Journal of Pakistan Psychiatric Society

DIGITAL MENTAL HEALTH: THE FUTURE IS NOW

Davor Mucic — 2024-09-28

Over a decade ago, we foresaw the imminent arrival of the digital health era. Yet, it wasn't until the outbreak of the COVID-19 pandemic that this future truly took shape. The pandemic became a catalyst, seamlessly integrating a spectrum of digital tools into clinical practice, fundamentally transforming the way mental health services were delivered. The inclusion of digital health technologies in our arsenal is not merely an addition; it's a revolutionary shift. These tools are pivotal in enhancing care accessibility and significantly augment our capabilities in diagnosis, treatment, and healthcare delivery, transcending national borders. Telemedicine and clinical systems enabled by the Internet are widely accessible and are beginning to affect the dynamics between doctors and patients, with this trend expected to continue in the future. Telemedicine consultations have become so ubiquitous that they are now routinely conducted via broadband Internet systems hosted in the cloud. This has enabled professionals from various fields within mental health (MH), including psychiatrists, psychologists, marriage and family therapists, and career counselors, to offer e-therapy services.

CHALLENGES OF USE OF ICD 11 IN THE MENTAL HEALTH SCENE OF PAKISTAN

Syed Azhar Kazmi — 2024-09-28

FREQUENCY OFANXIETY AND DEPRESSION AND ITS PSYCHOSOCIAL CORRELATES AMONG WOMEN RECEIVING ANTENATAL CARE IN A TERTIARY CARE HOSPITAL IN KARACHI

Rekhan Rekhan — 2024-09-28

Objective:

To determine the proportion of women suffering from antenatal depression and anxiety visiting a tertiary care hospital for routine antenatal visits to evaluate the psychosocial factors associated with their depression and anxiety.

Study Design:

A descriptive cross-sectional study

Place and Duration

Department of Gynaecology & Obstetrics Ward 9B, Jinnah Postgraduate Medical Center (JPMC), Karachi from January 2024 to May 2024.

Top of FormMethods:

This study was conducted with 249 pregnant women via non-probability, consecutive sampling. Anxiety and depression were assessed using Urdu validated version of Hospital Anxiety and Depression Scale. Psychosocial stressors were also recorded. Data was entered and analyzed using SPSS for Windows version 23.0.

Results: In this study, 20% of women in their second and third trimesters of pregnancies were anxious and 5% were depressed. Critical psychosocial factors included low education, marital stressors such as low social support from husband and/or in-laws, living separately from husband, and intimate partner violence, financial stressors such as husband unemployment and pregnancy-related factors such as unplanned pregnancy and narrow birth spacing.

Conclusion: The study provides a significant burden of antenatal mental health issues in our region and their specific associated psychosocial factors. The study emphasizes upon the need for Biopsychosocial support systems and interventions to mitigate the risk of antenatal depression and safeguard maternal well-being during this critical period.

QUALITY OF LIFE IN CHILDREN AND ADOLESCENTS WITH CONGENITAL ADRENAL HYPERPLASIA

Fawad Suleman — 2024-09-28

BACKGROUND: Congenital Adrenal Hyperplasia (CAH) is a hereditary endocrine condition, defined by insufficiency of enzymes that cause abnormalities in adrenal steroidogenesis, resulting in adrenal insufficiency and hyperandrogenism. In adults, Congenital Adrenal Hyperplasia has been linked to a lower quality of life (QoL). However, research in children has yielded inconsistent results. Therefore, this study was conducted to investigate the impact of CAH on the quality of life of children and adolescents.

OBJECTIVE: To assess the Quality of Life of children and adolescents with Congenital Adrenal Hyperplasia (CAH).

METHODS: It was a descriptive cross-sectional study with six months duration. We enrolled all children and adolescents in the range of 8 to 18 years of age who have been diagnosed with CAH. The World Health Organization Quality of Life-BREF (QOL-BREF) instrument was used for data collection. Four health domains including physical, psychological, social, and environmental areas were assessed, with higher transformed scores indicating better QOL. Data was entered on SPSS Version 23.

RESULTS: Our study population comprised of 30 children and adolescents with a mean age of 12.75 ±3.23 years. Mean transformed scores of physical, psychological, social, and environmental health domains were 31.37±12.15, 45.13±12.50, 34.8±20.49 and 37.6± 12.06 respectively.

CONCLUSION: The quality-of-life score in our population was relatively low in the physical and social domains of health as compared to psychological and environmental health domains. Larger community-based studies are required to further elaborate the causes and remedies of poor quality of life in children and adolescents.

