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2016| September-October | Volume 38 | Issue 5
Online since
September 29, 2016
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REVIEW ARTICLES
Neuroimaging studies in obsessive compulsive disorder: A narrative review
Arpit Parmar, Siddharth Sarkar
September-October 2016, 38(5):386-394
DOI
:10.4103/0253-7176.191395
PMID
:27833219
Obsessive compulsive disorder (OCD) is a relatively common psychiatric illness with a lifetime prevalence of 2–3% in general population. The pathophysiology of OCD is not yet fully understood, however over the last few decades, evidence for abnormalities of cortico-striatal-thalamic-cortico (CSTC) circuitry in etiopathogenesis of OCD has accumulated. Recent brain imaging techniques have been particularly convincing in suggesting that CSTC circuits are responsible for mediation of OCD symptoms. Neuroimaging studies, especially more recent studies using functional neuroimaging methods have looked for possible changes seen in the brain of patients with OCD, the specificity of the findings (as compared to other psychiatric illnesses) and the effects of treatment (pharmacotherapy/psychotherapy) on such changes were observed. This narrative review discusses the neuroimaging findings seen in patients with OCD with a special focus on relatively more recent neuroimaging modalities such as magnetic resonance spectroscopy and magnetoencephalography.
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ORIGINAL ARTICLES
Legal terms used in reception order and their relevance to judicial process
Nakkeerar Subramanian, Rajkumar Ramanathan, Venkatesh Madhan Kumar, Dhanabalan Kalingarayan Palayam Chellappan, Jeyaprakash Ramasamy
September-October 2016, 38(5):431-437
DOI
:10.4103/0253-7176.191377
PMID
:27833226
Introduction:
Law governs the admission and management of involuntary admissions of mentally ill persons who are admitted under the provisions of the mental health act. The court directs the doctor to take charge of such persons. In the further dealings of such person the medical officer of the psychiatric facility comes across legal terms, which require understanding so that patients could be dealt with properly. Various terms such as accused, under police custody, judicial custody, remand prisoner, or under trial prisoner are used to denote their legal status. It is imperative for the medical officer to understand the nuances in the meanings of these terms. There are many times when the relevant section under which the admission is ordered is not found in the reception order. In these cases the terminology by which the patient is mentioned throws a light on the status of the patient. Towards this aim a study was carried out to assess the awareness and understanding of such terms by the faculty and post- graduates of a tertiary care hospital that deals with the admission and care of such patients.
Method:
They were administered a questionnaire containing these terms and asked to provide the meaning of these terms.
Results:
The results showed that nearly half the faculty and students were not having clarity in awareness or understanding of the terms.
Discussion:
Hence these terms and their meanings were gleaned from various judgments. The proper meaning of these terms and their use in judicial process and their importance is discussed.
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REVIEW ARTICLES
Nonpharmacological interventions for children with attention deficit hyperactivity disorder in India: A comprehensive and comparative research update
Sujata Satapathy, Vandana Choudhary, Renu Sharma, Rajesh Sagar
September-October 2016, 38(5):376-385
DOI
:10.4103/0253-7176.191382
PMID
:27833218
The nonpharmacological treatments for children with attention deficit hyperactivity disorder (ADHD) have witnessed a sea change from a rudimentary and haphazard psychosocial to cognitive interventions to social and behavioral skills to body oriented interventions to more sophisticated neurocognitive interventions. As the objective of each treatment varied, the method or procedure of each treatment also differed across studies. Indian research although not very rigorous, did witness changes emphasizing on exploring interventions in reducing symptoms and improving overall behavior. The research literature between 2005 and 2015 was searched using PubMed, Google Scholar, IndMED, MedIND, ResearchGate, and other indexed databases. Results of 110 studies were organized into five broad categories of themes of interventions such as psychosocial, body-focused, cognitive/neuro-cognitive, and cognitive behavioral. Effects of ADHD on cognitive, academic, and behavioral outcomes were also highlighted before the themes of intervention to establish linkage with discussion. However, a limited number (
n
= 9) of reported Indian studies focusing either on the impact of ADHD on the function of children or on interventions were found, suggesting a huge gap between global and Indian research in the area of children with ADHD. It also highlights the need for development and efficacy testing of indigenous intervention program in different areas of intervention for research and clinical practice.
