anti depression medicine in saudi arabia

4 décembre 2020

2003, 327 (7424): 1144-1146. PLoS One. Psychiatric morbidity in primary care was estimated in 1995 around 30-46% of the visiting patients [17]. 2003, 41 (11): 1284-1292. JAMA. Relationships between PHQ 2, PHQ9 and “impact on daily life” question were explored, using linear regression. Br J Psychiatry. 1995, 4 (2): 99-105. No other significant relationships were found with other variables such as marital status, age, monthly income, working status, house space, house owner ship, chronic diseases, coffee intake and smoking among the study subjects.PHQ-2 and PHQ-9 were analyzed in term of calculating the severity scores for each question for the last 2 weeks. The point prevalence of screened depression is high in primary care visitors in Saudi Arabia. Compared to general population, it can be assumed that primary care visitors are more likely to have depression, because of their health status. The ideal blend of "Ancient knowledge of Medicine based on Natural and Holistic Living" with "Modern Scientific Research and Validation Techniques. Soc Psychiatry Psychiatr Epidemiol. Despite several studies that have shown benefit of early diagnosis and cost-savings of up to 80%, physicians in primary care setting continue to miss out on 30-50% of depressed patients in their practices. PubMed Central  PSS: Perceived Stress Scale. Data were collected using PHQ-2 and PHQ-9 Arabic version validated questionnaires for depression screening [42]. Given the wide reach that primary health care services have in Saudi Arabia, general physicians must be involved in identifying the risk factors and early signs of PPD to prevent its complications. Saudi Diagnoses in Mental Health. AHRQ Publication No. WQ conceived of the study, and participated in its design, coordination, and performed the statistical analysis. Greenberg PE, Kessler RC, Birnbaum HG, Leong SA, Lowe SW, Berglund PA, Corey-Lisle PK: The economic burden of depression in the United States: how did it change between 1990 and 2000?. It is also recommended to increase the awareness of benefits of early diagnosis of patients to prevent major form of depression and cost saving of health system. Adult depression screening in Saudi primary care: prevalence, instrument and cost. U.S., Preventive, Services, Task, Force: Screening for depression in adults: recommendation statement. Whooley MA: To screen or not to screen? Also, recently AI has been involved in review and revising data and manuscript. By this method a human being is valued by productivity. Diyya (Blood Money) estimate has been derived by averaging homicidal and accidental death cost of 2011 revised rates [50]. Depression, Overview He admits that life in Al Khobar was more challenging for expat women, who have to be transported everywhere and have more rules to live by. Pfizer Inc; [cited Feb 12, 2011]; Available from: Coyne JC, Fechner-Bates S, Schwenk TL: Prevalence, nature, and comorbidity of depressive disorders in primary care. Health Services/Technology Assessment Text. J Family Community Med. In the United States, depression prevalence has been reported around 9% in general population [4, 8, 9] and varying between 5-13% among adult patients visiting primary care [10]. Psychiatrists are few and far between in Saudi Arabia. The home-makers’ earning were estimated based on the average monthly salaries of the persons doing various jobs in the house, i.e. In Al-Khobar, while 22% of patients were found to have conditions such as depression and anxiety, only 8% of these were formally diagnosed. Health care in Saudi Arabia is a national health care system in which the government provides free health care services through a number of government agencies. This is based on the assumption that suicidal death although intentional yet can sometimes be accidental. Br J Psychiatry. 2008, 15 (1): 27-33. Ann Intern Med. List of Banned Medicines/Drugs in the Kingdom of Saudi Arabia Nov 13, 2017. For calculations, patients with mild symptoms were not considered for treatment or cost-analysis, those with moderate and severe symptoms of depression were grouped together and rounded to 20% and considered eligible for medication prescribed either by the family medicine physician or a psychiatrist. 2003, 52 (2): 118-124. Anti-fungal treatments address fungal infections affecting the skin, often occurring in the nails and outer skin layers. PubMed  Thus, all our medicines are safe and don’t contain any adulterants. 