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   2011| April-June  | Volume 53 | Issue 2  
    Online since June 30, 2011

 
 
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RESEARCH AND TRAINING
How to write a good abstract for a scientific paper or conference presentation
Chittaranjan Andrade
April-June 2011, 53(2):172-175
DOI:10.4103/0019-5545.82558  PMID:21772657
Abstracts of scientific papers are sometimes poorly written, often lack important information, and occasionally convey a biased picture. This paper provides detailed suggestions, with examples, for writing the background, methods, results, and conclusions sections of a good abstract. The primary target of this paper is the young researcher; however, authors with all levels of experience may find useful ideas in the paper.
  21,482 2,775 3
EDITORIAL
The MMR vaccine and autism: Sensation, refutation, retraction, and fraud
TS Sathyanarayana Rao, Chittaranjan Andrade
April-June 2011, 53(2):95-96
DOI:10.4103/0019-5545.82529  PMID:21772639
  17,197 1,320 5
ORIGINAL ARTICLES
Drug-emergent metabolic syndrome in patients with schizophrenia receiving atypical (second-generation) antipsychotics
Shiv Gautam, Parth Singh Meena
April-June 2011, 53(2):128-133
DOI:10.4103/0019-5545.82537  PMID:21772644
Background: Persons with schizophrenia are reported to be more likely to die from cardiovascular illness than those in the general population, and are at a greater risk of developing obesity, diabetes type 2, hypertension and dyslipidemias. Antipsychotic drugs used in the treatment of schizophrenia and other psychotic illnesses can induce weight gain, with some agents having a greater propensity to do so than others. These adverse effects associated with second-generation antipsychotics are also part of the metabolic syndrome. Aims: The aim of this study was to evaluate the emergence of metabolic syndrome due to second-generation antipsychotics as compared with conventional (typical) antipsychotics. Settings and Design: A prospective interventional study was conducted at the Psychiatric Centre, Jaipur. The study included 120 patients, both indoor and outdoor, suffering from schizophrenia diagnosed using the ICD-10 criteria. The patients were grouped into four categories, i.e. control group and three study groups, each group having 30 patients. Materials and Methods: Thirty patients were given conventional antipsychotics and 90 were given second-generation antipsychotics, including risperidone, olanzapine and clozapine. Metabolic parameters were taken before onset of drug treatment therapy and after 4 months. The changes in metabolic parameters were compared using appropriate statistical tools. Statistical Analysis: Chi square chart and Unpaired t-test were used for statistical analysis using a computer. Results: 11.66% of the patients developed metabolic syndrome after 4 months of antipsychotic medication. Conclusions: Second-generation antipsychotics cause significantly more changes in the metabolic parameters, increasing the chances of developing metabolic syndrome and associated disorders like diabetes mellitus type-II and cerebrovascular accidents. Olanzapine is the antipsychotic drug that has the maximum potential to cause metabolic syndrome.
  5,458 700 16
PRESIDENTIAL ADDRESS
A utilitarian concept of manas and mental health
M Thirunavukarasu
April-June 2011, 53(2):99-110
DOI:10.4103/0019-5545.82532  PMID:21772641
  5,499 401 1
ORIGINAL ARTICLES
Prevalence of psychiatric and physical morbidity in an urban geriatric population
K Seby, Suprakash Chaudhury, Rudraprosad Chakraborty
April-June 2011, 53(2):121-127
PMID:21772643
Background: With a rapidly increasing population of older aged people, epidemiological data regarding the prevalence of mental and physical illnesses are urgently required for proper health planning. However, there is a scarcity of such data from India. Aims: To study the frequency and pattern of psychiatric morbidity present and the association of physical illness with psychiatric morbidity in an elderly urban population. Settings and Design: Cross-sectional, epidemiological study. Materials and Methods: All the consenting elderly persons in a municipal ward division (n=202) were enrolled after surveying a total adult population of 7239 people. A door to door survey was undertaken where the participants were interviewed and physically examined. General Health Questionnaire-12, Mini Mental State Examination, CAGE Questionnaire and Geriatric Depression Scale were used in the interview apart from consulting the available documents. Other family members were also interviewed to verify the information. Statistical Analysis: Chi-square test with Yates correction. Results: Psychiatric illnesses were detected in 26.7% while physical illnesses were present in 69.8% of the population surveyed. Predominant psychiatric diagnoses were depressive disorders, dementia, generalized anxiety disorder, alcohol dependence and bipolar disorder. The most common physical illness was visual impairment, followed by cardiovascular disease, rheumatic illnesses, pulmonary illnesses, hearing impairment, genitourinary diseases and neurological disorders. Presence of dementia was associated with increased age, single/widowed/separated status, nuclear family, economic dependence, low education, cardiovascular disorders, rheumatic disorders and neurological disorders. Depression was associated with female sex, single/widowed/separated status, staying in nuclear families, economic dependence on others and co-morbid physical illnesses, specifically cardiovascular disorders and visual impairment. Conclusions: This study presented a higher rate of dementia and old age depression. The interesting association with several sociodemographic factors as well as physical illnesses may have important implications for health planning.
