Journal of Pakistan Psychiatric Society

Mental Health in the Era of Climate Change: A Rising Emergency for Pakistan

Rizwan Taj — 2025-09-29

Climate change has transformed over the past decades from a distant environmental issue to an immediate existential problem. Pakistan, which consistently ranks in the top ten most climate- vulnerable countries in the Global Climate Risk Index, stands at the forefront of this reality[1]. Heatwaves in Karachi, recurrent droughts in Sindh and Baluchistan, the devastating floods in 2022 affecting over 33 million people, and in the year 2010 super floods have highlighted the urgent threat. The psychological effects of climate change on Pakistan’s population are still not well understood, despite the fact that attention is frequently focused on the loss of infrastructure and physical health effects. The additional pressures of climate- related issues call for urgent attention to mental health policies and services, which are already under strain.

Liaison Psychiatry and Maternity Services - An Essential Interface

Tayyeb A Tahir — 2025-09-30

Liaison psychiatry teams collaborate closely with the surgical and medical departments in general hospitals. Regardless of the apparent reason, patients who present with both physical and mental health challenges are treated by these general hospital mental health teams. Physical and psychological co-morbidities, managing chronic illnesses, self-harm, and coping with illness are just a few examples of liaison psychiatry work. Liaison psychiatric services should continue expanding, including in low and middle-income nations. Furthermore, liaison psychiatry services ought to be more comprehensive. By acknowledging the emotional and clinical needs of mothers, liaison psychiatry, when partnered with maternity services, may offer a chance to establish a benchmark for managing mental health concerns.

When the Cradle Stays Empty: Grief is Different for Everyone

Fahmida Fahmida — 2025-09-29

Objective: To explore women's experiences of perinatal grief, depression, anxiety, and stress across various personal and social factors.

Study Design: Cross-sectional survey design.

Place & Duration of study: The present study was conducted online over four months from November 2024 to February 2025.

Subjects and Methods: The Fountain House Institute for Mental Health, Lahore, approved the study. A sample size of 139 women (aged 18-55) who had recently experienced a miscarriage was calculated through an online software by Raosoft Inc. A purposive sampling technique was used. Data were collected through an Urdu questionnaire, including an informed consent form, a demographic information sheet, the Perinatal Grief Scale and the Depression, Anxiety and Stress Scale. Informed consent was taken from the participants before the study. Anonymity and confidentiality of all research data were ensured. Data were analysed using the statistical software SPSS 27.

Results: Independent samples t-tests showed that women who reported satisfaction with their relationship had significantly lower scores on perinatal grief, depression, and anxiety. Similarly, women who reported satisfaction with their home environment scored lower on perinatal grief, depression, anxiety, and stress, and those who experienced emotional problems after miscarriage had significantly higher scores on all measures. One-way ANOVA analysis revealed significant differences in our study measures across three marital status groups: married, divorced, and widowed.

Conclusion: Women differ in their experiences of perinatal grief, depression, anxiety, and stress based on their satisfaction with relationships with their husbands, perceived family support, home environment, marital status, and emotional vulnerabilities.

MODERATING ROLE OF COPING STRATEGIES IN RELATIONSHIP BETWEEN HOUSEHOLD CHAOS AND SOCIAL ADAPTIVE FUNCTIONING OF ADOLESCENTS

Sadia Rehman — 2025-09-29

ABSTRACT

OBJECTIVE

To examine the interplay between the house hold chaos, social adaptive functioning and coping among adolescents.

STUDY DESIGN

Cross-sectional research design.

PLACE AND DURATION OF THE STUDY

The study was conducted at IIU during June 2020 to January 2021.

SUBJECTS AND METHODS

400 participants between age 10 to 19 years were selected through convenience sampling technique to participate in the study. Confusion, Hubbub and Order Scale (CHAOS), Child and Adolescents Social Adaptive Functioning Scale (CASAFS), and Brief Cope Scale (BCS) along with demographic sheet were used to collect data on the variables understudy.

RESULTS

Results revealed that as the household chaos increases the social adaptive functioning decreases (r=-.33**). The results of findings depict that problem-focused coping buffer the effect of household chaos on school performance (R²⁼.31, ∆R²=.30, p<.05) and on home duties /self-care (R²⁼.23, ∆R²=.22, p<.05). Results of emotion-focused coping revealed that EFC buffer the effect of household chaos on peer relationship (R²⁼.23, ∆R²=.22, p<.05) and on family relationship (R²⁼.33, ∆R²=.32, p<.05).

CONCLUSION

House hold chaos, social adaptive functioning and coping has an interdependent relationship among adolescents. Increased household chaos predicted decline in social adaptive functioning while coping played a moderating role between these two factors.

KEY WORDS

Household Chaos, Social Adaptive Functioning, Coping Strategies, Adolescents

DEVELOPMENT AND VALIDATION OF THE SELF-AWARENESS OF STRESS SCALE FOR TEACHERS

Sonia Mukhtar — 2025-09-30

OBJECTIVE
To develop a reliable and valid self-report instrument assessing teachers’ self-awareness of stress.
STUDY DESIGN
Mixed-method research design
PLACE & DURATION OF STUDY
Three private and semi-government higher education institutions in Pakistan (Lahore and Multan), from September 2015 to September 2017 (for a duration of 02 years).
METHOD
To determine the psychometric properties of the Self-Awareness of Stress Scale (SSS), it was administered with a demographic proforma to a sample of 250 teachers.
RESULTS
Exploratory factor analysis, internal consistency, inter-factor correlations, and convergent validity were assessed. The Cronbach’s alpha coefficients ranged from 0.89 to 0.97, demonstrating excellent internal reliability. Inter-factor correlations and concurrent validities were statistically significant at p < 0.01. Three factors were extracted: Interpersonal Challenges, Personal Malfunctioning, and Work Inefficacy.
CONCLUSION
The SSS demonstrated strong reliability and validity, identifying three core domains, which were Interpersonal Difficulties, Personal Dysfunction, and Work Ineffectuality, that overall demonstrate teachers’ self-awareness of stress.

