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The Composite International Diagnostic Interview (CIDI) has been clinically reappraised in several studies conducted mainly in the US and Europe. This report describes the methodology used to conduct one of the Middle East's largest clinical reappraisal studies. The study was carried out in conjunction with the World Mental Health Qatar-the first national psychiatric epidemiological study of common mental disorders in the country. This study aimed to evaluate the diagnostic consistency of core modules of the newly translated and adapted Arabic version of the CIDI 5.0 against the independent clinical diagnoses based on the Structured Clinical Interview for DSM-5 (SCID-5). Telephone follow-up interviews were administered by trained clinicians using the latest research edition of the SCID for DSM-5. Telephone administered interviews were key in the data collection, as the study took place during the COVID-19 pandemic. Overall, within 12 months, 485 interviews were completed. The response rate was 52%. Quality control monitoring documented excellent adherence of clinical interviews to the rating protocol. The overall methods used in this study proved to be efficient and effective. For future research, instrument cultural adaptation within the cultural context is highly recommended.

Objectives Lifetime DSM‐5 diagnoses generated by the lay‐administered Composite International Diagnostic Interview for DSM‐5 (CIDI) in the World Mental Health Qatar (WMHQ) study were compared to diagnoses based on blinded clinician‐administered reappraisal interviews. Methods Telephone follow‐up interviews used the non‐patient edition of the Structured Clinician Interview for DSM‐5 (SCID) oversampling respondents who screened positive for five diagnoses in the CIDI: major depressive episode, mania/hypomania, panic disorder, generalized anxiety disorder, and obsessive‐compulsive disorder. Concordance was also examined for a diagnoses of post‐traumatic stress disorder based on a short‐form versus full version of the PTSD Checklist for DSM‐5 (PCL‐5). Results Initial CIDI prevalence estimates differed significantly from the SCID for most diagnoses (χ12${\\chi }_{1}^{2}$  = 6.6–31.4, p = 0.010 < 0.001), but recalibration reduced most of these differences and led to consistent increases in individual‐level concordance (AU‐ROC) from 0.53–0.76 to 0.67–0.81. Recalibration of the short‐form PCL‐5 removed an initially significant difference in PTSD prevalence with the full PCL‐5 (from χ12${\\chi }_{1}^{2}$  = 610.5, p < 0.001 to χ12${\\chi }_{1}^{2}$  = 2.5, p = 0.110) while also increasing AU‐ROC from 0.76 to 0.81. Conclusions Recalibration resulted in valid diagnoses of common mental disorders in the Qatar National Mental Health Survey, but with inflated prevalence estimates for some disorders that need to be considered when interpreting results.

Telepsychiatry, a subset of telemedicine, has been increasingly studied to meet the growing demands for psychiatric care. The utility of telepsychiatry is relevant now more than ever as the world endures the COVID-19 global pandemic. This paper describes the prior state and the changes that the COVID-19 outbreak brought to telepsychiatry in a selected group of Arab countries of the Middle East and North Africa (MENA) region. We invited twelve early-career psychiatrists from different Arab nations to share information related to telepsychiatry in their respective countries before and during the COVID-19 pandemic. The information was collected using a semi-structured guide. This was complemented by a search for relevant articles in five search engines using terms such as \"COVID-19,\" \"telepsychiatry,\" and \"Arab world\". Before the pandemic, digital mental health services were provided in several Arab countries, mainly through hotlines and messaging services. The COVID-19 pandemic has marked a major shift in digital psychiatric services in the Arab MENA world, through the transformation of many clinics and some hospitals into digital mental health systems. Many non-governmental organizations also started remote initiatives for psychological support and psychiatric counseling. Three main barriers of patient-related, healthcare-related, and system-related hurdles of using telepsychiatry emanated from the analysis. The use of digital mental health services varies between different Arab countries. Even though some nations have laws that regulate the provision of such services, most struggle with multifactorial barriers. As affordable and attainable solutions cannot only rely on training and recruiting more psychiatrists, telepsychiatry would help meet the exceeding demands in the Arab world, particularly after the COVID-19 outbreak.

Background Type 1 diabetes (T1DM) in children is frequently associated with sleep disorders. The prevalence of these disorders varies by region attributable to variations in co-sleeping customs, nocturnal rituals, and environmental influences. This study aims to assess sleep problems and their related characteristics among children diagnosed with T1DM in the Upper Egypt region. This cross-sectional study involved 118 children with T1DM, aged 6 to 12 years. The outcomes from the Children’s Sleep Habits Questionnaire-Abbreviated (CSHQ-A) were utilized to categorize the subjects into two groups: the first group comprised individuals with sleep problems ( N  = 70), and the second group included individuals with non-sleep problems ( N  = 48). All participants were evaluated using the Socioeconomic Scale, the Clinical Evaluation of Emotional Regulation–9 (CEER-9), the Strengths and Difficulties Questionnaire, the Pediatric Quality of Life Inventory, and the Children’s Alexithymia Measure (CAM). Results Sleep problems were prevalent in 59.3% of participants. Children with sleep problems had elevated rates of overweight/obesity, ocular problems increased medication usage, exercise difficulties, diminished quality of life, higher mean scores on the emotional regulation scale, and greater levels of alexithymia as compared to those without sleep disorders. The prevalence of conduct and hyperactivity problems was greater in children with sleep problems compared to those without sleep problems. Regression analysis revealed that increased BMI, presence of ocular issues, higher alexithymia scores, and poor quality of life were associated with a greater likelihood of experiencing sleep problems. Conclusions Nearly two-thirds of children with T1DM in Upper Egypt experienced sleep problems. These issues were associated with higher BMI, ocular problems, elevated alexithymia scores, and poorer quality of life.

