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Objective: To assess psychological impact of COVID-19 pandemic among healthcare workers (HCWs) in a University Teaching Hospital, the main referral center for COVID-19 in Lahore Pakistan, by quantifying symptoms of acute stress disorder, depression, anxiety, insomnia and to explore their potential risk factors. Study Design: Descriptive Analytical study. Place and Duration of the Study: King Edward Medical University from March 30th-April 15th 2020. Methods: Following Institutional Review Board approval and informed consent, Demographic form, Patient Health Questionnaire, Generalized Anxiety Disorder scale, Insomnia Severity Index, and the stress reactions questionnaire were used for data collection. Descriptive statistics were computed. Binary logistic regression was done to determine potential risk factors for mental health outcomes. Results: Three hundred and thirty-seven healthcare workers participated with 79% physicians and 20% were nurses and paramedical staff. The prevalence of anxiety, depressive symptoms, acute stress disorder and insomnia was 36.2%, 30%, 27.9% &1.5% respectively. Women, frontline HCWs and junior staff had more anxiety, depression and insomnia symptoms with physicians reporting more acute stress symptoms compared to nurses. Binary logistic regression showed that being a junior staff member and a frontline worker appeared to be an independent risk factors for depression and anxiety (but not insomnia). Conclusion: High psychological distress among healthcare workers during COVID-19 reported in Pakistan. Failure to provide adequate psychosocial support can significantly impair their functioning and compromise patient care. [ABSTRACT FROM AUTHOR]

Background and Objective: Patient's perception of their illness influences their healthcare decisions. The objectives of this study were to explore patient's own beliefs about their illness (Schizophrenia) and perceived social support, and its impact on their attitudes toward pharmacological treatment in Lahore, Pakistan. Methods: This study was conducted at Mayo Hospital Lahore from March to September 2016. Hundred individuals suffering from Schizophrenia completed four questionnaires; a socio-demographic questionnaire, the Illness Perception Questionnaire for Schizophrenia (IPQ-S), Drug attitude Inventory-10 (DAI) and Multidimensional Scale of Perceived Social Support (PSS). Results: Stress, family problems, lack of friends & financial worries were endorsed strongly by patients as cause of their mental illness. Ambiguity regarding their mental illness duration and personal control was observed. Patients' perceived significant negative consequences, negative emotional response, as well as had poor understanding of their mental illness and treatment effectiveness. Statistically significant gender differences in treatment control and illness coherence subscales of IPQS were observed. Drug attitude inventory was positively correlated with Treatment control subscale (p < 0.01) and negatively correlated with Illness coherence subscale of IPQS (p < 0.05). The negative consequences subscale and perceived social support was negatively correlated (p < 0.01). Conclusion: Patient's perception about their own illness is predictor of their drug taking attitude and perceived social support. Study results should help to develop new interventions to correct inaccurate beliefs in patients with schizophrenia to improve illness outcome. [ABSTRACT FROM AUTHOR]

OBJECTIVE To determine the speciality preference amongst doctors during house job and postgraduate studies, their preferred place of working /choice of continuation in their profession. DESIGN Survey research design. PLACE AND DURATION OFSTUDY The study was conducted at the Academic Department of Psychiatry & Behavioural Sciences, King Edward Medical University, Lahore, Pakistan from March 2014 to September 2014. SUBJECTS AND METHODS Doctors of King Edward Medical University, session 2008 to 2010 were contacted through a mail survey by using convenience sampling. After ethical approval, 600 doctors were sent a questionnaire. 401 doctors responded. The questionnaire covered the demographic details, preferences about career, specialties, post-graduation program and current working place. RESULTS Our study revealed that out of 401 doctors who responded, 53 % were female and 47% were male with a mean age of 28.5 years (±1.4). 277 (69.1 %) were doing their post-graduation in different specialties. 60% were working in Pakistan while 40% doctors had proceeded abroad. A majority of doctors have continued in their profession (80%), while 20% have changed their profession to another field. 39.4% of those who responded are working in government hospitals. Medicine and surgery were the most preferred specialities while psychiatry was the third least preferred speciality, followed only by dermatology and pathology. Basic sciences were a lower priority than clinical fields. Majority preferred to work in major cities or go abroad. CONCLUSION Most doctors continue to pursue their own profession amongst both the genders. Psychiatry is an uncommon choice made by fresh graduates. Medicine is the commonest career choice. Fellowship and Membership of College of Physicians and Surgeons, Pakistan are the commonest postgraduate programmes chosen. A large number of doctors however continue to opt to settle abroad. [ABSTRACT FROM AUTHOR]

