Prevalence and Predictors of Non-Suicidal Self-Injury among Children with Autism Spectrum Disorder

Objectives: To find the prevalence as well as to identify the predictors as protective and risk factors of non-Suicidal Self-Injury [NSSI] among children with autism spectrum disorder [ASD]. Hods: In this analytical cross sectional survey 83 children with ASD age range from 8 to 18 years were ected through convenient sampling technique from five special schools of Lahore city. The Urdu form of a standardized tool was used to assess NSSI

Methods: Statistical analysis indicated overall point prevalence of NSSI was 33%. Moreover bangfngise ceating [47%], scratching [38], pinching [35%], picking scabs [33%], self-biting [32%], pulling hair [30%] and rubbing skin [19%] emerged as common forms of challenging behavior. Further regression analysis showed that age B[1.68*, P<0.05], gender B[3.72, P<0.001] and severity level of ASD B[1.85***, p<0.0001] as risk factors/positive predictors of NSSI. However early intervention [-0.66***, P<0.0001] and involvement of parents in counselling [-2.66*, P<0.05] emerged as protective factors/negative predictors of NSSI among children with ASD

Conclusion: Non-suicidal self-injury is a serious challenge among children with ASD. Early intervention, counselling and parental involvement in managing the children with ASD will not only prevent but reduce the challenging behaviors

Hemodialysis; psychosocial stressors in patients undergoing

To determine the nature and frequency of psychosocial stressors faced by the patients on hemodialysis admitted in Renal Dialysis Unit of Nishtar Hospital, Multan. A descriptive study. The study was conducted in the Renal Dialysis Unit of Nishtar Hospital, Multan, from 1[st] May, 2014 to 31[st] May, 2014. The sample consisted of 170 [112 Male, 58 Females] consecutive inpatients on Hemodialysis Treatment. They were interviewed and Hemodialysis Stressors Scale [HSS] was administrated to know the frequency of Hemodialysis Stressors. Results showed that all the patients reported Physiological and Psychosocial stressors. Most frequent physical stressors included feeling tired [92%] and stiffening of joints [91%]. In psychosocial stressors restriction of fluid [100%], dependence on dialysis machine and/ or equipment [95%], limitation of physical activity [93%], changes in family responsibilities [93%], dependency on nurses and technicians [93%], length of treatment [92%], dependency on physicians [91%], sleep disturbance [90%] and limitation of food [93%] were the most frequently reported. We concluded that both physiological and psychosocial stressors were present in significant majority of patients

Major depression in Jalal Pur Jattan, district Gujrat, Pakistan: Prevalence and gender differences

To assess the prevalence of depression along gender lines in the general population. Using multistage stratified proportionate sampling, the cross-sectional study was conducted in four Union Councils of Jalal Pur Jattan in Gujrat, Pakistan from November 2011 to November 2012. From each stratum, two samples were taken: adults and adolescents. Then each sample was divided into adult males and adult females [20-45 years]; adolescent boys and adolescent girls [13-19 years]. The questionnaire was developed on the basis of diagnostic criteria given in the revised version of the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders. Of the total population of 28,259, 1117[3.6%] were approached for the study. Of them, 1110[99.3%] people participated. Overall, 173[15%] were found to be vulnerable to psychological problems whereas 59 [5.31%] were found as vulnerable cases to depression. However, the diagnosis of major depression was handed to 38[3.4%] respondents. Of these 38 subjects, 7[18.42%] persons were suffering from mild; 22[57.89%] from moderate, and 9[23.68%] from severe symptoms. Further, 30[78.9%] of these subjects were women. Major depression was prevailing in the community of Jalal Pur Jattan in almost the same ratio as in other places around the globe, and, therefore, the inhabitants need psychiatric services

Heroin dependence; family support and relapse in patients

To determine the frequency and level of family support in Heroin Dependent patients presenting with 1st treatment and also the patients presenting with relapses. A descriptive study. The study was conducted in the Department of Psychiatry and Behavioral Sciences, Nishtar Hospital, Multan from September, 2013 to December, 2013. The sample consisted of 50 consecutive inpatients presenting with Heroin Dependence. They were interviewed and Family support Scale [FSS] was administered to know the level of support in heroin dependent patients. Results showed that 20% patients relapsed 3 times while 38% had more than three times relapses among whome 30% patients have family support, but 70% have very low level and family support decreased with increasing number of replace. We concluded that higher level of family support was during in the 1st treatment of Heroin Dependence and family support decreased as the number of relapses increased

