Unaiza Niaz

Objective: To obtain preliminary statistics of prevalence of Post-traumatic stress disorder (PTSD) and co-morbid depression in earthquake survivors. Design: Cross sectional survey. Place & Duration of study: A total of 155 people were interviewed from earthquake hit areas. The sample includes (N=105) staff and students of Jinnah Commerce College Mansehra, and (N=50) earthquake relief camp survivors in NWFP of Pakistan. These survivors volunteered to be interviewed during IPTP team’s visit to these centers. Subjects & Methods: PTSD and depression was assessed by Traumatic Stress Symptom Checklist (TSSC). Demographic information was obtained by a detailed Survivor Information Form (SIF). Descriptive statistics are used to present the results. Results: The mean age of the respondents was 22 years (S.D. =8.5). 70% of them were males. 41% had high school education. 23% had lost their first degree relatives and 60% their second degree relatives, 55% reported loss of property. The rate of ...

The objectives was to estimate the prevalence of intimate partner violence forms of domestic abuses faced by both genders and associated psychological consequences of domestic abuse particularly incidence of depression and anxiety in the victims. Specifically designed and validated instrument by the name of Karachi Domestic Violence Screening Scale (KDVSS) was used to screen out the victims of domestic violence in the sample. Data was collected from the outpatient departments of Psychiatry Liaquat National Hospital PNS Shifa and Sobraj Hospital in Karachi. The sample included equal representation of male and female participants. It consisted of 140 individuals with middle-age range. Most of them were married few were separated or divorced. Standardized self-rating depression and anxiety rating scales were used to check the incidence of depression and anxiety in victims and non-victims. 63% of the participants were identified as victims of domestic violence on Karachi Domestic Violen...

Objective: The study was conducted to identify the stressors at work faced by the professional women and their impact on their psychosocial well being. Design: Cross-sectional survey. Subjects and Methods: 150 women from Medical, Teaching and Secretarial professions were selected with the help of random sampling technique. They were interviewed through a structured questionnaire. Results: The mean age of the participants was 32 years. The mean duration of job was 8 years. 57% of the participants were married, 43% were single. 48% were availing the facilities like accommodation, transport, medical and education of children provided by the employers while 52% were working without any additional facilities. 48% were working in shifts and 52% had fixed job timings. Among those working in shifts 71% perceived that there work has affected their psychosocial well-being. Limited career-making opportunities (74%), lack of participation in decision making processes (77%), lack of social suppo...

Tienda online donde Comprar Contemporary Topics in Women's Mental Health: Global perspectives in a changing society al precio 136,80 € de Daniel Wilcox | Prabha S. Chandra | Helen Herrman | Marianne Kastrup | Marta Rondon | Unaiza Niaz | Ahmed Okasha | Jane E. Fisher, tienda de Libros de Medicina, Libros de Psicologia - Psicologia General

It is vital to identify forms of intimate partner violence (IPV) experienced by women and men in intimate relations, their underlying causes, and the impact on their own lives and the society. Research on victimization of women is ample; however, men’s victimization in intimate relations is a neglected area of research in many world regions, thus requiring more attention. Among the common psychosocial factors correlated with IPV, specific social, economic, and cultural factors in South Asian and Middle Eastern countries increase women’s vulnerability to face and bear the detrimental consequences of IPV. The review of existing literature and interviews with 16 notable agencies in Pakistan indicate that most of the existing intervention programs in these countries focus on providing legal and psychosocial support to female victims. In addition, there is lack of adequate evaluation or proper documentation of the activities and outcomes of intervention programs. These findings strongly ...

Post-traumatic stress disorder (PTSD) is known to occur after catastrophic events like wars, earthquakes, serious accidents etc. PTSD symptoms include anxiety, recurrent nightmares, flashbacks, fear, increased startle response and hyper-vigilance. These symptoms last for more than 1 month and can last to several years. PTSD significantly disrupts the normal functioning and quality of life of the sufferers. The current psychotrauma literature suggests that many factors like exposure to trauma, degree of loss, intensity of fear, history of mental illness etc are related to the increased risk for PTSD. The disastrous 8 th October earthquake in Northern areas of Pakistan and AJK resulted in massive destruction with total loss of infrastructure, and serious injuries to the sufferers. The survivors of the earthquake faced numerous problems after this catastrophic event. Consequently, these stressors might result in development of certain psychological problems in victims, specifically , P...

