Development of a stress scale for pregnant women in the South Asian context: the A-Z Stress Scale

Stress in pregnancy can lead to low-birth-weight and preterm babies and to psychological consequences such as anxiety and depression during pregnancy and the puerperium. Previous scales to measure stress contain items that overlap with the symptoms of pregnancy. A stress scale was developed based on in-depth interviews with pregnant women in Pakistan. Construct validity, test-retest reliability and inter-rater reliability were carried out. Cronbach alpha was 0.82 for the 30 short-listed items, with item-total correlations of 0.2-0.8. Multidimensional scaling determined 2 dimensions: socioenvironmental hassles and chronic illnesses. This was the first scale developed for pregnant women based on stressors in a developing country in South Asia

survey of psychosocial correlates of drug abuse in young adults aged 16-21, in Karachi: Identifying 'high risk' population to target intervention strategies

To study the prevalence and psychosocial correlates of drug abuse among young adults aged 16-21 from upper socio-economic strata. The survey was conducted to identify certain psychosocial risk factors such as coping skills, independence/self-confidence, family communication, peer relationships and motivational factors for drug abuse among adolescents. A cross-sectional survey was conducted, using a structured questionnaire with thirty-four close-ended questions, plus two open ended questions. Data was collected from different educational institutions located in Defence and Clifton areas of Karachi Pakistan. Researchers of this study collected the data and verbal consent was obtained from the participants. A total of 300 students were interviewed. 192 were males and 108 females. 51% of students were studying at school level and 47% at college level. 34% reported drug abuse out of which 21% were males and 13% were females. 52% reported cigarette smoking out of which 33% were male and 19% females. 17% of drug abusers, parents were divorced or separated. 31% reported their best friends consume drugs out of which 22% were drug abusers themselves. A total of 35% of students reported their parents' indulgence in alcohol/ drug abuse. Among students who themselves abuse drugs 63% reported their parent's indulgence in drugs. The most common drugs taken by students were Alcohol, Ecstasy and Hashih i.e. 37.9%. Highly significant positive correlations existed between drug abuse with parents' marital status as divorced or separated [p=.290]. Significant differences [p< 0.001] were observed between abusers and non-abusers on sub-scales of coping skill, selfcontrol, parental relations and peer relations. Highly significant negative correlations existed for high score on subscales of coping skill [-.344], self-control [-.332], peer relations [-.277] and parental relations [-.357] for drug abuse. There is a need for population-based studies to determine other correlates of drug abuse among young adults in Pakistan. Parents, teachers and public health agencies should be alert to this rising epidemic of drug abuse among the Pakistani youth

cross-sectional study of the frequency of psychiatric morbidity in affluent urban population of Karachi

Objective: To estimate the frequency and incidence of psychiatric morbidity in elite, affluent urban population of Karachi Pakistan

Sample: The new outpatients at The Psychiatric Clinic and Stress Research Center situated at Zamzama Boulevard over a period of three years [2001-2003]

Methods: Information about the demographic characteristics, socio-economic status and clinical diagnoses of patients was obtained from case history files maintained at the clinic, retrospectively. Secondly a list of specific stressors in the upper social class female patients lives [their own set of unique stressors, to keep up with their social class materialistically, competition, boredom, no meaningful application of their achievements having higher, education and professions, hectic banal social demands coffee parties, jet set life styles, alcohol and drug abuse was documented

Results: Most common psychiatric disorders were Depressive Illness [49.4%] Schizophrenia [16.2%], Schizoaffective Disorder [5.8%] Panic Disorder [5.2%], OCD [4.7%], Disorders of Childhood and Adolescence [2.8%], Epilepsy [1.6%], Substance Abuse Disorder [1.5%] and Conversion Disorder [1.4%]. The ratio of female patients to male patients was 2:1. The female patients in this sample of population had distinctly higher percentages in psychotic disorders [14.3% Vs 9.4%], mood disorders [37.5% Vs 18.6%] and conversion disorders [0.8% vs 0.6%], compared to the male patients, thereby indicating better living conditions, financial advantages and even post graduate professional education in upper affluent social class does not reduce their stress, every body has their axe to grind in life these women said!!!

Conclusion: The results of this study distinctly showed that depressive illness and other psychiatric disorders are not only the diseases of poverty but are twice as common among apparently adjusted upper class females. The Upper middle class is an affluent population of Karachi, a cosmopolitan city of Pakistan. This clearly indicates that causes of depression or other psychiatric morbidity may vary but the psychiatric morbidity in women is markedly more than men in every class of the society worldwide and the perception that depression is more common in females of lower socioeconomic class is not true in Pakistan

Psychological aspects of renal dialysis

Psychological aspects of renal dialysis are now well known. The multiple stresses-chronic illness, conflicts, dependency, multiple losses all result commonly in anxiety and depression, suicide is fairly common along with sexual dysfunctions. The role of psychiatrist is stressed in the management of renal dialysis patients as a team member. The psychiatrist should also play a role in training the professional staff of dialysis units about patient-doctor relationship in chronic illnesses, the "Burnout" Syndrome