The collaborative effort of an international research team from the Early Career Psychiatrists section of the World Psychiatry Association has brought about an easy-to-use, quick and stepwise mental health care toolkit for the identification and appropriate referral of those in need of mental health care during the pandemic. This simple guide can be applied in the general outpatient setting and is catered for all healthcare professionals, regardless of their expertise within the mental health field with minimal training. It is our hope that by incorporating this toolkit into our daily clinical care during the pandemic for high-risk patients and patients with non-specific complaints, we will be able to bridge the mental health gap present in our society.

BackgroundDementia is a pressing problem for families and society. In 2019, a total of 57.4 million people worldwide were estimated to be living with dementia, and this number will almost double every 20 years, especially in Africa and the Middle East. This study aimed to investigate knowledge about dementia among the Egyptian population. A cross-sectional online survey was conducted among a sample of adult Egyptians using a socio-demographics data sheet and a designed dementia knowledge questionnaire.ResultsNearly one-third (33.4%) had a poor knowledge score. The items most often answered incorrectly were the sudden onset of cognitive problems as characteristic of dementia (59.3%). The highest percentage of good knowledge was in the manifestations and prevention domains (62.20% and 67.18%, respectively). On the other hand, the lowest rate of good knowledge was in the treatment and life impact domains (35.23% and 25.70%, respectively). Not working in the medical field (OR 2.656, 95% CI: 1.504–4.688, p < 0.001), had no contact with dementia patients (OR 1.910, 95% CI: 1.229–2.970, p = 0.004), no previous knowledge on dementia (OR 3.184, 95% CI: 1.797–5.642, p < 0.001), or never heard about dementia \"Marad Alkharaf\" (OR 6.385, 95% CI: 4.127–9.878, p < 0.001) were significantly associated with poorer dementia knowledge.ConclusionThe findings of our study indicated variable levels of knowledge of dementia among Egyptians. Our recommendation is to encourage conducting campaigns for raising public awareness about dementia and through media that has an important and widespread effect in reaching the Egyptian population.

Clozapine is recommended as first-line treatment for treatment-resistant schizophrenia (TRS). Despite its established position in all international guidelines, prescribing and utilization rates of clozapine have consistently been low among psychiatrists. The primary aim of the current study was to survey psychiatrists in the Middle East and North Africa (MENA) region on clozapine prescription patterns and practices, attitudes towards the medication, and perceived barriers and facilitators for prescribing. Data were collected from 17 of the 21 countries belonging to the MENA region via an online questionnaire. The majority of participants stated that the most common indication for clozapine was TRS. While most reported high levels of expertise with clozapine and rated it as an effective treatment, only 53.1% used it as their first-line treatment. The main stated barriers were concerns over patients' poor compliance, the burden of regular blood testing, and the associated side effects. Years of practice and the setting of practice did not influence prescribing attitude and behavior. This study confirms that psychiatrists in the MENA do not diverge from the norm of clozapine under prescription. Structural reforms are required to establish services that have the capacity and experience to address clozapine prescribing.

Purpose A novel coronavirus (COVID-19) that has not been previously identified in humans and has no specific treatment has recently spread. Treatment trials using antiviral and immune-modulating drugs such as hydroxychloroquine (HCQ) were used to control this viral outbreak however several side effects have emerged. Berberine (BER) is an alkaloid that has been reported to reveal some pharmacological properties including antioxidant and antimicrobial activities. Additionally, Zinc oxide nanoparticles (ZnO-NPs) possess potent antioxidant and anti-inflammatory properties. Therefore, this study was undertaken to estimate the efficiency of both BER and synthetic ZnO/BER complex as an anti-COVID-19 therapy. Methods First, the ZnO/BER complex was prepared by the facile mixing method. Then in vitro studies on the two compounds were conducted including VeroE6 toxicity, anti-COVID-19 activity, determination of inhibitory activity towards papain-like proteinase (PL pro) and spike protein- and receptor- binding domain (RBD) as well as assessment of drug toxicity on RBCs. Results The results showed that ZnO/BER complex acts as an anti-COVID-19 by inhibiting spike protein binding with angiotensin-converting enzyme II (ACE II), PL pro activity, spike protein and E protein levels, and expression of both E-gene and RNA dependent RNA polymerase (RdRp) at a concentration lower than that of BER or ZnO-NPs alone. Furthermore, ZnO/BER complex had antioxidant and antimicrobial properties where it prevents the auto oxidation of 2,2-Diphenyl-1-picrylhydrazyl (DPPH) and the culture of lower respiratory system bacteria that affected Covid 19 patients. The ZnO/BER complex prevented as well the HCQ cytotoxic effect on both RBC and WBC (in vitro) and hepatotoxicity, nephrotoxicity and anemia that occurred after HCQ long administration in vivo. Conclusion The ZnO/BER complex can be accounted as promising anti-COVID 19 candidate because it inhibited the virus entry, replication, and assembly. Furthermore, it could be used to treat a second bacterial infection that took place in hospitalized COVID 19 patients. Moreover, ZnO/BER complex was found to eliminate the toxicity of long-term administration of HCQ in vivo .