Outpatient Health Clinic Research Articles

Changes in sick leave one year before and after starting treatment: a naturalistic study of employed outpatients with common mental health disorders

Background This study explores sick leave changes 1-year pre- and post-treatment start for common mental health issues and their associations with self-reported symptoms, functioning, and health changes. Methods Ninety-five employed patients, without previous disability benefits, underwent treatment at a public mental health outpatient clinic. Sick leave data was obtained from the Norwegian Labour and Welfare Administration. Symptoms, work/social functioning, and health quality were self-reported at treatment onset and completion. Results Twelve months before starting treatment, only 6.3% were on sick leave, contrasting with 69.5% at treatment start. At post-treatment, 25% received work assessment allowance (WAA), 63% were off sick leave, and 12% were on sick leave. Sick leave days exhibited an inverted U-shape for non-WAA recipients. Those on sick leave post-treatment reported less improvement in symptoms and health, while the WAA group showed diminished work functioning enhancement. Discussion Evaluating the effect mental health treatment has on sick leave is clearly affected by the timing of assessments. Treatment seems associated with improved sick leave outcomes compared with status at treatment start, but less so when compared with status one year before starting treatment. Also, a large group of patients went on to receive WAA, constituting a group in need of further longitudinal evaluations and interventions.

Feasibility and Acceptability Findings From a Pilot Study of the Adapted Ziba Ufa Intervention for Late Life Depression and Chronic Conditions in Tanzania

ObjectiveTo conduct a pilot study of the adapted Ziba Ufa intervention for the treatment of late life depression, to assess feasibility and acceptability. DesignA pilot clinical trial, using a single group design over eight months, using qualitative and quantitative methods. SettingFour rural and urban outpatient health clinics in Kilimanjaro, Tanzania. ParticipantsIndividuals aged 60 years and above, with chronic health conditions and mild-moderate depression symptoms, with no cognitive impairment or severe frailty. Intervention‘Ziba Ufa’ (‘Repair the Crack’) was adapted for Tanzania from the Depression in Late Life (DIL) intervention. It is a hybrid model of problem-solving therapy and healthy lifestyle advice. MeasurementsA locally validated depression screener (MOSHI-D) was used to screen for mild-moderate depression symptoms. Feasibility was assessed using recruitment and retention data, and acceptability was assessed using thematic analysis and the Theoretical Framework of Acceptability to analyze exit interviews with participants and counsellors at follow-up. ResultsA total of 157 older adults were screened, and thirty-two participants were enroled, with eight allocated to one counsellor per site. The enrolment rate of those clinically eligible at screening was 52%, with the majority unable to attend due to living too far away from the clinic. The retention rate was high at 97% (N=31). Qualitative feedback indicated the programme was acceptable because it helped older adults ‘open up’ and did not interfere with everyday life. ConclusionsZiba Ufa was feasible and acceptable in Tanzania when delivered in routine clinical settings, with travel reimbursed.

The Prevalence of Autistic Traits in a Sample of Young Adults Referred to a Generalized Mental Health Outpatient Clinic.

The diagnosis of Autism Spectrum Disorders (ASD) is undergoing significant revisions, impacting prevalence estimates in the general population. Moreover, the rise of a dimensional perspective on psychopathology has broadened our understanding of autism, recognizing that subthreshold autistic features extend throughout the general population. However, there remains a limited understanding of the prevalence of ASD traits in individuals with psychiatric disorders, particularly in young adults, who are at an age where several mental health conditions emerge. The aim of this study was to evaluate the prevalence of ASD traits in a sample of young adults (18-24 years old) attending a generalized mental health outpatient clinic. A total of 259 young adult patients completed the self-report screening questionnaires Autism Quotient (AQ) and Ritvo Autism and Asperger Diagnostic Scale-Revised (RAADS-R). A total of 16.2% of our sample scored above the cut-off in both scales; this percentage decreased to 13.13% when restricting the RAADS-R cut-off to >119, as suggested for clinical samples. The association with sociodemographic features is discussed. We argue that screening for autistic traits should be integrated into the assessment of young adults presenting with nonspecific psychiatric symptoms or psychological distress. Although there is ongoing debate over the use of self-report screening tools, a positive result on both the AQ and RAADS-R should prompt clinicians to pursue a comprehensive diagnostic evaluation using structured or semi-structured interviews.