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ORIGINAL ARTICLES
Development of a social skills assessment screening scale for psychiatric rehabilitation settings: A pilot study
Poornima Bhola, Chethan Basavarajappa, Deepti Guruprasad, Gayatri Hegde, Fatema Khanam, Jagadisha Thirthalli, Santosh K Chaturvedi
September-October 2016, 38(5):395-403
DOI
:10.4103/0253-7176.191392
PMID
:27833220
Context:
Deficits in social skills may present in a range of psychiatric disorders, particularly in the more serious and persistent conditions, and have an influence on functioning across various domains.
Aims:
This pilot study aimed at developing a brief measure, for structured evaluation and screening for social skills deficits, which can be easily integrated into routine clinical practice.
Settings and Design:
The sample consisted of 380 inpatients and their accompanying caregivers, referred to Psychiatric Rehabilitation Services at a tertiary care government psychiatric hospital.
Materials and Methods:
The evaluation included an Inpatient intake Proforma and the 20-item Social Skills Assessment Screening Scale (SSASS). Disability was assessed using the Indian Disability Evaluation and Assessment Scale (IDEAS) for a subset of 94 inpatients.
Statistical Analysis Used:
The analysis included means and standard deviations, frequency and percentages, Cronbach's alpha to assess internal consistency,
t
-tests to assess differences in social skills deficits between select subgroups, and correlation between SSASS and IDEAS scores.
Results:
The results indicated the profile of social skills deficits assessed among the inpatients with varied psychiatric diagnoses. The “psychosis” group exhibited significantly higher deficits than the “mood disorder” group. Results indicated high internal consistency of the SSASS and adequate criterion validity demonstrated by correlations with select IDEAS domains. Modifications were made to the SSASS following the pilot study.
Conclusions:
The SSASS has potential value as a measure for screening and individualised intervention plans for social skills training in mental health and rehabilitation settings. The implications for future work on the psychometric properties and clinical applications are discussed.
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EDITORIAL
Health-care ethics and the free market value system
MS Reddy, Starlin Vijay Mythri
September-October 2016, 38(5):371-375
DOI
:10.4103/0253-7176.191387
PMID
:27833217
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ORIGINAL ARTICLES
A study of soft neurological signs and its correlates in drug-naive patients with first episode psychosis
Vanishree Gunasekaran, V Mathan Kumar Venkatesh, TV Asokan
September-October 2016, 38(5):408-413
DOI
:10.4103/0253-7176.191393
PMID
:27833222
Background:
Soft neurological signs are minor, non localizing, objective abnormalities, thought to reflect damage in cortical and sub-cortical connections or connections within different cortical regions. Regional structural grey matter anomalies have already been observed and correlated with the presence of cognitive deficits and presence of soft neurological signs in schizophrenic patients.
Materials and Methods:
Drug naive patients presenting with first episode of psychosis (FEP)were clinically evaluated for soft neurological signs using the Cambridge Neurological Inventory. The soft neurological signs scores were compared with scores in healthy volunteers. In the patient group, this score was also correlated with demographic and disorder variables.
Results:
Of the 30 patients with FEP, 60% were women. The average age of the participant was 36.2 years. The average duration of illness was 1.55 years. More than 50% of the patients had schizophrenia. 93.3% of patients with FEP had atleast one soft neurological sign compared to 16.6% of controls. The average score on BPRS was 25.86 and on PANSS was 39.29, and BPRS, PANSS scores had a significant correlation with total soft neurological signs score.
