Journal of Pakistan Psychiatric Society 2022-12-31T18:58:25+00:00 Meritorious Prof. Dr M. Iqbal Afridi Open Journal Systems <p>ISSN: <strong>2224-8897</strong> (Online)<br>ISSN: <strong>1726-8710</strong> (Print)</p> <p>The Journal of Pakistan Psychiatric Society (JPPS) is the official publication of Pakistan Psychiatric Society (PPS), the pioneer representative body of psychiatrists in Pakistan.<br>This journal is dedicated to encourage and facilitate research at all levels and in all fields of Psychiatry and Mental Health.<br>We are devoted to reporting original investigations in the biomedical and health sciences relevant to the mental health including research in the basic sciences; clinical trials of therapeutic agents; effectiveness of diagnostic or therapeutic techniques; or studies relating to the behavioral, epidemiological or educational aspects of Psychiatry.</p> <p>JPPS is the only quarterly published journal in the field of Psychiatry in Pakistan with distribution amongst members of PPS both locally and globally. JPPS holds a strong position as the trailblazer in the Mental Healthcare and wellbeing sector of Pakistan, and is a prestigious medium owing to its credibility, acceptability and reach.</p> ADVANCES IN TREATMENT OF MOOD DISORDERS 2022-12-31T18:50:13+00:00 Asim A. Shah <p>In the last many decades psychotropics have mostly focused on Serotonin, Norepinephrine, and Dopamine for depression, and dopamine blockers for psychosis. Researchers started working diligently and explored new targets like Glutamate in treating depressive disorder and schizophrenia. The antagonist effect of Ketamine on N-methyl-D-aspartate (NMDA) receptors was investigated, which can result in a faster antidepressant response as compared to conventional treatment . GABA receptors were also explored to develop novel compounds, which resulted in the discovery of brexanalone, a neuroactive steroid-positive allosteric modulator of GABA<sub>A&nbsp; </sub>&nbsp;approved in March 2019 by the FDA for the treatment of postpartum depression. It is administered as an intravenous infusion over 60 hours and results in a rapid antidepressant response in` postpartum depression lasting for more than one week. Another neuroactive steroid Zuranolone effectively treats postpartum depression and major depressive disorder (MDD) . The antidepressant also modulates neuronal plasticity by enhancing the Brain-derived neurotropic factor BDNF levels.</p> 2022-12-31T18:23:36+00:00 Copyright (c) 2022 Journal of Pakistan Psychiatric Society PATTERN OF SUICIDE DEATHS: A RETROSPECTIVE 5-YEAR AUTOPSY SAMPLE ANALYSIS IN PAKISTAN 2022-12-31T18:50:13+00:00 Nazish Imran Fareeha Tariq Izwa Bhatti Summaiya Syed Tariq Riasat Ali Hafsah EhsanUllah <p><strong>Objective: </strong></p> <p>Suicide is a global public and mental health problem. In this study, we evaluated autopsy reports of suicidal deaths for 5 years to study the demographic distribution of the suicide victims, and methods of suicides.</p> <p><strong>Methods:</strong></p> <p>It is a descriptive cross-sectional study of suicide autopsies conducted at the mortuaries of two large Forensic departments in Punjab and Sindh (King Edward Medical University/Mayo hospital, Lahore, and Jinnah Postgraduate Medical Centre Karachi) for 5 years, between January 2017-December 2021. Data was collected on pre-designed proformas and was statistically analysed using SPSS 26.</p> <p><strong>Results:</strong></p> <p>Between 2017 and 2021, 98 cases of suicide were examined in the two study centres (67 males ,68.4% and 31 females, 31.6 %). Fifty-six suicides (57%) were in age group under 30 years old. The most frequently used methods for suicide were hanging (41,41.8%) , use of firearms (23, 23.5%), Self-poisoning (11,11.2%), and jumping from heights (6, 6.1%). Significant differences were noted regarding method of suicide among gender and different age groups as well as different study centres (P value&lt;.05). Firearms were used solely by males, and all deaths due to jumping from heights were in Karachi.