Substance use in patients of schizophrenia; local perspective

This study is aimed at exploring the demographic pattern of substance use disorder among patients of schizophrenia and to find out the reasons of drug use among them. Cross-sectional study. This study was conducted at Out-patient departments, of Psychiatry at Jinnah Post-Graduate Medical Centre Karachi and Sir Cowasjee Jehangir Institute of Psychiatry Hyderabad from July to December 2009. Approval from ethical research committee was taken, and a structured proforma was developed to record demographic details, reasons of substance use, pattern of use, and diagnosis of the patient after informed real consent from the patient or their attendants. Out of a total 100 patients 62 had substance use disorder. Males had 81% co morbidity. Niswar was the predominant substance of use [54%], followed by cigarette [24%]. Alcohol and cannabis were not much found to be used. Most common cause, stated by schizophrenics for substance use was to alleviate anxiety [40%], followed by use to induce sleep [16%], and peer pressure [8%]. In contrast to the findings in western literature, pattern and reasons of substance use disorder are different in local perspectives. Nicotine has been found to be used in different forms, which can be treated by reducing the perceived reasons of substance abuse by the patients

Association of order of birth with schizophrenia

To asses the association between Birth Order and Schizophrenia in relation to other demographic factors. A cross sectional study was done and data of twelve hundred and eight patients were evaluated and managed in the psychiatric department of Isra University Hospital, Hyderabad. Eighty two Schizophrenics were compared with the rest of the psychiatric population with reference to gender, catchment area, and family type. Statistically no significant difference was found between any of the birth order for the risk of Schizophrenia. Risk of Schizophrenia appears to be minimum in first born males, and maximum in first born females, but this does not reach statistical significance. Risk apparently seems to decrease as birth order goes down among urban setting; and decrease as birth order goes up; but again this finding does not reach the level of statistical significance. There appears to be no association between any birth order and risk of Schizophrenia, in our studied population

Factors determining, the time lost between onset of psychiatric disorders and first psychiatric consultation

To find out delay between onset of psychiatric illness and first psychiatric consultation; and the factors leading to such delay. Retrospective Study. Isra University Hospital from January 2002 to February 2004. The record of patients who had attended for psychiatric consultation at Isra University Hospital from January 2002 to February 2004; was transferred to a proforma on which demographic characteristics, diagnosis, delay and reason of delay in psychiatric contact after first onset of psychiatric disorder was recorded. The data was subjected to analysis after being fed on SPSS. Descriptive Statistics, i.e. frequencies, percentages and means were calculated. An average delay was of about 36.34 months. Neurotic patients, Females [37.63 months, as compared to 33.93 months' delay of males], and patients belonging to urban catchments [delay of 37.37 months as compared to 39.59 months' delay], had greater delay. Lack of awareness [25.41%] was found to be the most common reason for delay, followed by Un-reachable psychiatric facility [23.01%], non-affordability [21.27%], Stigma feeling [19.03%] and misconception that medicines are addictive [11.25%]. The delayed psychiatric help was pervasive in majority of people with the psychiatric disorders, studied. Most common reason of delay was found to be the lack of awareness about psychiatric illness