Conclusion:
There is a significantly higher incidence of soft neurological signs in patients with FEP, particularly schizophrenia. The presence of soft signs correlated with the severity of psychosis.
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CASE REPORTS
Self-injurious behavior in a young child with lesch-nyhan syndrome
Satyakam Mohapatra, Alok Jyoti Sahoo
September-October 2016, 38(5):477-479
DOI
:10.4103/0253-7176.191389
PMID
:27833236
Lesch-Nyhan syndrome (LNS) is a rare inherited disorder caused by a deficiency of the enzyme hypoxanthine-guanine phosphoribosyl transferase-1. Few reports on behavioral aspects especially self-injurious behavior in LNS patients are available. We report a case of LNS in an 8-year-old male child, who presented with characteristic self-injurious behavior.
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An unusual case of baclofen abuse
Soumitra Das, Dhanya Sasidharan Palappalllil, Sumesh Thoppil Purushothaman, Varun Rajan
September-October 2016, 38(5):475-476
DOI
:10.4103/0253-7176.191383
PMID
:27833235
Baclofen was initially used for the treatment of spastic conditions. Last decade has seen its emergence as a treatment of profound interest in alcohol dependence, opiates and cocaine abuse, and tobacco addiction. However, the published literature on baclofen abuse is sparse. Here, we report a patient with baclofen abuse.
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Effectiveness of metacognitive therapy in patients with social anxiety disorder: A pilot investigation
Jayasree Lakshmi, Paulomi Matam Sudhir, Mahendra Prakash Sharma, Suresh Bada Math
September-October 2016, 38(5):466-471
DOI
:10.4103/0253-7176.191385
PMID
:27833233
Metacognitive therapy (MCT) is a recent psychological intervention for emotional disorders. Its efficacy in social anxiety disorder (SAD) is yet to be established. Aims: We examined the effectiveness of an MCT in patients with SAD. A two group case–control design with baseline, post, and 3 months follow-up was adopted. The control group received training in applied relaxation (AR). Four patients with Diagnostic and Statistical Manual-IV diagnosis of social anxiety were sequentially allotted to receive either MCT or AR. Patients were assessed on postevent processing (PEP), social anxiety, depression, and fear on negative evaluation. Clinical significance was calculated. MCT was more effective than AR in reducing social avoidance, PEP, and self-consciousness. While overall both interventions were effective in reducing social anxiety, MCT was marginally more effective. MCT may be a promising therapeutic approach in the management of SAD.
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ORIGINAL ARTICLES
Creutzfeldt–Jakob disease phenotype and course: Our experience from a tertiary center
Sadanandavalli Retnaswami Chandra, Thomas Gregor Issac, Mariamma Philip, Veeranna Gadad
September-October 2016, 38(5):438-442
DOI
:10.4103/0253-7176.191376
PMID
:27833227
Introduction:
Prion diseases are protein conformation disorders and neither caused by viroid or virus but is a transmissible particle labeled a prion by Pruisner. Normal prion protein becomes infectious by a different folding, but the triggers are not known. Based on the characteristic brain pathology, they are grouped under spongiform encephalopathy affecting both man and animals. Estimated prevalence is one per million. Creutzfeldt–Jakob disease (CJD) registry from National Institute and Neurosciences (NIMHANS), Bengaluru, reported 69 cases in 30 years.
Patient and Methods:
Patients seen by our team from December 2011 to October 2015 who satisfied criteria for probable CJD were evaluated for clinical, electrophysiological, radiological, and demographic factors. None of them underwent histopathological examination of brain tissue or tonsils. Cerebrospinal fluid protein 14-3-3 was not done. All of them were followed up by telephonic inquiry for the course of the illness. All of them received symptomatic medications with anticonvulsants, flupirtine 200 mg orally daily, and other symptomatic medications.
Results:
Sporadic CJD is the most common form seen in India and is probably under reported. males seem to be more affected, and the mean duration for the bed bound state is 12 months. Drugs were only effective for a very brief period in controlling myoclonus and behavior.
