Indian Journal of PsychiatryIndian Journal of Psychiatry
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  Citation statistics : Table of Contents
   2009| July-September  | Volume 51 | Issue 3  
    Online since September 8, 2009

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Fronto-temporal dysfunction in schizophrenia: A selective review
John P John
July-September 2009, 51(3):180-190
DOI:10.4103/0019-5545.55084  PMID:19881045
Schizophrenia is conceptualized as a disorder of aberrant neurodevelopment, with evident stigmata such as minor physical anomalies (MPA), neurological soft signs (NSS), and abnormalities of brain structure and function, proposed as disease endophenotypes. We have examined the neurobiology of schizophrenia using neurodevelopmental markers, structural MRI (sMRI), EEG spectral power, and coherence as well as neuropsychological testing in neuroleptic-naïve, recent-onset schizophrenia (NRS) subjects. It has been our focus to link the positive and negative symptom dimensions of schizophrenia with their underlying neural correlates specifically reflecting fronto-temporal circuitry dysfunction. We found that MPAs and NSSs constituted independent neurodevelopmental markers of schizophrenia and would afford greater predictive validity when used as a composite endophenotype. In an exploratory factor analytic study of the dimensionality of psychopathology, we noted that the symptoms segregated into three dimensions, viz., positive, negative, and disorganization, even in NRS subjects. Executive function tests as well as EEG spectral power and coherence studies revealed that the symptom dimensions of schizophrenia could be linked to specific neural correlates. In an attempt to study the relationship between the symptom dimensions and brain structure and function using MRI, we have proposed neuroanatomical definitions with cytoarchitectonic meaning for parcellation of the prefrontal sub-divisions. Using sMRI, we have found specific corpus callosal abnormalities that possibly link the temporo-parietal association cortices with the positive symptom dimension. Recently, we also found evidence for neurodevelopmental deviance in schizophrenia possibly involving the frontal pole (FP)-driven cortical network, in a sMRI study linking FP volume and total brain volume with age in NRS subjects and age-, gender- and education-matched healthy subjects. Overall, our findings highlight the potential significance of linking the homogeneous symptom dimensions of schizophrenia with dysfunctional connectivity in the fronto-temporal region.
  16 7,602 1,137
Innovations in Psychiatry: Ambulatory services for the mentally ill
H Chandrashekar, NR Prashanth, C Naveenkumar, P Kasthuri
July-September 2009, 51(3):169-170
DOI:10.4103/0019-5545.55081  PMID:19881042
  4 2,974 554
Study of cenesthesias and body image aberration in schizophrenia
Gaurav Rajender, Krishna Kanwal, Dinesh M Rathore, Deepa Chaudhary
July-September 2009, 51(3):195-198
DOI:10.4103/0019-5545.55086  PMID:19881047
Background: Abnormal body sensations are reported frequently by schizophrenic patients. Cenesthesias are infrequently recognized and diagnosis of cenesthopathic schizophrenia is rarely made. There are very few studies regarding the same. Aims and Objectives: To assess cenesthesias and different aspects of body image aberration and their relationship with psychopathology in patients with paranoid schizophrenia. Materials and Methods: Seventy patients of paranoid schizophrenia meeting the inclusion and exclusion criteria were assessed with Positive and Negative Symptom Scale(PANSS) for psychopathology, Bonn Scale for Assessment of Basic Symptoms/Category D 'Cenesthesias' (BSABS), Image-Marking Procedure(IMP), alteration of body size and body cathexis. Assessments were made at baseline and after two weeks and assessed with SPSS 12.0. Results: The most commonly endorsed items on BSABS were depersonalization, motor weakness, abnormal pain, numbness and stiffness. Patients underestimated lower extremities and feelings of body size change which was positively correlated with PANSS-scores and improved on reassessment. Cenesthesias were positively correlated with disturbances of body concept and were present at onset in 40% and change form in 75.7%. Conclusions: Cenesthesias and body image aberrations are common in paranoid schizophrenia. They are present from onset in few, change form and improve on treatment. Cenesthesias and disturbances of body concept are correlated and body size is associated with other psychopathology.
