Psychiatry and Psychology Commons^™

The Epidemiology Of Traumatic Event Exposure Worldwide: Results From The World Mental Health Survey Consortium, Corina Benjet, E Bromet, E G. Karam, R C. Kessler, K A. Mclaughlin, A M. Ruscio, V Shahly, D J. Stein, M Petukhova, E Hill, J Alonso, Lukoye Atwoli, B Bunting, R Bruffaerts, J M. Caldas-De-Almeida

Internal Medicine, East Africa

Background: Considerable research has documented that exposure to traumatic events has negative effects on physical and mental health. Much less research has examined the predictors of traumatic event exposure. Increased understanding of risk factors for exposure to traumatic events could be of considerable value in targeting preventive interventions and anticipating service needs.

Method: General population surveys in 24 countries with a combined sample of 68 894 adult respondents across six continents assessed exposure to 29 traumatic event types. Differences in prevalence were examined with cross-tabulations. Exploratory factor analysis was conducted to determine whether traumatic event types clustered into interpretable factors. …

Large Scale Genetic Research On Neuropsychiatric Disorders In African Populations Is Needed, Shareefa Dalvie, Nastassja Koen, Laramie Duncan, Catherine Abbo, Dickens Akena, Lukoye Atwoli, Bonginkosi Chiliza, Kirsten A. Donald, Eugene Kinyanda, Christine Lochner

Internal Medicine, East Africa

In recent years there have been significant insights into the complex aetiologies of neurodevelopmental brain disorders. For example, neuropsychiatric genetics has achieved success with the identification of 108 loci for schizophrenia (Schizophrenia Working Group of the Psychiatric Genomics Consortium, 2014). Furthermore, meta-analyses of genomewide association study (GWAS) results encompassing thousands of samples have been completed for other psychiatric disorders including attention-deficit/hyperactivity disorder (ADHD), autism

Symptoms Of Depression Among Patients Attending A Diabetes Care Clinic In Rural Western Kenya, Kristen Shirey, Simon M. Manyara, Lukoye Atwoli, Ryan Tomlin, Benson Gakinya, Stephanie Cheng, Jemima Kamano, Jeremiah Laktabai, Sonak Pastakia

Internal Medicine, East Africa

Objective: The prevalence of diabetes in sub-Saharan Africa is rising, but its relationship to depression is not well-characterized. This report describes depressive symptom prevalence and associations with adherence and outcomes among patients with diabetes in a rural, resource-constrained setting.

Methods: In the Webuye, Kenya diabetes clinic, we conducted a chart review, analyzing data including medication adherence, hemoglobin A1c (HbA1c), clinic attendance, and PHQ-2 depression screening results.

Results: Among 253 patients, 20.9% screened positive for depression. Prevalence in females was higher than in males; 27% vs 15% (p = 0.023). Glycemic control trends were better in those screening negative; at 24 …

Association Between Traumatic Events And Post-Traumatic Stress Disorder: Results From The Esemed-Spain Study, B Olaya, J Alonso, Lukoye Atwoli, R C. Kessler, G Vilagut, J M. Haro

Internal Medicine, East Africa

Background: The relative importance of traumatic events (TEs) in accounting for the social burden of post-traumatic stress disorder (PTSD) could vary according to cross-cultural factors. In that sense, no such studies have yet been conducted in the Spanish general population. The present study aims to determine the epidemiology of trauma and PTSD in a Spanish community sample using the randomly selected TEs method.

Methods: The European Study of the Epidemiology of Mental Disorders (ESEMeD)-Spain is a cross-sectional household survey of a representative sample of adult population. Lifetime prevalence of self-reported TEs and lifetime and 12-month prevalence of PTSD were evaluated …

Frequency Of Metabolic Syndrome In Psychiatric Patients, Is This The Time To Develop A Standardized Protocol To Reduce The Morbidity From An Acute Care Psychiatry Unit., Tariq Munshi, Archana Patel, Mir Nadeem Mazhar, Emaduddin Siddiqui

Department of Emergency Medicine

OBJECTIVE:

To determine the frequency of Metabolic Syndrome among psychiatric patients and to look for the correlation between the two medical conditions.

