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| EDITORIAL |
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Practice of Ect in India |
p. 313 |
JK Trivedi
PMID:21206592 |
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| ARTICLES |
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Mind in Indian Philosophy |
p. 315 |
A Venkoba Rao
PMID:21206593The place of mind in the philosophical systems of India is briefly discussed. The philosophies selected are - Vedas, Upanishads, Six systems of philosophies (saddarsanas), Gita and materialistic school of Carvaaka. That mind is of subtle physical nature and that self is postulated as higher than
mind in the hierarchy is being pointed out. Mind can be man's own friend to elevate him or his foe debasing him. Modern neuro - science and the ancient materialistic schools do not subscribe to the existence of self. An integrated approach extending beyond the mind in psychiatric care is suggested. Scientific and technological advances do not necessarily preclude a transcendent (spiritual) dimension to the total care. |
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Geriatric Patients Attending Tertiary Care Psychiatric Hospital |
p. 326 |
Yvonne Da Silva Pereira, Ajoy Estibeiro, Rajesh Dhume, John Fernandes
PMID:21206594This retrospective study aimed to explore the Socio-demographic characteristics and clinical profile of patients aged 60 years and above, attending psychiatric services for the first time at the Institute of Psychiatry and Human Behaviour, Goa during 1993-1998. Hospital case files of six hundred and ninety-eight patients formed the study sample. Preliminary analysis revealed that 70% of the sample was between 60-69 years. Mean age was 65.8 years (Sd 6.11). Sex ratio male to female was 38:62. 59% came from extended families. The commonest psychiatric diagnosis was mood (affective) disorders seen in 43% of the sample, of which more than half had depression. Associated physical illnesses were seen in 68% of the sample. The differential occurrences of various psychiatric diagnostic categories as well as associated physical illnesses were significantly associated with the sex of the patients. |
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Insight, Psychopathology & Schizophrenia |
p. 332 |
K.P Lincoln Armstrongh, R Chandrasekaran, Bojir Perme
PMID:2120659525 inpatients with schizophrenia were examined to explore the relationship between insight and psychopathology and illness severity over a four-week period. The average degree of insight improved irrespective of the type of recovery. There was no consistent relationship between the changes in insight and changes in psychopathology. The severity of mental illness and awareness of mental disorder showed a semi-independent pattern of association. It is concluded that insight operates to some extent independent of psychopathology and severity of illness. |
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Caregivers Burden : A Comparison Between Obsessive Compulsive Disorder and Schizophrenia |
p. 337 |
C Jayakumar, K Jagadheesan, A.N Verma
PMID:21206596The present study compared burden of care between the key relatives of patients with obsessive compulsive disorder (OCD) and schizophrenia. For this study, consecutive key relatives of patients with either OCD (n=30) or schizophrenia (n=41) were evaluated with 40-item burden assessment schedule (BAS). In comparison with schizophrenia group, caregivers in OCD group had significantly high mean scores for the domains, spouse-related factor and caregiver's strategy of BAS. The degree of burden, evidenced by mean scores, was comparable between groups for other domains of BAS. Spouses and unemployed caregivers in OCD group had significantly elevated mean total burden scores. The present findings suggest that caregiver's burden imposed by OCD is either excess or nearly comparable to that of schizophrenia. |
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Executive Functions in Depression : A Clinical Report |
p. 343 |
Rajul Tandon, Anand Singh, PK Sinha, JK Trivedi
PMID:21206597Fifty patients of depression and thirty normal subjects were assessed using clinical rating scales and also for the executive functions by Wisconsin Card Sorting Test (WCST). The depressed subjects demonstrated poor performance on WCST suggesting cognitive inflexibility and prefrontal dysfunction. More severe illness was associated with greater impairment in the executive functioning. This pattern of result in conjunction with previous studies supported the idea that depressed patients may have fixed frontally based dysfunction and calls for the use of cognitive assessment and rehabilitation in the patients with depression. |
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Prevalence and Pattern of Alcohol and Substance Abuse in Urban Areas of Rohtak City |
p. 348 |
Meena , Pardeep Khanna, AK Vohra, Rajesh Rajput
PMID:21206598A sample of 4,691 subjects aged 14 years and above were interviewed on a schedule based on WHO Questionnaire to collect information about prevalence & pattern of alcohol and substance abuse The study revealed a prevalence rate of 19 78%. 42.41% of users were in the age group of 25-34 years while 44.1 % were literate (up to matric). 45.04% among labourers were alcohol users. In terms of age of onset, 94.83% respondents had their first drink between the ages of 15-25 years. Most common type of alcohol consumed was country liquor by 69.07%. Majority (63.44%) of alcohol users said that they usually drink with some companion, only in the evening and night. 50.03% had arguments with family or friends after taking alcohol while 13.57% alcohol abusers confessed that they had neglected their family and work due to alcohol. In family history of 23.16% alcohol users, father was abusing alcohol. 26.61% alcohol users cited to be sociable as reason for their drinking. 16.81% users were smokers also while 6.89% had the habit of taking Pan Masala/Zarda. 2.04% of alcohol users were taking soolfa also along with alcohol while the frequency of opium and cannabis abuse was 1.51 and 1.18% respectively. |
