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   2000| October-December  | Volume 42 | Issue 4  
    Online since February 20, 2009

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Organic Catatonia : A Review
Noraj Ahuja
October-December 2000, 42(4):327-346
Catatonia is a clinical syndrome associated with a wide variety of psychiatric, medical and neurological disorders. Despite several reports in the literature of a wide range of medical and neurological diseases causing catatonia, there has been a tendency to consider catatonia as purely psychiatric disorder. The review attempts to look at the concept of organic catatonia from a historical viewpoint, including its place in the psychiatric classification, discusses the various etiological causes of organic catatonia, and them goes through some important management issues in organic catatonia. The review suggests that organic catatonic disorder must be first considered in every patient with catatonic signs, particularly in a patient with new onset catatonia.
[ABSTRACT]   Full text not available  [PDF]  [PubMed]
  1,371 518 -
A Decade with the Mental Health Act, 1987
James T Antony
October-December 2000, 42(4):347-355
The Mental Health Act, 1987 came into force in 1993. Mental Health Authorities that were created by this Act are useful, but the present situation of not having Government Mental Hospitals under the scrutiny of these authorities is a shortcoming. The high capital needed for upgradation of Government mental hospitals; is likely to be found, only with the intervention of Mental Health Authorities Creation of a funding agency of Government of India is also needed Denying profoundly retarded persons access to a psychiatric hospital is a hard situation. Psychiatric patients in general hospitals' having to face the hassles of mental hospital admission is against the spirit of the act and needs to be remedied Courts' directly determining the presence of psychiatric illness in persons is not serving the end of justice. They should do this on the basis of evidence Several avoidable hardships that may be caused by having the act in the present form has to be corrected This could be done by amendment of the act in certain cases by approaching the High Court in certain others and by thoughtfully framing the State Mental Health Rules in a quite a few other situations. The success of Mental Health Act, 1987 is in its effectiveness to ensure basic human rights of mental patients. A set of Mental Health Rules, that incorporates adequate provisions to protect human rights of patients, in all respects, can go a long way to strengthen the Mental Health Act.
[ABSTRACT]   Full text not available  [PDF]  [PubMed]
  1,168 436 -
A Study of Prevalence and Comorbidity of Depression in Alcohol Dependence
Abdul Khalid, Arun Raj Kunwar, K. C Rajbhandari, Vidya Dev Sharma, Shishir K Regmi
October-December 2000, 42(4):434-438
Depressive symptoms are wide spread in alcohol abusing patients of all ages and are much more common than diagnosable depressive disorder. Studies have reported that depression diagnosed in the current episode of alcoholism remits after two weeks of abstinence and detoxification from alcohol. Despite the high prevalence of depression in alcohol dependent individuals, the nature of the relationship between depressive disorder and alcohol abuse have been difficult to define. The present work was undertaken with the aim to study the prevalence and comorbidity of major depression in alcohol dependence. The sample comprised of 34 (32 males and 2 females) DSM-IV alcohol dependent patients admitted in the Psychiatry ward of T.U. Teaching Hospital, Kathmandu during one year study period. Diagnosis of major depressive episode was made according to DSMIV criteria. Severity of dependence on alcohol was assessed with the Severity of Alcohol Dependence Questionnaire and severity of depressive symptoms was rated on Hamilton Rating Scale for Depression. Repeat assessment was done on day 14. A high prevalence of major depression (41.7%) was found for the episode of drinking which led to hospitalization. However, within a few days of detoxification from alcohol, only few of them had depressive symptoms amounting to major depression (17.64%). There was no significant correlation between severity of alcohol dependence and depression. The findings suggest that the nature of depression found in those patients with alcohol dependence needs further exploration. It appears that clinicians exercise appropriate judgement in not prescribing antidepressant treatments for symptoms which may change within days, providing that alcohol is not consumed.
