Indian Journal of PsychiatryIndian Journal of Psychiatry
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   2005| October-December  | Volume 47 | Issue 4  
    Online since September 19, 2009

 
 
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ORIGINAL RESEARCH PAPERS
A comparative study of coping skills and body image: Mastectomized vs. lumpectomized patients with breast carcinoma
Fiona Mahapatro, Shubhangi R Parkar
October-December 2005, 47(4):198-204
DOI:10.4103/0019-5545.43051  PMID:20711305
Background: The diagnosis of breast cancer encompasses not only physical, but also social and psychological implications because of the importance of the breast in a woman's body image, sexuality and motherhood. Women may experience a range of concerns and fears including physical appearance and disfigurement, the uncertainty about recurrence and the fear of death. There are no Indian studies on this subject. Aim: This study explores the various concerns of mastectomized and lumpectomized (breast conserved) patients, determines the coping mechanisms employed and the resolution of concerns. The levels of anxiety and depression in both groups were also studied. Methods: Seventy-five patients with breast carcinoma (50 mastectomized and 25 lumpectomized) were evaluated. The concern and coping checklist of Devlen was used. The severity of anxiety and depression was measured using the Hospital Anxiety and Depression Scale (HADS). Results: Body image or disfigurement was a concern only in the mastectomized group. Concerns were equally resolved between the two groups except for sexual role and performance, wherein the concern was resolved to a lesser extent in the mastectomized group. Coping strategies employed were effective in the resolution of concerns except for sexual role and performance, and recurrence or relapse. No statistically significant difference was found in the depression and anxiety levels of the two groups. Conclusion: Concern regarding sexual role and performance was resolved to a lesser extent in the mastectomized group. Specific psychological intervention is necessary to enhance coping strategies with regard to concerns of body image, and sexual role and performance.
  2,422 200 2
EDITORIAL
Antipsychiatry: Meeting the challenge
Nimesh G Desai
October-December 2005, 47(4):185-187
DOI:10.4103/0019-5545.43048  PMID:20711302
  2,320 221 -
BRIEF RESEARCH COMMUNICATIONS
Family education in schizophrenia: A comparison of two approaches
R Thara, R Padmavati, A Lakshmi, P Karpagavalli
October-December 2005, 47(4):218-221
DOI:10.4103/0019-5545.43056  PMID:20711310
Background: Family education programme (FEP) for families of persons with schizophrenia is practised in several centres as a part of patient- and family-related services. Aim: This paper describes two models of FEP conducted at the Schizophrenia Research Foundation (SCARF), Chennai. Methods: The first programme was a part of a research study and was structured utilizing standard evaluation instruments. The second was flexible and tailored to the needs of the family members. Results: After the first programme, the psychopathology of patients and the burden of caregiving on primary caregivers did not show any significant difference but there was a significant gain in caregivers' knowledge with information and experience sharing. Most families seemed to prefer the second programme, which recorded better attendance and participation. Conclusion: Informal educational sessions with periodic 'across-the-table' re-inforcers may be more effective and practical in the Indian setting.
  2,059 286 3
ORIGINAL RESEARCH PAPERS
Tobacco and alcohol use in rural elderly Indian population
Anil Goswami, VP Reddaiah, SK Kapoor, Bir Singh, SN Dwivedi, Guresh Kumar
October-December 2005, 47(4):192-197
DOI:10.4103/0019-5545.43050  PMID:20711304
Background: Tobacco and alcohol use are serious health problems. Studies focusing on problems associated with tobacco and alcohol use in the elderly are limited. Aim: To find out the prevalence of tobacco and alcohol use among rural elderly population. Methods: This cross-sectional study was conducted in the intensive field practice area of the Comprehensive Rural Health Services Project in Ballabgarh in Faridabad, Haryana, a rural field practice area of the Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi. The sample was selected using stratified random cluster sampling. The participants were ?60 years of age at the time of interview. Data on tobacco and alcohol use pattern of 1117 elderly were collected during the interview. Results: The prevalence of smoking was 71.8% in men (n=490) and 41.4% in women (n=497). Among men smokers, 41.5% were light smokers (:-5 beedis/day), 42.9% were moderate smokers (6-20 beedis/day) and 15.6% were heavy smokers (>20 beedis/day). Among women smokers, 71.8% were light smokers, 23.8% were moderate smokers and 4.4% were heavy smokers. Regular alcohol intake was seen in 16.3% of the men compared with 0.8% of the women. Conclusion: The finding of a high prevalence of smoking and alcohol consumption among men in this rural population of India is of serious concern and therefore needs remedial measures.
