Indian Journal of PsychiatryIndian Journal of Psychiatry
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   2000| April-June  | Volume 42 | Issue 2  
    Online since February 20, 2009

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Mental Hospitals in India
K Krishnamurthy, D Venugopal, AK Alimchandani
April-June 2000, 42(2):125-132
This review traces the history of the mental hospital movement, initially on the world stage, and later in India, in relation to advances in psychiatric care. Mental hospitals have played a significant role in the evolution of psychiatry to its present status. The earliest hospital in India were established during the British colonial rule. They served as a means to isolate mentally ill persons from the societal mainstream and provide treatments that were in vogue at the time. Following India's independence, there has been a trend towards establishing general hospital psychiatry units and deinstitutionalization, while at the same time improving conditions in the existing mental hospitals. Since 1947, a series of workshops of superintendents was conducted to review the prevailing situations in mental hospitals and to propose recommendations to improve the same. Implementation of the Mental Health Act, 1987, and governmental focus upon mental hospital reform have paved way for a more specific and futuristic role for mental hospitals in planning psychiatric services for the new millenium, especially for severe mental illnesses.
[ABSTRACT]   Full text not available  [PDF]  [PubMed]
  1,153 306 -
Psychiatric Referrals in Multispeciality Hospital
GS Bhogale, RM Katte, SP Heble, UK Sinha, BA Patil
April-June 2000, 42(2):188-194
K.L.E.S. hospital is a new multispecialty referral hospital attached to J.N. Medical College, Belgaum. All psychiatric referrals numbering 338 over a period from 1.7.1996 to 30.6.1997 were retrospectively studied. Socio-demographic data, source and reason for referral, diagnosis and treatment advised were noted. More than two-third of the referrals were male patients and belonged to the productive age group of 16 years to 45 years. 83.17% of the patients were referred from general medicine, medicine allied and medical superspeclality departments. Unexplained physical symptoms was the commonest reason for referral (64.44%). The commonest psychiatric diagnosis was neurotic, stress related, somatoform disorders (45.54%). Next common diagnosis was mood disorders (20 92%). Need for more dialogue and interaction between the referring doctor and the psychiatric team member is strongly felt.
[ABSTRACT]   Full text not available  [PDF]  [PubMed]
  949 150 -
Cognitive Behaviour Therapy Yesterday, Today & Tomorrow
K Kuruvilla
April-June 2000, 42(2):114-124
Full text not available  [PDF]  [PubMed]
  818 233 -
Brief Interventions in Substance Abuse
Suresh Kumar, Anil Malhotra
April-June 2000, 42(2):172-183
Brief interventions in substance abuse refer to a group of cost-effective and time efficient strategies that aim at reduction of substance use and/or harm related to substance use. They are grounded in the scientific principles of harm reduction stage of change, motivational interviewing and feasibility of community-level delivery. This review discusses the characteristics, elements, and techniques of brief interventions for abuse of alcohol, tobacco and other drugs. The available evidence for effectiveness of these strategies vis-a-vis no treatment or extended treatment is also reviewed, which clearly supports these interventions to be effective, especially for alcohol abuse but also for others It is argued that India presents a fertile ground for application of these strategies and that Indian research in this area should be a top priority.
