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|Year : 2014
: 56 | Issue : 5 | Page
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|Date of Web Publication||14-Jan-2014|
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. Workshop. Indian J Psychiatry 2014;56, Suppl S1:16-8
Dementia services today-tomorrow
Anand Ramakrishnan, S. C. Tiwari
Royal College of Psychiatrists, Nottinghamshire Healthcare NHS Trust, Kirkby-in-Ashfied, Nottingham, UK
Background: Dementia is the most common disorders of old age. It is predicted that between 2011 and 2020 it will increase 100% in western world and 300% in China, India, and other South Asian countries. Therefore, it is important to know how to diagnose and manage dementia and how to run dementia services that are medico-socio-culturally competent to look after people with dementia in the 21st century including advances in person centered care.
Objectives: Imparting skills in the management of dementia at present and in future.
Materials and Methods: Various clinical, sociocultural, and environmental issues related to dementias will be discussed. Presently available dementia treatment modalities and management strategies will be outlined and strategies for future will be discussed.
Results and Conclusions: The audience will be equipped and trained in dementia management strategies for present and future.
Female sexual dysfunction: The step daughter of psychiatric research in India!
Darpan Kaur, K. S. Jyothi, Shubhangi Dere, Narendra Nebhinani, Ajinkya Shaunak
Department of Psychiatry, MGM Medical College, Navi-Mumbai, Maharashtra, India
Background for conducting workshop: Female sexual dysfunction has been a culturally sensitive issue in India. Globally, the prevalence of sexual dysfunction is as high as 40-50%. Literature searches across databases such as PubMed, MEDLINE, and PsychINFO identified sparse studies from India. Moreover, the quality of research is largely confined to case reports with very few studies on original research. There is larger contribution from other medical specialties. There is not even a single randomized controlled trail (RCT) or systematic review on this topic from India. Aims and Objectives of the workshop: This workshop intends to sensitize psychiatrist, psychologist, and allied mental health professionals to this neglected subsection of psychiatry. Topics covered:
Epidemiology of female sexual dysfunction Types of female sexual dysfunction Sexual dysfunction in female psychiatric patients Sexual dysfunction and substance abuse Sexual dysfunction associated with general medical condition Psychopharmacological and psychotherapeutic management Indian scenario: Shame, stigma, cultural barrier, lack of knowledge, attitudinal influences, misconceptions, and countertransference.
Expected audience: Psychiatrist, psychologist, and allied mental health professionals. Materials: Information material shall be distributed. Overall description of workshop: Varied clinical scenarios shall be discussed among the participants. Role play simulating doctor patient interactions in female sexual dysfunction shall be done. Use of rating scales shall be discussed. Interactive group discussion shall be held on barriers and lacunae in existing knowledge base on female sexual dysfunction. The workshop shall attempt to conclude on generating solutions and planning future research designs on female sexual dysfunction in India.
Electroencephalogram for psychiatrists: A practical workshop
Dheeraj Kattula, R. Arun, Jayaprakash Russell Ravan, A. T. Prabhakar
Department of Psychiatry, Christian Medical College, Bagayam, Vellore, Tamil Nadu, India
Background : We observe that there are times when psychiatric symptomatology may mimic epileptic phenomena and seizure episodes mimic psychiatric presentations. Many psychotropic drugs are associated with electrophysiological abnormalities in brain including epileptiform discharges. These highlight the close relation between the practice of neuropsychiatry and understanding electrophysiological abnormalities of brain. A gap exists between psychiatrists requesting for electroencephalogram (EEG) and the EEG interpreting skills among psychiatrists. This workshop hopes to bridge this gap.
Aim: To equip psychiatrists in all aspects of electroencephalography.
Objectives: To understand the role of EEG in psychiatry, the situations in which EEG might be requested, and what has to be expected while requesting for EEG. To understand the basic principles and techniques of EEG. To discuss normal EEG and common EEG abnormalities among neuropsychiatric patients (practical session).
Psychiatry of old age training module
Pradeep Arya, Indira Sharma
Northwood Way Northwood Middlesex, UK
Background : India's population ages 60 and older is projected to increase dramatically over the next 4 decades, from 8% in 2010 to 19% in 2050, according to the United Nations Population Division. By mid-century, this age group is expected to encompass 323 million people, a number greater than the total US population in 2012. This profound shift in the share of older Indians brings with it a variety of challenges including the shift in nature of psychiatric morbidity.