METHODS:

The cross-sectional study was conducted from February to April 2013 at the acute care psychiatry in-patient unit at Kingston General Hospital, Ontario, Canada, and comprised adult patients of both genders diagnosed under the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. For Metabolic Syndrome, definitions outlined by the International Diabetes Federation were used. The patients were divided into two groups on the basis of presence or absence of the Syndrome and were compared for clinical and …

The Mini-Mental State Examination As A Diagnostic And Screening Test For Delirium: Systematic Review And Meta-Analysis, Alex J. Mitchell, Deepak Shukla, Hafsa A. Ajumal, Brendon Stubbs, Tayyeb Tahir

Brain and Mind Institute

Objective

To analyse the evidence concerning the accuracy of the Mini-Mental State Examination (MMSE) as a diagnostic and screening test for the presence of delirium in adults.

Method

Two authors searched MEDLINE, PsychINFO and EMBASE from inception till March 2014. Articles were included that investigated the diagnostic validity of the MMSE to detect delirium against standardised criteria. A diagnostic validity meta-analysis was conducted.

Results

Thirteen studies were included representing 2017 patients in medical settings of whom 29.4% had delirium. The meta-analysis revealed the MMSE had an overall sensitivity and specificity estimate of 84.1% and 73.0%, but this was 81.1% and …

Dsm‐5 And Icd‐11 Definitions Of Posttraumatic Stress Disorder: Investigating “Narrow” And “Broad” Approaches, Dan J. Stein, Katie A. Mclaughlin, Karestan C. Koenen, Lukoye Atwoli, Matthew J. Friedman, Eric D. Hill, Andreas Maercker, Maria Petukhova, Victoria Shahly, Mark Van Ommeren

Internal Medicine, East Africa

Background: The development of the Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5) and ICD-11 has led to reconsideration of diagnostic criteria for posttraumatic stress disorder (PTSD). The World Mental Health (WMH) Surveys allow investigation of the implications of the changing criteria compared to DSM-IV and ICD-10.

Methods: WMH Surveys in 13 countries asked respondents to enumerate all their lifetime traumatic events (TEs) and randomly selected one TE per respondent for PTSD assessment. DSM-IV and ICD-10 PTSD were assessed for the 23,936 respondents who reported lifetime TEs in these surveys with the fully structured Composite International Diagnostic Interview …

Protracted Effects Of Juvenile Stressor Exposure Are Mitigated By Access To Palatable Food, Jennifer Christine Mackay, Jonathan Stewart James, Christian Cayer, Pamela Kent, Hymie Anisman, Zul Merali

Brain and Mind Institute

Stressor experiences during the juvenile period may increase vulnerability to anxiety and depressive-like symptoms in adulthood. Stressors may also promote palatable feeding, possibly reflecting a form of self-medication. The current study investigated the short- and long-term consequences of a stressor applied during the juvenile period on anxiety- and depressive-like behavior measured by the elevated plus maze (EPM), social interaction and forced swim test (FST). Furthermore, the effects of stress on caloric intake, preference for a palatable food and indices of metabolic syndrome and obesity were assessed. Male Wistar rats exposed to 3 consecutive days of variable stressors on postnatal days …

Patient Attitudes Towards Physician Nonverbal Behaviors During Consultancy: Result From A Developing Country, Fahad Hanif Khan, Raheela Hanif, Rumina Tabassum, Waris Qidwai Dr, Kashmira Nanji

Department of Family Medicine

Background. Nonverbal behaviors have a significant impact on patients during consultations. This study was undertaken to find out the attitudes and preferences of the patients regarding nonverbal communication during consultations with physicians, in a tertiary care hospital.
Methods. A questionnaire based cross-sectional study was carried out at the Aga Khan University Hospital, Karachi, Pakistan, during the months of January to March 2012. All patients (>18 years of age) coming for consultancy in the family medicine clinics were approached; out of 133, 120 agreed to participate. The subjects were asked questions regarding physician’s comforting touch and eye contact and …

Child Sexual Abuse Leads To Psychological Disorders: Literature Review, Savera Aziz Ali, Sumera Aziz Ali

School of Nursing & Midwifery

This scholarly paper explains the relationship between child sexual abuse and psychological disorders. Childhood sexual abuse (CSA) is a forceful sexual contact with a child who is incapable of consenting. The impact of sexual abuse can range from physical to very severe psychological effects. Psychological disorders caused by child sexual abuse include panic disorder, anxiety, depression, substance abuse, low self-esteem and post-traumatic stress disorder. The phenomenon of child sexual abuse is shaped by some important theories like behavioral, psychodynamic, attachment, cognitive and integrated theory. These theories may help to develop a sound empirical base through which cost effective strategies can …

