Biomedical subjects

V Eapen

Publications and source records attributed to V Eapen.

At least 19 recordsLinked to original sources

PubMed2005

Familial predictors of childhood shyness: a study of the United Arab Emirates population.

OBJECTIVES: Phobic anxiety disorders generally breed true. In this regard, family studies have suggested an association between childhood shyness and maternal social phobia. In this study, the relationship between childhood shyness and maternal social anxiety was examined. SUBJECTS AND METHODS: 203 5-year-old children from an Arabian Gulf community and their mothers were evaluated. The children were assessed in stage 1 using the shyness scale of Stevenson-Hinde and Glover and the Preschool Behavior Checklist (PBCL), while mothers completed the Liebowitz Social Anxiety Scale. In the second stage, blind clinical interviews were carried out to ascertain the diagnosis of psychiatric diagnoses, if any, using DSM-IV criteria. RESULTS: 27% of the children were identified as shy using the shyness scale of Stevenson-Hinde and Glover and 19% scored above the cutoff for behavioral disturbance on the PBCL. Child shyness was associated with female gender and maternal social anxiety as indicated by scores on the Liebowitz Social Anxiety Scale, while an inverse relationship was noted with behavioral disturbance. The odds of the child having a high shyness score was increased if the mother had social anxiety (odds ratio = 2.14) and the child lived in a family that was 'not socially active' (odds ratio = 1.42). CONCLUSION: Our initial findings suggest that there may be a complex interaction between maternal social anxiety and family sociability in childhood shyness. Prospective longitudinal work is indicated.

Adult↗

PubMed2005

Correlation between hypertension and income distribution among United Arab Emirates population.

To determine the correlation between hypertension and income distribution among United Arab Emirates (UAE) population. Case-control study matched for age, sex, nationality and education. The survey included 500 hypertensive adults aged 20-65 years ascertained from Primay Health Care (PHC) Clinics along with a randomly selected sample of 500 control subjects from the community. Face-to-face interviews were done where data were gathered on socio-demographic-economic status (SES) and lifestyle habits. Hypertension was defined according to WHO criteria as having Systolic Blood Pressure (SBP) > or = 140 mm Hg and/or Diastolic Blood Pressure (DBP) > or = 90 mm Hg and/or being on antihypertensive treatment. The survey was carried out in urban and semi-urban PHC Clinics. A total of 818 subjects were included in this study from a sample of 1000; 409 cases and 409 controls. There were 422 males and 396 females in this study, with 255 UAE nationals and 438 expatriates. Hypertension was found to be significantly higher among the low income group (35.2% vs. 24.9% controls, p = 0.002; while mean SBP in the low income group was 130.2 +/- 17.6 vs. 128.0 +/- 17.4 controls, p = 0.022). Among males, smoking and alcohol consumption were higher among the group with low income level but only smoking showed significant difference (p value = 0.016). Activity level was higher among the low income groups. This study supports the importance of socio-economic factors as an income distribution effect on life-style habits and hypertension.

Adult↗

PubMed2004

Clinical features and associated psychopathology in a Tourette syndrome cohort.

OBJECTIVE: This study explored in detail the association between tic symptomatology, related clinical variables, and psychopathology in 91 consecutive adult TS subjects from a UK clinic. METHODS: Consecutive patients from a specialized Tourette clinic who met the DSM-III criteria for TS were evaluated using standardized rating scales for Tourette syndrome and other psychopathology. RESULTS: The male female ratio in our cohort was 1.8:1. Significantly more males had an earlier age at onset of TS and history of birth complications. Obsessive compulsive behaviors in the patient was positively correlated with presence of attention deficit hyperactivity disorder and self-injurious behaviors. With regard to adult psychopathology, principal components factor analysis yielded two factors, 'obsessionality' and 'anxiety/depression', which accounted for 72% of the variance. CONCLUSION: Our results support the high occurrence of anxiety, depression and obsessionality in adult TS subjects.

Adolescent↗

PubMed2004

Screening for language delay in the United Arab Emirates.

