Prevalence of suicidal ideation and suicide attempts in individuals with psychosis and bipolar disorder in South Asia: systematic review and meta-analysis.

BACKGROUND: Suicidal ideation and attempts are growing public health concerns globally. Evidence from high-income countries suggests that individuals with psychosis and bipolar disorder are at increased risk of suicidal ideation and attempts, but there is a scarcity of evidence from South Asia. AIMS: To estimate the prevalence of suicidal ideation and attempts in individuals with psychosis and bipolar disorder in South Asia. METHOD: In this systematic review and meta-analysis, four databases (PsycINFO, Web of Science, EMBASE and Medline) were searched until December 2022. Pooled prevalence was estimated with random-effects models. Heterogeneity was quantified with the I2-statistic. RESULTS: The pooled sample size across the 21 studies was 3745 participants, 1941 (51.8%) of which were male. The pooled prevalence of suicide attempts in South Asian people with either psychosis or bipolar disorder was 22% (95% CI 17-27; n = 15). The pooled prevalence of suicidal ideation with psychosis or bipolar disorder combined was 38% (95% CI 27-51; n = 10). Meta-regression, subgroup and sensitivity analysis showed that the pooled prevalence estimates for both suicide attempt and ideation remained unaffected by variations in critical appraisal ratings and study designs. Only one study reported data on suicide-related deaths. CONCLUSIONS: One in four individuals diagnosed with psychosis or bipolar disorder have reported suicide attempts, whereas up to one in three have experienced suicidal ideation. These findings underscore the urgent need for clinicians to regularly assess and monitor suicidal ideation and attempts among individuals with these disorders in South Asia.

Effectiveness of physical activity in managing co-morbid depression in adults with type 2 diabetes mellitus: A systematic review and meta-analysis.

BACKGROUND: Physical activity may be effective in alleviating depressive symptoms and improving glycaemic control; however, evidence to guide practice is limited. The current review was conducted to assess the effects of physical activity on depression and glycaemic control in people with type 2 diabetes mellitus. METHODS: Randomized controlled clinical trials, from the earliest record to October 2021, which recruited adults with the diagnosis of type 2 diabetes mellitus and compared physical activity with no interventions or usual care for the management of depression were included. The outcomes were change in depression severity and glycaemic control. RESULTS: In 17 trials, including 1362 participants, physical activity was effective in reducing the severity of depressive symptoms (SMD = -057; 95%CI = -0.80, -0.34). However, physical activity did not have a significant effect in improving markers of glycaemic control (SMD = -0.18; 95%CI = -0.46, 0.10). LIMITATIONS: There was substantial heterogeneity in the included studies. Furthermore, risk of bias assessment showed that most of the included studies were of low quality. CONCLUSIONS: Physical activity can effectively reduce the severity of depressive symptoms, nonetheless, it appears that physical activity is not significantly effective in improving glycaemic control in adults who have both type 2 diabetes mellitus and depressive symptoms. The latter finding is surprising, however, given the limited evidence on which this is based, future research on the effectiveness of physical activity for depression in this population should include high quality trials with glycaemic control as an outcome.

Stakeholders' perspective on mental health laws in Pakistan: A mixed method study.

The present study explored awareness and opinions pertaining to mental health legislation in Pakistan in the context of the United Nation Convention on Rights of People with Disabilities (UNCRPD) through a mixed method research design. In the quantitative arm of the study, a structured questionnaire examined awareness and opinions of key stakeholders pertaining to national mental health legislation. In the qualitative arm, face-to-face interviews further elaborated stakeholders perspectives pertaining to these topics with thematic analysis conducted. Stakeholders demonstrated a good awareness of legislation pertaining to guardianship (83.0 %) appointment of property managers (89.7%) and salary or pension entitlements (89.2%). Compared to other stakeholders, patients had less understanding of processes pertaining to involuntary admission (χ2 = 20.54, p = 0.02) and appointing a guardian (χ2 = 34.67, p < 0.01). High consensus across stakeholders was noted for processes of involuntary detention (83.5%) and appointment of guardians or property managers (80.0%) albeit patients demonstrated less agreement on these topics (p <0.01). Minimal support was noted for an involuntary patient to be discharged solely on a psychiatrist's recommendation (25.4%). Thematic analysis indicated fifteen emergent themes: 1) Alienation/ Seclusion; 2) Capacity building; 3) Communication Gap; 4) Conflict of interests; 5) Discomfort at hospital; 6) Economic burden; 7) Government's liability; 8) Family involvement; 9) Imbalance; 10) Acceptance of Legal Incapacity; 11) Legal reforms; 12) Patient centred environment; 13) Quality assurance; 14) Under developed infrastructure and 15) Potential unethical practices. This study advocates for increased patient involvement in collaborative decision making with mental health professionals and the creation of more appropriate inpatient treatment environments.

Indigenously adapted cognitive-behavioral therapy for excessive smartphone use (IACBT-ESU): A randomized controlled trial.

This study aims to assess whether 12 sessions of indigenously adapted cognitive-behavioral therapy for excessive smartphone use (IACBT-ESU) would reduce excessive smartphone use. A single-blind randomized controlled trial was conducted in students (12 to 19 years of age) to examine the potential beneficial effects of IACBT-ESU (n = 62) compared with brief educational data alone (n = 62). Symptoms of depression, anxiety, stress, and peer relations were also compared between the two groups. The IACBT-ESU group demonstrated significant reductions in excessive smartphone use, with reduced symptoms of depression, anxiety, stress, hyperactivity, and emotional difficulties at both trial end and at 3-month follow-up (p < .01) compared with control participants. IACBT-ESU was associated with reduced excessive smartphone use and improved psychological well-being, with beneficial findings maintained 3 months after the trial's end. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Smartphone addiction and its associated factors among students in twin cities of Pakistan.

OBJECTIVE: To determine the prevalence and indicators of smartphone addiction in local population. METHODS: The cross-sectional study was conducted in the twin cities of Islamabad and Rawalpindi, Pakistan, from August 2017 to August 2018, and comprised school, college and university students of either gender aged 12-19 years. Data was collected using Smartphone Addiction Scale-Short Version with a cut-off score of 31 for boys and 33 for girls. Data was analysed using SPSS 23. RESULTS: Of the 702 subjects screened, 422(60%) had smartphone addiction; 242(57.3%) males and 180(42.6%) females. Social networking applications were significant indicators of the addiction (p<0.05). CONCLUSIONS: Smartphone addiction was found to be high among Pakistani adolescents.

An Urdu adaptation of smartphone addiction scale-short version (SAS-SV).

OBJECTIVE: To adapt the English version of Smartphone Addiction Scale-Short Version into Urdu language. METHODS: The cross-sectional study was conducted from October 2017 to January 2018 at the International Islamic University, Islamabad, Pakistan. In the first stage, Smartphone Addiction Scale-Short Version was translated by 8 experts. In stage 2, the translated version was pilot-tested on 30 university students aged 18-19. Finally, the version was tested on the actual subjects who were students aged 11-30 years at schools, colleges and universities within Rawalpindi and Islamabad. SPSS 22 was used for data analysis. RESULTS: Of the 348 subjects, 216(62%) were males. Overall, 194(55.7%) students were above the addiction cutoff value. Inter-item reliability of the translated version was good (α = 0.81); the construct validity was adequate (P<0.001); Comparative Fit Index = 0.95; Tucker Lewis Index= 0.93; Normative Fit Index= 0.92; and Root Mean Squared Error Approximation = 0.05. CONCLUSIONS: Smartphone Addiction Scale-Short Version can be used as a screening tool for assessment and identification of smartphone addiction in Pakistan..