To determine the prevalence of psychiatric syndromes among the disaster victims in CABCOM, Pampanga who underwent psychosocial processing.
Human ; Male ; Female ; Adult ; PSYCHOLOGY ; PSYCHIATRY ; DISASTERS

Patients with schizophrenia presenting with agitated or violent behavior require pharmacological tranquilization. Olanzapine is the first atypical antipsychotic to have a short acting intramuscular preparation for control of agitation. There is a need to review the efficacy and safety of olanzapine intramuscular compared to intramuscular haloperidol. Objectives: To compare the efficacy of olanzapine intramuscular with haloperidol intramuscular in controlling acute agitation among patients with schizophrenia. Methodology: The authors searched the Cochrane Schizophrenia Group Register (November 2004), Cochrane Database for studies, Cochrane Controlled Trials Register (Issue 1, 2002), MEDLINE (1992 to the present), Clinical Trials.gov, Lilly Trial Registry and ClinicalTrialresults.org. Authors also hand-searched references of journal articles and contacted pharmaceuticals for relevant literature. Articles included in the meta analysis were randomized clinical trials comparing the efficacy of intramuscular olanzapine to intramuscular haloperidol for controlling agitation among patients with schizophrenia. Included studies had participants 18 years old and above who had schizophrenia and were acutely agitated. Intervention included olanzapine intramuscular 10-20 mgs compared with haloperidol 5-10 mgs. Outcomes included were decreased in agitation as measured by time to tranquility, change in PANSS scale or other appropriate scale and mean dose to achieve tranquility. Secondary outcomes measures were occurrence of adverse events, patient and care giver satisfaction and economic costs. Analysis: Two authors independently assessed the quality of the studies. Data were extracted using the Cochrane Data Extraction Form. Missing data from the studies furnished by ClinicalTrialresults.org. Data that were continuous were sing mean change. Difference in mean change was analyzed using inverse variance, fixed effects method at 95% confidence interval. Data that were dichotomous were analyzed using odds or risk ratio using Mantel-Haenszel method at 95% confidence interval. Results: Pooled data from the studies did not show that olanzapine intramuscular was not equal to haloperidol intramuscular in decreasing acute agitation among patients with schizophrenia. In terms of treatment emergent adverse events, the risk for treatment emergent adverse events was more for haloperidol IM compared olanzapine IM. Conclusions: It cannot be said that olanzapine IM and haloperidol IM are not equal in decreasing agitation among patients with schizophrenia. In terms of treatment emergent adverse events, the risk for extrapyramidal side effects and dystonia was more for haloperidal IM compared to olanzapine IM while the risk for abnormal blood pressure was more for olanzapine IM compared to haloperidol IM. There is need to assess other factors like economic cost, patient and caregiver satisfaction which the studies in this meta-analysis did not include.
Human ; Aged 80 and over ; Aged ; Middle Aged ; Adult ; Young Adult ; Adolescent ; SCHIZOPHRENIA ; PSYCHOMOTOR AGITATION ; OLANZAPINE ; HALOPERIDOL

This paper aims to describe the knowledge, attitudes, and practices of first-stroke patients regarding sex. It also aims to describe the socio demographic and clinical profiles of first-stoke patients. It is hope of the investigators to come up with recommendations that will respond to the needs of stroke patients as well as the caring physician.
Human ; Male ; Female ; Aged ; Middle Aged ; Adult ; STROKE ; SEXUAL BEHAVIOR ;

This is a case of a 22-year-old female who presented with labile mood, impulsivity and persistent suicidality. Despite numerous pharmacologic and psychotherapeutic regimens, she only had minimal improvement. Subsequently, she revealed traumatic events in younger years.She has been experiencing recurrent intrusive thoughts, low self-worth, guilt and avoidance behavior. Pharmacotherapeutic management was revised as well as her psychotherapy, which resulted in a positive outcome. However, recurrence occurred after she encountered negative life events. Electroconvulsive therapy and revision of pharmacologic treatment eventually led to significant improvement. This case highlights the importance of underlying psychological trauma that caused persistent symptoms. The intensity of impact and the chronic recurrent negative effect of the trauma on the patient influenced the treatment outcome. It is important to optimize therapeutic management with the use of pharmacologic agents, psychotherapy and somatic therapies.
Stress Disorders, Post-Traumatic ; Bipolar Disorder

