Background: As the SARS-CoV-2 Omicron variant emerged and spread globally at an alarming speed, healthcare workers’ (HCWs) uncertainties, worries, resilience, and coping strategies warranted assessment. The COVID-19 pandemic had a severe psychological impact on HCWs, including the development of Post-Traumatic Stress symptoms. Specific subgroups of HCWs, such as front-line and female workers, were more prone to poor mental health outcomes and difficulties facing stress. Methods: The responses to an online questionnaire among HCWs in the Kingdom of Saudi Arabia (KSA) were collected from 1 December 2021 to 6 December 2021, aiming to assess their uncertainties, worries, resilience, and coping strategies regarding the Omicron variant. Three validated instruments were used to achieve the study’s goals: the Brief Resilient Coping Scale (BRCS), the Standard Stress Scale (SSS), and the Intolerance of Uncertainty Scale (IUS)—Short Form. Results: The online survey was completed by 1285 HCWs. Females made up the majority of the participants (64%). A total of 1285 HCW’s completed the online survey from all regions in KSA. Resilient coping scored by the BRCS was negatively and significantly correlated with stress as scored by the SSS (r = −0.313, p < 0.010). Moreover, intolerance of uncertainty scored by the IUS positively and significantly correlated with stress (r = 0.326, p < 0.010). Increased stress levels were linked to a considerable drop in resilient coping scores. Furthermore, being a Saudi HCW or a nurse was linked to a significant reduction in resilient coping ratings. Coping by following healthcare authorities’ preventative instructions and using the WHO website as a source of information was linked to a considerable rise in resilient coping. Conclusions: The negative association between resilient coping and stress was clearly shown, as well as how underlying intolerance of uncertainty is linked to higher stress among HCWs quickly following the development of a new infectious threat. The study provides early insights into developing and promoting coping strategies for emerging SARS-CoV-2 variants.

Arabic Translation, Validation and Cultural Adaptation of the 7-Item Hamilton Depression Rating Scale in Two Community Samples

Background: The SARS-CoV-2 Omicron spread fast globally and became the predominant variant in many countries. Resumption of public regular life activities, including in-person schooling, presented parents with new sources of worry. Thus, it is important to study parental worry about the Omicron variant, willingness to vaccinate their children, and knowledge about school-based COVID-19 precautionary measures. Methods: A national, cross-sectional, pilot-validated online questionnaire targeting parents in the Kingdom of Saudi Arabia (KSA) was distributed between 31 December 2021, and 7 January 2022. The survey included sociodemographic, COVID-19 infection data, parental and children vaccination status, attitudes towards booster vaccine, parents’ Omicron-related perceptions and worries, and attitude towards in-person schooling. Results: A total of 1340 participants completed the survey, most (65.3%) of whom were mothers. Of the parents, 96.3% either received two or three doses of the COVID-19 vaccine. Only 32.1% of the parents were willing to vaccinate their young children (5–11 years of age). In relation to their children 12–18 years of age, 48% had already had them vaccinated, 31% were planning to vaccinate them, and 42.8% were willing to administer a booster dose. Only 16% were more worried about the Omicron variant compared to the Delta variant. Residents of western KSA were more worried about Omicron compared to Delta. Parents worried about the Omicron variant and male participants were significantly less aware of school-based COVID-19 precautionary measures. Parents with post-graduate degrees and those having more children were significantly more inclined to send their children to school even if COVID-19 outbreaks could occur in schools, while parents who were more worried about the Omicron variant and were more committed to infection prevention measures were significantly less inclined to do so. Conclusions: Overall, parents had lower worry levels about the Omicron variant compared to the Delta variant. They had a higher willingness to vaccinate their older children compared to the younger ones. In addition, our cohort of parents showed high willingness to send their children to schools and trusted the school-based preventative measures. These findings can inform policy makers when considering school related decisions during the current or future public health crises.

Background: Despite its superiority over other drugs for psychosis, clozapine remains underused and is associated with many clinical challenges, including difficulties in predicting therapeutic serum levels (350-600 ng/mL). We found no large or recent study that investigated the determinants of serum clozapine levels in Middle Eastern patients. Therefore, we investigated the association between clozapine dose and serum level, and the clinical predictors of the clozapine serum level, in Middle Eastern patients.Methods: This cross-sectional study included 94 patients of Middle Eastern ethnicity who attended the Clozapine Clinic in King Saud University Medical City in Riyadh, Saudi Arabia. We used a single measure of the serum clozapine level, which was collected 12 h after the last oral dose of clozapine under steady-state conditions.Results: The average clozapine dose and serum level were 400 mg/daily and 705 ng/mL, respectively. The majority of patients (59.8%) had serum levels higher than 600 ng/mL. Clozapine dose and serum level were positively correlated (r_s[94] = 0.32,p = 0.002). We generated a predictive model of the serum clozapine level, which revealed that the daily dose, smoking status, use of fluvoxamine or lamotrigine, and body mass index (BMI) predicted 43.6% of the variance in the serum level (p < 0.001). Using this model, we calculated that patients with a BMI of 25 kg/m²would require a clozapine dose between 50 to 275 mg/daily if they were non-smokers, and a dose of 200 to 450 mg/daily if they were smokers, in order to reach a serum clozapine level between 350 to 600 ng/mL. Patients with higher BMI and those receiving fluvoxamine would require lower doses.Conclusions: This was a naturalistic study of the clozapine dose-level relationship and the clinical predictors of the serum clozapine level in a sample of Middle Eastern patients. The ratios of clozapine level to dose in our patients more closely resembled those reported in Asian samples than in European samples. These findings do not reduce the value of individualised therapeutic drug monitoring, but may assist clinicians when prescribing clozapine to Middle Eastern patients. Further psychopharmacological studies are needed on this demographic population.

