Indian Journal of PsychiatryIndian Journal of Psychiatry
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   1999| July-September  | Volume 41 | Issue 3  
    Online since February 20, 2009

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Forensic Psychiatry in India Current Status and Future Development
LP Shah
July-September 1999, 41(3):179-185
Forensic psychiatry is a developing superspeciality in India and other SAARC countries. After a brief historical review, the paper describes the current status of forensic psychiatry in India and compares it with the development in this field in Europe and America. It takes the stock of current scenario in three different areas viz., i) legal and clinical ii) teaching and training and Hi) research. It deliberates on need for teaching this subject at the undergraduate and the postgraduate medical and legal courses and necessity of full time consultants devoted to the practice of forensic psychiatry. It focuses on the recent developments in the field of forensic psychiatry like enactment of Narcotic and Psychotropic Substance Act (1985), Mental Health Act (1987), Juvenile Justice Act (1989), Act for the Disabled (1994) and the Consumer Protection Act (1986). The paper also recommends some strategies for teaching, training, research and future developments in this field.
[ABSTRACT]   Full text not available  [PDF]  [PubMed]
  1,654 527 -
Psycho Ophthalmology : The Interface Between Psychiatry and Ophthalmology
Kirtana Rajsekar, YL Rajsekar, Santosh K Chaturvedi
July-September 1999, 41(3):186-196
The practice of ophthalmology and psychiatry meet over in several aspects of patient diagnosis, management & therapy. The ophthalmologists should be able to recognise signs and symptoms of psychiatric disorder. Non organic disorders could have ophthalmologic manifestations related both the afferent system and motor system related symptoms. Ophthalmologist should be aware of conditions like functional vision loss and visual field loss, voluntary nystagmus, spasm of near reflex, non-organic disturbances of eyelid function, ocular and facial sensation and psychosomatic diseases of eye. Many of the drugs used in psychiatry may cause ophthalmological side effects. These drugs can affect retina, optic nerve, higher visual centre, cornea, lens, ocular motor system and intra ocular pressure. Thalidomide used in 1950s was known to cause congenital ocular defects. Psychological reaction and psychiatric complications are well known after cataract surgery. Other then these problems there are psychiatric disorders which can present ophthalmologic signs and symptoms.
[ABSTRACT]   Full text not available  [PDF]  [PubMed]
  1,088 186 -
The Validation of the Tamil Version of the 12 Item General Health Questionnaire
A Kuruvilla, M Pothen, K Philip, D Braganza, A Joseph, KS Jacob
July-September 1999, 41(3):217-221
The 12 item General Health Questionnaire (GHQ-12), increasingly used to screen for common mental disorders (CMD) in primary care, has been validated in different languages and cultures. However, the validity of the Tamil version has not been established. Consecutive patients, attending a primary health care centre in Vellore, rural Tamil Nadu, India, were screened for CMD using the Tamil version of the GHQ-12. The subjects were also interviewed using the Revised Clinical Interview Schedule (CIS-R). The International Classification of Diseases-10: Primary care version (ICD-10 PHC) criteria were used to diagnose CMD. Various thresholds of the GHQ-12 were compared against the standards of the ICD-10 PHC. A receiver operator characteristic curve was drawn to obtain the best threshold value for screening. Principal Component Analysis was done to identify latent variables. The Cronbach's alpha and the split half reliability were also calculated. One hundred and eleven (33%) subjects of the 327 patients interviewed satisfied ICD-10 PHC criteria for CMD. The optimal threshold for the GHQ-12 was 2/3. This threshold had a sensitivity 87.4% and a specificity of 79.2%. Three factors were extracted with eigen values of 5.0 (depression-anxiety), 1.7 (social performance) and 1.1 (self-esteem) which explained 42.0%, 13.9% and 9.2% of the variance. The Cronbach's alpha was 0.86 while the split half-reliability was 0.83. The sensitivity and specificity of the Tamil version of the GHQ-12 is high. The factor structure is similar to that reported in other populations. The instrument can be employed as a screening instrument in this population.