Objectives: To develop and implement a comprehensive teaching module for the current and next generation of psychiatrists.
Materials and Methods: With the benefit of extensive teaching and training available in National Health Service (NHS), UK and Australia in psychiatry of old age, the knowledge and skills acquired will be designed and displayed to cater to the needs of Indian Psychiatry. A multimedia presentation with special emphasis on online teaching, internet-based video lectures, podcasts, problem-based learning, supervision, and guidance for research projects will be used to supplement the currently available resources in psychiatry teaching in India with special emphasis on old age psychiatry and psychiatric emergencies in the elderly. Consultants from UK and Australia will be flown in to deliver this program.
Results and Conclusions: There will be a generational shift on how psychiatry is taught and learnt in India, preparing us for the future.
Cognitive analytic therapy: Mind the gap
Hertfordshire Partnership University NHS Foundation Trust, St Albans, United Kingdom
Cognitive analytic therapy (CAT) is a type of brief psychotherapy. Dr Anthony Ryle developed CAT and introduced the concepts of traps, dilemmas, snags, reciprocal roles, and reciprocal role procedures (RRP). He theorized that the "self" is formed by a variety of such reciprocal roles and reciprocal role procedures. CAT incorporated ideas mainly from the object relations theory and those of the Russian educational psychologist Vygotsky. The reciprocal roles of an individual influence their relationships with others and themselves in such a way that others are recruited to the opposite pole to elicit desired reciprocation. These procedures of seeking or expecting specific outcomes are called as reciprocal role procedures. The theory suggests that the narrow repertoire of RRP may lead to maladaptive procedures. These maladaptive procedures are considered as the target problem procedure (TPP). The aim of the therapy is to find "exits" from these TPP. CAT can be of great assistance to understand the RRP between organizations or "systems". The contextual reformulation helps us to understand how the "system" relates to itself and others. The focused workshop will aim to show how the CAT model is useful to develop a profound insight in studying how "Mental Health" (professionals) relates to 'itself' and to the media. The diagrammatic representation of these relationships will demonstrate some maladaptive procedures. The TPPs that halt progress in improving the relationship with media will be identified. Further discussions will offer an unprecedented opportunity to improve relationships between media and mental health. The understanding of reciprocal roles and reciprocal role procedures between them will be of assistance to help bridge the gap. Dr Rajesh Nehete (CAT Practitioner) will illustrate these relationships between Mental Health, Media and legislation using CAT tools at Annual National Conference of Indian Psychiatric Society (ANCIPS) 2014 to find a way forward and to explore possible "exits".
Managing insomnia through the life cycle
Shashi K. Bhatia, Vishal Madaan, Venkata Kolli, Subhash C. Bhatia, Sriram Ramaswamy
Creighton University School of Medicine, California, USA
At the conclusion of this session, the participant should be able to: (1) Understand the basics of neurobiology of sleep. (2) Understand the problems with insomnia and their presentation across the life span. (3) Understand sleep hygiene strategy for managing insomnia. (4) Recognize the effects of psychotropic medications on sleep architecture and the potential beneficial/adverse outcomes.
Sleep is an active biochemical process essential for normal brain functioning. However, sleep-related problems are experienced by 30-40% of the general population and up to 66% of psychiatric patients. Sleep disorders and disturbances have diverse presentations; may mimic psychiatric conditions and may exacerbate comorbid psychiatric conditions. Sleep architecture changes across the life span, making the recognition and adequate treatment complex. Poor sleep has a detrimental impact on the functioning of other vital organs such as the cardiovascular and immune systems. Understanding and optimally treating these sleep problems can prove to be of immense benefit for the patients. In this interactive workshop, we will review the neurobiology of sleep, changes in sleep architecture from infancy to old age and their interface with medical and psychiatric disorders childhood, their overlap with psychiatric conditions and how to recognize and manage both. We engage in discussion about evidenced-based psychosocial and pharmacological interventions to promote sleep. The issues like management of abuse and dependence of prescribed medications will be addressed.
Cognitive hypnotherapy for common mental disorders
Shaunak Ajinkya, Deepali S. Ajinkya
Department of Psychiatry, MGM Medical College and Hospital, Navi Mumbai, Maharashtra, India
Outline of the Proposed Workshop
I) Aim and Objectives: The aim of this workshop is to help mental health professionals know about the basics of cognitive hypnotherapy which they can use as an effective additional tool in their clinical practice to get better results.
