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COLONEL KRIPAL SINGH AWARD |
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| Year : 2018
| Volume
: 60 | Issue : 5 | Page
: 17 |
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| Colonel Kripal Singh Award |
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email
| Date of Web Publication | 1-Feb-2018 |
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How to cite this article:
. Colonel Kripal Singh Award. Indian J Psychiatry 2018;60, Suppl S4:17 |
A Study of the Plasma Cortisol Levels in Post Traumatic Stress Disorder Soldiers in A Counter Insurgency Environment as A Predictor of Chronicity Using Dexamethasone Suppression Test (Dst)
Sojan Babya, Prabal Debb, Manish Bajpayeec, Vijay Panded, S Dixite, K S Rajmohanf
aLt Col, MD, Ph.D., classified specialist (Psychiatry & Addiction Psychiatry), CH(SC), Pune, bCol, MD, Post Doctor Fellow in Neuropathology, Senior Advisor (Pathology), CH(EC) Calcutta, cLt Col (retd), MD, Ruby Hall Clinic, Pune, dCol (retd), MD, eCol, MD,DPM, Classified specialist (Psychiatry), CH(SC), Pune, fCol, MD, PH.D. Senior Advisor (Pathology), BH(DC), Delhi
Background: Post Traumatic Stress Disorder (PTSD), refers to long standing symptoms of hyper reactivity, anxiety state and avoidance of trauma related memories or situations following exposure to a traumatic situation. Western studies have shown inconsistent association with lower basal serum cortisol level and increased negative feedback inhibition mechanism among individuals with PTSD. However there is no Indian study carried out to evaluate this phenomenon. It is in this background study was planned to evaluate the functioning of the Hypothalamic Pituitary Axis (HPA) to stress, by measuring the urinary and serum cortisol levels and also to check presence or absence of super suppression of HPA axis on low dose dexamethasone (DST)), there by identifying soldiers at high risk.
Materials and Methods: The study was carried out at large tertiary care service hospital. A total of hundred patients who were in active counter insurgency operational areas were selected as study group. Group I comprised of 50 soldiers who developed PTSD and group II were persons who faced similar trauma but did not develop PTSD. In groups, structured interview and Davidson’s Trauma scale scoring was done to assess the presence and severity of PTSD symptoms. Plasma levels and 24 hour urinary cortisol levels were measured. Measurements were taken twice, once before and once after administration of 01 mg of dexamethasone at bedtime. The results were statistically analyzed.
Results: The findings revealed statistically significant difference in basal cortisol (serum & urinary) levels of the subjects with PTSD and in suppression of serum cortisol levels after low dose cortisol supplementation (DST), compared to control subjects.
Conclusion: The patients developing PTSD seems to have significant differences in hypothalamic pituitary adrenal axis regulation compared to people who have faced trauma of similar nature. More studies are recommended in this field.
KEYWORDS: Posttraumatic Stress Disorder (PTSD), Hypo-thalamo-pituitary Axis (HPA Axis), Serum Cortisol, Urinary Cortiso, Dexa-methasone Suppression Test (DST).
Evaluation of attempted suicide cases in farming industry of central Maharashtra in comparison to non farming group
Dr (Surg Cdr) KSHIROD K MISHRA
Proff & HOD, Psychiatry, MGIMS, Sevagram, Maharashtra, India. [email protected]
Introduction: Attempted suicide or deliberate self harm are just the tip of iceberg of number of suicides occurring in a community. Attempted suicides occur 8-20 times more frequently than completed suicides. Suicide among rural agrarian community is now a universal phenomenon. Several factors like financial constraints, altercation with any family member, Easy availability of pesticides have been attributed as the common reasons for suicide attempt among the rural population.
Material and methods: On this background we evaluated all the cases of attempted suicide admitted to our rural medical college during a period of one year. Details of sociodemographic profile, mode of attempt, and reason for the attempt were evaluated. Factors among farmer and non-farmer group were analyzed using suitable statistical methods.
Results: Out of total 117 cases of attempted suicide, only 21 % of the cases were farmers. Majority of them were males and were married. Main mode of attempt was poisoning. The common psychiatric diagnosis was adjustment disorder followed by depressive disorder.
Conclusion: The study was done in a rural setup from agrarian background but majority of the attempters were non farmer. It indicates there may be a reduction in the suicide rate among the farmers due to intervention at all levels. The commonest mode of suicide attempt amongst farmers as well as non farmers was found to be pesticide ingestion owing to its easy availability. Though the Most common reason for attempt among the non farmer population was interpersonal problems, indebtness still remains the commonest reason among farmers which needs the attention of policy makers.
Key Words: Attempted Suicide, Farming industry
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 Source of Support: None, Conflict of Interest: None  | Check |
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