PYROMANIA The recurrent, deliberate, and purposeful setting of fires. Associated features Tension or affective arousal before setting the fires. Interest in fire and the actions and tools coupled with firefighting. Gratification, or relief setting fires or witnessing the aftermaths. Patients make substantial advance arrangements. Epidemiology Eight times more frequent in men compared to women Comorbidity Substance abuse disorders Affective disorders Other impulse control disorders Personality disturbances e.g. borderline personality disorder. Attention-deficit hyperactivity disorder Learning disabilities History of Enuresis Antisocial acts, such as truancy and delinquency Aetiology Psychosocial.  A symbol of sexuality.  Abnormal craving for power and social prestige  Retaliation about the absence of the father Volunteering as a firefighter to vent the frustration Promiscuity

Assessment and Management of The Risk of Violence in Schizophrenia Scenario A 21-year-old lady with the diagnosis of schizophrenia informs you she will kill her neighbour tomorrow as she has ruined her life. She tells not to disclose this to anyone. How will you assess the homicidal risk in this patient? What treatment and follow up recommendations will you make in this case? Clinical Assessment  Listen to the patient and develop a therapeutic relationship.  begin the assessment and enquire about her demographics.  Enquire about the issue that she brought up—she will kill her neighbour.  Elaborate on how she thinks her neighbour has ruined her life.  Explore her thoughts a nd whether the patient may have persecutory delusions Assess how much resentment she feels? Follow up with inquiry about her mood, esp. about irritability and depression How she plans to commit the act Has she threatened the person? Whether she has done so in the past If so, what provoked such an in

Disaster Management: Psychological First Aid Short- and Long-Term Disaster Management Waleed Ahmad Principles and Techniques of Psychological First Aid Meet 4 basic standards. They are: Consistent with research evidence on risk and resilience following trauma, Applicable and practical in field settings, Appropriate for developmental levels across the lifespan, Culturally informed and delivered flexibly. Disaster Management in the Short-term Intervening after disasters The World Health Organization (WHO) has recommended psychological and social interventions during the reconsolidation phase after disasters to improve the mental health of the affected populations and prevent psychopathology (WHO 2003b). These interventions include: Availability of community volunteers,  Provision of non-intrusive emotional support,  Psychoeducation, and  Encouraging pre-existing positive ways of coping. 

A Test of Cleverness You have worked hard throughout the year and are on the way to your college and take your final exam in a hurry. As you near the college, you notice a youngster riding a bike doing careless stunts. In the flash of a second, he hits an elderly man who drops to the ground, is rescued by a couple of men who were going with him.  What would you do?  a) Reach your college to take your paper  b) Call the police to report the misbehaviour   c) Find the boy and ask him what happened  d) Take the elderly to the hospital   e) Call the emergency number  A 30-year-old man is setting in the street begging you for money. Your elder cousin says he is definitely a heroin addict and spends most of his money on buying drugs and says they are all habitual beggars. The man sheds tears on hearing and said he never used drugs nor begged.   What would you do?  a) Counsel him to stop heroin  b) Let your cousin handle this  c) Give him some money   d) Listen to why he nee

Capgras Syndrome The patient believes that someone else has replaced a familiar person. Both have a close resemblance. For example, an unknown person replaces the daughter. The patient may attack the familiar person. The original name was ‘delusion des sosies’ a delusion and not a syndrome an example of reduplicative paramnesia.. the most common cause is schizophrenia. other causes include Lewy body dementia and other neuropsychiatric disorders. Always assess the risk of violence to the family person.         

Organic Amnestic Syndrome and Korsakoff Psychosis Dr Waleed Ahmad Vignette A 30-year-old woman is brought to you with memory deficits and rigid behaviour. On examination, she appears lean and weak, dishevelled, is disoriented to time, has a flat affect, registration is 3/3, short-term memory is 0/3 and long-term memory appears intact. She does not have any difficulty naming objects. On physical examination, her weight is 42Kg and her height 152 cm. The lady says, there is nothing wrong with her, while her father says she is speaking too many lies these days. The rest of the clinical evaluation is insignificant except for chronic diarrhoea and recent episodes of vomiting.  What finding will you look for on MRI? Diagnosis The clinical picture, in this case, is consistent with organic amnestic syndrome, specifically Korsakoff Psychosis. The most common cause of organic amnestic syndrome is thiamine deficiency.(1) Magnetic Resonance Imaging Increased signal (ie, hyperintensity) in midline