Conversion disorder; psycho-social stressors and life events in children

Objective: Frequency of the psychosocial stressors and stressful life events in children presenting with conversion disorder. Study design: A descriptive study. Place and duration of study: The study was conducted in the Department of Psychiatry and Behavioural Sciences, Bahawal Victoria Hospital and Quaid-e-Azam Medical College, Bahawalpur from January, 2010 to October, 2010

Subjects and Methods: The sample consisted of 100 in-patients [62 Female, 38 Male] with Conversion Disorder. They were interviewed and results were analysed from the entries in a Performa. The Presumptive Stressful life Events Scale [PSLES] was administered by an open ended interview to elicit major life events in the past 10 months

Results: Stressors were clearly identified in 100 patients. In all patients, we found more than one stressor. Among patients, there were [29%] Educational and study stressors, [20%] Parent's death / Separation, [20%] Sexual Abuse, [14%] Sibling Rivalry, [13%] Pampered / Demanding Child, [10%] Attention Seeking, [8%] Peer Group Problems, [8%] Improper Parenting, [8%] Learned behaviour, [7%] Emotional Involvement Issues, [5%] Habit of stealing and [4%] Adopted Child

Conclusions: We concluded that stressors and life events were present in all conversion disorder's patients and these stressful life events are important causal factors for Conversion Disorder. Severe and sudden emotional stress serves to precipitate conversion reaction in predisposed children. The symptom serves to solve the conflict and the gain obtained served to perpetuate the illness

Conversion disorder; childhood sexual abuse in patients, a descriptive study in in-patients of Tertiary Care psychiatric facility

The objective of the study was to find out association and pattern of childhood sexual abuse in patients presenting with conversion disorder. A descriptive study. The study was conducted in the Department of Psychiatry and Behavioural Sciences, Bahawal Victoria Hospital and Quaid-e-Azam Medical College, Bahawalpur from June, 2011 to December, 2011. The sample consisted of 60 Female in-patients with Conversion Disorder by purposive sampling. They were interviewed and results were analysed from the entries in a semi structured Performa. Out of 60 patients, 34[57%] reported sexually abused in childhood and 26[43%] not abused. There were 19[32%] patients reported uncomfortable sexual talk, sexual touching, 9[15%] reported attempted intercourse which was successful and 6[10%] reported attempted for intercourse but failed in their aim. 14[23%] patients abused by their relatives, 5[8%] by Neighbours and strangers, 3[5%] by their health caregivers, boyfriends and class fellows and 1[2%] by teachers. This study shows a positive association between severe sexual abuse [Uncomfortable talk, sexual touching, penetration or attempted penetration] in childhood and Conversion Disorder in adult life

Acne vulgaris; psychosocial stressors in patients

Objective: To find out the frequency and pattern of psychosocial stressors and adverse life events in patients presenting with Acne vulgaris

Study design: A descriptive study

Place and duration of study: The study was conducted in the Department of Psychiatry and Behavioural Sciences, in collaboration with Dermatological Department, Nishtar Hospital, Multan from September, 2012 to November, 2012

Subjects and Methods: The sample consisted of 50 consecutive out-patients [Female-42, Male-8] with acne. They were interviewed and The Presumptive Stressful life Events Scale [PSLES] was administered to elicit major life events and psychosocial stressors they had to face. Results were analysed from the entries in a semi structured Performa

Results: Out of 50 patients, 94% subjects reported more than one stress and 6% reported no stress. 15[30%] were suffering from the disease 6 months to one year. We found more than one stressor. Results showed 46% of the participants reported Social Withdrawal, 40% had Academic Problems, 38% showed Frustration and Anger, 32% had to face Critical Remarks / Stigmatization, 30% had Low self esteem and Negative thoughts about self, 12% presented with Suicidal Ideas / Attempts, about 22% reported disturbed Relationship with Spouse while 14% reported the Relationship problems with other family members

Conclusions: We concluded that psychosocial stressors and life events were present in significant majority of patients with acne and these emotional, social, behavioural and psychological reactions have strong association in patients suffering from acne vulgaris

