Phenomenology of delusions and hallucinations in schizophrenia in central Punjab, Pakistan

To examine the variations in the frequency and contents of delusions and hallucinations in schizophrenia and correlates the significant findings with other studies across culture. Case series study. Psychiatry Department CMH Kharian for four year duration. Eighty consecutive patients of schizophrenia [62 men and 18 women] were registered and evaluated for frequency of different delusions and hallucinations. The patients belonged to central Punjab [Pakistan]. DSM-IV diagnostic criteria were used for diagnosis. Most patients i.e. 72.25% belonged to lower social class. Auditory hallucinations were the commonest [81.25%] followed by tactile hallucinations [14.75%] and visual hallucinations [7.5%]. Delusions of persecution were found in very high percentage [91.25%] delusions of reference in 42.5% and delusions of control in 31.25%. The patients believed that they were influenced by magic, demons and pirs. First rank symptoms of schizophrenia were present in 76.25% of patients; made affect, made impulse and made volition were present in [40.8%] and somatic passivity were present in [18%] of cases. Sociocultural background of the patients is likely to contribute in shaping the phenomenology of delusions and hallucinations and it is recommended that more elaborate/different diagnostic criteria may be designed for diagnosis of schizophrenia in developing countries

Psychiatric morbidity in Pakistani peacekeepers and their perception about deployment in Liberia

To identify the Psychiatric morbidity among personnel deployed in Liberia and to explore their perception about the deployment. Descriptive study. The study was carried out at in the United Nations Peace Keeping Mission in Liberia from December 2007 to December 2008. Sources of stress, positive and negative perception of the deployment were recorded on a semi structured proforma along with demographic characteristics of subjects. The General Health Questionnaire-28 was administered to identify case-ness. One hundred seventy two non- commissioned officers participated in this study. All of them were males. Their ages ranged from 23 to 51 years with the mean age of 30,2 years [SD =6.3]. The most common sources of stress for all personnel were the lack of recreations [46.5%, 57.1% respectively]. This was more so for singles. Almost half of married personnel rated separation from home and family to be the source of maximum stress. Approximately eighty three percent [50%+32.56%] had positive perception of the deployment on comparison to nearly sixty-four percent [50% + 13.59%] who had negative perception. Married personnel had more likely than singles to have negative perception of the deployment [70% vs. 54%].11% [n=19] of studied personnel scored high on GHQ who were later subjected to present state examination and diagnosed using ICD-10. About 25% [n=5] were diagnosed to be suffering from depressive episode mild with somatic features [F32.1] 50% [n=9] were diagnosed having Anxiety disorders. About 25% [n=5] had emotional and behavioural disorder associated with use of Medicine [Mefoloquine]. Lack of recreational facilities, separation from family and risk of getting infectious disease were common stressors. Financial advantage and professional grooming were positive perceptions. Depressive episode mild with somatic features and anxiety disorders were main psychiatric morbidities

Psychiatric morbidity among lung and blood cancer patients

To investigate the relationship of psychological well-being with depression in cancer patients. This was a prospective study using purposive convenient sampling technique. The study was carried out in the Combined Military Hospital, Rawalpindi and the National Oncology radiology Institute [NORI] Islamabad from 2003 to 2004. Forty-eight cancer patients were assessed using Beck Depression Inventory for assessing depressive symptoms and Affectometer-2. The patients were taken from two hospitals located in Rawalpindi and Islamabad from 2003-2004. The findings indicate a significantly high negative relationship between depression and psychological well being and the level of depression in these two types of cancer patients. Blood cancer patients were found high on depression and low on psychological well being than the lung cancer patients. Women and the young individuals scored high on depression and low on psychological well being as compared to men and elderly cancer patients respectively. The findings of the present research support that depression has great influence on the psychological well being of cancer patients

There is significant stress among parents having children with autism

To assess the level of parenting stress and associating factors of stress in parents rearing children with autism. The sample included 60 parents [30 fathers, 30 mothers] of 30 children with diagnosis of autism. The sample was taken from different hospitals and institutions of mental retardation in Islamabad, Rawalpindi and Wah Cantt, Pakistan from 2005-2006. Stress in parents was measured through parental stress scale [PSS]. PSS score of fathers was 46.63 +/- 7.99 and mothers 50.03 +/- 9.60 [p 0.01]. Score for parents of children 4-9 years age was 50.38 +/- 7.93 and for parents of children 10-18 years age 47.13 +/- 10.26 [p 0.01]. Score for parents of boys was 46.81 +/- 8.39 and for parents of girls 50.00 +/- 9.34 [p 0.01]. There was significant stress in parents of autistic children. Mothers experienced more stress than fathers. The level of stress was different in parents with the increasing age of the children. The implication is that mothers of children with autism are more prone to experience stress, thus requiring special attention from mental health professionals