[ABSTRACT]   Full text not available  [PDF]  [PubMed]
  1,216 371 -
Insight and Psychopathology in Schizophrenia
Anna Tharyan, B Saravanan
October-December 2000, 42(4):421-426
Among a group of patients with schizophrenia, severity of psychopathology was significantly correlated with dimensional measures of awareness of the abnormal experiences whereas a similar relationship with global measures of insight could not be demonstrated. The awareness of the abnormal nature of individual items of psychopathology does not necessarily overlap with insight as measured by awareness of the concept or consequences of mental illness or the need for treatment.
[ABSTRACT]   Full text not available  [PDF]  [PubMed]
  1,181 226 -
A Study of Psychiatric Manifestations of Physically Asymptomatic HIV - I Seropositive Individuals
Ramanand Satapathy, Murali N Krishna, Ashok M Babu, M Vijayagopal
October-December 2000, 42(4):427-433
Neuropsychiatric disorders are common both secondary to the complications of immune suppression and as direct effects of HIV on the brain. A high prevalence of psychiatric disorder is reported both in physically asymptomatic and symptomatic persons. A thorough search was made in MEDLAR for the research literature available in the field of neuropsychiatric manifestations of AIDS. There is paucity of literature particularly in India and to be more specific in asymptomatic AIDS individuals, hence this study is intended to fill up the lacuna. The findings of this study show that the prevalence rate of psychiatric manifestations is 90% in HIV positive individuals and 33% in HIV negative group. This rate is significantly high though they are not suffering with physically disabling symptoms. So, the coping mechanisms and defence mechanisms in an individual who acquired HIV infection should be assessed and the significance of counselling before screening, plays a major role in the management of asymptomatic positive and negative individual.
[ABSTRACT]   Full text not available  [PDF]  [PubMed]
  913 140 -
Psychometric Properties of Quality of Life (QLS) Scale : A Brief Report
Nitin Gupta, Surendra K Mattoo, Debasish Basu, Aprajita Lobana
October-December 2000, 42(4):415-420
Quality of life research in chronic schizophrenia has not adequately focussed upon psychometric properties of the disease specific scales (including Quality of Life Scale); especially in the cross-cultural perspective. The authors attempted to assess certain psychometric properties of the Quality of Life Scale (QLS); modified as per the Indian cultural background Fifteen patients of ICD-10 chronic schizophrenia and their key relatives were administered QLS and rated by two investigators. Patients were also administered Lehman's Quality of Life Interview-Brief Version. Correlation coefficients were high for inter-rater reliability and divergent validity and inconsistent for convergent validity. Results support the original construct of QLS and demonstrate its easy crosscultutral applicability to key relatives by clinicians.
[ABSTRACT]   Full text not available  [PDF]  [PubMed]
  832 189 -
National Policies to Meet the Challenge of Substance Abuse : Programmes and Implementation
Anil Malhotra, Ashwin Mohan
October-December 2000, 42(4):370-377
Drug abuse has become a growing issue of concern to humanity. India has a large consumer base of drug and alcohol abusers. This has serious repercussions in terms of morbidity & mortality. Hence the need for a national policy. In India, the Narcotic Drugs and Psychotropic Substances Act. 1985 (NDPS) provides the framework for drug abuse control in the country. A large number of measures have been undertaken as part of demand reduction activities. These include framing policies and programmes, setting up of centres, developing pilot projects, etc. However, the implementation still needs a lot to be desired. The efforts have not yet been streamlined and no revision of policies has taken place based on experience. This paper critically reviews the initiatives taken thus far to control drug abuse in our country.
