RESUMEN
Introduction: First rank symptoms (FRS) are considered to be pathognomic for Schizophrenia. However, FRS is not distinctive feature of Schizophrenia. It has also been noticed in affective disorder, albeit not inclusive in diagnostic criteria. Its existence in the first episode of bipolar disorder may be predictor of poor short-term outcome and decompensating course of illness. Objective: To determine the frequency of first rank symptoms in manic patients. Method: The cross sectional study was done at psychiatric services of Aga Khan University Hospital, Karachi, Pakistan. 120 manic patients were recruited from November 2014 to May 2015.FRS was assessed by administration of validated Urdu version of Present State Examination (PSE) tool. Result: The mean age of the patients was 37.62 + 12.51, and the patient less than 35 years had 69.6% FRS with p-value of 0.009. The mean number of previous manic episode was 2.17 + 2.23. 11.2% males and 30.6% females had FRS. This association of first rank symptoms with gender in patients of mania was found to be significant with a p-value of 0.008. All-inclusive, 19.2% exhibited FRS in their course of illness. 43.5% had thought broadcasting, made feeling, impulses, action and somatic passivity. 39.1% had thought insertion, 30.4% had auditory perceptual distortion, and 17.4% had thought withdrawal. However, none displayed delusional perception. Conclusion: The study confirms the presence of FRS in mania in both male and female, irrespective of the duration of current manic illness or previous number of manic episodes. A substantial difference was established between both the genders and association of younger age with FRS.
RESUMEN
General anxiety disorder is a chronic disorder. The prevalence of GAD is variable in different part of world, with some region having higher figure than others. It’s uncertain to quote if the variation is due to genetic loading or environmental factors. It is twice more common in females than males. It has constituted substantial burden on global economy as well as over all quality of life of an individual suffering from GAD. The prognosis of GAD is mainly correlated with the environmental constraints. However, the efficacy of response to pharmacological intervention is better explained on biological model. Certain studies are done to widen the ground of genesis of GAD. Although, by and large it still remains debatable about distinctive gene causing GAD. Nonetheless, the alteration of gene coding of 5-HTTLPR of serotonin is relatively favorable finding in studies, both independently done on GAD and in parallel to other anxiety disorders and psychiatric morbidities.
RESUMEN
Background: Depression is projected to become the 2nd worldwide leading cause of disability by 2020. Marriage is one of the principal facets when it comes to interpersonal context of Depression. Th ere is evidence supporting bidirectional casual eff ect between Depression and marital satisfaction. However the phenomenon of marital adjustment and its related variable has not been given much attention in the Pakistan. Aim of the study: Th e primary objective is to determine the frequency of marital adjustment by using validated Urdu version of Kansas Marital Satisfaction Scale in patients with Depression, who are under treatment at Psychiatry outpatient clinics at tertiary care hospital in Karachi. Method: Patient presenting in outpatient clinic and diagnosed with Depression for at least last 6 months according to ICD-10 criteria by Consultant psychiatrist, who were aged between 15-65 were included. Patients who had documented co morbid of substance use or any unstable serious general medical condition were excluded. Th e severity of Depression was evaluated by using Urdu validated Hamilton Depression Rating Scale. Marital adjustment is determined by using Urdu validated version of Kansas Marital Satisfaction Scale. Result: Only 8.6% were well adjusted in their marital life, and all were females; most of them were living in nuclear setting, unemployed, severely depressed, educated above intermediate, aged above 30 years, and had duration of illness more than 12 months. Th e association of marital adjustment and severity of Depression is insignifi cant. It further revealed to have insubstantial diff erence on KANSAS scale between both genders. Th e odd ratio of duration of illness was 7.6, which indicated that the longer the duration of illness, the more positively it is interrelated to the marital adjustment. Being employedand above 30 years of age wereinversely related to marital satisfaction with odd ratio of 6.1 and 5.4 respectively. However, the correlation between other independent variables and marital adjustment were insignifi cant in both genders. Conclusion: Th is study confi rms the presence of high frequency i.e. 91.4% of marital dissatisfaction in Depression in both male and females, irrespective of their severity of Depression. No substantial diff erence was established between both the genders based on KANSAS score. Longer duration of illness, unemployment, and above 30 age have protective eff ect on quality of marital life.