The objectives are:
- Knowing the science behind hypnosis
- Learning about self-hypnosis and hetero-hypnosis
- How to use cognitive therapy in association with hypnosis
- Learning to frame hypnotic and post-hypnotic suggestions to patients, for example, for understanding and modifying core belief systems.
At the end of this workshop, participants should be able to:
- Define and list the stages of hypnosis
- List the common psychological disorders for which cognitive hypnotherapy can be used
- Describe in brief an entire cognitive hypnotherapeutic session in a clinical setting
- Practice self-hypnosis or hetero-hypnosis with effective suggestions.
II) Brief Description of Workshop:
The facilitators are internationally certified clinical hypnotherapists and highly trained in several styles of clinical hypnotherapy. The workshop will be mix of didactic presentations, demonstrations and faculty-led group practice.
Contents of the Workshop:
- Brief history of hypnosis
- Laws of hypnosis
- Stages of hypnosis
- What is cognitive hypnotherapy?
- Wording of effective suggestions: How to frame and plant positive suggestions in the mind in order to reverse negative thoughts/emotions and alter core belief systems
- Advantages of cognitive hypnotherapy over regular cognitive behavioral therapy (CBT)
- How to conduct a cognitive hypnotherapeutic session (with demonstration)
This workshop will include the most modern, scientifically-validated information, and the best evidence-based methods from research and clinical practice.
Neurobiology of aging and dementias
Subhash C. Bhatia, Sriram Ramaswamy, Venkata Kolli
Department of Psychiatry, Creighton University School of Medicine, California, USA. E-mail: [email protected]
At the conclusion of this session, the participant should be able to:
- Understand the neurobiological challenges of old age
- Strategies at recognizing and treating various dementias
- Understand the current evidence and strategies at prevention and early intervention in dementia.
3.7 million citizens of India suffer from dementia with an estimated cost of 14,700 crore INR. This economic burden is greater in western societies. Eight percent of the Indian population is above the age of 60 and these numbers will increase to 19% by 2050. In general with increase in life expectancy and ageing, the prevalence of dementia will double by 2030. Alzheimer's dementia has distinct stages of prodrome, mild cognitive impairment, and dementia-mild, moderate and advanced. Early detection and intervention might provide an opportunity for better care across these stages. Old age poses distinct psychosocial and medical burden that need to be distinguished from cognitive disorders. In this interactive workshop we will discuss on the biological and common psychosocial adversity posed by ageing and early diagnostic strategies . We will review the evidence for preventative strategies like reducing vascular and nonvascular risk factors and lifestyle changes related to smoking cessation, reducing proinflammatory burden. We then review the evidence of pharmacological like cholinesterase inhibitors, N-methyl-D-aspartate (NMDA) antagonists, and contemporary interventions with anti-amyloid therapies and other evidenced-based pharmacological well as behavioral interventions for management of afflicted individuals and their caregivers.
CBT in depressed patients from psychiatrist's point of view
Tushar S. Bhat, Nikhil Pande
Beck Institute, USA
What is intended in workshop?
Cognitive behavioral therapy (CBT) in India is not rampant and as commonly used as in western countries; few reasons may be:
- Lack of time. In view of huge patient load it is very difficult to give time to patients
- Patient's educational status
- Lack of expertise and training among psychiatrists.
In this 2-h workshop we would like to remove myths behind CBT and would like to suggest some practical tips about implementation of CBT in busy practice.
Our agenda will be:
- Basics of CBT
- Case conceptualization and cognitive formulation
- How to recognize automatic thoughts
- Problem solving strategies
- Methods for recognizing, coping, and working on your own thoughts
- Home and work structuring
- Extra highlight about suicidal patients
If possible we will demonstrate with patients or dummy.
Calculating sample size - A primer for beginners
T. P. Subhalakshmi
Department of Psychiatry, Malankara Orthodox Syrian Church Medical College Hospital, Kolenchery, Ernakulam, Kerala, India
Everyone is expected to do research nowadays along with the clinical and teaching work. However, many are apprehensive about doing research mainly because of unfamiliarity with the concepts and practical difficulties. Targeted primarily at 1st year postgraduate students this paper attempts to make the initiation into the fascinating area of research interesting. The concepts of sampling, determining sample size, confidence level, confidence interval, and significance are discussed with examples taken mainly from clinical practice.
