Year : 2017  |  Volume : 59  |  Issue : 6  |  Page : 147--148

Bhagawat Award


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. Bhagawat Award.Indian J Psychiatry 2017;59:147-148

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. Bhagawat Award. Indian J Psychiatry [serial online] 2017 [cited 2021 Oct 18 ];59:147-148
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Clinical profile, severity of substance dependence and quality of life among treatment seeking natural opiates (opium/poppy husk) users at a tertiary care centre: An exploratory study

Arpit Parmar, & Vaibhav Patil,

Senior Resident, Department of Psychiatry, AIIMS, New Delhi, India. [email protected]

Background: Use of natural opioids is socio-culturally accepted and has been reported across various parts of India. Systematic studies assessing the clinical profile, quality of life and severity of dependence of natural opiates users among the treatment seeking individuals are unavailable.

Aims and Objectives: The study aimed to assess the socio-demographic profile, clinical profile, addiction severity and quality of life in treatment-seeking users of natural opiates (poppy husk and opium).

Settings and design: This cross-sectional exploratory study was conducted at the National Drug Dependence Treatment Centre (NDDTC), All India Institute of Medical Sciences (AIIMS), New Delhi, a tertiary care hospital located in North India.

Materials and methods: This is an observational study of 100 male subjects (aged 18 to 65), users of natural opiates (opium and poppy husk) seeking outpatient treatment at NDDTC, AIIMS. Information pertaining to socio-demographic data, and substance use and clinical profile was obtained. In addition, quality of life (using WHO Quality of Life-Bref version) and addiction severity (using Addiction Severity Index-Lite version) were also assessed.

Results: All the subjects were male with a mean age of 44.6 (±11.0) years. 97/100 reported using poppy husk ("doda0" or "bhukki") daily in a dependent pattern with age of onset of 28.1±8.3 years. The most common reasons for initiation of opiate use were out of curiosity/experimentation (n=63) followed by peer pressure (n=59). Prior abstinence attempts rate was low (n=21) while only 6/100 participants sought treatment before coming to our centre. The most common reason for seeking treatment was an inability to afford opiates (n=72). Rates of medical, familial, social, psychological and legal complications were low.

Conclusion: Natural opiate users seem to be a unique subpopulation of treatment seeking substance users with fewer/no complications despite the long duration of uninterrupted opiate use. There is a need to study their clinical needs in more depth for adequate management of these patients.

Key words: Afim, Doda, Bhukki, Natural opiates, Opium.

Is there a relationship between internalized stigma, depression and cognitive insight in patients with schizophrenia? : An exploratory study

Swapnajeet Sahoo*, Sandeep Grover, Subho Chakrabarti, Ajit Avasthi

Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh- 160012. [email protected]

Aim: To estimate the prevalence of internalized stigma among patients with schizophrenia and to study the association of internalized stigma with insight (clinical and cognitive insight), depression, disability and socio-occupational functioning. Methods: In this cross-sectional study, 150 participants diagnosed with schizophrenia as per DSM-IV TR were assessed on Internalised Stigma of Mental Illness Scale (ISMIS), Calgary Depression Rating Scale for Schizophrenia (CDSS), Positive and Negative Syndrome Scale (PANSS), Indian Disability Evaluation and Assessment Scale (IDEAS), Participation Scale (P-Scale), Global Assessment of Functioning (GAF) and Social and Occupational Functioning Assessment Scale (SOFS). Clinical insight was assessed by PANSS-G12 item. Cognitive insight was assessed by Beck Cognitive Insight Scale (BCIS). Results: About one third (37%) of patients experienced internalized stigma. On the basis of mean scores of various domains of ISMIS, two-fifth (40%) of participants reported discrimination experience and stereotype endorsement and this was followed by stigma resistance (37.3%) and social withdrawal (30.7%). About one-fourth (25.3%) of the sample was found to have depression. Comorbid depression was associated with significantly higher stigma in the domain of stereotype endorsement (p=0.006). Insight as assessed by PANSS-G12 item did not correlate significantly with stigma. Higher cognitive insight in the form of composite score (R-C index) and higher cognitive self-reflectiveness was associated with higher level of stigma in all the domains except for stigma resistance. Higher stigma was associated with negative symptoms, higher disability and lower socio-occupational functioning. Conclusion: Present study suggests that internalised stigma is highly prevalent among patients with schizophrenia. In terms of correlates, internalized stigma is not associated with depression. Clinical insight doesn't have any association with stigma, but cognitive insight in the form of self-reflectiveness is associated with higher stigma. Higher level of stigma is associated with more disability and poor functioning.

