Psychiatry Commons^™

Patterns Of Suicide And Self-Harm In Pakistan: A Retrospective Descriptive Study Protocol, Nargis Asad, Shahina Pirani, Summaiya Tariq, Asra Qureshi, Mohammad Zaman, Mustafa Aslam, Farhat Mirza, Murad M. Khan

Department of Psychiatry

Introduction: Suicide is a major global public health problem. Low-income and middle-income countries contribute 78% of all suicidal deaths. Pakistan, a South Asian country, lacks official statistics on suicides at national level. Statistics on suicide are neither collected nationally nor published in the annual national morbidity and mortality surveys. Medicolegal reports on suicides and self-harm are extremely rich and important source of information but greatly underused in Pakistan. We aim to examine the patterns of suicides and self-harm retrospectively in patients who were registered with medicolegal centres (MLCs) in Karachi, during the period January 2017 to December 2021.
Methods and …

Psychometric Properties Of The Sindhi Version Of The Mood And Feelings Questionnaire (Mfq) In A Sample Of Early Adolescents Living In Rural Pakistan, Janavi Shetty, Florence Perquier, Susan C. Campisi, Yaqub Wasan, Madison Aitken, Daphne J. Korczak, Suneeta Monga, Sajid Bashir Soofi, Peter Szatmari, Zulfiqar Ahmed Bhutta

Centre of Excellence in Women and Child Health

There is a need for reliable and valid screening tools that assess depressive symptoms in adolescents in Pakistan. To address this need, the present study examined the psychometric properties and factor structure of a Sindhi-translated and adapted version of the child-report Mood and Feelings Questionnaire (MFQ-C) and the Short Mood and Feelings Questionnaire (SMFQ-C) in a community sample of adolescents living in Matiari, Pakistan. Questionnaires were translated into Sindhi and administered by study psychologists to 1350 participants (52.3% female) 9.0 to 15.9 years old. Measurement structure was examined using confirmatory factor analysis. Internal consistency was estimated, and convergent and divergent …

Suicide Numbers During The First 9-15 Months Of The Covid-19 Pandemic Compared With Pre-Existing Trends: An Interrupted Time Series Analysis In 33 Countries, Jane Pirkis, David Gunnell, Sangsoo Shin, Marcos Del Pozo-Banos, Vikas Arya, Pablo Analuisa Aguilar, Louis Appleby, S. M. Yasir Arafat, Ella Arensman, Murad Khan

Department of Psychiatry

Background: Predicted increases in suicide were not generally observed in the early months of the COVID-19 pandemic. However, the picture may be changing and patterns might vary across demographic groups. We aimed to provide a timely, granular picture of the pandemic's impact on suicides globally.
Methods: We identified suicide data from official public-sector sources for countries/areas-within-countries, searching websites and academic literature and contacting data custodians and authors as necessary. We sent our first data request on 22nd June 2021 and stopped collecting data on 31st October 2021. We used interrupted time series (ITS) analyses to model the association between the …

Psychometric Properties Of The Urdu Version Of The Eortc Qlq-H&N35 (European Organization For Research And Treatment Of Cancer Head And Neck Module) Quality Of Life Tool, Nida Zahid, Russell Seth Martins, Wajeeha Zahid, Iqbal Azam Syed, Mubasher Ikram, Aneesa Hassan, Shireen Shehzad Bhamani, Adnan Abdul Jabbar, Nargis Asad, Shabbir Akhtar, Moghira Iqbaluddin Siddiqui, Mohammad Sohail Awan, Khabir Ahmad

Department of Surgery Docs

Background: We translated and validated the Urdu version of the European Organization for Research and Treatment of Cancer Quality of Life (QoL) Questionnaire's Head and Neck (H&N) Cancer Module (EORTC QLQ-H&N35) and assessed its convergent and discriminant validity by examining correlations of QoL with depression, anxiety, and resilience.
Methods: We translated the EORTC QLQ-H&N35 according to EORTC instructions. Patients at a tertiary care hospital in Pakistan completed a survey consisting of Urdu versions of EORTC QLQ-C30 (core QoL tool), QLQ-H&N35, Hospital Anxiety and Depression Scale, and Wagnild and Young Resilience Scale (RS-14). Content validity, convergent validity, discriminant validity, and reliability …

