Do arthritic patients talk more?

BACKGROUND: The modification of speech properties in patients may indicate a more profound pathology. Ample research has been undertaken in relation to different demographic and genetic factors on arthritis but significant research on speech in arthritis had not been conducted globally. The objective of this study was to investigate the effect of arthritis on the duration of speech in patients. METHOD: It was a randomised control trial conducted at Rehman Medical Institute (RMI), Peshawar, Pakistan between the months of July and August 2010. Two groups of patients were randomised prospectively; 50 arthritic and 50 non-arthritic, seen in an Orthopaedic OPD. Six standard history questions were asked from each patient and the duration of speech was recorded with the help of a stopwatch. A standard Performa was filled for each participant recording his/her personal information, duration of symptoms, time taken to answer the history questions and a brief past history. The Student's t-test was used to compare the mean durations of speech between arthritic and non-arthritic patients whilst the ANOVA test was applied to compare the mean durations of speech amongst the different forms of arthritis. Pearson's correlation test and odds ratio were also used to check the association of different quantitative and qualitative variables. RESULTS: A statistically significant correlation was deduced in that arthritic patients talked more than non-arthritic ones (p < 0.001). The other factors of age, sex, duration of symptoms and multiplicity of the pain had no influence on the time taken to talk. CONCLUSION: Arthritic patients speak for a significantly prolonged duration than non-arthritic ones.

Behavior therapy in dissociative convulsions disorder.

OBJECTIVE: To compare the remission in symptoms achieved with behavior therapy and routine clinical care to that with routine clinical care given alone to patients having dissociative disorder. DESIGN: A randomized controlled trial. PLACE AND DURATION OF STUDY: Psychiatry Unit, Lady Reading Hospital, Peshawar from April 2004 to September 2004. SUBJECTS AND METHODS: A total sample of 100 patients was recruited through Psychiatric OPD and Emergency unit. Patients were randomly allocated to the intervention or control group. The number of fits were recorded each day during admission. The patients were followed-up for four weeks after discharge. Hospital anxiety and depression scale and clinical global impression scales were applied. The two-sample Kolmogorov-Smirnov test was used to show the differences in relative frequencies of fits between the two groups. RESULTS: There were no statistically significant differences in sociodemographic and clinical variables in the intervention and control groups at baseline. There was a highly significant difference between the two groups in frequency of fits at discharge, on the first follow-up and on the fourth follow-up (p=0.000). Similarly, patients in the intervention group showed more improvement on hospital anxiety and depression scale compared to the control group, (p=0.000) at the end of four weeks. CONCLUSION: Behavioral intervention in the management of conversion disorder is more effective than the methods applied in our daily practice.