Relatively small numbers of students identified psychiatry as their specialty of choice. This trend is similar to many other studies. Given the small number of practicing psychiatrists in Pakistan, this finding is not very encouraging.

Schizophrenia (SCZ) is a chronic mental illness and among the most debilitating conditions encountered in medical practice. A recent landmark SCZ study of the protein-coding regions of the genome identified a causal role for ten genes and a concentration of rare variant signals in evolutionarily constrained genes1. This recent study—and most other large-scale human genetics studies—was mainly composed of individuals of European (EUR) ancestry, and the generalizability of the findings in non-EUR populations remains unclear. To address this gap, we designed a custom sequencing panel of 161 genes selected based on the current knowledge of SCZ genetics and sequenced a new cohort of 11,580 SCZ cases and 10,555 controls of diverse ancestries. Replicating earlier work, we found that cases carried a significantly higher burden of rare protein-truncating variants (PTVs) among evolutionarily constrained genes (odds ratio = 1.48; P = 5.4 × 10−6). In meta-analyses with existing datasets totaling up to 35,828 cases and 107,877 controls, this excess burden was largely consistent across five ancestral populations. Two genes (SRRM2 and AKAP11) were newly implicated as SCZ risk genes, and one gene (PCLO) was identified as shared by individuals with SCZ and those with autism. Overall, our results lend robust support to the rare allelic spectrum of the genetic architecture of SCZ being conserved across diverse human populations.

Background:Studies have shown an association between parental anxiety and depression, and caretaking of children with developmental cognitive delays. There is little data in developing countries, such as Pakistan, concerning the impact of raising children with Mental Retardation, upon the quality of parent functioning and risk for psychopathology.Objective:To evaluate for anxiety and depression among parents of children with Mental Retardation (MR).Methods:This was a prospective study conducted at a tertiary care hospital in Pakistan. Participants were 198 parents (99 fathers/99 mothers) of 100 children with the diagnosis of MR. The parents were assess for anxiety and depression using DSM IV criteria. Informed consent was obtained. The study was approved by the Institutional Research Committee.Results:Significantly high proportion (p-value = 0.024) of mothers (89%) had anxiety, depression or both anxiety and depression together as compared to fathers (77%). Among mothers, 35% met criteria for anxiety, 40% for depression and 13% for both anxiety and depression. Among fathers 42% had anxiety, 31% depression and 3% both anxiety and depression. There was a significant association (Pvalue = 0.027) between gender of parent and individual psychiatric diagnosis of anxiety, depression and anxiety and depression together. A significant association (pvalue = < 0.043) was also found between mother's anxiety, depression or both and degree of mental retardation of their children.Conclusions:Parents of children with MR are at higher risk for anxiety, depression or both, needing mental health assessment.There was correlation between mother's anxiety, depression or both and level of MR among children.

IntroductionStudies have shown an association between parental distress and caretaking of children with cognitive delays. There is little data in developing countries, such as Pakistan, concerning the impact of raising children with Mental Retardation, upon the quality of parent functioning and risk for psychopathology.ObjectiveTo assess the level of distress and risk for psychopathology among parents of children with Mental Retardation (MR).MethodsThis was prospective study conducted at a tertiary care hospital in Pakistan. Participants were 200 parents (100 fathers/100 mothers) of 100 children with the diagnosis of MR. Parents were administered Self Report Questionnaire 20 (SRQ 20) and the Quality of Life BREF (QOL BREF).ResultsMean age for mothers was 40.2 years while fathers was 42.9 years. The mean age of children was 10.5 years (30% females/70% males) with 25% mild MR, 42% moderate MR, 20% severe MR and 13% profound MR. On SRQ 20, 25% mothers and 43% fathers scored above the cut off indicating possible psychiatric disorder. Mean QOL domain scores were for mothers (M) and fathers (F): M 13.2/ F 13.9 for physical health; M13.1 / F 13.7 for psychological health; M 13.9 / F 13.9 for social relationships, M 13.4 / F 14.8 for environment.ConclusionsParents of children with MR are at higher risk for psychopathology, needing mental health assessment.Fathers scores on the SRQ reflect more distress and psychiatric symptoms than mothers SRQ scores.Limitations include lack of comparison group and small sample size.

Background Escitalopram is widely used for the management of the major depressive disorder and generalized anxiety disorder, but there is no to very limited data available regarding efficacy and safety in Pakistani patients. This study was conducted to evaluate the efficacy and safety of escitalopram oral drops to manage the major depressive disorder and generalized anxiety disorder in a local cluster within Pakistan. Methods This prospective multicenter observational study was conducted in the department of psychiatry from August 2018-August 2019. Eighty-five patients meeting the selection criteria were included in the study. Adolescent, adult, and geriatric patients of either gender with generalized anxiety disorder having Hamilton Anxiety Rating Scale (HAM-A) rate ≥ 10 and major depressive disorder having Montgomery-Asberg Depression Rating Scale (MADRS) rate ≥ 7 or patients with co-morbid generalized anxiety disorder (GAD), major depressive disorder (MDD) were selected for the study. We are reporting patients' improvement from baseline, response rate, and remission rate. Data analysis is performed by using SPSS version 21 (IBM Inc, Armonk, USA). Results Among enrolled patients, 42 were adolescents, 22 were adults, and 21 were geriatric. The mean age of an adolescent, adult, and geriatric patients was 14.92 ± 2.04, 44.54 ± 12.08, and 64.61 ± 3.16 years, respectively. Among enrolled patients, the mean change in a total score of HAM-A for anxiety and MADRS for depression were-10.04 ± 4.32 and-17.67 ± 14.42, respectively. At the end of the study, the remission rate and response rate for depression were 82 % and 75%, respectively. Similarly, the remission rate and the response for anxiety were 76% and 81%, respectively. Mean HAM-A and MADRS scores were significantly improved for adolescent, adult, and geriatric patients. Adverse events were reported in eight (9.41%) patients with six having gastrointestinal (GI) disturbance and two having to worsen anxiety. All reported adverse events were of mild severity. Conclusion Escitalopram oral drops are found effective and tolerable in reducing both anxiety and depression 1 2 3 4 5 6 6