Cardiologist perceptions on automated alerts and messages to improve heart failure care

IntroductionElectronic health record (EHR)-embedded tools are known to improve prescribing of guideline-directed medical therapy (GDMT) for patients with heart failure. However, physicians may perceive EHR tools to be unhelpful and be hesitant to implement these in their practice. MethodsThe BETTER CARE-HF trial (NCT05275920) ran from April 28, 2022 to October 26, 2022 at NYU Langone Health outpatient clinics being seen by 180 cardiologists. The trial compared the effectiveness of an Alert during visits, Messages between visits, or usual care with the primary outcome of MRA prescribing. In this study, we sent surveys via electronic mail to cardiologists who either received an Alert or a Message during BETTER CARE-HF (60 cardiologists per survey). ResultsOf the 120 cardiologists who were sent the survey, response rate was 27% in the Alert group and 33% in the Message group. A majority of respondents in both the alert and message groups agreed that EHR tools were easy to use (Alert 79%; Message 69%), served as a reminder to prescribe therapy (Alert 77%; Message 77%;), and that the underlying evidence (Alert 86%; Message 62%) and clinical information (Alert 86%; Message 69%) were trustworthy. Overall, 54% agreed with continued use of the Alert, while 31% agreed with continued use of the Message. ConclusionCardiologists perceived the EHR tools to be easy to use, helpful, and improve the overall management of their patients with heart failure.

A comparative study of comorbidities, symptom profiles, and childhood trauma in PTSD and non-PTSD trauma patients at Oslo University Hospital

Purpose To explore the differences in mental health symptom profiles, trauma profiles, childhood trauma and comorbidities in patients with PTSD and those without PTSD. Materials and methods A cross-sectional study was carried out on 110 adult patients with trauma backgrounds attending a mental health outpatient clinic in Southern Oslo, Norway. In addition to self- report questionnaires, several standardized validated diagnostic tools were used to assess mental disorders. Multiple linear regression models were used to assess the association between trauma history, the mental health symptom profile of the patients, and PTSD diagnosis. Bivariate logistic regression was used to examine if childhood trauma/adversities were associated with PTSD. Results Patients diagnosed with PTSD had significantly higher rates of comorbid major depressive disorder, panic disorder, agoraphobia disorder, and social phobia compared to those without PTSD. We also found a positive association between PTSD diagnosis and all the different mental health symptoms domains of the Symptom Checklist-90-Revised instrument. When adjusted for age, gender, education, smoking habits, immigration, relationship, and employment status, these associations persisted with varying effects. We did not find any association between PTSD and childhood trauma/adversities, however, sexual abuse trended towards an association. Conclusion Adult trauma patients with PTSD may have more comorbid disorders and mental health symptoms. Childhood trauma may be less critical for the PTSD diagnosis in this group. In clinical practice, personalized treatment plans addressing both the symptom burden and its comorbidities may be beneficial.

Socioeconomic inequity in the utilization of healthcare among people with eating disorders in Australia.

Little is known about socioeconomic equity in access to healthcare among people with eating disorders in Australia. This study aims to measure the extent of inequity in eating disorder-related healthcare utilization, analyze trends, and explore the sources of inequalities using New South Wales (NSW) administrative linked health data for 2005 to 2020. Socioeconomic inequities were measured using concentration index approach, and decomposition analysis was conducted to explain the factors accounting for inequality. Healthcare utilization included: public inpatient admissions, private inpatient admissions, visits to public mental health outpatient clinics and emergency department visits, with three different measures (probability of visit, total and conditional number of visits) for each outcome. Private hospital admissions due to eating disorders were concentrated among individuals from higher socioeconomic status (SES) from 2005 to 2020. There was no significant inequity in the probability of public hospital admissions for the same period. Public outpatient visits were utilized more by people from lower SES from 2008 to 2020. Emergency department visits were equitable, but more utilized by those from lower SES in 2020. Public hospital and emergency department services were equitably used by people with eating disorders in NSW, but individuals from high SES were more likely to be admitted to private hospitals for eating disorder care. Use of public hospital outpatient services was higher for those from lower SES. These findings can assist policymakers in understanding the equity of the healthcare system and developing programs to improve fairness in eating disorder-related healthcare in NSW.