[ABSTRACT]   Full text not available  [PDF]  [PubMed]
  952 253 -
Secondary Gender Identity Disorder - A Case Report
Nandini Chakrabarti, VK Sinha, A Parial
July-September 1999, 41(3):257-259
An eighteen year old Christian male, diagnosed as Bipolar Affective Disorder, 2nd manic episode with mood congruent psychotic features presented during the episode with the explicit wish for sex reassignment surgery. He even claimed to be married to a local man. With effective management of the manic episode, his wish for sex reassignment surgery has completely subsided. This report discusses the literature regarding secondary gender identity disorder occurring in psychotic conditions and further implications of the same.
[ABSTRACT]   Full text not available  [PDF]  [PubMed]
  853 114 -
Awareness About Psychiatry in Undergraduate Medical Students in Nepal
RK Chadda, Meghachandra M Singh
July-September 1999, 41(3):211-216
Undergraduate medical students in developing countries have a number of misnotions and misconceptions about psychiatry. Carefully planned teaching programmes providing more interactions of students with faculty during a short span may be helpful in increasing students' awareness and positive attitude towards psychiatry. This study was conducted to assess the impact of a two weeks training programme on the awareness of medical students about psychiatry, its scope and treatment modalities. The subjects included a batch of 29 third year medical students in a medical college in Nepal. A pre and post-test was done before and after conducting the training programme for two weeks using a 20 item semi-structured questionnaire. Students' awareness about psychiatric disorders like anxiety disorders, somatoform disorders, personality disorders, delirium and mania, psychological manifestations of physical illnesses, electroconvulsive therapy and psychological methods of treatment improved significantly after the teaching programme. The findings show that teaching programme on psychiatry even for a brief period of two weeks is useful in increasing awareness and correcting the misconceptions about the speciality.
[ABSTRACT]   Full text not available  [PDF]  [PubMed]
  773 118 -
Brief Addiction Rating Scale (Bars) For Alchoholics : Description and Reliabilty
N Janakiramaiah, P.J. Naga Venkatesha Murthy, TM Raghu, DK Subbakrishna, BN Gangadhar, Pratima Murthy
July-September 1999, 41(3):222-227
There is a need for a short instrument to assess the multiple areas of dysfunction as well as drinking dyscontrol in alcoholics. The Brief Addiction Rating Scale (BARS), covering 10 areas of functioning has been developed to meet this need. This report describes the rationale and development of this new scale. A high interrater reliability (0.9) on all the items of the scale and the ease of administration justify its clinical and research use.
[ABSTRACT]   Full text not available  [PDF]  [PubMed]
  747 117 -
Neuronal Mechanisms of Increased Accessibility of Unpleasant Memories in Helpless Rats - A Summary of Present Findings and Implication
KB Kumar, KS Karanth
July-September 1999, 41(3):203-210
Several studies in humans have indicated an association between enhanced retrieval of unpleasant memory and depressive moods. No analogy has so far been demonstrated in laboratory animals, however. A series of z-tperiments, therefore, was initiated in this laboratory with an aim to develop an analogous model of memory bias and to define the neuronal substrate that may account for the differential memory bias, in rats. This paper summarizes current results of these experiments and discusses the likely neuronal mechanism of the enhanced retrieval of unpleasant memories. Also, the implications of these experimental data in understanding the psychobiologicai aspects of "emotive biasing", so characteristics of human conditions like depression and post-traumatic stress disorders are discussed.
[ABSTRACT]   Full text not available  [PDF]  [PubMed]
  763 57 -
Hypothalamic Digoxin and Schizophrenia - A Model for Conscious and Subliminal Perception and its Dysfunction in Schizophrenia
Ravikumar A Kurup, Jyothi Augustine, PA Kurup
July-September 1999, 41(3):197-202
In view of reports of an upregulated cation pump in genetically related Bipolar Affective Disorders the role of hypothalamic digoxin, an endogenous regulator of the cation pump was studied with special reference to its role as a modulator of glycoprotein synthesis. The study demonstrated elevated serum digoxin levels, elevated HMG CoA reductase activity suggesting increased digoxin synthesis, reduced sodium-potassium ATPase activity and altered sugar residues of serum glycoprotein in schizophrenia. A hypothalamic digoxin mediated model for conscious and subliminal perception is proposed and the significance of its dysfunction due to abnormal glycoprotein induced synaptic connectivity defects in schizophrenia is discussed.
