JPMA. The Journal of the Pakistan Medical Association, 2015
To assess the knowledge and practices of general practitioners about diagnosis and treatment of s... more To assess the knowledge and practices of general practitioners about diagnosis and treatment of schizophrenia and determine their association with clinical exposure to such cases in practice. The cross-sectional study was conducted in Peshawar from August 2009 to December 2011 at the clinics of general practitioners enrolled with the provincial Health Regulation Authority. All the listed GPs were contacted and those consenting to participate were included. A semi-structured questionnaire was used to assess their knowledge and practices related to diagnosis and treatment of schizophrenia. They were categorised as having Good Knowledge/Practice, in this regard, when they responded to >60% of the questions correctly. Of the 135 general practitioners contacted, 114(84.5%) agreed to participate and represented the study sample. Of them, 61(53.5%) physicians did not treat any diagnosed case while 15(13.2%) treated more than 10(8.8%) annually. Only 6(5.3%) practitioners spent more than ...
To determine the efficacy of brief Culturally adapted CBT (CaCBT) for depression when added to Tr... more To determine the efficacy of brief Culturally adapted CBT (CaCBT) for depression when added to Treatment As usual (TAU)-delivered by trained therapists using a manual compared with alone TAU. This was an assessor-blinded, randomised controlled clinical trial. Particpants with a diagnosis of depression, attending psychiatry departments of three teaching hospitals in Lahore, Pakistan, were included in the study. We screened a total of 280 patients and randomly allocated 137 of them to CaCBT plus Treatment As Usual (TAU) [Treatment group] or to TAU alone [Control group]. Assessments were completed at baseline, at 3 months and at 9 months after baseline. Reduction in depression score (Hospital Anxiety and Depression-Depression Subscale) at 3 months was primary outcome measure. The secondary outcome measures included anxiety scores (Hospital Anxiety and Depression-Anxiety Subscale), somatic symptoms (Bradford Somatic Inventory), disability (Brief Disability Questionnaire) and satisfaction with the treatment. A total of 69 participants were randomised to Treatment group and 68 to Control group. Participants in Treatment group showed statistically significant improvement in depression (p=0.000), anxiety (p=0.000), somatic symptoms (p=0.005) and disability (p=0.000). This effect was sustained at 9 months after baseline (Except for disability). Participants in Treatment group also reported higher satisfaction with treatment compared with those in Control group. Brief CaCBT can be effective in improving depressive symptoms, when compared with treatment as usual. This is the first report of a trial of Culturally adapted CBT from South Asia and further studies are needed to generalise these findings.
JPMA. The Journal of the Pakistan Medical Association, 2015
To assess the knowledge and practices of general practitioners about diagnosis and treatment of s... more To assess the knowledge and practices of general practitioners about diagnosis and treatment of schizophrenia and determine their association with clinical exposure to such cases in practice. The cross-sectional study was conducted in Peshawar from August 2009 to December 2011 at the clinics of general practitioners enrolled with the provincial Health Regulation Authority. All the listed GPs were contacted and those consenting to participate were included. A semi-structured questionnaire was used to assess their knowledge and practices related to diagnosis and treatment of schizophrenia. They were categorised as having Good Knowledge/Practice, in this regard, when they responded to >60% of the questions correctly. Of the 135 general practitioners contacted, 114(84.5%) agreed to participate and represented the study sample. Of them, 61(53.5%) physicians did not treat any diagnosed case while 15(13.2%) treated more than 10(8.8%) annually. Only 6(5.3%) practitioners spent more than ...
To determine the efficacy of brief Culturally adapted CBT (CaCBT) for depression when added to Tr... more To determine the efficacy of brief Culturally adapted CBT (CaCBT) for depression when added to Treatment As usual (TAU)-delivered by trained therapists using a manual compared with alone TAU. This was an assessor-blinded, randomised controlled clinical trial. Particpants with a diagnosis of depression, attending psychiatry departments of three teaching hospitals in Lahore, Pakistan, were included in the study. We screened a total of 280 patients and randomly allocated 137 of them to CaCBT plus Treatment As Usual (TAU) [Treatment group] or to TAU alone [Control group]. Assessments were completed at baseline, at 3 months and at 9 months after baseline. Reduction in depression score (Hospital Anxiety and Depression-Depression Subscale) at 3 months was primary outcome measure. The secondary outcome measures included anxiety scores (Hospital Anxiety and Depression-Anxiety Subscale), somatic symptoms (Bradford Somatic Inventory), disability (Brief Disability Questionnaire) and satisfaction with the treatment. A total of 69 participants were randomised to Treatment group and 68 to Control group. Participants in Treatment group showed statistically significant improvement in depression (p=0.000), anxiety (p=0.000), somatic symptoms (p=0.005) and disability (p=0.000). This effect was sustained at 9 months after baseline (Except for disability). Participants in Treatment group also reported higher satisfaction with treatment compared with those in Control group. Brief CaCBT can be effective in improving depressive symptoms, when compared with treatment as usual. This is the first report of a trial of Culturally adapted CBT from South Asia and further studies are needed to generalise these findings.
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