2002, 32 (3): 271-283. In Riyadh, the same pattern has emerged. To further satisfy our needs to simplify, we explored the use of PHQ-2 by correlating with PHQ-9. For PHQ-2, presence or absence of depression was based on a score of 3 and above out of 6 on the screening instrument [44]. Kroenke K, Spitzer RL, Williams JB: The PHQ-9: validity of a brief depression severity measure. A simple cost-analysis was done by estimating direct and indirect costs of depression, followed by an estimate of possible cost-savings that may emerge as a beneficial outcome of improved screening and management of depression. Also, Saudi Arabia is the only Arab country to be part of the G-20 major economies. This article is published under license to BioMed Central Ltd. Those currently having an occupation were 259 (54.3%), housewives 45% and over 85% were living in a rented house. 2013, Available from In a recent study, Van den Berg et al. Barring people with either Israeli passports or Israeli stamps in their passport from visiting Saudi Arabia, has been a long-established practice. Board Eligible Resident, Family Medicine Department, King Abdulaziz Medical City-National Guard, Riyadh, Saudi Arabia, Consultant Community Medicine, Family Medicine Department, King Abdulaziz Medical City-National Guard, Riyadh, Saudi Arabia, Family Medicine Department, CoDirector- National & Gulf Center for Eveidance Based Health Practice, King Abdulaziz Medical City-National Guard, Riyadh, Saudi Arabia, Staff physician, Family Medicine Department, King Abdulaziz Medical City-National Guard, Riyadh, Saudi Arabia, You can also search for this author in It makes a person feel sad, frustrated, hopeless, have low self-esteem, and lose interest in things one usually enjoys [2]. The severity score of PHQ-2 ranged between 0–6 points (mean of 1.57 ± 1.63SD) and that of PHQ-9 was found ranging between 0–27 points (mean of 5.57 ± 4.91SD) (See Figure 1). More specifically, … 2004, 184: 393-403. Indexed in MEDLINE/Index Medicus (National Library of Medicine) available through PubMed, PubMed Central, Europe PubMed Central, PubMed Central Canada, SCOPUS, EMR Index Medicus, Excerpta Medica Database (EMBASE), BIOBASE, and Thomson ISI in Science Citation Index Expanded online at ISI Web … Pakistan has an overall prevalence of 34% [14, 15]. In addition, OB/GYN physicians must be familiar with PPD and at the very least, know the required methods available to detect PPD during standard postpartum visits. Depression. “Saudi needs to be a place where people believe they can come, work and live a good life, regardless of who they are,” says Muhammad al-Ahwal, a Qatar-based psychiatrist who previously conducted research on depression rates in Saudi Arabia and now works as a clinician. Nearly half of the adults walking into primary care clinics had depressive symptoms, in our study. 2012, 85 (2): 139-144. 2011, [updated 01/2011]; Available from: using Hospital Anxiety and Depression Scale (HAD), versus the PHQ scale [20]. Bureau of Emigration & Overseas Employment Government of Pakistan. Ltd. is primarily engaged as the Manufacturers, Exporters and Suppliers of Ayurvedic Medicine, Herbal Medicine, Herbal Cough Medicine, Herbal Energy Medicine, Herbal Cough Syrup. Based on the assumptions of another study [40], applying the cost differential of 20% savings in treated versus untreated patients with depression, revealed net cost saving of over a third of a million SAR, ($86,347) i.e. During the process all data were kept secure. Hishimo Pharmaceuticals Pvt. In general, mental health disorders in Saudi Arabia have a very low detection rate. Regression equation: PHQ-9 = 1.83 + 2.37 x PHQ-2. Arch Gen Psychiatry. Husain N, Chaudhry IB, Afridi MA, Tomenson B, Creed F: Life stress and depression in a tribal area of Pakistan. United States Preventive Services Task Force (USPSTF) has recommended screening elderly, adults and adolescents 12–18 years of age for depression [4, 33, 34]. Barrett B, Byford S, Knapp M: Evidence of cost-effective treatments for depression: a systematic review. Moderate or severe depression in our study totaled around 19%, which is a little higher than 12% reported by Abdul Wahid et al., in 2011 in primary care settings, but closer to reported by Becker et al., at 20% in 2002 [22, 24] and by El Rufaie et al., 25 years ago at 17% [20]. Another reason of this variation