Indian Journal of Psychological Medicine
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ORIGINAL ARTICLES
A prospective, randomized double-blind, placebo-controlled study of safety and efficacy of a high-concentration full-spectrum extract of Ashwagandha root in reducing stress and anxiety in adults
K Chandrasekhar, Jyoti Kapoor, Sridhar Anishetty
July-September 2012, 34(3):255-262
DOI:10.4103/0253-7176.106022  PMID:23439798
Context: Stress is a state of mental or emotional strain or tension, which can lead to underperformance and adverse clinical conditions. Adaptogens are herbs that help in combating stress. Ayurvedic classical texts, animal studies and clinical studies describe Ashwagandha as a safe and effective adaptogen. Aims: The aim of the study was to evaluate the safety and efficacy of a high-concentration full-spectrum extract of Ashwagandha roots in reducing stress and anxiety and in improving the general well-being of adults who were under stress. Settings and Design: Single center, prospective, double-blind, randomized, placebo-controlled trial. Materials and Methods: A total of 64 subjects with a history of chronic stress were enrolled into the study after performing relevant clinical examinations and laboratory tests. These included a measurement of serum cortisol, and assessing their scores on standard stress-assessment questionnaires. They were randomized to either the placebo control group or the study drug treatment group, and were asked to take one capsule twice a day for a period of 60 days. In the study drug treatment group, each capsule contained 300 mg of high-concentration full-spectrum extract from the root of the Ashwagandha plant. During the treatment period (on Day 15, Day 30 and Day 45), a follow-up telephone call was made to all subjects to check for treatment compliance and to note any adverse reactions. Final safety and efficacy assessments were done on Day 60. Statistical Analysis: t-test, Mann-Whitney test. Results: The treatment group that was given the high-concentration full-spectrum Ashwagandha root extract exhibited a significant reduction (P<0.0001) in scores on all the stress-assessment scales on Day 60, relative to the placebo group. The serum cortisol levels were substantially reduced (P=0.0006) in the Ashwagandha group, relative to the placebo group. The adverse effects were mild in nature and were comparable in both the groups. No serious adverse events were reported. Conclusion: The findings of this study suggest that a high-concentration full-spectrum Ashwagandha root extract safely and effectively improves an individual's resistance towards stress and thereby improves self-assessed quality of life.
  30,163 359 1
A descriptive study on behavioral and emotional problems in orphans and other vulnerable children staying in institutional homes
Ravneet Kaur, Archana Vinnakota, Sanjibani Panigrahi, RV Manasa
March-April 2018, 40(2):161-168
DOI:10.4103/IJPSYM.IJPSYM_316_17  PMID:29962573
Introduction: Orphans and the other vulnerable children and adolescents (OVCA) living in institutional homes are more prone to behavioral and emotional problems than others as they are deprived of a family's love and care. There is a dearth of studies focusing on the psychological health of these children in India. Hence, we have conducted a cross-sectional descriptive study to explore the behavioral and emotional problems in these institutionalized children. Materials and Methods: The sample consisted of 292 orphans and OVCA in institutional homes of Visakhapatnam city. The sociodemographic data were collected using a semi-structured questionnaire. The Strengths and Difficulties Questionnaire (SDQ) with impact supplement was used to assess the behavioral and emotional problems in them. Results: In our study, 49 (16.78%) out of 292 children and adolescents were found to be having behavioral and emotional problems. Factors such as age, sex, reason for being in the institute, age of admission, and years of stay in the home were all seen to be significantly associated (P < 0.05) with emotional and behavioral problems. Conduct problems (34.90%) were found to be most prevalent followed by peer problems (15.80%), emotional problems (14.70%), hyperactivity (8.60%), and low prosocial behavior (3.40%). Conclusion: The present study shows that the orphans and OVCA in institutional homes are vulnerable to behavioral and emotional problems. The screening for conduct problems, emotional problems, hyperactivity, and peer problems needs to be done at a regular basis for these children. Given the paucity of data in this regard, several multicenter studies also need to be done to get an overall comprehensive view of these problems.
  28,756 531 -
REVIEW ARTICLE
How to calculate sample size for different study designs in medical research?
