Anxiety symptoms in patients with conversion disorder

Objective: to determine the frequency of anxiety symptoms in patients with conversion disorder

Methodology: this cross sectional study was conducted in Department of Psychiatry, Khalifa Gul Nawaz Hospital Bannu from August 2014 - March 2015. Sixty consecutive indoor patients of conversion disorder, diagnosed on the basis of ICD-10 criteria were assessed in detail. A semi-structured interview was conducted for demographic details

Results: among Sixty indoor patients, 52 [86.6%] were females, thirty six [66%] unmarried and more than 80% [n=50] were uneducated. Similarly, about 89% [n=54] belonged to the age range between 10 and 30 years. Large majority [n=56, 93.3%] were residing in the rural areas. All patients [100%] reported somatic anxiety symptoms along with clinical presentation of conversion disorder. Most common symptoms reported were feelings of being light and weak [n=59, 98.3%], followed by palpitation [n=58, 96.6%]

Conclusion: patients with conversion disorder need to be assessed in detail for somatic anxiety symptoms in order to improve upon intervention strategies in this common psychiatric disorder

Comparison of mean platelet volume in patients with psoriasis and healthy individuals

To compare mean platelet volume in patients with psoriasis and healthy individuals. This case control study was conducted in outpatients department and indoor of department of Dermatology, DHQ Hospital, Faisalabad. The duration of study was six months. Thirty consecutive patients of psoriais, 20 to 60 years of age and thirty age and gender matched healthy individuals were selected. 2cc venous blood sample from each subject was sent to the pathology laboratory of DHQ Hospital. Mean platelet volume [MPV] was measured as a part of blood complete analysis in Medonic M series Haematology analser. MPV was found higher in the patients of psoriasis as compared to the healthy individuals. The mean value of MPV in the case group was 8.24 +/- 1.22 fl, whereas in the control group, it was 7.29 +/- 0.77 fl [p<0.05]. The study demonstrated that mean platelet volume is increased in patients with psoriasis as compared to healthy individuals. Such patients are at an increased risk of cardiovascular complications

Beliefs and attitudes of family members towards patients suffering from conversion disorder

To evaluate the attitudes and beliefs of family members towards patients suffering from conversion disorder. Descriptive Cross Sectional study. Place and Duration of study: The study was carried out in Khalifa Gul Nawaz Teaching Hospital Bannu, Pakistan, from February to May 2013. Subjects and Methods: A consecutive sample of sixty patients, suffering from conversion disorder was approached for the study. Family members were interviewed, using the Urdu version of a questionnaire modified from that of short explanatory model interview [SEMI] by Jackob et al. Data was analyzed by SPSS version 15 using descriptive statistics. Among sixty family members interviewed 56[93.6%] were males, and 30% of them were uneducated. Clinical presentation in most of the patients was in the form of pseudo seizures. One third of the family members were of the view that conversion symptoms were precipitated by stressful events in the close environment. One third of the informants thought that some of the close relative's behavior was working as maintaining factor behind the mental illness. Most of the family members visited psychiatric facility at "other's" advice. Before contacting the nearby mental health facility most of patients were first taken to faith healers [87%]. Ninety percent of them did not agree with any form of punishment therapy for their patients. Majority of family members had reasonable awareness about the psychological nature of the problem. However they also believe in spiritual and super natural forces as causative factors behind the common psychiatric disorder

Knowledge and practice of general practitioners about schizophrenia

To obtain information about the number of patients attended by general practitioners in different stages of schizophrenia; relevant knowledge, diagnostic skills and ongoing practice concerning management of patients suffering from severe mental illness. For this cross sectional survey conducted from May to September 2010, a semi-structured questionnaire, obtained and modified from that of Simon AE et al was distributed among general practitioners working in Bannu district. The participants were requested to fill the questionnaire anonymously and return it to research worker. Out of 100, 72 general practitioners responded to the request of filling the questionnaire. Among them 60 [85%] were males. Only 17% replied that they could spare more than half an hour for the assessment of schizophrenic patients. Sixty four percent reported delusions and hallucinations as the most frequent symptoms of schizophrenia. Seventy percent relied on personal history for diagnosis of schizophrenia. Sixty percent practitioners considered pharmacotherapy as the first line therapy. More than half of them wanted to continue treatment for six to twelve months in first psychotic episode. Seventy percent preferred to refer the patients to specialist care for complete handover. No one of the working practitioners participated in continuing medical education CME on schizophrenia during the past few months of their professional life. The knowledge of general practitioners about signs and symptoms of schizophrenia is reasonable but they lack interventional skills. They need easily accessible specialized services for referral and regular training programmes to update their knowledge