  4,506 947 2
AWARD PAPER
Indianizing psychiatry - Is there a case enough?
Ajit Avasthi
April-June 2011, 53(2):111-120
DOI:10.4103/0019-5545.82534  PMID:21772642
Psychiatry is different from all other branches of medicine as it pertains on "psyche" which is intangible, effervescent and indefinable. It is influenced by interviewer and client's communication skills, personality, socio-cultural beliefs and interpretations. The inference of "normal" and "abnormal" varies across cultures and understanding of the cultural nuances is an integral part of understanding psychopathology. Knowledge gained in one culture cannot be extrapolated completely to another culture. Indian psyche is distinct as it is has been influenced by various invaders into the country, collectivism and interdependence. Because of all these factors, presentation of mental illness is different in the Indian culture and many a times it is difficult to fit patients into the categories developed by the Western world. Similar factors also influence attitude towards treatment seeking and visit to magico-religious healers and those practicing alternative system of medicine. Moreover, the principles of Western psychotherapy cannot be applied to the Indian subjects. Compared to West, family plays a vital role in all major decision in an individual's life including his treatment and care. They bear the major burden and take up the responsibility of care of the persons with mental illness and dampen the effect of limited resources. These families cope by trusting and passing on the responsibility to almighty. Hence, there is a need for Indianization of psychiatry.
  4,674 634 1
ORIGINAL ARTICLES
Study of emotional intelligence and empathy in medical postgraduates
Abhijeet Faye, Gurvinder Kalra, Rajeev Swamy, Aniket Shukla, Alka Subramanyam, Ravindra Kamath
April-June 2011, 53(2):140-144
DOI:10.4103/0019-5545.82541  PMID:21772646
Objectives : The important domains of emotional intelligence (EI) are self-awareness and control of emotions, motivating oneself, and empathy. These are necessary to handle any relationship. This study aims to (i) assess emotional intelligence focusing specifically on empathy; (ii) to study the level of anger; and (iii) correlating level of anger with (a) EI and (b) empathy in medical postgraduates. Materials and Methods: Subjects were assessed randomly after obtaining informed consent, through semi-structured proforma and various scales, including Emotional Quotient Self-Assessment Checklist, Multi-Dimensional Emotional Empathy Scale, and Clinical Anger Scale. Data was analyzed using multivariate analysis with analysis of covariance test. Results: On Emotional Quotient Self-Assessment checklist, more than 70% had poor emotional intelligence. Married males in the study were more confident and empathizing. Those with some major problem at home were more aware of their own emotions and other's feelings. Residents who had voluntarily chosen their specialty postgraduation training course (eg, medicine, surgery, and others), those who had less work load, those who had time for recreational activities, and exercise had scored high on EI. Good control of emotions in self was associated with good relationship with superiors and colleagues. Score on Clinical anger was moderate to severe in 10.6% of the subjects. EI and clinical anger correlated negatively.
  4,259 539 1
CASE REPORTS
Successful management of vaginismus: An eclectic approach
Thippeswamy Harish, KrishnaPrasad Muliyala, Pratima Murthy
April-June 2011, 53(2):154-155
DOI:10.4103/0019-5545.82548  PMID:21772650
Vaginismus is defined as recurrent or persistent involuntary spasm of the musculature of the outer third of the vagina, which interferes with coitus and causes distress and interpersonal difficulty. In this report, we describe the successful treatment of vaginismus in a 25-year-old lady based on a model proposed by Keith Hawton. The eclectic approach involved education, graded insertion of fingers, Kegel's exercises and usage of local anesthesia with vaginal containment along with the prescription of Escitalopram.