Using Neuropsychological Profiling to Tailor Mental Health Care for Children and Youth: a Quality Improvement Project to Measure Feasibility.

Precision child and youth mental healthcare has great potential to improve treatment success by tailoring interventions to individual needs. An innovative care pathway in a pediatric mental health outpatient clinic was designed to allow for neuropsychology data to be integrated in psychotherapeutic care. This paper describes the feasibility of this new pathway, including implementation outcomes, acceptability, and potential for future integration. The target population was outpatients 6-17years old referred for individual treatment to a tertiary outpatient mental health (OPMH) clinic. The new care pathway was co-developed by neuropsychologists and mental health practitioners. A logic model was created to guide the evaluation, which was informed by the Reach Effectiveness Adoption Implementation Maintenance framework. As part of the logic model, a stepped assessment protocol was implemented, and reports on neuropsychological function were shared with patients, caregivers, and care providers. Evaluation data were collected from phone surveys, questionnaires, a focus group, and administrative records. Forty-two patients scheduled to receive therapy over a 6-month period were offered the opportunity to participate in the new care pathway and 39 (93%) agreed. Self-reported outcome data showed that 83% of patients and 94% of caregivers valued neuropsychology-informed care, with some describing it as transformative. Almost all practitioners (91%) reported that the project added value to their clinical care. There were no adverse effects on participants nor the flow of patients through the system. Neuropsychology-informed pediatric OPMH care was feasible and well-received. Clinical effectiveness should be studied in an experimental trial.

An Investigation into Sleep Habits in Obese Children

Aim: This study aims to reveal the extent to which sleep habits differ between obese children and healthy children. Materıal And Method: In this study, 236 obese children and adolescents, aged 8-17, who we were followed up in our clinic, and 114 children and adolescents who applied to the child health and diseases outpatient clinic for various reasons participated. All participants in the present study underwent an assessment of sleep habits in children using face-to-face interviews. The evaluation included 33 questions regarding bedtimes, sleep behavior, instances of waking up during the night, getting up in the morning, and daytime sleepiness. Results: There was no statistically significant difference in age and gender characteristics between the patient and control groups. The sleep duration for obese children was 6.44±1.3 hours, compared to 6.31±1.29 hours in the control group (P=0.426). No statistical difference was observed in the components assessing sleep habits between the patient and control groups. Regarding the evaluation, only the obese patient group, no statistical difference was found between the sleep duration of girls and boys, respectively; 6.41±1.41, 6.5±1.07) (P=0.603). Conclusion: Our findings indicate that there are no significant differences in sleep habits between obese children and healthy children. However, in the literature, some studies reported that different parameters, such as age, pubertal status, timing of sleep and eating behaviors, and sleep duration (or restriction), can affect the relationship between sleep and obesity. Therefore, longitudinal and experimental studies with children are needed to determine the nature of the relationships between sleep and obesity in children.

Framing openness: Exploring Similarities and Differences in Patients' and Their Social Networks' Experiences with Participating in Dialogical Network Meetings Through the Lens of Mattering.

In this qualitative study conducted at a public mental health outpatient clinic in Norway, the integration of patients' social network in treatment was examined. The aim was to explore the experiences of patients and their network during dialogical network meetings and discuss any similarities and differences between the two participant groups. Reflexive thematic analysis was performed on data obtained from fifty-three meetings, resulting in the development of five themes. For patients, there were two themes: "Enhanced trust within our relationships" and "Providing us a safe space to talk openly," and for network members there were three: "Empowered through participation," Being welcomed and taken seriously," and "Provide more clarity to enhance our ability to contribute." Mattering was employed as a conceptual framework to discuss the similarities and differences between the themes of the two participant groups. Both patients and network members placed strong emphasis on the freedom of expression and acknowledged the crucial role of the meeting leaders in facilitating discussions on important and challenging topics. Differences included network members' emphasis on feeling welcome and their need to add value, while patients emphasized strengthened relationships and feeling valued and empowered by being trusted to control the discussion content. Overall, mattering appears to be a valuable tool for understanding the relational dynamics within network meetings.\.