Association of Perceived Parenting Styles with General Family Functioning in Young Adults with Borderline Personality Disorder

Ayesh Bibi — 2025-09-30

ABSTRACT

OBJECTIVES

Current study focused on the predictive association of perceived parenting styles (i.e., permissive, authoritative, & authoritarian) with general family functioning (i.e., problem solving, communication, roles, affective responsiveness, affective involvement and behavior control). in young adults with borderline personality disorders.

HYPOTHESIS

Considering the literature it was hypothesized that the perceived parenting styles (mothers & fathers) would predict the dysfunctional pattern of general family functioning in young adults with borderline personality disorders.

METHOD AND SAMPLE

A cross-sectional study design, using a sample of 51 participants diagnosed with borderline personality disorder ages between18-25 years (M = 22.55, SD = 1.629). Among them 16 (31.4%) were male and 35 (68.6%) were female. Participants were recruited from different out-patient setups in Karachi. Instruments used in this study were, Socio-demographic Information Form, Parental Authority Questionnaire (PAQ) and The McMaster Family Assessment Device (FAD). .

RESULTS

The findings of the study highlighted that coefficient of the multiple regression analysis found that perceived permissive style of mothers and fathers (β= .122, t= .751 p> 0.05 and β, -.171 t, -.789 p> 0.05) does not significantly predicts the general family functioning, while perceived authoritative parenting of both parents (β,=-.400, t= -2.537, p< 0.05and β, -.417 t, -2.312 p< 0.05) significantly predict general family functioning of participants of study. Moreover, perceived authoritarian parenting styles of mothers (β= .387, t= 2.342 p< 0.05) have a significant effect on general family functioning, while authoritarian approach of fathers (β, .051 t, .270 p> 0.05) does not affect the general family functioning of young adults with borderline personality disorder.

CONCLUSION

Further limitations of the study and future implications were discussed.

PERCEIVED STRESS LEVEL AMONG MEDICAL STUDENTS

Shafiq Ur Rahman — 2025-09-30

ABSTRACT
Objective
To assess perceived stress levels among medical students and identify key stressors.

Study design
Cross sectional study design was used.

Place and duration of study
The study was conducted in Saidu Medical College over a period of 3 months from 10 May to 11 August 2024.

Subjects and Methods
This quantitative, descriptive study enrolled students who consented for participation, while non-consenting were excluded. A self-administered questionnaire was used to gather data, which included demographic inquiries and the Perceived Stress Scale (PSS-14). Means for continuous parameters and frequencies for categorical parameters were used for analysis.

Results
Out of 180 students, 150 completed questionnaires. The sample included 61 females (40.6%) and 89 males (59.4%). Most respondents were boarders (72.6%) and single (93.3%). Stress levels revealed 24 students (16%) with low stress, 37 (24.6%) with moderate stress, and 89 (59.3%) with high stress. Males reported 23.6% low, 23.6% moderate, and 52.8% high stress, while females reported 28.26% low, 18.03% moderate, and 53.69% high stress. First-year students had the lowest stress, while final-year students experienced the highest overall stress.

Conclusion

The study concludes that medical students, especially those in their last year, report high levels of stress, with substantial gender differences. These results highlight the necessity of focused treatments to improve the wellbeing of students and deal with particular pressures in medical school.

Key words
Perceived Stress, Medical Students, Stress Level

THE USE OF CLOZAPINE IN PAKISTAN: A STUDY BASED ON CLOZARIL PATIENTS MONITORING SYSTEM (CPMS)

Raza ur rehman Rehman — 2025-09-30

Clozapine is the drug of first choice for Treatment Resistant Schizophrenia (TRS) but it is underutilized and very little information is available about its use in developing countries. We analyzed the medical record of patients who are currently on the data base of Clozapine Monitoring System in Pakistan. Only 1256 patients, almost all concentrated in four major cities were receiving the Clozapine. The mean maintenance dose of Clozapine was 230mg and only a quarter of the psychiatrists working in Pakistan were prescribing Clozpine. The reasons for inadequate use of Clozapine need to be investigated and psychiatric training and perception of the drug needs to be improved in view of the estimated high prevalence of TRS in developing countries.

Pakistan Psychiatric Society and the Evolving Landscape of Mental Health in Pakistan

Zain Ullah Khan — 2025-09-30

Mental health has increasingly become a central issue of discussion across the globe, and Pakistan is no exception. With a population exceeding 240 million people, the country faces numerous challenges ranging from poverty, unemployment, and displacement to natural disasters, political instability, and the aftereffects of global crises such as the COVID-19 pandemic. These challenges not only affect physical health and economic progress but also deeply impact the psychological well-being of individuals and communities.

Breaking the Chain of Digital Dependency

Mishal Fatima — 2025-09-30

In an era overwhelmingly dominated by digital screens, the role of parents has become pivotal, yet paradoxically, many inadvertently contribute to their children's dependence on digital devices. Left unaddressed, this reliance can significantly impact children's physical, mental, and emotional well-being, necessitating a reevaluation of parental approaches towards technology's influence on their children's lives. Over the past two decades, technological advancements have permeated every aspect of society, with digital devices ranging from smartphones to social media platforms becoming ubiquitous. While technology undeniably offers numerous benefits, excessive usage can lead to detrimental effects, particularly among children.

Heaven on earth

JPPS — 2025-09-29