Psychiatry and Psychology Commons^™

Hypertension In Women: A South-Asian Perspective, Fatima Farrukh, Amin Abbasi, Misbah Jawed, Aysha Almas, Tazeen Jafar, Salim S. Virani, Zainab Samad

Medical College Documents

Introduction: Hypertension is an important contributor to cardiovascular disease related morbidity and mortality. Despite the magnitude of its negative impact on cardiovascular outcomes, treatment and control of hypertension remain suboptimal in both men and women.
Materials and methods: Numerous databases, i.e., PubMed, ScienceDirect, etc., were searched using keywords to identify relevant studies to our narrative review. The findings from the most pertinent articles were summarized and integrated into our narrative review on hypertension in women.
Results: The pathophysiology of essential hypertension is still being delineated in both men and women; there are multiple sex specific factors in association with 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 …

The Impact Of Covid-19 On The Psychological Well-Being Of Surgeons In Pakistan: A Multicenter Cross-Sectional Study, Sana Zeeshan, Mehdia Rajab Ali, Rehan N. Khan, Asad R. Allana, Nida Zahid, Muhammad Kazim Najjad, Arslan A. Abro, Muhammad Ali Nadeem, Zeeshan Mughal, Irshad Ahmed

Section of General Surgery

Introduction The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic left a profound and pervasive impact on the healthcare infrastructure on a global scale. Since its onset, the pattern of reported cases and its associated mortality had shown variability with intermittent peaks causing a significant effect on the psychological well-being of the surgeons of Pakistan. The aim of this study was to assess the effects of the COVID-19 pandemic on the mental well-being of surgeons in Pakistan. Methods This multicenter cross-sectional study was carried out to assess the impact of COVID-19 on the psychological well-being of surgeons in Pakistan. The …

Role Of Surgery In Multifocal Glioblastoma, Syeda Kubra Kishwar Jafri, Syed Sarmad Bukhari, Muhammad Shahzad Shamim

Section of Neurosurgery

The management of multifocal glioblastomas is a point of constant discussion amongst neuro-oncologists. Best outcomes in glioblastoma management come from gross total resection (GTR) followed by concomitant radiation and chemotherapy (CCRT). Multifocal disease is resistant to GTR. Conventional management of these lesion is usually biopsy only followed by CCRT. Recent evidence has shown that there may be some benefit to attempting GTR of the largest lesion whenever safe to do so.

Psychosocial Risk Factors And Cardiovascular Disease And Death In A Population-Based Cohort From 21 Low-, Middle-, And High-Income Countries, Ailiana Santosa, Annika Rosengren, Chinthanie Ramasundarahettige, Sumathy Rangarajan, Jephat Chifamba, Scott A. Lear, Paul Poirier, Karen E. Yeates, Rita Yusuf, Romaina Iqbal

Community Health Sciences

Importance: Stress may increase the risk of cardiovascular disease (CVD). Most studies on stress and CVD have been conducted in high-income Western countries, but whether stress is associated with CVD in other settings has been less well studied.
Objective: To investigate the association of a composite measure of psychosocial stress and the development of CVD events and mortality in a large prospective study involving populations from 21 high-, middle-, and low-income countries across 5 continents.
Design, setting, and participants: This population-based cohort study used data from the Prospective Urban Rural Epidemiology study, collected between January 2003 and March 2021. Participants …

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 …

Fears And Barriers: Problems In Breast Cancer Diagnosis And Treatment In Pakistan, Sidra Saeed, Muhammad Asim, Malik Muhammad Sohail

Community Health Sciences

Background: Women in Pakistan lack appropriate awareness about diagnosis and treatment for breast cancer due to a range of multifaceted barriers. There is a dearth of literature examining the socio-cultural factors that inhibit women from breast cancer screening, diagnosis and treatment in Punjab, Pakistan. Addressing this gap, this qualitative study sought to identify and explore the barriers that hinder women from seeking timely screening and treatment.
Methods: In this process 45 women (age = 18-50 years) with breast cancer were purposively sampled and interviewed from the Punjab Institute of Nuclear Medicine (PINUM) hospital, Faisalabad, Pakistan.
Results: An inductive approach was …

Sexual Violence And Suicide In Bangladesh, S M Yasir Arafat, Murad M. Khan

Department of Psychiatry

No abstract provided.

