Rafia Ghubash - Academia.edu (original) (raw)

Papers by Rafia Ghubash

Research paper thumbnail of Al Ain Community Survey of Psychiatric Morbidity III. The natural history of psychopathology and the utilization rate of psychiatric services in Al Ain

Social Psychiatry and Psychiatric Epidemiology, 2000

We evaluated the natural history of psychopathology in a stratified sample (n = 245) comprising s... more We evaluated the natural history of psychopathology in a stratified sample (n = 245) comprising subjects with no DSM-III-R psychiatric disorder, subthreshold disorder and threshold (DSM-III-R) psychiatric disorder, respectively, over a 12-months period, using the Structured Clinical Interview for DSM-III-R mental disorders (SCID) as an assessment tool. A representative sample categorized 1 year earlier into DSM-III-R psychiatric disorder, subthreshold disorder and no DSM-III-R psychiatric disorder were reassessed with SCID 1 year on. The incidence, recovery rates and the percentage of subthreshold disorders which become DSM-III-R disorders were calculated. The utilization rate of psychiatric services was also assessed. The incidence rate of new cases was 10.4%. The recovery (remission) rate was 41.5%, and approximately 20% of subthreshold disorders became definitive disorders (DSM-III-R) after 1 year. Anxiety disorders tend to have a higher magnitude of temporal stability in comparison with depressive disorders. Male sex and contact with psychiatric services were found to affect the recovery rate. Approximately 13% of the sample had made contact with psychiatric services with no gender differences, but men were significantly more often hospitalized than women. Our findings indicate that mental disorders are relatively common. The high incidence rate found in this study is attributed in part to the high negative rate at baseline assessment. Approximately 60% of psychiatric disorders in the community are persistent, and patients with emotional disorder under-utilize existing services.

Research paper thumbnail of Behavioural Problems in School Children in the United Arab Emirates: Cross-Informant Variance

Research paper thumbnail of Postpartum Psychiatric Admissions in Al Ain

Research paper thumbnail of The Dubai Community Psychiatric Survey .2. Development of the Sociocultural Change Questionnaire

Soc Psych Psych Epid 28 60 65, Apr 1, 1993

Research paper thumbnail of Ethics in Psychiatry

Journal of the Bahrain Medical Society, May 5, 2013

Research paper thumbnail of Al Ain community survey of psychiatric morbidity II. Sex differences in the prevalence of depressive disorders

Journal of Affective Disorders, Nov 30, 2002

Research paper thumbnail of The validity of the Arabic Edinburgh Postnatal Depression Scale

Social psychiatry and psychiatric epidemiology, 1997

For the purpose of this study, a consecutive sample of 95 postpartum women were assessed at 1 wee... more For the purpose of this study, a consecutive sample of 95 postpartum women were assessed at 1 week postpartum with the (EPDS) and at 8 +/- 2 weeks postpartum using the Present State Examination (PSE). A moderate correlation between PSE total score and EPDS score was found (r = 0.57). A moderate agreement between EPDS and Catego diagnosis of depression was also found (Kappa = 0.52). Using a cut-off score of 12 on EPDS and Catego diagnosis as a criterion variable, the sensitivity and specificity of the scale were 73% and 90%, respectively. However, using a cut-off score of 10, the sensitivity of the scale rose to 91% without much fall in its specificity (84%). The internal reliability of the scale was 0.84 (alpha Cronbach). We conclude that the Arabic version of the EPDS is a reliable and valid screening tool for depression in postpartum women.

Research paper thumbnail of The rationale, development and reliability of a new screening psychiatric instrument