Association Between Suicide Rate And Human Development Index, Income, And The Political System In 46 Muslim-Majority Countries: An Ecological Study, S. M. Yasir Arafat, Marthoenis Marthoenis, Murad Khan, Mohsen Rezaeian

Brain and Mind Institute

Very little has been researched assessing the relationship between the suicide rate and the ecological perspectives of the country, especially in the Muslim majority countries. We aimed to determine the association between suicide rate and the ecological parameters of 46 Muslim majority countries. We extracted the Muslim majority countries and their suicide rate, income distribution, distribution of the WHO region and continents, and Human Development Index (HDI). We assessed the correlation of the proportion of Muslim populations, the total population of the countries, number of suicides, continent, income group, political system, and HDI score with the suicide rate. The median …

Suicide Prevention In Bangladesh: The Role Of Family, S M Yasir Arafat, Tamkeen Saleem, Todd M. Edwards, Syeda Ayat-E-Zainab Ali, Murad M. Khan

Department of Psychiatry

Background: Suicide is a public health problem that gets little attention in Bangladesh especially in prevention aspects. Recent studies revealed that a significant portion of risk factors is closely related to family events. However, potential prevention strategies considering the family structure and involving family dynamics of Bangladesh have not been discussed.
Objectives: We aim to highlight areas of family vulnerability and resilience when the threat of suicide is present, as well as the potential roles of family in suicide prevention in Bangladesh.
Methods: We conducted a thorough narrative and focused literature search and synthesized evidence based on available articles discussing …

Modifying Group Interpersonal Psychotherapy For Peripartum Adolescents In Sub-Saharan African Context: Reviewing Differential Contextual And Implementation Considerations, Manasi Kumar, Helen Verdeli, Shekhar Saxena, Inge Petersen, Keng Yen Huang, Caleb Othieno, Nancy Grote, Roslyn Law, Jurgen Unutzer, Mary Mckay

Brain and Mind Institute

Background: This study describes adaptation and modification of World Health Organization (WHO) recommended group interpersonal psychotherapy (IPT-G) for depressed peripartum adolescents. The adaptation process includes accommodating contextual factors and strategies to address intervention implementation barriers, such as engagement problems with adolescents, caregivers, and providers, and stigma and dearth of mental health specialists. The modifications include and adolescent relevant iterations to the therapy format and content.

Methods: A multi-stakeholder led two-stage intervention adaptation and modification process integrating mixed qualitative methods were used with pregnant and parenting adolescents, their partners, and health care workers. In-depth interviews focusing on personal, relationship, social, and …

Psychosocial And Mental Health Challenges Faced By Emerging Adults Living With Hiv And Support Systems Aiding Their Positive Coping: A Qualitative Study From The Kenyan Coast, Moses K. Nyongesa, Carophine Nasambu, Rachael Mapenzi, Hans M. Koot, Pim Cuijpers, Charles R. J. C. Newton, Amina Abubakar

Institute for Human Development, East Africa

Background: In sub-Saharan Africa, there is little data on the challenges faced by young people living with HIV tran- sitioning into adult life. Adapting the socio-ecological framework, this qualitative study investigated the challenges faced by emerging adults living with HIV from a rural Kenyan setting. Additionally, the study explored support systems that aid positive coping among these young adults.

Methods: In April 2018, in-depth interviews were conducted with a convenience sample of 22 young adults living with HIV (12 females), 18–24 years old, from rural Kilifi, coast of Kenya. Data were analyzed thematically using NVIVO 11 software.

Results …

Endoxifen: A New Hope For Bipolar Disorder, Muneeba Amin, Alviya Shafique, Muhammad Yusuf Hafiz

Department of Psychiatry

No abstract provided.

Alcohol And Illicit Drug Use Among Young People Living With Hiv Compared To Their Uninfected Peers From The Kenyan Coast: Prevalence And Risk Indicators, Moses K. Nyongesa, Paul Mwangi, Michael Kinuthia, Amin S. Hassan, Hans M. Koot, Pim Cuijpers, Charles R. J. C. Newton, Amina Abubakar

Institute for Human Development, East Africa

Background: In sub-Saharan Africa, there is paucity of research on substance use patterns among young people living with HIV (YLWH). To address the gap, we sought to: i) determine the prevalence of substance use, specifically alcohol and illicit drug use, among YLWH compared to their HIV-uninfected peers; ii) investigate the independent association between young people’s HIV infection status and substance use; iii) investigate the risk indicators for substance use among these young people.