Peer Victimization And Experiences Of Violence At School And At Home Among School Age Children With Disabilities In Pakistan And Afghanistan, Rozina Somani, Julienne Corboz, Rozina Karmaliani, Esnat D. Chirwa, Judith Mcfarlane, Hussain Maqbool Ahmed Khuwaja, Nargis Asad, Yasmeen Hassan Somani, Ingrid Van Der Heijden, Rachel Jewke

School of Nursing & Midwifery

Background: Children with disabilities are more likely to experience violence or injury at school and at home, but there is little evidence from Central Asia.
Objective: To describe the prevalence of disability and associations with peer violence perpetration and victimization, depression, corporal punishment, school performance and school attendance, among middle school children in Pakistan and Afghanistan.
Method: This is a secondary analysis of data gathered in the course of evaluations of interventions to prevent peer violence conducted in Pakistan and Afghanistan as part of the 'What Works to Prevent Violence against Women and Girls Global Programme'. In …

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 …

Right To Play's Intervention To Reduce Peer Violence Among Children In Public Schools In Pakistan: A Cluster-Randomized Controlled Trial, Rozina Karmaliani, Judith Mcfarlane, Hussain Maqbool Ahmed Khuwaja, Yasmeen Hassan Somani, Shireen Shehzad, Tazeen Saeed Ali, Nargis Asad, Esnat D. Chirwa, Rachel Jewkes

School of Nursing & Midwifery

Background: Peer violence is common globally, but a little researched topic in low-and middle-income countries. This study presents the evaluation of a two-year randomized controlled trial of a structured play-based life-skills intervention implemented in schools in Hyderabad, Pakistan.
Objective: To determine the impact of the intervention on school-based peer violence (victimization and perpetration) and depression among school children.
Methods: 40 single-sex public schools were randomized into two study arms (20 per arm 10 of each sex). A total of 1752 grade 6 students (929 from intervention and 823 from control schools) were enrolled in the trial. The two-year intervention was …

Suicidal Behaviours Among Adolescents From 90 Countries: A Pooled Analysis Of The Global School-Based Student Health Survey, Susan C. Campisi, Bianca Carducci, Nadia Akseer, Clare Zasowski, Peter Szatmari, Zulfiqar Ahmed Bhutta

Woman and Child Health

Background: Understanding the burden and determinants of suicide during adolescence is key to achieving global health goals. We examined the prevalence and determinants of self-reported suicidal ideation and attempts among younger (13-15 years) and older adolescents (16-17 years).
Methods: Pooled prevalence estimates with 95% confidence interval, were calculated for suicide ideation and attempts for 118 surveys from 90 countries that administered the Global School-based Student Health Survey (GSHS) to adolescents (13-17 years of age) from 2003 to 2017. Indicators (including individual and social factors) associated with suicidal ideation and attempts were determined from multivariable linear regressions on key outcomes.
Results: …

Psychological Distress And Its Associated Factors Among Informal Care Givers Of Disabled Young Adults With Traumatic Brain Injuries, Samera Punjwani, Yasmin Parpio, Rubina Barolia, Muhammad Shahzad Shamim, Nargis Asad

Department of Surgery Docs

Objective: To measure the psychological distress among the informal caregivers of disabled young adults with traumatic brain injuries (TBI) and to identify its associated factors.
Methods: An analytical cross sectional study was conducted with 76 informal caregivers of young adults (19 - 50 years) with TBI, using admission records of one of the tertiary care hospitals in Karachi, Pakistan from 2015 to 2016. Data were collected using a structured questionnaire comprising a general demographic questionnaire and the General Health Questionnaire- 28. The effect of the predictors on the psychological distress was determined by applying multiple linear regression analysis.
Results: The …

Psychosocial Implications In Breast Cancer, Daniyal Aamir, Yamna Waseem, Mustafa Saleem Patel

Medical College Documents

No abstract provided.

Prevalence And Correlates Of Depressive Symptoms Among Adults Living With Hiv In Rural Kilifi, Kenya, Moses K. Nyongesa, Paul Mwangi, Stanley W. Wanjala, Agnes M. Mutua, Charles R. J. C. Newton, Amina Abubakar

Institute for Human Development, East Africa

Background: Published research on depression among people living with HIV/AIDS (PLWHA) from Africa is increasing, but data from Kenya remains scarce. This cross-sectional study measured the prevalence and correlates of depressive symptoms among PLWHA in rural Kilifi, on the Kenyan coast.

Methods: Between February and April 2018, we consecutively recruited and interviewed 450 adults living with HIV and on combination antiretroviral therapy (cART). Depressive symptoms were assessed with the 9-item Patient Health Questionnaire (PHQ-9), with a positive depression screen defined as PHQ-9 score ≥ 10. Measures of psychosocial, health, and treatment characteristics were also administered.

