Prevalence of anxiety and depression in an urban squatter setlement of karchi

A cross sectorial survey was conducted in 1995 to assess the prevalence of anxiety and depression in Azam Basti an urban squatter settlement of Karachi. The subjects included consenting adult volunteers. Four hundred and eightyseven adults were interviewed by psychiatrists using DSM- IIIR criteria. Anxiety alone was present in 9.7%, depression alone in 7.8%, and anxiety and depression both in 12.9% cases. The overall prevalence of anxiety and depression was 30.4%

Syndrome X and family practitioners

Increased incidence of hypertension, non-insulin dependent diabetes [NIDDM] and coronary heart disease often cluster in the same individuals and there have been speculations that a common mechanism may be responsible for all of these pathological conditions. This risk factor constellation, which is associated with an enhanced risk for cardiovascular disease, is sometimes referred to as the 'Insulin Resistance Syndrome', 'Syndrome X', or the 'Metabolic Syndrome'. To find out the prevalence of Syndrome X in the population of patients coming to a preventive health check clinic at a tertiary care teaching hospital in a megacity of the developing world. A total of 270 patients, above the age of 40 years, who attended preventive health check clinics of 2 Family Physicians at the Aga Khan University from January 1996 to July 1997 were selected. Patients below 40 years were excluded from the study. The prevalence of Syndrome X, defined as association of obesity, NIDDM, hypertension, raised LDL and raised triglycerides is 2.6% in patients above 40 years, who were screened in this study. The significant prevalence of Syndrome X is alarming and we need to strengthen our existing educational programs for prevention of obesity, increased physical activity and better control of hypertension. When drugs are selected for pharmacological treatment, priority should be given to those, which improve the insulin sensitivity index or are at least neutral in this respect

Validation of an indigenous screening questionnaire for anxiety and depression in an urban squatter settlement of Karachi

Concern about the validity of screening instruments for anxiety and depression designed in the west and used in the east has long been a matter of debate. The Aga Khan University anxiety and depression scale is an indigenous screening instrument developed from the symptoms of patients with anxiety and depression coming to the community health center of the Aga Khan University hospital and validated in an urban squatter settlement of Karachi. Four trained CHWs verbally administered the questionnaire to 500 consenting adults who could understand urdu. 487 respondents were interviewed by psychiatrists who were blind to the questionnaire scores. At a cut off score of 19 the scale displayed a specificity of 81% sensitivity of 74% a positive predictive value of 63% a negative predictive value of 88% and an overall misclassification rate of 21%. It is suggested that this questionnaire could be used as a screening instrument in urdu understanding population in Pakistan and in countries with similar immigrant population