[ABSTRACT]   Full text not available  [PDF]  [PubMed]
  789 220 -
Treatment Setting and Follow-Up in Alcohol Dependence
Suveera Prasad, Pratima Murthy, D. K Subbakrishna, P. S Gopinath
October-December 2000, 42(4):387-392
This study aimed at evaluating patient and treatment variables influencing six month treatment outcome in alcohol dependence. 134 serially registered patients selected their treatment setting as either outpatient or inpatient. Sociodemographic variables, alcohol consumption patterns, drinking consequences were measured at intake. Following treatment, drinking patterns and consequences were re-measured at three and six months follow up in each of the groups. 86 of 134 chose the inpatient program and 48 the outpatient program. Overall, 58 maintained total abstinence, and 11 had significantly reduced alcohol consumption at six months follow up. The inpatient group did marginally better than the outpatient group. More severely dependent patients, those with greater physical and psychosocial consequences opted for an inpatient program, and did well. Less severely dependent patients did favourably with outpatient intervention alone. Improvements made within the first three months tended to influence subsequent treatment compliance The observation that less severely dependent individuals who opted for outpatient services did favourably suggests that extensive treatment may be required only for those with more severe dependence or greater psychosocial consequences. Our findings also highlight the need for developing community based low cost interventions.
[ABSTRACT]   Full text not available  [PDF]  [PubMed]
  787 158 -
Acute Non-Organic Psychosis-Outcome After 10 Years
L. N Gupta, Pramod Bhardwaj
October-December 2000, 42(4):356-362
62 out of 68 acute psychosis patients who were initially recruited from the Bikaner Centre in 1982 for the Indian Council of Medical Research (ICMR) study on "phenomenology and natural history of acute psychosis" were assessed after completion of 10 years in 1992-93 on SCAAPS and PSE with the objective of studying the long term course and outcome of acute psychosis. The results show that 35 (56.45%) patients of acute brief episode of psychosis never had any psychotic illness during the course of follow-up. Remission was significantly better in the young, the unmarried, in those who belonged to the Hindu religion and in those who developed the full blown psychosis abruptly within 48 hours. Other sociodemographic, personal history variables, and symptomatology could not distinguish this remitted group from the rest of the patients.
[ABSTRACT]   Full text not available  [PDF]  [PubMed]
  786 147 -
P 300 Event Related Potential in Depression
R Singh, R Shukla, P. K Dalal, P. K Singh, J. K Trivedi
October-December 2000, 42(4):402-409
P300 component of the event related potential (ERP) provides one neurophysiological index of cognitive dysfunction in depression. Forty subjects fulfilling DSM-III criteria for depression were compared to 40 age and sex matched normal controls. The P300 was recorded using the auditory odd-ball paradigm. Depressives had a significantly prolonged P300 latency and reduced P300 amplitude as compared to the controls. The P300 latency showed a significant positive correlation with age of the patient and severity of depression while P300 amplitude showed a significant negative correlation with age. The clinical subcategory of depression, duration of illness and sex did not show any relationship with P300 abnormality. Twelve out of 40 depressives (30%) had an abnormal P300. The mean Hamilton Rating Scale for Depression (HRSD) score was significantly high in those with an abnormal P300.
[ABSTRACT]   Full text not available  [PDF]  [PubMed]
  783 82 -
Endorsement and Concordance of ICD-10 Versus DSM-IV Criteria for Substance Dependence : Indian Perspective
Debasish Basu, Nitin Gupta, Narendra Singh, Surendra K Mattoo, Parmanand Kulhara
October-December 2000, 42(4):378-386
Substance use disorders have undergone major changes in both the international (ICD-10) and American (DSM-IV) nosological systems, thus necessitating a study of cross-system agreement between ICD-10 and DSM-IV substance dependence, especially from a developing country setting. Further, endorsement rates for various substance dependence criteria in the two systems need to be studied from a similar perspective. Hence, 221 consecutive patients with 279 diagnostic categories of substance dependence attending a de-addiction centre in Northern India were studied with regard to endorsement of the various ICD-10 and DSM-IV criteria as well as for cross-system agreement for severity of dependence. High endorsement rates were seen for most criteria in both the systems, except for those related to 'persistence despite harm' and 'salience (neglect of various activities, plus excessive time spent to procure the substance)'. There were some significant differences, however, between endorsement rates across different substance categories in both the systems. Cross-system agreement on severity of substance dependence ranged from fair to good for all categories combined, and was good to excellent for the opioid category. The category of 'others' (nicotine, cannabis and sedative-hypnotics) showed poor cross-system agreement Overall, the results lend support to the basic theoretical construct behind both ICD-10 and DSM-IV substance dependence syndrome from a developing country perspective.