Objective: To obtain preliminary statistics of prevalence of Post-traumatic stress disorder (PTSD) and co-morbid depression in earthquake survivors. Design: Cross sectional survey. Place & Duration of study: A total of 155 people were interviewed from earthquake hit areas. The sample includes (N=105) staff and students of Jinnah Commerce College Mansehra, and (N=50) earthquake relief camp survivors in NWFP of Pakistan. These survivors volunteered to be interviewed during IPTP team’s visit to these centers. Subjects & Methods: PTSD and depression was assessed by Traumatic Stress Symptom Checklist (TSSC). Demographic information was obtained by a detailed Survivor Information Form (SIF). Descriptive statistics are used to present the results. Results: The mean age of the respondents was 22 years (S.D. =8.5). 70% of them were males. 41% had high school education. 23% had lost their first degree relatives and 60% their second degree relatives, 55% reported loss of property. The rate of ...

Objective: To estimate the frequency and incidence of psychiatric morbidity in ielite, affluenti 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 n 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 Diso...

SECTION 4 Impact of violence, disasters, migration and work Unaiza Niaz1 and Marianne Kastrup2 1The Psychiatric Clinic & Stress Research ... in Women's Mental Health Edited by Chandra, Herrman, Fisher, Kastrup, © 2009 John Wiley & Sons, Ltd Niaz, Rondon and Okasha ...

In Pakistan, societal attitudes and norms, as well as cultural practices (Karo Kari, exchange marriages, dowry, etc.), play a vital role in women's mental health. The religious and ethnic conflicts, along with the dehumanizing attitudes towards women, the extended family system, role of in-laws in daily lives of women, represent major issues and stressors. Such practices in Pakistan have created the extreme marginalisation of women in numerous spheres of life, which has had an adverse psychological impact. Violence against women has become one of the acceptable means whereby men exercise their culturally constructed right to control women. Still, compared to other South Asian countries, Pakistani women are relatively better off than their counterparts.

Domestic violence is a serious public health problem. In order to identify and treat psychological consequences associated with domestic abuse. The health care providers should be screening patients for physical psychological and sexual forms of intimate partner violence. The objective was to design a validated instrument for screening out victims of domestic violence in both genders. A form consisting of 77 statements was developed on the basis of an operational definition and literature review of domestic abuse. It was then distributed among 300 individuals. Each statement was to be rated on 7-point scale from strongly disagreeing to strongly agreeing with the statement. Chi-square and percentages were calculated for the data. The statements which were rated towards the agreeing point by more than 75% of the respondents irrespective of the sex were selected for KDVSS. For validity check KDVSS was conducted on 35 known victims of domestic abuse; for statistical reliability chi-squa...

Objective: The study was conducted to identify the stressors at work faced by the professional women and their impact on their psychosocial well being. Design: Cross-sectional survey. Subjects and Methods: 150 women from Medical, Teaching and Secretarial professions were selected with the help of random sampling technique. They were interviewed through a structured questionnaire. Results: The mean age of the participants was 32 years. The mean duration of job was 8 years. 57% of the participants were married, 43% were single. 48% were availing the facilities like accommodation, transport, medical and education of children provided by the employers while 52% were working without any additional facilities. 48% were working in shifts and 52% had fixed job timings. Among those working in shifts 71% perceived that there work has affected their psychosocial well-being. Limited careermaking opportunities (74%), lack of participation in decision making processes (77%), lack of social suppor...

Major depressive illnesses are well known to be prevalent during the stress of bereavement. The nature of these depressive syndromes is that they are persistent and disabling and add to the burden of mood changes associated with bereavement. This issue contains a study by Haroon Rashid Chaudhry and colleagues on frequency of depression after the death of spouse. Though it has certain limitations as it was a hospital based descriptive study and the number of patients enrolled were too small and even the number of female patients were much less 35% compared to 65% male, but it does highlight the problem which needs attention of healthcare professionals in general and the psychiatrists in particular. Fortunately, a substantial number of bereaved individuals may suffer from these depressive symptoms that do not require quite the requisite number to meet the criteria for major depressive episode; and yet they may be quite disabling, if not be the actual forerunner of the major depression...

SUMMARY Role of faith & resilience in recovery from traumatic events is a common observation. Recent experience with the earthquake victims in NWFP & AJK clearly demonstrated the positive effects of faith & resilience. Faith in God Almighty was a major factor in strengthening resilience and promoting recovery from traumatic stress disorders. Author suggests partnering media in resilience promotion and capacity building of the disaster affected population and developing psychotherapeutic techniques to enhance the natural resilience and strength in victims of psycho-trauma.