</p> <p><strong>Conclusion:</strong></p> <p>Due to local cultural and religious beliefs, the autopsy rate in suicide seems too low. There was a male preponderance amongst suicidal death autopsies in our study sample. Hanging&nbsp; Firearms and self-poisoning were the most frequent suicidal methods. Provision of psychological and social supports along with restriction to easy access to firearms and poisons should be considered by policy making and healthcare authorities to tackle this preventable public health problem.</p> <p><strong>&nbsp;</strong></p> 2022-12-31T18:24:37+00:00 Copyright (c) 2022 Journal of Pakistan Psychiatric Society MENTAL HEALTH COMORBIDITY IN A CANADIAN COURT 2022-12-31T18:50:13+00:00 Pauline Leung Najat Khalifa Tariq Hassan <p>Objective</p> <p>Over the past two decades, Canada has seen a rapid growth in problem-solving courts. Such courts are predicated on the rationale that certain populations of individuals who come into contact with the law do so not out of choice, but because of personal circumstance. One prominent example of a problem-solving court is the mental health court. the current investigation serves as a preliminary look into the needs of individuals in contact with the law in southeastern Ontario, Canada. At the time of the writing of this report, no mental health courts had yet been established in the region. We sought to assess the need for such a court by reviewing some key demographics in a sample of offenders in a ‘guilty plea’ court.</p> <p>Design:</p> <p>To this end, data from guilty plea court was collected over the course of several months. The data was publicly available and therefore university ethics though enquired was not required. At the completion of data collection, information from 79 court cases had been documented. These cases were coded for the presence or absence of identified mental health concerns, and subsequent analysis was conducted to discern whether mental health status could predict the type and severity of charges accrued.&nbsp;</p> <p>Results:</p> <p>Of the 79 cases, 24 individuals attending guilty plea court were identified as presenting with mental illness</p> <p>Conclusion:</p> <p>Everything taken together, the current study highlights the need and utility for mental health courts. We offer empirical evidence of such a need, and add to the slowly growing—and altogether much-needed—body of literature surrounding mental health courts in Canada.</p> 2022-12-31T18:25:43+00:00 Copyright (c) 2022 Journal of Pakistan Psychiatric Society EXPLORING THE ASSOCIATION OF MEANING IN LIFE WITH PSYCHOLOGICAL DISTRESS IN MALE PATIENTS WITH SUBSTANCE USE DISORDER IN PAKISTAN 2022-12-31T18:50:13+00:00 Muhammad Ali Khan Salman Shahzad Nasreen Bano Zakia Bano Mahreen Siddiqui <p><em>The objective of the present research is to explore the predictive association of meaning in life (presence &amp; search) with psychological distress (depression, anxiety &amp; stress) in people with substance use disorder. </em><em>Sample of the present study comprised 200 Muslim participants (male patients with substance use disorder), ages ranging from 18 to 45 years (M =18; SD =6.55). The sample was recruited from different substance use treatment and rehabilitation centers situated in different areas of Karachi, through purposive sampling. Instruments used in this study were the Personal Information Form, Meaning in Life Questionnaire (MLQ; Stegaer, et al., 2006), and Depression Anxiety and Stress Scale (DASS; Lovibond, &amp; Lovibond, 1995). Regression analysis shows a significant predictive relationship of meaning in life (i.e., presence &amp; search of the meaning) with depression </em><em>(adj R<sup>2</sup></em><em>=</em><em>.988, </em><em>F </em><em>(2, 198)</em><em> =8278.46</em><em>, P &lt; .0001</em>(<em>, anxiety </em><em>(adj R<sup>2</sup></em><em>=</em><em>.943, </em><em>F </em><em>(2, 198)</em><em> =1659.8</em><em>2, P &lt; .0001</em>(<em>, stress </em><em>(adj R<sup>2</sup></em><em>=</em><em>.982, </em><em>F </em><em>(2, 198)</em><em> =5390.7</em><em>8, P &lt; .0001</em>(<em>. Overall findings revealed that meaning in life is a significant predictor of psychological distress (i.e., depression, anxiety &amp; stress) in people with SUD. The finding and implications are discussed in detail.