Social Psychiatry and Psychiatric Epidemiology, 1999

This paper describes the rationale, development, reliability and validity of a new screening psyc... more This paper describes the rationale, development, reliability and validity of a new screening psychiatric instrument. The instrument comprises 26 items that tap the cardinal features of main psychiatric categories as defined by ICD-10 and DSM-IV. These items were adapted from various structured and semi-structured diagnostic interviews that yield ICD-10 and DSM-IV psychiatric diagnoses. After a training course, 12 trainees and the trainer rated blindly the 26 items on 45 subjects (22 with psychopathology and 23 without). Inter-rater reliability coefficient (Kappa) was estimated between trainees and the trainer on each item of the instrument. The total score on the new instrument was then correlated with the total score on the Arabic Self Reporting Questionnaire (SRQ-20) and the Arabic version of the General Health Questionnaire (GHQ) in a random sample from the general population (n = 365). Logistic regression was utilised to estimate the power of the total score on the new instrument in discriminating between cases and non-cases as classified by the SRQ-20. Excellent levels of agreement (Kappa > 0.80) were found for all items except for obsession (Kappa = 0.65) and for depressed mood (Kappa = 0.70). Moderate correlations were found between the total score on the new instrument and total score on SRQ-20 (r = 0.69) and the total score on the Arabic GHQ (r = 0.7). The new instrument correctly classified 89% of subjects into cases and non-cases. The results of this study indicate that the new instrument is a highly reliable and valid screening instrument. The authors are now investigating its test-retest reliability and its procedural validity.

Research paper thumbnail of The Dubai Community Psychiatric Survey: acculturation and the prevalence of psychiatric disorder

Psychological Medicine, 1994

SynopsisDubai, an Emirate in the Gulf region, has experienced spectacular social change as a resu... more SynopsisDubai, an Emirate in the Gulf region, has experienced spectacular social change as a result of the exploitation of its oil reserves. The Dubai Community Psychiatric Survey was designed to study the effects of this social change on the mental health of female nationals.In this paper, we approach the problem by quantifying social change in two main ways: the first focused on social change at the individual level as measured by the Socio-cultural Change Questionnaire (Bebbington et al. 1993). The second examined the effect of social change at the community level by identifying areas of residence at different levels of development. We hypothesized that attitudes and behaviours markedly at odds with traditional prescriptions would be associated with high rates of psychiatric morbidity.On the individual level, the association between psychiatric morbidity and the amount of social change reflected in the behaviours and views of the subjects was not significant. However, there was a...

Research paper thumbnail of P02.250 Factors predicting depression among male and female in an Arab community

European Psychiatry, 2000

Research paper thumbnail of Post-partum psychiatric morbidity

European Psychiatry, 1996

Research paper thumbnail of A comparison of the validity of two psychiatric screening questionnaires: the Arabic General Health Questionnaire (AGHQ) and Self-Reporting Questionnaire (SRQ-20) in UAE, using Receiver Operating Characteristic (ROC) analysis

European Psychiatry, 2001

The aim of this study is to investigate the clinical features and frequency and importance of rel... more The aim of this study is to investigate the clinical features and frequency and importance of related co-morbid disorders of social phobia in a clinical sample. Eighty-seven patients meeting DSM-III-R diagnostic criteria for social phobia were studied. All patients were assessed by using a semi-structured socio-demographic form, the Structured Clinical Interview for DSM-III-R, Manual for the Structured Clinical Interview for DSM-III-R Personality Disorders, Liebowitz Social Anxiety Scale, Hamilton Rating Scale for Depression and Hamilton Rating Scale for Anxiety. Sixty-eight (78.2%) of the group were male, 19 (21.8%) were female. The ages varied between 16–58 years, with a mean of 26.2 years (SD = 8.5). Fifty-one point seven percent of the subjects were assessed as having a co-morbid axis I disorder, of which 12.6% consisted of panic disorder and 10.3% agoraphobia. An additional axis II disorder had been found in 67.8% of the subjects, and 54.0% of them had been diagnosed as having ...

Research paper thumbnail of Personality profile among primary care patients: experimenting with the Arabic IPDE ICD-10

Acta Psychiatrica Scandinavica, 2002

To estimate the prevalence of personality disorder (PD) among primary health care (PHC) patients,... more To estimate the prevalence of personality disorder (PD) among primary health care (PHC) patients, and to investigate the characteristic features of the International Personality Disorder Examination, the ICD-10 module (IPDE ICD-10). A sample (n = 158) PHC patients in Al Ain, United Arab Emirates (UAE) were interviewed by general practitioners (GPs) using the Arabic version of the IPDE ICD-10. Patients interviewed were 82 males and 76 females. Definite PD was identified in 12.7%. Prevalence rates among males and females were 9.8 and 15.8% consecutively. Commonest personality disorders were the schizoid (5.1%), anankastic (4.4%) and the emotionally unstable, borderline type (3.8%). Comorbidity of PD was manifested by 30% of definite PD patients. The mean dimensional scores of definite and probable PD patients were 5.6 and 4.3 consecutively. The IPDE-ICD-10 is useful but relatively time consuming with repetition and need of rephrasing in some items. Dimensional measurement proved essential.