Vikram Patel*, Shekhar Saxena*, Crick Lund†, Graham Thornicroft†, Florence Baingana‡, Paul Bolton, Dan Chisholm, Pamela Y Collins, Janice Cooper, Julian Eaton, Helen Herrman, Mohammad M Herzallah, Yueqin Huang, Mark Jordans, Arthur Kleinman, Maria Elena Medina Mora, Ellen Morgan, Unaiza Niaz, Olayinka Omigbodun, Martin Prince, Atif Rahman, Benedetto Saraceno, Bidyut K Sarkar, Mary De Silva, Ilina Singh, Dan J Stein, Charlene Sunkel, Jurgen Unutzer

... In the Afghan war against the Soviet Union, women in refugee camps on the borders with Pakistan,Niaz et al., found many pregnant women were malnourished, psychologically traumatised, underweight, exhausted and highly susceptible to disease and infection. ...

It is vital to identify forms of intimate partner violence (IPV) experienced by
women and men in intimate relations, their underlying causes, and the impact
on their own lives and the society. Research on victimization of women is
ample; however, men’s victimization in intimate relations is a neglected area
of research in many world regions, thus requiring more attention. Among the
common psychosocial factors correlated with IPV, specific social, economic, and
cultural factors in South Asian and Middle Eastern countries increase women’s
vulnerability to face and bear the detrimental consequences of IPV. The review
of existing literature and interviews with 16 notable agencies in Pakistan indicate
that most of the existing intervention programs in these countries focus on
providing legal and psychosocial support to female victims. In addition, there
is lack of adequate evaluation or proper documentation of the activities and
outcomes of intervention programs. These findings strongly suggest that further
research on structured perpetrators programs in this part of the world is
needed.
KEYWORDS: intimate partner violence; partner abuse; risk factors; victimization; perpetrator intervention
program

Issues related to the mental health of women are a priority these days. Many international organisations working in the field of psychiatry are having sections on it now. This approach can go a long way in the improvement of the available mental health services for this population. Women's mental health has grown rapidly as a sub-specialty over the last few decades including research in gender specific illnesses, differences in psychotropic drugs use in different phases of women's life cycles, especially the reproductive phases of life, besides gender specific differences in onset, presentations, and prognosis of psychiatric illnesses, fertility issues, etc. Most of the international psychiatric organisations have realised the importance of women's mental health, its scope and importance in psychiatry. Therefore to improve the mental health of women globally, most of the international mental health organisations as the World Psychiatric Association (WPA), the American Psychiatric Association (APA), the Royal College of Psychiatrists (RCP), the World Federation of Mental Health (WFMH) have formed sections of women's mental health. Founding a section on mental health of women is valuable and crucial in improving the mental health of women globally. Goals include promotion of mental health education and information on women's mental health: promotion of gender-sensitive and autonomy-enhancing mental health services for women. For instance, work on violence against women, which has a major toll on mental health of women (which overall deteriorates the socioeconomic status of their nations).

Aspects of the social environment, including social conditions (socioeconomic status, household situations, chronic illnesses) and social relations (attitude and behaviors of relations) are major determinants of depression among women. This study evaluates the relative power of social relations and social conditions in predicting depression among pregnant women in Pakistan. In the qualitative phase of the study, social environmental determinants were identified through literature search, and experts' opinions from psychologists, psychiatrists, gynecologists, sociologists and researchers. Along with this, 79 in-depth interviews were conducted with pregnant women drawn from six hospitals (public and private) and two communities in Karachi, Pakistan. Identified determinants of depression were grouped into themes of social conditions and social relations and pregnancy-related concerns. In the study's quantitative phase, the relative power of the identified themes and categories, based on their scores for predicting depression (determined by the Center for Epidemiological Studies—Depression Scale (CES-D scale)), was determined through multivariate linear regression. Social environmental determinants of pregnant women were described under the themes and categories of (1) social relations: involving husband, in-laws and children; (2) social conditions: involving the economy, illness, life events, household work, environmental circumstances and social problems; and (3) pregnancy-related concerns i.e. symptoms of pregnancy, changes during pregnancy, dependency and concern for unborn baby. Multivariate analysis found that among these themes, social relations and pregnancy-related concerns were significantly associated with total CES-D scores. Among the categories besides increasing age and less education, husband, in-laws, household work and pregnancy symptoms were significantly associated with total CES-D scores. The study highlights the importance of social relations compared to social conditions for determining depression in pregnant women.