Discussion:
Sporadic CJD is one of the most common and rapidly fatal forms of dementia in India. Cortical ribboning and periodic complexes are the most common laboratory findings. Familial CJD is a very rare occurrence and variant CJD is probably not prevalent.
Conclusion:
All patients with rapidly progressive dementia should be handled with biohazard precautions unless proved otherwise. Role of alcohol and smoking in the transformation of PrPc to PrPsc needs to be evaluated.
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Risk factors for substance use among street children entering treatment in India
Shibendu Bhattacharjee, Rajesh Kumar, Alok Agrawal, Kevin E O'Grady, Hendree E Jones
September-October 2016, 38(5):419-423
DOI
:10.4103/0253-7176.191375
PMID
:27833224
Background:
Although empirical studies have reported on substance use in children in India, multivariable statistical models examining risk factors in children seeking treatment for substance use are largely lacking. The goal of this study was to test a conceptual model predicting age of first use, duration of use of any psychoactive substance, and primary substance of choice from child and family characteristics in a sample of children entering substance use treatment.
Methods:
This was a single-sample cross-sectional study of 159 children entering a treatment and rehabilitation center in Delhi that provides substance use treatment and teaches children the skills to allow for their re-integration into society. De-identified data were extracted from clinical case records. Summary statistics were used to describe the sample characteristics. Regression analyses were used to examine the proposed conceptual model.
Results:
Child's age, schooling, and age at first crime were unrelated to age at first use of a psychoactive substance, duration of use of such substances, or choice of primary substance. However, parental and family factors served as risk factors for predicting one or more of these three outcomes.
Conclusions:
Findings suggest that child psychoactive substance use may have a multidimensional set of possible family and parental origins, and that child factors such as age, education, and age at first crime may play a lesser or insignificant role in a child's psychoactive substance use.
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Does birth order and academic proficiency influence perfectionistic self-presentation among undergraduate engineering students? A descriptive analysis
Preeti Tabitha Louis, Navin Kumar
September-October 2016, 38(5):424-430
DOI
:10.4103/0253-7176.191388
PMID
:27833225
Background:
Perfectionism is a multifaceted concept. It had both advantages and disadvantages. Perfectionistic traits have been associated with leadership and very intellectual people. The present study is an attempt to understand if engineering students possess perfectionistic orientation and whether it influences self-efficacy, social connectedness, and achievement motivation.
Materials and Methods:
The present study adopts a random sampling design to evaluate the presence of perfectionism as a personality trait among undergraduate engineering students (
N
= 320). Standardized inventories such as Almost Perfect Scale-Revised were administered first to identify perfectionists and second to differentiate the adaptive from the maladaptive perfectionists. Scheduled interviews were conducted with students to obtain information regarding birth order and family functioning.
Results:
Findings from the study reveal that there were a significant number of maladaptive perfectionists and that they experienced higher levels of personal and societal demands leading to a negative emotional well-being in comparison to the adaptive perfectionists. We also observed that first-born children were more likely to display a perfectionistic self-presentation and from scheduled interviews, we understood that paternal influences were stronger when it came to decision-making and display of conscientiousness.
Conclusion:
The study draws on important implications for helping students to understand perfectionism and to respond to demands of the family and societal subsystems in a positive and an adaptive manner.
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CASE REPORTS
Extrapyramidal side effects with low dose amisulpride: A report of two cases
Pattath Narayanan Suresh Kumar, Arun Gopalakrishnan
September-October 2016, 38(5):480-482
DOI
:10.4103/0253-7176.191391
PMID
:27833237
Amisulpride, recently introduced atypical antipsychotic, is well-known for its broad spectrum effectiveness and lower profile for extrapyramidal side effects (EPS). Its selective affinity for dopamine receptors in the limbic structures, but not in the striatum, leads to a low risk of extrapyramidal side effects. Here, we report two cases of EPS associated with lower dose of amisulpride. The proposed mechanism for its causation is also discussed. Authors invite more studies, specifically from the Indian context to find out the incidence of EPS and other associated side effects.