[ABSTRACT]   Full text not available  [PDF]  [PubMed]
  761 211 -
Musculoskeletal Morbidity with Unmodified ECT may be Less than Earlier Believed
Chittaranjan Andrade, Kiran Rele, R Sutharshan, Nilesh Shah
April-June 2000, 42(2):156-162
Official guidelines for the practice of electroconvulsive therapy (ECT) recommend routine seizure modification to minimize musculoskeletal complications; nevertheless, unmodified ECT continues to be administered in India. We therefore assessed musculoskeletal morbidity with unmodified ECT with particular reference to the development of vertebral fractures and backache X-rays of the thoraco'umbar spine were routinely obtained before and after a course of 6 ECTs in 50 consecutive schizophrenic patients receiving unmodified sinusoidal wave treatment. Backache was reported by 52% of patients; the symptom was severe in 14%. Severe backache developed early during *he ECT course and was commoner in older patients. Gender, height and weight did not predict either presence or severity of backache. One patient experienced a vertebral fracture which was not considered serious' this contrasts with the 20-40% incidence of adverse orthopedic events described with unmodified ECT in early studies. There were no other untoward events. It is concluded that, with specific reference to Indian patients, musculoskeletal morbidity with unmodified ECT may be less than earlier believed Risks with modified vs unmodified ECT therefore need to be systematically reassessed, and decision-making processes may need to be reformulated taking individual situations into account. The findings, conclusions and recommendations of this study carry much medicolegal significance for practitioners of ECT in India.
[ABSTRACT]   Full text not available  [PDF]  [PubMed]
  830 109 -
Predictors of Response to Electro-Convulsive Therapy in Major Depression
B Sivaprakash, R Chandrasekaran, Ajit Sahai
April-June 2000, 42(2):148-155
This study analyses the predictors of response to electro-convulsive therapy in major depression The significance of the initial response to ECT as a predictor of outcome was also studied. 30 patients who met the diagnostic catena for major depression, single episode, as defined by DSM-IIIR were treated with 6-10 ECT sessions. Patients who had shown overall improvement by 50% or more on the Hamilton Depression Rating Scale (HDRS) were considered responders. 19 (63.33%) patients were responders while 11 (36.67%) patients were non-responders. These two groups differed significantly with regard to presence/absence of a delusion, diurnal variation of mood, and baseline HDRS score for hypochondriasis. Early improvement in depression was found to have a positive correlation with overall improvement in depression after the full course of ECT. Multiple linear regression analysis showed that approximately 56% of variability m outcome could be explained by the variables hypochondriasis, delusion and diurnal variation of mood taken together. A logistic regression model nosed on these 3 variables classified 83.3% of the patients correctly. The implications of these findings are discussed.
[ABSTRACT]   Full text not available  [PDF]  [PubMed]
  799 114 -
An Experiment in Psychotherapy Training
Anna Tharyan
April-June 2000, 42(2):142-147
Group supervision was initiated in order to meet the training needs of psychiatric postgraduates. The experience of the group was surveyed at the end of one year. It was found that the use of groups as an adjunct to individual supervision was an eminently practical and acceptable method of facilitating training, accessing peer group support and auditing clinical care.
[ABSTRACT]   Full text not available  [PDF]  [PubMed]
  779 125 -
Rave Drug (Ecstasy) and Selective Serotonin Reuptake Inhibitor Anti-Depressants
AN Singh, J Catalan
April-June 2000, 42(2):195-197
3, 4 Methylenedioxymethamphetamine (MDMA) also known as Ecstasy is a common recreational drug of abuse and reports of abuse of tricyclic antidepressants are also known. We report two cases of misuse of selective serotonin re-uptake inhibitors (SSRIs) antidepressants in combination with Ecstasy and their beneficial subjective effects experienced by misusers. We hypothesise the probable underlying pharmacological reasons and recommend its use in the treatment of neurotoxic effects of MDMA.
[ABSTRACT]   Full text not available  [PDF]  [PubMed]
  762 110 -
A Case Report of Carisoprodol Dependence
D Venugopal, G Deepak, N Murali, KB Kumar, PS Sharma
April-June 2000, 42(2):211-213
Carisoprodol is a centrally acting skeletal muscle relaxant whose active metabolite is meprobamate. There have been few reports of carisoprodol abuse from India. This is a report of a case with carisoprodol dependence. The patient also had poly substance abuse of alcohol, nicotine, benzodiazepine and dextropropoxyphene. Although no specific withdrawal syndrome could be identified, the patient had symptoms of anxiety, insomnia, restlessness and craving. Clinicians must be aware of the dependence potential of carisoprodol and need to be cautious in its prescription, especially in view of its free availability in the Indian market.
