Arab / Middle East Adult ADHD
Resources and Planning


Adult Attentian Deficit Hyperactivity Disorder
In the Arab World and Beyond


Cairo July 2018
Jeff Marck
PhD
Institute of Advanced Studies
Australian National University
MA
University of Hawai'i
BA MA
University of Iowa
-----------------------------
Research Officer 1992-1999
Australia's
National Centre for Epidemiology
and Population Health
Box 96 - Remaya 12572 Egypt
+20-1068407394
jeffmarckcairo@gmail.com
www.jeffmarck.net

Arabic Version, Adult ADHD Self-Report Scale (ASRS)
Letter of Introduction from Dr. Mona El Rakhawy MD

There has been a great deal of attention paid internationally to the common comorbidity of SUD with adult ADHD.

But SUD is a minority comorbidity with ADHD in adults and testing persons with MDD, OCD, Bipolar, Anxiety D and other afflictions for  ADHD comorbidity has been widely neglected and results in significant case mismanagement.

Adult ADHD normally involves adult onset rather retentions of childhood ADHD which tends to become less pronounced.

Lack of childhood histories often result in failure to consider adult ADHD screening, diagnosis and treatment and may be behind about half of adult male criminal incarcertations internationally. The rare statistics often show little evidence of wealthy countries having better screening, diagnosis and treatment outcomes than those countries with more limited resources.

Conduct of untreated males while incarcerated and upon release involves a considerable amount of reoffending and subsequent reincarceration.

The good news for Egypt and other middle income countries is that diagnosis and treatment diversions are inexpensive and result in cost savings to incarcertation systems that can supply growing programs of diagnosis, treatment and reductions in reoffending of adult ADHD prisoners in prison and upon release.

The same medications as used for childhood ADHD are effective in reducing impulsiveness and offending in adults as are those used for some of the comorbidities which do not find SUD at the top of the list.  Yet it is only SUD comorbidity that seems to be researched with some frequency.

When time is taken to include screening of all adults presenting with issues to clinics (gender balanced), diagnosis of adult ADHD has been found in
24.5% percent of cases  (gender balanced) in Egypt with the females more often having inattention issues rather than the well known impulsiveness of the afflicted males. The same medications as used with children result in improvements in the lives of both the adult male and adult female afflicted.

1)    Frequency of  Psychiatric Disorders:

Table (35): Comparison between Patients with and without Adult ADHD using DSM-5
Criteria as regards Frequency of different Psychiatric Disorders (Nashaat): 

Psychiatric Disorder

Patients with Adult ADHD
(n=72)

Patients without Adult ADHD
(n=228)

Total
(n=300)

p value

N

%

N

%

N

%

MDD

11

15.3

68

29.8

79

26.3

0.015

Bipolar I D

30

41.7

74

32.5

104

34.7

0.152

Bipolar II D

9

12.5

9

4.6

18

6.0

0.008

SUD

33

45.8

108

47.3

139

46.3

0.543

Alcohol use Disorder

6

8.3

20

 

8.8

26

 

8.7

0.908

OCD

22

30.6

38

16.7

60

 

20.0

0.010

Anxiety D

34

47.2

125

54.8

161

53.7

0.450

Panic D

16

22.2

47

 

20.8

63

 

21.0

0.770

GAD

17

23.6

64

 

28.1

81

 

27.0

0.457

Social phobia

15

20.8

43

18.9

58

9.3

.712

MDD: Major Depressive Disorder; SUD: Substance Use Disorder;
OCD: Obsessive Compulsive Disorder; GAD: Generalized Anxiety Disorder; D: Disorder
(Nashaat PhD  thesis)


__________________________
Jeff Marck is an anthropological linguist retired to his wife's native Cairo with experience:
    1) as an  attendant on a leading psychiatric research hospital's adult wards (1969-1971);
   2) as the lead research officer for Australia's beloved Emeritus Professor John C. Caldwell (1992-1999) in Caldwell's Health Transition Centre (HTC)  at Australia's National Centre for Epidemiology and Population Health (NCEPH) including the three years Caldwell was President of the International Union for the Scientific Study of Population (IUSSP); a gentleman's gentleman.
   3) as a volunteer to one of the Australian Capital Territory mental health community activities, 2006-2008, meeting once a week at a Canberra cafe with schizophrenics returning to the community, conversing about their situation and options.
   After assisting Moustafa and Mona Rakhawy of Cairo's Diwan Day Center in publishing their deceased colleague's adult ADHD research, Marck took the decision to make better outcomes for the Arab and Muslim worlds' afflicted ADHD adults his main project in retirement. He is doing this, in one element, by completing the native English copy editing of adult ADHD thesis and journal submissions concerning the Arab and Muslim world at no charge and by offerring special rates for the native English copy editing of other kinds of Arab and Muslim world psychiatric research reports.

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