Suicide is one of the leading causes of mortality among adolescents and young adults, with suicidal ideation and attempts representing critical predictors of suicide-related outcomes. Although global evidence highlights rising trends in suicidal behaviors, regional patterns remain varied. In the MENAT region (Middle East, North Africa, and Turkey), where cultural stigma, conflict, and insufficient mental health infrastructure may exacerbate vulnerability, evidence remains fragmented. This study systematically reviewed and meta-analyzed the prevalence, risk factors, and protective factors associated with suicidal ideation and suicide attempts among young people in the MENAT region. The study protocol was registered with PROSPERO (ID: CRD420251101524) and conducted following PRISMA guidelines. A systematic search of six electronic databases (PubMed, MEDLINE, Scopus, Web of Science, Embase, and PsycINFO) was conducted for studies published between January 2010 and June 2025. Eligible studies were observational in design, published in English, and reported the prevalence of suicidal ideation or suicide attempts among individuals aged ≤25 years in the MENAT region. Many included studies relied on single-item measures of suicidality rather than validated multi-item scales, which was considered when interpreting results. Pooled prevalence and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using random-effects models. Heterogeneity, sensitivity analyses, and publication bias were examined. A total of 47 studies encompassing 115,152 participants were included. The pooled prevalence of suicidal ideation was 25% (95% CI: 0.19–0.31), while suicide attempts were reported by 12% (95% CI: 0.06–0.19). Suicidal ideation reached as high as 52.7% in individual studies from Jordan, while suicide attempts were most prevalent in studies from Kuwait. Female gender, bullying (OR = 1.6), loneliness (OR = 2.2), substance use, including smoking (OR = 2.0), alcohol (OR = 3.0), and amphetamines (OR = 3.5), as well as depression (OR = 1.5), anxiety (OR = 2.1) and history of sexual abuse (OR = 2.0) were significantly associated with suicidal ideation. Suicide attempts were strongly linked to alcohol (OR = 3.0), cannabis use (OR = 1.7), anxiety (OR = 3.1), depression (OR = 1.5), and a history of sexual abuse (OR = 2.2). Evidence on protective factors such as family connectedness, religiosity, and social support was limited and inconsistently reported across studies, highlighting a major research gap in understanding resilience factors among youth in the MENAT region. Suicidal ideation and attempts are prevalent among young people in the MENAT region and were significantly associated with psychosocial stressors and substance use. However, the reliance of many included studies on single-item assessments of suicidality limits the precision and comparability of estimates. These findings highlight the urgent need for culturally tailored, evidence-based suicide prevention strategies and enhanced mental health services in this vulnerable population. Not applicable.

Background Poor sleep quality in children can lead to physical and psychosocial problems. The FIFA World Cup has been shown to impact adult behaviors, but its effect on children’s sleep patterns is less understood. The study aimed to evaluate the impact of the FIFA World Cup 2022 (FWC-2022) on children’s sleep patterns. Methods A cross-sectional survey was conducted between 27 November and 25 December 2022, targeting parents in Saudi Arabia (Arabia standard time) and countries with a +6-hour time difference. Participants completed the validated Children’s Sleep Habits Questionnaire (CSHQ), alongside demographics, time spent watching matches, and parental perceptions on sleep. Results A total of 848 parents participated, with 60.6% being mothers. The study found that children averaged 9.10 hours of sleep; 64.2% of parents observed no change, while 10.4% reported substantial changes. Parents aged ≥45 and those noticing shifts in sleep habits reported higher problematic sleep scores. Larger families reported fewer sleep issues, with a negative correlation between family size and sleep problems. Children’s CSHQ scores indicate mild to moderate sleep difficulties across domains. No significant differences were observed between Saudi Arabia and countries with +6-hour time difference. However, one-third of children experienced delays in sleep onset exceeding one hour on weekdays during the World Cup. Conclusion Sociodemographic factors, family dynamics, and major events like the FWC-2022 influence parental perceptions of child sleep issues. Older parents and smaller families reported more challenges, while higher socioeconomic status was linked to fewer bedtime difficulties. Our findings may be particularly relevant for FIFA 2026, where transcontinental hosting across North America will expose children globally to matches at even more variable times. Subtle impacts of prolonged event schedules highlight the need for interventions supporting healthy routines during such events, potentially through engaging, sleep-friendly technologies.