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ORIGINAL ARTICLES
Profile of patients attending psychogeriatric clinic in a tertiary care setting
Suresh Neethu, PV Indu, Prabhakaran Anil
September-October 2016, 38(5):404-407
DOI
:10.4103/0253-7176.191373
PMID
:27833221
Background:
Proportion of elderly is increasing among the total population of Kerala, and mental health problems of this group are unique.
Objectives:
To assess the clinical and sociodemographic profile of patients attending Psychogeriatric Clinic in a tertiary care center and to study the correlation of sociodemographic and clinical variables with psychiatric diagnoses in this population.
Materials and Methods:
A retrospective chart review of patients, who attended the Psychogeriatric Clinic of a tertiary care center over a period of 1 year, was done. The Institutional Ethics Committee discussed and waived clearance for the review.
Results:
There were 85 cases with a mean age of 69.5 years (standard deviation-7.36). Majority of them were females (56.5%) and belonged to low socioeconomic status (52.9%). Comorbid physical illnesses were seen in 76.5% cases. Diagnoses were made by Junior Residents in Psychiatry and confirmed by a qualified psychiatrist, as per International Classification of Diseases-10 criteria. The most common psychiatric diagnosis was organic mental disorders (24.7%), which included dementias, delirium, and organic mood disorders. This was followed by bipolar affective disorders (22.4%), schizophrenia and related disorders (20.0%), depressive and anxiety disorders (17.6%) and mental and behavioral disorders due to substance use (2.4%). Occurrence of organic psychiatric disorders showed positive correlation with age (Spearman's
ρ
=0.253,
P
= 0.02) and occurrence of hypertension (
ρ
=0.222,
P
= 0.04).
Conclusions:
Organic psychiatric disorders are more common in elderly patients attending a tertiary care center. Comorbid physical illnesses are seen in more than three-fourths of this population. Organic psychiatric disorders are seen more commonly with increasing age and occurrence of hypertension.
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CASE REPORTS
Hypocalcemia masquerading as schizophreniform disorder
Shivangi Mehta, Sahil Mehta
September-October 2016, 38(5):463-465
DOI
:10.4103/0253-7176.191386
PMID
:27833232
Among the symptoms of hypocalcemia, tetany, papilledema, and seizures may occur in patients who develop hypocalcemia acutely. We describe a rare case of hypocalcemia presenting as schizophreniform disorder. Among other presentations of hypocalcemia, one should also look for the relation between psychotic symptoms and calcium levels in a patient presenting with psychotic symptoms.
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ORIGINAL ARTICLES
Sexual dysfunction among females receiving psychotropic medication: A hospital-based cross-sectional study
Veda N Shetageri, Govind S Bhogale, NM Patil, RB Nayak, SS Chate
September-October 2016, 38(5):447-454
DOI
:10.4103/0253-7176.191379
PMID
:27833229
Background:
Sexual dysfunction (SD) is a known adverse effect of psychotropic medications. Even though sexual difficulties are common among women; very few studies have been carried out in India.
Objective:
To study the prevalence and nature of SD among females receiving psychotropic medications and to compare the SD among female patients receiving antipsychotics and antidepressants.
Materials and Methods:
Female investigator conducted a hospital-based cross-sectional study on female patients visiting the psychiatry outpatient department. Patients meeting inclusion criteria were assessed for SD disorder as per Diagnostic and Statistical Manual of Mental Disorders 4
th
Edition Text Revision. SD severity was measured using Female Sexual Function Index (FSFI) scale.
Results:
The prevalence of SD in this study was 68.32%. There was more than one SD in 48 (47.52%). FSFI score was significantly low in patients with SD as compared to patients not having SD (
P
= 0.001). SD was more common in patients who were on combination of antidepressants and benzodiazepines than antidepressant alone or antipsychotic alone.