“User participation? Isn’t that what i do all day?” Implementing user participation in Norwegian mental health outpatient clinics: a street-level bureaucrat perspective

ABSTRACT In 2019, care pathways for specialist mental health services were officially launched in Norway. These pathways were designed according to several goals to improve services. One of the overall goals was to increase user participation. The purpose of this study was to examine how professionals, in their role as street-level bureaucrats, interpreted the overall goal of increased user participation and how this interpretation influenced the involvement of patients in treatment facilitation. A case study was conducted at one outpatient clinic for adults in western Norway using 10 qualitative, in-depth interviews with treatment personnel. Additionally, user participation in the care pathway was evaluated. The results indicated that mental health professionals interpreted the overall goal as indicating that user participation are integrated into professional practice, not something that could be isolated alone. Furthermore, the idea of involving patients in treatment decisions was rejected by utilizing two coping strategies: one strategy was understood as a mechanism of ‘routinizing’, whereby providers promoted the method they practice, and the other strategy was a mechanism of ‘rationing’, whereby providers became gatekeepers of access to certain services. By investigating street-level bureaucracy theory and related coping mechanisms, this study shows how these two mechanisms may move the provision of care away from patients to benefit themselves in a public service gap where there are never enough resources.

Lessons Learnt From Running a Transition-Age Youth Mental Health Outpatient Clinic in Italy: The PRecocity of Intervention in Adolescent Medicine (PRIMA) Experience.

This study assessed whether transition age between adolescence and young adulthood poses a challenge for both patients and mental health services. We retrospectively examined the baseline characteristics, diagnoses and treatments of 99 individuals aged 16-35 presenting to the PRecocity of Intervention in Adolescent Medicine (PRIMA) transition-age mental health outpatient clinic, Italy, over a 24-month period. Most patients were female, aged 20 or younger, employed and did not experience impairment in daily autonomies. About half patients were referred by general practitioners or self-referred, often as initial contact with any adult mental health services, complaining with multiple symptoms (88%), mainly including anxiety, affective disturbances and insomnia. Most of them received a single diagnosis (68%), one out of three being diagnosed with a neurodevelopmental disorder. Patients presenting with anxiety (63% vs. 32%; OR = 3.55, p = 0.01) and affective symptoms (56% vs .23%; OR = 4.26, p = 0.01) and receiving multiple diagnoses (30% vs. 9%; χ2(2) = 19.7, p < 0.01) were more likely to be prescribed with psychopharmacological medication at the first visit. At a 6-month follow-up, one in two patients remained in PRIMA, while the others required different services tailored to their specific conditions, especially neurodevelopmental disorders. Findings from this study warrant the need for specialised mental healthcare facilities ensuring timely and high-quality interventions for adolescents transitioning into young adulthood.

Disruptive mood dysregulation disorder, parental stress, and attachment styles

Disruptive mood dysregulation disorder (DMDD) is a relatively new diagnostic entity concerning children with chronic irritability and severe anger outbursts. Currently, there is limited knowledge about the parental factors associated with the disorder. The aim of this study was to compare stress levels and attachment styles in parents of children with DMDD with those of parents of children with other diagnoses. Our sample consisted of 218 children (6–12 years, Mage = 9.68 years) referred to child mental health outpatient clinics. Clinicians used a standardized semi-structured diagnostic interview to identify diagnoses. Parental stress levels and attachment styles were assessed using parent reports. We found that parents of children with DMDD experience significantly higher levels of parenting stress related to factors in the child than parents of children with other diagnoses. Furthermore, parents of children with DMDD show a higher association with insecure adult attachment styles than parents of children without DMDD. Finally, an adult preoccupied-ambivalent attachment style explains the variability in parental stress in the DMDD group to a large degree. We discuss how parental stress and an insecure attachment style can be associated with negative parenting practices. An implication from this study could be that treatment results might be improved by involving parents more in treatment programs for children with DMDD.