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Changing Pattern of Drug Abuse Among Patients Attending De - Addiction Centre at Faridkot |
p. 353 |
Jaswant Singh Sachadev, Ranvir Singh Yakhmi, Ajay Kumar Sharma
PMID:21206599Prevalence and patten of drug abuse among patients attending deaddiction centre of GGS Medical College and Hospital Faridkot in the year 1994 were analysed and compared with pattern of drug abuse among the patients attending the same centre in 1998 It was observed that there was an increase in the patients using the drugs available over the counter with chemists. It was also found that there was a decrease in the number of patients using raw opium in the year 1998 as compared to the year 1994. |
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Culture, Psychiatry and New Zealand |
p. 356 |
AN Chowdhury, Teara Wharemate Dobson
PMID:21206600This paper provides a critical appraisal of the importance of cultural perspective in the psychiatric diagnosis and management plan. The working philosophy of mental health services in New Zealand is primarily monocultural and based on Western medical conceptualisation of diagnosis and treatment protocol. In view of the emphasis on bicultural health perspectives in recent years and in tune with the objectives of the Treaty ofWaitangi's ethnocultural partnership, the provision of a culturally safe and sensitive mental health coverage of Maori and Pacific Islander clients has become an important health issue in the country. The present discussion of the ethnocultural influence on clinical psychiatry highlights some of the relevant issues from the transcultural perspective. |
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Reliability of the Icd - 10 International Personality Disorder Examination (IPDE) (Hindi Version) : A Preliminary Study |
p. 362 |
Pratap Sharan, P Kulhara, SK Verma, Manju Mohanty
PMID:21206601The study was aimed at estimating the joint-rater reliability and applicability of Hindi version of ICD-10 IPDE that was obtained following a standard translation protocol. The instrument was administered to 22 non-psychotic patients by two raters. The average intraclass correlation for each item (0.89), number of criteria met per disorder (0.92) and dimensional scores (0.98) was high. Kappa for definite (0.65-0.78) and probaole personality disorder (PD) (0.78-1.00) and for presence/absence of any PD (0.78) was acceptable. Overall weighted kappa was 0.81 for definite and 0.91 for probable PD. Findings suggest that ICD-10 IPDE (Hindi version) has acceptable joint- rater reliability and applicability in the North Indian Hindi speaking population. |
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Comparative Efficacy of Centbutindole & Risperidone in Schizophrenia |
p. 365 |
R Chandra, H Singh, PK Dalal, OP Asthana, JS Srivastava
PMID:21206602Centbutindole is a new antipsychotic agent related to butyrophenone group. The drug is dopamine antagonist but it also blocks 5HT2 receptors. Clinically the drug has passed through phase I, II & III clinical trials successfully and it has shown effective antipsychotic activity in schizophrenic patients. In the present study the drug was compared with risperidone in a double blind manner for a period of 8 weeks to assess the efficacy in schizophrenic patients. Patients of schizophrenia evaluated on PANSS, CGI & UKU side effect rating scale weekly Out of 44 patients included in study, 38 completed the trial. The intergroup comparison of two drugs showed that centbudindole and risperidone have similar onset of antipsychotic action as both the drugs showed significant decrease in the total PANSS score as well as positive syndrome score, negative syndrome score and general psychopathology score from 2nd week onwards. The scores in both the groups showed a steady and significant decline from 2nd week to 8th week of study. The present study showed that centbutindole has similar improvement on clinical global impression with risperidone. The side effect profile was similar in the two drugs except dystonia (5 patients in centbutindole vs 1 patient in risperidone group). The findings of present study shows that Centbutindole could be used as a promising new drug for treatment of schizophrenia in place of a typical antipsychotics as it has shown improvement on negative symptoms similar to risperidone. |
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Impulsive Pica : A New Diagnostic Category ? |
p. 372 |
AN Chowdhury, Saikat Basu
PMID:21206603Pica is an interesting psychiatric entity that merits special clinical attention. This report describes three cases of pica and calls for its separate nosological placement in clinical psychiatry. In the Diagnostic and statistical manual of mental disorders fourth edition (DSM-IV), pica is described as persistent eating of nonutritive substances for a period of at least 1 month which is inappropriate to the developmental level and not part of a culturally sanctioned practice (American Psychiatric Association, 1994). On the other hand, impulse-control disorders not elsewhere classified is defined as failure to resist an impulse, drive or temptation to perform an act that is harmful to the person or to others, feeling of an increasing sense of tension or arousal before committing the act and pleasure, gratification or relief at the time of committing the act or shortly thereafter (American Psychiatric Association, 1994). Regarding the aetiologies of Pica most contemporary literatures have cited various causative factors, e.g. normal exploratory orality of children, pregnancy, stress and conflicts, cultural beliefs, mental retardation, psychotic disorders and even nutritional deficiencies (Chatoor, 2000; Popper & West, 2001). Here, we report 3 atypical cases of Pica, attending outpatient department of the Institute of Psychiatry, Calcutta. These reported cases are unique in their time of onset, phenomenological progression and therapeutic responsiveness. |