Methods: Between November 2018 and September 2019, a cross-sectional study was conducted at the Kenyan coast recruiting 819 young people aged 18–24 years (407 HIV-positive). …

Psychological Autopsy Study And Risk Factors For Suicide In Muslim Countries, S M Yasir Arafat, Murad M. Khan, Vikas Menon, Syeda Ayat-E-Zainab Ali, Mohsen Rezaeian, Sheikh Shoib

Department of Psychiatry

Background: Suicide and risk factors have been poorly studied in the Muslim-majority countries that hinder the formulation of prevention strategies and affect suicide prevention eventually.
Objectives: We aimed at identifying and analyzing the psychological autopsy studies assessing the risk factors for suicide conducted in Muslim-majority countries.
Methods: We did a search to trace all the available psychological autopsy studies in the Muslim countries with the search term "psychological autopsy study in Muslim countries." We also checked the available bibliographies to identify the psychological autopsy studies in the Muslim countries so that all the possible studies could be included.
Results: Out …

Perceptions And Experiences Of Healthcare Providers During Covid-19 Pandemic In Karachi, Pakistan: An Exploratory Qualitative Study, Anam Shahil Feroz, Nousheen Pradhan, Zarak Hussain Ahmed, Mashal Murad Shah, Nargis Asad, Sarah Saleem, Sameen Siddiqi

Community Health Sciences

Objective: To explore healthcare provider's perspectives and experiences of the barriers and facilitators to treat and manage COVID-19 cases.
Design and setting: We conducted an exploratory qualitative study using a purposive sampling approach, at a private tertiary care teaching hospital in Karachi, Pakistan. Study data were analysed manually using the conventional content analysis technique.
Participants: Key-informant interviews (KIIs) were conducted with senior management and hospital leadership and in-depth interviews (IDIs) were conducted with front-line healthcare providers.
Results: A total of 31 interviews (KIIs=19; IDIs=12) were conducted, between April and May 2020. Three overarching themes emerged. The first was 'challenges faced …

Integrating Telepsychiatry Services In A Care Setting In Kenya: A Case Report, Frank Njenga, Linnet Ongeri, Anna Nguithi, Jacqueline Anundo, Maryann Mugane, Zawadi Kimari, Gathoni Mbugua, Cushny Kaigwa, Lukoye Atwoli

Internal Medicine, East Africa

Globally, health providers and patients alike have been forced to adapt rapidly to the use of telemedicine during the COVID-19 pandemic. Although telepsychiatry has been tested and found just as effective as face-to-face care, there still remains little uptake of this form of care provision in sub-Saharan Africa. This case study highlights the use of telepsychiatry in a previously telemedicine-naive private mental health facility in Kenya. We describe the challenges and lessons learned from the experience. We conclude on the need to test the effectiveness and acceptability of this mode of therapy in sub-Saharan Africa.

Mental Disorders Among Health Care Workers At The Early Phase Of Covid-19 Pandemic In Kenya; Findings Of An Online Descriptive Survey, Edith Kamaru Kwobah, Ann Mwangi, Kirtika Patel, Thomas Mwogi, Robert Kiptoo, Lukoye Atwoli

Internal Medicine, East Africa

Background: Healthcare workers responding to the Corona Virus Pandemic (COVID-19) are at risk of mental illness. Data is scanty on the burden of mental disorders among Kenyan healthcare workers responding to the pandemic that can inform mental health and psychosocial support. The purpose of this study was to establish the frequency and associated factors of worry, generalized anxiety disorder, depression, posttraumatic stress disorder and poor quality of sleep among Kenyan health care workers at the beginning of COVID-19 pandemic.

