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   2014| April-June  | Volume 36 | Issue 2  
    Online since April 17, 2014

 
 
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LETTERS TO EDITOR
Clinical potential of allopurinol in the treatment of bipolar disorder
Ram J Bishnoi
April-June 2014, 36(2):218-220
DOI:10.4103/0253-7176.131008  PMID:24860233
  1 1,431 53
Management of prolonged seizures during electroconvulsive therapy
Amy S Aloysi, Ethan O Bryson, Charles H Kellner
April-June 2014, 36(2):220-221
DOI:10.4103/0253-7176.131012  PMID:24860234
  1 918 46
ORIGINAL ARTICLES
Domestic violence as a risk factor for maternal depression and neonatal outcomes: A hospital-based cohort study
Rida Nongrum, Elsy Thomas, Jessie Lionel, Kuruthukulangara S Jacob
April-June 2014, 36(2):179-181
DOI:10.4103/0253-7176.130989  PMID:24860221
Objectives: This study attempted to follow up a cohort of women who presented to a tertiary hospital to investigate the effect of domestic violence on maternal and neonatal outcomes. Materials and Methods: Women, between 26-34 weeks of gestation, attending the obstetrics outpatient department, were recruited and followed up until delivery. They were assessed at recruitment and after delivery using the Edinburgh Postnatal Depression Scale, the Abuse Assessment Screen, and a pro forma to assess socio-demographic and clinical characteristics. Bivariate and multivariate statistics were employed to assess statistical significance. Results: One hundred and fifty women were recruited, 132 delivered in the hospital and were followed up. Domestic violence was associated with antenatal and postnatal depression, spouse's insistence of a boy baby, medical complications during pregnancy, preterm delivery, and lower birth-weight. Conclusion: Domestic violence has a significant impact on maternal and neonatal outcomes. Screening for domestic violence and interventions should be part of all antenatal programs. India should also employ public health approaches to change its patriarchal culture.
  1 1,770 109
Sexual crime in India: Is it influenced by pornography?
Suresh Bada Math, Biju Viswanath, Ami Sebastian Maroky, Naveen C Kumar, Anish V Cherian, Maria Christine Nirmala
April-June 2014, 36(2):147-152
DOI:10.4103/0253-7176.130976  PMID:24860215
Purpose: Studies on whether pornography poses a greater risk for sexually aggressive behavior have revealed conflicting results. This study aims to examine the relationship between the consumption of pornography and the subsequent increase in sexual violence, thus testing the hypothesis that increase in consumption of pornography is related to increased sexual crime, in the Indian scenario. Materials and Methods: The current study explored the association between reported incidence of crime over a period of four decades - 1971-2008 (time periods being divided into: Pre-liberalization and post-liberation - India adopted liberalization policy in 1992) and availability of pornography over internet with a particular focus on crime against women (such as rape, sexual harassment, and crime against women). Results: Comparison of pre-liberalization and post-liberalization growth of rape rates was not significant. Though there were statistically significant positive correlations between the number of internet users and sexual crime rates, the association was non-significant after controlling for the effects of population growth using regression analysis. Conclusion: Results presented needs to be interpreted with extreme care and caution. Nevertheless, the results from this study suggest that easy access to pornography did not have a significant impact on rape rates and crime rate against women.
  1 5,123 283
REVIEW ARTICLES
Evidence based psychosocial interventions in substance use
Sonali Jhanjee
April-June 2014, 36(2):112-118
DOI:10.4103/0253-7176.130960  PMID:24860208
In recent years, there has been significant progress and expansion in the development of evidence-based psychosocial treatments for substance abuse and dependence. A literature review was undertaken using the several electronic databases (PubMed, Cochrane Database of systemic reviews and specific journals, which pertain to psychosocial issues in addictive disorders and guidelines on this topic). Overall psychosocial interventions have been found to be effective. Some interventions, such as cognitive behavior therapy, motivational interviewing and relapse prevention, appear to be effective across many drugs of abuse. Psychological treatment is more effective when prescribed with substitute prescribing than when medication or psychological treatment is used alone, particularly for opiate users. The evidence base for psychological treatment needs to be expanded and should also include research on optimal combinations of psychological therapies and any particular matching effects, if any. Psychological interventions are an essential part of the treatment regimen and efforts should be made to integrate evidence-based interventions in all substance use disorder treatment programs.
