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Kanwal A, Sheikh SA, Iftikhar A, Naz S, Pardo JV. Preliminary studies on apparent mendelian psychotic disorders in consanguineous families. BMC Psychiatry 2022; 22:709. [PMID: 36384485 PMCID: PMC9667425 DOI: 10.1186/s12888-022-04304-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 06/23/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Psychiatric disorders are characterized by alteration in emotions, mood and behavior. Genetics is known to play a significant role in the development of psychiatric disorders. Genome-wide association studies have identified several loci associated with psychiatric illnesses. We hypothesize the existence of rare variants following Mendelian recessive mode of inheritance. These variants can be identified in families with multiple affected individuals born to unaffected consanguineous parents. METHODS We visited psychiatric outpatient departments of multiple hospitals in Lahore, Pakistan. We focused on psychosis, as it can occur in several DSM disorders such as schizophrenia, dementia and bipolar disorder. After clinical diagnosis by an American trained psychiatrist, detailed clinical assessments using Diagnostic Interview for Genetic Studies (DIGS), Diagnostic Interview for Psychosis and Affective Disorders (DI-PAD), Positive and Negative Syndrome Scale (PANSS), Hamilton Depression and Anxiety Rating Scale (HAM-D; HAM-A) were administered to all willing affected and unaffected participants. RESULTS We identified eight pedigrees with two or more psychotic individuals in each family. Clinical diagnoses determined by their psychiatrists included ten individuals with schizophrenia; four individuals with psychosis and bipolar disorder; and two patients with "unspecified psychosis." The rating instruments rigorously confirmed the diagnosis of psychosis in the affected patients from the six families as well as the absence of psychotic disorders in unaffected individuals from the six families. We obtained DNA samples from willing members of all eight families for future genetic analyses. CONCLUSION Our research highlights an alternative approach to discovery of rare recessively inherited genetic variants causing psychiatric disorders that have remained unidentified to date. These findings could illuminate underlying biological mechanisms leading toward development of targeted therapies in future.
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Affiliation(s)
- Ambreen Kanwal
- grid.11173.350000 0001 0670 519XSchool of Biological Sciences, University of the Punjab, Quaid-e-Azam campus, 54590 Lahore, Lahore Pakistan
| | | | - Amina Iftikhar
- Rainbow Obesity and Eating Disorders Centre, Lahore, Pakistan
| | - Sadaf Naz
- School of Biological Sciences, University of the Punjab, Quaid-e-Azam campus, 54590, Lahore, Lahore, Pakistan.
| | - José V. Pardo
- grid.17635.360000000419368657Department of Psychiatry, University of Minnesota, Minneapolis, MN USA ,grid.410394.b0000 0004 0419 8667Minneapolis Veterans Affairs Health Care System, Minneapolis, MN USA
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Al-Yateem N, Fakhry R, Saifan AR, Saqan R, Alrimawi I. Assessing sense of coherence as an element of primary-focused health services in schools for children and adolescents with complex health care needs. J Nurs Manag 2021; 30:582-591. [PMID: 34799949 DOI: 10.1111/jonm.13517] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 11/08/2021] [Accepted: 11/14/2021] [Indexed: 11/29/2022]
Abstract
AIM This study aimed to clarify if sense of coherence (SOC) could be used as an element of primary-focused health services in schools. BACKGROUND The United Arab Emirates (UAE) is striving to develop a high-quality, primary-focused health care system. School health care services are well established in the UAE but have not yet been fully used to play a key role in this development. METHODS This is a cross-sectional survey study to explore adolescents' SOC and their behavioural, psychosocial and clinical outcomes. RESULTS A total of 408 adolescents participated in this study. Compared with others, adolescents with higher SOC had better adherence to treatment, fewer visits to the school nurse, better self-efficacy, fewer hyperactivity problems, fewer emotional problems, more prosocial behaviours and fewer conduct problems. CONCLUSION Implementing interventions that improve SOC may support improved well-being among adolescents. The findings also support the use of SOC and salutogenesis as a framework to reinforce primary health care services for this population. IMPLICATIONS FOR NURSING MANAGEMENT Health service managers can utilize SOC as a framework to focus service on illness prevention and health promotion, they should collaborate with education authorities to include more health-related topics as part of school curricula to promote students' SOC and, finally, they should assess and build awareness of SOC and associated tools among school nurses and primary health care providers.
