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Objective: To study the effect of a culturally adapted, structured family intervention on symptom severity, medication attitudes and knowledge, social functioning and quality of life in patients with schizophrenia. Methods: Thirty subjects with schizophrenia were selected to receive 14 sessions of a culturally adapted behavioural family psychoeducational programme (BFPEP). Another 30 subjects received standard treatment as usual (STU) for 6 months. Pre- and post-intervention outcomes were assessed using the Positive and Negative Syndrome Scale (PANSS), Drug Attitude Inventory 10-item scale (DAI-10), Quality of Life Scale (QLS) and Social Functioning Questionnaire (SFQ). Results: There was a no significant difference between BFPEP and STU at baseline on all measures. There was a significant difference (p<.05) between pre- and post-treatment scores for BFPEP on all measures, a significant difference (p<.05) between pre- and post-treatment scores for STU on all measures (favouring pre-treatment scores) and a significant difference (p<.05) favouring BFPEP over STU on all measures post-treatment. Conclusions: These results demonstrate the feasibility and effectiveness of implementing family therapy psychoeducational interventions in different cultural settings, with relatively minor modifications. This may have implications for mental health policy makers to make available such programmes for patients and mental health professionals. [ABSTRACT FROM AUTHOR]

Background: The four-dimensional symptom questionnaire (4DSQ) is a Dutch self-administered screening tool that has been developed in primary care to differentiate non pathologic general distress from depression, anxiety and somatization. It has been validated in the English language as well as other languages yet it has not been validated in Arabic. For the sake of developing the appropriate Arabic version, linguistic validation has been sought with the guidance of cross cultural adaptation guidelines. Objective: To design the appropriate Arabic version of the 4DSQ that has linguistic and conceptual equivalence to its validated English version and that is appropriate for administration to Egyptian primary care attendees. Methods: The validated English version of the 4DSQ was translated by 5 translators (including specialist psychiatrist, internists and English language specialist) into Arabic (Egyptian spoken dialect) without mutual consultation. An expert committee that consisted of 2 professors of public health and family medicine and an associate professor of neuropsychiatry was formed. The consensus version was created after expert committee modification and approval of each questionnaire item using DELPHI method. After that the back translation to English was carried out by two independent bilingual physicians whose English is their mother tongue. A pilot study was carried out on 17 bilingual participants after answering the questionnaire in both languages to test its equivalence. The consensus Arabic version was updated based on the pilot study and the final version was developed. The final version was then tested on 278 Egyptian primary care attendees. Results: After the course of forward and back translation, expert committee’s review and developer’s comments, the final version of Arabic 4DSQ was developed for assessment of distress, depression, anxiety and somatization. There was no significant difference between results of Arabic and English questionnaire using paired T test. Final testing showed very good internal consistency of each of the 4 scales of the questionnaire. Conclusion: The Arabic 4DSQ linguistically and conceptually corresponds to the validated English 4DSQ. It has good structural validity and internal consistency reliability and thus could be used in primary care after further psychometric validation. [ABSTRACT FROM AUTHOR]

Background: Illness anxiety disorder is a condition of having a persistent fear of having a serious or life-threatening illness despite few or no symptoms. Current classification systems assume that illness anxiety is experienced relative to one's own health, and not towards others ("by proxy"), yet it has been observed to occur in parents towards their children. This study was designed to survey doctors about how commonly they encounter illness anxiety by proxy (IAP)., Methods: We conducted a qualitative survey of 149 physicians who work with children (pediatricians, psychiatrists, and general practitioners) from the United Arab Emirates (UAE) and Egypt. The survey was administered via email and a paper-based form. In the UAE, 108 physicians were emailed the survey; 55 (50.1%) responded. For the email survey we used items from the Checklist for Reporting Results of Internet E-Surveys (CHERRIES). An additional 100 physicians were surveyed in person; 94 (94%) responded., Results: Nearly all respondents (98.7%) reported having encountered IAP in parents. Of these, 51 (34.2%) reported frequently encountering these types of health anxieties, and 50 (33.6%) reported that the parents' concern that their child had a serious disease persisted despite reassurance and appropriate medical evaluation. Seventy-eight (52.3%) respondents reported that exaggeration of actual existing symptoms was the most common reason for parents' fears; 72 (48.3%) reported that the concerned parent was more likely to be the mother; and 36 (24.2%) reported that most parents were not 100% certain of their own beliefs., Conclusions: IAP is frequently encountered by pediatricians, psychiatrists, and general practitioners. Practitioners who work with children and their parents need to be aware of this phenomenon to provide appropriate support and treatment. More research is needed to screen for the extent and severity of this phenomenon.