  1 4,160 188
CASE REPORTS
Psychosis in a case of Kleine-Levin syndrome: A diagnostic challenge
Vasantmeghna Srinivasa Murthy, Amol Deepak Kelkar, Sushma Sanjiv Sonavane
April-June 2014, 36(2):192-194
DOI:10.4103/0253-7176.130993  PMID:24860224
Kleine-Levin syndrome (KLS) is a rare disorder of sleep diagnosed mainly on clinical grounds. It presents a unique diagnostic dilemma for neurologists and psychiatrists; especially due to a high risk of being diagnosed as a psychiatric condition like a mood disorder. However, there is literature available documenting the cooccurrence of psychiatric illnesses in patients diagnosed with KLS. The following case highlights the above points.
  - 1,173 52
Use of electroconvulsive therapy in an adolescent patient with catatonia
Sandeep Grover, Natasha Kate, Gaurav Gupta
April-June 2014, 36(2):195-197
DOI:10.4103/0253-7176.130994  PMID:24860225
There is lot of skepticism about the use of electroconvulsive therapy (ECT) in children and adolescents. However, available literature suggests that use of ECT can be at times life-saving in adolescents, especially those presenting with severe catatonia. We treated a 16-year-old female who presented to us with catatonia with a course of nine ECTs, with which she showed marked improvement. Review of the literature suggests that ECT should be considered as the second line treatment in the management of catatonia in adolescents.
  - 1,397 75
Fetishistic transvestism in a patient with mental retardation and psychosis
Rajmohan Velayudhan, Asfia Khaleel, Nideesh Sankar, Manoj Kumar, Firoz Kazhungil, Thazhe Mangool Raghuram
April-June 2014, 36(2):198-200
DOI:10.4103/0253-7176.130995  PMID:24860226
Fetishistic transvestism is a disorder of sexual preference associated with fantasies and sexual urges to dress in opposite gender clothing as a means of arousal and as an adjunct to masturbation and coitus. The disorder has been reported in people with learning disabilities. The disorder has been reported in a young male with dull normal intelligence. Transvestism though has been described in schizophrenia and psychosis and fetishism has been described in the course of simple schizophrenia, there are no reports of fetishistic transvestism in a patient with mental retardation and psychosis. A case of fetishistic transvestism in a patient with mental retardation and psychosis with treatment and relevant review of literature is reported.
  - 1,146 54
Induction of response to psychotropic medications in depression and panic after concurrent treatment of diabetes
Murthy Vasantmeghna Srinivasa, Bombe Abhijeet Pradeep, Lokhande Chetan Sadashiv, Shah Nilesh Bhagwandas
April-June 2014, 36(2):201-203
DOI:10.4103/0253-7176.130997  PMID:24860227
We present a case of depression with panic disorder, which did not respond to adequate psychiatric interventions over a period of several months. However, it improved completely with the diagnosis and treatment of diabetes mellitus. Hence, we infer that comorbid diabetes mellitus can render depression resistant to psychiatric interventions and must always be ruled out when treating patients who show poor response to adequate interventions for an adequate period of time. The role of antidepressants should also be considered in poor glycemic control.
  - 632 47
Child's play: Therapist's narrative
Rajakumari P Reddy, Uma Hirisave
April-June 2014, 36(2):204-207
DOI:10.4103/0253-7176.130998  PMID:24860228
Play has been recognized as an essential component to children's healthy development. Schools of play therapy differ philosophically and technically, but they all embrace the therapeutic and developmental properties of play. This case report is an illustration of how a 6-year-old child with emotional disorder was facilitated to express concerns in child-centered play therapy. The paper discusses the therapist's narration of the child's play.
  - 1,203 86
Very late-onset schizophrenia like psychosis: Case series and future directions
Era R Sharma, Ashish V Debsikdar, Nilesh M Naphade, Jyoti V Shetty
April-June 2014, 36(2):208-210
DOI:10.4103/0253-7176.130999  PMID:24860229
The quest to unravel the mysteries of schizophrenia has led to immense research in this area over the years. Previously schizophrenia was considered to strictly be an early onset disorder. However, the heralding of baby boomers, with a subsequent surge in the elderly population, has led to growing curiosity in the geriatric age group with schizophrenia. The nosology of late-onset and very late-onset schizophrenia like psychosis (VLOSLP) has remained contentious. The international late-onset schizophrenia (LOS) group has proposed that schizophrenia with an onset between ages 40 and 60 be termed LOS and above 60 years termed VLOSLP. We present two case reports of VLOSLP and its relevance to the present day context.
