Preferred antipsychotic by mental health professionals of Sindh and Balauchistan

Objective: To determine the preferred antipsychotic drug of mental health professionals

Material and Methods: This cross-sectional survey was conducted among mental healthcare professionals of 25 public/private healthcare facilities of Sindh and Blochistan provinces form April 2007 to March 2008. After approval from ethical committee of Dow University of Health Sciences mental health professionals [trainees, consultants with experience only and consultant with postgraduate qualification] present on the day of visit to a facility were approached and asked to fill a semi-structured questionnaire to determine the preferred antipsychotic for patient as well as for themselves if they got ill and the factors they consider while choosing that antipsychotic. Descriptive analysis of the data was performed by SPSS v. 14

Results: One-hundred five mental health professionals were divided in 3 groups i.e. trainees [29], experienced doctors [24] and consultants psychiatrists [52]. They have almost equal experience of using typical [48%] and atypical [49%] antipsychotic, but when asked to chose antipsychotic for themselves, atypical [81%] were preferred over typical [14%] antipsychotic with Risperidone as the most common choice [55%] followed by quetiapine, olanzapine and clozapine. Regarding the factors influencing prescription, efficacy and safety were most considered factor while choosing antipsychotic for themselves as compare to efficacy and cost while experiencing prescription for patients

Conclusion: Clinical approach varies while prescribing anti-psychotic drug for the patients and for themselves between typical and atypical. Efficacy and safety were considered while choosing for themselves, whereas efficacy and cost while prescribing for patients

Comparison of urdu version of strengths and difficulties questionnaire [SDQ] and the child behaviour check list [CBCL] amongst primary school children in Karachi

To compare CBCL [Child Behaviour Check Llist] Urdu, with the validated Urdu version of Strengths and Difficulties Questionnaire [SDQ] used as "gold standard" among school children in Karachi, Pakistan, and to develop local cutoffs for CBCL using SDQ as a gold standard. A cross-sectional study. Schools of Karachi metropolitan area from January to December 2006. The Strengths and Difficulties Questionnaire [SDQ] and Child Behaviour Check List [CBCL] was completed by parents of 5-11 years old primary school children in Karachi. Appropriate cutoff points for total problem, internalizing and externalizing scales were obtained for CBCL. A total of 556 parents filled out both the SDQ Urdu version as well as CBCL. Scores from the parent rated total SDQ scores were highly correlated with the total CBCL scores [r=0.589]. The local cutoffs derived for CBCL were considerably lower than USA norms. Slightly higher cutoff for males was found as compared to females for the total CBCL scores. Like the original English version, the Urdu version of CBCL and SDQ are both equally valid assessment tools to be used for both clinical and research purpose in Pakistani settings, where Urdu is widely spoken and understood

Psychiatric morbidity in children reporting at a tertiary care hospital

The study is designed to assess the psychiatric morbidity in children reporting at psychiatry OPD, of National Institute of Child Health [NICH], Karachi. Simple descriptive study. This study was conducted during the period of two years from January 2005 to January 2007 at National Institute of Child Health [NICH] Karachi. All consecutive patients who reported in child psychiatry clinic were enrolled in this study if they fulfilled the inclusion criteria having age of 3 years to 15 years of either sex. Cases excluded in the study were psychiatric presentation associated with physical illness and symptoms related to drug side effects. The facility received direct referrals from other professional colleagues, and from parents, school teachers who have been sensitized to child psychiatric issues. Semi-structured interview based on DSM-IV along with an open ended slot of question were used for evaluation. Data regarding demographic characteristics, referral source, reasons for referral and diagnostics based on clinical judgment were collected. Five hundred and seventy new cases were inducted in this study over a period of two years. Males outnumbered females with the ratio of 1.7:1. Majority [42.28%] of children were in the age range from 11-15 years. Standard deviation of age was 6.8 years for male and 3.5 years for female children. Most [69.6%] of the referrals were made from professionals working in pediatric medicine. The most common reason for referral was disruptive behaviour [26.32%], followed by behavioural problem with fits [15.79%] and physical over activity [7.89%]. Other presenting complaints [reasons for referral] included slow learner, self injurious behaviour, aggression, speech delay, unexplained physical symptoms, bed wetting, emotional problems poor attention and tics etc. Mental retardation with behavioural problem was the most frequent [36.14%] provisional diagnosis. About 16.14% of cases related to seizure disorder with behavioural problem while 10.53% were attention deficit hyperactivity disorder [ADHD]. Other diagnoses made were depressive illness, conversion disorder, functional enuresis and autism. After mental retardation, one third of cases comprised of seizure disorder with behavioral problem, attention deficit hyperactivity disorder [ADHD], and depressive illness. It is therefore recommended that professionals at primary health care level should be trained to identify psychiatric illness in children so that early intervention, proper referral and effective management may be possible

Prevalence of nocturnal enuresis in children: a community study

Enuresis is a common distressing problem among children and can lead to important social or psychological disturbances. To determine the prevalence of nocturnal enuresis in a community. The study was carried out in a community of Korangi town, Karachi from 12[th] January-20[th] March, 2009. A total of 300 children aged 4-14 years, suffering from nocturnal enuresis were included in the study. Information was collected on semi-structured proforma, comprising of personal profile, frequency of bedwetting, drinking of water and urinary habit before going to bed, concern shown by parent/care givers and treatment etc. Respondents were interviewed after taking a verbal informed consent and confidentiality was assured. Data was analyzed using SPSS software package. Of 300 children, 183 [61%] were boys and 117[39%] girls. Bedwetting was common in age group to 10 years and 90% of them were primary enuretic. Most of the parents showed concern about this problem but only 23% consulted a doctor/hakim/homeopath and 19% received treatment. Family history of nocturnal enuresis was present in 35% cases. Though parents were apprehensive about enuresis but only few consulted or received treatment from medical professionals while majority sought orthodox management, probably because of ignorance. Health education about nocturnal enuresis is required for its right management