Internally displaced persons [IDPS]; anxiety and depression

Most internally displaced persons [IDPs] live in low-income countries experiencing a war; their psychosocial health has not been well addressed. Objectives: To find out the prevalence of anxiety and depression in internally displaced persons [IDPs]. Design: A r and omized cluster sampling, case-controlled study. Period: 10th April 2009 to 10th July 2009. Setting: This study was conducted at Kacha Ghari camp and Sheikh Yaseen camp for IDPs. Patients and Method: A total of 220 cases [those whom were exposed to traumatic experiences] were selected through cluster r and om sampling. 220-matched controls [those whom were not exposed to traumatic experiences] were selected same day using the same sampling method. Both sexes were included. Socio-demographic information was obtained from IDP- information form. Anxiety and depression was assessed using Hopkins symptoms checklist – 25 [HSCL-25]. SPSS version -17 was used for statistical analysis. Chi square test was applied for group comparison to calculate statistical significance. Results: More than half of the participants [60 %] in this study were in age group between 18 to 38 years. 55 % of the population were females. Majority of participant were married [86% - 90%] and were uneducated [74% - 90%] belongs to lower socio-economical class. The total Scores and the Depression Scores on Hopkins symptoms checklist – 25 [HSCL-25], were significant high in case group than in control group with the P values of 0.04 and 0.05 respectively. Discussion:Traumaandtorture leaves a permanent scar on the survivors. It has physical, psychological and social squeals. Hopkins Symptoms Checklist-25 is intended to provide primary care physicians, mental health practitioners and other health care providers with an instrument for detecting anxiety and depression in torture and trauma victims. Conclusions: Besides being displaced from their residence exposure to trauma come out to be the important causative factor in creating psychological disturbance among internally displaced persons.

Skin disorders in patients with primary psychiatric conditions

Objective To determine the frequency of skin dermatosis in patients with primary psychiatric conditions.

Methods This cross-sectional study was conducted in the Fountain House, Lahore, which is a tertiary care center for psychiatric patients having indoor and outdoor facility. All the admitted psychiatric patients [294] were enrolled in the study. They were thoroughly examined for any skin dermatosis. Out of 294, skin disorders were seen in 172 [58.5%] patients, 89 [60.6%] males and 58 [39.4%] females. The most common primary psychiatric conditions was schizophrenia 47.5% followed by patients of substance abuse 26.5%, bipolar disorder 13.1%, depression and psychosis each in 8.2%. 2.7% patients were manic. Of the study group, 16.3% patients had infective dermatoses and the rest had noninfective dermatoses. A high incidence of generalized xerosis and pruritus was seen in both males and females. Among noninfective dermatoses, 10.1% had eczema, 6.2% acne, 5% melasma, 4.1% palmoplantar keratoderma, 3.2% neurotic excoriations, 3.2% dermatitis artifacta, 2.7% trichotillomania, 2.1% miliaria, and 1.4% had ichthyosis.

Conclusion A high incidence of fungal infections mainly tinea versicolor and onychomycosis was seen in the patients with primary psychiatric conditions.

Pattern of dermatoses and underlying psychopathological disorders in patients attending dermatology clinic in earthquake affected areas of Azad Kashmir

Psychological stress such as sexual assault, major earthquake, or plane crash has long been recognized as an etiological or precipitating factor in dermatological disorders. Treatment of these patients comprises of not only management of dermatological disorders but also on treating the underlying psychopathological diseases. These disorders can be identified by the application of the twelve item General Health Questionnaire [GHQ-12] which is a self-administered screening tool requiring only few minutes to complete and score the findings. To recognize different types of dermatoses and screen the patients for associated psychopathological disorders using General Health Questionnaire [GHQ-12] in the earthquake affected areas of Azad Kashmir. Subjects and an outpatient dermatology clinic was set up in the earthquake affected area of Muzaffarabad for four days. As it was advertised to be a dermatology specific clinic, so all patients presenting with some dermatological disorder were enrolled using non-probability convenient sampling technique. Demographic data was filled by social workers and clinical data was recorded by dermatologists on a specially designed pro forma. The patients were asked to complete 12 items General Health Questionnaire [GHQ] which was filled by patients who were literate while for others social workers assisted. Chi-Square test was used for data analysis. A total of 522 patients with different skin diseases were enrolled Dermatological infestations were seen in 207 [39%] cases followed by eczemas 90 [17.3%] and infections 80 [15.3%]. Stress mediated dermatological problems like acne 40 [7.6%] and psoriasis 27[5%] were found in these cases. Overall 192 [36.8%] patients were living in shelter based homeless situation and psychiatric morbidity was seen in 55% [173] cases having dermatological illness. Infestations, infections and eczemas were the most common skin diseases seen in earthquake victims and increased psychiatric morbidity may be responsible for rise in stress related dermatological disorders