  - 1,558 75
Folie a trois : Atypical presentation as shared transient psychotic episode
VK Aravind, VD Krishnaram, Rupavathy A Vimala
April-June 2014, 36(2):211-214
DOI:10.4103/0253-7176.131002  PMID:24860230
Shared psychotic disorder or induced delusional disorder can occur in different clinical settings and profile and is not uncommon. A case of Folie a trois with atypical clinical presentation as shared acute transient episode in a bereavement setting is reported. Suggestibility, close association and intimacy of the affected persons and major stress as psychological trigger act as psychopathological factors.
  - 1,188 66
A rare case of imitation injury
Paakhi Srivastava, Rishab Gupta, Mohit Varshney, Pratap Sharan
April-June 2014, 36(2):215-217
DOI:10.4103/0253-7176.131005  PMID:24860231
The impact of media on cognitions and behaviors of adolescents is well-known. High frequency of exposure to media may distort the reality testing among predisposed youth, hence the rise in risk taking behaviors among this population. We present a rare manifestation of risk taking behavior in an adolescent who injected mercury in his body after exposure to a Hollywood film. The results of investigations and possible explanation to understand risk taking behavior in the present case are discussed.
  - 880 61
EDITORIAL
Irritability as a criterion in diagnosis of child and adolescent bipolar disorder: Thorny road ahead
MS Reddy
April-June 2014, 36(2):109-111
DOI:10.4103/0253-7176.130954  PMID:24860207
  - 997 82
LETTERS TO EDITOR
Should publications be the only means of assessment? Some alternatives!
Sundar Gnanavel
April-June 2014, 36(2):218-218
DOI:10.4103/0253-7176.131006  PMID:24860232
  - 598 74
ORIGINAL ARTICLES
Socio-emotional factors in alcohol dependence
Deyashini Lahiri Tikka, Daya Ram, Indu Dubey, Sai Krishna Tikka
April-June 2014, 36(2):153-157
DOI:10.4103/0253-7176.130978  PMID:24860216
Background: Alcohol-dependent patients are traditionally believed to have insecure attachment styles, higher anger expression, and lower self-esteem. There is a need to study them together. Aim: To understand the relationships amongst various of the socio-emotional factors. Materials and Methods: Forty male patients with Alcohol dependence syndrome and 40 matched healthy controls (General Health Questionnaire-12 score <3) were compared on attachment styles (on Relationship Scale Questionnaire), anger domains (on State Trait Anger Expression Inventory), and self-esteem (on Rosenberg Self-esteem Scale). Statistics and Analysis: Comparison using independent samples t test and chi square test; correlation using Pearson's correlation coefficient. Results: Patients had significantly higher anger expression, 'anger in' and 'anger out,' and lower self-esteem than healthy controls. Severity of alcohol dependence had significant correlation with 'anger out,' and self-esteem had significant negative correlation with anger expression. Conclusion: The present study suggests that the socio-emotional factors studied are developmentally linked to each other.
  - 1,894 119
A placebo controlled trial on add-on modafinil on the anti-psychotic treatment emergent hyperglycemia and hyperlipidemia
Pathapati Lakshmi Prasuna, Kommu John Vijay Sagar, Thatikonda Padma Sudhakar, Gundugurthi Prasada Rao
April-June 2014, 36(2):158-163
DOI:10.4103/0253-7176.130982  PMID:24860217
Modafinil is non stimulant drug which is marketed for mainly Narcolepsy and daytime drowsiness. The clinical experience and Summary of Product Characteristics (SPC) of the drug also mentions Anorexia as one of the side effects. Anorexia can have a direct impact on the carbohydrate and fat intake, which may, in turn, regulate antipsychotic induced dyslipidemia and Hyperglycaemia. Aim: To compare the effects of Modafinil- ADDON with Placebo add on with olanzapine, Clozapine and Risperidone in drug naive subjects and people who were started on the drugs within 15days of assessment. Materials and Methods: Randomized, Double blind, Placebo controlled study, which was conducted at two centres, one at department of Psychiatry, S.V Medical College, Tirupati and the other at Asha hospitals, Hyderabad. Seventy two patient were randomised, sixty three patients have completed the total study period of three months.The dose of Modafinil was 200 mgs constantly as Flexible doses of Olanzapine, Clozapine and Risperidone as per clinical need was given. A baseline, three week and twelve week assessments of Fasting blood Glucose and fasting Serum cholesterol were made and the groups were compared on these parameters. Results: From baseline to week 3 there was a significant raise in Fasting serum cholesterol followed by a fall from week 3 to week 12 in the Modafinil addon group, though it could not be considered a drug for hypercholesteremia like Statins in controlling hyperlipidaemia. The implications of these findings were discussed.