OBJECTIVES To determine the speciality preference during house job and postgraduate program. To determine the preferred place of working and whether they continued or discontinued their profession for other fields. DESIGN Descriptive study. PLACE AND DURATION OF THE STUDY Doctors of King Edward Medical University, session 2008 to 2010 were contacted through mail survey by using convenience sampling. SUBJECTS AND METHODS After ethical approval, 600 doctors were sent a questionnaire, 401 doctors responded. The questionnaire covered the demographic details, preferences about career, speciaities and current working place. RESULTS Our study revealed that out of 401 sample 53 % female and 47% male with mean age(28.5±1.4). Most of the doctors were doing their post-graduation in different specialties (277,69.1 %) while 124 (30.9%) did not. Mostly doctors are working in Pakistan (60%) while 40% doctors settled in abroad. Of the following, majority doctors have continued their profession (80%) and of them (20%) have changed profession. Results also depicted that doctors (39.4%) are working in government hospitals. CONCLUSION Medicine and surgery were the most preferred specialities while dermatology and psychiatry were least preferred. Basic sciences were of further lower priority than clinical fields. Majority preferred to work in major cities or go abroad. A significant number (20%) discontinued and adopted other fields. [ABSTRACT FROM AUTHOR]

OBJECTIVE: CONCLUSION KEYWORDS To find out the relationship between frustration intolerance, self-efficacy, and sleep quality in medical students and to determine the moderating role of self-efficacy in relationship between frustration intolerance and sleep quality in Medical Students. STUDY DESIGN: Correlational study. PLACE AND DURATION OF STUDY: The study was conducted from November 2020 to January 2021 and the data was collected from different medical colleges of Lahore and Faisalabad. SUBJECTS AND METHODS: The sample comprised of 150 MBBS (Bachelor of Medicine and Bachelor of Surgery)students from different medical colleges, 126 (84%) were females and 24 (16%) were males. The participants' age range was between 18-26 years and their mean age was 21.79 + 1.74 years. Self-constructed demographic form, Frustration discomfort scale, Generalized Self efficacy Scale and Sleep quality scales were also used to assess the sample. Data were collected online by employing a non-probability convenient sampling strategy. RESULTS: Frustration intolerance is positively related with poor sleep quality indicating higher frustration linked with acute sleep problems, while self-efficacy showed a negative relationship with poor sleep quality indicating higher self-efficacy decreased the sleep problems. The results also showed that self-efficacy moderates the effect of frustration intolerance on sleep problems in medical students. CONCLUSION: This study identified a high prevalence of frustration intolerance and poor sleep quality in medical students during the pandemic of Covid-19 and highlighted the role of self efficacy in dealing with frustration intolerance and sleep problems among medical students. [ABSTRACT FROM AUTHOR]

Abstract: Background: Currently clinicians and researchers in Pakistan have to use translated western instruments to screen for anxiety and depressive disorders. This study investigated the local idioms of emotional distress in Pakistan to develop a culturally valid and easy-to-use instrument to screen for common mental disorders in general clinical settings. Methods: A systematic survey was conducted of psychiatric case notes of patients attending clinics in Peshawar and Lahore, diagnosed with anxiety or depressive disorders, to identify the range of common idioms of psychological distress. A pilot version of the questionnaire was refined and validated among a composite sample of 330 patients in inpatient, outpatient and rural community settings. ICD-10 Diagnostic Criteria for Research were used to define cases and patients'' relatives acted as normal controls. Results: The pilot version of the questionnaire was reduced to 42 items based on odds ratios between cases and controls. Anxiety symptoms were generally reported by depressed patients, but not vice versa. Finally 30 items were selected, in two sub-scales. This final version achieved sensitivity, specificity, and positive and negative predicted values of over 90% when comparing cases and controls. Limitations: This questionnaire was based on what patients tell doctors and may not capture the entire repertoire of local idioms of distress. The validation study was conducted only in an Urdu/Punjabi speaking population, in Lahore and surrounding areas. Conclusions: The Pakistan Anxiety and Depression Questionnaire consists of an anxiety/depression scale and a depression scale, each of 15 items. It demonstrates excellent validity as screening instrument for anxiety and depressive disorders in clinical settings in Pakistan. [Copyright &y& Elsevier]

Smart phones are central to communication in the current century. We administered a survey to determine the impact of excessive smart phone use on academic performance, interpersonal relationships and mental health in medical students. During the study, 700 medical students from King Edward Medical University, Lahore, Pakistan, were administered a questionnaire which recorded information about demographics, academic performance, interpersonal relationships and psychological problems. Out of 630 respondents, 255(40.5%) were males and 375(59.5%) were females with a mean age of 21.1}1.8 years. Results showed smart phone use during class lectures was associated with significant reduction in academic performance and problems with interpersonal relationships. Medical students bullied via smart phones were likely to bully others. Excessive use of smart phones was associated with students preferring to communicate emotions through texting rather than verbal communication. Various psychological problems were found prevalent in excessive users of smart phones.