[ABSTRACT]   Full text not available  [PDF]  [PubMed]
  749 63 -
An Open Trial of Zuclopenthixol in Management of Acute Psychoses : A Multicentered Study
John Fernandes, PV Pradhan, Partha Choudhary, Somnath Chatterji, J Pereira, Henal Shah, Hozefa A Bhinderwala, Dushyant M Bhadlikar, R Radhakrishanan
July-September 1999, 41(3):242-248
In an open trial, patients with ICD-10 diagnosis of acute functional psychoses were administered injection Zuclopenthixol acetate (Acuphase) in the initial phase. Patients were rated with CGI, BPRS-24 item and UKU side effect rating scale at baseJine, 24 hours and 72 hours. Of the 120 patients recruited, 119 finished this part of the trial. The most common side effect was sedation, which was preferable as most of the patients were in the acute state. The issues concerning less dosing efficacy and the rapid onset of antipsychotic activity are discussed. Patients who had been administered zuclopenthixol acetate in the acute phase were maintained with injection zuclopenthixol decanoate (depot) starting at 72 hours over the baseline. Patients were assessed at 72 hours, one week, 2 weeks, 3 vseeks, 4 weeks and 8 weeks using the same instruments. The issues concerning the dosage and therapeutic efficacy are discussed.
[ABSTRACT]   Full text not available  [PDF]  [PubMed]
  688 88 -
Psychosis in Systemic Lupus Erythematosus : A Case Report
Rajesh Kumar, Jayesh Sahayata, Ritambhara Mehta
July-September 1999, 41(3):260-262
Neuropsychiatric manifestations are common presenting features in systemic lupus erythematosus. Many a times they appear much earlier than other signs and symptoms of systemic involvement. This case report highlights the difficulty in diagnosis and importance of screening patients with specific test when the presentations are not clear.
[ABSTRACT]   Full text not available  [PDF]  [PubMed]
  675 82 -
Comparison of Therapeutic Efficacy of Ect and Imipramine : A Randomized Controlled Trial
C Panner Selvan, Prashanth M Mayur, BN Gangadhar, N Janakiramaiah, DK Subbakrishna, N Murali
July-September 1999, 41(3):228-235
Efficacy studies comparing ECT and tricyclics in depression have had methodological limitations. This study compared EC T and imipramine (IMN) prescribed as the first line of treatment in major depression, Drug-naive, consenting, DSM-IV major depression patients (n=28), were randomized to receive either bilateral ECTs or IMN (225 mg/d) for four weeks. Severity of depression was scored at twice weekly intervals. Subjective side effects were scored at second and fourth week. Patients had significant reductions in depression scores over time but there were no differences between the two treatment groups. The rate of antidepressant response did not significantly differ between the two groups. ECT group had significantly fewer side effects. IMN offered therapeutic response comparable to ECT without compromising on the speed of antidepressant response, but caused more side effects.
[ABSTRACT]   Full text not available  [PDF]  [PubMed]
  650 72 -
Multicentric Efficacy Study of Centpropazine and Imipramine in Depressed Patients
JS Srivastava, OP Asthana, H Singh, AK Agarwal, LP Shah, KC Sharma, PS Gopinath, RC Srimal
July-September 1999, 41(3):249-253
Centpropazine is a new antidepressant with minimal anticholinergic effects in preclinical animal models. In this study centpropazine has been compared with imipramine in a double blind randomized multicentric study. A total of 159 patients of major depressive disorder (79 in centpropazine group and 80 in imipramine group) from four centres were included in this trial. Each patient was randomised to receive either centpropazine in a dose of 40 to 120 mg per day or imipramine in a dose of 50 to 150 mg per day for a period of six weeks. The antidepressant efficacy of centpropazine was comparable to imipramine but anticholinergic side effects were four times less than imipramine. This establishes centpropazine as an effective antidepressant with remarkably safer tolerability profile.