Jaykaran Charan, Tamoghna Biswas
April-June 2013, 35(2):121-126
DOI:10.4103/0253-7176.116232  PMID:24049221
Calculation of exact sample size is an important part of research design. It is very important to understand that different study design need different method of sample size calculation and one formula cannot be used in all designs. In this short review we tried to educate researcher regarding various method of sample size calculation available for different study designs. In this review sample size calculation for most frequently used study designs are mentioned. For genetic and microbiological studies readers are requested to read other sources.
  25,327 1,363 -
ORIGINAL ARTICLES
Impact of disability of mentally retarded persons on their parents
Thiyam Kiran Singh, Vishal Indla, Ramasubba Reddy Indla
July-December 2008, 30(2):98-104
DOI:10.4103/0253-7176.48482  
Mental retardation is a permanent condition unlike many other diseases. It is a highly prevalent and highly disabling condition. In this study an attempt has been made to study both positive and negative impact on parents so as to help manage this problem in the best possible way. The study was conducted at the outpatient department of P.G.I. Behavioral and Medical Sciences, Raipur, and two special schools of mentally challenged children and it was done by purposive sampling method. Using specially designed semi-structured sociodemographic and clinical data sheet, information was gathered about mentally challenged children and their parents. Vineland Social Maturity Scale (VSMS) and Developmental Screening Test (DST) were used to assess their intelligence. Parents fulfilling inclusion and exclusion criteria consenting for the study were selected. National Institute for the Mentally Handicapped Disability Impact Scale (2003) was then administered on them. The results are reported and discussed.
  23,383 1,250 1
REVIEW ARTICLE
Special employment exchange for persons with psychiatric disability
C Ramasubramanian
July-December 2008, 30(2):75-79
DOI:10.4103/0253-7176.48477  
  18,850 609 -
GUEST EDITORIAL
Mental healthcare Act 2017: Liberal in principles, let down in provisions
Manoj Therayil Kumar
March-April 2018, 40(2):101-107
DOI:10.4103/IJPSYM.IJPSYM_23_18  PMID:29962564
  14,505 761 -
REVIEW ARTICLES
Expressed Emotion in Schizophrenia: An Overview
Anekal C Amaresha, Ganesan Venkatasubramanian
January-March 2012, 34(1):12-20
DOI:10.4103/0253-7176.96149  
The expressed emotion (EE) is considered to be an adverse family environment, which includes the quality of interaction patterns and nature of family relationships among the family caregivers and patients of schizophrenia and other psychiatric disorders. Influence of EE has been found to be one of the robust predictors of relapse in schizophrenia. This review article aims to provide a brief description of the origins and evolution of the EE as a construct from the available literature. The EE is modulated by multiple factors-some of which include certain personality profile, attribution factors by caregivers toward patient symptoms, and patient's vulnerability to stress. The psychosocial assessment and interventions specifically focused on family psychoeducation can potentially reduce high EE and relapse of symptoms as well. However, the theory surrounded with EE undermines the caregiver's positive attitudes toward the patients. Hence, it is important that the future studies should focus on both protective and vulnerable factors within the construct of EE in schizophrenia to facilitate comprehensive care.
  9,495 527 3
CASE REPORTS
A giant trichobezoar causing rapunzel syndrome in a 12-year-old female
Nadeem Ul Nazeer Kawoosa, Babar Rashid Zargar
January-June 2011, 33(1):77-79
DOI:10.4103/0253-7176.85401  PMID:22021959
Bezoar is a tightly packed collection of undigested material that is unable to exit the stomach. Most bezoars are of indigestible organic matter such as hair-trichobezoars; or vegetable and fruit-phytobezoars; or a combination of both. Trichobezoars commonly occur in patients with psychiatric disturbances who chew and swallow their own hair. In very rare cases, the Rapunzel syndrome hair extends through the pylorus into the small bowel causing symptom and sign of partial or complete gastric outlet obstruction. A case report of trichobezoar in the stomach causing Rapunzel syndrome in a 12-year-old female is reported.
