Objective: To consider adverse childhood experiences in patients admitted to a tertiary care hospital in Pakistan with depressive disorder. Study Design: Comparative cross-sectional study. Place and Duration of Study: Fauji Foundation Hospital, Rawalpindi Pakistan from Sep 2018 to Aug 2020. Methodology: All the patients who were admitted to the psychiatry ward of the hospital after being diagnosed with depression were included in the study. Detailed history and mental state examination were carried out on all patients by a psychiatrist, and the adverse childhood experience questionnaire was administered. Results: Out of 400 patients admitted with a diagnosis of depressive episode in the hospital during the study period, 59(14.75%) were males, and 341(85.25%) were females. The mean age of the study participants was 39.49±8.926 years. 153(38.25%) did not have significant adverse childhood experiences, while 247(61.75%) had significant adverse childhood experiences. The severity of depressive episodes and substance use had a statistically significant relationship with the presence of significant adverse childhood experiences in our study participants (p-value<0.001). Conclusion: The presence of significant adverse childhood experiences was alarmingly high in patients admitted with a depressive episode in our study. These experiences were associated with the more severe forms of depressive illness and comorbid illicit substance use.
Objective: To study the association of sociodemographic factors and Vitamin D levels with the severity of depressive symptoms in patients with depression. Study Design: Cross-sectional study. Place and Duration of Study: Psychiatry Department, Fauji Foundation Hospital, Rawalpindi Pakistan, from May to Nov 2021. Methodology: This study included all the patients diagnosed with depression per ICD 10 criteria by the consultant psychiatrist. Depression was further categorized in severity using Beck’s Depression Inventory. Vitamin D levels were sent to all the patients diagnosed with depression in the laboratory of our hospital. The cut-off score of less than 50nmol/l was taken as low vitamin levels. Results: Out of 103 patients studied, 23(22.3%) had mild, 49(47.6%) had moderate, and 31(30.1%) had severe depression. In severely depressed patients, 19(61.3%) were above 50 years of age, 12(38.7%) had no formal education, and 21(67.7%) had low vitamin D levels. Among mildly depressed patients, 5(21.7%) were above 50 years of age, 2(8.7%) had no formal education,and 17(73.9) had low vitamin D levels. We found that vitamin D levels, age of the patient, and level of education had a statistically significant relationship with the severity of depression, (p-valve less than 0.05). Conclusions: The level of vitamin D, age, and the level of education had a significant association in the target population with the severity of depressive symptoms.
Profound deafness is a lifelong impairment, leading to the physical disability as well as poor psychological adjustment. We herein present a mental health disorder rarely seen among the patients of profound deafness. A 16-year deaf and dumb girl, previously treated for depression, presented with unusual laughter, irritability, flight of ideas, decreased sleep, ideas of self importance, and decreased social functioning and educational performance. These problems were understood by the parents via sign language, who interpreted them to the interviewer. Her Young Mania Rating Scale (YMRS) score was 19 and Brief Psychiatric Rating Scale (BPRS) score was 52. She was diagnosed as a case of bipolar affective disorder (BPAD). Marked improvement in the symptoms and social and educational performance was noted after two weeks of the treatment with sodium valproate, resperidone and clonazepam. Treatment options were explained to the patient with risks and benefits, and she was involved in the decision-making. This case report highlights the importance of accurately diagnosing and managing a rare mental health disorder among the physically handicapped people, especially those who cannot communicate effectively and explain their unusual subjective experiences.
IntroductionThe environment at medical colleges is competitive and typically generates higher stress levels. Both academic and psychosocial stresses appear to play a role, and the resourceful students who are able to employ effective coping strategies to deal with their stress are shown to outperform their peers in the academic settings.ObjectivesObjective: To determine the Association of Perceived Stress and Coping Strategies with Depressive symptoms in students at a private medical college in IslamabadMethodsFourth and Final year medical students of Foundation university medical college were enrolled in the study. Beck’s Depression Inventory was used to assess the depressive symptoms, Perceived Stress Scale (PSS) was the tool used to look for the perceived stress and the coping strategies were assessed using the Brief COPE Inventory. Association of Perceived Stress and Coping Strategies with Depressive symptoms and other sociodemographic factors was established.ResultsOut of 262 medical students studied, 211 (80.5%) had no or mild depressive symptoms while 51 (19.5%) had moderate to severe depressive symptoms. 66 (25.2%) had low stress, 127 (48.4%) had moderate stress while 69 (26.3%) had high stress. Chi-square test revealed that perceived stress, self-distraction, active coping, denial, substance use, behavioral disengagement, positive reframing, acceptance, religion/ spirituality and self-blaming had statistically significant relationship with presence of depressive symptoms among the target population.ConclusionsConsiderable number of medical students had presence of moderate to severe depressive symptoms in our study. Perceived stress and some specific kinds of coping strategies had significant association with presence of depressive symptoms among target population
Background: Society's attitude towards patients with mental illness has been evolving over the past century and the speed of this evolution has particularly accelerated since the advent of modern ways of communication and media. As with other areas of development, attitude change may be expected to be slow-paced in our country but local evidence is lacking in this regard. Objective: To measure the level of stigma towards mental illness in medical students along with its association with their prior exposure to Psychiatry. Method: This is across-sectional study conducted between May to August 2019 at a private medical college. Consecutive sampling was used to include a total of 247 (71% female and 29% male) students of the fourth and final year MBBS after written informed consent. A specially designed form was used to collect relevant socio-demographic details along with data regarding exposure to Psychiatry. The scores from self-reported Mental Illness: Clinicians' Attitudes scale (MICA)were also recorded. Chi-Square test was used to assess the association of exposure to psychiatry to stigmatizing attitudes. Data were analyzed using SPSS20. Results: Prior exposure to mental illness in family or friend was reported by 60.5% of the students, 70% described an exposure through media and only 32% had undergone a clinical psychiatry rotation. Average stigma scores on MICA were found in 41% of our sample, while 32% had above-average scores and 27% had lower than average stigma. Pearson' schisquare test showed that the previous exposure to mental illness via media sources was found to be significantly associated with lower levels of stigma in medical students (p=
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