[ABSTRACT]   Full text not available  [PDF]  [PubMed]
  642 60 -
Cardiovascular Response to ect is Unaffected by Extent of Motor seizure Modification
N Murali, E. S. M Saravanan, MG Santosh, BN Gangadhar, N Janakiramaiah, G.S. Umamaheshwara Rao, S Satish Kumar, DK Subbakrishna, Rita Christopher
July-September 1999, 41(3):236-241
Effect of the extent of motor seizure modification on cardiovascular responses in ECT was studied at the second ECT session in 50 (ULECT=25) consenting patients. Twenty five patients each received either 0.5 mg/kg or 1 mg/kg of succinylcholine in a random design. Blood pressure and heart rate were recorded on five occasions during the ECT session. Extent of motor seizure was assessed on a five point scale by two raters blind to succinylcholine dose. Two raters had good interrater agreement on the scale. Significantly more patients had poor modification with 0.5 mg/kg (68%) than with 1 mg/kg (12%) of succinylcholine. Rate-pressure-product (RPP=systolic BPx Heart rate) significantly changed over the five occasions, maximal being in ictal occasion, but the two succinylcholine dose groups did not differ. Ictal RPP positively correlated with post-anaesthesia RPP, ECT stimulus dose, seizure threshold and both seizure durations (Motor and EEG). Likewise, postictal RPP correlated with seizure threshold and actual ECT stimulus dose. Neither correlated with the motor seizure modification scores. In multiple, stepwise, linear regression models neither ictal nor post-ictal RPP variance was significantly explained by the extent of motor seizure modification scores. Hence, RPP changes during ECT may be reflecting cerebral mechanisms of ECT.
[ABSTRACT]   Full text not available  [PDF]  [PubMed]
  609 49 -
Psychoanalytic Group Psychotherapy
SC Gupta
July-September 1999, 41(3):273-273
Full text not available  [PDF]
  499 85 -
Hand Book of Psychotherapy
RC Jiloha
July-September 1999, 41(3):275-275
Full text not available  [PDF]
  425 67 -
Text Book of Postgraduate Psychiatry
PK Chakraborty
July-September 1999, 41(3):272-272
Full text not available  [PDF]
  415 57 -
Case Studies In Psychopharmacology : The Use of Drugs in Psychiatry
Chittaranjan Andrade
July-September 1999, 41(3):274-274
Full text not available  [PDF]
  371 44 -
Disability Benefits for Psychiatrically Ill
JK Trivedi
July-September 1999, 41(3):177-178
Full text not available  [PDF]  [PubMed]
  340 72 -
Is monitoring of Platelets Necessary During Clozapine Therapy ?
Prathap Tharyan
July-September 1999, 41(3):263-264
Full text not available  [PDF]  [PubMed]
  340 64 -
6th World Congress On Innovations In Psychiatry

July-September 1999, 41(3):276-276
Full text not available  [PDF]
  308 47 -
Risperidone Induced Dystonic Reaction and Akathisia
SK Pandey
July-September 1999, 41(3):267-268
Full text not available  [PDF]  [PubMed]
  288 21 -
Catatonic Syndrome : Treatment Response to Lorazepam
Alok Patra, Harpreet S Duggal, D Ram
July-September 1999, 41(3):269-270
Full text not available  [PDF]  [PubMed]
  289 20 -
Fluoxetine Induced Akathisia and Suicidally
SK Pandey
July-September 1999, 41(3):265-265
Full text not available  [PDF]  [PubMed]
  270 17 -
Psychiatric Illness and the Lunar Synodic Cycle
Chittaranjan Andrade
July-September 1999, 41(3):270-270
Full text not available  [PDF]  [PubMed]
  263 22 -
Genetic Counselling in Schizophrenia
Amita Pandey
July-September 1999, 41(3):270-271
Full text not available  [PDF]  [PubMed]
  258 25 -
Depressive Disorder in the Elderly
Kirpal Singh
July-September 1999, 41(3):264-264
Full text not available  [PDF]  [PubMed]
  252 21 -
Risperidone in Indian Patients with Schizophrenia
Harpreet S Duggal, Haque S Niazmie
July-September 1999, 41(3):265-267
Full text not available  [PDF]  [PubMed]
  247 24 -
P.N. Suresh Kumar
July-September 1999, 41(3):268-269
Full text not available  [PDF]  [PubMed]
  240 19 -
AK Agarwal
July-September 1999, 41(3):267-267
Full text not available  [PDF]  [PubMed]
  196 15 -