Research paper thumbnail of The prevalence of early postpartum psychiatric morbidity in Dubai: a transcultural perspective

Acta Psychiatrica Scandinavica, 1997

Research paper thumbnail of Prevalence and psychosocial correlates of global developmental delay in 3-year-old children in the United Arab Emirates

Research paper thumbnail of The Dubai Community Psychiatric Survey IV. Life events, chronic difficulties and psychiatric morbidi

Soc Psychiat Psychiat Epidem, 1998

The relationship between life events, chronic social difficulties and psychiatric morbidity was i... more The relationship between life events, chronic social difficulties and psychiatric morbidity was investigated in 297 women selected at random as part of the Dubai Community Psychiatric Survey. The PSE-ID-CATEGO system was used to identify psychiatric cases, based on an Index of Definition level of 5 or more. Life events in the 6-month period prior to illness or interview were elicited through the Life Events and Difficulties Schedule. Chronic difficulties were explored through direct questioning based on a list of possible problems. The study demonstrates a significant excess of marked and moderately threatening life events in acute cases of psychiatric disorder (50%) compared to chronic cases (16.7%) and non-cases (27.9%). The association was particularly marked for events in the 3-month period before the onset. Around 33% of psychiatric morbidity may be attributed to marked and moderately threatening life events. Rates for mild events were similar in the three groups of subjects. Subjects experiencing chronic social difficulties included a significantly higher proportion of cases (33.3%) than those who did not experience such difficulties (9.1%). The effect of chronic social difficulties was more pronounced than, and independent of, the effects of life events. There were no interactions between life events and vulnerability factors in their effect on psychiatric morbidity, although numbers were small. The results suggest that the overall influence of life events and chronic difficulties on psychiatric morbidity is commensurate with that in Western societies, despite the different coping traditions of Islam.

Research paper thumbnail of Al Ain Community Psychiatric Survey. I. Prevalence and socio-demographic correlates

Soc Psychiat Psychiat Epidem, 2001

... Mood disorders and anxiety (neurotic) disorders were more common in women and alcohol and sub... more ... Mood disorders and anxiety (neurotic) disorders were more common in women and alcohol and substance use disorders were exclusively confined to men. ... MT Abou-Saleh Department of Addictive Behaviour & Psychological Medicine, St. ...

Research paper thumbnail of The Dubai Community Psychiatric Survey: II. Development of the Socio-cultural Change Questionnaire

Soc Psychiat Psychiat Epidem, 1993

The Dubai Community Psychiatric Survey was carried out to assess the effect of very rapid social ... more The Dubai Community Psychiatric Survey was carried out to assess the effect of very rapid social change on the mental health of women in Dubai, one of the United Arab Emirates. In order to measure social change at an individual level, we developed a questionnaire covering behaviour and attitudes in a wide range of situations, the Socio-cultural Change Questionnaire (ScCQ). In this paper we give an account of the considerations that determined the form of the ScCQ, its structural characteristics, and its validity.

Research paper thumbnail of The convergence between different definitions of functional psychoses

Nord J Psychiatr, 1997

... functional psychoses TEWFIK K. DARADKEH, EMAD HAMDI. YOUSREYA AMIN,MOHAMMED T. ABOU-SALEH. RA... more ... functional psychoses TEWFIK K. DARADKEH, EMAD HAMDI. YOUSREYA AMIN,MOHAMMED T. ABOU-SALEH. RAFIA GHUBASH ... Dahl (39) investigated the relationship of the DSM-111 categories to the national diag-nostic use of ICD. ...