Conclusion:
SD was prevalent in more than 50% of female patients on psychotropic drugs. Number of patients on individual psychotropic drugs was so small that a definite conclusion could not be drawn. Study emphasizes the need to carry out similar study on larger number of patients to get better insight into this problem.
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Psychiatric comorbidity and physical correlates in alcohol-dependent patients
Deepak Gauba, Pramod Thomas, Yatan P.S Balhara, Smita N Deshpande
September-October 2016, 38(5):414-418
DOI
:10.4103/0253-7176.191397
PMID
:27833223
Aim:
To examine the prevalence and pattern of comorbidity in alcohol dependence and its relationship with physical and laboratory findings.
Materials and Methods:
Eighty males with alcohol dependence were examined using the Hindi version of Diagnostic Interview for Genetic Studies, the International Classification of Disease-10
th
Edition Personality Disorder Examination, Alcohol Use Disorder Identification Test for alcohol use, global assessment of functioning, blood sampling electrocardiogram, and ultrasonogram.
Results:
Eighty-seven percent had a comorbid Axis I or an Axis II psychiatric disorder, over 78% had nicotine dependence, and 56% had comorbid Axis II disorder, antisocial personality being the most common. Gamma glutamyl transpeptidase levels were significantly associated with comorbidity.
Conclusions:
High comorbidity of Axis I psychiatric disorders was found among persons with alcohol dependence. Axis II disorders were also present.
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Minnesota multiphasic personality inventory-2 profiles of patients with gender identity disorder requesting sex reassignment surgery
Sagar Karia, Sanhita Jamsandekar, Alpa Alure, Avinash De Sousa, Nilesh Shah
September-October 2016, 38(5):443-446
DOI
:10.4103/0253-7176.191378
PMID
:27833228
Background:
Gender identity disorder (GID) is a distressing disorder characterized by a persistent unhappiness with one's own sex and a desire to be of the opposite sex as well as seeking sex reassignment surgery for the same. The aim of the study was to assess the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) profiles in patients with GID and examine differences in the profiles based on original gender of the patients.
Methodology:
Twenty-seven patients with GID that fulfilled the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Text Revision criteria for the same were participants of the study. They were administered the MMPI-2 and the scores across various scales were statistically analyzed. Before analysis, the sample was divided into groups according to gender, i.e., male-to-female and female-to-male patients who were requesting sex reassignment surgery.
Results:
No significant elevation of scores on any of the scales was noted in keeping with the fact that patients with GID usually demonstrate minimal psychopathology. All patients showed elevation on at least one subscale other than the masculinity-femininity subscale. No differences across gender were noted indicating that gender was probably not a determinant of psychopathology in GID.
Conclusions:
MMPI-2 profiles in patients with GID failed to reveal major psychopathology though the MMPI still remains a useful tool in the assessment of this population.
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CASE REPORTS
Acute dystonia after single dose of bupropion
Forouzan Elyasi, Elham Mahtiyan
September-October 2016, 38(5):460-462
DOI
:10.4103/0253-7176.191384
PMID
:27833231
Bupropion is an antidepressant that is effective in the treatment of major depressive disorders, smoking cessation, and sexual side effects of selective serotonin reuptake inhibitors. Acute dystonia is characterized by prolonged muscle contraction often represented by spasms of the head and neck muscles as well as occasional jaw clenching and temporomandibular joint syndrome. Although it is believed that dystonia is the result of an abnormality of the basal ganglia, its pathophysiology is still unclear. A few cases of dystonia resulting from bupropion have been reported in prior research papers. This case report discusses a patient who had a neck spasm painful enough to wake him up and dystonic distortion after taking only one dose of 75 mg bupropion. The patient was a young 34-year-old man with a diagnosis of obsessive-compulsive disorder treated with 60 mg fluoxetine. Bupropion was added to his medications because of sexual side effects caused by the fluoxetine. It seems that we must be careful to watch for dystonic symptoms when bupropion is mixed with other drugs that affect serotonin reuptake. Although dystonia is a rare side effect of bupropion, physicians should be aware of it and manage it if it occurs.