  2,006 303 3
BRIEF RESEARCH COMMUNICATIONS
Suicidal ideation and attempts in patients with major depression: Sociodemographic and clinical variables
AS Srivastava, Rakesh Kumar
October-December 2005, 47(4):225-228
DOI:10.4103/0019-5545.43059  PMID:20711312
Background: There is a high risk of suicidal attempt in patients with depression. This risk varies according to the sociodemographic status and clinical presentation. Aim: To assess the prevalence of suicidal ideation and attempt in patients with major depressive disorder, and to find the correlation between the two. Methods: Sixty patients with major depressive disorder having suicidal ideation were recruited in the study. Of these, 10 had a history of suicidal attempt made in the past or current episode. Sociodemographic details were evaluated and the Hamilton Rating Scale for Depression (HAM-D) was administered. Results: Analysis of the data showed that the incidence of suicidal attempt was 16.6% in patients with suicidal ideation. Statistically, a higher risk of suicidal attempt was found in individuals <30 years of age. Single men, married women and students were more likely to attempt suicide; higher education was also a vulnerability factor. Attempters scored significantly higher in severity of suicidal ideation, agitation and paranoid symptoms whereas among non-attempters, hypochondriasis and general somatic symptoms were more often present. Conclusion: All patients expressing suicidal ideation do not attempt suicide. Young patients with depression, especially unmarried men, married women and students, having severe suicidal ideation with agitation or paranoid symptoms are more likely to attempt suicide.
  1,775 420 -
CASE REPORTS
Management of trichotillomania
Harprit Kaur, BS Chavan, Lok Raj
October-December 2005, 47(4):235-237
DOI:10.4103/0019-5545.43063  PMID:20711315
Hallopeau, a French dermatologist, coined the term trichotillomania (TM) to describe alopecia (baldness) caused by self-traction of the hair, but the term now encompasses the entire syndrome of pathological hair­pulling. It is a disorder of impulse control. The authors present three (adult and child) cases of TM managed successfully using a combination of pharmacotherapy and a package of behaviour therapy. Some psychopathological aspects of the disorder are also discussed.
  1,876 176 -
BRIEF RESEARCH COMMUNICATIONS
Psychiatric co-morbidity among alcohol dependants
N Heramani Singh, SG Sharma, Angelia M Pasweth
October-December 2005, 47(4):222-224
DOI:10.4103/0019-5545.43058  PMID:20711311
Background: Psychiatric disorders are common in alcoholics and such patients have a poorer prognosis. Aim: To determine the prevalence of psychiatric co-morbidity among alcohol-dependent subjects and to compare the prevalence of specific psychiatric disorders between them and a control group. Methods: The study assessed the prevalence of psychiatric co-morbidity in 100 alcohol-dependent subjects and 100 controls. A semi-structured proforma was used to record the sociodemographic variables and the history of alcohol abuse. Statistical analysis was done using the chi-square test. Results: The prevalence rate of psychiatric co-morbidity in alcohol-dependent subjects and controls was found to be 92% and 12%, respectively. The most common disorders were depression, antisocial personality disorder (ASPD) and phobia. There was a significant difference in the prevalence of psychiatric co-morbidity between alcohol-dependent subjects and controls. Conclusion: The findings indicate the need for an active consultation service for better insight into the prevention, treatment and outcome of alcohol dependence.
  1,471 450 1
CASE REPORTS
Isolated sleep paralysis
Neena S Sawant, Shubhangi R Parkar, Ravindra Tambe
October-December 2005, 47(4):238-240
DOI:10.4103/0019-5545.43064  PMID:20711316
Sleep paralysis (SP) is a cardinal symptom of narcolepsy. However, little is available in the literature about isolated sleep paralysis. This report discusses the case of a patient with isolated sleep paralysis who progressed from mild to severe SP over 8 years. He also restarted drinking alcohol to be able to fall asleep and allay his anxiety symptoms. The patient was taught relaxation techniques and he showed complete remission of the symptoms of SP on follow up after 8 months.
  1,779 119 -
BRIEF RESEARCH COMMUNICATIONS
Psychological symptoms in women in a primary care setting in Tamil Nadu
Edwina Lawson, Tom Craig, Dinesh Bhugra
October-December 2005, 47(4):229-232
DOI:10.4103/0019-5545.43060  PMID:20711313
Background: Common mental disorders, especially depression, are likely to increase as a result of globalization and industrialization and it is likely that the resultant burden of care will increase proportionately. Women have a higher prevalence of depression and also carry the burden of caring for the affected individuals. Aim: To study the psychological symptoms with possible common mental disorders in a primary care setting. Methods: One hundred two women of Tamil ethnicity were approached to take part in answering the Self­Report Questionnaire (SRQ). The mean age of cases and non-cases were 39 years and 33 years, respectively. Results: Nearly three-fifths scored above the cut-off point. Age, physical illness and chronic pain were found to be important factors in the genesis of depression in particular. Conclusion: These findings have major implications for any preventative or intervention strategies.
