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   2008| October-December  | Volume 50 | Issue 4  
    Online since December 29, 2008

 
 
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GUEST EDITORIAL
Spirituality and mental health
Abraham Verghese
October-December 2008, 50(4):233-237
DOI:10.4103/0019-5545.44742  PMID:19823605
  4 7,004 1,058
PRESIDENTIAL COLUMN
Future perspective of planning child guidance services in India
PC Shastri
October-December 2008, 50(4):241-243
DOI:10.4103/0019-5545.44744  PMID:19823607
  3 4,199 401
CASE REPORTS
Cognitive rehabilitation for reversible and progressive brain injury
Ravi Samuel
October-December 2008, 50(4):282-284
DOI:10.4103/0019-5545.44752  PMID:19823615
Cognitive rehabilitation (CR) is a specialized treatment procedure to develop the cognition affected by internal or external injury to the brain. The process of cognitive rehabilitation involves assessment of cognitive functions, goal setting, and applying appropriate cognitive exercises to improve the cognitive function. There are two types of CR: Restorative rehabilitation and Compensatory rehabilitation. The CR therapist will make a comprehensive assessment of the impairment and design appropriate cognitive exercises. Studies on the efficacy of CR for brain damage have shown two extremes; one opinion was CR has a positive effect on the patients cognitive functioning and the other opinion was that CR has no effect on the cognitive functioning. This case study examines the dynamics and relevance of CR in reversible and progressive brain injury. It was observed that in reversible condition CR improves cognition and thereby functional ability. In progressive conditions like Alzheimer's disease (AD), CR improves the cognition marginally and thereby improves functional ability and also reduces Behavioral and Psychological Symptoms in Dementia (BPSD).
  2 2,841 349
Genital self-mutilation in nonpsychotic heterosexual males: Case report of two cases
Rajendra B Nerli, Indupur R Ravish, Shrishailesh S Amarkhed, Ujjaini D Manoranjan, Vikram Prabha, Ashish Koura
October-December 2008, 50(4):285-287
DOI:10.4103/0019-5545.44753  PMID:19823616
Genital self-mutilation is a rare event that is commonly associated with psychotic disorders. However such injuries have also been reported from nonpsychotic patients as a result either from bizarre autoerotic acts, attempts at crude sex change operation by transsexuals or secondary to complex religious beliefs and delusions regarding sexual guilt. We report two cases of genital self-mutilation in nonpsychotic married heterosexual males as a result of conflict and frustration.
  2 7,420 454
ORIGINAL ARTICLES
Impact of vocational rehabilitation on social functioning, cognitive functioning, and psychopathology in patients with chronic schizophrenia
PN Suresh Kumar
October-December 2008, 50(4):257-261
DOI:10.4103/0019-5545.44747  PMID:19823610
Aim: To assess the impact of vocational rehabilitation on psychopathology, social functioning and cognitive functioning in schizophrenia Materials and Methods: 34 patients with DSM IV diagnosis of chronic schizophrenia were compared 40 patients with same diagnosis but not attending vocational rehabilitation using PANSS, SCARF social functioning Index and MMSE. Results and Discussion: Basic psycho-socio-demographic data were comparable in both groups except more hospitalization in the no rehabilitation group. Comparison of social functioning, cognitive functioning and psychopathology showed significant improvement in rehabilitated patients. Cognitive functioning had positive correlation with occupational role in the rehabilitated group and negative correlation in the rehabilitated group. Social functioning had negative correlation with positive and negative symptoms, general psychopathology and total PANSS score and cognitive symptoms in patients without rehabilitation. Conclusion: The present concludes that there is a definite limitation in the domains of social functioning, cognitive functioning and psychopathology in chronic schizophrenia patients who had no rehabilitation. However vocational rehabilitation significantly improves these limitations, which in turn help these patients to integrate into the society so as to function efficiently in their roles as parents, home makers and social beings.