  - 1,814 100
Visual Image-induced Craving for Ethanol (VICE): Development, validation, and a pilot fmri study
Bharath Holla, Biju Viswanath, Sri Mahavir Agarwal, Sunil Vasu Kalmady, Ami Sebastian Maroky, Deepak Jayarajan, Rose Dawn Bharath, Ganesan Venkatasubramanian, Vivek Benegal
April-June 2014, 36(2):164-169
DOI:10.4103/0253-7176.130984  PMID:24860218
Background: Craving induction in a controlled environment is helpful in the research of craving mechanism and its role in development of alcohol dependence (AD). We describe a novel tool Visual Image-induced Craving for Ethanol (VICE) and its effects on brain activation with pilot functional magnetic resonance imaging (fMRI). Materials and Methods: Alcohol-related visual cues (ARCs) in 5 scenarios were photographed, which included pictures of bars, alcoholic beverage bottles, pouring of alcohol into glasses, glasses filled with alcohol, and scenes of people sipping alcohol, counterbalanced with neutral pictures (involving water, milk etc.,). Craving scores were obtained from 15 hospitalized patients with AD to validate this tool. In the pilot fMRI (3-Tesla) study, 5 patients were examined using VICE in a symptom provocation model. Group level-fixed effect analysis of brain activation differences was done using SPM8. Results: VICE showed a high internal consistency with Cronbach's α coefficient of 0.86, which confirmed its reliability. Concurrent validity of VICE was demonstrated via its convergence with the Penn Alcohol Craving Scale. ARCs had significantly greater mean craving scores than neutral cues in all the 5 scenarios (intentional validity). In the pilot fMRI, patients were found to have greater activation while viewing ARCs compared to the neutral cues in right insular cortex and deficient activation in right orbitofrontal cortex. Conclusions: The VICE is a reliable and valid measure of alcohol craving with promising clinical and translational research implications. Preliminary fMRI findings indicate it can be used as a symptom provocation tool for fMRI experiments.
  - 1,277 69
Olanzapine discontinuation emergent recurrence in bipolar disorder
Manu Arora, Samir Kumar Praharaj
April-June 2014, 36(2):170-173
DOI:10.4103/0253-7176.130986  PMID:24860219
Objective: The efficacy of atypical antipsychotics including olanzapine in acute treatment of manic episode has been established, whereas its role in maintenance treatment is not clear. Materials and Methods: Thirteen patients of bipolar disorder who were on regular treatment with mood stabilizer and subsequently relapsed into mania or depressive episode after discontinuation of olanzapine were studied for various socio-demographic and clinical factors using retrospective chart review. Results: There was no correlation found between the period of tapering olanzapine, time to recurrence of episode after discontinuation, and the dosage of olanzapine at the time of discontinuation. The predominant early signs of relapse after discontinuation of olanzapine included sleep disturbance (72.7%), lack of insight for change in behavior (72.7%), irritability (54.5%), and elevated mood (45.5%). Conclusion: Mood stabilizer alone as a maintenance therapy of bipolar disorder may be inadequate for long-term management. A low dose of olanzapine along with mood stabilizers might be useful for prevention of recurrence in bipolar disorder.