Research paper thumbnail of P02.351 Al Ain community survey of psychiatric morbidity III: The natural history of psychopathology and the utilization rate of psychiatric services in Al Ain

Research paper thumbnail of Al Ain Community Survey of Psychiatric Morbidity III. The natural history of psychopathology and the utilization rate of psychiatric services in Al Ain

Social Psychiatry and Psychiatric Epidemiology, 2000

We evaluated the natural history of psychopathology in a stratified sample (n = 245) comprising s... more We evaluated the natural history of psychopathology in a stratified sample (n = 245) comprising subjects with no DSM-III-R psychiatric disorder, subthreshold disorder and threshold (DSM-III-R) psychiatric disorder, respectively, over a 12-months period, using the Structured Clinical Interview for DSM-III-R mental disorders (SCID) as an assessment tool. A representative sample categorized 1 year earlier into DSM-III-R psychiatric disorder, subthreshold disorder and no DSM-III-R psychiatric disorder were reassessed with SCID 1 year on. The incidence, recovery rates and the percentage of subthreshold disorders which become DSM-III-R disorders were calculated. The utilization rate of psychiatric services was also assessed. The incidence rate of new cases was 10.4%. The recovery (remission) rate was 41.5%, and approximately 20% of subthreshold disorders became definitive disorders (DSM-III-R) after 1 year. Anxiety disorders tend to have a higher magnitude of temporal stability in comparison with depressive disorders. Male sex and contact with psychiatric services were found to affect the recovery rate. Approximately 13% of the sample had made contact with psychiatric services with no gender differences, but men were significantly more often hospitalized than women. Our findings indicate that mental disorders are relatively common. The high incidence rate found in this study is attributed in part to the high negative rate at baseline assessment. Approximately 60% of psychiatric disorders in the community are persistent, and patients with emotional disorder under-utilize existing services.

Research paper thumbnail of Behavioural Problems in School Children in the United Arab Emirates: Cross-Informant Variance

Research paper thumbnail of Postpartum Psychiatric Admissions in Al Ain

Research paper thumbnail of The Dubai Community Psychiatric Survey .2. Development of the Sociocultural Change Questionnaire

Soc Psych Psych Epid 28 60 65, Apr 1, 1993

Research paper thumbnail of Ethics in Psychiatry

Journal of the Bahrain Medical Society, May 5, 2013

Research paper thumbnail of Al Ain community survey of psychiatric morbidity II. Sex differences in the prevalence of depressive disorders

Journal of Affective Disorders, Nov 30, 2002

Research paper thumbnail of The validity of the Arabic Edinburgh Postnatal Depression Scale

Social psychiatry and psychiatric epidemiology, 1997

For the purpose of this study, a consecutive sample of 95 postpartum women were assessed at 1 wee... more For the purpose of this study, a consecutive sample of 95 postpartum women were assessed at 1 week postpartum with the (EPDS) and at 8 +/- 2 weeks postpartum using the Present State Examination (PSE). A moderate correlation between PSE total score and EPDS score was found (r = 0.57). A moderate agreement between EPDS and Catego diagnosis of depression was also found (Kappa = 0.52). Using a cut-off score of 12 on EPDS and Catego diagnosis as a criterion variable, the sensitivity and specificity of the scale were 73% and 90%, respectively. However, using a cut-off score of 10, the sensitivity of the scale rose to 91% without much fall in its specificity (84%). The internal reliability of the scale was 0.84 (alpha Cronbach). We conclude that the Arabic version of the EPDS is a reliable and valid screening tool for depression in postpartum women.

Research paper thumbnail of The rationale, development and reliability of a new screening psychiatric instrument