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Sexual Dysfunction in an Adult Female with Obsessive Sexual Thoughts : A Case Report |
p. 375 |
Sunil Awana, Shivananda Jena
PMID:21206604We report a case of an adult married Muslim female from an orthodox background having sexual obsessions about males other than her husband and her 7 year-old son. She developed diminished sexual desire to have sex with her husband as a result of her obsessions. The role of sexual obsessions in sexual dysfunction in females is discussed. |
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Obsessive Compulsive Disorder : Co-Morbidity in Manic Phase of Bipolar Affective Disorder |
p. 377 |
Harish Kalra, Rajul Tandon, Bharat Saluja, Indra Mohan
PMID:21206605Comorbidity is known to occur among various psychiatric disorders. About the third of the patients with Obsessive Compulsive Disorder have major depressive disorder and anxiety disorder but coexistence of Obsessive Compulsive Disorder with mania is rare to see. Here we report a case of Obsessive Compulsive Disorder where manic phase was accompanied by obsessions of contamination and pathological doubts along with cleaning rituals and spitting rituals. |
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Use of Faradic Stimuli in a Case of Recurrent Hystericial Aphonia |
p. 380 |
Minhaj Nasirabadi, Gauri Kamat, Nilesh Shah
PMID:21206606Hysterical aphonia is characterized by abrupt loss of voice without neurological or laryngeal cause and is preceded by conflicts or other stressor. This case report describes the use offaradic stimuli in a case of recurrent hysterical aphonia. |
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Delusional Parasitosis Responding to Risperidone |
p. 382 |
B.S Narayana Gowda, S Heebbar, MT Sathyanarayana
PMID:21206607Delusional parasitosis (DP) appears to be common in India. This condition is more prevalent in elderly people. Currently used treatment pimozide, a high potency antipsychotic, has disadvantage of extra-pyramidal symptoms & tardive dyskinesia in this age group. Hence there is a need to evaluate the use of high potency atypical antipsychotic risperidone in DP. This case report documents the efficacy of risperidone in DP. |
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Risperidone Induced Tardive Dyskinesia - A Case Report |
p. 384 |
OV Vasudevan, Denzil A Pinto, P.S Gopinath
PMID:21206608Risperidone is a serotonin - dopamine antagonist which has got less propensity to cause tardive dyskinesia than conventional antipsychotics. There have been few reports of tardive dyskinesia induced by risperidone. This is a report of a case of risperidone induced tardive dyskinesia. A 56 year old female with a 6 months history of paranoid schizophrenia, developed bucco-oro-masticatory abnormal involuntary movements after receiving risperidone 8 mg/day for about 1 year. She had some of the risk factors for the development of tardive dyskinesia like age, sex, anti-chotinergic drugs and earlier emergence of neuroleptic-induced parkinsonism. Clinicians must be aware of the possibility of the patients developing tardive dyskinesia when they are given the supposedly safe neuroleptic risperidone. |
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Challenge with Atypical Antipsychotic Drugs in Risperidone Induced Neuroleptic Malignant Syndrome : A Case Report |
p. 387 |
DN Mendhekar, RC Jiloha, MM Mehndiratta, L War
PMID:21206609There are several reports available on neuroleptic malignant syndrome (NMS) associated with risperidone but when a more stringent criterion is applied there are only a few. Report on challenge and rechallenge with various atypical antipsychotic drugs in re-emergence of post NMS psychosis is scanty. Our aim of presenting this is to highlight the differential response of various atypical antipsychotic drugs in the treatment of post NMS psychosis. This paper reports a young male with mild mental retardation who developed NMS on a low dose of nspendone. Eariierhe was on haloperidol 10 mg. which was stopped 10 days prior to initiation of risperidone therapy. Symptoms of NMS resolved within 36 hours with bromocnptine; but the patient relapsed to psychosis. Re-challenge with risperidone 1mg resulted in a dystonic reaction, with clozapine 12.5 mg he developed marked sedation, hypotension and urinary incontinence. Ultimately post NMS psychosis responded well to olanzapine 10mg and there was no recurrence of NMS. Olanzapine may be the better choice for the treatment of post NMS psychosis. |
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Psychological Intervention in Tuberous Sclerosis : A Case Report |
p. 391 |
Puja Sharma, Kiran Rao
PMID:21206610Tuberous sclerosis (TS) is characterized by the clinical triad of epilepsy, mental subnormality and adenoma sebaceum. TS is a multi-system disorder resulting in severe distress for the individuals and their family members. The present study illustrates an eclectic psychosocial management of a patient with TS and normal intelligence. |
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| LETTERS TO THE EDITOR |
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Mental Disorders and Systems of Medicine |
p. 397 |
KS Jacob
PMID:21206611 |
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Zolpidem Induced Delirium |
p. 398 |
Ajeet Sidana, Gurvinder Pal Singh, Rakash Pal Sharma
PMID:21206612 |
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| CD REVIEW |
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Electro Convulsive Therapy - Interactive Multimedia |
p. 399 |
| P.S.V N Sharma |
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