could be due to use of different scales for of screening depression in the studies, e.g., DOI: Edited by: Haden A, Campanini B. Saudi Med J. Mental health services are still not recognized as a pressing need of the time in Saudi society. Waleed Al-Qadhi. BetterMedicine. Whooley et al. in 2009, found screening to be cost effective in primary care setting, only if followed by a collaborative care program [41]. There was a significant relationship between prevalence of depression with female gender (Mann Whitney 22864, Z 1.97, p-value 0.049), and with higher level of education (Kruskal Wallis chi-square 14.9, p-value 0.002). Correlation between PHQ-2 & PHQ-9 scores. J Pak Med Assoc. J Affect Disord. 1996, 34 (7): 723-734. van den Berg M, Smit F, Vos T, van Baal PH: Cost-effectiveness of opportunistic screening and minimal contact psychotherapy to prevent depression in primary care patients. With an average monthly salary of SAR 8000 ($2133), the loss would be in millions per person depending upon the age of suicidal death. In our study we also found significant relationship of depressive symptoms with higher level of education. Similar relation was reported in many studies either local [18, 20, 22, 23] or international [4, 11, 52]. The female gender and higher education level were factors associated with depression. The following essential data were used from the current study to insert in calculations for cost-analysis: Percentage of males and females in the study, age range of patients, who were primarily adults in their productive life 18–65 years, marital status, and percentage of housewives. Chisholm D, Sanderson K, Ayuso-Mateos JL, Saxena S: Reducing the global burden of depression: population-level analysis of intervention cost-effectiveness in 14 world regions. 1995, 6 (2): 162-175. Article  Other relevant demographic and personal data were also collected including age, gender, level of education, work status, monthly income, past medical history, social habits and place of residence. This study was approved by King Abdullah International Medical Research Center, Riyadh. In retrospect not more than half a century ago, lifestyle of the majority of the population was nomadic and there was hardly any wealth. But screening for these potential comorbidities in a hospital’s accident and emergency department has seldom been undertaken, particularly in Saudi Arabia and elsewhere in the Middle East. Depression in Saudi Arabia.,,,,,,,, Two questions are as good as many. No local study has noted this relationship previously or one found no differences between being literate or illiterate [21]. Saudi Arabia has a high prevalence of depression, and as population grows, along with rising risk factors of depression such as chronic disease, stress of modernization, sedentary life style and social isolation, coupled with pre-existing stigmas of having a mental health disorder, paucity of psychiatrist and resources supporting mental health, the direct and indirect costs of depression are expected to rise [26]. Symptoms that may occur include redness, inflammation, itching, and skin lesions. WHO reported depression as the leading cause of disability as measured by years lost due to disability (YLD) and the 4th leading contributor to the global burden of disease, as calculated by (DALYs) Disability Adjusted Life Years; depression is already the second major cause of DALYs lost in the age category 15–44 years for both sexes combined [5, 7, 15]. J Affect Disord. Narrow WE, Rae DS, Robins LN, Regier DA: Revised prevalence estimates of mental disorders in the United States: using a clinical significance criterion to reconcile 2 surveys' estimates. Al-Qadhi, W., ur Rahman, S., Ferwana, M.S. Psychotherapy was not added to the costs, due to infrequent availability of the service in the region, and variability in practice which might have made cost estimates fluctuate unreasonably. A community survey. Professionals such as psychologists and behavior therapists are even less. A low total cumulative estimate of SAR 4000 ($1067) was used as monthly income, for all the job-types carried out at home. The pre-publication history for this paper can be accessed here: Kroenke K, Spitzer RL, Williams JB: The patient health questionnaire-2: validity of a two-item depression screener. A total of 550 questionnaires were distributed, 39 (7%) refused to participate, 23 (4.1%) were excluded from the study with