Methods: We conducted an online survey among 1,259 health care workers in Kenya. A researcher developed social demographic questionnaire and several …

Perceived Stress May Mediate The Relationship Between Antenatal Depressive Symptoms And Preterm Birth: A Pilot Observational Cohort Study, Sharifa Bashir Lalani, Aliyah Dosani, Ntonghanwah Forcheh, Shahirose Sadrudin Premji, Sana Siddiqui, Kiran Shaikh, Ayesha Mian, Ilona S Yim Ilona S Yim, Maternal-Infant Global Health Team (Might) Collaborators In Research

School of Nursing & Midwifery

Background: Screening for changes in pregnancy-related anxiety and depressive symptoms during pregnancy may further our understanding of the relationship between these two variables and preterm birth.
Objectives: To determine whether changes in pregnancy-related anxiety and depressive symptoms during pregnancy influence the risk of preterm birth among Pakistani women; explore whether perceived stress moderates or mediates this relationship, and examine the relationship between the various components of pregnancy-related anxiety and preterm birth.
Methods: A prospective cohort study design was used to recruit a diverse sample of 300 low-risk pregnant women from four centers of Aga Khan Hospital for Women and Children …

Child Maltreatment And Neglect In The United Arab Emirates And Relationship With Low Self-Esteem And Symptoms Of Depression, Syed M. Shah, Gul Nowshad, Fatima Al Dhaheri, Mariam H. Al-Shamsi, Alfan M. Al-Ketbi, Alaa Galadari, Priyam Joshi, Heba Bendak, Michal Grivna, Danilo Arnone

Department of Family Medicine

Objectives: To our knowledge, this study is the first in the United Arab Emirates (UAE) to investigate the prevalence of child maltreatment in relation to depressive symptoms and self-esteem.
Study design: Exposure to physical maltreatment, emotional abuse and neglect was evaluated in 518 adolescents (86% response rate) randomly selected from schools in Al Ain in the Emirate of Abu Dhabi. The Rosenberg self-esteem scale and the Beck Depression Inventory were used to measure self-esteem and depressive symptoms by using multivariate logistic regression analyses.
Results: The mean age of study participants was 14.3 years. Emotional abuse was the most frequent form …

Autism: A Deep Insight, Hemaila Tariq, Muhammad Yusuf Hafiz

Medical College Documents

No abstract provided.

A Multidisciplinary Approach To Triage Patients With Breast Disease During The Covid-19 Pandemic: Experience From A Tertiary Care Center In The Developing World, Abida K. Sattar, Hania Shahzad, Adnan Abdul Jabbar, Azmina Tajdin Valimohammad, Sadaf Khan, Yasmin Vellani, Romana Idrees, Nasir Ali, Imrana Masroor, Humera Saeed, Gulzar S. Lakhani, Nadia Ayoub, Atif Waqar, Muhammad Zia-Ul Islam, Salman Kirmani, Asad Latif, Ather Enam

Section of General Surgery

Background: The COVID-19 pandemic has created a need to prioritize care because of limitation of resources. Owing to the heterogeneity and high prevalence of breast cancers, the need to prioritize care in this vulnerable population is essential. While various medical societies have published recommendations to manage breast disease during the COVID-19 pandemic, most are focused on the Western world and do not necessarily address the challenges of a resource-limited setting.
Aim: In this article, we describe our institutional approach for prioritizing care for patients presenting with breast disease.
Methods and results: The breast disease management guidelines were developed and approved …

Risk Factors For Suicide In Bangladesh: Case-Control Psychological Autopsy Study, S M Yasir Arafat, M A. Mohit, Mohammad S I. Mullick, Russell Kabir, Murad M. Khan

Department of Psychiatry

Background: Suicide is an important, understudied public health problem in Bangladesh, where risk factors for suicide have not been investigated by case-control psychological autopsy study.
Aims: To identify the major risk factors for suicide in Dhaka, Bangladesh.
Methods: We designed a matched case-control psychological autopsy study. We conducted a semi-structured interview with the next-of-kin of 100 individuals who died by suicide and 100 living controls, matched for age, gender and area of residence. The study was conducted from July 2019 to July 2020.
Results: The odds ratios for the risk factors were 15.33 (95% CI, 4.76-49.30) for the presence of …

Interpersonal Psychotherapy Delivered By Nonspecialists For Depression And Posttraumatic Stress Disorder Among Kenyan Hiv–Positive Women Affected By Genderbased Violence: Randomized Controlled Trial, Susan M. Meffert, Thomas C. Neylan, Charles E. Mcculloch, Kelly Blum, Craig R. Cohen, Elizabeth Bukusi, Helen Verdel, John C. Markowitz, James G. Kahn, David Bukusi

Obstetrics and Gynaecology, East Africa

Background: HIV–positive women suffer a high burden of mental disorders due in part to gender-based violence (GBV). Comorbid depression and posttraumatic stress disorder (PTSD) are typical psychiatric consequences of GBV. Despite attention to the HIV-GBV syndemic, few HIV clinics offer formal mental healthcare. This problem is acute in sub-Saharan Africa, where the world’s majority of HIV–positive women live and prevalence of GBV is high.

