Journal of Pakistan Psychiatric Society

No Health Without Public Mental Health - A Strategic Roadmap for Pakistan

2026-03-31T19:30:42+00:00

Pakistan faces a mental health emergency with mental disorders affecting around 24 million individuals. The economic implications are equally devastating. The economic burden of mental illness reached approximately £2.97 billion in 2020, while the allocated mental health budget of 2.4 billion PKR represents merely 0.4% of total health expenditure, covering less than 2% of the actual burden. Current mental health approaches in Pakistan fail because they treat symptoms while ignoring root causes. Traditional biomedical models focus on individual pathology while systematically overlooking the traumatic experiences that drive mental health outcomes across Pakistani society. To address this failure of symptom-focused care, and the mismatch between current approaches and what people actually need, we propose a special initiative as an alternative framework for mental health in Pakistan through an approach that recognizes trauma and adversity as primary drivers of mental health outcomes and structures entire systems around this understanding.

From Stigma to Care: Reframing Mental Health Clinics for better Accessibility

2026-03-31T19:29:05+00:00

World Health Organization (2022), report shows that more than 12% of world population suffers one or the other mental health condition, but the treatment gap remains most pronounced in low- and middle-income countries (LMICs). In Pakistan, and neighboring countries, deep rooted societal taboos, lesser mental health awareness, shortage of culturally appropriate services are the main contributing factors for this treatment. Stigma attached to mental disorders continues to be a major hinderance to accessing help, in Pakistan. As a consequence to reluctance to seeking mental health support, symptoms get worse, severity aggravates, recovery becomes more complicated. The “change of label” strategy is likely to effectively minimize psychological resistance, and increase acceptability and treatment of mental health conditions. The successful implementation of this model at Sir Cowasjee Jehangir Institute has proved that how thoughtful, relabeling and language modification can meaningfully create comfortable access and reduce barriers, without compromising on clinical standards.

Cannabis Use in First-Episode Psychosis: Associations with Symptom Dimensions and Sociodemographic Factors

2026-03-31T19:29:24+00:00

Abstract

Objective:
To determine sociodemographic and clinical predictors of cannabis use among patients with first-episode psychosis (FEP) admitted to a tertiary care psychiatric unit in Pakistan.

Methods:
This cross-sectional study was conducted at the Psychiatry Unit, Khyber Teaching Hospital, Peshawar, from January 2021 to December 2024. Consecutive inpatients with FEP and no prior antipsychotic exposure were assessed using a structured proforma for sociodemographic and clinical data. Symptom severity was measured with the Positive and Negative Syndrome Scale (PANSS). Binary logistic regression was applied to identify predictors of cannabis use.

Results:
Among 104 participants (77.9% male; mean age 23.4 ± 8.4 years), cannabis use was reported exclusively among males (28.4%). Unemployment and lower socioeconomic status significantly predicted cannabis use. Being employed (OR = 0.017, 95% CI [0.001–0.367]) or a student (OR = 0.064, 95% CI [0.006–0.693]) was associated with markedly lower odds of cannabis use compared with unemployment. Satisfactory socioeconomic status was also protective (OR = 0.074, 95% CI [0.010–0.522]). Clinically, moderate manic symptoms and higher PANSS activation scores were linked with lower likelihood of cannabis use (p < 0.05).

Conclusion:
Cannabis use in first-episode psychosis is strongly influenced by social determinants such as occupation and socioeconomic status rather than symptom severity. Culturally informed, gender-sensitive prevention strategies are needed to address substance use risk in psychosis within South Asian contexts.

The Relationship between Internet Gaming Addiction and Attention Deficit Hyperactivity Disorder’s Symptoms in Young Adults

2026-03-31T19:28:46+00:00

OBJECTIVE

The aim of this study is to explore the relationship between video gaming addiction and Attention Deficit Hyperactivity Disorder (ADHD) symptoms among young adults.

STUDY DESIGN

A correlational cross-sectional quantitative research design was used.

PLACE AND DURATION OF STUDY

This study was conducted at different universities of Sialkot, Pakistan from February, 2024 to July, 2024.

METHOD

A purposive sample of 200 young adults with internet gaming addiction was taken. A self-developed demographic sheet was administered along with the Internet Gaming Disorder Scale Short-Form (Pontes, & Griffiths, 2015) to measure internet gaming addiction. Attention deficit/ hyperactivity disorder’s symptoms were measured using Adult ADHD Self-Report Scale (ASRS-v1.1 Symptom Checklist) (Kessler, et al., 2005). For the analysis of data, descriptive statistics, Pearson Product Moment Correlation Coefficient and regression were applied using SPSS v25.0 software.

RESULTS

Study found a significant positive relationship between IGD (Internet Gaming Disorder Scale) score and ADHD (Attention deficit/ hyperactivity disorder) symptoms in young adults.

CONCLUSION

This research highlights the comorbidity of psychopathology such as ADHD, in video gaming addicts, suggesting that individuals with higher internet gaming addiction are more likely to exhibit signs of ADHD symptoms.

Antenatal depression and its associated risk factors among males: evidence from an urban setting in a lower-middle income country

2026-03-31T19:28:27+00:00

Objective: To estimate the prevalence and associated risk factors of paternal antenatal depression among men attending urban healthcare settings in Karachi, Pakistan.

Study Design: Cross-sectional

Place and Duration of the study: This study was conducted at the Department of Obstetrics and Gynaecology, Dow University of Health Sciences and the Modern Sindh Government Hospital from November 2023 to April 2024.