Key words: Stigma, Schizophrenia, Depression, Insight, Cognitive Insight

Prevalence and predictors of family accommodation in obsessive-compulsive disorder in an indian setting: an exploratory study

Ananya Mahapatra

AIIMS, New Delhi. [email protected]

Background: Family accommodation (fa) is the phenomenon whereby caregivers assist or facilitate rituals/behaviours related to obsessive compulsive disorder (OCD). Western studies have found an association of fa with symptom severity and functional impairment, however there is a dearth of research in indian settings.

Aims: The study aims to assess the extent of family accommodation in the caregivers of adult patients with OCD, examine the clinical correlates of fa and explore for its predictors in a sample of indian patients.

Settings And Design: Cross-sectional study conducted in out-patient setting in a tertiary care hospital in india

Materials And Methods: A 101 adult patients with dsm 5 diagnosis of ocd and 101 caregivers were included. The patients were assessed using ybocs, ham-d, who das-2.0 (12 Item), cgi-s and cgi-i. The family accommodation scale-self rated scale (fas-sr) was applied on caregivers after translation to hindi and back-translation, which was carried out in keeping with the world health organization’s translation back-translation methodology.

Statistical Analysis: Descriptive statistics, group comparisons, and pearson's product moment correlations were carried out. Stepwise multiple linear regression models were performed with total fas-sr score as the dependent variable.

Results: Around 92% caregivers displayed at least some form of fa, with the mean score on the fas-sr being 27.28 (Sd: 15.7). A significant correlation was found between fas-sr score and ham-d, ybocs, who das 2.0.12, And cgi-s scores. Higher scores on ham-d, ybocs and cgi-s were independently associated with greater scores on fas-sr scale, as revealed from the regression analysis.

Conclusions: Family accommodation in ocd appears to be a frequent phenomenon. Higher fa is, which is associated with greater symptom severity and disability. Fa may be a possible target for interventions in order to improve patient outcomes. Further research in this direction is warranted specifically from the indian settings.

Spirituality, religiousness and coping in patients with schizophrenia: a cross sectional study in a tertiary care hospital

Soumitra Das

Senior Resident, Dept. Of Psychiatry, National Institute Of Mental Health and Neurosciences, Bangalore. [email protected]

Spirituality, religiousness and coping in patients with schizophrenia: a cross sectional study in a tertiary care hospital dr. Soumitra das1 , dr. Nimisha doval2 1. Senior resident, national institute of mental health & neuro sciences (nimhans), bangalore. 2. Senior resident, university college of medical sciences (ucms), delhi. Abstract: background: religion is a form of coping that helps individuals to deal with a wide variety of difficult life situations. But most of the research in this field has been in acute patients of schizophrenia. Also, most of the research on religion and schizophrenia has focused on religion and spirituality as coping mechanisms, and research evaluating the relationship between spirituality/religiousness and repertoire of other coping skills is sparse. Aim: to evaluate the association between spirituality, religiousness and coping skills in patients with schizophrenia in remission. Methodology: a total of 48 consecutive patients with schizophrenia attending the outpatient dept. Of psychiatry, satisfying the inclusion and exclusion criteria were assessed on panss, personal and social performance scale (psp), whoqol-srpb and ways of coping checklist - revised (wcc).Results were analysed using spss 16. Results: patients who used more religiosity and spirituality as measured with who-srpb domain score were better in their managing their stress as they used all the adaptive strategies like planful problem solving, positive reappraisal, distancing, self-controlling, seeking social support rather than maladaptive skills like confrontive coping and escape avoidance. Conclusion: a sound spiritual, religious, or personal belief system positively affects active and adaptive coping skills in patients with schizophrenia during remission, thus helping the individual to cope with illness-related stressors. Further large scale studies are needed to corroborate the findings of the study. Key words: spirituality, religiousness, coping.