Mental health and service developments in the Rawalpindi district of Pakistan

The innovative community mental health programme of the Institute of Psychiatry and WHO Collaborating Centre for Mental Health Research and Training, Rawalpindi General Hospital has revolutionized the concept of community mental health globally and is echoing in the international corridors. Various studies have evaluated this indigenous and low-cost programme and is being replicated in many countries. This brief summary tries to encompass the evaluation of this programme by various independent assessors, and its impact on the community mental health in particular and community health in general. Various studies published in indexed journals around the world by local and foreign authors for evaluation and impact of this programme are included. The success of the programme is visible by not only the decrease in mental health problems in the community but in increased utility of general care services, reproductive health care facilities and immunization rates. This exciting innovative model of health care developed at the WHO Collaborating Centre at Rawalpindi is transforming the health care scenario in Rawalpindi district. There is great need for replication of this model not only in other areas of Pakistan but other developing and developed countries

Prevalence of personality disorder in a tertiary care psychiatric outpatient population

The current study on selected two-hundred psychiatric patients was carried out in the outpatient departments of a tertiary care psychiatric facility to determine the prevalence of personality disorders. Patients were subjected to Present State Examination based on lCD-10 research criteria to establish the diagnosis. This was followed by introduction of Personality Assessment Schedule by researcher [s], blind to the diagnosis. It was found that about 60% of the patients fulfilled the criteria of personality disorder. Strong association between psychopathic personality and substance abuse existed along with associations between passive dependent personality and stress/adjustment as well as neurotic disorders leading to conclusion that assessment of personality must be integrated into routine clinical assessment using objective measures

Incidence of acute mountain sickness, high altitude pulmonary edema, high altitude cerebral edema among acclimatised individual on graded ascent

Acute mountain sickness [A.M.S.] and its severe complications-high altitude pulmonary edema [HAPE] and high altitude cerebral edema [HACE] were studied in 634 individuals resident of Northern Areas of Pakistan at an altitude from 3000 ft to 9000 ft. These subjects were acclimatized to various altitudes according to the laid down procedures. 91 cases developed A.M.S. The over-all incidence varied from 6.25% to 21.68% at an altitude of 14000 ft to 19000 ft. Out of these 91 cases, 11 developed H.A.P.E. [12.08%] and 04 developed H.A.C.E. [4.39%]. The severity of A.M.S., H.A.P.E. and H.A.C.E. was related to the highest altitude attained and was highly correlated with the speed of ascent. Acetazolamide reduced both the incidence and the severity of A.M.S. Those who did not improve and developed signs of H.A.P.E. and H.A.C.E. were given intermittent oxygen inhalation, diuretic and dexamethasone pending their evacuation to lower altitudes