pre-existing depression or affective disorders according to the medical records, and 11 (2%) incomplete questionnaires were rejected. PubMed  2005, 3, WHO: The World Health Report: 2001: Mental health: new understanding, new hope. Depression scores were significantly associated with female gender (p-value 0.049), and higher educational level (p-value 0.002). I would like to express appreciation and great thanks to Dr. Ali Al-Farhan, Head of Family Medicine and Primary Health Care Department, King Abdulaziz Medical City and Dr. Mohammed Al-Ateeq, Residency Program Director, Family Medicine and Primary Health Care Department, King Abdulaziz Medical City for their support and cooperation. and Nease et al., found that one time screening with PHQ-9 is cost effective rather than the annual and periodic screening [38, 40]. Ayuso-Mateos JL, Vazquez-Barquero JL, Dowrick C, Lehtinen V, Dalgard OS, Casey P, Wilkinson C, Lasa L, Page H, Dunn G, Wilkinson G, ODIN Group: Depressive disorders in Europe: prevalence figures from the ODIN study. 1999, 282: 1737-1744. Herbal medicines have been used for ages because they offer n numbers of benefits without causing any side effects. Google Scholar, Gilbody S, House AO, Sheldon TA: Screening and case finding instruments for depression. In Riyadh Becker et al., found depression prevalence to be 20% in primary care settings [23, 24]. Google Scholar. There is dearth of data regarding the cost of depression screening in Saudi population. Corresponding Author. For conservative estimates in calculations, the suicide incidence rate was reduced to 1% of the patients with moderate-severe symptoms of depression (0.2% of total), screened in this study. The kingdom of Saudi Arabia is one of the most populous and economically stable nations in the Middle East. Nearly half of the patients visiting primary care have some depressive symptoms, which require further exploration into their psychiatric history. Majority … Diyya: The Supreme Judicial Council. The primary objective of this study was to estimate point prevalence of screened depression in primary health care settings in Riyadh, Saudi Arabia on the basis of screening instruments. 2011, 32 (9): 948-952. Several studies have been conducted each of which looks at the rates of depression found in certain populations. Whooley MA, Avins AL, Miranda J, Browner WS: Case-finding instruments for depression. housekeeping, cooking and babysitting. Our executives would be happy to assist you. The medical program comprises of a 6-year MBBS degree. The study funded by King Abdullah International Medical Research (KAIMRC) at King Saud bin Abdulaziz University for Health Sciences (KSAU-HS) in National Guard Health Affairs (NGHA). Completed forms were forwarded to the data entry clerk, who entered the data in IBM-SPSS version 20. No Saudi studies regarding the cost of treatment, lost productivity and/or monetary benefit of screening for depression were found upon literature review. SR contributed in the conception and designs the study, analyzing and interpreting of data. Depression is a mental illness that causes persistent low mood and a sense of despair in the suffering person [1]. in 2011, reported an overall prevalence of depression nearing 12%, with 6% as severe cases, in the south-eastern region [22]. Literature review shows that nearly 45% of patients with major depression receive treatment, while most patients with major depression are managed by primary care physicians, only 5% get referred to a psychiatrist and 1% get admitted for treatment of depression [40]. Simon GE, VonKorff M, Piccinelli M, Fullerton C, Ormel J: An international study of the relation between somatic symptoms and depression. Part of Diclofenac products were amongst top four drugs from 2010 to 2015. Correspondence to Programs for screening depression should be implemented in primary care settings. Medhat M. Bassiony M.B.B.Ch, M.Sc, M.D. DOUGLAS M, MAURER DM, Carl R: Screening for depression. On the financial and cost aspect, Barrett et al., in 2005 found that there is no evidence that screening in primary care populations is a cost effective strategy [39]. Individuals and the society as a whole are stressed in trying to adapt to pace of modernization. PubMed Google Scholar. Arroll B, Khin N, Kerse N: Screening for depression in primary care with two verbally asked questions: cross sectional study. The indirect costs due to lost productivity came