  - 1,244 69
Profile of nicotine use among alcohol dependent patients visiting a tertiary care center in north India
Rizwana Quraishi, Raka Jain, Yatan Pal Singh Balhara
April-June 2014, 36(2):174-178
DOI:10.4103/0253-7176.130987  PMID:24860220
Background: Use of tobacco among alcohol dependent population is quite frequent. This co-morbidity increases the risk for various diseases. Understanding the pattern of tobacco use with co-morbid alcohol use may help in planning appropriate prevention/treatment strategies. The study aimed at examining the profile and pattern of nicotine use among alcohol dependent patients visiting a tertiary care treatment center in North India. Materials and Methods: Male patients fulfilling diagnostics and statistical manual of mental disorder fourth edition, criteria for nicotine and alcohol diagnostics and statistical dependence, attending the out-patient department of the tertiary care treatment center were recruited after obtaining informed consent. The socio-demographic profile, drug use history, nicotine associated health problems and general health problem were recorded. Motivation to stop tobacco use was assessed qualitatively using the direct questions about their interest and intentions to quit. Results: A total of 150 subjects were included in the study. The mean age of the study sample was 37.6 ± 10.44 years. Tobacco was reported as the gateway drug in 90% of the cases. Exclusive bidi use reported in 42% of the subjects. Mean duration of bidi and co-morbid alcohol use was higher than cigarette or smokeless tobacco use. Self-reported health problems associated with nicotine use and general health was reported by 41% and 39% of the subjects. Unsuccessful past quit attempts was present in 85% cases. More than 90% of subjects remained interested in quitting the tobacco use. An increased liver enzyme (aspartate transaminase, alanine transaminase and gamma-glutamyl transferase) were observed in 43, 32 and 47% of the cases. Conclusion: The results suggest the nicotine and alcohol dependent patients represent a separate population requiring higher attention from the treating physician.
  - 917 80
Hypothyroidism and bipolar affective disorder: Is there a connection?
Bindu Menon
April-June 2014, 36(2):125-128
DOI:10.4103/0253-7176.130966  PMID:24860210
Context: Hypothalamic-pituitary-thyroid axis dysfunction in the pathophysiology of bipolar disorder has received less attention as compared with that in depressive disorder. Aims: To study the prevalence of hypothyroidism in patients diagnosed with bipolar disorder and compare it with a population norm. Settings and Design: The setting was the psychiatry inpatient unit of a tertiary care hospital. The design was retrospective and observational. Subjects and Methods: A retrospective observational study was performed, referring to the case records of 84 cases of bipolar disorder admitted to the Department of Psychiatry in a Tertiary Referral Center during the year 2010-2012. The prevalence of hypothyroidism both subclinical as demonstrated by elevated thyroid stimulating hormone (TSH) levels (cut-off value 4.2 μU/ml) and overt hypothyroidism (fasting T4 <0.92 ng/dl and TSH >4.2 μU/ml) was calculated. This was compared with the population prevalence of hypothyroidism as determined by an epidemiological study carried out in the year 2009, in the same region. The correlation between hypothyroidism, gender, lithium prophylaxis and family history of mood disorder was computed. Statistical Analysis: Percentage prevalence of hypothyroidism in the sample was calculated and compared to a population norm. The correlation between hypothyroidism, gender, lithium prophylaxis and family history of mood disorder was computed using the odds ratio (OR). Results: The total prevalence of hypothyroidism in both males and females in the bipolar group was comparable with that in the general population. There is a significant association between family history of mood disorder in first degree relatives and patients having hypothyroidism (OR 5.504 and P = 0.012). There were no statistically significant associations between thyroid abnormalities and age, duration of illness and lithium prophylaxis. Conclusions: There is no significant association between hypothyroidism and bipolar disorder. Family history of mood disorder and hypothyroidism show significant association. (OR -5.504 AND P = 0.012).
  - 2,603 176
A controlled study of serum lipid profiles in Indian patients with depressive episode
Bichitra Nanda Patra, Sudhir K Khandelwal, Rakesh K Chadda, Lakshmy Ramakrishnan
April-June 2014, 36(2):129-133
DOI:10.4103/0253-7176.130968  PMID:24860211
Background: Lower levels of circulating lipid fractions and cholesterol are risk factors for impulsivity and depressive disorder. A lower level of serum cholesterol is also associated with patients presenting with history of self-harm. Materials and Methods: A total of 30 depressive patients and 30 healthy matched control subjects were recruited from the department of Psychiatry of a tertiary care hospital. We measured serum total cholesterol (TC), low-density lipoprotein (LDL) and high-density lipoprotein cholesterol and triglyceride levels of both patient and control group. Results: The serum TC and LDL-cholesterol levels were found to be significantly lower in study group than that of control group. Conclusion: Lower levels of serum cholesterol are associated with depressive disorder.
