Stalking and its effects

To examine the social, occupational, psychological and emotional effects of stalking. A group of 100 subjects of stalking who attended psychiatry O.P.D. at Jinnah Hospital and Private Clinic of the authors for advice and help were included in this study. One hundred subjects [88 females and 12 males] with age range 18-45 years from city of Lahore. Majority of the victims were subjected to multiple forms of harassment including being followed, repeatedly approached, received many letters and telephone calls for period varying from 6 weeks to 6 months. Threats were received by 58 subjects and 38 were physically assaulted; majority [94%] victims made major changes in their social and work lives with 52% having decreased work capacity and 12% moving their place of residence. Increased levels of anxiety were reported by 83%, aggressive or guilt thoughts 65%, intrusive recollections by 55%, with changes in appetite 48%, disturbance in sleep 74% and suicidal ruminations were acknowledged by 12% of the subjects. Forty seven percent full filled criteria for diagnosis of post traumatic stress disorder with further 38% having the evidence of numbness to responses. This study indicates the extent of the social, occupational and psychological damage sustained by the subjects of persistent stalking and underlines the inadequacy of current legal, medical responses to the needs of these subjects

Deliberate self poisoning [unemployment and debt]

To study the characteristics of deliberate self harm patients in financial difficulties [Debt] and find any link between the seriousness of the attempt and the severity of financial problems of Debtees. A comparative study of patients of self-poisoning with loan and without financial problems. Accident and emergency and psychiatry department of Jinnah Hospital, Lahore. One hundred and sixty patients of self poisoning were studied for financial difficulties on a 4-point scale and self report scales, Beck depression inventory [BDI] Beck Hopelessness scale [BHS], General Health Questionnaire [GHQ] and Locus of Control of Behaviour Scale [LCBS]. One hundred and forty seven patients completed study, 54[37%] were in loan [Debt] and 93 were no-Loan group. Unemployment was common in loan group. The loan group had a greater suicidal intent, reported more psychiatric symptoms, had more hopelessness, less in control of events and received more psychiatric diagnoses. Patients with loan were more likely to harm themselves with greater suicidal intent and, after the episode, to report more symptoms of depression

Combined haloperidol and electro convulsive therapy in the treatment of selected cases of mania

To compare efficacy of combined haloperidol and electro convulsive therapy [ECT] in the treatment of Mania in selected cases who are resistant to medication alone and are severely ill. Two groups of 20manic patients received eight ECT sessions either actual or simulated, in a double blind controlled study. All patients received 30mg of Haloperidol daily until the sixth treatment and subsequently dose of anti-psychotic medication was adjusted for individual patient according to level of improvement. Department of Psychiatry Jinnah Hospital, Lahore. Forty patients were included in the study between 1st July 1999 and 30th June 2000, the two groups did not differ significantly in any of the sociodemographic variables or any clinical variables as rated on Mania Rating Scale [MRS]4 and Brief Psychiatric Rating Scale [BPRS]19 before intake into the study and severity of index episode. At the end of eight sessions although 17 patients in the ECT group had made a complete recovery, in the simulated ECT group only one had recovered. Significantly more patients [16] in the simulated ECT group required an increase in anti-psychotic medication compared with the ECT group [two patients] [P < 0.05, Fisher's Exact Probability Test]. The results indicate that the group receiving the combination of Haloperidol and ECT did significantly better than the other group in severely disturbed patients. It is not recommended as routine procedure as modern antimanic drugs are affective in mania

Suicidal behavior [parasuicide]

Suicidal behavior [SB] or Parasuicide is on the increase in Pakistan as indicated by news media and increase in OPD cases hence it has a great importance as a Public Health Problem. Although there is no paucity of data about the pattern of SB in European Countries, in Pakistan, only few studies have been reported. The objective was to study this problem in local population. Socio-demographic characteristics and psychosocial events were recorded on a semi-structured questionnaire. Diagnosis for Psychiatric illness was made on the basis of ICD-10 classification of mental behavioral disorder. Patients attending Accident and Emergency Department of Jinnah Hospital attached to Allama Iqbal Medical College, Lahore were included in this study. Three hundred and ninety four consecutive subjects of SB attending the Accident and Emergency Department were enrolled for this study. Their age, sex, marital status, educational standards, socio-economic status, methods employed for suicidal behavior, psychiatric illness and various reasons for suicidal intents were recorded. Data was analyzed through Statistical Package of Social Sciences [SPSS] [8.0], overall differences were assessed using percentages and Chi-square test. Three hundred and eighty five patients were analyzed since nine subject refused interview on personal grounds. Majority [56 percent] was young and preponderance was of females [55 percent]. SB was common among single female [50.6 percent]. Seventy nine percent were graduate and less and 21 percent postgraduates and professionals. Lower social class was predominant [55 percent], followed by middle class [40 percent] and common mode applied was drug overdose [52 percent]. Relationship problems was the main reason [55 percent], other was financial difficulties [35 percent] and loss of objects or person [10 percent]. Majority [48 percent] had no psychiatric illness although 23 percent had depression 16 percent stress reaction and 8 percent had serious illness of schizophrenia and drug dependence. Suicidal behavior is on the increase. It is common in young age, predominantly seen in females [55 percent]. It indicates impulsiveness, unpredictability, and acute stress reaction. Preponderance of females show restrictions, less privileges and gender indiscrimination which is present in our community values. Majority had no psychiatric illness some had depression and few had schizophrenia. The suicidal behavior is under reported as it is a criminal offence and no facilities are available for psychiatric evaluation guidance for follow up

Fluoxetine and it's good sexual side effects

Fluoxetine- a selective serotonin re-uptake inhipitor has been used extensively like other SSRI for the treatment of depression. Four case reports of good sexual side effects of this drug are reported as these noted sexual side effects are interesting and need further investigation to use these as one of the methods of treatment of erectile importance

Comparative trial of selective serotonin reuptake inhibitors in depression

To compare efficacy of sertaline and imipramine in depressed patients in 50mg twice-daily dose. Design: A comparative open trial of both drugs was carried out in 92 depressed patients attending as out patients. Setting: Out patients attending Department of Psychiatry, Jinnah Hospital, Lahore. 40 patients received sertaline and 52 received imipramine in 50mg twice-daily dose for 4 weeks. 33 patients in sertaline group and 40 patients in imipramine group completed the trial; 24 [72%] and 29 [72%] in each group showed improvement whereas 9 [27%] in sertaline and 11 [27%] in imipramine showed no change. Both sertaline and imipramine are effective in the treatment of depression