  9,731 65 2
Gratification disorder mimicking childhood epilepsy in an 18-month-old Nigerian girl: A case report and review of the literature
Aliyu Ibrahim, Belonwu Raymond
October-December 2013, 35(4):417-419
DOI:10.4103/0253-7176.122247  PMID:24379510
Gratification disorder is common in younger children, but is often unrecognized because unlike in adolescents, it does not involve manual genital manipulation and the clinical features are quite variable; therefore a thorough history, physical examination, and video recording of the events will go a long way in making the correct diagnosis, otherwise it could easily be misdiagnosed as epilepsy, nonepileptic paroxysmal movement disorder, or even gastrointestinal disorder.
  9,679 62 -
ARTICLES
A study of stress and psychiatric morbidity in the central industrial security force
G Prasad Rao, Khaja Moinuddin, P Geeta Sai, Eva Sarma, Angers Sarma, P Srinivasa Rao
January-June 2008, 30(1):39-47
DOI:10.4103/0253-7176.43133  
The Central Industrial Security Force (CISF) provides security cover to several of the Nation's vital industrial sectors and the CISF personnel are trained so as to meet expected and unexpected emergencies for varied periods of time. The present study is undertaken at the National industrial security Academy, NISA, Hyderabad with the objectives of assessing the psychiatric morbidity and the factors contributing to stress among the CISF personnel. A Random stratified sample of 500 subjects stratified to include personnel from all ranks such as SI's, Executive officials and constables are screened using the Goldberg's General Health Questionnaire. A detailed screening Questionnaire adapted from Channabasavanna S.M etal (1996) to assess the stress and coping was used. Those who are screened positive are further evaluated using the Mini International Neuro-psychiatric Interview, M.I.N.I to confirm the psychiatric diagnosis and using detailed personal interviews the factors contributing to stress in the CISF personnel are identified. The results of the study have shown that personnel posted in stressful areas and of the Rank of constables had perceived stress and more morbidity compared to those posted in nonstressful areas.
  8,801 447 -
ORIGINAL ARTICLES
Work-life balance among married women employees
N Krishna Reddy, MN Vranda, Atiq Ahmed, BP Nirmala, B Siddaramu
July-December 2010, 32(2):112-118
DOI:10.4103/0253-7176.78508  PMID:21716777
Family-work conflict (FWC) and work-family conflict (WFC) are more likely to exert negative influences in the family domain, resulting in lower life satisfaction and greater internal conflict within the family. Studies have identified several variables that influence the level of WFC and FWC. Variables such as the size of family, the age of children, the work hours and the level of social support impact the experience of WFC and FWC. However, these variables have been conceptualized as antecedents of WFC and FWC; it is also important to consider the consequences these variables have on psychological distress and wellbeing of the working women. Aim : to study various factors which could lead to WFC and FWC among married women employees. Materials and Methods : The sample consisted of a total of 90 married working women of age between 20 and 50 years. WFC and FWC Scale was administered to measure WFC and FWC of working women. The obtained data were analyzed using descriptive and inferential statistics. Carl Pearson's Correlation was used to find the relationship between the different variables. Findings and Conclusion : The findings of the study emphasized the need to formulate guidelines for the management of WFCs at organizational level as it is related to job satisfaction and performance of the employees.
  8,299 501 1
REVIEW ARTICLES
Dhat syndrome: A review of the world literature
Koushik Sinha Deb, Yatan Pal Singh Balhara
October-December 2013, 35(4):326-331
DOI:10.4103/0253-7176.122219  PMID:24379489
Dhat syndrome is described as a culture bound syndrome (CBS). There is an ongoing debate on the nosological status of CBS. Dhat syndrome has been found to be prevalent in different geographical regions of the world. It has been described in literature from China, Europe, Americas, and Russia at different points of time in history. Mention of semen as a "soul substance" could be found in the works of Galen and Aristotle who have explained the physical and psychological features associated with its loss. However, the current classification systems such as International Statistical Classification of Diseases and Related Health Conditions-10 (ICD-10) (World Health Organization (WHO)) and Diagnostic and Statistical Manual (DSM)-IV-TR (American Psychiatric Association) do not give guidelines to diagnose these culture-bound conditions in the main text. The revisions of these two most commonly used nosological systems (the ICD and DSM) are due in near future. The status of this condition in these upcoming revisions is likely to have important implications. The article reviews the existing literature on dhat syndrome.
