Year : 2005 | Volume
: 47 | Issue : 1 | Page : 51--53
Neurocognitive function in women affected by the Bhopal gas disaster
RN Sahu1, GP Naik2, Asha Dusad1, Vikas K Agrawal1,
1 Department of Psychiatry, Hamidia Hospital, Gandhi Medical College, Bhopal, MP, India
2 Department of Community Medicine, Hamidia Hospital, Gandhi Medical College, Bhopal, MP, India
R N Sahu
Department of Psychiatry, Gandhi Medical College, Bhopal, MP
Background: Methyl isocynate (MIC) is a reactive, toxic, volatile and inflammable gas. Exposure to MIC causes neurotoxicity and somatic abnormalities in human beings.
Aim : We compared neurocognitive function in MIC-exposed women and a control group, as well as cognitive function in the MIC group and examined them with reference to age.
Methods: The study sample comprised 30 women and a control group of 30 women. Both the groups were subjected to a detailed neuropsychiatric examination along with assessment of neurocognitive function using the PGI-Battery of Brain Dysfunction (PGI-BBD).
Results: Mean scores of immediate recall, visual retention, difference in performance quotient/verbal quotient, Nahar-Bensen and Bender-Gestalt test were significantly affected in MIC-exposed women. However, among MIC-exposed women, neurocognitive functions were similarly affected in women in various age groups.
Conclusion: Women in the MIC-exposed group had significant neurocognitive dysfunction in some specific areas as compared to women in the control group. The mean score of dysfunction rating of the PGI-BBD showed significant differences in neurocognitive functions between MIC-exposed and non-exposed women.
|How to cite this article:|
Sahu R N, Naik G P, Dusad A, Agrawal VK. Neurocognitive function in women affected by the Bhopal gas disaster.Indian J Psychiatry 2005;47:51-53
|How to cite this URL:|
Sahu R N, Naik G P, Dusad A, Agrawal VK. Neurocognitive function in women affected by the Bhopal gas disaster. Indian J Psychiatry [serial online] 2005 [cited 2019 Nov 17 ];47:51-53
Available from: http://www.indianjpsychiatry.org/text.asp?2005/47/1/51/46076
On the night of 2 December 1984, 40 tonnes of methyl isocynate (MIC) gas leaked from tank 610 of the Union Carbide India Limited factory in Bhopal into the surrounding environment. This leak of MIC gas, an extremely hazardous chemical, which occurred over a short span of a few hours, covered the city of Bhopal in a cloud of poisonous gas. The estimated mortality from this accident is believed to have been between 2500 and 5000, with up to 200,000 injured. 
Although the devastating psychiatric trauma caused by the disaster is well known, serious attention has not been given to it, in spite of significant psychiatric morbidity being reported, e.g. neuroses, anxiety and exacerbation of pre-existing adjustment reaction. 
Cytogenetic studies carried out by Ghosh et al. after the accident on a sample of 40 exposed males and 40 exposed females revealed a statistically higher frequency of chromosomal aberrations among those exposed compared with nonexposed controls.  These chromosomal aberrations were more pronounced in females.
The present study was carried out to assess the effects of MIC gas on neurocognitive functions among exposed and unexposed women.
This prospective study was carried out from May 2004 to April 2005.
The sample for the present study comprised 30 women, selected randomly from patients attending Kamla Nehru Hospital (a specialized centre for the treatment of gas victims), Jaiprakash Nagar and Quazi Camp. These areas were severely exposed to MIC.
The control group comprised 30 women drawn from the medical college hospital. They were relatives of patients attending/admitted in the medical or surgical wards (excluding psychiatric wards). Care had been taken to ensure that none of the subjects lived within 100 km of the factory, and had never resided in MIC-exposed areas. The study subjects were from Bhopal or nearby areas such as Vidhisha, Sehore, Bairagarh, etc. Both the groups belonged to a low socio-economic status and were matched for age (20-60 years) and education level (at least class 5). The study group was further divided into two age groups-20-40 years and 40-60 years.
Patients who had other organic causes of neurocognitive impairment, e.g. space-occupying lesions, encephalopathy, history of trauma, drug-induced impairment, infections or neurological disorders such as stroke, epilepsy, meningitis and encephalitis were excluded from the study.
A written consent was taken from subjects of both the study and the control groups. Both the groups underwent a detailed neuropsychiatric examination along with assessment of neurocognitive functions. The PGI-Battery of Brain Dysfunction (PGI-BBD) developed by Prasad D and Verma  was administered individually to all subjects. The score obtained was statistically analysed with the appropriate tools to assess the effects of MIC gas on neurocognitive functions.
The components of the PGI-BBD are as follows:
1. PGI Memory Scale (PGIMS)
2. Revised Bhatia Short Battery of Performance Tests of Intelligence (BSR-R)
-Koh block design
-Pass a long test
3. Verbal Adult Intelligence Scale (VAIS)
4. Nahar-Benson test
5. Bender visual motor Gestalt test (Bender-Gestalt test)
The Student t test was used to analyse the difference between mean scores of the PGI-BBD among cases and controls. A p value of  They found that severely affected victims had significantly impaired SPM, associated learning problems, motor speed and neurocognitive function. Gupta et al. studied 350 exposed subjects, 2.5 months after the accident occurred, and reported that auditory and visual memory, attention response speed and vigilance were significantly impaired in the MIC exposed group, in comparison with controls.  No significant difference in intelligence was found.
We found that the dysfunction score on VAIS showed that TQ on information, digit span, arithmetic and comprehension were slightly higher among MIC-affected women but it was not statistically significant. However, the difference in PQ/VQ was significantly higher (p 
In the present study, the dysfunction rating scores of all subtests of the PGI-BBD showed a significant difference (p 
The present study concludes that MIC can cause long-term neurocognitive impairment in an exposed population.
Thus, improvement in psychiatric services and psychological rehabilitation are essential for those affected by exposure to MIC. Community-based mental health programmes and group therapy are required to improve the personality and neurocognitive abilities of those living in gas-affected areas.
|1||Mehta PS, Mehta AS, Mehta SJ, et al. Bhopal tragedy's health affects: A review of methyl isocynate toxicity. JAMA 1990;264:2781-7.|
|2||Sethi BB, Sharma M, Trivedi HK, et al. Psychiatric morbidity in patients attending clinics in gas affected areas in Bhopal. Indian J Med Res 1987;86 (Suppl.):45-50.|
|3||Ghosh BB, Sengupta S, Roy A, et al. Cytogenetic studies in human population exposed to gas leak at Bhopal, India. Environ Perspect 1990;86:323-6.|
|4||Prasad D, Verma SK. PGI Battery of Brain Dysfunctions. Agra: National Psychological Corporation; 1985.|
|5||Mishra UK, Kalita J. A study of cognitive functions in methyl isocynate victims. One year after Bhopal accident. Neurotoxicity 1997;18:381-6.|
|6||Gupta BN, Rastogi SK, Chandra H, et al. Effects of exposure to toxic gas on the population of Bhopal. I: Epidemiological, clinical, radiological and behavioral studies. Indian J Exp Biol 1988;26:149-60.|
|7||Bhiman A. Study of organic brain damage in Bhopal gas victims. Consolidated report. Bhopal: Bhopal Gas Disaster Research Centre (ICMR), Gandhi Medical College; 1992:223-30.|
|8||Singer R, Scott NE. Progression of neuropsychological deficits following toluene diisocyanate exposure. Arch Clin Neuropsychol 1987;2:135-44.|