INTRODUCTION: Child abuse, sexual and domestic violence are among the most destructive experiences afflicting women and children that result to physical, behavioral, psychological and economic consequences. Physicians in the front line need to be sensitive and vigilant in identifying both overt and subtle signs of these violations. As such, identification of victims is vital to prevent further abuse and injury, as well as to manage the patient holistically.
OBJECTIVE: To assess the skill of Family Medicine (FM) residents in detecting cases of violence against women and children (VAWC).
METHODS: Eight case scenarios were presented to 48 resident trainees from government and private hospitals in Metro Manila. They were tasked to identify cases pertaining to VAWC, and distinguish the case type.
RESULTS: Red flags that were easily detected by more than 80% of trainees were cases of physical abuse towards men, and neglect. Circumstances with moderate challenge were sexual harassment, rape, and abandonment, in that order. On the other hand, respondents had inadequacy in detecting cases of sexual abuse and physical abuse towards children; while the most difficult to recognize was emotional abuse.
CONCLUSION: Acquisition of this new skill set may prove beneficial in providing the ideal environment for proper management and support provision for the VAWC subjects. Lack of knowledge and training in this rising societal and health threat may cause underdiagnosis of common VAWC presentations. Consequently, this leads to failure of identification, assessment, documentation, and management of such patients.

Human ; Male ; Female ; Child ; Sexual Harassment ; Rape ; Physical Abuse ; Domestic Violence ; Child Abuse ; Sex Offenses ; Surveys And Questionnaires

OBJECTIVE: To determine the prevalence and possible risk factors associated with nonsuicidal self-injury (NSSI) and suicide attempt among young adult university students.

METHODS: A cross-sectional study involving six colleges from a university in Manila, from which randomization through a computer-generated random number was done. Data were obtained through self-administered questionnaires. Descriptive analysis and logistic regression were done to evaluate the data.

RESULTS: A total of 225 students participated in the study (mean age of 20.33 years). Majority were females (60.44%). Ideations of self-harm were reported in 49.33%. NSSI and suicide attempts were reported at 26.22% and 14.67%, respectively. In general, self-harm (NSSI and/or suicidal attempt) was reported at 33.78%, while 7.11% of the respondents reported both NSSI and suicidal attempt in the past. Furthermore, 2-3 out of 10 students who engaged in NSSI would have a suicide attempt. Associated factors of NSSI and suicide attempt were age, female gender, gender orientation, parental civil status, employment, economic standing, and psychopathology which support the findings cited in literature.

CONCLUSION: The high prevalence of self-harm NSSI and/or suicidal attempt (33.78%) and the finding that NSSI was a gateway for suicidal attempt and that 2-3 out of ten who engaged in NSSI would have a suicide attempt underscores the need to develop an early intervention upon detecting self-harming behaviors and a preventive program for the progression of NSSI to suicide attempts.

Human ; Adult (a Person 19-44 Years Of Age) ; Students ; Suicide, Attempted ; Self-injurious Behavior

: One of the most commonly used tools by clinicians to identify cases of anxiety and depression in medically ill patients is the Hospital Anxiety and Depression Scale, or the HADS Filipino version. However, there were some “gray areas” with its use, particularly for those who are in the non-psychiatric setting. Some translated items may pertain to something else which could influence patients' responses. Furthermore, local studies showed differences in the conception, understanding, and expression of depression unique to Filipino culture and could be potentially missed during the assessment. This paper determined the validity and reliability of the Anxiety and Depression Symptom Assessment Guide or ADSAto a sample of 91 adult cardiac Filipino patients in the in-patient setting. In addition to the 29-item ADSAtool that was generated from HADS, the review of literature and other sources was also reviewed by experts from two rounds of Delphi Survey. It was written in a yes-or-no format and available in both English and Filipino versions. The tool was tested for internal consistency, intra-class and inter-item reliability. Another test used was criterion-based validity utilizing HADS to identify cases of anxiety and depression. The results showed that ADSAis highly reliable with Cronbach's alpha of 0.97, poor-to-moderate intra-class correlation (0.670 for anxiety, 0.440 for depression), and consistent/acceptable interitem correlation (0.528 for anxiety, 0.382). Both HADS and ADSAwere positively correlated with correlation coefficients of 0.667 and 0.391 (p-value<0.5) for anxiety and depression respectively. Using a cut-off score of 5, ADSA has moderate sensitivity and specificity of 72.5% and 78.4% for anxiety, and 66.7% and 64.3% for depression. Further research is needed to strengthen ADSA's validity by increasing the sample size and the multi-center sites.
Anxiety ; Depression