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BRIEF COMMUNICATION
Screening for depression among community-dwelling elders: Usefulness of the center for epidemiologic studies depression scale
Sebind Kumar, Anisha Nakulan, Sumesh Purushothaman Thoppil, Rejani Parameshwaran Parassery, Shaji Sivaraman Kunnukattil
September-October 2016, 38(5):483-485
DOI
:10.4103/0253-7176.191380
PMID
:27833238
Context:
Though common, depressive disorders often remain undetected in late life.
Aim:
To examine the usefulness of Center for Epidemiologic Studies Depression (CES-D) for identifying depression among older people.
Settings and Design:
Community resident older people (aged 65 years or more), were evaluated by clinicians trained in psychiatry, as part of a cross-sectional study of late-life depression. Assessments were done in the community.
Methods and Material:
The participants were assigned ICD-10 diagnoses and assessed using Montgomery-Asberg Depression Rating Scale (MADRS) and CES-D. A short version of CES-D with 10 items, translated to the local language Malayalam, was used.
Statistical Analysis:
The sensitivity and specificity of CES-D was evaluated against ICD-10 clinical diagnosis of depression. The correlation of CES-D and MADRS was assessed using Pearson correlation coefficient.
Results:
220 consenting adults from 3 wards of the Panchayath were assessed. On analysis of the Receiver Operating Characteristic (ROC) curve of CES-D scores in relation to clinical diagnosis, the large Area Under Curve (AUC) showed efficient screening and a cut off score of 4 in CES-D had a sensitivity of 97.7% and a specificity of 79.1% for depression. There was also good correlation between the MADRS and CES-D scores (0.838).
Conclusion:
CES-D is a short simple scale which can be used by health care professionals for detecting depression in older people in primary care settings.
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CASE REPORTS
Successful management of patient with treatment resistant schizophrenia and Swyer–James–macleod syndrome with clozapine
Arpit Parmar, Rajeev Ranjan, Rajesh Sagar
September-October 2016, 38(5):472-474
DOI
:10.4103/0253-7176.191396
PMID
:27833234
Swyer–James–Macleod syndrome (SJMS) is a rare disorder characterized by infective bronchiolitis. It typically presents with a history of recurrent chest infections during childhood. Cardinal sign of the disease includes the hyperlucency of the lung fields. Till date, only a few cases have been reported of this syndrome. We report a very unusual case of SJMS along with comorbid schizophrenia in a 20-year-old female and the successful management using clozapine.
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ORIGINAL ARTICLES
Prevalence and characteristics of cavum septum pellucidum in schizophrenia: A 16 slice computed tomography study
Sourav Khanra, Naveen Kumar Srivastava, Vivek Chail, Christoday Raja Jayant Khess
September-October 2016, 38(5):455-459
DOI
:10.4103/0253-7176.191381
PMID
:27833230
Objective:
Several significant midline abnormalities including cavum septum pellucidum (CSP) have been reported in schizophrenia. However, not all studies were able to replicate similar findings. Furthermore, very few of them were conducted with large samples.
Methods:
CSP was identified and graded with 16 slice computed tomography (CT) machine in 138 patients of schizophrenia and 64 controls.
Results:
We found 21.0% of patients in schizophrenia group had abnormal CSP compared to only 9.4% in control group (
P
= 0.047). Grade III was most frequent type (19.6%) in schizophrenia group.
Conclusions:
Our study adds to the existing literature suggesting abnormal CSP may reflect neurodevelopmental process in schizophrenia. The strength of our study was larger sample size. Limitations were use of CT, male predominance in schizophrenia group, the inclusion of nonpsychiatric patients in control group.
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November, 2008