Method: The study population comprised adult males with pregnant wives attending the selected healthcare facilities for antenatal examinations. Participants’ information statements and consent forms were shared with eligible males, accompanying their pregnant wives for antenatal check-ups during the research period. Edinburgh Postnatal Depression Scale was utilized to assess antenatal depression among the participants.

Results: A total of 312 males participated in this study. The prevalence of antenatal depression among expectant fathers was found to be 52%. This study found a very high prevalence of paternal antenatal depression among the sample, with the advanced paternal age, lower income levels, experiencing sleep disturbance and being a smoker among the significant risk factors of depression among expectant fathers. The results of the study help to explain why fathers should also be engaged in perinatal mental health interventions.

Conclusions: This study identified prevalence of paternal antenatal depression among expectant fathers in Karachi. Significant risk factors included advanced paternal age, lower socioeconomic status, sleep disturbances, and smoking habits, indicating an urgent need for involving fathers in perinatal mental health programs, vital for promoting overall family well-being.

Silver lining as a predictor of mental health outcomes among caregivers of patients with mental disorders

2026-03-31T19:28:08+00:00

ABSTRACT

Objective

To understand the relationship and predictive role of silver lining on mental health outcomes among caregivers of patients with mental disorders.

Study design

Cross-sectional correlational research design.

Place and duration of Study

Inpatient and outpatient settings of the psychiatric unit of Allied Hospital 2, Faisalabad, from August 2025 to September 2025.

Subjects and Methods

200 family caregivers of individuals diagnosed with mental disorders, for at least 6 months, aged 18 years and above, both male and female, took part in the study. Participants were enrolled through a purposive sampling technique. General Health Questionnaire-28 (GHQ-28)¹ and silver lining scales (SLS)² were utilised to measure the outcome variables. SPSS version 25 was used, and ethical issues were addressed according to the IRB of the institute.

Results

Significant negative correlation was found between silver lining and its sub-scales, and mental health outcomes and its sub-scales. Multiple linear regression revealed that personal growth and familial bonding were significant negative predictors of poor mental health outcomes. But empathy emerged as a significant positive predictor. The final model accounted for 18% of the variance in mental health outcomes.

Conclusion

Silver lining in the caregiving experience, particularly through personal growth and familial bonding, can mitigate negative mental health outcomes among caregivers of individuals with mental disorders. This highlights the protective role of positive psychological resources.

The Clinical Presentation of Early-Onset Psychotic Disorders: A Descriptive Study in Child and Adolescent Inpatient Setting

2026-03-31T19:27:48+00:00

Background: Early-onset psychosis starts before the age of 18 years. It differs from the adult-onset psychosis in terms of the clinical presentation and response to the therapy. The aim of the study was to identify the common symptoms of Early Onset Psychosis and the social and educational impairment resulting from it.

Methods: A retrospective study was conducted in Child and Adolescent Psychiatry Department, Mayo Hospital, Lahore to assess the clinical profile of patients diagnosed with psychotic disorders.. A proforma was designed for data extraction based on the literature review and in accordance with DSM-5 which included common presenting symptoms at admission along with other relevant clinical and demographic information. Data was collected from the inpatient file records

Results: A total of 116 inpatient record files of admitted patients were included. 70% of the patients were females and the mean age at admission was 13(±1.6). Schizophrenia spectrum disorders were present in 78% of the patients and Brief Psychotic Disorder was the most common diagnosis. Symptoms including odd behavior, speech disorganization, deterioration in daily life activities, and perceptual abnormalities were the most common symptoms.

Conclusion: The study provides insight into the clinical presentation and psychosocial impact of psychosis in children and adolescents. It can help in the early detection of Psychotic Disorders in this age group and in formulating a better treatment and management plan.

Breaking Barriers; Building Resilience

2026-03-31T19:30:22+00:00

Mental-wellbeing is not the absence of adversity, it is the ability to go beyond what holds you back. Despite advancements in technology and pharmacology, the most important cure has always laid within us. Mankind’s gift of perseverance, our resilience. Often, we forget what we’re capable of, especially in the midst of calamity. Among others, one such vulnerable population is that of medical students. Increasing figures of depression, anxiety and burn out have been reported among medical students concurrent with seniority in clinical years. It is vital to ensure that we care for and empower the caregivers of tomorrow, therefore, equipping them with resilience today. Resilience begins as early as a child begins to walk, preparing one for stepping into bigger shoes as we grow.

The Next Could Be Me

2026-03-31T19:30:03+00:00

This essay reflects the dual reality of being a female medical student in Pakistan, where hope and fear coexist. It highlights the aspiration to become a successful doctor while confronting societal pressures, gender-based violence, and systemic barriers. Through a deeply personal narrative, the essay challenges stigma, emphasizes mental resilience, and calls for empathy and change. By shifting the perspective from distant victims to personal vulnerability, it reinforces a powerful message: mental health struggles and societal injustices can affect anyone; the next could be me.

Knock at Midnight

2026-03-31T19:29:43+00:00

This essay explores the fear, vulnerability, and resilience shaping the experiences of women in medicine through the parallel stories of a resident facing danger during night duty, and a medical student struggling with anxiety and burnout. Set against the realities of workplace violence, harassment, and emotional strain, the essay argues that female medical professionals must navigate both personal and structural barriers. It concludes that resilience alone is insufficient without institutional reform, collective support, and stronger protections to ensure women in medicine can work and learn safely.

Breaking barriers, building resilience

2026-03-31T19:27:29+00:00