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.

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

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

Depression and drug non- adherence

To determine the different levels of drug non-adherence in patients suffering from Depression. A case-controlled study. Hayatabad Medical Complex Peshawar, From February 2008 to August 2008. 50-Cases were selected from the out patient department with the DSM-IV diagnosis of major depressive disorder, 50- non psychotic patients were selected as controls. Both sexes were included. The basic socio-demographic characteristics and the clinical profile of all the patients were collected. The level of drug non-adherence was recorded at week 4, week 8 and week 12. SPSS version 15 was used for statistical analysis. The applied method for group comparison was the Chi-square test. The age in mean was 33.78 +/- .30 for the sample and 30.65 +/- 40 for control group. 38% of these patients were males and 62% females. 58% were married and uneducated from lower socio-economical class. 70% of the study group and 59% of control group received treatment. The rates of non adherence were statistically not significant at week 4. However, at week 8 and week 12 the rates of non adherence were statistically significant with the p values of less than [0.001] respectively. Rates of non-adherence with psychotropic / antidepressants are difficult to summarize because they vary with setting, diagnosis, severity of illness and type of adherence difficulties. Drug non-adherence is a serious clinical problem and it has direct effects on illness management and prognosis. The available evidence suggests that the outcome for patients who vary medication doses without consulting a professional is poor

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

hysteria; conversion disorders

To find out the sociodemographic characteristics of conversion disorders and to find if there is any difference between the presenting symptoms of rural and urban population. A non-probability, purposive, hospital based sample. Psychiatry department of Victoria Hospital Bahawalpur, from February 2004 to April 2005. A sample of 100-patients was collected. Both sexes were included. DSM-IV criteria for conversion disorder were applied for diagnosis of all these patients. Informed consent was taken for inclusion in the study. Patients suffering from concurrent physical disorders were excluded. The first author [NM.] using a semi-structured pro-forma interviewed all these patients. The sociodemographic characteristics and the clinical profile were collected. Statistical analysis was made with the statistical package for windows, SPSS [version -10]. The applied method for group comparison was chi square- test. The mean age of patients from the urban area was 24.26 +/- 7.25 years, as compared to 22.15 +/- 7.49 years for the patients from the rural area. Most of the patients were females and were married. Majority of the patients from the urban as well as from the rural area were uneducated and from the lower socio-economic class. The onset of illness was typically acute and sudden, with precipitating life event. Majority of the patients had family history of the illness and co-morbid psychiatric disorders. The presenting symptoms were either sensory, motor, mixed symptoms and psuedoseizures. The presenting symptoms of patient from both urban [p value of 0.008], and rural area [P value =0.013], were statistically significant. There were no statistically significant association between the presenting symptoms and the area of living. The p values of the entire chi square tests were greater than [0.05]. Prompt elimination of the symptoms of conversion disorder is important to prevent secondary gains from reinforcing it and causing it t o persist or reoccur. Psychiatric services need to be developed and updated for the provision of prompt and efficient treatment, for the patients with these chronic and sometimes disabling conversion disorders