Results: The overall prevalence of …

Using Heart Rate Profiles During Sleep As A Biomarker Of Depression, Mysa Saad, Laura B. Ray, Brad Bujaki, Amir Parvaresh, Iryna Palamarchuk, Joseph De Koninck, Alan Douglass, Elliott K. Lee, Louis J. Soucy, Zul Merali

Brain and Mind Institute

Background: Abnormalities in heart rate during sleep linked to impaired neuro-cardiac modulation may provide new information about physiological sleep signatures of depression. This study assessed the validity of an algorithm using patterns of heart rate changes during sleep to discriminate between individuals with depression and healthy controls.

Methods: A heart rate profiling algorithm was modeled using machine-learning based on 1203 polysomnograms from individuals with depression referred to a sleep clinic for the assessment of sleep abnormalities, including insomnia, excessive daytime fatigue, and sleep-related breathing disturbances (n = 664) and mentally healthy controls (n = 529). The final algorithm …

Khat Use And Psychotic Symptoms In A Rural Khat Growing Population In Kenya: A Household Survey, Linnet Ongeri, Fredrick Kirui, Erastus Muniu, Veronica Manduku, Leah Kirumbi, Lukoye Atwoli, Safari Agure, Peter Wanzala, Lydia Kaduka, Mercy Karimi, Richard Mutisya, Elizabeth Echoka, Joseph Mutai, David Mathu, Charles Mbakaya

Internal Medicine, East Africa

Background:Khat is an amphetamine like psychostimulant chewed by over 10 million people globally. Khat use is thought to increase the risk of psychosis among its chewers. The evidence around this however remains inconclusive stemming from the scanty number of studies in this area and small study sample sizes. We undertook a large household survey to determine the association between psychotic symptoms and khat chewing in a rural khat growing and chewing population in Kenya.

Methods:For this cross-sectional household survey, we randomly selected 831 participants aged 10 years and above residing in the Eastern region of Kenya. We used …

Liaison Psychiatry Services In Wales, Tayyeb Tahir, Adam Watkins, Philip Slack

Brain and Mind Institute

Aims and method: Recent funding from Welsh Government for mental health has helped to develop liaison psychiatry services in Wales. Systematic data collection was undertaken to map the liaison psychiatry services in Wales in collaboration with the Royal College of Psychiatrists in Wales and Public Health Wales 1000 Lives Improvement. A questionnaire was designed and circulated to all the health boards in Wales to gather information to map liaison psychiatry services in Wales. Up-to-date information was confirmed in January 2018, via email.

Results: Over the past 2 years, liaison psychiatry services have been set up in six out of …

Clozapine Is Associated With Secondary Antibody Deficiency, Mark Ponsford, Daniel Castle, Tayyeb Tahir, Rebecca Robinson, Wendy Wade, Rachael Steven, Kathryn Bramhall, Mo Moody Mo Moody, Emily Carne, Catherine Ford

Brain and Mind Institute

Background: Schizophrenia affects 1% of the population. Clozapine is the only medication licensed for treatment-resistant schizophrenia and is intensively monitored to prevent harm from neutropenia. Clozapine is also associated with increased risk of pneumonia although the mechanism is poorly understood.AimsTo investigate the potential association between clozapine and antibody deficiency.

Methods: Patients taking clozapine and patients who were clozapine-naive and receiving alternative antipsychotics were recruited and completed a lifestyle, medication and infection-burden questionnaire. Serum total immunoglobulins (immunoglobulin (Ig)G, IgA, IgM) and specific IgG antibodies to haemophilus influenzae type B, tetanus and IgG, IgA and IgM to pneumococcus were measured.

Results: Immunoglobulins …

Palatable Food Dampens The Long-Term Behavioral And Endocrine Effects Of Juvenile Stressor Exposure But May Also Provoke Metabolic Syndrome In Rats, Eliza Fatima Ali, Jennifer Christine Mackay, Samantha Graitson, Jonathan Stewart James, Christian Cayer, Marie-Claude Audet, Pamela Kent, Alfonso Abizaid, Zul Premji

Brain and Mind Institute

The juvenile period is marked by a reorganization and growth of important brain regions including structures associating with reward seeking behaviors such as the nucleus accumbens (NA) and prefrontal cortex (PFC). These changes are impacted by stressors during the juvenile period and may lead to a predisposition to stress induced psychopathology and abnormal development of brain reward systems. Like in humans, adult rodents engage certain coping mechanisms such as increases in the consumption of calorie-rich palatable foods to reduce stress, but this behavior can lead to obesity and metabolic disorders. In this study, we examined whether stressors during the juvenile …

