RESUMEN
Schizophrenia patients demonstrate variations in response to different therapies that are currently being used for the treatment of disorders, such as augmentation therapy (ECT or mood stabilizer) and combination therapy (with antipsychotics). These therapies are also used to treat schizophrenia patients in Pakistan; however, patients show poor overall response. Therefore, this study was conducted to investigate the association between the patients' response to treatment and the use of antipsychotic agents, with variability in overall response, within different groups of patients. Methods: We conducted a retrospective study that included schizophrenia subjects (N = 200) belonging to different age groups, ethnicities, and regions from different outpatient and inpatient departments in psychiatric institutes located in different cities of Pakistan. These patients were assessed for their response to treatment therapies and categorized into four groups (non-responders (N-R), slow response (S-R), patients with relapse, and completely recovered patients (C-R)) according to their responses. Results: The final analysis included 200 subjects, of which 73.5% were males. Mean age was 34 ± 10 years. Percentage of N-R was 5%, S-R was 42%, patients with relapse were 24%, and C-R was 1.5%. The generalized linear regression model shows a significant association between medication response and age (p = 0.0231), age of onset (p = 0.0086), gender (p = 0.005), and marital status (p = 0.00169). Variability within the medication responses was a result of the treatment regime followed. Antipsychotic agents were significantly associated with the treatment response (p = 0.00258, F = 4.981) of the patients. Significant variation was also observed in the treatment response (p = 0.00128) of the patients that were given augmentation therapy as well as combination therapy. Conclusion: The data suggests proper monitoring of patients' behavior in response to treatment therapies to implement tailored interventions. Despite several genetic studies supporting the heritability of schizophrenia, an insignificant association between characteristic features and family history might have been due to the limited sample size, suggesting collaborative work with massive sample sizes.
RESUMEN
OBJECTIVE: To ascertain the frequency of depressive disorder in women after miscarriage. STUDY DESIGN: Cross-sectional study. PLACE AND DURATION OF STUDY: The Outdoor Department of Gynaecology and Obstetrics, Services Hospital, Lahore, from January to June 2017. METHODOLOGY: A total of 150 women from Outdoor Department of Gynecology and Obstetrics, Services Hospital, Lahore, fulfilling the inclusion criteria, were registered. Clinical assessment and the diagnosis for depressive disorder was performed by psychiatrist by putting criteria given in International Classification of Disease: 10th Revision (ICD-10). ICD 10 criteria require at least 2 symptoms out of three core symptoms (depressed mood, loss of interest, and reduced energy) along with at least 2 other symptoms, to be diagnosed as depression (ICD 10 criteria is given in annexure 2 of our article as well). The whole data was analyzed on SPSS-10 and p-value was measured. Chi-square was the test of significance. RESULTS: The 150 cases, 62% (n=93) were in age of 15-30 years while 38% (n=57) were in age of 31-40 years, with mean of 29.17 +5.94 years, frequency of depressive disorder among women after miscarriage was recorded in 15.33 (n=23). Stratification for frequency of depressive disorder among women after miscarriage with relation to family history shows that 10 out of 57 cases had family history, while 13 out of 93 cases had no family history of depression (p=0.55). CONCLUSION: The frequency of depressive disorder was not very high among women after miscarriage; however, by taking appropriate interventions like guiding the family members, including friends, to provide emotional support to the women after miscarriage, it may further reduce.