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Affiliation(s)
- Nabeel Al-Yateem
- Nursing Department, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.,School of Nursing, Midwifery and Indigenous Health, Charles Sturt University, Orange, New South Wales, Australia
| | - Randa Fakhry
- Nursing Department, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | | | - Roba Saqan
- Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Intima Alrimawi
- School of Nursing and Health Professions, Trinity Washington University, Washington, District of Columbia, USA
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Al-Yateem N, Subu MA, Al-Shujairi A, Alrimawi I, Ali HM, Hasan K, Dad NP, Brenner M. Coping among adolescents with long-term health conditions: a mixed-methods study. ACTA ACUST UNITED AC 2020; 29:762-769. [PMID: 32649257 DOI: 10.12968/bjon.2020.29.13.762] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Adolescents with long-term health conditions may be at risk of developing psychological comorbidities and adopting ineffective coping mechanisms if they are not adequately supported at home or school. AIM To understand the strategies adolescents use when dealing with challenging health situations, and gain an in-depth understanding of the characteristics of their preferred care environment if they have unexpected health crises. DESIGN The study used a concurrent mixed-methods design, with data gathered between January and May 2019. Descriptive and non-parametric tests were used to analyse quantitative and qualitative data. RESULTS 'Problem-focused disengagement' was the most-often used coping strategy. The second and third most common strategies were 'problem-focused engagement' and 'emotion-focused engagement'. Finally, girls tended to adopt more negative coping strategies than boys. The analysis revealed that most adolescents preferred home over school as the care environment because these caring agents were close and available, knew how to care for them and had the resources to provide or access care, and listened and understood them. CONCLUSION Adolescents adopted disengagement and negative coping strategies early in their attempts to cope with stressful events before adopting more positive strategies. This is alarming, especially as school health services are not sufficiently supportive of adolescents at times of stress and illness. Adolescents often perceive school providers as unavailable and lacking knowledge about their health needs.
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Affiliation(s)
- Nabeel Al-Yateem
- Associate Professor, Department of Nursing, University of Sharjah, United Arab Emirates (UAE), School of Nursing, Midwifery and Indigenous Health, Charles Sturt University, Australia, and Sharjah Institute for Medical and Health Research, University of Sharjah, UAE
| | - Muhammad Arsyad Subu
- Associate Professor, Department of Nursing, University of Sharjah, United Arab Emirates (UAE), School of Nursing, Midwifery and Indigenous Health, Charles Sturt University, Australia, and Sharjah Institute for Medical and Health Research, University of Sharjah, UAE
| | - Arwa Al-Shujairi
- Associate Professor, Department of Nursing, University of Sharjah, United Arab Emirates (UAE), School of Nursing, Midwifery and Indigenous Health, Charles Sturt University, Australia, and Sharjah Institute for Medical and Health Research, University of Sharjah, UAE
| | - Intima Alrimawi
- Associate Professor, Department of Nursing, University of Sharjah, United Arab Emirates (UAE), School of Nursing, Midwifery and Indigenous Health, Charles Sturt University, Australia, and Sharjah Institute for Medical and Health Research, University of Sharjah, UAE
| | - Hend Mohd Ali
- Associate Professor, Department of Nursing, University of Sharjah, United Arab Emirates (UAE), School of Nursing, Midwifery and Indigenous Health, Charles Sturt University, Australia, and Sharjah Institute for Medical and Health Research, University of Sharjah, UAE
| | - Khadija Hasan
- Associate Professor, Department of Nursing, University of Sharjah, United Arab Emirates (UAE), School of Nursing, Midwifery and Indigenous Health, Charles Sturt University, Australia, and Sharjah Institute for Medical and Health Research, University of Sharjah, UAE
| | - Nawal Peer Dad
- Associate Professor, Department of Nursing, University of Sharjah, United Arab Emirates (UAE), School of Nursing, Midwifery and Indigenous Health, Charles Sturt University, Australia, and Sharjah Institute for Medical and Health Research, University of Sharjah, UAE