Association Between Parental Psychopathology And Suicidal Behavior Among Adult Offspring: Results From The Cross-Sectional South African Stress And Health Survey, Lukoye Atwoli, Matthew K. Nock, David R. Williams, Dan J. Stein

Internal Medicine, East Africa

Background: Prior studies have demonstrated a link between parental psychopathology and offspring suicidal behavior. However, it remains unclear what aspects of suicidal behavior among adult offspring are predicted by specific parental mental disorders, especially in Africa. This study set out to investigate the association between parental psychopathology and suicidal behavior among their adult offspring in a South African general population sample.

Method: Parental psychopathology and suicidal behavior in offspring were assessed using structured interviews among 4,315 respondents from across South Africa. The WHO CIDI was used to collect data on suicidal behavior, while the Family History Research Diagnostic Criteria Interview …

Substance Use Among Inmates At The Eldoret Prison In Western Kenya, Daniel Wc Kinyanjui, Lukoye Atwoli

Internal Medicine, East Africa

Background:Criminal activity and social problems are recognized as important outcomes of substance use and abuse. Little research has been carried out on substance use among prison inmates in Kenya. General population surveys that have examined drug use usually omit this‘hidden’population which may offer insight into drug related morbidity and invaluable preventive measures. This study is set out to determine the lifetime prevalence and factors associated with substance use, including the most frequently used substances, among inmates at a government prison in Western Kenya.

Methods:Design: A cross-sectional descriptive study, using the WHO model questionnaire and an additional drug use …

The Journey Of Addiction: Barriers To And Facilitators Of Drug Use Cessation Among Street Children And Youths In Western Kenya, Lonnie Embleton, Lukoye Atwoli, David Ayuku, Paula Braitstein

Internal Medicine, East Africa

This mixed-methods study examined barriers to and facilitators of street children’s drug use cessation in Eldoret, Kenya utilizing a cross-sectional survey and focus group discussions with a community-based sample of street-involved children and youth. The primary objective of this study was to describe factors that may assist or impede cessation of drug use that can be utilized in developing substance use interventions for this marginalized population. In 2011, 146 children and youth ages 10–19 years, classified as either children on the street or children of the street were recruited to participate in the cross-sectional survey. Of the 146 children that …

Molecular Pathway Reconstruction And Analysis Of Disturbed Gene Expression In Depressed Individuals Who Died By Suicide, Vladimir Zhurov, John D. H. Stead, Zul Merali, Miklos Palkovits, Gabor Faludi, Caroline Schild-Poulter, Hymie Anisman, Michael O. Poulter

Brain and Mind Institute

Molecular mechanisms behind the etiology and pathophysiology of major depressive disorder and suicide remain largely unknown. Recent molecular studies of expression of serotonin, GABA and CRH receptors in various brain regions have demonstrated that molecular factors may contribute to the development of depressive disorder and suicide behaviour. Here, we used microarray analysis to examine the expression of genes in brain tissue (frontopolar cortex) of individuals who had been diagnosed with major depressive disorder and died by suicide, and those who had died suddenly without a history of depression. We analyzed the list of differentially expressed genes using pathway analysis, which …

Water Pipe Smoking Amongst The University And College Students Of Karachi, Pakistan, Shehla Batool Jaffri, Aisha Yousuf, Waris Qidwai

Department of Family Medicine

Background:

An extensive literature search revealed that water pipe smoking is an emerging health risk and deserves the attention of health professionals. This study was therefore undertaken to determine the frequency of water pipe smoking among students in college and universities of Pakistan and to assess the practices, knowledge and attitude towards water pipe smoking among them.

Method:

A cross sectional survey was conducted in the College and Universities of Karachi, Pakistan from April 2009 to October 2009. Students were selected through non probability sampling and given self administered questionnaire after the informed consent.

