Year : 2017 | Volume
: 59 | Issue : 6 | Page : 150--151
Young Psychiatrist Award
|How to cite this article:|
. Young Psychiatrist Award.Indian J Psychiatry 2017;59:150-151
|How to cite this URL:|
. Young Psychiatrist Award. Indian J Psychiatry [serial online] 2017 [cited 2020 Jul 9 ];59:150-151
Available from: http://www.indianjpsychiatry.org/text.asp?2017/59/6/150/197009
Challenging Unitary Psychosis: RS-fMRI Differences Between Psychotic And Non-psychotic Bipolar Disorder
Achalia Neuropsychiatry Hospital, email@example.com
Background: Bipolar disorder is a heterogeneous disorder with diverse symptoms, course and outcome. Whether the heterogeneity in clinical features is also reflected in neurobiology is not completely known. Studies have reported psychotic symptoms to be associated with poorer prognosis, aggregation within family, poorer cognitive functions. However, whether these differences are also seen in functional brain activity is under examined.
Methodology: 30 patients with bd and 30 age, gender and education matched healthy controls participated in the study. Out of 30 patients, 16 had lifetime history of psychotic symptoms. Resting state fMRI (RS-fMRI) data was obtained using 1.5 T scanner. Regional homogeneity (reho) a marker of RS-fMRI connectivity was analysed using rest toolbox with kendall correlation coefficient of 27.
Results: Compared to healthy controls, patients with psychotic symptom had higher reho in right cingulate gyrus, middle frontal and superior frontal gyri, left parahippocampal gyrus, left middle frontal gyrus and left thalamus and decreased reho in left superior frontal gyrus, left middle temporal gyrus. However those without psychotic symptoms had higher reho in right insula, left caudate, left precuneus, left inferior frontal gyrus and left middle frontal gyrus and decreased reho in right precentral gyrus, right superior temporal gyrus, right and left middle temporal gyrus.
Conclusion: Different pattern of abnormal local synchronization of spontaneous brain activity among BPAD patients with and without psychotic symptoms indicate possible differences in the underlying neurobiology for these clinical subgroups. Our findings are important in the background of growing recognition of shared psychopathology and neurobiology between schizophrenia and bipolar disorder. Future studies need to examine whether all bipolar patients share the similarities with schizophrenia or only a subgroup of patients.
Brain circultries lined to Opioid dependence: A controlled diffusion tensor imaging study
Departments of Psychiatry and Experimental Medicine and Biotechnology, Postgraduate Institute of Medical Education and Research, Chandigarh, firstname.lastname@example.org
Background: Drug addiction has been linked with micro-structural changes in the fronto-striatal white matter (wm) tracts. However, little is known regarding the onset (cause or effect of drug use) and reversibility of such changes. Methods: 30 direction-diffusion tensor imaging (dti) was employed to examine the wm integrity of various fronto-striatal circuitries, namely the orbito-frontal(ofc), anterior cingulate(ac), inferior frontal (ifc) circuit, and also the genu of corpus callosum(cc-g). Fractional anisotropy of age, gender, education, and handedness matched opioid dependent subjects[od,n=30],their non-substance dependent siblings[sg,n=30],opioid dependent subjects, currently abstinent[ag,n=15] and non-substance-dependent controls [cg, n = 15 ] were compared. Trait impulsivity and executive function were also assessed and compared. Results: compared to cg, od group had significantly lower fa in the bilateral ifc and right ofc. Reduced fa in the left ifc was also present in sg, when compared to cg, whereas sg had higher fa in the left anterior cingulum than od. Ag had significantly low fa in the left ifc and cc-g than cg. The non-planning impulsiveness score was significantly correlated with the fa of left ifc. Od had more impairment in wcst, compared to cg. Conclusion: wm changes in opioid dependence involve various fscs, implicated in poor decisional balance and impulsivity. Changes in the left ifc appear to predate the onset of addiction, conferring vulnerability, and persist during abstinence. The behavioral and neuro-psychological assessments concur with the imaging results.