EVALUATION OF ORAL AND DENTAL HEALTH POLYCLINICS IN TERMS OF ERGONOMIC DESIGN FACTORS

The comfort conditions of oral and dental health clinics depend on physical environment factors. The satisfaction of the patient, physician, and staff is directly proportional to the suitability of the ergonomic conditions of the environment. Physical factors affect the health and performance of physicians and personnel working all day long. At the same time, the spatial and technical organization of clinic structures is very important for patient health and comfort. In the literature research, there were no adequate studies on the physical risk factors that the dentist, staff, and patients are exposed to during clinical applications in terms of architectural discipline. This study aims to reveal the ergonomic comfort conditions of dentists, staff, and patients in the oral and dental health outpatient clinic. The research method is fieldwork. An oral and dental health polyclinic in Istanbul was determined as the research area. The research technique is “on-site observation,” “measurement,” “survey” and “interview”. "Luxury Light Meter", "Sound Meter" and "Thermometer" applications were used to measure the light, sound, and temperature values of the space. A questionnaire with the Likert Scaling Model was administered to patients, physicians, and staff. As a result, patients prefer to be treated in the outpatient clinic where they feel comfortable, and dentists and their staff can work more motivated and more efficiently in environments where they feel comfortable and healthy. To provide quality service in an oral and dental health clinic, attention should be paid to physical environmental factors, spatial and technical characteristics, and the comfort of patients, dentists, and staff should be considered.

Implementing paper-based patient-reported outcome collection within outpatient integrative health and medicine.

To investigate the feasibility of pre- and post-encounter patient-reported outcome (PRO) measure collection within an outpatient integrative health and medicine (IHM) clinic and to characterize factors associated with successful completion. We conducted a retrospective review of 27,464 outpatient IHM encounters including 9,520 chiropractic; 8,237 acupuncture; 5,847 massage; 2,345 IHM consultation; and 1,515 osteopathic manipulation treatment encounters at four clinics offering IHM over 18 months. Patients were asked to complete paper questionnaires rating pain, anxiety, and stress from 0-10 immediately pre- and post-encounter. Generalized linear mixed effect regression models were used to examine the relationship between demographic, clinical, and operational covariates and completing (1) pre-encounter and (2) paired (i.e., pre and post) PROs. Patients (N = 5587, mean age 49 years, 74% white, 77% female) generally presented for musculoskeletal conditions (81.7%), with a chief complaint of pain (55.1%). 21,852 (79.6%) encounters were among patients who completed pre-encounter PROs; 11,709/21,852 (53.6%) completed subsequent post-encounter PROs. Odds of PRO completion were more impacted by provider, operational, and clinical-level factors than patient factors. Covariates associated with increased odds of pre-encounter PRO completion included being female, having additional IHM encounters, and having a pain or anxiety complaint. Covariates associated with increased odds of paired PRO completion included being aged 31-40 vs. 51-60 years and having additional IHM encounters. Implementing a paper-based PRO collection system in outpatient IHM is feasible; however, collecting post-encounter PROs was challenging. Future endeavors should leverage the electronic health record and patient portals to optimize PRO collection and engage patients and clinical providers.

Regressive autism with autoimmune encephalitis: case report and literature review of subtype of autism spectrum disorder

About one-third of individuals with autism spectrum disorder (ASD) show a sudden loss of acquired skills between the 2nd or 3rd years of life. The primary areas of loss were grouped into language skills, social interest, adaptive functioning, and motor skills. A 4-year and 2-month-old boy presented to the child and adolescent mental health and disease outpatient clinic with his parents with complaints of decreased eye contact, and regression in speech. His developmental milestones were within the typical range of three years and two months. During the investigation into the organic etiology of regression, serum anti-CASPR2 positivity was detected, and intravenous immunoglobulin administration was initiated. After 6 months of treatment and special education, there was a slight decrease in the CARS score along with improvements in adaptation to change, visual response, and non-verbal communication. This rare case of regressive autism accompanied by autoimmune encephalitis provides further evidence in the field that autoimmune encephalitis may influence the development of the regressive subtype of ASD. Differential diagnosis is crucial because additional immunotherapy may be beneficial in these cases. Further investigation is needed to identify the relationship.

