Year : 2019 | Volume
: 61 | Issue : 9 | Page : 362--363
Col Kripal Sing Final Award Papers
|How to cite this article:|
. Col Kripal Sing Final Award Papers.Indian J Psychiatry 2019;61:362-363
|How to cite this URL:|
. Col Kripal Sing Final Award Papers. Indian J Psychiatry [serial online] 2019 [cited 2020 Aug 7 ];61:362-363
Available from: http://www.indianjpsychiatry.org/text.asp?2019/61/9/362/250215
1 Age at first drink and severity of alcohol dependence.
Surg Capt K Chatterjee, MD (Psychiatry)a
Dept of Psychiatry, INHS Aswini, Mumbai
Lt Col AK Dwivedi, MD (Psychiatry)b
Dept of Psychiatry, Base Hospital Delhi Cantt, New Delhi
Lt Col R Singh, MD (Psychiatry)c
Dept of Psychiatry, Command Hospital (SC), Pune
Corresponding author : Lt Col AK Dwivedi
Early Age at First Drink (AFD) has been linked to early onset and increased severity of Alcohol Dependence in various studies. Few Indian studies on AFD have shown a negative correlation between age at first drink and severity of Alcohol Dependence. Our study aimed to explore this relationship in patients of Alcohol Dependence Syndrome (ADS) diagnosed using ICD-10 criteria.
Material and Methods:
One hundred and fifty one consecutive patients freshly diagnosed with ADS were included in the study, which was conducted at the psychiatry unit of a tertiary care,multi-specialty hospital. Addiction Severity Index (ASI) was used to assess severity of Alcohol Dependence.
Mean age at first drink was 24.85 years (range – 13 to 40 years). Mean ASI score was 36.07 (range– 21 to 57). The study yielded a weak negative correlation (ρ=−0.105) between AFD and ASI, which was statistically not significant.
We found no correlation between age at first drink and severity of alcohol dependence at detection in Indian armed forces personnel which is contrary to what has been reported worldwide and in previous Indian studies. Delayed initiation of alcohol use amongst those enrolling in the Indian armed forces and early detection of Alcohol Dependence within the military environment are possible explanations.
Alcohol dependence, age at onset, Addiction Severity, Armed Forces, Military
To correlate serum Brain Derived Neurotrophic Factor (BDNF) levels with severityof depression and treatment response among soldiers and their dependants in a tertiary care hospital.
Principal Author: Col(Dr) VS Chauhan, Assoc Prof, Psychiatry, AFMC Pune
BDNF is a modulator of neuroplasticity in the brain and is implicated in the pathophysiology of depression through the stress pathway. The information about correlation of BDNF levels with severity of depression in Indian population is lacking and very few studied subsequent assessment of BDNF levels after antidepressant treatment. Hence this study is being done to find out whether BDNF can be used as state marker for severity of depression and its level changes with anti-depressant treatment. Materials and Methods:
60 randomly sampled (lottery method) never treated patients with depression reporting to large tertiary care psychiatry unit from 01 Jan 2016 to 31 Dec 2016 were enrolled for the study. Socio-demographic data was collected. Diagnosis of depression was done as per ICD-10 criteria by psychiatrist. Hamilton depression rating scale (HDRS) was administered and accordingly scored. 60 age, sex and education-matched healthy volunteers were also enrolled for the study. Consent was obtained from all subjects. The study was approved by Institution ethics committee. Venous blood for BDNF levels was collected from all cases (before starting medication) and controls. Cases were reassessed after 04 weeks of treatment and again HDRS was administered and BDNF levels was assessed.
Mean serum BDNF was significantly lower in patients with depression (18.65 ng/ml) in comparison with healthy controls (27.7 ng/ml). The BDNF levels in never treated patients is negatively correlated with HRSD scores and has significant p value (<.05). However, BDNF levels taken after the period of treatment given does not correlate significantly with HSRD scores taken post treatment. Mean BDNF levels were lowest in severe depression and significantly lower than that of controls. The increase of the mean BDNF values in the patient group is clinically correlated with the treatment response as shown by variation of the HDRS scores.
Serum BDNF level is lower in never treated patients with depression compared to healthy controls. BDNF levels improve with treatment response. There is possible relationship between severity of depression and BDNF levels. It provides a basis for a strong case for BDNF as biomarker for severity of depression and its treatment response.
Keywords: Brain derived neurotrophic factor, depression, Hamilton depression rating scale
PSYCHOSOCIAL CORRELATES OF MEDICATION ADHERENCE IN PATIENTS WITH DEPRESSIVE ILLNESS: PERSPECTIVES FROM AN INDUSTRIAL PSYCHIATRIC SETUP
Jyoti Prakash MD*, T Madhusudan MD DNB PGDHCM#, YK Yadav MD+, Kalpana Srivastava PhD**
* Prof & Head Psychiatry, Command Hospital Eastern Command Kolkata
# Senior Adv & Head Psychiatry, Command Hospital Central Command Lucknow
+ Psychiatrist, Railways Hospital, Indian Railways
** Scientist G & Clinical Psychologist AFMC, Pune Email: email@example.com
Non-adherence to medication is common in depressive illness and the same may lead to increased risk of relapse, morbidity, burden of care and avoidable health cost. Factors which may cause non-adherence are multiple. Study of such nature in an industrial psychiatric setup is not known.
A study was undertaken in an industrial psychiatric setup to appreciate the role of various psychosocial factors in adherence to various antidepressant medication in the patients of depressive disorder. 150 patients after due consent were subjected to Medico-psychosocial Structured Performa, Becks Depression Inventory, The belief about Medicines Questionnaire and Morisky Medication Adherence Scale.
Non-adherence to antidepressant medication in our study was 73.33%. Characteristics of the disease, disease therapies, patient associated aspects including beliefs, social and economic support did affect medication adherence. CONCLUSION: Non-adherence to medication was common in patients with depressive illness. Finding emphasises the need to sensitise the patients about the importance of proper adherence and implementation of preventive measures in the standard industrial health protocol.
KEY WORDS: Depressive illness, medication adherence, antidepressants