</em></p> <p><em>&nbsp;</em></p> <p><strong><em>Keywords:</em></strong><em> Meaning in life, presence, search, depression, anxiety, stress, substance use disorder</em></p> 2022-12-31T18:27:18+00:00 Copyright (c) 2022 Journal of Pakistan Psychiatric Society ROLE OF EMOTIONAL REGULATION STRATEGIES IN DETERMINING PSYCHOLOGICAL DISTRESS AMONG UNDERGRADUATE UNIVERSITY STUDENTS 2022-12-31T18:50:13+00:00 uzma jillani Anila Amber Malik <p><img src="/public/site/images/uzmaj/abstract.PNG"></p> 2022-12-31T18:28:15+00:00 Copyright (c) 2022 Journal of Pakistan Psychiatric Society IMPACT OF USE OF SOCIAL APPLICATIONS AND APPEARANCE-RELATED CONSCIOUSNESS ON BODY DYSMORPHIC DISORDER SYMPTOMS AND LOWER SELF-ESTEEM AMONG FEMALES 2022-12-31T18:50:13+00:00 Laiba Waqar Arooj Fatima Mazhar Maria Rafique MIsbah Rehman <p><strong>Abstract </strong></p> <p><strong>Objective:</strong> To investigate the impact of use of social applications and appearance-related consciousness on Body dysmorphic disorder symptoms and lower self-esteem among females.</p> <p><strong>Research Design: </strong>Study uses cross-sectional research design to examine the association of social applications and appearance-related consciousness with symptoms of body dysmorphic disorder and lower self-esteem.</p> <p><strong>Place and duration of study: </strong>The study was conducted in 6 months at Riphah International University from January to August 2022.</p> <p><strong>Methods:</strong> A total of 200 females were approached via convenience sampling for this study from universities, colleges and workplace of Pakistan. Female participants of age range young adults i. e. 17-35 years were included in study. Females actively using social media for more than 6 months were recruited.</p> <p><strong>Results:&nbsp; </strong>According to the results it was found that social application use and appearance-related conciseness both were positively related to symptoms of body dysmorphic disorder. However, it was showed that social application use and appearance-related conciseness were negatively related to self -esteem.</p> <p><strong>Conclusion:</strong> The present study demonstrated that individuals who excessively use social applications and are more likely to be unhappy with their own body image and experience more negative feelings after viewing appealing self-images on social media. Higher body dysmorphic and worse self-esteem were revealed to be positively correlated with appearance-related awareness.</p> 2022-12-31T18:29:07+00:00 Copyright (c) 2022 Journal of Pakistan Psychiatric Society IMPACT OF COVID-19 UPON THE MENTAL HEALTH OF HEALTHCARE WORKERS AND STUDENTS IN PAKISTAN: REVIEW ARTICLE 2022-12-31T18:58:25+00:00 Ali Burhan Mustafa Saima Mustafa Mussarat Saleem <p><strong>Background: </strong>The pandemic COVID-19 affected all sections of society globally including Healthcare workers (HCWs). The numerous studies showed the negative impact of COVID upon the mental health of healthcare workers and healthcare students in Pakistan.</p> <p><strong>Methods: </strong>Cross sectional studies of 12 articles selected out of which, 09 articles from Pakistan included. These articles were published in various journals of good impact factor. The two psychometric tools and questionnaires used to assess the prevalence. The participants included Healthcare workers, students, and graduates.</p> <p><strong>Results</strong>: Of the studies included, 64.3% HCW graduates followed by 44.9% nurses, 44.5% doctors and 35.7% students. Female HCWS, frontline HCWS, nurses, young staff were more likely to suffer from mental health issues, i.e., anxiety and depression.</p> <p><strong>Conclusion</strong>: During the recent pandemic COVID-19, a considerable number of HCWS struggled through various mental health issues. The findings call for a workable psychological intervention model especially designed for HCWS.