| | - Maria Brenner
- Associate Professor, Department of Nursing, University of Sharjah, United Arab Emirates (UAE), School of Nursing, Midwifery and Indigenous Health, Charles Sturt University, Australia, and Sharjah Institute for Medical and Health Research, University of Sharjah, UAE
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Al-Yateem N, Rossiter RC, Robb WF, Slewa-Younan S. Mental health literacy of school nurses in the United Arab Emirates. Int J Ment Health Syst 2018; 12:6. [PMID: 29387149 PMCID: PMC5778639 DOI: 10.1186/s13033-018-0184-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 01/15/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To support promotion, prevention and early intervention for mental illness school nurses need to be mental health literate. METHODS Three hundred and thirty-nine school nurses employed in government and private schools from three Emirates in the UAE were surveyed. A culturally adapted Mental Health Literacy questionnaire comprising three vignettes of fictional characters meeting diagnostic criteria for the target conditions along with the Kessler Psychological Distress Scale (K10) was administered to ascertain school nurses' ability to correctly identify the conditions and to elicit beliefs about helpfulness of treatment interventions and of health care providers for these conditions. RESULTS Less than 50% of the respondents correctly identified the disorders presented, while accurate identification of evidence-based interventions was also limited. Correlations between level of psychological distress and level of inaccurate survey responses was also revealed, respondents who correctly identified the correct diagnosis of the vignette and the most appropriate interventions were those who had a significantly lower K10 score. CONCLUSIONS Low levels of mental health literacy amongst respondents in combination with potential religious and cultural factors as reported in the literature, highlight the need for curriculum enhancements for future health professionals and a targeted program of culturally appropriate professional development focused on mental health promotion for those in clinical practice. The level of psychological distress noted in this cohort also signals a need to ensure that appropriate supports are available for clinical staff employed in schools.
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Affiliation(s)
- Nabeel Al-Yateem
- College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Research Institute for Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
- School of Nursing, Midwifery and Indigenous Health, Charles Sturt University, Orange, Australia
| | | | | | - Shameran Slewa-Younan
- Mental Health, School of Medicine, Translational Health Research Institute, Western Sydney University, Sydney, Australia
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
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Bustamante ML, Herrera L, Gaspar PA, Nieto R, Maturana A, Villar MJ, Salinas V, Silva H. Shifting the focus toward rare variants in schizophrenia to close the gap from genotype to phenotype. Am J Med Genet B Neuropsychiatr Genet 2017; 174:663-670. [PMID: 28901686 DOI: 10.1002/ajmg.b.32550] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 04/25/2017] [Indexed: 01/16/2023]
Abstract
Schizophrenia (SZ) is a disorder with a high heritability and a complex architecture. Several dozen genetic variants have been identified as risk factors through genome-wide association studies including large population-based samples. However, the bulk of the risk cannot be accounted for by the genes associated to date. Rare mutations have been historically seen as relevant only for some infrequent, Mendelian forms of psychosis. Recent findings, however, show that the subset of patients that present a mutation with major effect is larger than expected. We discuss some of the molecular findings of these studies. SZ is clinically and genetically heterogeneous. To identify the genetic variation underlying the disorder, research should be focused on features that are more likely a product of genetic heterogeneity. Based on the phenotypical correlations with rare variants, cognition emerges as a relevant domain to study. Cognitive disturbances could be useful in selecting cases that have a higher probability of carrying deleterious mutations, as well as on the correct ascertainment of sporadic cases for the identification of de novo variants.
