Mental health morbidity pattern in Pakistan

Pakistan is a developing country with meager mental health facilities, low number of psychiatrists and dearth of systematic data on mentally ill patients. A study was conducted with a view to obtain data on mental health morbidity patterns and the socio-demographic profile of mentally ill patients. Sixty psychiatrists who met the agreed criteria were included in the study and were asked to fill-in a questionnaire eliciting relevant information. The results indicated that 45 percent of the patients attending these psychiatrists were suffering from depression, 17 percent from schizophrenia, 11 percent from substance abuse disorder and 2 percent from dementia besides other mental disorders. Antidepressant regime outnumbered all other treatment methods. It was reflected that depression was commonest followed by schizophrenia and substance abuse disorder. It was concluded that there was a high number of psychiatric disorders among patients attending clinics and hence there is a need to conduct and compare studies, which are community-based in order to get elaborate insight into the magnitude and prevalence of mental disorders

Knowledge of depression among general practitioners

General practitioners [GPs] are the backbone of any health care delivery system. This is also true for Pakistan where a large number of patients approach them as a first line of care for their health related problems. Among psychiatric illnesses, depression is the most common and a cause of great psychiatric morbidity. Most of the patients presenting to general practitioners with the problem of depression are treated for physical illness and hence the core problem remains unaddressed. A study was conducted with the aim of assessing the level of knowledge among the general practitioners about depression. A proforma comprising objective test items was designed and administered to 115 GPs from all the districts of Karachi who were conveniently selected. The expected standard of answers was compared with the answers given by the GPs. This proforma besides eliciting demographic information also yielded a score which when converted into a percentage scale gave a mean score of 33.9%. On the basis of the international standard, a score of 60 was acceptable in order to judge that the knowledge was adequate. The scoring did not have significant association with the years of practice, age group and postgraduate qualification of the general practitioners. It was thus concluded that the level of knowledge of GPs about depression was inadequate and there was a need to improve undergraduate training in psychiatry and promotion of continuing medical education for general practitioners

Children of the corn A study conducted at juvenile prison in Karachi - overview I

A study was conducted in Juvenile Prison of Karachi where children and adolescents are kept in custody on account of various charges. 200 children were interviewed in the initial stage with the help of a questionnaire aiming at getting demographic information, reviewing social milieu, examining crime circumstances, custody details, biological profile, psychiatric assessment and the prognostic prediction. The preliminary results indicate that 78.6% were subjected to severe torture during investigation, 17.4% were subjected to torture while in custody, besides being deprived from other basic rights, emotional and psychological support. Majority of these children were the victims of social disorganization, poverty, lack of opportunities, faulty role model, and evil influence of political scenario. The psychological consequences of the circumstances leading to incarceration and the agony of the non-conducive custody environment are manifested in depression, anxiety, neurosis, psychosis, seizure disorder along with physical ailments. 52% of these children needed psychotherapeutic intervention while 17% were in need of psychotropic medication in addition to psychotherapy. 9% of these children had psychopathic traits in their personality and there remain chances that they would form potential group of criminals unless corrective rehabilitative measures are taken. It is concluded that preventive measures should be taken at primary, secondary and tertian levels to avoid psychiatric morbidity and to prevent these children from becoming potential criminals