BACKGROUND: Developmental language delay (DLD) is frequent among two- and three-year-olds but little is known about this condition in the Arabian Peninsula. This paper forms part of a multipurpose community psychiatric survey conducted in the United Arab Emirates (UAE). The findings regarding the prevalence and psychosocial correlates of DLD are reported here. METHODS: A total of 694 children, representative of the UAE 3-year-old population were screened using the Denver Developmental Screening Test (DDST) and the language screening procedure as used by Westerlund and Sundelin. RESULTS: Of the 694 children screened for DLD at 3 years of age, 69 children (9.9%; CI 7.8-12.4) were found to have delays in the language sector of DDST. A total of 45 (6.5%; CI 4.3-8.7) were identified as having general language disability, both in comprehension and expression as per the language screening procedure. Language delay was found to be associated with rural living, mother being from a different nationality, non-involvement of domestic help in child care, family history of language delay, obstetric and perinatal problems and presence of behavioural problems in the child. Using stepwise multiple logistic regression analysis, two factors emerged as important with regard to general language delay, which were previous non-UAE nationality of the mother and total monthly income of the family. CONCLUSION: The pattern and correlates of DLD found in this survey are in line with those reported by other surveys, but some unique socio-cultural risk factors specific to this community were identified. The implications of these findings to screening and referral for further evaluation and intervention are discussed.

Child Behavior Disorders↗

PubMed2003

Psychosocial correlates of paediatric cancer in the United Arab Emirates.

To study the psychosocial factors and illness variables associated with children's and parents' perceptions of and ways of coping with cancer, in 38 childhood cancer patients aged 5-15 years, coping was studied in relation to sociodemographic variables and self-perception in terms of competence, behaviour and self-worth. Less optimal coping was found to be associated with poor family communications and lack of sharing/expression of emotions ( P=0.005), presence of behavioural and emotional problems in the child ( P=0.008) and parental lack of hope ( P=0.001). No association was found with gender, parental education or occupation, socioeconomic status, or child's self-perception including global estimation of self-worth. Furthermore, none of the illness variables was found to be associated with coping. Awareness about health-related issues was found to be strongly associated with parental education ( P=0.000). Our findings suggest that parental hope and both social and family communication are integral to helping patients and families cope with the illness experience.

Adaptation, Psychological↗

PubMed2003

Epilepsy in children with cerebral palsy.

OBJECTIVES: To study the occurrence, associated factors, nature and prognosis of seizures in children with cerebral palsy (CP). DESIGN: A prospective, descriptive, hospital-based, case-control study. SETTING: Tertiary level University Teaching Hospitals in the Al Ain Medical District, United Arab Emirates. PATIENTS: Fifty-six children with CP and seizures seen in the neurodevelopmental clinics at Al Ain and Tawam University Hospitals during the period of 1997-1999 were studied (group 1). Two control groups of 35 children with CP without seizures (group 2) and 50 children with seizures but no CP (group 3) were also studied. RESULTS: Spastic tetraplegia was the commonest type of CP associated with seizures whereas spastic diplegia was the commonest variety of CP in group 2. Most children with CP had an early onset of seizures within the first year of life as against those without CP. The children in group 1 had a higher incidence of neonatal seizures (42.9% vs. 29.4% in group 2 and 0% in group 3), presence of significant developmental delay (98.2% vs. 20.0% in group 3), occurrence of significant abnormalities on brain imaging (94.6% vs. 19.6% in group 3) and a need for use of more than 1 antiepileptic drug (66.1% vs. 30.0% in group 3). Over half of children in the study group presented with generalized tonic clonic seizures; the electroencephalogram (EEG) showed focal epileptic discharges with or without secondary generalization in 39.3%. The overall outcome of seizures in children with CP was poor needing prolonged course of anticonvulsant medications, polytherapy and higher incidence of refractory seizures and admissions for status epilepticus compared to the control group. CONCLUSIONS: Cerebral palsy is associated with a higher incidence of seizure disorders, which, in a majority, has its onset in the neonatal period; brain imaging showed abnormal pathology in most affected children, which possibly accounts for the tendency to more refractory seizures in these children.

Adolescent↗

PubMed2001

Prevalence of tics and Tourette syndrome in an inpatient adult psychiatry setting.

OBJECTIVE: Given the widely recognized genetic basis for Gilles de la Tourette syndrome (TS) and the suggestion that the putative TS gene(s) may be expressed as or associated with a variety of psychiatric illnesses, this study was undertaken to assess the prevalence of tics and TS in a psychiatric inpatient population. DESIGN: Cross-sectional study. SETTING AND PATIENTS: 200 consecutive adult patients who were admitted to the psychiatric wards of University College London Teaching Hospitals. OUTCOME MEASURES: TS and related behaviours, as assessed by the comprehensive semi-structured National Hospital Interview Schedule. RESULTS: None of the 200 patients had definite TS, but 2 were observed to have motor tics; 10 had a history of tics (present for less than a year), and 7 reported a family history of tics. Thus, 19 (9.5%) inpatients qualified for inclusion in a broadly defined TS diathesis. These rates are significantly lower than those reported in a similar community based epidemiological study of adolescents (p = 0.018). CONCLUSIONS: Our findings do not support the theory that TS and related behaviours are over-represented among adult inpatients with psychiatric illnesses.