[ABSTRACT]   Full text not available  [PDF]  [PubMed]
  752 105 -
P300 Event Related Potential in Normal Healthy Controls of Different Age Groups
R Shukla, J. K Trivedi, R Singh, Y Singh, P Chakravorty
October-December 2000, 42(4):397-401
P300 event related potential was recorded in 115 healthy controls with a mean age of35.9±14.81 years and a male : female ratio of 72 : 43. There was significant difference in the P300 latency in <40 years as compared to > 40 years group (p<0.001). There was no significant difference between males and females. There was a strong positive correlation between age and P300 latency (p<0.001). The regression equation for P300 latency was Y=287.9+1.492x with an SEE of 20.2 (where Y is the P300 latency in ms, x is the age in years, SEE is the standard error of estimate). There was a negative correlation between age and P300 amplitude which was significant in < 40 years age group while in > 40 years age group it was not significant.
[ABSTRACT]   Full text not available  [PDF]  [PubMed]
  709 104 -
Mania in Parkinsons Disease with Treatment Emergent Dyskineisa : A Case Report
Raheev Yadav, Charles Pinto
October-December 2000, 42(4):439-441
A case of parkinson's disease starting 7 yrs. ago in 1993 with 2 episodes of mania is presented. The 1st episode (1993) was of 1-1A months duration, when early parkinsons symptoms had already set in. This was treated with anti-psychotic medications for a month, the picture was complicated with stroke and post-stroke sequlae for 5-6 months, where anti-psychotics were continued. He developed dyskinesia, when antipsychotics were stopped. The patient was on selegiline for Parkinson's disease for 2 years and off all medications subsequently. The 2nd episode of mania occurred after 7 years in January 2000. This episode of mania lasting for 2 months duration was treated with divalproate sodium and l-dopa for Parkinson's. Treatment emergent dyskinesia had to be treated with Clozapine. This unusual combination ofbipolar-l disorer (2 episodes of mania) with Parkinson's disease and treatment emergent dyskinesia is presented with management strategy.
[ABSTRACT]   Full text not available  [PDF]  [PubMed]
  694 116 -
Long Term Effects of Lithium on Glomerular Filtration Rate in Indian Subjects - A Cross Sectional Study
Baljinder Singh, Bhagwant R Mittal, Kamal Sud, Anish Bhattacharya, Pratap Sharan, Surinder K Jindal, Shridhar D Deodhar
October-December 2000, 42(4):410-414
Glomerular filtration rate (GFR) was evaluated in thirty patients on lithium and in thirty healthy prospective kidney donors by single compartment, multiple sample plasma clearance method using 99m Technetium diethylene triamine pentaacetic acid ( 99m TC-DTPA). Normality test revealed that dose and treatment duration were skewed and the coefficient of skewness were 0.067 (p<0.0001) and 1.41 (p<0.0001) respectively. Age was marginally skewed (p =0.04) for the control group. At 5% significance level, dose and creatinine were negatively correlated (r=-0.030), whereas age and duration were positively correlated (r =+ 0.53) (single tailed only). Duration and GFR seems to be negatively correlated (r = -0.23), however this correlation did not reach statistically significance level. In the present cross sectional study no significant difference in mean GFR was observed in lithium treated affective disorder patients when compared with the age matched normal subjects.