  1,335 160 1
CASE REPORTS
Dermatitis artefacta
Bimal Tamakuwala, Parag Shah, Kamlesh Dave, Ritambhara Mehta
October-December 2005, 47(4):233-234
DOI:10.4103/0019-5545.43061  PMID:20711314
Dermatitis artefacta, also known as factitious dermatitis, is a condition in which cutaneous lesions are self ­inflicted and are the result or manifestation of some psychological conflicts. This report presents the case of a 20-year-old man, whose initial presentation resembled a dermatological disorder. Psychological and personality factors as well as issues in the management are discussed.
  1,312 133 1
COMMENTARIES ON THE COST OF ILLNESS OF SCHIZOPHRENIA
Perspective from an NGO
R Thara
October-December 2005, 47(4):212-214
DOI:10.4103/0019-5545.43054  PMID:20711308
  1,223 172 -
CASE REPORTS
Effectiveness of fluoxetine in the treatment of skin-picking
RC Sharma, NL Sharma
October-December 2005, 47(4):241-242
DOI:10.4103/0019-5545.43065  PMID:20711317
The case of an 18-year-old girl with skin-picking is reported. The patient used to pick at healthy skin and small skin lesions, leading to ulceration, hyperpigmentation and disfigurement. She recovered almost fully with fluoxetine. The implications of diagnosis and the need for early treatment are discussed.
  1,243 95 1
COMMENTARIES ON THE COST OF ILLNESS OF SCHIZOPHRENIA
Overview and emerging trends
Sandeep Grover, Ajit Avasthi, Subho Chakrabarti, Paramanand Kulhara
October-December 2005, 47(4):205-210
DOI:10.4103/0019-5545.43052  PMID:20711306
  1,106 216 1
LETTERS TO EDITOR
Psychotropic drug utilization pattern among patients with schizophrenia
Shakti Bala Dutta, DC Dhasmana, Reena Bhardwaj
October-December 2005, 47(4):243-244
DOI:10.4103/0019-5545.43066  PMID:20711318
  1,057 152 1
Combination of ECT and clozapine in drug-resistant schizophrenia
S Kurian, P Tharyan, KS Jacob
October-December 2005, 47(4):245-245
DOI:10.4103/0019-5545.43067  PMID:20711319
  994 183 1
ORIGINAL RESEARCH PAPERS
Parental deprivation due to death in male soldiers with psychiatric disorders
M.S.V Kama Raju, Kalpana Srivastava, M Diwakar, PS Bhat
October-December 2005, 47(4):188-191
DOI:10.4103/0019-5545.43049  PMID:20711303
Background: The importance of early relationship with parents has been stressed by most personality theorists. Deprivation of the nurturing influence can lead to an adverse impact. Aim: To study the effect of early parental loss in the development of adult psychiatric disorder. Methods: A total of 289 soldiers suffering from assorted ICD-10 identified psychiatric disorders were studied to ascertain parental losses during their developmental period. The findings were compared with those of 127 patients drawn from general medical wards. Results: A higher percentage of psychiatric patients had lost their parents before the age of 18 years compared with medical patients (21.5% vs. 8.7%). The difference, which was highly significant, was due to bipolar disorder to some extent and alcohol dependence syndrome to a larger extent. Loss of the father appears to be more significant than loss of the mother. Parental loss is found to be not a significant factor in depression and neurotic disorders. There is no excess of maternal loss in cases of depression. Conclusion: This study indicates that parental loss is a significant factor in the future development of psychiatric disorders. It does not appear to be an important factor in the development of neurotic disorders. The aspect requires comprehensive evaluation.
  1,044 98 -
COMMENTARIES ON THE COST OF ILLNESS OF SCHIZOPHRENIA
Perspective from a general hospital psychiatric unit
Smita N Deshpande
October-December 2005, 47(4):210-212
DOI:10.4103/0019-5545.43053  PMID:20711307
  929 124 -
A community-based perspective
R Parthasarathy
October-December 2005, 47(4):215-217
DOI:10.4103/0019-5545.43055  PMID:20711309
  758 172 -
MY VOICE
Experience of depression: Need for support
Pratibha Bajpai
October-December 2005, 47(4):246-247
DOI:10.4103/0019-5545.43068  PMID:20711320
  757 76 -