Major depressive illnesses are well known to be prevalent during the stress of bereavement. The nature of these depressive syndromes is that they are persistent and disabling and add to the burden of mood changes associated with bereavement. This issue contains a study by Haroon Rashid Chaudhry and colleagues on frequency of depression after the death of spouse. Though it has certain limitations as it was a hospital based descriptive study and the number of patients enrolled were too small and even the number of female patients were much less 35% compared to 65% male, but it does highlight the problem which needs attention of healthcare professionals in general and the psychiatrists in particular. Fortunately, a substantial number of be-reaved individuals may suffer from these de-pressive symptoms that do not require quite the requisite number to meet the criteria for major depressive episode; and yet they may be quite disabling, if not be the actual forerun-ner of the major depress...

Objective: To estimate the frequency and incidence of psychiatric morbidity in ìelite, affluentî 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 diag- noses 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 ñ 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 Di...

Objective: A survey of three medical colleges’ pre-clinical and post-clinical clerkship students’ attitudes towards Psychiatry and their actual decision in choosing Psychiatry as a career. Design: An instrument comprising of 15 items checks the perceptions of students about psychiatry and choosing Psychiatry as a career was developed and administered upon the students of three medical schools of Karachi. Results: Nearly more than 60% students hold positive views about Psychiatry. About 32% students believed psychiatrist are not so well-respected and 42% believe they earn less money than other specialists. 54% students were reluctant to choose Psychiatry as a career. The students of post-clinical groups hold more positive view about Psychiatry than pre-clinical groups. Differences were also ob-served among the responses of students belonging to different medical schools. Conclusion: Overall the students of all medical colleges showed positive perception about Psychiatry as a subject....

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.

Editorial Depression following death of a spouse Unaiza Niaz * Major depressive illnesses are well known to be prevalent during the stress of bereavement. The nature of these depressive syndromes is that they are persistent and disabling and add to the burden of mood changes associated with bereavement. This issue contains a study by Haroon Rashid Chaudhry and colleagues on frequency of depression after the death of spouse. Though it has certain limitations as it was a hospital based descriptive study and the number of patients enrolled were too small and even the number of female patients were much less 35% compared to 65% male, but it does highlight the problem which needs attention of healthcare professionals in general and the psychiatrists in particular. Fortunately, a substantial number of be-reaved individuals may suffer from these de-pressive symptoms that do not require quite the requisite number to meet the criteria for major depressive episode; and yet they may be quite d...

This article reviews the impact of cultural factors on mental health of South Asian women. Marked gender discrimination in South Asia has led to second class status of women in society. Their mobility, work, self-esteem and self-image, in fact their worth and identity, seem to depend upon the male members of a patriarchal society. Women's lack of empowerment and both financial and emotional dependence have restricted their self-expression and choices in life. This, along with family, social and work pressures, has a definite impact on women's mental health.

1. The antidepressant action of mianserin was tested in a double-blind clinical trial lasting 6 weeks. Forty-six patients with moderate to severe degrees of depression were treated at random with mianserin or diazepam. Patients who failed to improve by week 3 were taken out of the trial. 2. Mianserin was more effective than diazepam in reducing scores on the Hamilton Rating Scale for depression. Fewer patients allocated to mianserin had to be withdrawn from the trial on account of failure to improve. Mianserin was more effective than diazepam in reducing symptoms of 'retarded depression' and as effective as diazepam in reducing symptoms of 'anxious depression'. 3. Mianserin did not cause any more side-effects than diazepam, very few side-effects being encountered with either drug. 4. The design of this trial on antidepressant drugs is commended on ethical grounds.

This article reviews the impact of cultural factors on mental health of South Asian women. Marked gender discrimination in South Asia has led to second class status of women in society. Their mobility, work, self-esteem and self-image, in fact their worth and identity, seem to depend upon the male members of a patriarchal society. Women's lack of empowerment and both financial and emotional dependence have restricted their self-expression and choices in life. This, along with family, social and work pressures, has a definite impact on women's mental health.

In Pakistan, societal attitudes and norms, as well as cultural practices (Karo Kari, exchange marriages, dowry, etc.), play a vital role in women's mental health. The religious and ethnic conflicts, along with the dehumanizing attitudes towards women, the extended family system, role of in-laws in daily lives of women, represent major issues and stressors. Such practices in Pakistan have created the extreme marginalisation of women in numerous spheres of life, which has had an adverse psychological impact. Violence against women has become one of the acceptable means whereby men exercise their culturally constructed right to control women. Still, compared to other South Asian countries, Pakistani women are relatively better off than their counterparts.