Association Between A Single Nucleotide Polymorphism In Neuregulin-1 And Schizophrenia In Pakistani Patients, Haider Ali Naqvi, Shafqat Huma, Hira Waseem, Kashaf Aqeel Zaidi, Hina Saeed Zuberi, Syed Hani Abidi

Department of Biological & Biomedical Sciences

Objective: To determine the association of single-nucleotide polymorphism8nrg433E1006 in the neuregulin-1 gene associated with schizophrenia.
Methods: This case-control study was conducted at the Fountain House, Lahore, and the psychiatric clinics at the Aga Khan University, Karachi, from 2010 to 2013.The total genomic deoxyribonucleic acid was isolated and single-nucleotide polymorphism8nrg433E1006 was screened by nested polymerase chain reaction followed by sequencing. These sequences, from patients and controls, were aligned with the human neuregulin-1-glial growth factor 2 gene sequence, which served as a reference sequence. The single nucleotide polymorphism genetic algorithm was characterised at position 433 in the neuregulin-1 gene by …

Stress Of Infertility: Can The Couple Cope?, Faiza Alam, Taseer Ahmed Khan, Rehana Rehman

Department of Biological & Biomedical Sciences

No abstract provided.

Loss Of Mecp2 In Adult 5-Ht Neurons Induces 5-Ht1a Autoreceptors, With Opposite Sex-Dependent Anxiety And Depression Phenotypes, Tristan J. Philippe, Faranak Vahid-Ansari, Zoe R. Donaldson, Brice Le François, Amin Zahrai, Valérie Turcotte-Cardin, Mireille Daigle, Jonathan James, René Hen, Zul Merali, Paul R. Albert

Brain and Mind Institute

The 5-HT1A autoreceptor mediates feedback inhibition of serotonin (5-HT) neurons, and is implicated in major depression. The human 5-HT1A gene (HTR1A) rs6295 risk allele prevents Deaf1 binding to HTR1A, resulting in increased 5-HT1A autoreceptor transcription. Since chronic stress alters HTR1A methylation and expression, we addressed whether recruitment of methyl-binding protein MeCP2 may alter Deaf1 regulation at the HTR1A locus. We show that MeCP2 enhances Deaf1 binding to its HTR1A site and co-immunoprecipitates with Deaf1 in cells and brain tissue. Chromatin immunoprecipitation assays showed Deaf1-dependent recruitment of MeCP2 to the mouse HTR1A promoter, and MeCP2 modulated human and mouse HTR1A gene …

Evaluation Of Alcohol Screening And Community-Based Brief Interventions In Rural Western Kenya: A Quasi-Experimental Study, Risa Takahashi, Calistus Wilunda, Karani Magutah, Wanja Mwaura-Tenambergen, Lukoye Atwoli, Usaneya Perngparn

Internal Medicine, East Africa

Aims:To assess the effectiveness of community-based alcohol brief interventions (ABI) implemented by community-health workers with and without motivational talks (MT) by former drinkers, in reducing harmful and hazardous alcohol consumption. Methods:We conducted a three-arm quasi-experimental study (one control and two intervention groups) between May and December 2015 in Kakamega County, Kenya. Participants were hazardous or harmful alcohol drinkers with an Alcohol Use Disorders Identification Test (AUDIT) score of 8–19 at baseline. One intervention group received only ABI while the other received ABI + MT. The interventions’ effects on AUDIT scores were analysed using linear mixed models. Logistic regression …

Prevalence Of Psychiatric Morbidity In A Community Sample In Western Kenya, Edith Kwobah, Steve Epstein, Ann Mwangi, Debra Litzelman, Lukoye Atwoli

Internal Medicine, East Africa

Background:About 25% of the worldwide population suffers from mental, neurological and substance use disorders but unfortunately, up to 75% of affected persons do not have access to the treatment they need. Data on the magnitude of the mental health problem in Kenya is scarce.

The objectives of this study were to establish the prevalence and the socio-demographic factors associated with mental and substance use disorders in Kosirai division, Nandi County, Western Kenya.

Methods:This was a cross sectional descriptive study in which participants were selected by simple random sampling. The sampling frame was obtained from a data base of …

Posttraumatic Stress Disorder In The World Mental Health Surveys, K C. Koenen, A Ratanatharathorn, L Ng, K A. Mclaughlin, E J. Bromet, D J. Stein, E G. Karam, A Meron Ruscio, C Benjet, K Scott, Lukoye Atwoli

Internal Medicine, East Africa

Background: Traumatic events are common globally; however, comprehensive population-based cross-national data on the epidemiology of posttraumatic stress disorder (PTSD), the paradigmatic trauma-related mental disorder, are lacking.