[ABSTRACT]   Full text not available  [PDF]  [PubMed]
  755 116 -
Gender Difference in Resolution of Mania
Ratanendra Kumar, Baxi Neeraj Prasad Sinha, Nandini Chakrabarti, Sanjib Baruah, VK Sinha
April-June 2000, 42(2):198-202
Gender differences are being increasingly reported across psychiatric disorders. Females are known to be more at risk for developing unipolar depressive disorders. In bipolar disorder there is more dysphoria, rapid cycling and more number of depressive episodes in females. However studies on gender difference in resolution are scarce. This study was conducted in Central Institute of Psychiatry to assess the gender difference in resolution of mania. 24 males and 16 females were rated at day 0, 3, 7, 14, 21 & 28 on scale for Manic States, ft was found that males settled faster than females, which was evident at day 14. The rate of resolution was more in males in the first week. Remission was also reached earlier by males.
[ABSTRACT]   Full text not available  [PDF]  [PubMed]
  777 87 -
Expression of Suicidal Intent in Depressives
Sunil Srivastava, Namita Kulshreshtha
April-June 2000, 42(2):184-187
The study was undertaken to find out correlation, if any, between severity of depression and suicidal intent communication and its relation to age, marital status, duration of iilness, previous admission in a psychiatric hospital in patients of depression diagnosed using criteria of ICD-IX category codes F31.3, F31.4, F31.5, F32 and F33. Sample consisted of 30 patients from the OPD of Agra Mansik Arogyashala. The Hamilton Rating Scale for depression was used to measure severity of depression and suicidal intent questionnaire was used to assess suicidal intent communication. A positive correlation between severity of depression, being married, being male, being employed, being ex-mental hospital patient, duration of illness being more than one month and age being less than or equal to 35 years was found. Further research in this area is required.
[ABSTRACT]   Full text not available  [PDF]  [PubMed]
  729 134 -
Psychological Blindness - A Case Report
MN Parikh, HM Shah
April-June 2000, 42(2):209-210
Rarely does malingering present in the form of complete blindness and that too of prolonged duration, in presence of possible organic corroboration and well supported by relatives. This case is reported to highlight the extremes of psychological production of symptoms and how it can be successfully dealt with.
[ABSTRACT]   Full text not available  [PDF]  [PubMed]
  705 97 -
A Questionnaire Survey of Psychiatrists Attitudes Towards Genetic Counselling
D Venugopal, G Ranjith, MK Issac
April-June 2000, 42(2):163-166
Genetic counselling in psychiatry aims at facilitating mentally ill patients and their relatives to make informed choices after understanding what is known about the genetics of a given mental disorder This area of practice is a recent development in mental health care. This study surveyed the attitudes and practices of Indian psychiatrists towards genetic counselling. Fifty-nine out of 150 randomly selected psychiatrists completed a semi-structured questionnaire assessing various aspects of genetic counselling in practice. The results show that there is a felt need for genetic counselling among patients. Most of the respondents provide information regarding the hereditary nature and risk of inheritance of mental illnesses in single sessions of less than 30 minutes duration in clinical situations. Most psychiatrists (76%) felt that genetic counselling is feasible in practice, but 24% felt inadequate knowledge, illiteracy among patients and time constraints as some hindering factors for the same. Genetic counselling was considered to be important in planning management for patients by most respondents. The need to improve their knowledge and skills in the genetic understanding of mental illnesses was also reported. These results have implications for future practice of genetic counselling in the Indian setting.
[ABSTRACT]   Full text not available  [PDF]  [PubMed]
  659 139 -
Genomic Imprinting in Bipolar Affective Disorder
Ratanendra Kumar, VK Chopra, A Parial, C.R.J Khess
April-June 2000, 42(2):167-171
With recent advances in molecular genetics, a new mechanism proposed for the inheritance of Bipolar Disorder is Genomic Imprinting or Parent of Origin Affect. In this study of 79 consecutive first episode manic patients, predominantly male, we failed to establish the phenomenon of imprinting. With other proposed non-Mendelian patterns of inheritance, it may be that bipolar disorder is genetically heterogenous.