Methods and findings: We conducted a randomized controlled trial at an HIV clinic in Kisumu, Kenya. GBV-affected HIV–positive women with both major depressive disorder (MDD) and PTSD were randomized to 12 sessions of interpersonal psychotherapy (IPT) …

Reliability And Validity Of The Rs14 In Orphaned And Separated Adolescents And Youths In Western Kenya, Sarah C. Sutherland, Harry S. Shannon, David Ayuku, David L. Streiner, Olli Saarela, Lukoye Atwoli, Paula Braitstein

Internal Medicine, East Africa

Purpose: The 14-item Resilience Scale (RS14) is a tool designed to measure psychological resilience. It has been used effectively in diverse populations. However, its applicability is largely unknown for Sub-Saharan adolescent populations and completely unknown for orphaned and separated adolescents and youths (OSAY), a highly vulnerable population for whom resilience may be critical. This study assesses the RS14's psychometric properties for OSAY in Uasin Gishu County, Kenya.

Methods: Survey responses from a representative sample of 1016 OSAY (51.3% female) aged 10-25 (mean = 16; SD = 3.5) living in institutional and home-based environments in Uasin Gishu County were analyzed. The …

Association Of Depression And Resilience With Fertility Quality Of Life Among Patients Presenting To The Infertility Centre For Treatment In Karachi, Pakistan, Shireen Shehzad Bhamani, Nida Zahid, Wajeeha Zahid, Salima Farooq, Saima Sachwani, Marilyn Chapman, Nargis Asad

School of Nursing & Midwifery

Background: In Pakistan there is a dire need to explore the quality of life in infertile males and females and its undesirable psychological outcomes. This, study aimed to compare the quality of life (QoL) of males and females visiting an infertility centre for treatment and to assess its association with resilience, depression, and other socio-demographic factors.
Methods: An Analytical Cross-Sectional study was conducted amongst infertile males and females at the Australian Concept Infertility Medical Centre (ACIMC), Karachi, Pakistan. The non-probability (purposive) sampling strategy was used to recruit the participants. The sample size was 668. Data was analysed using STATA version …

The Reliability, Validity And Factorial Structure Of The Swahili Version Of The 7-Item Generalized Anxiety Disorder Scale (Gad-7) Among Adults Living With Hiv From Kilifi, Kenya, Moses K. Nyongesa, Paul Mwangi, Hans M. Koot, Pim Cuijpers, Charles R. J. C. Newton, Amina Abubakar

Institute for Human Development, East Africa

Background: Generalized Anxiety Disorder (GAD) is under-investigated in people living with HIV/AIDS from sub-Saharan Africa. In part, this is due to paucity of culturally appropriate measures for GAD which are psychometrically robust. This study aimed to evaluate the reliability, factorial structure, and validity of Swahili version of the 7-item GAD questionnaire (GAD-7) among adults living with HIV.

Study design: Descriptive cross-sectional study.

Methods: 450 adults receiving comprehensive care from an HIV specialized clinic in Kilifi County, coastal Kenya, were consecutively recruited. Swahili versions of GAD-7, Patient Health Questionnaire (PHQ-9) and a 12-item HIV stigma scale were administered alongside measures of …

Substance Use Service Availability In Hiv Treatment Programs: Data From The Global Iedea Consortium, 2014-2015 And 2017, Angela M. Parcesepe, Kathryn Lancaster, E. Jennifer Edelman, Raquel Deboni, The Foundation For Aids Research, Bangkok, Thailand, Lukoye Atwoli

Internal Medicine, East Africa

Background: Substance use is common among people living with HIV and has been associated with suboptimal HIV treatment outcomes. Integrating substance use services into HIV care is a promising strategy to improve patient outcomes.