[ABSTRACT]   Full text not available  [PDF]  [PubMed]
  723 84 -
Type A- Type B Clustering of Alcoholics - A Preliminary Report from an Indian Hospital
Sujit Varma, Somnath Sengupta
October-December 2000, 42(4):363-369
To generate homogeneous clusters of alcoholics and to check the empirical stability of the clusters. Patients from consecutive admissions were assessed by face to face interview on 7 or 8 post abstinence day in a cross-sectional design. 73 male inpatients satisfying DSM-IV criteria of alcohol dependence syndrome without significant physical or cognitive deficits formed the sample. Apart from socio demographic variables, twelve other parameters were assessed with appropriate instruments over a span of last six months. Cluster analysis was followed by ANOVA on the twelve variables between the clusters. Stability of the clusters was checked by a three step statistical technique. Two clusters with 61 subjects and 12 subjects were accepted. ANOVA showed significant difference on nine out of twelve variables. Throughout the three steps of the check mechanism eight variables were found to consistently discriminate the two clusters. On a small sample of hospitalized alcoholics using twelve parameters we could obtain a preliminary evidence that subtypes simulating Type A - Type B could occur in a different sociocultural setting. Further studies on a bigger sample with data on treatment response are indicated.
[ABSTRACT]   Full text not available  [PDF]  [PubMed]
  716 75 -
Innovations in Psychiatric Rehabilitation
AK Agarwal
October-December 2000, 42(4):451-451
Full text not available  [PDF]
  549 126 -
The Adequacy of Drinking History Elicited by Junior Doctors in a Teaching General Hospital : An Exploratory Study
K Srinivasan, Mary Kutty Augustine
October-December 2000, 42(4):393-396
We reviewed the case records of patients admitted to the medical, surgical and orthopaedic wards of a teaching general hospital to see whether junior doctors took an adequate drinking history from their patients. Results showed that in more than 50% of the case sheets examined, the resident doctors failed to document any details regarding alcohol consumption. Pattern of drinking was mentioned in 14% of the case records. Few case sheets carried details of alcohol related problems. Overall, interns were better than post-graduate students at documenting details of alcohol consumption among their patients. The junior doctors did not identify harmful drinking in 43% of their patients.
[ABSTRACT]   Full text not available  [PDF]  [PubMed]
  610 59 -
Relevance of Ancient Indian Knowledge to Modern Psychiatry
JK Trivedi
October-December 2000, 42(4):325-326
Full text not available  [PDF]  [PubMed]
  418 140 -
Risperidone-Induced Oculogyric Crisis
Abdul Khalid, Mahendra K Nepal
October-December 2000, 42(4):449-450
Full text not available  [PDF]  [PubMed]
  358 34 -
Evidence-Based Psychiatry : A Distant Dream?
Chittaranjan Andradb
October-December 2000, 42(4):442-442
Full text not available  [PDF]
  284 84 -
Modified Versus Unmodified ECT
GD Shukla
October-December 2000, 42(4):445-446
Full text not available  [PDF]  [PubMed]
  295 36 -
Epidemiological Findings on the Prevalence of Mental Disorder in India
PN Sureshkumar
October-December 2000, 42(4):444-444
Full text not available  [PDF]  [PubMed]
  282 40 -
Agranulocytosis During Clozapine Therapy
K Jagadheesan, YK Agrawal, Vinod K Sinha, S Haque Nizamie
October-December 2000, 42(4):447-449
Full text not available  [PDF]  [PubMed]
  257 42 -
Do Indian Researchers Read Indian Research? A Reappraisal, Four Years Later
RC Jiloha
October-December 2000, 42(4):447-447
Full text not available  [PDF]  [PubMed]
  256 39 -
Unilateral ECT and Dosing
Chittaranjan Andrade
October-December 2000, 42(4):442-443
Full text not available  [PDF]  [PubMed]
  243 36 -
Is a Grandmal Seizure Necessary and Sufficient for the Efficacy of ECT?
BN Gangadhar, K Girish, N Janakiramaiah
October-December 2000, 42(4):443-444
Full text not available  [PDF]  [PubMed]
  248 30 -
Misinterpreter of Maladies!
Chittaranjan Andrade
October-December 2000, 42(4):446-447
Full text not available  [PDF]  [PubMed]
  243 33 -