Adolescent↗

PubMed2001

Prevalence and correlates of childhood fears in Al-Ain, United Arab Emirates.

The prevalence of fear was explored in 340 adolescents in Al-Ain, United Arab Emirates. More than 50% reported feeling extremely frightened of 6 out of 60 fear items surveyed. These items were: someone dying in the family (66.5%), parents getting divorced (65.3%), the devil (63.8%), breaking a religious law (61.5%), being kidnapped (53.2%) and being adopted (49.9%). The level of fear showed a significant positive correlation with female gender, parental death/divorce, living with a single parent/relatives, living in low income families and an adverse home environment. Nearly half of the children reported that the fear caused considerable distress and interfered with daily activities.

Activities of Daily Living↗

PubMed2001

Childhood behavioural disturbance in a community sample in Al-Ain, United Arab Emirates.

The prevalence of behavioural and emotional problems was evaluated among 620 United Arab Emirates nationals aged 6-18 years using the Rutter Parent Questionnaire. Of these children, 11.8% scores above the cut-off point indicating behavioural disturbance. The prevalence of conduct problems was greater among boys, while emotional problems were more common among girls. Certain unspecified chronic life difficulties, parental distress in relation to their children, family history of psychiatric illness and alcohol or drug use in a family member were associated with behavioural disturbance, but no significant association was found with gender, socioeconomic status, family size or recent life events. Our findings suggest that behavioural disturbance exists among a substantial number of school-aged children in the community.

Child↗

PubMed2000

A controlled study of psychiatric morbidity among developmentally disabled children in the United Arab Emirates.

A cross-sectional study of the prevalence of psychiatric problems among 26 children each with a learning disability (mental retardation) and specific speech disorder was conducted in an Arab population using the Rutter Behavioural Scale, and compared with a community sample of 100 control children matched for age. The prevalence of psychiatric problems, as identified by both the parents and the teachers was 35, 19 and 4 per cent respectively, in the learning disabled, speech impaired and control groups. Children with global disability or mental retardation showed significantly higher rates of psychiatric morbidity than those with specific speech disorder, both of which were significantly higher than that in the control group. Higher rates of psychiatric problems noted in the developmentally disabled children may be the result of specific socio-demographic and cultural factors in addition to neurodevelopmental factors and low IQ.

Age Distribution↗

PubMed1999

School mental health screening: a model for developing countries.

Using the experience derived from a screening programme of all school-going children in the Al Ain District, United Arab Emirates, this article reports on a cost-effective model that can be used in other developing countries. The need for training child health and school professionals in identifying mental and developmental disorders is discussed.

Child↗

PubMed1999

Self-perception profile in children with cancer: self vs parent report.

Self-perception about competence, behaviour, and self-worth were examined in 30 children (8 to 14 years) recently diagnosed as having cancer and were compared with that of their parents' perception. The poor agreement between parents' and children's ratings on physical appearance and social acceptance is noteworthy in that these two domains are particularly vulnerable in children with cancer, given the effect of chemotherapy on physical appearance and children's tendency to view themselves as socially undesirable or a burden to others. This finding, if replicated, can have implications for therapeutic intervention since the discrepancy score could be used to challenge children's negative views in the context of cognitive therapy to improve their self-esteem.

Adolescent↗

PubMed1998

Learning disorders in school-going children--detection and diagnosis.

A screening programme was carried out among school-going children in Al-Ain, United Arab Emirates (UAE), to identify children with learning disorders. During the course of one academic year, 34 such children were identified. The cause was considered preventable in around half of the cases. In a third of cases with a genetic cause, prevention was possible with existing knowledge and practice.

Child↗

PubMed1998

Mental health problems among schoolchildren in United Arab Emirates: prevalence and risk factors.

