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Papers by Mundher Al-Maqbali

Background: Mandatory quarantine during COVID-19 has disrupted normal social and economic life an... more Background: Mandatory quarantine during COVID-19 has disrupted normal social and economic life and many people became trapped and isolated with increasing levels of anxiety and financial difficulties. Especially for vulnerable people, COVID-19 pandemic had shown by many studies to increase the depressive and anxiety symptoms as well as suicidal ideation and suicidal attempts. Increased suicidal attempts had been associated with the increased burden of the health and economic impacts of the pandemic.Cases Presentation: Here, we report four cases of suicidal attempts during the COVID 19 outbreak due to the lockdown and related economic difficulties. Those cases were admitted in a general hospital from the period April 2020 to June 2020.All patients were males, tested negative for corona virus and used violent methods of suicide. After receiving the appropriate treatment, all cases were discharged from hospital.Conclusion: The COVID-19 pandemic and its economic and social impacts could...

Background: Most documented cases of menstrual psychosis have been from Euro-American populations... more Background: Most documented cases of menstrual psychosis have been from Euro-American populations with reports from cross-cultural populations being only few in number. Objective: To determine whether the cyclical/episodic nature of menstrual psychosis among case series observed at a tertiary care unit in Oman fulfills the diagnosis criteria of the International Classification of Diseases (ICD-10) and diverge into Brockington's subtypes (World Psychiatry. 2005;4(1):9-17.). Related aims were to solicit measures of psychometric functioning of those with menstrual psychosis and narrated idioms of distress. Results: The spectrum of distress menstrual psychosis covers does fit into existing psychiatric nosology. Evaluations revealed that a majority of the participants displayed something akin to morbid phenomenon related manic and psychotic symptoms or, in parlance of Omani society, spirit possession. In terms of classification by timing within the menstrual cycle as expounded by Brockington, the present case series in Oman fulfilled the definition of catamenial psychosis and paramenstrual psychosis. With regard to psychometric function, all participants performed adequately on indices of intellectual functioning but appeared to have impairments in neuropsychological functioning, including dimensions of processing speed, episodic memory, and executive functioning.

Prodromal schizophrenia is the initial phase of disturbance prior to the full-blown psychotic pic... more Prodromal schizophrenia is the initial phase of disturbance prior to the full-blown psychotic picture. It comprises of various and non-specific symptoms such as affective changes anxiety symptoms, unusual perceptions, obsessions and odd beliefs. These manifestations may last from few weeks to several years. Approximately 80%-90% of schizophrenic patients experience the prodrome 1 . However, only 30%-40% of people with prodromal stage convert to florid manifestations of schizophrenia 2 . Many studies of prodromal stage schizophrenia confirm the value of early psychosis intervention.

Background: The term burden of care is defined as the subjective assessment of stress and anxiety... more Background: The term burden of care is defined as the subjective assessment of stress and anxiety which may result from the
perception that external caregiving demands exceed available resources 2 .The main domains of this burden are physical, emotional and
financial burden. Several studies evidenced that caregivers are at increased risk of hypertension, dyslipidemia, and depression.
Objective: to determine the degree of burden of care among caregivers of people with dementia attending the Memory Clinic, Sultan
Qaboos University Hospital, Oman Methods:This is a cross-sectional study conducted in sultan Qaboos university hospital in the period
from May 2014 to March 2015. All dementia caregivers accompanying their relative to the memory clinic at Sultan Qaboos University
Hospital were invited to participate in this study. The diagnosis of dementia was based on DSM 5 criteria, and the severity was rated
according to the Global Deterioration Scale for Assessment of Primary Degenerative Dementia and Clinical Dementia Rating. The level
of dependency was measured using the Katz Index of Independence in Activities of Daily Living (ADL) and Lawton Instrumental
Activities of Daily Living (IADL) Scale. For the caregivers, Zarit Burden Interview (ZBI) was used to determined the burden of care.
Results: 50 patients with dementia and their primary caregivers were included in the study. 90% of caregivers were adult children who
are supported by other relatives. As quantified by ZBI, 70 % of caregivers demonstrated a high degree of burden. Factors such as
patient’s age, duration, and severity of dementia, the level of dependency and female gender of the caregiver were associated with higher
burden.Conclusion: The burden is common among dementia caregivers and several factors interplay to influence the perceived stress.
As increased burden was evidenced to be associated with higher incidence of mental disorders, screening, and early intervention will
impact positively on the caregiver as well as the patient.

ackground: Clozapine and olanzapine are highly associated with the risk of metabolic syndrome res... more ackground: Clozapine and olanzapine are highly associated with the risk of metabolic syndrome resulting in lower functional outcomes, poorer quality of life and non-compliance to treatment. Objective: The current study examined the rate of assessment of metabolic syndrome parameters in patients on olanzapine attending Almasarrah Hospital in Muscat. Methods: Patients starting olanzapine between January 2014 and May 2015 were recruited to the study, which is based on the retrospective revision of cases gathered from medical records over a period of 18 months. Patients aged 18 years or above, who were prescribed olanzapine and had five or more hospital visits were included. Demographics included physical health parameters with regards to metabolic syndrome, namely blood pressure, weight, fasting blood sugar level and lipid profile. Results were compared to the ADA-APA monitoring protocol for patients on second generation antipsychotics. Results: N=46 patients met study inclusion criteria. No gender difference was identified. Most (74%) were between 21 and 40 years of age with 50% diagnosed with schizophrenia; 50% did not have a baseline lipid profile and 30% had blood sugar levels checked prior to olanzapine therapy. The majority (97%) had blood pressure and weight measured at baseline and follow-up. Overall, none of the patients matched the full standards of the ADA-APA protocol. Conclusion: Screening for metabolic syndrome among patient prescribed olanzapine in Almasarrah Hospital is behind international standards. This is especially true for lipid profile and fasting blood sugar level parameters. Findings are consistent with similar studies. Further studies should assess factors contributing to suboptimal monitoring of olanzapine-induced metabolic syndrome.

Suicide is a global phenomenon in all regions of the world affecting people of all ... more Suicide is a global phenomenon in all regions of the world affecting people of all age
groups. It has detrimental consequences on patients, their families, and the community
as a whole. There have been numerous risk factors described for suicide including mental
illness, stressful life situations, loss of social support, and general despair. The association
of suicide with Islam has not been extensively studied. The common impression from
clinical practice is that being a practicing Muslim reduces the risk of suicide. Another
factor associated with suicide is starting a patient on antidepressants. However, this
has been questioned recently. This report describes a middle-aged man with depression
and multiple social stressors who survived a serious suicide attempt. The discussion
will focus on the factors that lead him to want to end his life and the impact of the
assumed protective factors such as religious belief and family support on this act of self-
harm. Such patients can be on the edge when there is an imbalance between risk factors
(such as depression, insomnia, and psychosocial stressors) and protective factors (like
religious affiliation and family support). All physicians are advised to assess the suicide
risk thoroughly in patients with depression regardless of any presumed protective factor.

This is a cross-sectional study conducted in sultan Qaboos