To examine the factors that are associated with changes in depression in people with type 2 diabetes living in 12 different countries.

People with type 2 diabetes treated in out-patient settings aged 18–65 years underwent a psychiatric assessment to diagnose major depressive disorder (MDD) at baseline and follow-up. At both time points, participants completed the Patient Health Questionnaire (PHQ-9), the WHO five-item Well-being scale (WHO-5) and the Problem Areas in Diabetes (PAID) scale which measures diabetes-related distress. A composite stress score (CSS) (the occurrence of stressful life events and their reported degree of ‘upset’) between baseline and follow-up was calculated. Demographic data and medical record information were collected. Separate regression analyses were conducted with MDD and PHQ-9 scores as the dependent variables.

In total, there were 7.4% (120) incident cases of MDD with 81.5% (1317) continuing to remain free of a diagnosis of MDD. Univariate analyses demonstrated that those with MDD were more likely to be female, less likely to be physically active, more likely to have diabetes complications at baseline and have higher CSS. Mean scores for the WHO-5, PAID and PHQ-9 were poorer in those with incident MDD compared with those who had never had a diagnosis of MDD. Regression analyses demonstrated that higher PHQ-9, lower WHO-5 scores and greater CSS were significant predictors of incident MDD. Significant predictors of PHQ-9 were baseline PHQ-9 score, WHO-5, PAID and CSS.

This study demonstrates the importance of psychosocial factors in addition to physiological variables in the development of depressive symptoms and incident MDD in people with type 2 diabetes. Stressful life events, depressive symptoms and diabetes-related distress all play a significant role which has implications for practice. A more holistic approach to care, which recognises the interplay of these psychosocial factors, may help to mitigate their impact on diabetes self-management as well as MDD, thus early screening and treatment for symptoms is recommended.

Psychological distress and suicide are known to be associated with exposure to traumatic life events. No literature is available on prevalence of suicidal ideation in the aftermath of terrorist attacks in Pakistan.

To study suicidal ideation and desire for death in trauma exposed population in Pakistan.

To estimate the prevalence of suicidal ideation and desire for death one year after exposure to extreme trauma in a well-defined and accessible group in Pakistan.

Subjects were examined 1 year after exposure to a bomb blast in Islamabad, Pakistan. A semi-structured interview schedule and Beck Scale for Suicidal Ideation were used to assess a group of female University students. Assessment record of 50 consecutive study participants were evaluated to estimate point prevalence of suicidal ideation and desire for death in the study population.

All subjects were enroled in full time university education at the time of assessment. 17 subjects (34%) presented with weak desire for death whilst 5 subjects (10%) presented with moderate to severe desire for death. 15 Subjects (30%) presented with active suicidal ideation at the time of assessment. However, ony 3 subjects (6%) presented with moderate to severe suicidal ideation. The subjects presenting with suicidal ideation described family ties, religious beliefs, fear of irreversible injury as protective factors against their suicidal thoughts. Only 2 subjects (4%) had engaged in some degree of planning towards committing suicide.

This study provides the first structured estimate of prevalence of suicidal ideation in trauma exposed population of Pakistan.

Severe stress or exposure to life threatening trauma is known to affect social functioning and quality of life.

To study well-being and anger arousal as markers of social functioning and quality of life in a group of University students exposed to a suicide bomb attack on a University in Pakistan.

To examine indicators of social functioning in order to higlight them as targets for therapeutic interventions.

Subjects were assessed after one year of exposure to a life threatening incident on University campus. Subjects completed an assessment schedule incorporating World Health Organization's Well-Being Index and Novarco Anger Inventory (25 items).

54 students completed the assessment. The mean age of the group was 24 years. All subjects had completed 14–16 years of education and were in full time education at the time of assessment. The Well Being Index Score range was 1–24 with 26 sujects scoring 13 or lower scores indicating poor quality of life. 29 subjects scored higer levels of anger arousal on 10 or more items of Novarco Anger Inventory indicating difficulties in social functioning. The overall group showed a statistically significant negative correlation between the Well-Being Index Scores and the number of Novarco Anger Inventory items scored in the two highest categories of anger arousal.

The results of the study highlight anger arousal and well-being as important markers of functioning in the aftermath of a stressful life event. The study confirms their usefulness as legitimate therapeutic targets for pharmacotherapy, psychotherapeutic, and social interventions.

Mental illnesses are common, serious, brain disorders that seriously hamper an individual's ability to think feel and act.Studies have shown that risk of developing an illness is increased if another family member is similarly affected, suggesting strong hereditary component. (N.I.M.H.Report, 1997.)

Study sample consists of 721 mentally ill patients.Patients were diagnosed in the Outpatients Department of Psychiatry, Pakistan Institute of Medical Sciences Islamabad. Dept. of Psychiatry was visited from June 1998 to September 1999 for collection of data.

Study comprises 721 mentally ill patients. Bipolar (manic-depressive) patients are 62.97% (n=454) Personality disorders 26.21% (n=189) and schizophrenics are 10.89% (n=78).Ratio of females to males is 100♀♀: 100.27♂♂.

Mean age at diagnosis of mental illness in sample is 25.86 ± 0.40 years. Majority of patients fell in age cohort ranging from 10 years to 29 years. (n=477:66.16%).

The study shows total number of inbred marriages to be 400(55.47%) while outbred marriages are 321(44.52%). The coefficient of inbreeding (F) for mental illness patients is 0.0348 and that of control sample is F=0.0273.

There were 220 (30.51%) patients with positive family history 29(4.02%) with negative family history and 472 (54.66%) where occurrence of disease sporadic. Consanguinity is more in positive(23.35%) and negative group(3,30%) while in sporadic cases outbred cases are more in number(39.43%).

This study shows consanguinity as an important factor in the onset of mental illness and is a fertile base for further molecular genetic studies to locate genes contributing in the development of illness

The northern area of Pakistan is hosting the terrorist actively involved in terrorism across the country and in neighboring country of Afghanistan. Government with support of international community initiated a war against terrorism which resulted in migration of huge number of population in the effected areas which was accommodated in refugee camps mainly established in Khyber Pukhtun Kha province.

To assess the extent of psychological impact on IDP's residing in the camps of Shahmansoor

The sample of the study was taken from the Shahmansoor camp, Swabi and was comprised of 200 individuals, including equal number of males and females. Random sampling was used in data collection. The age ranges from 18–80 years and literacy rate was estimated from illiterate people to master's level, Study tools included standardized psychological tests i.e. Pak anxiety and depression scale, and Bradford somatic inventory along with that clinical observation and interviews were also conducted. Findings of the study comprise of both qualitative and quantitative methods.

Majority of the IDP's were diagnosed as having the symptoms of Somatization, along with that depression, PTSD, ASD, anxiety and insomnia also predominates.

Leaving homes and migration to camps is actually a traumatic experience. Many people felt helpless in the current situation and they were hopeless about their future, lost their confidence in proper planning for their future and the flashback of the traumatic experience tortured them. Consequently, refugee residing in camps faced multiple problems which resulted in multiple psychological problems.