  4,403 256 -
BRIEF RESEARCH COMMUNICATION
Why do we prescribe ECT to schizophrenia patients?
Vivek H Phutane, Jagadisha Thirthalli, Muralidharan Kesavan, Naveen C Kumar, BN Gangadhar
April-June 2011, 53(2):149-151
DOI:10.4103/0019-5545.82544  PMID:21772648
Electroconvulsive therapy (ECT) is prescribed for schizophrenia patients for various indications, in our country. However, official guidelines in other countries have been cautious in prescribing ECT for schizophrenia. To study the indications for which patients with schizophrenia receive ECT. We studied records of schizophrenia inpatients receiving ECT in one year (2005) (n=101) retrospectively, as well as the consecutive data of patients between May 2007 and June 2008 (n=101) prospectively. The various indications for ECT in schizophrenia were studied by frequency analysis. Of the 202 schizophrenia patients who received ECT, the most common reason was 'to augment pharmacotherapy' in (n=116) cases. The target symptoms for which ECT was prescribed the most was catatonia (n=72). The mean number of ECTs (SD) received was 8.4 (2.8). Augmentation of pharmacotherapy was the most common indication of ECT in patients with schizophrenia.
  3,555 372 6
PSYCHIATRIC PEARLS
Antidepressants: From MAOIs to SSRIs and more
Chaitra T Ramachandraih, Narayana Subramanyam, Kral Jurgen Bar, Glen Baker, Vikram K Yeragani
April-June 2011, 53(2):180-182
DOI:10.4103/0019-5545.82567  PMID:21772661
  3,425 427 -
ORIGINAL ARTICLES
Comparison of clinical characteristics of migraine and tension type headache
Ravi Gupta, Manjeet Singh Bhatia
April-June 2011, 53(2):134-139
DOI:10.4103/0019-5545.82538  PMID:21772645
Context: Migraine and tension type headache (TTH) are two most common types of primary headaches. Though the International Classification of Headache Disorders-2 (ICHD-2) describes the diagnostic criteria, even then in clinical practice, patients may not respect these boundaries resulting in the difficulty in diagnosis of these pains. Materials and Methods: This cross-sectional study involved 50 subjects in each of the two groups - migraine and TTH - after screening for the inclusion and exclusion criteria. Diagnosis was made according to the ICHD-2 criteria. Their clinical history was taken in detail and noted in a semi-structured performa. They were examined for the presence of a number of factors like pericranial tenderness and muscle parafunction. Statistical analysis was done with the help of SPSS v 11.0. To compare the non-parametric issues, chi-square test was run and continuous variables were analyzed using independent sample t test. Results: In general, migraineurs had progressive illness (χ2=9.45; P=0.002) with increasing severity (χ2 =21.86; P<0.001), frequency (χ2 =8.5; P=0.04) and duration of each headache episode (χ2 =4.45; P=0.03) as compared to TTH subjects. Along with the headache, they more commonly suffered orthostatic pre-syncope (χ2 =19.94; P<0.001), palpitations (42%vs.18% among TTH patients; χ2 =6.87; P=0.009), nausea and vomiting (68% vs. 6% in TTH; χ2 =41.22; P<0.001, and 38% vs. none in TTH; χ2 =23.45, P<0.001, respectively), phonophobia (χ2 =44.98; P<0.001), photophobia (χ2 =46.53; P<0.001), and osmophobia (χ2 =15.94; P<0.001). Their pain tended to be aggravated by head bending (χ2 =50.17; P<0.001) and exercise (χ2 =11.41; P<0.001). Analgesics were more likely to relieve pain in migraineurs (χ2 =21.16; P<0.001). In addition, post-headache lethargy was more frequent among the migraineurs (χ2 =22.01; P<0.001). On the other hand, stressful situations used to trigger TTH (χ2 =9.33; P=0.002) and muscle parafunction was more common in TTH patients (46% vs. 20%; χ2 =7.64; P=0.006). All the cranial autonomic symptoms were more common in migraineurs as compared to TTH subjects (conjunctival injection: χ2 =10.74, P=0.001; lacrimation: χ2 =17.82, P<0.001; periorbital swelling: χ2 =23.45, P<0.001; and nasal symptoms: χ2 =6.38, P=0.01). Conclusion: A number of symptoms that are presently not included in the ICHD-2 classification may help in differe-ntiating the migraine from the TTH.
