Despite a large body of research evaluating factors associated with the relapse of psychosis in schizophrenia, no studies in Pakistan have been undertaken to date to identify any such factors, including specific cultural factors pertinent to Pakistan. Semistructured interviews and psychometric measures were undertaken with 60 patients diagnosed with schizophrenia (49 male and 11 female) and their caregivers at four psychiatric hospitals in the Peshawar region in Pakistan. Factors significantly associated with psychotic relapse included treatment non-adherence, comorbid active psychiatric illnesses, poor social support, and high expressed emotion in living environments (P < 0.05). The attribution of symptoms to social and cultural values (97%) and a poor knowledge of psychosis by family members (88%) was also prevalent. In addition to many well-documented factors associated with psychotic relapse, beliefs in social and cultural myths and values were found to be an important, and perhaps treatable, factor associated with relapse of psychosis in Pakistan. The provision of evidence-based psychotherapeutic interventions, such as behaviour and family therapy and cognitive behaviour therapy for psychosis, could potentially ameliorate the relapse rate of psychosis in Pakistan.

Objectives: This paper discusses the increasing incidence of mental health problems in Pakistan, and specifically in the Swat Valley, in relation to the growing insurgency and current violence in Pakistani society. The paper argues that the health care system's response in Pakistan is not adequate to meet the current challenges and that changes in policy are needed to build mental health care services as an important component of the basic health package at primary care level in the public sector.

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Plethora of researches has been carried out for the last many decades and has identified relationship between mental health and religious convictions; in particular, range of religious practices has been found instrumental in the promotion of mental health. The aim of this paper is to find out association between mindfulness in Salah (prayer) and mental health of individuals who identify themselves with Islam and to examine the mental health of those Muslims who offer Salah prayer with mindfulness and those who offer without mindfulness. A total of 174 participants with mean age of 21.57 including 62% males and females 38% were selected through convenient sampling. RAND Mental Health Inventory was used to measure mental health and other three variables; three self-reported measures were constructed. They included Islamic religious education scale, Salah education scale and mindfulness in Salah scale. Psychometric properties for all scales were established. The findings indicated that mean on mindfulness and mental health was significantly higher for those who were offering Salah (prayer) regularly (p < 0.01) as compared with those who were not offering it regularly. Moreover, those who were offering Salah (prayer) with mindfulness had also significantly higher mean for mental health (p < 0.01) as compared with those who were offering it without mindfulness. Religious education, Salah education and mindfulness were able to account for 13% of the variance in mental health (p < 0.01). Of note two of the measures included Salah education and mindfulness made a significant contribution in the prediction of mental health (p < 0.01). The present study indicated that individuals who offer prayer regularly and with mindfulness have better mental health as compared with those who don't offer it regularly and with mindfulness. The findings of this study urge to spread awareness regarding offering prayer regularly with mindfulness for the better outcome of mental health in people.

Introduction Ascertaining putative sociodemographic and clinical causes for death by probable suicide can potentially help implement region‐specific strategies to reduce suicide rates. In this study, we wanted to investigate methods utilized and the psychosocial and mental health characteristics of youths (aged 12‐26 y) who died by probable suicide. Method We examined data from mental health clinical files and forensic reports and performed qualitative psychological autopsy interview from more than multiple sources for each youth who died by probable suicide between 1 May and 31 December 2015 in the Khyber Pakhtunkhwa Province of Pakistan. Results The two most common methods of probable suicide were by firearm use and self‐poisoning utilizing pesticides that were significantly associated with male and female gender, respectively. The most common mental health difficulties were major depressive disorder and harmful use of psychoactive substances. Other clinical features particularly evident included thoughts of self‐harm, irritability and aggression, low self‐esteem, treatment nonadherence, family dispute, and financial distress. Conclusion Efforts to reduce the ease of access to firearms and pesticides may potentially have a beneficial effect in reducing the suicide rate in this region of Pakistan.