  7,765 260 1
Contemporary perspectives on spirituality and mental health
Pulkit Sharma, Ruby Charak, Vibha Sharma
January-June 2009, 31(1):16-23
DOI:10.4103/0253-7176.53310  PMID:21938086
The paper strives to elucidate the complex yet intimate relation between spirituality and mental health from contemporary perspectives. The diverse and constantly evolving views that spiritualists and mental health professionals have held toward each other over last century are discussed with special accent on the transpersonal spiritual framework within psychology. The role of spirituality in promoting mental health and alleviating mental illness is highlighted. The paper is concluded with an increasing need to integrate spirituality within the mental health field albeit there are several impediments in achieving the same, which need to be worked through circumspectly.
  7,254 650 2
ORIGINAL ARTICLES
Emotion recognition deficits in antipsychotic-naive schizophrenia
Balaji Bharadwaj, Rashmi Arasappa, Rishikesh V Behere, Ganesan Venkatasubramanian, PN Jayakumar, BN Gangadhar
July-December 2008, 30(2):90-97
DOI:10.4103/0253-7176.48481  
Background: Emotion recognition deficits in schizophrenia form an important component of deficits seen in the disorder. Emotion recognition abilities correlate well with symptom dimensions and sociooccupational outcome of the disorder. The influence of pharmacological treatment on brain functions makes it important to design studies examining emotion recognition in drug-naive patients. However, emotion recognition deficits in antipsychotic-naive schizophrenia patients have not been previously examined. Methods: In this study, TRENDS - A Tool for Recognition of Emotions of Neuropsychiatric Disorders - a tool validated in Indian population, was used to assess emotion recognition abilities of antipsychotic-naive schizophrenia patients ( n = 20) and group-matched healthy controls ( n = 20). Results: The study showed significant deficits in emotion recognition in patients, especially with regard to fear ( P = 0.001), followed by disgust ( P = 0.006), and anger ( P = 0.017). The under-recognition of these emotions was positively correlated with high negative symptom scores ( r = 0.470; P = 0.018) and negatively correlated with high positive symptom scores ( r = -0.447; P = 0.048). Conclusions: Presence of significant emotion recognition abnormalities in antipsychotic-naive schizophrenia suggests that these abnormalities might be intrinsically related to the pathogenesis of this disorder.
  7,378 213 -
EDITORIAL
Depression: The disorder and the burden
MS Reddy
January-June 2010, 32(1):1-2
DOI:10.4103/0253-7176.70510  PMID:21799550
  7,025 472 9
ORATION
Burden of being a psychiatrist - professional stress
C Shamasundar
July-December 2008, 30(2):70-74
DOI:10.4103/0253-7176.48476  
Psychiatrists suffer professional stress. This is being studied for about four decades in the West, but not in India. The reported etiological factors are related to the nature of the profession and clinical situations, characteristics of the psychiatrist, and of the patient. But, there are many unanswered questions. This article briefly overviews the topic, poses few questions, and suggests certain remedial paradigms. The theme of this article applies equally well to mental health profession in general.
  6,764 374 1
ORIGINAL ARTICLES
Effect of fluoxetine on some cognitive functions of patients of depression
Jaykaran , Pankaj Bhardwaj, ND Kantharia, Preeti Yadav, Arvind Panwar
January-June 2009, 31(1):24-29
DOI:10.4103/0253-7176.53311  PMID:21938087
Background: This study was carried out to evaluate the effect of long-term administration of a commonly prescribed antidepressant, fluoxetine from different group on memory and psychomotor functions in patients of various psychiatric disorders using a battery of simple tests that can be conveniently applied to the Indian population. Materials and Methods: Memory was evaluated using the PGI memory scale and psychomotor functions were evaluated using six letter cancellation test. Statistical analysis was carried out using Wilcoxon signed-rank test. Results and Conclusion: The results of the study reveal that there was significant improvement in some cognitive function. Cognitive functions are improved at first follow-up and they improved continuously up to last follow-up that is at one month. It is observed that there was improvement in the primary disease. So, final score of the cognitive parameters is because of the resultant activity of direct drug action and improvement in the underlying disease.