Social Psychiatry and Psychiatric Epidemiology, 1999

This paper describes the rationale, development, reliability and validity of a new screening psyc... more This paper describes the rationale, development, reliability and validity of a new screening psychiatric instrument. The instrument comprises 26 items that tap the cardinal features of main psychiatric categories as defined by ICD-10 and DSM-IV. These items were adapted from various structured and semi-structured diagnostic interviews that yield ICD-10 and DSM-IV psychiatric diagnoses. After a training course, 12 trainees and the trainer rated blindly the 26 items on 45 subjects (22 with psychopathology and 23 without). Inter-rater reliability coefficient (Kappa) was estimated between trainees and the trainer on each item of the instrument. The total score on the new instrument was then correlated with the total score on the Arabic Self Reporting Questionnaire (SRQ-20) and the Arabic version of the General Health Questionnaire (GHQ) in a random sample from the general population (n = 365). Logistic regression was utilised to estimate the power of the total score on the new instrument in discriminating between cases and non-cases as classified by the SRQ-20. Excellent levels of agreement (Kappa > 0.80) were found for all items except for obsession (Kappa = 0.65) and for depressed mood (Kappa = 0.70). Moderate correlations were found between the total score on the new instrument and total score on SRQ-20 (r = 0.69) and the total score on the Arabic GHQ (r = 0.7). The new instrument correctly classified 89% of subjects into cases and non-cases. The results of this study indicate that the new instrument is a highly reliable and valid screening instrument. The authors are now investigating its test-retest reliability and its procedural validity.

Research paper thumbnail of The Dubai Community Psychiatric Survey: acculturation and the prevalence of psychiatric disorder

Psychological Medicine, 1994

SynopsisDubai, an Emirate in the Gulf region, has experienced spectacular social change as a resu... more SynopsisDubai, an Emirate in the Gulf region, has experienced spectacular social change as a result of the exploitation of its oil reserves. The Dubai Community Psychiatric Survey was designed to study the effects of this social change on the mental health of female nationals.In this paper, we approach the problem by quantifying social change in two main ways: the first focused on social change at the individual level as measured by the Socio-cultural Change Questionnaire (Bebbington et al. 1993). The second examined the effect of social change at the community level by identifying areas of residence at different levels of development. We hypothesized that attitudes and behaviours markedly at odds with traditional prescriptions would be associated with high rates of psychiatric morbidity.On the individual level, the association between psychiatric morbidity and the amount of social change reflected in the behaviours and views of the subjects was not significant. However, there was a...

Research paper thumbnail of P02.250 Factors predicting depression among male and female in an Arab community

European Psychiatry, 2000

Research paper thumbnail of Post-partum psychiatric morbidity

European Psychiatry, 1996

Research paper thumbnail of A comparison of the validity of two psychiatric screening questionnaires: the Arabic General Health Questionnaire (AGHQ) and Self-Reporting Questionnaire (SRQ-20) in UAE, using Receiver Operating Characteristic (ROC) analysis

European Psychiatry, 2001

The aim of this study is to investigate the clinical features and frequency and importance of rel... more The aim of this study is to investigate the clinical features and frequency and importance of related co-morbid disorders of social phobia in a clinical sample. Eighty-seven patients meeting DSM-III-R diagnostic criteria for social phobia were studied. All patients were assessed by using a semi-structured socio-demographic form, the Structured Clinical Interview for DSM-III-R, Manual for the Structured Clinical Interview for DSM-III-R Personality Disorders, Liebowitz Social Anxiety Scale, Hamilton Rating Scale for Depression and Hamilton Rating Scale for Anxiety. Sixty-eight (78.2%) of the group were male, 19 (21.8%) were female. The ages varied between 16–58 years, with a mean of 26.2 years (SD = 8.5). Fifty-one point seven percent of the subjects were assessed as having a co-morbid axis I disorder, of which 12.6% consisted of panic disorder and 10.3% agoraphobia. An additional axis II disorder had been found in 67.8% of the subjects, and 54.0% of them had been diagnosed as having ...

Research paper thumbnail of Personality profile among primary care patients: experimenting with the Arabic IPDE ICD-10

Acta Psychiatrica Scandinavica, 2002

To estimate the prevalence of personality disorder (PD) among primary health care (PHC) patients,... more To estimate the prevalence of personality disorder (PD) among primary health care (PHC) patients, and to investigate the characteristic features of the International Personality Disorder Examination, the ICD-10 module (IPDE ICD-10). A sample (n = 158) PHC patients in Al Ain, United Arab Emirates (UAE) were interviewed by general practitioners (GPs) using the Arabic version of the IPDE ICD-10. Patients interviewed were 82 males and 76 females. Definite PD was identified in 12.7%. Prevalence rates among males and females were 9.8 and 15.8% consecutively. Commonest personality disorders were the schizoid (5.1%), anankastic (4.4%) and the emotionally unstable, borderline type (3.8%). Comorbidity of PD was manifested by 30% of definite PD patients. The mean dimensional scores of definite and probable PD patients were 5.6 and 4.3 consecutively. The IPDE-ICD-10 is useful but relatively time consuming with repetition and need of rephrasing in some items. Dimensional measurement proved essential.

