Role play, a teaching strategy for psychiatry - students' comparative perspective versus traditional teaching.

OBJECTIVE: To compare the effectiveness of conventional teaching methodology against the role play method from the standpoint of medical students. METHODS: The questionnaire-based study was conducted at Majmah University, Saudi Arabia, during the 2018-19 academic year, and comprised final year medical students. The study was conducted in two settings during the psychiatry module; first while discussing suicide and second while discussing violence. In both the settings, the students were divided in two randomised groups of cases and controls. The controls were taught with conventional methodology, while the cases were taught primarily using role play. Data was collected using a questionnaire pertaining to students' level of satisfaction regarding different aspects of the learning process. Data was analysed using SPSS 21. RESULTS: In the first setting, there were 53 students; 29(54.7%) controls and 24(45.3%) cases. In the second setting there were 54 students; 27(50%) cases and as many controls. In both settings, students in the control group rated conventional teaching significantly more interactive compared to the role play method (p<0.05). Clarification of doubt was more in the control group in the first setting (p<0.05). CONCLUSION: Although change in curricula is the need of the time, students' feedback is essential.

Attempted Suicide and Seriousness of Intent.

This descriptive research was conducted to estimate the method of suicide and suicidal intent among hospitalised suicide attempters at Pakistan Ordinance Factory (POF) Hospital, Wah Cantt, from December 2012 to June 2013. Data were collected from 49 hospitalised suicide attempters through purposive sampling technique by using Suicidal Intent Scale. Majority of suicide attempters (92%) used self-poisoning as the method of suicide regardless of their gender, age, occupation, past medical history, past psychiatric history, and history of suicide and psychiatric illness in their families. Additionally, most of them (43%) reported high level of suicidal intent, while 16 (33%) reported medium suicidal intent and 12 (24%) reported mild suicidal intent. Keeping in view the fact that majority of suicide attempters used self-poisoning as a method and most of them reported high level of suicidal intent, it is important to plan preventive measures.

Perceived childhood paternal acceptance-rejection among adults.

OBJECTIVE: To determine the childhood perceptual difference of paternal acceptance-rejection between those having psychological disorders and non-clinical population during adulthood. STUDY DESIGN: Comparative study. PLACE AND DURATION OF STUDY: Karwan-e-Hayat, Psychiatric Care and Rehabilitation Centre, Keamari, Karachi, Pakistan, from January to August 2011. METHODOLOGY: To test our hypotheses, 69 participants were selected from Karwan-e-Hayat Psychiatric Care and Rehabilitation Centre, Karachi on the basis of purposive sampling technique and 79 from Karachi city on the basis of convenient sampling technique. To measure their perceived paternal acceptance-rejection during childhood, Adult Parental acceptance-rejection questionnaire (PARQ)/control: father-short form (Urdu translation) was administered. The statistical analysis of data was done with the predictive analytics software (PASW). RESULTS: One hundred and forty eight (78 males and 70 females) participants with mean age of 31.28 ± 9.54 years were included. Out of them 69 (40 males and 29 females) were clinical cases of depression, mania and psychosis with mean age of 33.26 ± 9.51 years. Seventy nine (38 males and 41 females) were normal individuals with mean age of 29.54 ± 9.29 years of the demographics corresponding to the clinical population. Independent t-test revealed a significant difference in perceived childhood father acceptance-rejection between clinical and non-clinical population (p < 0.05) and significant gender difference (p < 0.05). CONCLUSION: The studied clinical population and male participants perceived to be more rejected by their father during their childhood than non-clinical population and female participants.

Depression, anxiety and their associated factors among medical students.