Psychosocial stressors in patients with conversion disorder presenting with non epileptic fit

To study the psychosocial stressors in patients with conversion disorder presenting with non epileptic fit. This descriptive study was carried out at Lady Reading Hospital Peshawar Pakistan from January to June 2009. 101 consecutive patients with conversion disorder satisfying the inclusion and exclusion criteria were selected. They were interviewed by using Holmes and Rahe stress scale for the exploration of stressors and the results were analyzed from the entries in the Proform. Stressors were clearly identified in all patients. Ninety six [95.04%] out of the total 101 subjects had a history of stressors, while the rest 5 [4.95%] could not come up with any. The commonest stressors were Troubles with in-laws [21.78%], Major change in family get together [17.82%], Death of close family member [12.87%] respectively. Significantly higher number of the patients presents with the stressor of troubles with in-laws, when assessed on the Holmes and Rahe social scale

Present and severity of depressive symptoms in Schizophrenia

The present study aims to assess the presence and severity of depressive symptoms in persons suffering from schizophrenia as compared to normal healthy controls. This case control comparative study was carried out at the Department of Psychiatry, Postgraduate Medical Institute, Lady Reading Hospital Peshawar from January to December 2005. One twenty subjects were included in the study by non probability convenient sampling. Group 1 [the study group] included sixty patients suffering from schizophrenia between the ages of 15-60 and Group 2 [the control group] included sixty normal subjects without any major psychiatric disorder proportionally matched for age and gender. Those suffering from schizoaffective illness, major depression and organic brain damage were excluded. Hamilton Depression Rating Scale [HDRS], a 21 item scale was used to assess the presence and severity of depressive symptoms. The spectrum of depressive symptoms was broad in the schizophrenic sample. The difference in two groups was observed specially in depressed mood i.e., 19 patients in the study vs. 3 subjects in the control group with a p value of 0.0001 and in psychomotor retardation i.e., 19 patients in the study vs. 4 subjects in the control group, again with a p value of 0.0001. The results of this study suggest that depressive symptoms are a part and parcel of schizophrenia and every patient suffering from schizophrenia should be assessed in detail for the presence and severity of depressive symptoms

Comparison of lipid profile and apoprotein in sedentary workers and those involved in regular exercise

One of the important effects of exercise on human body is on the metabolic system especially on lipids; elevated lipids and lipoprotein are risk factors for coronary heart disease. This case-control study was conducted to compare the lipid profile and apo-protein B levels in sedentary workers and subjects involved in regular exercise. The study was conducted at Women Medical College Abbottabad, from July 2004 to January 2005. Subjects were civilians and army men involved in regular exercise for more than 6 months duration [test group] and sedentary workers [control group]. The age, body weight, height, waist hip ratio and other related findings were recorded on a special proforma. Fasting blood samples were taken and were analyzed for lipid profile and apoprotein B levels. Statistical analysis was done by the Chi square and the Student t tests and level of significance was recorded. The subjects comprised 29 army men, 24 civilians and 39 sedentary workers. Significant differences were found between the control and test groups for WHR, total cholesterol, HDL, LDL, Triglycerides, Apo B, and Cholesterol/HDL ratio; in addition the civilian group also showed significant differences from the control group in BMI values. Although LDL levels were lower in army than sedentary group, the difference was statistically nonsignificant. Significant differences were found between the army and civilian groups in age, HDL, Triglycerides and Apo B values. Long term aerobic exercise has beneficial effects in decreasing Apo- protein B levels, LDL levels and total cholesterol /HDL ratio. Exercise habits should be encouraged in general population to decrease the cardiovascular disease risk

Sociodemographic and clinical characteristics of IV drug users presenting to a tertiary care treatment centre

To identify the association between sociodemographic factors and injectable drug use. This descriptive study was carried out in drug abuse treatment centre of psychiatry department Lady Reading Hospital Peshawar. The patients were recruited through United Nations Office, Drug and Crime Programme [UNODC]. They were interviewed in detail by a psychologist and psychiatrist, through an instrument, specifically designed to collect the information about sociodemographic factors among injecting drug users. Data was recorded and analyzed by using SPSS. The sample consisted of 52 injecting drug users out of the total five hounded patients [10.4%]. All of them were male. Majority belonged to the age group 21-40 years [76.9%]. One third of them [34.6%] were illiterate while about half [50.5%] had professional skills. About one fourth patients [26.9%] started drug use in early age [11-20 years], and only four patients admitted sharing syringe or needle with others patients. The most common reason for 1/V drug use was, influence of friends followed by the desire to get quick and light response. Problem of injectable drug use is common in the illiterate and in younger age group and needs attention of health care planners and research workers