  6,440 419 -
ARTICLE
Limits to psychiatry and limitations of psychiatrists
K Chandra Sekhar
January-June 2008, 30(1):6-10
DOI:10.4103/0253-7176.43128  
  6,511 298 -
REVIEW ARTICLES
Neuroanatomical, neurochemical, and neurodevelopmental basis of obsessive-Compulsive symptoms in schizophrenia
Ganesan Venkatasubramanian, Naren P Rao, Rishikesh V Behere
January-June 2009, 31(1):3-10
DOI:10.4103/0253-7176.53308  PMID:21938084
The prevalence of the obsessive-compulsive symptoms in schizophrenia (OCSS) appears to be higher than that expected on the basis of comorbidity rates. Review of brain abnormalities in schizophrenia and obsessive-compulsive disorder (OCD) reveals involvement of similar regions namely the frontal lobe, the basal ganglia, the thalamus, and the cerebellum, in both the disorders. Neurodevelopmental etiopathogenesis has been proposed to explain schizophrenia as well as OCD. Significant overlap in neurotransmitter dysfunction (serotonin, glutamate, and dopamine) has been documented between schizophrenia and OCD. The New-onset obsessive-compulsive (OC) symptoms have been reported with the use of atypical antipsychotics in the schizophrenia patients In this background, OCSS is an emerging area of recent interests. This article attempts to review the literature on the neurobiology of OCSS. Neuroimaging, neuropsychological, and neuromotor abnormalities in OCSS discussed in the context of neurodevelopmental etiopathogenesis suggest glutamate abnormalities in OCSS. Atypical antipsychotic induced OCSS points towards the possible roles of glutamate and serotonin. Dopamine may be responsible for the beneficial role of antipsychotics in the treatment of OCD. In summary, we propose that glutamate, serotonin, and dopamine abnormalities may be the probable basis for OCSS.
  6,232 527 3
NEW HORIZON
Need for a realistic mental health programme in India
Ankur Barua
January-June 2009, 31(1):48-49
DOI:10.4103/0253-7176.53316  PMID:21938092
India, with a population of a billion, has very limited numbers of mental health facilities and professionals in providing mental health care to all the people. The disability associated with mental or brain disorders stops people from working and engaging in other creative activities. Gradual implementation of district mental health programme in a phased manner with support of adequate managerial and financial inputs is the need of the day. Trained mental health care personnel, treatment, care, and rehabilitation facilities should be made available and accessible to the masses. The voluntary organizations should be encouraged to participate in mental health care programme.
  5,888 627 -
REVIEW ARTICLES
Mind, brain and psychotherapy
Hitesh C Sheth
January-June 2009, 31(1):11-15
DOI:10.4103/0253-7176.53309  PMID:21938085
There is long-standing debate about superiority of mind over brain, in other words about superiority of mind over matter. And outcome of this debate is going to decide future of psychiatry. The psychiatrists believing in materialism may say that brain is all and by changing neurotransmitters level with new molecules of drugs would cure all illnesses. On the other hand, antipsychiatry activists and some psychotherapists oppose all types of treatment despite of convincing evidence that drug therapy is effective (although sometimes it is not as effective as it claims to be). However, truth lies somewhere in between. Pharmacotherapy and psychotherapy are like two legs of psychiatry and psychiatry cannot walk into a future on one leg. The studies have shown that judicious use of pharmacotherapy along with psychotherapy gives better outcome than any one of them used alone. We must heal dichotomy between mind and brain before we heal the patients.
  5,871 506 -
Cognitive impairment and rehabilitation strategies after traumatic brain injury
Apurba Barman, Ahana Chatterjee, Rohit Bhide
May-June 2016, 38(3):172-181
DOI:10.4103/0253-7176.183086  PMID:27335510
Traumatic brain injury (TBI) is among the significant causes of morbidity and mortality in the present world. Around 1.6 million persons sustain TBI, whereas 200,000 die annually in India, thus highlighting the rising need for appropriate cognitive rehabilitation strategies. This literature review assesses the current knowledge of various cognitive rehabilitation training strategies. The entire spectrum of TBI severity; mild to severe, is associated with cognitive deficits of varying degree. Cognitive insufficiency is more prevalent and longer lasting in TBI persons than in the general population. A multidisciplinary approach with neuropsychiatric evaluation is warranted. Attention process training and tasks for attention deficits, compensatory strategies and errorless learning training for memory deficits, pragmatic language skills and social behavior guidance for cognitive-communication disorder, meta-cognitive strategy, and problem-solving training for executive disorder are the mainstay of therapy for cognitive deficits in persons with TBI. Cognitive impairments following TBI are common and vary widely. Different cognitive rehabilitation techniques and combinations in addition to pharmacotherapy are helpful in addressing various cognitive deficits.