SEASONAL AFFECTIVE DISORDER AMONG UNDERGRADUATE STUDENTS IN PESHAWAR DISTRICT

Izaz Jamal — 2024-09-28

The current study was conducted to identify the impact of seasonal affective disorder on the academic lives of undergraduate students in the Peshawar district. SAD is defined as "seasonal depression" that is brought on by a particular season's depressive episodes as well as other symptoms, especially during the winter. The sample size consisted of 100 undergraduate students from different universities in Peshawar (N = 100). Their ages ranged from 18 to 26 years old. The Seasonal Pattern Assessment Questionnaire (SPAQ) along with a demographic and informed consent sheet was administered. Statistical analysis revealed that among 100 participants, 71 were affected by SAD. Further on, it was elaborated that female students have high rates of SAD as compared to male students. The present study has a high value of significance (10.928). The results of the study supported the proposed hypotheses and confirmed the impact of seasonal affective disorder on the academic performance of undergraduate students while having a large female population. Depression is a recurrent and serious medical condition that negatively affects moods, how you see the world, and how you behave. It is the illness that drives feelings of dissatisfaction in one's actions. Students' cognitions are affected, which negatively affects their grades. They are unable to manage their everyday activities. Exercise, a balanced diet, and psychiatric treatments should also be employed as part of a treatment plan for symptoms.

METACOGNITIVE BELIEFS AS DETERMINANT OF IMPOSTOR PHENOMENON AMONG UNIVERSITY STUDENTS IN KARACHI, PAKISTAN

Hira Mukhtar — 2024-09-28

OBJECTIVE: The purpose of current research is to explore the association between metacognitive skills and impostor phenomenon in University students.

BACKGROUND: Dysfunctional metacognitions include in the etiological factor of mental health problems[1]. Metacognitions have importance to maintain and increases worry and anxiety[2]. Likewise, same approach plays important role in the development of impostor phenomenon which also involves anxiety and worries related to self-doubt, and leading an individual mental health difficulties and maladaptive coping mechanisms.

STUDY DESIGN

Quantitative Survey design

PLACE AND DURATION OF STUDY

Present study was conducted in Karachi, Pakistan from July- September, 2016.

SAMPLE AND METHOD: The convenient sampling was employed to recruit the sample of 199 (85 males and 114 females) university students, age ranging from 18 to 25 years (Mean=20.52, SD=1.52) from different Universities of Karachi, Pakistan.

MEASURES: To assess the variables Well’s Metacognitive Beliefs Questionnaire[3] and Clance Impostor Phenomenon Scale [4] were used.

RESULTS: The findings indicated that metacognitive beliefs significantly predict impostor phenomenon (R²= .283, F=15.316, p<.01) particularly “negative beliefs about uncontrollability and danger of worry” (t= 2.60, P <0.05), “Cognitive Control” (t= 2.19, P <0.05), and “need for control” (t= 1.99, P< 0.05) significantly associated with impostor phenomenon.

CONCLUSION: It is summarize that metacognitive skills play significant role in the development of fear related to success and impostor syndrome which can further lead to towards psychological distress and maladaptive coping mechanisms. Considering the findings implications and future directions have been suggested.

KEYWORDS

Metacognitive skills, impostor phenomenon, mental health problems.

TRANSLATION AND VALIDATION OF URDU VERSION OF BRIEF DISSOCIATIVE EXPERIENCE SCALE FOR SUBSTANCE USE DISORDER IN PAKISTAN

Muqaddas Asif — 2024-09-28

Objective
Dissociation is a ubiquitous construct in psychology and is of high clinical relevance. The objective of this study was to translate and validate the Brief Dissociative Experience Scale (DES-B) in the Urdu language for individuals with substance use disorder (SUD).
Design
This was a cross sectional study.
Place and Duration of Study
The study was conducted with a sample of 200 individuals with SUD aged 18 and above from drug rehabilitation centres across Pakistan between July to November 2023.
Methods
This study utilized a rigorous procedure of Mapi guidelines for translation and validation of DES-B. The validation of DES-B was determined through confirmatory factor analysis.
Results
The data was analyzed using SPSS and AMOS software and factor structure, internal consistency, composite reliability, and convergent validity of the scale were determined. Of the 200 participants, 79.0% were male. The mean age of the participants was 30.61 years (SD = 8.87) with a range between 18 to 65. The findings indicated a good model fit for a one-factor structure with 8 items (χ²/df = 2.61, p < 0.00, RMSEA = 0.089, CFI = 0.908, GFI = 0.944). Moreover, the composite reliability (CR = .77), convergent validity (AVE = .31), and internal consistency (α =.76) showed favorable results. Overall, the Urdu version of DES-B demonstrated acceptable results in terms of the construct’s validity and reliability.
Conclusion
The Urdu version of DES-B can be used as a reliable and valid tool to assess dissociative experiences in individuals with SUD suitable for research and clinical settings.