Depression; prevalence in patients presenting with alcohol and drug addiction

Prevalence of Depression in patients presenting with Alcohol and Drug addiction. The study was conducted in the Department of Psychiatry and Behavioural Sciences, Bahawal Victoria Hospital and Quaid-e-Azam Medical College, Bahawalpur from March, 2009 to May, 2009. The sample consisted of 50 in-patients [Male 46, Female 4] with Alcohol and Drug addiction. They were interviewed and results were analysed from the entries in a Performa and Hamilton Rating Scale for Depression. Majority of the patients were male [92%], age group majority [74%] were between 21-40 years. Depression was found in 23[46%] patients, 14[28%] had severe depression and 9[18%] had mild to moderate depression. Significant numbers of patients of alcohol and drug addiction have depression as co-morbidity, which can have important implications in the aetiology and prognosis. So every patient seeking treatment for alcohol and drug addiction should be assessed for depression and we should develop a protocol to treat depression in these patients

Patients with conversion disorder; psycho-social stressors and life events

To assess the frequency of the various psychosocial stressors and stressful life events in patients presenting with conversion disorder. Case series study. The study was conducted in the Department of Psychiatry and Behavioural Sciences, Bahawal Victoria Hospital and Quaid-e-Azam Medical College, Bahawalpur from January, 2009 to March, 2009. The sample consisted of 100 in-patients [89 Female, 11 Male] with Conversion Disorder. They were interviewed and results were analysed from the entries in a Performa. Stressors were clearly identified in 100 patients. In all patients, we found more than one stressor. Among patients, there were [24%] in-laws problems, [23%] love problems, [21%] relationship problems with family, [20%] exam/study stress, [15%] marriage against will, [13%] demanding and pampered child, [11%] issue less, [10%] sexual abuse, [8%] demand of marriage, [6%] overage in wait of marriage, [4%] death of partner, [3%] husband abroad and [3%] patient's engagement break. We concluded that stressors and life events were present in all conversion disorder's patients and these stressful life events are important causal factors for Conversion Disorder. Conversion Disorder has strong relationship with psychosocial stressors

Psychiatric in patients; pattern and prevalence of psychiatric morbidity. A study based on psychiatric case-register

To explore the pattern and prevalence of inpatient psychiatric morbidity and to see how it differs from the pattern of psychiatric morbidity in community. The details of all in-patients from the case register developed for a health information system was included in study. In Department of Psychiatry and Behavioral Sciences, Bahawal Victoria Hospital, Bahawalpur. From 1998-2003. A total of 5426 patients were admitted in the six year. There was a slight difference of 0.8% in total number of males and females cases [i.e., 2764 males Vs 2662 females]. Overall difference reported in the present study, in mean ages of males and females was 3.45 years [i.e., males = 31.85 Vs females = 28.40]. Mean stay of patients in ward is 10-12 days. Most patients were admitted with Conversion disorder 24% followed by Schizophrenia 23%, Depressive disorder 20%, Drug Dependence 10%, Bipolar Disorder 7%. The patients with Neurotic Disorder and Organic Disorder were below 5%. The study showed that overall general pattern of inpatient psychiatric morbidity is in line with pattern of psychiatric morbidity in community and the partial variance can be explained in terms of social variables, as this variance exist even across studies within community samples

HBV and HCV infection: incidence and risk factors among injecting drug users in Bahawalpur city

To determine the incidence and risk factors in a well characterized cohort of injecting drug users who have been monitored in Psychiatry and Behavioral Sciences Department, Bahawal Victoria Hospital, Bahawalpur. Prospective and experimental. April, 06 to April, 08 in Psychiatry and Behavioral Sciences Department, QAMC and Bahawal Victoria Hospital, Bahawalpur. The 12 month incidence of HCV infection was relatively high in IDUs aged 24 years or younger [36%] and also elevated in 26-40 years old [23%] compared with older injectors [12%]. Statistically significant [P=<0.01] differences in incidence was found in subjects who belonged to low socioeconomic group [67%] verses high socioeconomic group [19%]. Similarly higher incidence [P=<0.23] seen in heterosexuals [20%] verses homosexuals IDU's [10%]. HCV incidence was particularly higher among IDU's who had been injecting for more than 6 years [P<0.01], whereas HBV incidence was not associated with duration of drug [P<0.7]. High incidence of HCV and HBV infection is seen in IDU's. Patients with age groups < 24, lower socioeconomic status and sharing of syringes among drug users and showed statistically significant [<0.05] higher chances of HBV and HCV infection