Attitude of the university students and teachers towards mentally ill, in Lahore, Pakistan.

BACKGROUND: Although, much is known about the attitudes and beliefs people hold towards mental illness in the west, no such work has been done in the developing countries. It is difficult to measure the attitudes of the general public in developing countries due to differences in terminology and concepts of the illness. However, majority of educated people in the developing countries can recognise common psychiatric disorders by their western names. We therefore, decided to measure attitudes of university students and teachers in Lahore, Pakistan. This study was carried out to assess the attitude of university students and teachers in Lahore, Pakistan. METHODS: A survey form was circulated among the university students and the teachers in Lahore, Pakistan. Of the 300 survey forms 194 were returned. RESULTS: Majority of the respondents held negative attitudes towards people with schizophrenia, depression and drug and alcohol disorders. CONCLUSIONS: The views held by the university teachers and students reveal negative attitudes towards mentally ill. Attitudes of those who knew someone with mental illness were similar to those who did not.

Development and validation of a questionnaire for anxiety and depression in Pakistan.

BACKGROUND: Currently clinicians and researchers in Pakistan have to use translated western instruments to screen for anxiety and depressive disorders. This study investigated the local idioms of emotional distress in Pakistan to develop a culturally valid and easy-to-use instrument to screen for common mental disorders in general clinical settings. METHODS: A systematic survey was conducted of psychiatric case notes of patients attending clinics in Peshawar and Lahore, diagnosed with anxiety or depressive disorders, to identify the range of common idioms of psychological distress. A pilot version of the questionnaire was refined and validated among a composite sample of 330 patients in inpatient, outpatient and rural community settings. ICD-10 Diagnostic Criteria for Research were used to define cases and patients' relatives acted as normal controls. RESULTS: The pilot version of the questionnaire was reduced to 42 items based on odds ratios between cases and controls. Anxiety symptoms were generally reported by depressed patients, but not vice versa. Finally 30 items were selected, in two sub-scales. This final version achieved sensitivity, specificity, and positive and negative predicted values of over 90% when comparing cases and controls. LIMITATIONS: This questionnaire was based on what patients tell doctors and may not capture the entire repertoire of local idioms of distress. The validation study was conducted only in an Urdu/Punjabi speaking population, in Lahore and surrounding areas. CONCLUSIONS: The Pakistan Anxiety and Depression Questionnaire consists of an anxiety/depression scale and a depression scale, each of 15 items. It demonstrates excellent validity as screening instrument for anxiety and depressive disorders in clinical settings in Pakistan.