The Association of Central Sensitisation with Depression, Anxiety, and Somatic Symptoms: A Cross-Sectional Study of a Mental Health Outpatient Clinic in Japan.

For patients with chronic pain and persistent physical symptoms, understanding the mechanism of central sensitisation may help in understanding how symptoms persist. This cross-sectional study investigated the association of central sensitisation with depression, anxiety, and somatic symptoms. Four hundred and fifteen adults attending an outpatient psychosomatic clinic were evaluated. Participants completed the Hospital Anxiety and Depression Scale, Somatic Symptom Scale 8, and the Central Sensitisation Inventory. The relationships between these factors were examined using descriptive statistics and multiple logistic regression analyses. The mean age was 42.3 years, and 59% were female. The disorders included adjustment disorders (n = 70), anxiety disorders (n = 63), depressive disorders (n = 103), feeding and eating disorders (n = 30), sleep-wake disorders (n = 37), somatic symptoms and related disorders (n = 84), and others (n = 28). In multiple logistic regression analyses, higher central sensitisation was associated with more severe anxiety, depression, and somatic symptoms after controlling for potential confounders. In the disease-specific analysis, somatic symptoms correlated more positively with central sensitisation than with depression or anxiety. Central sensitisation and depression, anxiety, and somatic symptoms were associated with patients attending an outpatient clinic. These findings highlight the importance of evaluating depression, anxiety, and somatic symptoms when assessing central sensitisation.

Autism Spectrum Disorders traits in a sample of young adults referring to a generalized mental health outpatient clinic

IntroductionThe diagnosis of Autism Spectrum Disorders is currently witnessing several changes, with direct consequences on the prevalence rates in the general population. However, little is known about ASD traits prevalence in clinical samples, and how much these traits interact with other mental health conditions, especially in young adults, a critical age for the outbreak of many psychiatric diseases.ObjectivesThe aim of this study was to assess the prevalence of ASD traits in a sample of young adults (aged between 18 and 24 years old) referring to a specialized mental health outpatient clinic.MethodsWe administered to 259 patients the Autism Quotient (AQ) and the Ritvo Autism and Asperger Diagnostic Scale-Revised (RAADS‐R), along with a detailed sociodemographic and anamnestic interview.ResultsWe found that 16.2% of our sample scored above the cut-off at both scales (a percentage that went down to 13.13% when restricting the RAADS-R cut-off at &gt;119, as suggested for clinical samples).Conclusions This prevalence seems considerably higher than the one reported in the general population, and not negligible. The association with sociodemographic features such as sex assigned at birth, gender identity and employment status, and the validity of the screening tools we implemented, are discussed. In conclusion, we suggest that an assessment for autistic traits should be implemented in young adults seeking help for unspecified psychiatric symptoms and psychological suffering and that, despite the not unanimous consensus over self-report screening tools, a positivity to both the AQ and the RAADS-R should lead the clinician to conduct a full diagnostic evaluation with structured or semi-structured interviews.Disclosure of InterestNone Declared

The effect of Self-Regulation Based Cognitive Psychoeducation Program on emotion regulation and self-efficacy in children diagnosed with attention deficit hyperactivity disorder