Cognitive dysfunction and depression in end-stage renal disease outpatients undergoing haemodialysis
Darpan Kaur, MsPriyam Bhushan
MGM Medical College, Navi Mumbai, email@example.com
Background: End stage renal disease (ESRD) has become a worldwide public health problem. Currently, there is paucity of literature on cognitive dysfunction and depression in esrd from developing countries such as India.
Aims And Objectives: To study the prevalence and patterns of cognitive dysfunction and depression in ESRD patients undergoing haemodialysis.
Methodology: Open label, cross sectional hospital based study conducted at haemodialysis setting. Apriori sample size of 50 ESRD outpatients on haemodialysis fulfilling inclusion criteria and willing to participate were administered montreal cognitive assessment scale (moca) for cognitive dysfunction, hamilton depression rating scale (ham-d) for depression rating, predesigned data collection form and informed consent form. Data was statistically analyzed using spss with descriptive statistics and logical regression. ethics committee approval was obtained.
Results: Sample profile was 62% males and 38% females; average age being 52.38 years (sd=14.169) cognitive dysfunction was found in 96% of the patients; 52% had mild cognitive dysfunction, 40% had moderate, and 4% had severe cognitive dysfunction. The prevalence of depression was 76% with 52% having mild, 18% having moderate and 6% having severe depressive symptoms. Cognitive problems in domains of visuospatial/ executive functioning were the commonest. Significant correlation between cognitive dysfunction and depression severity (p value 0.004) and a positive relationship between serum creatinine levels and ham-d scores (r= 0.212) was present.
Conclusion: Depression and cognitive dysfunction symptoms are highly prevalent in esrd patients relevant clinical and research implications such as consultation-liaison psychiatry services and intervention-outcome based studies in esrd patients on hemodialysis are further recommended.
Key Words: Cognitive Dysfunction, Depression, End Stage Renal Disease, Haemodialysis
A study of clinical characteristics and pattern of non suicidal self injury (NSSI) among patients with suicide attempts: a tertiary care centre study
Hemendra Singh, MrsRadhika Kunnavil, Prof.Murali Thyloth
Department Of Psychiatry M. S. Ramaiah Medical College & Hospital, Bangalore. firstname.lastname@example.org
Title: A study of clinical characteristics and pattern of non suicidal self injury among patients with suicide attempts: a tertiary care centre study
Introduction: Non-suicidal self injury (NSSI), suicide ideation, and attempted suicide are often closely related. However, there is paucity of literature about the relationship and characteristics of nssi and suicide attempts.
Aim: To examine the characteristics of nssi among patients with suicide attempt.
Methods: One hundred patients with suicide attempt, aged 17-60, were systematically evaluated over a period of one year, for depression severity, hopelessness, suicide ideations, suicide intent, and past attempts (both suicidal and nssi) by using beck depression inventory, beck hopelessness scale, beck scale of suicide ideation, beck suicide intent scale, and non suicidal self injury assessment tool.
Results: Lifetime history of nssi was found to 36%. The number of lifetime suicide attempts ranged from 1 to 16 (m = 1.71, Sd = 1.79), And frequency of nssi ranged from 0 to 250 (m = 12.97, Sd = 41.35). Most frequently endorsed motives for nssi were to cope with uncomfortable feelings, to deal with frustration and anger. In patients with or without nssi, there were no significant difference in hopelessness, suicidal ideation and suicide intent. However, the frequency of nssi positively co-related with the number of suicide attempts (r = 0.404, P < .01) Independent of depression severity, hopelessness.
Conclusions: Nssi frequency appears to be an independent factor for increased suicide risk among patients with suicide attempts given that it has a positive association with the number of suicide attempts. This study emphasizes the need for developing culture specific awareness and preventive measures to identify and intervene in case of individuals with a history of nssi, so that risk of future suicide can be minimized.
Key Words: Non - Suicidal Self Injury, Suicide Attempt, Suicide