  6,131 159 -
ORIGINAL ARTICLES
A comparative study of stress among students of medicine, engineering, and nursing
Shashank P Behere, Richa Yadav, Prakash B Behere
July-December 2011, 33(2):145-148
DOI:10.4103/0253-7176.92064  PMID:22345838
Background: In today's ultra competitive environment, students face more stress than ever - be it related to studies, examination, peer, teachers or parent's pressure. Stress is the "wear and tear" our bodies experience as we adjust to our continually changing environment. On one hand, stress compels us to action. However, it can result in feelings of rejection, anger, and depression, leading to health problems such as headaches, upset stomach rashes, insomnia, ulcers, high blood pressure, heart disease, and stroke. Materials and Methods: A cross-sectional questionnaire-based survey of 100 randomly selected students each from Medical College Engineering College and 50 Nursing College was done. For reliability, anonymity and confidentiality were maintained. Stress was measured by using stress measurement scale having 24 Yes/No questions. The questionnaire was in English and Hindi so that language would not be problem. Results: Stress as an entity is universally present among students of all three streams, irrespective of age, sex, and other variables. Students in all three streams have shown denial to existence of problems, with maximum among nursing students. Medical and Engineering students had stress level of such a degree that requires clinical attention, while none of the nursing students belonged to this category. Conclusions: There is attitude among students of turning a blind eye toward existing stress which is a serious problem and may be harbinger of serious mental and psychosocial problems.
  5,817 292 2
CASE REPORTS
Cognitive behavior therapy for Stuttering: A case series
RP Reddy, MP Sharma, N Shivashankar
January-June 2010, 32(1):49-53
DOI:10.4103/0253-7176.70533  PMID:21799560
The present investigation was aimed at studying the efficacy of cognitive behavior therapy (CBT) in reducing the symptoms of stuttering and dysfunctional cognitions and in enhancing assertiveness and quality of life in clients with stuttering. Five clients with stuttering who met the inclusion criteria (male clients with diagnosis of stuttering) and exclusion criteria (clients with brian damage), substance abuse or mental retardation were enrolled for the study. A single-case design was adopted. The pre-, mid- and post-assessment were carried out using Stuttering Severity Scale (SSI), Perception of Stuttering Inventory (PSI), Beck's Anxiety Inventory (BAI), Dysfunctional Attitude (DAS), Fear of Negative Evaluation (FNE), Assertiveness Scale (AS), Rosenberg's Self-Esteem Scale (RSES), and World Health Organization - Quality of Life Scale (WHO-QOL). Five clients received cognitive behavioral intervention comprising of psycho-education, relaxation, deep breathing, humming, prolongation, cognitive restructuring, problem-solving strategies and assertiveness. At post-treatment assessment, there was improvement. The findings of the study are discussed in the light of available research work, implications, limitations of the study and suggestions for future research.
  5,895 182 -
REVIEW ARTICLES
Reviewing Two Types of Addiction - Pathological Gambling and Substance Use
Seyed Amir Jazaeri, Mohammad Hussain Bin Habil
January-March 2012, 34(1):5-11
DOI:10.4103/0253-7176.96147  
Gambling, including pathological gambling and problem gambling, has received increased attention from clinicians and researchers over the past three decades since gambling opportunities have expanded around the world. Gambling disorders affect 0.2-5.3% of adults worldwide, although measurement and prevalence varies according to the screening instruments and methods used, and availability and accessibility of gambling opportunities. Several distinct treatment approaches have been favorably evaluated, such as cognitive behavioral and brief treatment models and pharmacological interventions. Although promising, family therapy and support from Gamblers Anonymous are less well empirically supported. Gambling disorders are highly comorbid with other mental health and substance use disorders, and a further understanding is needed of both the causes and treatment implications of this disorder. This article reviews definition, causes and associated features with substance abuse, screening and diagnosis, and treatment approaches.
  5,973 99 5
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