  - 1,515 115
Consultation-liaison approach for the management of psychiatric manifestations in Parkinson's disease and related disorders: A report from Neuropsychiatric Hospital, India
Harish Thippeswamy, Biju Viswanath, Girish N Babu, V Senthil K. Reddi, Santosh K Chaturvedi
April-June 2014, 36(2):134-137
DOI:10.4103/0253-7176.130971  PMID:24860212
Background: Non-motor psychiatric manifestations of Parkinson's disease have been increasingly noted to contribute to morbidity and mortality. Materials and Methods: We studied the psychiatric manifestations among inpatients with Parkinson's disease and other movement disorders by examining the referrals (N = 127) to consultation-liaison psychiatry services from neurology/neurosurgery between July 2009 and April 2010 using structured clinical proforma. Results: Parkinson's disease and other movement disorders was the most common neurological diagnosis (19%). The most common reason for referral was depression (38%) followed by behavioral problems (33%). Post-assessment, depression rates were higher (54%) and behavioral manifestations were diagnosed as sleep problems (13%), organic psychiatric syndrome (13%), psychosis (8%), anxiety and obsessive compulsive disorder (8%), nil psychiatry (4%). Conclusion: Psychiatric comorbidity is high among in-patients with movement disorders and affective changes are common. Timely assessment using structured clinical proforma would help in enhanced detection of depression in patients with movement disorders.
  - 1,068 92
Expressed emotions in patients with obsessive compulsive disorder: A case control study
Sateesh R Koujalgi, Raghavendra B Nayak, Nanasaheb M Patil, Sameeran S Chate
April-June 2014, 36(2):138-141
DOI:10.4103/0253-7176.130972  PMID:24860213
Background: Expressed emotion (EE) is the attitude that the relatives show towards the illness and the person. EE is identified as a direct factor in the relapse of patients with psychological disorders. Literature on EE in anxiety disorders is limited. Role of EE in obsessive compulsive disorder (OCD) may help in better understanding of the role of social factors in OCD. Aim: To compare EE in patients with OCD and compare with controls. Materials and Methods: The sample included 30 cases and 30 age and sex matched controls. The patients were diagnosed as having OCD using International Classification of Diseases-10 Diagnostic Criteria for Research (ICD-10 DCR) criteria. Yale-Brown Obsessive Compulsive Scale (Y-BOCS) was used to assess severity of OCD among patients. General health questionnaire (GHQ) was used to rule out any psychiatric disorder among control population. EE was assessed in cases and controls using Family Emotional Involvement and Criticism Scale (FEICS). Chi-square test and t-test were used to assess the difference between two groups. Results: OCD patients in comparison controls had significantly increased total FEICS score (P = 0.001). There was an increase in both subscales of perceived criticism (PC) with P = 0.001 and emotional involvement (EI) with P = 0.001 in patients with OCD than controls. Conclusion: EE are significantly increased in patients with OCD. EE should be assessed regularly in patients with OCD.
  - 1,170 118
Mortality among inpatients of a psychiatric hospital: Indian perspective
Shireesh Shatwaji Shinde, Nagarajaiah, Janardhanan C Narayanaswamy, Biju Viswanath, Naveen C Kumar, BN Gangadhar, Suresh Bada Math
April-June 2014, 36(2):142-146
DOI:10.4103/0253-7176.130974  PMID:24860214
Objective: The objective of this study is to assess mortality and its correlates among psychiatric inpatients of a tertiary care neuropsychiatric hospital. Given the background that such a study has never been undertaken in India, the findings would have a large bearing on policy making from a mental health-care perspective. Materials and Methods: The medical records of those psychiatric inpatients (n = 333) who died during their stay at the National Institute of Mental Health and Neurosciences in past 26 years (January 1983 to December 2008) constituted the study population. Results: During the 26 years, there were a total of 103,252 psychiatric in-patient admissions, out of which 333 people died during their inpatient stay. Majority (n = 135, 44.6%) of the mortality was seen in the age group of 21-40 years. Most of the subjects were males (n = 202, 67%), married (n = 172, 56.8%) and from urban areas (n = 191, 63%). About, 54% of the subjects had short inpatient stay (<5 days, median for the sample). In 118 (39%) of the subjects, there was a history of physical illness. Leading cause of death were cardiovascular system disorders (n = 132, 43.6%), followed by respiratory system disorders (n = 45, 14.9%), nervous system disorders (n = 30, 9.9%) and infections (n = 31, 10.1%). In 21 (7%), cause of death was suicide. Conclusions: Identifying the factors associated with the death of inpatients is of utmost importance in assessing the care in a neuropsychiatric hospital and in formulating better treatment plan and policy in mental health. The discussion focuses on the analysis of different factors associated with inpatient mortality.