Background: We aimed to explore inner city school teachers' perceptions of problems faced in schools, it causes and role of schools and teachers in promoting child social and emotional well-being, using qualitative approach., Methods: Following ethical approval and informed consent, In-depth interviews were conducted in 2017 with twenty teachers belonging to four private schools in inner city area of Provincial capital, Lahore, Pakistan. Inclusion criteria were at least 12 years of formal education and minimum of 5 years' experience in teaching profession. Framework Analysis was used to analyze data., Results: Teachers identified learning problems, inattention, disobedience, aggression, lying & disrespect as the most commonly encountered problems of children, with very few teachers mentioning emotional difficulties. Teachers view the family, parenting practices and home environment alongside media (in particular social media) as being the main causes of child behavioral problems. With prompts, however, they did identify various school and teacher-related factors having negative impact on children. Fair conceptualization of good school and good teacher was observed. Need for teacher awareness and training for strategies promoting child emotional and social wellbeing was highlighted., Conclusion: As perceived by teachers, children studying in inner city schools have several behaviour problems. Study results and the gaps identified will help in ensuring that teachers receive training targeted towards their needs. Findings of the study also substantiate the need for targeting whole school-wide preventive approach as efforts begin to implement school mental health initiative in Pakistan., Competing Interests: Conflict of Interest Authors report no conflict of interest.

Objective: To determine the relationship of burnout and quality of life among nurses of different departments at a tertiary care hospital., Methods: The observational, cross-sectional study was conducted at Mayo Hospital, Lahore, from November 2013 to May2014, and comprised nurses recruited by convenience sampling. Maslach Burnout Inventory was used to assess burnout and World Health Organisation Quality of life instrument's BREF version was used to assess quality of life of the subjects. Data was analysed using SPSS 16., Results: Of the 106 nurses with a mean age of 35.5±7 years, 83(79%) were experiencing severe burnout and a low quality of life. Nurses of Surgery and Obstetrics/Gynaecology departments who worked longer hours on the night shift scored higher on burnout and lower on quality of life., Conclusions: Burnout in nurses was very common because of increasing workload and can negatively affect their quality of life leading to compromised patient care.

Objective: To determine the frequency, severity and risk factors of depression in Alzheimer's disease., Study Design: Descriptive study., Place and Duration of Study: The Department of Psychiatry, Sir Ganga Ram Hospital, Lahore, from August 2007 to December 2008., Methodology: Consecutive patients of Alzheimer's disease reporting to the department during the study period were included and those with extreme cognitive impairment were excluded. The cognitive status was judged by using the Mini- Mental State Examination (MMSE). The Hamilton rating scale for depression (Ham-D) was used as a symptom checklist to diagnose major depression according to the DSM-IV criteria. Chi-square test was used to check the significance of association., Results: There were 76 patients comprising of 34 males and 42 females. The mean age was 67.74 + or - 6.71 years; 66% were married, 14% were single and 20% were widowed; 47% had family history of depression and medical co-morbidity was observed in 48%. Based on MMSE, 31.5% had mild Alzheimer, 55.3% had moderate and 13.1% had severe Alzheimer. Judging from Hamilton rating scale, 25% patients were free from depression, 19.7% had mild depression, 27.6% had moderate depression and 27.6% were suffering from severe depression. The frequency of depression was significantly higher (p=0.0013) among females (90%) as compared to males (55.9%)., Conclusion: There is a high frequency of depression among patients of Alzheimer's disease particularly among female patients. This finding is consistent with the reports from other countries.

Objective: To study the characteristics of the epileptics and the risk factors contributing to the development of epilepsy., Design: Descriptive study., Place and Duration of Study: Epilepsy Clinic at Ahbab Hospital, Lahore, from June 2002 to August 2002., Subjects and Methods: Data was collected from 158 subjects, 89 males and 69 females, suffering from epilepsy. The information about socio-demographic characteristics and family history of illness, perinatal morbidity, birth place and mother s age at the time of delivery was obtained using a pre-tested questionnaire. Data was analyzed on SPSS version 10., Results: Majority of the subjects were single (77.84%), 1st born among their siblings (25.95%), belonged to low social class (50.63%), and unemployed (25.31%). The major risk factors were family history of illness (23.52%) and positive medical problem around birth (12.66%). The presence of family history of illness, positive medical problem around birth and advanced maternal age at birth were associated with early onset of epilepsy. Vulnerability for the epilepsy also increases among hospital deliveries., Conclusion: Although the present study has identified various risk factors, yet the results need to be further confirmed through case-control studies.