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Affiliation(s)
- M Leonor Bustamante
- Faculty of Medicine, Program of Human Genetics, Biomedical Sciences Institute, Universidad de Chile, Santiago de Chile, Chile.,Clínica Psiquiátrica Universitaria, Universidad de Chile, Santiago de Chile, Chile
| | - Luisa Herrera
- Faculty of Medicine, Program of Human Genetics, Biomedical Sciences Institute, Universidad de Chile, Santiago de Chile, Chile
| | - Pablo A Gaspar
- Clínica Psiquiátrica Universitaria, Universidad de Chile, Santiago de Chile, Chile.,Faculty of Medicine, Department of Neurosciences, Universidad de Chile, Santiago de Chile, Chile.,Biomedical Neurosciences Institute, Universidad de Chile, Santiago de Chile, Chile
| | - Rodrigo Nieto
- Clínica Psiquiátrica Universitaria, Universidad de Chile, Santiago de Chile, Chile.,Faculty of Medicine, Department of Neurosciences, Universidad de Chile, Santiago de Chile, Chile
| | - Alejandro Maturana
- Clínica Psiquiátrica Universitaria, Universidad de Chile, Santiago de Chile, Chile
| | - María José Villar
- Clínica Psiquiátrica Universitaria, Universidad de Chile, Santiago de Chile, Chile
| | - Valeria Salinas
- Faculty of Medicine, Program of Human Genetics, Biomedical Sciences Institute, Universidad de Chile, Santiago de Chile, Chile
| | - Hernán Silva
- Clínica Psiquiátrica Universitaria, Universidad de Chile, Santiago de Chile, Chile.,Faculty of Medicine, Department of Neurosciences, Universidad de Chile, Santiago de Chile, Chile.,Biomedical Neurosciences Institute, Universidad de Chile, Santiago de Chile, Chile
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Teixeira AL, Salem H, Frey BN, Barbosa IG, Machado-Vieira R. Update on bipolar disorder biomarker candidates. Expert Rev Mol Diagn 2016; 16:1209-1220. [PMID: 27737600 DOI: 10.1080/14737159.2016.1248413] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Bipolar disorder is a chronic and disabling mood disorder with a complex pathophysiological basis. A significant percentage of patients do not receive correct diagnosis which directly influences therapeutic response, rendering recovery troublesome. There is a long-standing need for proper non-clinically based tools for diagnosis, treatment selection and follow-up of such patients. Areas covered: In the past decade, the scientific community has shown a great interest in biomarker development. Here, we highlight the different potential biomarkers and we discuss their feasibility and their possible clinical relevance. Expert commentary: To date, despite the major ongoing trials and consortia with promising future perspectives, no reliable biomarker of bipolar disorder has been fully defined.
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Affiliation(s)
- Antonio L Teixeira
- a Department of Psychiatry and Behavioral Sciences, McGovern Medical School , The University of Texas Health Science Center at Houston , Houston , TX , USA
| | - Haitham Salem
- a Department of Psychiatry and Behavioral Sciences, McGovern Medical School , The University of Texas Health Science Center at Houston , Houston , TX , USA
| | - Benicio N Frey
- b Department of Psychiatry and Behavioural Neurosciences , McMaster University , Hamilton , ON , Canada.,c Mood Disorders Program and Women's Health Concerns Clinic , St. Joseph's Healthcare Hamilton , ON , Canada
| | - Izabela G Barbosa
- d Interdisciplinary Laboratory of Medical Investigation, School of Medicine , Federal University of Minas Gerais , Belo Horizonte , MG , Brazil
| | - Rodrigo Machado-Vieira
- e Experimental Therapeutics and Pathophysiology Branch, Intramural Research Program , National Institute of Mental Health , Bethesda , MD , USA
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