Psychiatry Commons^™

Association Between Antipsychotics And Weight Gain Among Psychiatric Outpatients In Pakistan: A Retrospective Cohort Study., Syed Ahmer, Rashid A. M Khan, Saleem Perwaiz Iqbal

Department of Psychiatry

Background: It has been known for a long time that use of antipsychotics, particularly atypical antipsychotics, is associated with weight gain and increase in risk of metabolic disturbances. In this study we have tried to find out if use of antipsychotics is associated with increase in weight and body mass index (BMI) in the Pakistani population. Methods: We performed a case note review of all Patients who had been prescribed antipsychotic medication at the psychiatry outPatient clinic of a tertiary care university hospital in Pakistan over a 4-year period. Results: A total of 50% of Patients had a BMI in …

Factors Associated With Non-Adherence Among Psychiatric Patients At A Tertiary Care Hospital, Karachi, Pakistan: A Questionnaire Based Cross-Sectional Study, Fawad Taj, Mansoor Tanwir, Zarmeneh Aly, Ameer Ali Khowajah, Asma Tariq, Fahd Khalid Syed, Fahd Waqar, Khezar Shahzada

Department of Psychiatry

OBJECTIVE: To elucidate predictors of non-adherence among psychiatric patients presenting at a tertiary care hospital of Pakistan, for follow-up with consultant psychiatrist.

METHODS: A convenient sampleof psychiatric patients from Aga Khan University Hospital was enrolled between April and May, 2005. An interviewer assisted, standardized questionnaire was used for data collection. Patients with cognitive deficit or psychosis and those presenting for the first time were not included in the study.

RESULTS: Out of 128 patients, those with co-morbidity (32.81%) were less adherent than those without comorbidity (p-value:0.002). Adherence among depressed was 61.53%; psychotic was 58.82%; bipolar disorder was 73.91%. Reasons for …

Perceptions About The Cause Of Schizophrenia And The Subsequent Help Seeking Behavior In A Pakistani Population - Results Of A Cross-Sectional Survey, Syed Nabeel Zafar, Reema Syed, Sarah Tehseen, Saqib A. Gowani, Sana Waqar, Amina Zubair, Wajeeha Yousaf, Akbar J. Zubairi, Haider Naqvi

Department of Psychiatry

Background: There is a cultural variability around the perception of what causes the syndrome of schizophrenia. Generally Patients with schizophrenia are considered dangerous. They are isolated and treatment is delayed. Studies have shown favorable prognosis with good family and social support, early diagnosis and management. Duration of untreated psychosis is a bad prognostic indicator. We aimed to determine the perceptions regarding the etiology of schizophrenia and the subsequent help seeking behavior. Methods: This cross-sectional study was carried out on a sample of 404 people at the out Patient departments of Aga Khan University Hospital Karachi. Data was collected via a …

Schizophrenia: A Concept, Haider A Naqvi

Department of Psychiatry

Much of the current research-work into biological basis of mental disorders is predicted on implicit concept of disease that is less critical and sophisticated as it should be. It is remarkable, how the fundamental conceptual frame work of schizophrenia, as proposed by Professor Emil Kraepelin has stayed the same, since its inception almost 100-years ago. This review explores these issues besides highlighting alternative disease classification that suits behavioural neuroscience research.

What Do Patients Want From Their Psychiatrist? A Cross-Sectional Questionnaire Based Exploratory Study From Karachi, Roomasa Channa, M. N. Siddiqi

Department of Psychiatry

Background: The aspects of consultation that are important for psychiatric Patients have always remained a less acknowledged area. The aim of this study was to identify these aspects. Methods: A Cross- sectional, questionnaire based study was carried out in a psychiatry outPatient clinic of two tertiary care hospitals in a developing country. The Patients were asked to fill out the questionnaire containing a total of 11 close-ended questions plus 1 open- ended question. They graded them as not important, important, very important or do not know. Non-psychotic Patients aged 18 and above, visiting the clinic were recruited into the study …

Psychiatric Rating Scales In Urdu: A Systematic Review, Syed Ahmer, Rafey A. Faruqui, Anita Aijaz

Department of Psychiatry

Background: Researchers setting out to conduct research employing questionnaires in non-English speaking populations need instruments that have been validated in the indigenous languages. In this study we have tried to review the literature on the status of cross-cultural and/or criterion validity of all the questionnaires measuring psychiatric symptoms available in Urdu language.Methods: A search of Medline, Embase, PsycINFO and http://www.pakmedinet.com was conducted using the search terms; Urdu psychiatric rating scale, and Urdu and Psychiatry. References of retrieved articles were searched. Only studies describing either cross-cultural or criterion validation of a questionnaire in Urdu measuring psychiatric symptoms were included.Results: Thirty two …

Mapping Exercise Of Mental Health Research And Researchers In Pakistan, Haider A. Naqvi, Murad M. Khan

Department of Psychiatry

Objective: To systematically identify mental health research and researchers in Pakistan. Subsidiary objectives were to identify methodologies of studies published in the indexed journals along with their country wide mean impact factor.
Methods: A systematic search strategy using key words related to neuropsychiatry was carried out to identify various studies published in Indexed and Non-indexed databases.
Results: We identified 108 studies from Indexed data bases (77.8% Medline; 22.2% PsychInfo). Beside these, 51 studies were also identified from non-indexed databases. Among the indexed articles, 97 (89.8%) were Journal articles while 10 were other type of documents--there were 3 clinical trials of …

Keeping Alive The "Jazba", Murad M. Khan

Department of Psychiatry

No abstract provided.

