IntroductionPsychological 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.ObjectivesTo study suicidal ideation and desire for death in trauma exposed population in Pakistan.AimsTo 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.MethodsSubjects 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.ResultsAll 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.ConclusionsThis study provides the first structured estimate of prevalence of suicidal ideation in trauma exposed population of Pakistan.

IntroductionSevere stress or exposure to life threatening trauma is known to affect social functioning and quality of life.ObjectivesTo 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.AimsTo examine indicators of social functioning in order to higlight them as targets for therapeutic interventions.MethodsSubjects 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).Results54 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.ConclusionsThe 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.

Background Sleep is a fundamental component of good health, however its promotion in acute hospital settings does not appear to be a priority. Causes of sleep disruption are varied and include environmental and bio-cognitive factors, including pain, bright light, noise, anxiety and stress. The environmental and bio-cognitive consequences of sleep deprivation on the health and recovery of hospital inpatients are various. Inadequate sleep can lead to both psychological and physiological consequences. Objective This observational study was aimed at determining the pattern, quantity and quality of sleep and the prevalence, causes and effect of sleep deprivation / disturbance among patients hospitalized at the elective wards of a tertiary care hospital. Methods This observational study was conducted from August 2015 to January 2016, upon a sample of 50 patients admitted to Liaquat University Hospital (who had spent at least 4 weeks at the hospital). The sample of patients (chosen via simple random sampling), were interviewed consecutively every morning for 4 days and their mean response was evaluated to account for irregularities in experience. Data was collected using interview based structured questionnaire which included the 42 point DAS scale approved by Australian Center for Posttraumatic Mental Health. The data was analyzed in SPSS v. 17.0 and MS Excel 2013. Results During the stay at the hospital, DAS score of depression, anxiety and stress all rose. The most reported bothersome elements that disturbed sleep included, pain (30%), Noise (6%), and feeling of unease, irritation and panic (6%). Majority of the sample comprised of female (56%) respondents coming from rural areas (74%) with a low socioeconomic background (86%). The quantity of sleep dwindled between (but not more than) 5 to 6 hours. The quality too (self-rated by the respondents did not rise above a value of 6.5. Conclusion The conclusion is in line with our hypothesis. With the hustle and bustle happening at all hours in a hospital, patients have trouble getting adequate sleep, which has an evident the quality and quantity of sleep during their stay. Owing to the belief that sleep-deprived patients are less likely to be fully active participants in their care. It is recommended that steps should be taken to deal with this problem on a priority basis.