  3,364 395 -
GUEST EDITORIAL
Pathway of psychiatric care
JK Trivedi, Abdul Qadir Jilani
April-June 2011, 53(2):97-98
DOI:10.4103/0019-5545.82530  PMID:21772640
  3,073 534 6
CASE REPORTS
Male genital self-mutilation
Vishal Mago
April-June 2011, 53(2):168-169
DOI:10.4103/0019-5545.82555  PMID:21772655
Psychiatric case reports of male genital self-mutilation (GSM) in the literature are rare and mostly anecdotal. Most of them are connected with personality disorders (Goldfield and Glick, 1970; Wise et al., 1989). In men, psychosis is an important cause for GSM, causing up to 80% of automutilations.
  3,166 223 2
Psychogenic polydipsia
Ajay Kohli, Shishir Verma, Ashish Sharma
April-June 2011, 53(2):166-167
DOI:10.4103/0019-5545.82554  PMID:21772654
To the best of our knowledge psychogenic polydipsia has not been reported in an Indian journal. We are reporting one such case, which was diagnosed as having depression according to ICD 10 R criteria. Fully investigated patient had some reversible changes in the urinary tract. There was no antidiuretic hormone-related abnormality as indicated by absence of hyponatremia. The patient recovered with antidepressant drugs. The followup was done for 6 months.
  3,002 213 -
ORIGINAL ARTICLES
Utility of repetitive transcranial magnetic stimulation as an augmenting treatment method in treatment-resistant depression
Venu Gopal Jhanwar, Ram Jeevan Bishnoi, Lakshman Singh, MR Jhanwar
April-June 2011, 53(2):145-148
DOI:10.4103/0019-5545.82543  PMID:21772647
Background: About 30-46% of patients with major depressive disorder (MDD) fail to fully respond to initial antidepressants. Treatment-resistant depression is a severely disabling disorder with no proven treatment options; novel treatment methods, such as repetitive transcranial magnetic stimulation (rTMS) can be used as augmentation to ongoing pharmacotherapy or as a solitary method of treatment. Aim: To evaluate the utility of rTMS as an augmenting method in treatment-resistant depression. Materials and Methods: In an open-label study, 21 patients with DSM-IV MDD without psychotic features who had failed to respond to an adequate trial of at least 2 antidepressants were given rTMS therapy for 4 weeks keeping the dose of pre-existing antidepressants unchanged. High-frequency (10 Hz) stimulations were delivered over left dorsolateral prefrontal cortex at an intensity of 110% of the patient's motor threshold. Treatment response was defined as a reduction in score on the Hamilton Rating Scale for Depression (HAM-D) from baseline to end of treatment. Secondary efficacy measures included scores on the Clinical Global Impressions-Change and -Severity scales. Results: At the end of 4 weeks, 19 patients completed the 4 weeks study and were assessed. In ITT analysis the mean HAM-D17 scores were reduced from 30.80±5.00 to 19.00±6.37 (t=8.27, P<0.001). Only 4 patients reported headache but there was no discontinuation due to adverse effects. Conclusions: The study indicates the potential utility of rTMS as an augmenting agent in treatment-resistant depression. Adequately powered, randomized controlled trials are necessary to evaluate the role of rTMS in treatment-resistant depression.