ILLNESS PERCEPTION AND TREATMENT EXPECTATION IN PATIENTS WITH FUNCTIONAL NEUROLOGICAL SYMPTOM DISORDER AT LAHORE, PAKISTAN

Sara Latif — 2024-09-28

OBJECTIVE

To explore the perceived illness and treatment expectations of patients with Functional Neurological Symptom Disorder.

DESIGN OF STUDY

It is a Descriptive Research Design

PLACE AND DURATION

The study was executed at Department of Psychiatry of government and private teaching hospitals of Lahore, Pakistan over a period of 12 months, from Jan 2023 to Dec 2023.

METHOD

A total of 100 adult participants were recruited as per criteria. Demographic Information Questionnaire and Short Explanatory Model Interview (SEMI) were employed and the qualitative data generated from SEMI was converted to numerical codes and discrete categories by the method of stepwise reduction. The descriptive frequencies were then presented in the tabular format.

RESULTS

Majority of the participants were female, educated, students and housewives, with 1 – 6 months duration of the illness, mixed symptoms presentation, pseudo seizures and motor symptoms. The main reasons of onset of illness was mentioned as marriage related factors and familial and social factors and majority participants believe that magic can affect others. The intensity of the symptoms were perceived as ‘extreme intense’ associated with the fear about the worsening of symptoms and serious discomfort. The main difficulties due to illness was reported to be lack of interest in daily activities, and increase in problem in relationships. The patients expect proper treatment and prescription of medicines which was followed by responses that they will learn the diagnosis and will receive advice from doctors regarding their illness.

CONCLUSION

The patient’s perception towards their illness was serious and concerned and their expectations was receiving proper treatment, medications and learning the disorder and doctor’s advice.

UNDERSTANDING ALEXITHYMIA: A REVIEW OF PSYCHOSOCIAL PERSPECTIVE

Memoona Jahangir — 2024-09-28

Objective: The objective of the review is to understand the multifaceted construct of alexithymia and its association with psychosocial variables.

Method: A thorough examination of the literature on the construct of alexithymia was conducted, encompassing studies published over several years. The empirical findings over the years regarding various psychosocial variables, including attachment styles and empathy, were also reviewed. The Sociodemographic characteristics and comorbidity of alexithymia with other mental health conditions were also analyzed.

Results: The review revealed that attachment bond plays a significant role in the development of alexithymia, childhood trauma because of unhealthy mother-infant bond can be one of the reasons for difficulty in understanding emotions, which leads to difficulties in empathy as well. Furthermore, alexithymia has been found to be comorbid with depression, anxiety, autism, and other mental illnesses.

Conclusion: The findings of the review suggest that alexithymia is an important construct which can influence various psychosocial aspects of life. Although some of the variables have been extensively studied, much remains to be unclear. Further research will add up value to comprehensively evaluating the impact of alexithymia on psychosocial aspects.

Keywords: alexithymia, psychosocial perspective, attachment styles, empathy.

PAKISTANI YOUTH AND THEIR CURRENT FINANCIAL NEEDS. DO WE HAVE A PLAN?

Sahar Rameez — 2024-09-28

Pakistan has been experiencing a financial crisis for several years, characterized by inflation and rising debt. These economic difficulties have had a significant impact on the country's young, who make up a significant portion of the population. In addition, current political crises and inflation have exacerbated the situation, leading to an increase in adolescent mental health crises.

FOOD FOR THOUGHT

creative Corner — 2024-09-28

Nutrition is a crucial yet often overlooked component in achieving optimal mental health and cognition, serving as one of the missing pieces in the complex puzzle of the gut-brain connection. The gut-brain axis highlights how gut health directly influences brain function, with gut microbiota playing a significant role in neurotransmitter production that regulates mood and cognition. A diet rich in whole foods, including omega-3 fatty acids, prebiotics, probiotics, polyphenols, and B vitamins, supports both gut and brain health. By prioritizing these nutrients, individuals can enhance cognitive function and emotional stability, addressing the gut-brain conflict that arises from poor nutrition. Thus, good nutrition is crucial for mental wellness, acting as the missing puzzle piece in the gut-brain relationship. By prioritizing gut health through proper nutrition, individuals can enhance mental health, cognitive function, and overall wellbeing.