  - 1,028 100
Symptoms specificity of anxiety sensitivity dimensions in Korean adults
Young-Jin Lim
April-June 2014, 36(2):182-186
DOI:10.4103/0253-7176.130990  PMID:24860222
Context: Relation of three dimensions of anxiety sensitivity (AS) (physical concerns [PC], cognitive concerns [CC] and social concerns [SC]) with anxiety or depression has been inconsistently reported. One possible explanation on the mixed findings is the lack of reliable measurement that assesses AS dimensions. Aims: This study was aimed to examine the specificity of dimensions of AS to anxiety and depression in a sample of Korean adults. Settings and Design: Participants included 426 Korean adults who were recruited by means of advertisements requesting volunteers for the psychological assessments. Materials and Methods: Participants completed measures of AS, anxious symptoms and depressive symptoms. Statistical Analysis: Linear regression equations were constructed. Results: It was found that PC and SC showed specificity to anxiety after adjusting for depression, while CC showed specificity to depression after controlling for anxiety. Conclusions: The findings suggest specificity of PC and SC to anxiety and of CC to depression when their relationship was explored with the more reliable measurement. The present findings clarify the nature of dimensions of AS in Korean adults.
  - 776 36
The diagnostic accuracy and validity of the teen screen questionnaire-mental health for clinical and epidemiological studies in primary-care settings
MK Nair, Deepa Chacko, Venkateswaran Rajaraman, Babu George, Leena Samraj, Paul Swamidhas Russell
April-June 2014, 36(2):187-191
DOI:10.4103/0253-7176.130991  PMID:24860223
Background : To validate a brief, self-reported, Teen Symptom Questionnaire-Mental Health (TSQ-M), for identifying adolescents with mental ill-health, designed for conducting epidemiological studies and clinical work in primary-care settings. Materials and Methods: In this prospective, cross-sectional study of 146 adolescents, re­cruited six rural and urban schools, the newly developed TSQ-M as the measure for validation and General Health Questionnaire-12 item (GHQ-12) as the gold standard measure were administered by independent trained raters. Tests for diagnostic accuracy and validity were conducted. Results: A TSQ-M score of ≥29 (Sn=75.68%, Sp=68.06, +LR=2.37, -LR=0.36, PPV=70.9, NPV=73.1) with the AUC of 0.79, is suggested for screening use in Indian populations. Besides the adequate face and content validity, TSQ-M has moderate internal consistency (Cronbach's α = .64) suggesting that the construct of mental ill-health as conceptualized by TSQ-M has multiple sub-constructs. The presence of sub-constructs was demonstrated by an 8- factor structure, which explained 60% of variance. Conclusion: The TSQ-M is a psychometrically adequate, yet a brief measure, for clinical and research work in identifying mental ill-health among adolescents in primary-care settings in India.
  - 1,666 120
REVIEW ARTICLES
Religion, spirituality, and schizophrenia: A review
Sandeep Grover, Triveni Davuluri, Subho Chakrabarti
April-June 2014, 36(2):119-124
DOI:10.4103/0253-7176.130962  PMID:24860209
Religion and spirituality exert a significant role in the lives of many individuals, including people with schizophrenia. However, the contribution of religion and spirituality to various domains (psychopathology, explanatory models, treatment seeking, treatment adherence, outcome, etc.) has not received much attention. In this article, we review the exiting data with regards to the relationship of religion, spirituality, and various domains in patients with schizophrenia. Available evidence suggests that for some patients, religion instills hope, purpose, and meaning in their lives, whereas for others, it induces spiritual despair. Patients with schizophrenia also exhibit religious delusions and hallucinations. Further, there is some evidence to suggest that religion influences the level of psychopathology. Religion and religious practices also influence social integration, risk of suicide attempts, and substance use. Religion and spirituality also serves as an effective method of coping with the illness. Religion also influences the treatment compliance and outcome in patients with schizophrenia.
  - 4,221 197
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