around 1.3 million SAR per year ($346,667) for a thousand persons screened in primary health care. 2005, Available from:, Bethesda: Table 1: prevalence of depressive illness. A limited cost-analysis and cost saving estimates of depression screening was done using the Human Capital approach. Ali BS, Rahbar MH, Naeem S, Tareen AL, Gul A, Samad L: Prevalence of and factors associated with anxiety and depression among women in a lower middle class semi-urban community of Karachi, Pakistan. The climate is hot and arid with relatively cool nights. Al Ibrahim et al., in 2010 showed an overall prevalence of 41% in a systematic review on depression [19]. Andersen I, Thielen K, Bech P, Nygaard E, Diderichsen F: Increasing prevalence of depression from 2000 to 2006. We chose the PHQ over many other modalities such as Beck Depression Inventory BDI, Rahim-Anxiety-Depression Scale RADS, and General Health Questionnaire GHQ for two reasons; Arabic version was validated by a study done on our population [24], and it had high sensitivity and specificity [4, 38]. In addition, no association was found with social habits such as coffee intake or smoking among study subjects. Cookies policy. 2005, 84 (1): 1-13. Depression and anxiety are prevalent psychiatric comorbidities that are known to have a negative impact on a patient’s general prognosis. [49]. Despite the oil riches, Saudi Arabia has not been immune to social and economic challenges that have affected different sections of its population. The cost-analysis showed savings of up to 500 SAR ($133) per adult patient screened once a year. 2001, 134 (5): 345-360. Abdul Wahid et al. Google Scholar. Similarly, if it is assumed that treatment costs would go up by say 50%, as more patients are likely to received medical treatment for depression as screening becomes common practice, it is also assumed simultaneously that it would reduce indirect losses in productivity by a certain percentage, say 50%, as treated patients are less likely to be absent from work and coupled with reduced risk of suicide, it is estimated that over half a million SAR ($130,800) can be saved per thousand persons screened in the primary care clinics. Secondary objectives include exploring association of screened depression with some risk factors, comparing screening questionnaires PHQ-2 and PHQ-9, conducting cost analysis for depression and estimating possible cost-savings of screening for depression. Note, however, that Saudi Arabia has banned the import and export of some medications that might be commonplace in western countries. Superior Product Quality, Exceptional Customer Support. Luppa M, Heinrich S, Angermeyer MC, Konig HH, Riedel-Heller SG: Cost-of-illness studies of depression: a systematic review. For the sake of conservative estimate, Diyya was taken into account instead of the ‘life-time’ monetary loss of an earning person who commits suicide that can be extended to the whole span of productive life, with annual earnings discounted at 3-5%. Médecin urologue sexologue Hopital universitaire international Cheikh Zaid ‏فبراير 2019 - ‏مايو 2019 4 شهور. In 2002, depression and anxiety disorders were noted around 18% among adults in central Saudi Arabia [18]. 2013, Available from: Patients without education were assisted by an Arabic speaking nurse, who read out the questionnaire to the patient, and documented responses. Rates of Depression in Saudi Arabia. General medicines, such as painkillers, cough medicine and eye drops, are widely available in supermarkets and large stores. 2005, 4: CD002792. Care-givers productivity losses were applied to both the employees. J Clin Psychiatry. The prevalence of depression in primary care setting varies according to the subtype, with major depression at 4.8-8.6%, dysthymia between 2.1-3.7%, and minor depression around 8.4-9.7%. Antisemitism in public administration. Abbreviations. At the end, I would like to thank all the people who participated in the research for their patience and kindness. Determination of the prevalence of stress and to identify the risk factors of stress among Saudi medical students at Faculty of Medicine, King Faisal University, Saudi Arabia. Unit costs of physician fees and per diem cost of hospital stay were averaged based on current market charges in the private sector, and validated by local experts in the field of psychiatry and health administration.

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