</p> <p><strong>Keywords</strong>: COVID-19, healthcare workers, mental health</p> 2022-12-31T18:32:03+00:00 Copyright (c) 2022 Journal of Pakistan Psychiatric Society THE EMERGING ROLE OF REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION IN TREATING THE MENTAL CONDITION 2022-12-31T18:50:13+00:00 Amima Salam <p>repetitive Transcranial Magnetic Stimulation (rTMS) is a form of brain stimulation therapy which is approved by FDA (USA) and CE (Europe). In rTMS treatment, an instrument called a stimulator supplies electrical energy to a magnetic coil that generates a magnetic field in the brain for a short period of time. rTMS is based on the principle of electromagnetic induction that can either stimulate or inhibit the neuronal activity of specific brain areas as per need. This drug free treatment is helpful in many neurological and psychological disorders such as depression, OCD, migraines, autism, ADHD, epilepsy, Bipolar and sexual disorders. The treatment is so safe that it could be conducted on one year old child to an old age. It is an outpatient procedure which does not require hospitalization or anesthesia and entails no memory loss. After the session, patients require no recovery period and are able to go about their daily activities immediately following treatment. Other than some precautions, it is often ideal for patients, because it has none of the side effects of traditional medications and other treatments. It can be said rtms is a focal, non-invasive and very well-tolerated form of brain stimulation in clinical use which is safe for almost all patients suffering from mental or psychological disturbance.</p> 2022-12-31T18:42:28+00:00 Copyright (c) 2022 Journal of Pakistan Psychiatric Society LETTER TO EDITOR 2022-12-31T18:50:13+00:00 Ahmed Mashood <p>Pakistan has been listed as a developing country by the UNO for several decades now. However, in terms of accredited opportunities for further specialisation abroad by students gaining their MBBS in Pakistani medical colleges and universities, it is evident that mental health and psychiatric training is not at par with, say, medicine and surgery entry pathways. The reasons for this lag are likely to be multifactorial including but not limited to, the lack of attention by the Pakistani educational institution in developing the training pathways within Pakistan; the stigma attached to mental illness including the cultural and sub-cultural aspects of guilt and shame experienced by the families of the persons suffering mental illnesses and disorders; as well as the lack of interest in bright students having an ambition towards specialising in this field; lack of funding and resources; and lack of alignment with international institutions.</p> <p>Remember: mental illness does not discriminate and can affect anyone; it is best countered by the professionals with the same discrimination-free approach.</p> 2022-12-31T18:48:57+00:00 Copyright (c) 2022 Journal of Pakistan Psychiatric Society UNITY OF MIND, HEART AND BODY 2022-12-31T18:50:13+00:00 creative Corner <table> <tbody> <tr> <td width="111">&nbsp;</td> </tr> <tr> <td>&nbsp;</td> <td>&nbsp;</td> </tr> </tbody> </table> <p><br>To the casual eye, the whirling ritual known as ‘sema’, may appear to be a theatrical performance, but it is actually a sacred Muslim religious ritual performed as part of praying by the Mevlevi Order. This order is about 750 years old, and is a living tradition based on the teachings of Rumi, also known as Mevlana, who is perhaps Turkey's most celebrated poet and second only to Hafiz in Iran. The Mevlevis or the “whirling dervishes, as they are called” due to their famous practice of whirling as a form of remembrance of “The Al Mighty.” Mevlevis believe that during the sema ritual, the soul is freed from its earthly bonds and able to continue its journey freely. The ritual of 'whirling' brings the Dervish into harmony with nature, while they thank and pray to “The Creator”. Sema brings together the three basic components of human nature: mind, heart, and body.</p> 2022-12-31T18:49:33+00:00 Copyright (c) 2022 Journal of Pakistan Psychiatric Society