Frequency of ICD-10 psychiatric diagnosis in children with intellectual disability in Lahore, Pakistan and caregivers perspective

Association between Intellectual disability [ID] and psychiatric disorders in children and adolescents is well established but there is a paucity of published studies from Pakistan on this topic. The main aim of the study was to assess the frequency of ICD-10 psychiatric diagnosis in the hospital outpatient sample of children with ID in Lahore, Pakistan as well as to find out which challenging behaviors, caregivers find difficult to manage in this setup. Socio-demographic information was collected, Wechsler Intelligence Scale for Children-Revised and ICD-10 diagnostic criteria was used to assess children [age range 6–16 years] with suspected ID along with identification of behaviors found to be difficult to manage by caregivers. 150 children were assessed with mean age of 10.7 years [males 70%]. Majority [72%] had mild ID while 18.7% and 9.3% had moderate and severe ID respectively. Thirty percent of children met the criteria for any psychiatric diagnosis, the most common being Oppositional Defiant Disorder [14%] and Hyperkinetic Disorders [10%]. Verbal and physical aggression, school difficulties, socialization problems, inappropriate behaviors [e.g. disinhibition], sleep and feeding difficulties were the significant areas identified by the caregivers as a cause of major concern. Significantly high prevalence of ICD-10 psychiatric diagnosis in children with ID was found in Lahore, Pakistan. Support services for these children should be responsive not only to the needs of the child, but also to the needs of the family

Psychiatric co morbidity in medical patients

To assess the rate of anxiety and depression in the patients suffering from various medical diseases. Cross sectional study. The study was conducted in District Headquarter Hospital and Allied Hospital, Faisalabad from 2005 to 2007. Participants were inducted in the study through purposive convenient sampling technique, 339 patients of cardiac, cancer, hepatic, and dermatological diseases from both the above mentioned hospitals participated in this study. Co morbidity of psychiatric disorders was screened out with the help of DSM IV TR's criteria for depression and generalized anxiety. Anxiety [n=32, 9.43%] was the major diagnosis in age group 40-49 and depression [n=31, 9.14%] in age group 50-59. All the diagnosis i.e., anxiety [n=30, 8.84%], depression [n=51, 15.04%] and both anxiety and depression [n=25, 7.37%] were common in illiterate patients. Anxiety [n=37, 10.91%] and depression [n=57, 16.81%] was found more in housewives. All the diagnosis i.e., anxiety [n=77, 22.71%], depression [n=93, 27.43%] and both anxiety and depression [n=45, 13.27%] were common in married patients. Anxiety [n=54, 15.92%] was common in hepatic patients and cardiac patients were having highest share of depression [n=51, 15.04%] and both anxiety and depression [n=32, 9.43%]. Most cardiac patients were depressed; most hepatic patients were anxious; almost half of cancer patients were both anxious and depressed; while majority of dermatological were having no psychiatric illness

Depression and anxiety in cancer patients in outpatient department of a tertiary care hospital in Pakistan

To examine the prevalence of depression and anxiety in patients with cancer in an outpatient department of a tertiary care hospital in Pakistan. This study was conducted between May 2006 and January 2007. The sample consisted of 60 diagnosed cancer patients [30 males/30 females]. DSM- IV criteria and Hospital Anxiety and Depression Scale [HADS] were used to diagnose and assess anxiety and depression. Fifty two percent [31 patients, 10 males/21 females] of the subjects reported having symptoms of anxiety, depression or both according to DSM IV Criteria, [anxiety =14, males six / females eight, depression=6, males two / females four, and depression + anxiety both=11, males two / females nine]. A total of 70% [21/30] of the entire female sample met the criteria for depression, anxiety or both. A total of 33% [10/30] of the entire male sample met the criteria for depression, anxiety or both. This study shows high prevalence rates of depression and anxiety in cancer patients in Pakistan. The oncologists and internists treating cancer patients should screen their patients for symptoms of depression and anxiety

AUTISM: assessment and management

Autism and the related pervasive developmental disorders are characterized by patterns of delay and deviance in the development of social, communicative and cognitive skills, which arise in the first years in life. Differential diagnosis includes other psychiatric and pervasive developmental disorders, deafness and profound hearing loss. Autism is frequently associated with fragile X syndrome and tuberous sclerosis. Common co-morbidities include Mental Retardation, Seizure Disorder and Psychiatric disorders such as depression and anxiety. Early detection and intervention significantly improve outcomes, with about one third of autistic persons achieving some degree of independent living. Various treatment modalities administered by Multidisciplinary team are helpful. [e.g. Pharmacotherapy, special education, speech, communication therapy, and behavior modification]. A Medline search dating back to 1970 was done, to look at the literature related to autism. Based on this search, up to date review of autism has been discussed with special emphasis on assessment and management