Depression In Primary Care: Difficulties And Paradoxes, Haider Naqvi, Murad Moosa Khan

Department of Psychiatry

The presentation of depression in primary care is in many ways different from that seen in psychiatric settings. The process of detection and treatment is also different. This is particularly so in developing countries like Pakistan, which has high prevalence rates of depression but poorly organized primary health care services and primary care physicians (PCPs) who have little psychiatric training, either at undergraduate or postgraduate levels. There is a need to review difficulties faced by primary care physicians in detection and management of depression. It is hoped this would lead to better and more effective management of depression at primary …

Prescription Pattern Of Benzodiazepines For Inpatients At A Tertiary Care University Hospital In Pakistan, Muhammad Rizwanulhaq Khawaja, A Majeed, F Malik, K A. Merchant, M Maqsood, R Malik, S Mazahir, H Naqvi

Department of Psychiatry

Objective: To determine the point prevalence of benzodiazepine prescriptions for inpatients at a tertiary care university hospital in Pakistan and to correlate it with prescription patterns of various specialties, indications and demographic variables of the patients.Methods: This 24-hours point prevalence study was done at The Aga Khan University Hospital, Karachi. By convenient random sampling, 208 inpatients were interviewed. Patients' files were also studied to record the drugs administered. Data was entered into questionnaires and analyzed by SPSS 10.0.Results: The point prevalence of the benzodiazepines was 21.2%. It was higher among males than females and among surgical than non-surgical patients. Midazolam …

Spontaneous Recovery From Depression In Women: A Qualitative Study Of Vulnerabilities, Strengths And Resources, S Naeem, Badar Sabir Ali, A Iqbal, S Mubeen, A Gul

Department of Psychiatry

Objective: To gain insight into the perceived vulnerability and restitution factors for anxiety/or depression.Methods: Focus group discussion of seven married women recovered spontaneously from anxiety and/or depression, belonging to a lower middle class semi-urban community of Karachi.Results: Poverty, unemployment, abuse and on going difficulties were perceived as risk factors for depression. A reliable social support system, positive thinking approach, faith, prayers, and experiencing a "turning point" event were reported as factors that promoted recovery from anxiety and/or depression.CONCLUSION: Individual vulnerabilities, strengths and resources can have an important role in recovery from anxiety and/or depression in women.

The Transformative Effect Of Training In Counselling And Its Application, On The Community Counsellors Themselves, S Naeem, Badar S. Ali, S Mubeen, Iqbal Azam

Department of Psychiatry

Objective: To identify the changes in community counsellors' own level of anxiety and depression as a result of learning counselling skills and to explore their subjective experiences after learning and providing counselling.Design: Quantitative: Repeated Measures. / Qualitative: Focus Group Discussions.SETTING: A lower middle class semi urban community of Karachi, Pakistan.PARTICIPANTS: Twenty-one self selected women from the community.Results: Reduction was seen in the post training scores of anxiety and/or depression in the trainees. As a result of learning and then providing counselling the community counsellors' self esteem, self confidence and sense of competence were enhanced and they developed a more positive …

Clinical And Demographic Characteristics Of Psychiatric Inpatients Admitted Via Emergency And Non-Emergency Routes At A University Hospital In Pakistan, E U. Syed, S Mehmud, R Atiq

Department of Psychiatry

Objective: To examine the differences in the demographic and clinical characteristics of patients admitted through emergency versus non-emergency routes and see if these two groups of patients were significantly different from each other with respect to criteria mentioned in the title.Methods: Retrospective data was analysed in all 2576 patient records were reviewed and these patients were divided in two groups with respect to their mode of admission (emergency vs non emergency). These groups were then compared with respect to sex, age, length of stay, discharge status and diagnostic categories. Statistical package for social sciences version 8.0 (SPSS 8.0) was used …

Conversion Disorder: Difficulties In Diagnosis Using Dsm-Iv/Icd-10, E U. Syed, R Atiq, S Effendi, S Mehmud

Department of Psychiatry

Objective: Conversion disorder presents differently in various cultures. The commonest symptoms in the Asian subcontinent may be very different from those seen in Western Hemisphere. This causes some difficulty in making a diagnosis while using DSM-IV and ICD-10.METHOD: This study searched inpatient records for the last 10 years at the Aga Khan University and collected some demographic data as well as assessed the phenomenology of conversion disorder in the patient population.Results: We found unresponsiveness to be the most common symptom in this sample thus not exactly fitting the DSM-IV/ICD-10 picture.CONCLUSION: We observed that current criteria of conversion disorder as stated …

Benzodiazepine Self-Poisoning In Pakistan: Implications For Prevention And Harm Reduction, M M. Khan, Hashim Reza

Department of Psychiatry

The pattern of all index admissions for benzodiazepine self-poisoning to a university hospital in Karachi, Pakistan are described. Of the 329 medication self-poisoning cases, 84% were benzodiazepine overdoses. Diazepam was the preferred drug in 69% of these cases, with majority ingesting between 20-30 tablets of 5 mg each, 44% bought the benzodiazepine over the counter (OTC) for the purpose of overdose. The preference for benzodiazepines over analgesics (as freely available) may be related to the motives underlying parasuicide acts and their popularity as 'sleeping pills' in Pakistan. Educating the 'chemist' and limiting the number of tablets dispensed at a time …

Neuroleptic Induced Incontinence--Case Report, Tabasum Alvi, Hashim Reza

Department of Psychiatry

No abstract provided.

Trichotillomania, Shahin H. Hussain

Department of Psychiatry

No abstract provided.

Recent Concepts In Clinical Psychiatry: Drug Treatment In Schizophrenia, Shahin H. Hussain

Department of Psychiatry

No abstract provided.