ABSTRACT
Objective@#Pharmacotherapy including mood stabilizers and antipsychotics are frequently used in bipolar disorder (BD); however, the lack of consensus regarding the definition of polypharmacy hinders conducting comparative studies across different settings and countries. Research on Asian Prescription Pattern (REAP) is the largest and the longest lasting international collaborative research in psychiatry in Asia. The objective of REAP BD was to investigate the prescription patterns of psychotropic medications across Asian countries. The rates of polypharmacy and psychotropic drug load were also analyzed. @*Methods@#The data collection was web-based. Prescription patterns were categorized as (1) mood stabilizer monotherapy: one mood stabilizer; (2) antipsychotic monotherapy: one antipsychotic; (3) simple polypharmacy: one mood stabilizer and one antipsychotic; and (4) complex polypharmacy: ≥ 2 mood stabilizers or/and antipsychotics. The psychotropic drug load in each patient was calculated using the defined daily dose method. @*Results@#Among 2003 patients with BD (52.1% female, 42.4 years) from 12 countries, 1,619 (80.8%) patients received mood stabilizers, 1,644 (82.14%) received antipsychotics, and 424 (21.2%) received antidepressants, with 14.7% mood stabilizer monotherapy, 13.4% antipsychotic monotherapy, 48.9% simple polypharmacy, 20.3% complex polypharmacy, and 2.6% other therapy. The average psychotropic drug load was 2.05 ± 1.40. Results varied widely between countries. @*Conclusion@#Over 70% of psychotropic regimens involved polypharmacy, which accords with the high prevalence of polypharmacy in BD under a permissive criterion (2 or more core psychotropic drugs) worldwide. Notably, ≥ 80% of our sample received antipsychotics, which may indicate an increasing trend in antipsychotic use for BD treatment.
ABSTRACT
To develop and validate a new screening instrument in Urdu language for bipolar spectrum disorders in patients presenting to tertiary care center. This instrument is called the Services Institute Medical Sciences screening instruments for bipolar spectrum disorders [SIBD]. It was quasi-experimental study. Department of Psychiatry, Services Institute of Medical Sciences and Services hospital, Lahore. January 2006 to November 2006. A total of 200 patients attending outpatient and in-patient facilities of Psychiatry Department, Services hospital, Lahore suffering from mood disorders completed the SIBD. A research professional, blind to the SIBD results, conducted a semi structured interview using DSM - IV diagnostic criteria for the diagnosis of bipolar disorder. SIBD with a screening score of 30 or positive responses to at least 7 items yielded good sensitivity [0.73] and very good specificity [0.90]. The SIBD is a useful screening instrument for bipolar spectrum disorder to be used in clinical practice in tertiary care centers initially
ABSTRACT
The tolerability and efficacy for patients with obsessive-compulsive disorder [OCD] in a large, sample on Escitalopram was studied. A total of 100 adults with a confirmed diagnosis of OCD were included. The percentage of patients with an adequate drug trial, defined as 42 days of continuous treatment with a serotonin- reuptake inhibitor or placebo at dosages at or above established minimal effective dosages. Ninety-six percent of the adults who were newly diagnosed with OCD in the index year had an adequate trial of medication after their first visit for OCD. By the second half of 42 days the patient who were responding to the treatment were randomly allocated to two groups. One group received the same drug and other group was given placebo. The results were complied at the end of three months of each patient treatment. No additional psychotherapy was offered to these patients during this time period. Despite the typically chronic course of OCD, many patients with OCD responded to the Esciatolpram at the dosage of twenty milligram per day
Subject(s)
Humans , Male , Female , Obsessive-Compulsive Disorder/drug therapy , Double-Blind Method , PlacebosABSTRACT
To examine the frequency of Post Traumatic Stress Disorder [PTSD] in victims of October 2005 earthquake in Pakistan and to evaluate its association with type of physical injuries and depressive disorder. 210 victims were assessed for PTSD and depression by using semi-structured clinical interview and HADS respectively. These subjects were selected at random. Victims, both with or without physical injuries, were assessed. Of the two hundred ten victims, 141 had sustained physical injuries. Among those, 51% had soft tissue injuries, 36% had bony injuries and 13% had spinal injuries. Among physically injured victims 87 [62%] developed PTSD and 54 [38%] did not. Sixty nine victims who did not sustain physical injuries, 32 [46%] developed PTSD while 37 [54%] did not. The results indicate significant relationship between PTSD and physical injury [Chi square=4.43, df=1, p<0.05]. Frequency of PTSD was markedly increased in people suffered from physical injuries as compared to those who did not sustained injuries
ABSTRACT
To find out the association of family size and birth order in patients suffering from conversion disorder, and to observe its correlation with pattern of conversion symptoms and co morbid anxiety and depressive symptoms. This was a hospital based, descriptive, cross sectional study. The study was conducted in the Department of Psychiatry, Services hospital, Lahore from August 2003 to January 2004. One hundred patients, suffering from conversion disorder diagnosed on the basis of DSM-IV criteria were assessed for symptom pattern. A semi-structured interview was used to collect details of family size and birth order. Anxiety and Depressive symptoms were evaluated by using Hospital Anxiety and Depression Scale [HADS]. The majority of the patients were having 4-6 siblings. A strong correlation was found between the larger sized family and the middle born patients with the pattern of the conversion symptoms as well as with the anxiety and depressive symptoms. The patients with a diagnosis of conversion disorder need to be managed for, not only the psychological aspects but also the social issues like family size and stresses associated with it