Methods: Data were analyzed from 26 population surveys in the World Health Organization World Mental Health Surveys. A total of 71 083 respondents ages 18+ participated. The Composite International Diagnostic Interview assessed exposure to traumatic events as well as 30-day, 12-month, and lifetime PTSD. Respondents were also assessed for treatment in the 12 months preceding the survey. Age of onset distributions were examined by country income level. Associations of PTSD were examined with country …

Sexual Behavior Among Orphaned Adolescents In Western Kenya: A Comparison Of Institutional-And Family-Based Care Settings, Lonnie Embleton, Joram Nyandat, David Ayuku, Edwin Sang, Allan Kamanda, Samuel Ayaya, Winstone Nyandiko, Peter Gisore, Rachel Vreeman, Lukoye Atwoli

Internal Medicine, East Africa

Purpose: This study sought to assess whether risky sexual behaviors and sexual exploitation of orphaned adolescents differed between family-based and institutional care environments in Uasin Gishu County, Kenya.

Methods: We analyzed baseline data from a cohort of orphaned adolescents aged 10–18 years living in 300 randomly selected households and 19 charitable children's institutions. The primary outcomes were having ever had consensual sex, number of sex partners, transactional sex, and forced sex. Multivariate logistic regression compared these between participants in institutional care and family-based care while adjusting for age, sex, orphan status, importance of religion, caregiver support and supervision, school attendance, …

Post-Traumatic Stress Disorder Associated With Natural And Human-Made Disasters In The World Mental Health Surveys, Evelyn J. Bromet, Lukoye Atwoli, Norito Kawakami, Fernando Navarro-Mateu, P Piotrowski, A J. King, Sergio Aguilar-Gaxiola, Jordi Alonso, Brentan Bunting, Koen Demyttenaere

Internal Medicine, East Africa

Background: Research on post-traumatic stress disorder (PTSD) following natural and human-made disasters has been undertaken for more than three decades. Although PTSD prevalence estimates vary widely, most are in the 20–40% range in disaster-focused studies but considerably lower (3–5%) in the few general population epidemiological surveys that evaluated disaster-related PTSD as part of a broader clinical assessment. The World Mental Health (WMH) Surveys provide an opportunity to examine disaster-related PTSD in representative general population surveys across a much wider range of sites than in previous studies.

Method: Although disaster-related PTSD was evaluated in 18 WMH surveys, only six in high-income …

Posttraumatic Stress Disorder Associated With Unexpected Death Of A Loved One: Cross-National Findings From The World Mental Health Surveys, Lukoye Atwoli, Dan J. Stein, Andrew King, Maria Petukhova, Sergio Aguilar-Gaxiola, Jordi Alonso, Evelyn J. Bromet, Giovanni De Girolamo, Koen Demyttenaere, Silvia Florescu

Internal Medicine, East Africa

Background: Unexpected death of a loved one (UD) is the most commonly reported traumatic experience in cross‐national surveys. However, much remains to be learned about posttraumatic stress disorder (PTSD) after this experience. The WHO World Mental Health (WMH) survey initiative provides a unique opportunity to address these issues.

Methods: Data from 19 WMH surveys (n = 78,023; 70.1% weighted response rate) were collated. Potential predictors of PTSD (respondent sociodemographics, characteristics of the death, history of prior trauma exposure, history of prior mental disorders) after a representative sample of UDs were examined using logistic regression. Simulation was used to estimate overall …

Associations Between Lifetime Potentially Traumatic Events And Chronic Physical Conditions In The South African Stress And Health Survey: A Cross-Sectional Study, Lukoye Atwoli, Jonathan M. Platt, Archana Basu, David R. Williams, Dan J. Stein, Karestan C. Koenen

Internal Medicine, East Africa

Background: This study examined the association between the type, and cumulative number of lifetime potentially traumatic events (PTEs), and chronic physical conditions, in a South African sample. PTE exposures have been associated with an increased risk for a wide range of chronic physical conditions, but it is unclear whether psychiatric disorders mediate this association. Given the established differences in trauma occurrence, and the epidemiology of posttraumatic stress disorder (PTSD) in South Africa relative to other countries, examining associations between PTEs and chronic physical conditions, particularly while accounting for psychiatric comorbidity is important.

Methods: Data were drawn from the South African …