Result:

A total …

Risk Factors For Depression Among Married Women Belonging To Higher And Lower Socioeconomic Status In Karachi, Pakistan, Saima Zainab, Zafar Fatmi, Ambreen Kazi

Community Health Sciences

OBJECTIVES: To determine the risk factors for depression among married women belonging to low and high socioeconomic status in Karachi.METHODS: The study design was cross-sectional. The data was collected from 128 adult married women during July to September 2005. The women were selected from different socioeconomic classes from five hospitals/institutes in Karachi. The Centre for Epidemiology Studies-Depression (CES-D) scale was used to screen the subjects for depression and a structured questionnaire was used to identify the factors for depression.RESULT: According to the CES-D scale, 65% of the study population was found to be depressed. Among the women from high socioeconomic …

Vitamin D: Does It Play A Role In Psychiatry, Mukesh Mohan Bhimani

Department of Psychiatry

No abstract provided.

Evidence Based Treatment Of Schizophrenia: Do We Know Enough, Faheem Khan, Haider A Naqvi

Department of Psychiatry

No abstract provided.

A Randomized Controlled Trial Of Quetiapine Versus Placebo In The Treatment Of Delirium, Tayyeb Tahir, Eamonn Eeles, Venugopal Karapareddy, Prem Muthuvelu, Sian Chapple, Bethan Phillips, Toyin Adyemo, Daniel Farewell, Jonathan I. Bisson

Brain and Mind Institute

Background

Delirium is a commonly occurring complex neuropsychiatric disorder. Evidence for its treatment based on randomized controlled trials (RCTs) is poor.

Aims

To determine the efficacy and acceptability of quetiapine in the treatment of delirium.

Method

A double-blind, RCT was conducted. A total of 42 patients were randomized to quetiapine or a placebo group. The primary outcome measure was the Delirium Rating Scale Revised 98. Other scales used were the Brief Psychiatric Rating Scale, Mini-Mental State Examination and Clinical Global Improvement. In order to account for missing data, a nonlinear mixed-effects model was used to estimate the difference …

Gender Difference In Age At Onset Of Schizophrenia: A Cross Sectional Study From Pakistan, Imama Naqvi, Muhammad Murtaza, Muhammad Ressam Nazir, Haider Ali Naqvi

Department of Psychiatry

OBJECTIVE: To validate the effect of gender on age at onset of schizophrenia in a developing country

METHODS: Medical records of 252 patients diagnosed with schizophrenia according to DSM-IV criteria at a tertiary care hospital in Karachi, Pakistan between 2002 and 2008 were reviewed using a structured questionnaire. Age at onset was defined as age at onset of psychotic symptoms, age at first contact with a health care provider and age at first hospitalization. Socio-demographic variables were reported using descriptive statistics and all measures of age at onset were compared across gender using t-test.

RESULTS: There were 119 women and …

Maternal Morbidity In The First Year After Childbirth In Mombasa Kenya; A Needs Assessment, Matthew F. Chersich, Nicole Kley, Stanley Luchters, Carol Njeru, Elodie Yard, Mary J. Othigo, Marleen Temmerman

Population Health, East Africa

Background: In sub-Saharan Africa, few services specifically address the needs of women in the first year after childbirth. By assessing the health status of women in this period, key interventions to improve maternal health could be identified. There is an underutilised opportunity to include these interventions within the package of services provided for woman-child pairs attending child-health clinics.

Methods: This needs assessment entailed a cross-sectional survey with 500 women attending a child-health clinic at the provincial hospital in Mombasa, Kenya. A structured questionnaire, clinical examination, and collection of blood, urine, cervical swabs and Pap smear were done. Women's health care …

Psychosocial Support Programme To Reduce Stress Among Emergency Physicians, Muhammad Shahid

Department of Emergency Medicine

No abstract provided.

Center-Based Prevalence Of Anxiety And Depression In Women Of The Northern Areas Of Pakistan, Sunita Dodani, Rukhsana Wamiq Zuberi

Department for Educational Development

Objective: To estimate the prevalence of anxiety and depression in women of the Northern areas. Methods: A cross-sectional center-based study was conducted at Singal Medical Center (SNIC), Gilgit, in the Northern Areas of Pakistan, using the Hospital Anxiety and Depression Scale (HADS).

Results: One hundred and twenty women, between the ages of 16 and 60, attended the SMC over a two month period and were included in the study. Using HADS, it was found that 50% of the women had anxiety and/or depression; 25% suffered only from anxiety, 8% from depression and 17% had features of both.

Conclusion: This study …

Managing Depression In General Practice In Pakistan: Do We Need To Re-Invent The Wheel?, Hashim Reza, Murad M. Khan

Department of Psychiatry

No abstract provided.