers consultation rate was 80%. Being younger, less formally educated, married, and female was significantly associated with faith healers consultation. Fourteen types of religious therapeutic rituals were identified. We concluded that faith healers consultation is popular and accessible among patients with schizophrenia in Iraq. Some rituals are harmful. Collaborative work with faith healers is recommended for a better quality of care.
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