  2,362 294 3
LETTERS TO EDITOR
Hyperglycemia associated with olanzapine treatment
PN Suresh Kumar, Biju Thomas
April-June 2011, 53(2):176-177
DOI:10.4103/0019-5545.82562  PMID:21772658
  2,269 147 -
CASE REPORTS
Clozapine induced eosinophilia
Pradipta Majumder, RK Chadda, P Goyal, A Mittal, Nand Kumar
April-June 2011, 53(2):152-153
DOI:10.4103/0019-5545.82546  PMID:21772649
Clozapine is associated with a number of side effects and careful monitoring of them is a very important aspect of management of the patients receiving the same. Common side effects of clozapine are sedation, sialorrhoea, weight gain etc. Rarely clozapine is also associated with eosinophilia. Here we present a case of schizoaffective disorder who was receiving clozapine and developed eosinophilia during the initial weeks of treatment with clozapine which came down to baseline after a few weeks of continuation of therapy. Although there are reports of eosinophilia developing in course of treatment with clozapine among patients suffering from schizophrenia but this may be the first case of eosinophilia associated with clozapine use in case of schizoaffective disorder.
  2,166 170 -
Bifrontal ECT for drug-induced psychosis in Parkinson's disease
K Muralidharan, R Thimmaiah, V Chakraborty, S Jain
April-June 2011, 53(2):156-158
DOI:10.4103/0019-5545.82549  PMID:21772651
Psychosis has been documented to occur during treatment for idiopathic Parkinson's disease (PD). This case report describes an elderly male who developed psychosis during the course of treatment for idiopathic PD. He was treated with clozapine but experienced significant adverse effects without clinical improvement. He was prescribed bifrontal electroconvulsive therapy (BF-ECT). Here, we report the efficacy of BF-ECT in treating psychosis and motor symptoms in PD, without producing cognitive side effects in an elderly male.
  2,017 137 3
Severe neuropsychiatric presentation of Wilson's disease
Rahul T Chakor, NS Santhosh
April-June 2011, 53(2):170-171
DOI:10.4103/0019-5545.82556  PMID:21772656
Wilson's disease (WD) is a relatively rare disease of copper metabolism. The diagnosis is often missed initially. The presentation is usually neurologic or hepatic, seen in 40% of patients. Psychiatric presentation of WD is reported in only 15% of patients. We present a 32-year-old patient with severe psychiatric manifestations. On examination, he had mild rest and postural tremors and a KF ring was seen. Serum ceruloplasmin was low and 24-hour urinary copper was elevated. The patient responded to penicillamine, lorazepam and quetiapine, and is being followed up.
  1,947 187 1
Diagnostic dilemma: A case of self-injurious behavior
Mamta Sood, Alok Agrawal, S Sivaraman, Sudhir K Khandelwal
April-June 2011, 53(2):159-162
DOI:10.4103/0019-5545.82551  PMID:21772652
We report a case of repeated self-injurious behavior. Self injury to the operated eye had resulted in complete loss of vision in one eye. This case illustrates multiple challenges posed to the treating teams managing the causes and consequences of such self-injurious behaviors.
  1,773 170 2
LETTERS TO EDITOR
Dementia mortality: Estimates of survival after the onset of dementia range from 4 to 12 years
Samuel Ravi
April-June 2011, 53(2):178-179
DOI:10.4103/0019-5545.82565  PMID:21772660
  1,694 132 -
CASE REPORTS
Glaucoma: Adverse event on use of topiramate in alcohol de-addiction
Keshava Pai, Pooja Rajashekaran
April-June 2011, 53(2):163-165
DOI:10.4103/0019-5545.82552  PMID:21772653
To report oral topiramate-induced glaucoma and to asses its severity and preventability. A 40-year-old manpresented with watering, redness, pain, and diminution of vision of both eyes, one week after initiation of oral topiramate 100 mg/day for alcohol de-addiction. On examination, both eyes showed conjunctival chemosis, corneal edema, shallow anterior chamber, and intraocular pressure 48 and 46 mm Hg. The symptoms and clinical findings resolved completely upon discontinuation of topiramate and administration of antiglaucoma drugs. Topiramate-induced angle-closure glaucoma and other ocular side effects are reversible if the diagnosis is made early and the drug is discontinued in time. Hence, clinician awareness is an important aspect of preventability of this adverse event.
  1,683 138 4
LETTERS TO EDITOR
Lithium not only stabilizes mood, it is also neuroprotective
Samir Kumar Praharaj
April-June 2011, 53(2):177-178
DOI:10.4103/0019-5545.82563  PMID:21772659
  1,228 158 -