New approaches underlined to treat psychiatric disorders

PESHAWAR: Mental health experts underlined new approaches to treat psychiatric disorders to keep a pace with the developments in the field.

They were speaking at a two-day training on “New approaches to Psychosis and Cognitive Behaviour Therapy [CBT]” which concluded here on Sunday.The training was arranged by the Horizon non-profit organisation at the Ibadat Hospital in collaboration with the Pakistan Psychiatric Society. Dr Ali Ahsan Mufti, a consultant psychiatrist, hosted the event as coordinator.

The resource persons included Dr Muhammad Aslam, Dr Shahida Tanveer, Dr Bashir Ahmad and Dr Mukhtarul Haq.Psychosis is a collection of symptoms that affect the mind, where there has been some loss of contact with reality. During psychosis, a person’s thoughts and perceptions are disrupted and they may have difficulty recognizing what is real and what is not.

The CBT is a psycho-social intervention that aims to reduce symptoms of various mental health conditions, primarily depression and anxiety disorders. It is one of the most effective means of treatment for substance abuse and co-occurring mental health disorders.

Dr Muhammad Aslam, a clinical psychologist, CBT therapist and president of Institute of CBT, Lahore, gave a brief history of CBT for psychosis.

He said the people with psychosis typically experience delusions (false beliefs such as others are trying to hurt them) and hallucinations (seeing or hearing things that others do not, such as hearing voices telling them to do something or criticizing them). He said there could be other symptoms as well.

Dr Aslam said a person would often show changes in behavior before developing psychosis and that highlights the importance of the CBT to treat illness.

“The behavioral warning signs for psychosis included uneasiness with others, suspiciousness, paranoid ideas, trouble thinking clearly, spending time alone, a lack of feelings, decline in self-care, disturbed sleep, anxiety, lack of motivation, etc,” he added.

About the causes, the doctor said psychosis may be a symptom of a mental illness, such as schizophrenia, bipolar disorder, or severe depression. However, a person can experience psychosis and never be diagnosed with schizophrenia or any other disorder.

He said the CBT for psychosis is a form of psychotherapy that engages the person in examining and challenging their psychotic experiences and developing coping strategies to manage symptoms.

Dr Aslam said it had been developed for schizophrenia against a backdrop of intense skepticism because of past failures of other individual psychotherapies. He said techniques were based on the general principles of CBT that were initially developed for the treatment of depression.

He said the CBT for psychosis addresses delusion, negative symptoms and reduces distress. He gave the types of the delusions and mentioned trauma, bereavement, financial problems among the main causes of psychosis.

Professor Dr Bashir Ahmad, CBT Programme Director, said the CBT was the most widely used evidence-based therapy for treating mental disorders. He said it focused on the development of personal coping strategies that target solving current problems and changing unhelpful patterns of thinking, behaviors, and emotions.

Dr Bashir said the CBT had demonstrated efficacy in treating a broad range of psychological disorders, from anxiety and depression to post-traumatic stress disorder, substance abuse, obsessive compulsive disorder, eating disorders, personality disorders and psychosis.

Dr Mukhtarul Haq said the CBT could be used to treat psychiatric and other mental disorders as it was the first time intervention in the treatment. He called for a manualized therapy to attain uniformity in the entire process.

He deplored the shortage of qualified psychiatrists in the country. “The present number of psychiatrists in the country is little over 500. Keeping in view the population of the country and the international guidelines, the tally should have been 17,000,” he pointed out.

He welcomed the efforts to fill in the gap by first launching a 6-month certificate training programme in CBT and later a one-year diploma. The candidates are trained in CBT for depression and anxiety disorders.

Dr Shahida Tanveer talked about headache management. “Headache represents the most frequent human discomfort and 90 per cent of the headache patients have depression. Headache is a psychological expression of unease which is linked to physical and psychological stress,” said the doctor in early 80 by citing different models to explain her topic.