Research paper thumbnail of The prevalence of early postpartum psychiatric morbidity in Dubai: a transcultural perspective

Acta Psychiatrica Scandinavica, 1997

Research paper thumbnail of Prevalence and psychosocial correlates of global developmental delay in 3-year-old children in the United Arab Emirates

Research paper thumbnail of The Dubai Community Psychiatric Survey IV. Life events, chronic difficulties and psychiatric morbidi

Soc Psychiat Psychiat Epidem, 1998

The relationship between life events, chronic social difficulties and psychiatric morbidity was i... more The relationship between life events, chronic social difficulties and psychiatric morbidity was investigated in 297 women selected at random as part of the Dubai Community Psychiatric Survey. The PSE-ID-CATEGO system was used to identify psychiatric cases, based on an Index of Definition level of 5 or more. Life events in the 6-month period prior to illness or interview were elicited through the Life Events and Difficulties Schedule. Chronic difficulties were explored through direct questioning based on a list of possible problems. The study demonstrates a significant excess of marked and moderately threatening life events in acute cases of psychiatric disorder (50%) compared to chronic cases (16.7%) and non-cases (27.9%). The association was particularly marked for events in the 3-month period before the onset. Around 33% of psychiatric morbidity may be attributed to marked and moderately threatening life events. Rates for mild events were similar in the three groups of subjects. Subjects experiencing chronic social difficulties included a significantly higher proportion of cases (33.3%) than those who did not experience such difficulties (9.1%). The effect of chronic social difficulties was more pronounced than, and independent of, the effects of life events. There were no interactions between life events and vulnerability factors in their effect on psychiatric morbidity, although numbers were small. The results suggest that the overall influence of life events and chronic difficulties on psychiatric morbidity is commensurate with that in Western societies, despite the different coping traditions of Islam.

Research paper thumbnail of Al Ain Community Psychiatric Survey. I. Prevalence and socio-demographic correlates

Soc Psychiat Psychiat Epidem, 2001

... Mood disorders and anxiety (neurotic) disorders were more common in women and alcohol and sub... more ... Mood disorders and anxiety (neurotic) disorders were more common in women and alcohol and substance use disorders were exclusively confined to men. ... MT Abou-Saleh Department of Addictive Behaviour & Psychological Medicine, St. ...

Research paper thumbnail of The Dubai Community Psychiatric Survey: II. Development of the Socio-cultural Change Questionnaire

Soc Psychiat Psychiat Epidem, 1993

The Dubai Community Psychiatric Survey was carried out to assess the effect of very rapid social ... more The Dubai Community Psychiatric Survey was carried out to assess the effect of very rapid social change on the mental health of women in Dubai, one of the United Arab Emirates. In order to measure social change at an individual level, we developed a questionnaire covering behaviour and attitudes in a wide range of situations, the Socio-cultural Change Questionnaire (ScCQ). In this paper we give an account of the considerations that determined the form of the ScCQ, its structural characteristics, and its validity.

Research paper thumbnail of The convergence between different definitions of functional psychoses

Nord J Psychiatr, 1997

... functional psychoses TEWFIK K. DARADKEH, EMAD HAMDI. YOUSREYA AMIN,MOHAMMED T. ABOU-SALEH. RA... more ... functional psychoses TEWFIK K. DARADKEH, EMAD HAMDI. YOUSREYA AMIN,MOHAMMED T. ABOU-SALEH. RAFIA GHUBASH ... Dahl (39) investigated the relationship of the DSM-111 categories to the national diag-nostic use of ICD. ...

Research paper thumbnail of P02.351 Al Ain community survey of psychiatric morbidity III: The natural history of psychopathology and the utilization rate of psychiatric services in Al Ain