Year : 2019 | Volume
: 61 | Issue : 9 | Page : 357-
|How to cite this article:|
. Marfatia Award.Indian J Psychiatry 2019;61:357-357
|How to cite this URL:|
. Marfatia Award. Indian J Psychiatry [serial online] 2019 [cited 2021 Sep 17 ];61:357-357
Available from: https://www.indianjpsychiatry.org/text.asp?2019/61/9/357/250212
1)Mortality in schizophrenia: A study of verbal autopsy from cohorts of two rural communities of South India
Narayana Manjunatha, C Naveen Kumar, Jagadisha Thirthalli, Suresha KK, Harisha DM, Udupi Arunachala1 Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru 1Manasa Nursing Home, Thirthahalli, Shimoga, India
Schizophrenia is a life shortening disease. Though, the rate of mortality of persons with schizophrenia in India is established to be more compared to that in general population, there is little exploration of the causes for the same. Aim: To explore the causes of death in two rural cohorts of schizophrenia. Method: In-person interviews of primary caregivers of 53 deceased persons with schizophrenia were conducted using the World Health Organization’s Verbal Autopsy 2014 instrument. Physician based method was used to determine the causes of death. Results and Discussion: Average age of 53 deceased schizophrenia patients was 50.45 + 13.65 years with almost equal gender ratio. Just more than two thirds patients were married, just above one third each are educated up to primary school and had no formal education. Noncommunicable diseases (NCDs) were the most common causes of death [30 (56.6%)] in this sample, followed by communicable disease [7 (13.2&)], and then unnatural deaths [suicide-8 (15%), road traffic accidents-3 (5.6%)]. Conclusion: It is the first study in India to explore causes of death in schizophrenia. NCDs being the most common cause of death in schizophrenia suggests to the need of integration of schizophrenia care into general healthcare. Key words: Schizophrenia, cause of death, community cohorts, India.
2)Thyroid Function in Postpartum Psychosis
Rati Ranjan Sethy, MD DPM
Assistant professor, Dept of psychiatry IMS & Sum Hospital, Bhubaneswar E mail- [email protected]
Purpose: To assess thyroid profile in patients with postpartum onset psychosis and to compare them with patients of psychosis without postpartum onset and subjects with normal postpartum.
Methods: forty female patients were clinically diagnosed with psychotic disorder due to postpartum onset and without postpartum onset were taken up for the study. Twenty normal postpartum groups were taken. The CPRS and YMRS was applied in psychosis with and without postpartum group; The measurement of thyroid volume by using ultrasonography and measurement of free T3, free T4 and TSH, was done in all the patients.
Results: The postpartum onset psychosis group had significantly higher score (p<0.01) on CPRS compared to psychosis without postpartum onset group. The HDRS score was significantly higher in postpartum psychosis group (p<0.05) compared to psychosis without postpartum onset. The volume of the total thyroid volume were significant different (p<0.01) among postpartum onset psychosis, psychosis without postpartum and normal postpartum group. The blood free T4 level was significantly different among postpartum onset psychosis from other groups (P<0.01). In Pearson correlation TSH was shown positive correlation with the age of onset (p<.05).
Conclusion: Women with postpartum onset psychosis are at higher risk for clinical thyroid abnormality mainly free T4 level and also increase in thyroid size.
Key point: Postpartum, thyroid, ultrasonography, psychosis
3)Title: Relationship of Metabolic syndrome and Neurocognitive deficits in patients with schizophrenia
Dr. SANDEEP GROVER,
PROF. OF PSYCHIATRY,
Aim of the study: To evaluate the association of metabolic syndrome (MS) and its components with neurocognition among patients with schizophrenia. Methodology: 121 patients with schizophrenia attending two psychiatric outpatient service centres (Chandigarh, Chennai) were assessed on neurocognitive battery (Trail making test (TMT)-A and B, Stroop test, Controlled Word Association Test, Rey auditory and verbal test and Tower of London) and their metabolic parameters were assessed by a detailed physical examination (waist circumference, blood pressure, height and weight) and relevant laboratory investigations (fasting blood glucose and fasting lipid profile). Results: 68 patients (56.2%) fulfilled the consensus criteria for MS. After controlling/adjusting for various co-variates, it was found that as compared to patients without MS, those with MS had significantly poor performance in the cognitive domains of processing speed (TMT-A; p=0.025; effect size-0.29), cognitive processing and selective attention (Stoop effect percentile ; p value0.002;effect size-0.45), auditory and verbal total memory (AVLT; p value <0.001;effect size0.68) and immediate recall memory (p value-0.009; effect size-0.2). Hyperglycemia was associated with poor performance in the auditory and verbal memory and some of the domains of executive functions. Higher systolic blood pressure was associated with poor performance in the domains of executive functions; higher diastolic blood pressure was associated with poor processing speed and poor auditory and verbal memory. Other components like waist circumference, hypertriglyceridemia and low HDL levels were also associated with poor performance in more than one cognitive domains. Additionally, it was seen that patients with higher number of abnormal components of MS had poorer functioning in the domains of cognitive processing and selective attention, auditory and verbal memory and executive functions. Conclusions: Our findings suggest that almost all the components of MS affect either one or the other domain of neurocognitions in patients with schizophrenia. The study findings could have significant clinical implications in terms of monitoring and identifying metabolic abnormalities among patients with schizophrenia to minimize the negative effect of metabolic parameters on neurocognition. Key words: Schizophrenia, Neurocognition, Metabolic Syndrome