  2 3,148 563
AWARD PAPER
Molecular mechanisms underlying electroconvulsive therapy-induced amnestic deficits: A decade of research
Chittaranjan Andrade
October-December 2008, 50(4):244-252
DOI:10.4103/0019-5545.44745  PMID:19823608
  1 3,192 623
BRIEF RESEARCH COMMUNICATION
Long-term outcome of in-patients with substance use disorders: A study from North India
Shubh M Singh, Surendra K Mattoo, Alakananda Dutt, Kaustav Chakrabarti, Naresh Nebhinani, Suresh Kumar, Debasish Basu
October-December 2008, 50(4):269-273
DOI:10.4103/0019-5545.44750  PMID:19823613
Background: Research into substance use disorders (SUD) has been unable to unequivocally demonstrate effectiveness of treatment modalities. Aims: The aim of the study was to study the long-term outcome after in-patient treatment in a cohort of patients admitted for SUD in a deaddiction unit of a hospital in North India. Materials and Methods: The case notes of all in-patients with a primary diagnosis of alcohol and/or opioid dependence syndrome (F10.24 and F11.24) in the calendar year 2006 were examined. All patients without any physical or mental comorbidity other than comorbid SUD were included in the study. They were contacted telephonically or their case notes examined in September, 2007. Status regarding abstinence or relapse was determined and data was analyzed. Independent samples t- test and chi-square test were used for determining significance of difference between continuous and categorical variables respectively. Kaplan-Meier analysis was applied to find the survival times of different groups with the duration to relapse as variable of interest. Log rank test was applied to find the significance of differences in various groups. Cox's Regression analysis was applied to find the hazard ratio. Results and Conclusions: Data for 59.22% of patients included in the study were available for analysis. Mean survival time was 36.35 weeks (28.74-43.95, 95% CI) for patients across different groups, 36.71 weeks (26.24-47.18, 95% CI) for the alcohol group, 34.00 weeks (8.37-59.36, 95% CI) for natural opioids group, 37.53 weeks (26.33-48.73, 95% CI) for semi/synthetic opioids group and 17.00 weeks (3.39-30.60, 95% CI) for the mixed group. Kaplan-Meier analysis revealed that those who were following-up at time of evaluation had significantly longer durations to relapse. Deaddiction services should stress on keeping patients on follow-up as a means to better outcomes.
  1 2,153 379
CME
Self-injurious behavior: A clinical appraisal
K Nagaraja Rao, CY Sudarshan, Shamshad Begum
October-December 2008, 50(4):288-297
DOI:10.4103/0019-5545.44754  PMID:19823617
A case series of self-injurious behavior (SIB) encountered in a General Hospital setting has been described. Limitations of current definition of SIB are explained. SIB is not a single clinical entity and it occurs in various psychiatric syndromes with wide range of psychopathology. Based on clinical criteria, a classification of SIB into three groups has been proposed viz 1) Mild and isolated form, 2) Moderately severe and repetitive form, and 3) Very severe and isolated form. Psychodynamic, cognitive and neurochemical explanations of SIB have been reviewed. Frustration, aggression and impulsivity appearing in helpless situation appear to be a common script across most of these models of explanations. Severity of injury seems to be determined by severity of psychopathology. Site of injury appear to have symbolic significance for a particular patient. Understanding some of these clinicopsychopathological issues helps in management of these cases.
  1 4,846 659
ORIGINAL ARTICLES
High prevalence of depression among Iranian patients with first onset pseudoseizures
Alireza Farnam, Mohammad Ali Goreishizadeh, Sara Farhang, Fatemeh Abdolaliyan
October-December 2008, 50(4):266-268
DOI:10.4103/0019-5545.44749  PMID:19823612
Background: Pseudoseizures are common and can pose a significant diagnostic and therapeutic challenge. Exploring the role of psychiatric disorders can be helpful. The aim of this study was to evaluate depression in patients with first onset pseudoseizure. Materials and Methods: Consecutive patients with pseudoseizure (DSM IV) in an emergency room (Tabriz, northwestern Iran) were evaluated with beck depression inventory (BDI) and were compared to age- and sex-matched patients with other neurologic disorders. Results: Forty-two patients with pseudoseizure (52% male; age: 25.7 ± 6.4) were compared to 50 patients with other neurologic disorders (55.1% male; age: 27.2 ± 5.7) by BDI. Marriage status and educational level were almost similar between two groups. The mean (±SD) score of BDI in patients with pseudoseizures and controls was 23.6 ± 7.4 and 14.14 ±10.5, respectively. Depression was more common and more severe among patients with pseudoseizures (96% vs. 60%). Conclusion: Depression is common among patients with pseudoseizure even in patients with first onset attacks.
  1 1,858 180
PERISCOPE: ASSISTANT EDITOR’S COLUMN
Faking it - I The Menace of Counterfeit Drugs
G Swaminath
October-December 2008, 50(4):238-240
DOI:10.4103/0019-5545.44743  PMID:19823606
  1 2,693 212
CULTURE AND PSYCHIATRY
Some personal reflections relating to psychotherapy
C Shamasundar
October-December 2008, 50(4):301-304
DOI:10.4103/0019-5545.44756  PMID:19823619
This article briefly sketches five important beliefs that shaped the evolution of my professional assumptive-world in respect of psychotherapeutic practice. They are: (a) Every human has some knowledge of what we call psychology and sociology. A professional too has a share of this, which must be integrated with his or her professional knowledge. (b) Therapist's professional knowledge should ideally be practised in his or her personal life. (c) Ideal qualities, which promote mental health are similar to desirable therapist qualities. (d) Mental health is effective management of one's miseries and illnesses. (e) Coping skills are behavioural expressions of ideal values and attitudes.