[ABSTRACT]   Full text not available  [PDF]  [PubMed]
  632 101 -
Do Indian Researchers Read Indian Research? A Reappraisal, Four Years Later
Chittaranjan Andrade, Shashi Kiran, Sanjay Kumar N Rao, Partha Choudhury
April-June 2000, 42(2):203-208
A previous study found that many papers in the Indian Journal of Psychiatry (UP) had failed to reference relevant papers previously published in the same journal. The present study examined whether any change in referencing patterns had occurred The database comprised 182 eligible articles published in the UP during 1993-1996. In general, few articles cited previous UP papers (median citations, 0-1); however, few articles omitted to cite previous (relevant) UP research (median omissions, 0-1). The average number of articles cited: omitted was 2:1. Original articles cited as well as omitted more UP references than brief communications. The larger the number of total references cited, the larger was the number of UP references both cited and omitted. No significant changes in referencing patterns was evident across the years. Indexing of articles, an important method of identifying relevant, previously published research was grossly adequate in 89% of articles; the average article received 2 index entries. While UP papers appear to be receiving greater attention, it is suggested that room for improvement remains.
[ABSTRACT]   Full text not available  [PDF]  [PubMed]
  658 62 -
Asylums and Artists
O Somasundaram
April-June 2000, 42(2):133-141
Relationship between genius and mental illness has always been an issue of interest and controversy. Creative people in arts have been more prone to mental illness as compared to the men of science. Asylums of yesteryears in England, France and Spain have had eminent artists such as Hogarth, Dadd, Van Gough and Goya either as residents or as records of the scenes in those hospitals. These relationships, the paintings of the places and the artists are discussed.
[ABSTRACT]   Full text not available  [PDF]  [PubMed]
  632 82 -
Psychosomatic Disorders in General Practice
Vihang N Vahia
April-June 2000, 42(2):221-221
Full text not available  [PDF]
  491 112 -
"All Antidepressants are Created Equal" (Some are More Equal Than Others)
Dinshaw R Doongaji
April-June 2000, 42(2):111-113
Full text not available  [PDF]  [PubMed]
  420 125 -
Clinical Methods in Psychiatry
Mukul Sharma
April-June 2000, 42(2):220-220
Full text not available  [PDF]
  416 61 -
Towards Suicide Prevention
Lakshmi Vijayakumar
April-June 2000, 42(2):214-214
Full text not available  [PDF]  [PubMed]
  331 107 -
Ear Disease and Mania - A Preliminary Study
Ratanendra Kumar, MK Srivastava, Rebecca N Srivastava
April-June 2000, 42(2):218-219
Full text not available  [PDF]  [PubMed]
  274 26 -
Regional Differences in the Concept and Therapeutic Value of Yoga - An E-mail Survey
Ravi S Pandey, OK Subbakrishna
April-June 2000, 42(2):215-216
Full text not available  [PDF]  [PubMed]
  260 38 -
Animal Model for Increased Retrieval of Unpleasant Memories : Fact or Artefact?
Chittaranjan Andrade
April-June 2000, 42(2):217-218
Full text not available  [PDF]  [PubMed]
  251 23 -
How Do People React to a NGO Website?
R Thara
April-June 2000, 42(2):216-217
Full text not available  [PDF]  [PubMed]
  238 28 -
A Venkoba Rao
April-June 2000, 42(2):214-215
Full text not available  [PDF]  [PubMed]
  210 31 -
Intolerance to Noise in Psychiatric Disorders
Chittaranjan Andrade
April-June 2000, 42(2):218-218
Full text not available  [PDF]  [PubMed]
  207 33 -