OBJECTIVE: To examine child psychiatric morbidity in an Arab culture. METHOD: Emotional and behavioral problems were investigated in 3,278 schoolchildren aged 6 to 15 years using a two-stage epidemiological study in Al Ain District, United Arab Emirates. Children were screened using standardized questionnaires completed by parents and school physicians in the first stage, and a stratified random sample were interviewed by a child psychiatrist in the second stage. RESULTS: 23.9% of children were reported to have a mental health problem by either the parent or the school health physician. Boys were more often reported to be having problems than girls (1.8:1). Using the Rutter A2 scale for parents, the prevalence estimate for behavioral disorders was 16.5%. The weighted prevalence for DSM-IV disorders was 10.4% for the entire population. The presence of certain culture-specific risk factors such as male gender, number of children in the household, polygamy, and low socioeconomic status were identified for psychiatric disorders. A positive family history and consanguinity were the most significant factors associated with learning disorders. CONCLUSIONS: The prevalence rates of child psychiatric disorders and the symptomatology observed in this Middle East community are similar to those reported in Western studies.

Adolescent↗

PubMed1998

The prevalence of Tourette syndrome in a mainstream school population.

The aim of this study was to ascertain accurately the prevalence of Tourette syndrome (TS) in a mainstream school population. All year 9 pupils (aged 13 to 14 years) in a mainstream secondary school were investigated using a two-stage procedure. Standardized questionnaires were completed by parents, teachers, and pupils. Class observations were also carried out to identify tics. Those pupils identified as having tics underwent a semistructured interview to determine whether they had TS according to DSM-III-R criteria. Data were available from at least one source (parent, teacher, or self-reports) on 166 of the 167 pupils in the year. Five subjects were identified as having TS according to DSM-III-R criteria, yielding a prevalence estimate of 299 per 10,000 pupils in this age group. The results of this study suggest that TS in the community as a whole is more common and milder than those prevalence estimates and descriptions of the disorder based on TS encountered in secondary or tertiary health-care service settings.

Adolescent↗

PubMed1997

Obsessive compulsive symptoms in Gilles de la Tourette syndrome and obsessive compulsive disorder: differences by diagnosis and family history.

The distribution of obsessive compulsive symptoms was compared in 16 individuals with primary obsessive compulsive disorder (OCD) and 16 individuals with Gilles de la Tourette syndrome (GTS) and associated obsessive compulsive behaviors (OCB). The two groups showed significant differences in the distribution of OC symptomatology. Furthermore, those OCD probands who shared a similar symptom profile with GTS individuals all had a positive family history of OCD. All of the other OCD probands were isolated cases. Implications of this finding on the etiology and pathogenesis of the two disorders are discussed.

Adolescent↗

PubMed1997

United Arab Emirates population data on three DNA tetrameric short tandem repeat loci: HUMTHO1, TPOX and CSF1PO--derived using multiplex polymerase chain reaction and manual typing.

Allele and genotype frequencies for three tetrameric short tandem repeat (STR) loci: HUMTHO1, TPOX, and CSFIPO, were determined in a United Arab Emirates (UAE) national population sample (n = 119). The loci were amplified simultaneously and the PCR products were separated in polyacrylamide DNA sequencing gels. Detection of the DNA fragments was accomplished using silver staining. Allele designations were determined by comparison to an allelic ladder. One allele at each locus was sequenced to confirm the nature of the repeats and their number. Alleles at the HUMTHO1 and TPOX loci were distributed bimodally, while CSF1PO showed unimodal distribution. The observed heterozygosities were 76% for HUMTHO1, 64% for TPOX, and 71% for CSF1PO. No deviation from the Hardy-Weinberg expectations was observed in the genotype distribution for the loci TPOX and CSF1PO, but the HUMTHO1 locus did depart from HWE based on the likelihood ratio and the exact test. No correlation was detected between the alleles at any of the three pairs of loci. The allelic frequency data of these three loci in the UAE population sample can thus be used in human identity testing.

DNA↗

PubMed1997

Gilles de la Tourette's syndrome in special education schools: a United Kingdom study.

In order to determine the prevalence of tic disorders in children with severe school problems requiring a residential facility and comparison groups of children in regular day schools, we performed direct clinical examinations for the presence of tics and Gilles de la Tourette's syndrome (GTS) in 20 children from a residential school for emotional and behavioral difficulties (EBD); 25 children from a residential school for learning disabilities; 17 "problem" children (PC) (identified by teachers as having academic or behaviour problems) and 19 normal children (NC) selected at random (using random numbers) from a regular school. Of the EBD students, 65% were judged to have definite tics as compared with 24% of students with learning difficulties (P < 0.05), 6% of PC (P < 0.003) and none of the NC (P < 0.0006) group. Most of the affected students met diagnostic criteria for GTS. Our findings suggest that GTS is commonly associated with the need for special education and that this association is particularly robust for children with severe school problems. In these children, the presence of tics may be an indicator of an underlying dysfunction of neurological development.

Adolescent↗