  - 1,781 269
EDITORIAL
Agenda for specialty section in addiction medicine
TS Sathyanarayana Rao, MN Anil Kumar
October-December 2008, 50(4):229-232
DOI:10.4103/0019-5545.44741  PMID:19823604
  - 2,150 267
HISTORY AND PSYCHIATRY
Institute of mental health and hospital, Agra: Evolution in 150 years
Sudhir Kumar, Rakesh Kumar
October-December 2008, 50(4):308-312
DOI:10.4103/0019-5545.44759  PMID:19823622
  - 29,967 662
LETTERS TO EDITOR
Ciprofloxacin induced nightmares in an adult patient
Amit Dang, Rajasi Kamat, Rataboli V Padmanabh
October-December 2008, 50(4):305-306
DOI:10.4103/0019-5545.44757  PMID:19823620
  - 2,454 145
LITERARY PSYCHIATRY
This is pain
Sanju George
October-December 2008, 50(4):307-307
DOI:10.4103/0019-5545.44758  PMID:19823621
  - 1,268 112
ORIGINAL ARTICLES
The association between attention-deficit/hyperactivity disorder and early-onset alcohol dependence: A retrospective study
Sujaya Kumara R Singeri, Ravi Philip Rajkumar, Kesavan Muralidharan, Channapatna R Chandrashekar, Vivek Benegal
October-December 2008, 50(4):262-265
DOI:10.4103/0019-5545.44748  PMID:19823611
Background: Early onset (EO) alcohol dependence (AD) has been found to represent a subtype of alcoholism with a distinct profile and prognosis compared to late onset (LO) alcohol dependence. Externalizing disorders, especially attention deficit hyperactivity disorder (ADHD) that may continue as attention deficit hyperactivity disorder, residual type (ADD, RT) in adulthood, may increase susceptibility to early-onset AD. Aims: To examine the relationship between ADHD and ADD, RT symptoms and age at onset of AD in a sample of Indian male patients. 70 male subjects with AD presenting to the De-Addiction Services of the National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, were studied. The study had a retrospective design. Materials and Methods: Patients were examined for evidence of past ADHD in childhood and current ADD, RT using structured instruments. Chi-square tests and odds ratios were used to express the relative risk of association of ADHD with early- and late-onset AD. Results: Significantly more EO alcoholics (19/30, 63.3%) had a history of ADHD in childhood compared to LO alcoholics (7/28, 25%, P < 0.05) ADD, RT was also over-represented in EO probands. Conclusions: The results of this study are consistent with previous research that shows a high incidence of ADHD in early-onset alcoholics. This may have important management implications.
  - 2,811 555
Platelet serotonin level and its correlation with finger length relation
Devasis Ghosh
October-December 2008, 50(4):253-256
DOI:10.4103/0019-5545.44746  PMID:19823609
Background: Serotonin is one of the neurotransmitters implicated in normal personality. Many psychobiological models of personality include some dimensions related to serotonin. Moreover, platelets have long been proposed as easily obtainable, neurological models of serotonergic neurons. Aim: This study was done to examine whether measurement for platelet serotonin could aid as a marker for increased neuroticism trait amongst (arbitrarily named Group C) males and females having the tip of the little fingers below the distal finger mark on the adjacent ring fingers in both their outstretched hands compared to (arbitrarily named Group A) the males and females who have the tip of the little fingers above the distal finger mark on the adjacent ring fingers in both their outstretched hands. Materials and Methods: Platelet serotonin estimation was done by Elisa Method (LDN, Germany Kit) from randomly selected 48 healthy subjects [24 males (12 males belonging to Group A and 12 belonging to Group C) and 24 females (12 females belonging to group A and 12 females belonging to Group C)]. Results: Preliminary results showed that the platelet serotonin levels were significantly lower (level of significance: 0.05 in t -Test analysis) in Group C males compared to those observed in Group A males and the platelet serotonin levels were also significantly lower (level of significance: 0.05 in t -Test analysis) in Group C females compared to those observed in Group A females. Conclusion: Thus, it may be inferred that the platelet serotonin may be used as a biochemical marker for increased neuroticism trait in Group C subjects.
  - 2,338 211
PERSPECTIVES IN PSYCHIATRY
Charisma: The phenomenon and its psychology: A mental health perspective
Ajit V Bhide
October-December 2008, 50(4):274-281
DOI:10.4103/0019-5545.44751  PMID:19823614
  - 4,869 328
PG CME
Postgraduate corner: Continuing medical education
Chittaranjan Andrade
October-December 2008, 50(4):298-300
DOI:10.4103/0019-5545.44755  PMID:19823618
  - 1,348 257