Mass Media interventions as a tool for stigma reduction of Mental illness as well as Prevention and Positive Mental Health
226/6-7, Safdarjang, Development Area, New Delhi, India. E-mail: [email protected]
Mental illness are a problem worldwide but each culture differs in its perception of the problem. Similarly, the available infrastructure and facilities for treatment and rehabilitation may vary widely within a country, especially in India with its diverse cultures, socio, economic status and systems of medicine apart from socio cultural background.
The media response of the challenge of awareness about mental health and illness must emcompass local informal means of mass communication (word of mouth; option of leaders and doctors; folklore; street plays etc.) to tools of information technology at small level (local newspapers, magazines and radio; cable operators etc.) to National and International level (National Newspapers; National channels of Radio and Television; Satellite channels; internet etc.) Each of these medias serves a purpose as well as target populations and is a piece in the larger picture of successfully integrating awareness, treatment and rehabilitation in a stigma free society.
Mental health now is in news all the time and psychiatrists are being called upon to interact with the media (As a group, mental health professionals are most sought after and quoted). Handling Mass-Media is an art and we all need to utilize the tools available to us to bring about awareness in the population to go beyond treatment as well as to foster preventive health and demystify myths. The need is for us to be proactive and look for ways and opportunities to create awareness it requires communication skills as well as understanding various medias to be able to harness them. The Workshop would focus on hands on experience / practical aspects of handling the mass media to benefit largest section of the population in a sustained manner of mental health awareness, early intervention and comprehensive management of apart from stigma reduction.
'Spirituality and Mental Health'
226/6-7, Safdarjang, Development Area, New Delhi, India.
E-mail: [email protected]
The world around is changing faster than we can cope. The increase in stress in all age groups, both sexes, all socioeconomic strata in rural and urban area s is increasing on one hand and social supports are dwindling on the other. Mental health professional in varied settings has to increasingly deal with clients who do not fall into water light psychiatric syndromes. The needs of these large subgroups of patients are beyond what is taught as a part of psychiatric education or it is traditionally practiced.
It is found that 80-90% of the population, in any culture, level of development or socio-economic status believes in 'Soul' 'Spiritual Principles' or 'Religion'. The clients may not feel comfortable with a mental health professional who does not share, can't understand or does not wish to address their client's religious / psycho spiritual beliefs. They may also be seeking simultaneous treatments from Ojha, new age therapists, Astrologers or just religious / spiritual beliefs.
The recent boom of new age / alternative therapies has not only attracted those having these existential concerns but also those who have not benefited from mainstream psychiatric treaments. There is now increasing evidence of efficacy of many therapeutic techniques like Yoga, Meditation, Prayers and Spirituality based interventions. It is time of incorporate Spirituality in Medical Sciences and Mental Health along with other ingredients in a cultural context as a viable model, which is cost effective and acceptable to the population it cater to.
Management of Anorexia Nervosa
S.M. Manohari, Vijaya Raman
Departmental of Psychiatry, St. John's Medical College Hospital, Sarjapur Road, Bangalore, Karnataka, India. E-mail: [email protected]
Introduction: Anorexia Nervosa (AN) is a disorder that Mental Health Professionals in India are having to treat in the last few years. Most psychiatrist trained in India have not had the opportunity of treatment AN during their training period as incidence of AN in India was very low till the last few years.
Content of Workshop: This workshop will focus on acute, short term and long term medical psychological management of AN in adults and children.
Psychiatric and Mental Management: Planning a treatment protocol based on our experience will be discussed.
Practical aspects of constituting an inter-disciplinary team avoiding and handling serious problems like the refeeding syndrome, cardiac failure, electrolyte disturbances, poor gut motility, and other medical problems will be discussed. The difficulties with setting a desired body mass index, calculating and suggesting dietary calorie requirement will be dealt with in detail. Management of common co-morbid disorders like Obsessive Compulsive Disorder, Depression and family dysfunction will be talked about.
Role of medication for AN per se will be evaluated.
Psychological Management: This will involve techniques (including cognitive behavior therapy, supportive and family therapies) of managing self-image issues, self-esteem, interpersonal issues, family related issues as well as diet and exercise related issues. In addition, psychological management of co-morbid conditions will be discussed.
Conclusion: The format of the workshop will have didactic lectures, small group discussions, as well as question and answer sessions. A detailed handout will be provided.
Source of Support: None, Conflict of Interest: None