Frequency of anger and its potential relationship with Selfesteem and Adverse Childhood Experiences among Medical and Sociology undergraduate students in Pakistan.

Objectives: To determine the frequency of clinical anger, adverse childhood experiences, self-esteem, and their mutual relationship among undergraduate medical and sociology students. Methods: In this descriptive cross-sectional study, data from 400 undergraduate medical and sociology students was collected from the Northwest School of Medicine, Peshawar, and the sociology department of the International Islamic University, Islamabad, from July to September 2021. A self-administered questionnaire incorporating a Clinical Anger Scale (CAS), Adverse childhood experience (ACE) scale and Rosenberg self-esteem (RSE) scale was utilized for data collection. Descriptive statistics, ANOVA and logistic regression model were executed to perform data analysis using SPSS. Result: The mean CAS score was 19.65 ± 13.23 suggesting that 60.2% of the participants experienced mild to severe degrees of clinical anger. Females were experiencing more anger issues than males (64% vs 54%, p = .040) RSE scale showed that 72.8% of the participants had low self-esteem with a mean score of 12.70 ± 5.43. Besides, 51.5% of the participants had at least one type of adverse childhood experience while 15.8% of the sample population reported being sexually abused in childhood. Significant correlation was found between CAS and age, ACEs and RSE score (p = <0.01). The logistic regression model also suggested that the prevalence of anger was higher in individuals with ACEs (OR = 1.29, 95% CI: 1.12, 1.14, p = <.001) and low self-esteem (OR = 1.15, 95% CI: 1.09, 1.22, p = <.001). Conclusion: The high frequency of clinical anger necessitates the implementation of periodic screening across all universities. Keeping in mind the problem of low self-esteem and the history of ACEs, there is an urgent need for the development of strategies to preserve and improve the mental well-being of the young generation.

An analysis of whether a working-age ward-based liaison psychiatry service requires the input of a liaison psychiatrist.

Aims and method This article presents a 12-month case series to determine the fraction of ward referrals of adults of working age who needed a liaison psychiatrist in a busy tertiary referral teaching hospital. Results The service received 344 referrals resulting in 1259 face-to-face contacts. Depression accounted for the most face-to-face contacts. We deemed the involvement of a liaison psychiatrist necessary in 241 (70.1%) referrals, with medication management as the most common reason. Clinical implications A substantial amount of liaison ward work involves the treatment and management of severe and complex mental health problems. Our analysis suggests that in the majority of cases the input of a liaison psychiatrist is required.

Opening the 'black box': liaison psychiatry services and what they actually do.

Aims and method To develop a simple, pragmatic typology to characterise the nature of liaison interventions delivered by a liaison service in a National Health Service setting. We carried out a retrospective electronic case-note review of referrals to a ward-based liaison psychiatry service. Results Three hundred and forty-four patients were referred to the service over a 12-month period. Ten different types of liaison interventions were identified, with the most common interventions being diagnosis (112 patients, 32.6%), medication management (57 patients, 16.6%), risk assessment and treatment (56 patients, 16.3% each). Mental Health Act work accounted for the greatest number of contacts per patient (median 7). Clinical implications There are inherent limitations in any single-site observational study, as site-specific results cannot be generalised to other liaison services. The intervention categories we developed, however, are easy to use and will provide a way of comparing and benchmarking the range of interventions delivered by different liaison psychiatry services.

A survey of risk assessment skills and training among health professionals in Pakistan.

Over the past two decades, psychiatric services have evolved globally and generally there has been a gradual transition from hospital-based practice to a more community-based approach. The stigma associated with psychiatry has somehow diminished and society in general can now relate better to this field of medicine.