OBJECTIVE: To determine the frequency of anxiety and depression among medical students of Wah Medical College and their associations with sociodemographic and educational characteristics if any. STUDY DESIGN: Cross-sectional survey. PLACE AND DURATION OF STUDY: Wah Medical College, from September 2007 to March 2008. METHODOLOGY: A sample of 279 students was included in the study after excluding first year medical students because they were admitted for less than 6 months. A self administered Encounter Form was administered. Sociodemographic and educational characteristics included age, gender, birth order, number of siblings, monthly income, monthly expenditure on education, academic performance in professional examination, past medical and past psychiatric history, substance abuse and family history of psychiatric illness. Beck depression inventory and beck anxiety inventory were used to assess the level of depression and anxiety. The chi-square test was applied at 5% level of significance to determine associated factors for anxiety and depression respectively. RESULTS: The mean age of students was 21.4+/-1.41 years with female preponderance i.e. 202 (72.4%). Anxiety was present in 133 (47.7%) students and depression in 98 (35.1%) students. Both were found concomitantly in 68 (24.37%) students. Age (p=0.013), gender (p=0.016), examination criteria dissatisfaction (p=0.002) and overburden with test schedule (p=0.002) were significantly associated with depression. Anxiety was significantly associated with gender (p=0.007), birth order (p=0.049), year of study (p=0.001), examination criteria dissatisfaction (p=0.010) and overburden with test schedule (p=0.006). CONCLUSION: One third of students were found to have anxiety and depression which was associated with the sociodemographic and educational factors as stated above.

Type of presentation of dissociative disorder and frequency of co-morbid depressive disorder.

OBJECTIVE: To determine the frequency distribution of various types of dissociative disorders, along with existing co-morbid depression and its level of severity in patients with dissociative disorder. STUDY DESIGN: Observational, cross-sectional study. PLACE AND DURATION OF STUDY: The Institute of Psychiatry, Rawalpindi General Hospital from October 2004 to March 2005. METHODOLOGY: Fifty consecutive patients were included in the study through non-probable purposive sampling technique. Encounter form included socio-demographic profile and brief psychiatric history. ICD 10 diagnostic criteria for research were administered for determining the presentation of dissociative disorder. Present state examination was applied to make diagnosis of depressive disorder in the studied patients. Descriptive statistics for frequency analysis of sociodemographic variables, type of presentation of dissociative disorder and the frequency of depressive disorder in patients of dissociative disorder. RESULTS: The mean age was 23.6+/-8.67 years with female preponderance (n=40, 80% patients). Most of them were single, unemployed and belonged to urban population. Main stress was primary support group issue. Mixed category of dissociative disorder was highest (n=18, 38%) followed by unspecified and motor symptoms (n=13, 26%) in each group. Depression was present in 42 (84%) patients. Moderate depression was most frequent (n=19, 38%). CONCLUSION: Mixed dissociative symptoms were found in 38%, while 26% had motor and unspecified category of dissociative symptoms respectively. Depressive disorder was present in 42 (84%) cases of dissociative disorder with 38% having moderate depression.

Anxiety and depression in burn patients.

BACKGROUND: The psychological aspects of burn injury have been researched in different parts of world producing different outcomes. Therefore objective of this research is to determine the frequency of Anxiety and Depression in burn patients. To assess the socio-demographic distribution of patients developing Anxiety and Depression and to determine the effects of burn related factors on development of Anxiety and Depression. METHODS: A Case series was conducted at the Department of Burn, Pakistan Ordinance Factory Hospital, Wah Cantt. for a duration of 12 months commencing from June 2007 and concluded in May 2008. The study population comprised of hospitalized patients with 1% to 50%, selected through non probable sampling technique who were assessed for Anxiety and Depression on fifteen day after burn injury. Testing protocol comprised of questionnaire having socio-demographic variables and burn related variables. Beck Depression Inventory and Beck Anxiety Inventory was applied to evaluate Anxiety and Depression in Burn patients. Descriptive statistics like mean with Standard Deviation was calculated for age. Frequencies along with percentages were calculated for socio-demographic variables. The frequencies and proportions were also calculated for presence and extent of severity of depression and anxiety in burn patients. RESULTS: Fifty patients were included in the study, thirty patients (60%) were male and 20 (40%) were females. The mean age of participants was 33.64 +/- 19 years. Majority of participants, 38 (76%) had sustained burn injury up to 25%. Flame was found to be most common agent of burn injuries affecting 19 (38%) patients. Depression was seen amongst 29 (58%) patients. Thirteen (26 %) patients had mild, 7 (14%) had moderate and 9 (18%) had severe Depressive symptoms. Anxiety was seen among 41 (82%) patients, thirteen (26%) patients had mild, 11 (22%) had moderate and 17 (34%) had severe Anxiety symptoms. CONCLUSION: Anxiety was present in 41 (82%) and Depression was present in 29 (58%) patients following burn injury. This study highlights the importance of the simultaneous evaluation and management of Anxiety and Depression in burn injured patients.