IntroductionAttention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder with early onset (Christiansen, H., et al. CPR 2019, 1–11), which is characterized by several symptoms, including lack of attention, hyperactivity, and impulsivity that are incompatible with age and developmental level (Caye, A., et al. 2020 JAACAP, 990–997)ObjectivesThis study aimed to determine the effect of Self-Regulation Based Cognitive Psychoeducation Program on emotion regulation and self-efficacy in children diagnosed with attention deficit hyperactivity disorder (ADHD) and receiving medication.MethodsThe sample of this study with control group and pre-test, post-test and follow-up randomized experimental design consisted of children followed in the child and adolescent mental health outpatient clinic of a state hospital. The data were evaluated by parametric and non-parametric analyses.ResultsA statistically significant increase was determined in the internal functional emotion regulation mean scores of children, who participated in the Self-Regulation Based Cognitive Psychoeducation Program, measured before, immediately after, and 6 months after the intervention (p &lt; 0.05). A statistically significant increase was also found in their external functional emotion regulation mean scores measured before and 6 months after the intervention (p &lt; 0.05). In addition, a statistically significant difference was found between their internal dysfunctional and external dysfunctional emotion regulation mean scores measured before and 6 months after the intervention; however the mean scores of those in the control group 6 months after the intervention were higher than those in the intervention group (p &lt; 0.05). Furthermore, there was a statistically significant increase in their self-efficacy mean scores measured before and 6 months after the intervention (p &lt; 0.05).ConclusionsThe Self-Regulation Based Cognitive Psychoeducation Program was found be effective in increasing the levels of emotion regulation and self-efficacy in children with ADHD.Disclosure of InterestNone Declared

Trajectory of gestational weight gain in patients with gestational diabetes mellitus

Introduction: Weight gain in pregnancy is a significant modifiable factor that impacts immediate and future health of the mother and her fetus Hence, worldwide guidelines are developed about weight gain in pregnancy. In a recent study patients with abnormal glucose tolerance test and diagnosed with gestational diabetes had less deviation from expected gestational weight gain. Purpose: The aim of our study is to look at the trajectory of gestational weight gain for women diagnosed with gestational diabetes followed at the King Faisal Specialist Hospital and Research Centre (KFSH&amp;RC) Methods: Our study population included 215 pregnant women with singleton pregnancy diagnosed with diabetes mellitus who attended the obstetrics outpatient clinic and family health clinics from first antenatal visit until delivery. Results: From among the 215 women in the study cohort, the total number of weight gain was 143. The number of patients who lost weight was 48, and the number of patients who remained stable were 24. Overall, the amount of weight gain for women in this study was comparable to the expected. Conclusion: In our study we found the patients diagnosed with gestational diabetes mellitus have a wide range of changes in their weight gain trajectory from previously expected parameters in the healthy population, which might be explained by other factors like adherence to diet, exercise and medications designed control the metabolism.

Autistic traits, sensory sensitivity and eating disturbances in a sample of young adults referring to a generalized mental health clinic

PurposeThe relationship between autistic traits and eating disturbances has been given considerable attention over the last decades. The rise of a dimensional approach to psychopathology has expanded the way we think about autism, acknowledging that subthreshold autistic manifestations span across the general population and are more pronounced in psychiatric patients. Here we investigated the prevalence of eating disorders and its potential relationship with autistic traits and sensory sensitivity in a group of patients who were referred for the first time to a mental health outpatient clinic, without a formal diagnosis yet.Methods259 young adults (between 18 and 24 years old) completed: the Eating Attitude Test (EAT-26), the Swedish Eating Assessment for Autism Spectrum Disorders (SWEAA), the Autism Quotient (AQ), the Ritvo Autism Asperger Diagnostic Scale-Revised (RAADS-R), and the Sensory Perception Quotient—Short Form 35 item (SPQ-SF35).Results23.55% of participants scored above the cut-off at the EAT-26, suggesting that they presented a risk for eating disorders and should be assessed by a specialized clinician; associations emerged between hypersensitivity in the touch and vision domain and both the EAT-26 and the SWEAA; the presence of autistic traits was largely associated with eating disturbances.ConclusionsThis study underlines the significance of the eating domain as a central psychopathological feature in the distress experienced by young adults with general psychiatric symptoms and psychological suffering; it adds evidence to the association between autistic traits and eating disorders and opens to new research questions about the role of subthreshold autistic traits in general psychopathology.Level of evidence: Level I: Evidence obtained from experimental studies.