Methods: We report on substance use education, screening, and referral practices from two surveys of HIV care and treatment sites participating in the International epidemiology Databases to Evaluate AIDS (IeDEA) consortium. HIV care and treatment sites participating in IeDEA are primarily public-sector health facilities and include both academic and community-based hospitals and health facilities. A total of 286 sites in 45 countries participated in the 2014–2015 …

Piloting Relaxation Techniques As Part Of Occupational Therapy Programme In An In-Patient Psychiatric Setting, Humera Saeed, M. Shameel Khan, Natasha Farid

Department of Psychiatry

No abstract provided.

Perceptions Of Stakeholders About The Role Of Health System In Suicide Prevention In Ghizer, Gilgit-Baltistan, Pakistan, Anila Anjum, Tazeen S. Ali, Nousheen Pradhan, Murad M. Khan Dr., Rozina Karmaliani Professor

Community Health Sciences

Background: Suicide is a serious global public health problem, with more than 800,000 people dying by suicide worldwide every year. 79% of suicides happen in Low and Middle-Income Countries (LMICs), where lack of national suicide prevention programs coupled with inadequate MH facilities for early identification and treatment of mental disorders add to seriousness of the problems. Although there is paucity of research, studies suggest that the rate of suicide in district Ghizer, Gilgit-Baltistan (GB), in northern Pakistan may be higher compared to rest of the country.
Methods: This study aimed to explore the perceptions of stakeholders about the role of …

Mental Health Challenges And Psycho-Social Interventions Amid Covid-19 Pandemic: A Call To Action For Pakistan, Salima Farooq, Saima Sachwani, Sonia Ijaz Haider, Sajid Abrar Iqbal, Yasmin Parpio, Humera Saeed

School of Nursing & Midwifery

The increase in death and spread-related coronavirus (COVID-19) has shifted the world focus to the containment of the disease by emphasising measures to prevent spread in the general population. Such a complex, threatening, and unprecedented situation has left the psycho-social wellbeing needs of general public unaddressed. This paper aims to review the current COVID-19 scenario and its effects on the psycho-social wellbeing of people; and an attempt to shed some light on the aforementioned questions. Furthermore, the review will propose some recommendations for overcoming the mental illness issues, during and after the COVID-19 outbreak. We extracted information from reliable published …

New Horizons: Covid-19 And The Burden Of Neuropsychiatric Illness In Pakistan, Ali M. Hashmi, Haider Ali Saleem

Medical College Documents

This manuscript reviews the current state of knowledge about the burden of mental illness and assesses the impact of COVID-19 illness on mental health in Pakistan. For this we analyzed secondary data obtained from the Institute of Health Metrics and Evaluation. The Global Burden of Disease (GBD) study draws from a wide range of data sources to quantify global and regional effects of a disease. We also did a literature search on the effects of COVID-19 illness on mental health and the psychosocial effects of COVID-19 and other Corona virus related illnesses such as SARS-CoV and MERS-CoV. Data from the …

Reasons For Facebook Usage: Data From 46 Countries, Marta Kowal, Piotr Sorokowski, Agnieszka Sorokowska, Małgorzata Dobrowolska, Katarzyna Pisanski, Anna Oleszkiewicz, Toivo Aavik, Grace Akello, Charlotte Alm, Rizwana Shaikh

Department of Paediatrics and Child Health

No abstract provided.

Assessing Physical Activity In People With Mental Illness: 23-Country Reliability And Validity Of The Simple Physical Activity Questionnaire (Simpaq), S Rosenbaum, R Morell, A Abdel-Baki, M Ahmadpanah, T V. Anilkumar, L Baie, A Bauman, S Bender, Zahra Hoodbhoy, Romaina Iqbal, Ayesha Mian

Department of Paediatrics and Child Health

Background: Physical inactivity is a key contributor to the global burden of disease and disproportionately impacts the wellbeing of people experiencing mental illness. Increases in physical activity are associated with improvements in symptoms of mental illness and reduction in cardiometabolic risk. Reliable and valid clinical tools that assess physical activity would improve evaluation of intervention studies that aim to increase physical activity and reduce sedentary behaviour in people living with mental illness.
Methods: The five-item Simple Physical Activity Questionnaire (SIMPAQ) was developed by a multidisciplinary, international working group as a clinical tool to assess physical activity and sedentary behaviour in …