Psychiatry Research EG

Several studies have suggested the presence of ethnic/ racial differences in psychiatric presentation and diagnosis [1–5], prevalence of psychiatric disorders [6,7], response to psychotropic medications [8], and mental healthcare utilization [9]. Most of these studies have been carried out in the USA comparing African Americans with white psychiatric patients [2–5,7–8] and a few studies have included Asians [1,10]and Latinos [1,6]. In the 20th century, catatonia was redefined as a neuropsychiatric syndrome that is known to occur in association with several mental disorders [11]. It presents commonly in psychiatric patients in both acute and longterm settings. Despite its common occurrence, catatonia remains a poorly understood, poorly studied, and poorly recognized syndrome, presenting with a variety of psychiatric and medical illnesses, which can be treated once a diagnosis is established [12]. It is most commonly characterized by mutism, stupor, refusal to eat or drink, posturing, and excitement or hypokinesis [13]. Although catatonia is associated with schizophrenia and had been deemed to be a subtype of it throughout the 20th century, it is most often caused by affective disorders and medical or neurological illness, leading to its nature and classification being reconsidered [14]. Moreover, being reported to be commonly presented in different cultures in different ways [15,16] implies that culture and ethnicity may influence how catatonia manifests in relation to different psychiatric disorders [11]. A study carried out in Camberwell, London, comparing white with Afrocaribbean schizophrenic patients regarding their symptom profile, revealed that the latter group showed more catatonic symptoms [17]. An earlier study of the psychiatric morbidity among university students in Egypt showed a high prevalence of paranoid and catatonic symptoms [18]. Also, in another review on the prevalence of mental illnesses in Egypt, Okasha et al. [19] reported that catatonic forms of schizophrenia are relatively common compared with other varieties. In contrast, a study on the psychopathology of schizophrenia in a Kuwaiti sample showed that catatonic symptoms were rare (2.9%), compared with other symptoms of the disorder [20]. Furthermore, when 104 consecutively admitted patients in Wales and India were screened for catatonic features using the same standardized rating instrument, and by the same psychiatrist, differences were seen in both prevalence and symptoms, although not in severity [15]. Although the reasons for ethnic differences in psychiatric diagnosis are unclear, several hypotheses have been proposed, including the existence of actual ethnic differences in the rates of psychiatric disorders, clinical presentation, and clinician biases. Research regarding these issues is scarce in the Arabian Gulf region, which has been recently characterized by the presence of multiple racial and ethnic minorities. In the state of Kuwait, as in most other Gulf Cooperation Council countries, the number of expatriates exceeds that of national citizens. South Asians and Arabs form the largest segment of non-Kuwaiti population living in Kuwait [21]. Over the last few years, however, the number of black Africans, especially Ethiopians, has been increasing. The presence of these different ethnic groups and the presence of only one inpatient psychiatric service in Kuwait have contributed to the need for carrying out this study. Therefore, the objectives of this study were to compare the prevalence and study the ethnic differences of catatonic symptoms in different ethnic groups of hospitalized psychiatric patients in Kuwait.