Mefloquine - neuropsychiatric side effects profile

Mefloquine is a drug widely used for prophylaxis and treatment of malaria. The current study was aimed at finding out the common neuropsychiatric side effects in Pakistani troops serving abroad on United Nations peace keeping mission in malaria endemic areas and to prescribe alternative therapy in individuals more susceptible to these side effects. In a case control study 76 subjects taking mefloquine on weekly basis and reporting sick to the hospital were assessed for neuropsychiatric symptoms and compared with another 50 subjects not on this drug. This study was conducted at Pak-Field Hospital at Siera leone during 2003 to 2004. Sleep disturbances were found in 52.63%, while 60.52% had depressive and other mood related disorders. Anxiety was present in 35.52% whereas 6.57% subjects had psychotic symptoms. Other neurological symptoms like headache and tremors were common. General fatigue was seen in 61.84% of cases. Visual disturbances, delirium and seizure were not significant in our study. Mefloquine therapy in malaria is frequently associated with serious toxic and neurological side effects. An alternative regimen for prophylaxis and treatment is recommended in subjects who have history of mood disorders, paranoia, anxiety and convulsions

Hysteria: a symptom or a syndrome

A descriptive follow up study of 100 consecutive cases of hysterical [dissociative/ conversion] disorders was conducted from 1995-1998 at CMH Kharian to describe find out the relative frequency of hysterical disorders and other underlying conditions in the patients presenting with hysterical symptoms and also to see the long term validity of this diagnosis. The findings of this work indicated that in 40% of the cases there was either a physical or psychiatric underlying cause of these symptoms i.e. depression [40%], anxiety state [15%], adjustment disorder [17.5%], personality disorder [5%] and medical illnesses [25%]. In 60% of the cases of hysterical disorder who responded to the follow up questionnaire, the diagnosis of hysterical disorder was sustained. The prevalence of hysterical disorder was more in women, among young, undereducated and lower socio-economic groups. In majority of the patients, a psychosocial stress was identified. Convulsions, sensory loss, visual symptoms, aphonia, headache, amnesia and possession state dominated the presenting complaints. Further sound methodological studies using the structured instruments are needed to replicate these findings

Psychiatric aspects of primary infertility in females

This study is designed to investigate the prevalence and pattern of psychiatric morbidity in females with primary infertility and to identify risk factors for psychiatric morbidity. One hundred females having primary infertility, who visited various outpatient departments at MH Rawalpindi and CMH Kharian, have been screened using General Health Questionnaire [GHQ 12] for the possible psychiatric morbidity. Another hundred females with one live issue have been taken as control and screened for psychiatric morbidity. They were ultimately evaluated by two psychiatrists on clinical psychiatric interview and final diagnosis made on ICD 10 diagnostic criteria. In 100 infertile women, psychiatric morbidity was detected in 76% of the cases, while 32% psychiatric morbidity were found in the control. Amongst those having the psychiatric illness, depression was the most common illness 46.03%. Other common diagnosed categories were somatization disorder 20.63%, conversion disorder 15.87% and generalized anxiety disorder 9.52%. obsessive compulsive disorder [OCD] was found in 4.76%, whereas panic disorder and phobic disorder were found in 1.58%. A positive correlation between depression and the duration of infertility was found. Anxiety and related disorders were found in earlier age group whereas depression was found in later age group. A significant proportion of women suffering from primary infertility have psychiatric morbidity. Early detection of these symptoms by screening instruments like General Health Questionnaire [GHQ 12] can enhance the early detection of psychiatric morbidity, formulate psychiatric interventions and possible reduction in morbidity and cost of the treatment. Efforts should be made to increase the awareness among the general population and to impart training in community health care workers to address the psychiatric issues in females who are treated for infertility

Contribution of minnesota multiphasic person inventory in the differential diagnosis of psychosis and neurosis

The utility of Minnesota Multiphasic Personality Inventory is examined as a diagnostic tool in the present study in a selected sample of defence service personnel which comprised of 25 diagnosed neurotic and 25 diagnosed psychotic subjects. The results of the research work support the hypotheses and it is revealed that neurosis score higher on neurotic scales at t value of.025 level of significance and that psychotics score higher on psychotic scales at t value of.01 level of significance