  4 3,924 363
Roadmap to Indian Psychiatry
E Mohandas
July-September 2009, 51(3):173-179
DOI:10.4103/0019-5545.55083  PMID:19881044
  4 4,399 800
Idiopathic unilateral focal hyperhidrosis with social anxiety disorder
V Anand Prakash Ghorpade
July-September 2009, 51(3):214-215
DOI:10.4103/0019-5545.55094  PMID:19881053
Hyperhidrosis especially palmoplantar type are commonly referred to psychiatrist for management. Focal type of hyperhidrosis is less commonly seen more so associated with social anxiety disorder. Focal type is associated with variety of organic causes which has to be excluded before labeling it as Idiopathic variety. The variety of treatment that they are subjected to and its outcome are discussed in this case report.
  2 1,894 218
Women in psychiatry: A view from the Indian subcontinent
Mamta Sood, Rakesh Kumar Chadda
July-September 2009, 51(3):199-201
DOI:10.4103/0019-5545.55088  PMID:19881048
Background: Psychiatry has not been a preferred medical specialty for women in the Indian subcontinent unlike in the Western countries like USA, Canada or UK. Recent years have seen an increase in the number of women doctors in India choosing psychiatry as career. Materials and Methods: Information on women in psychiatry in the Indian subcontinent was collected using resources like PubMed, directories of the professional societies, websites of medical institues, souvenirs and scientific programme of various conferences and personal communication with psychiatrists, and the data about postgraduate trainees available with the authors' own institute. Results: Women psychiatrists constitute about 15% of total psychiatrists in India, out of whom only 10% are at a relatively senior level, and the most are young. The women psychiatrists are also in faculty positions in a number of medical schools and have held important positions in the Indian Psychiatric Society at different times. Conclusions: Most of the women psychiatrists appear to be still at junior levels, having joined the profession relatively recently as compared to their male counterparts. The trend at increasing number of women psychiatrists in the Indian subcontinent is similar to the worldwide trends.
  2 2,288 354
Prevalence of neuroleptic malignant syndrome in 672 consecutive male in-patients
Pradyot Sarkar, Chandrashekhar Natarajan, Neeta Gode
July-September 2009, 51(3):202-205
DOI:10.4103/0019-5545.55089  PMID:19881049
Background: Neuroleptic malignant syndrome (NMS) is the most serious and potentially fatal adverse effect of neuroleptic medications. Although it occurs most frequently with conventional antipsychotic medicines, it may occur with newer antipsychotic medicines also. So far, there is no study available about the prevalence of this condition in the Indian population. Aim: To find the prevalence of NMS in the Indian population . Materials and Methods: A total of 672 consecutive male patients who were hospitalized with psychotic breakdowns and treated with neuroleptics were screened for evidence of the development of NMS, clinically, and supported by laboratory investigations. Results: Three patients, all suffering from manic episode, developed NMS within few days of initiation of neuroleptic medicines. Haloperidol injection was given in all three cases . Conclusion: The prevalence of NMS was 0.45%. All were young males, suffering from manic episode with psychotic symptoms and managed with oral and parentral neuroleptic medicines.
  2 2,899 292
Catatonia and multiple pressure ulcers: A rare complication in psychiatric setting
Abhishek Srivastava, Anupam Gupta, Pratima Murthy, Thyloth Murali
July-September 2009, 51(3):206-208
DOI:10.4103/0019-5545.55091  PMID:19881050
The incidence of pressure ulcers in patients with psychiatric illness, especially with catatonia might be more than what is reported in the literature. We report a case of catatonia secondary to severe depression presenting with multiple pressure ulcers. Single case report - description and management. An 18 yrs old boy reported with a continuous course illness characterized by features of catatonia secondary to severe depression with multiple pressure ulcers over sacrum and heels. Ulcers were effectively managed by a multidisciplinary team of physiatrist, psychiatrist, and rehabilitation nurses. Immobility, reduced nocturnal movements, increased skin fragility, and poor nutrition contribute to the development of the pressure ulcer in bed-bound psychiatric patients. Efforts should be directed toward the prevention of pressure ulcers in these patients to reduce additional morbidity.
  1 1,966 217
Emotional lability secondary to the application of a very potent topical corticosteroid
Srinivasa Sastry Malladi
July-September 2009, 51(3):212-213
DOI:10.4103/0019-5545.55093  PMID:19881052
A 66 yrs old gentleman presented with severe mood changes following application of very potent topical corticosteroid cream, clobetasol propionate, which was prescribed for his recalcitrant eczema. The symptoms disappeared within 24 hours of discontinuation of the cream and he remained mentally well when reviewed after 2 weeks.
  1 1,685 194
Surgical treatment of obsessive compulsive disorders: Current status
Paresh K Doshi
July-September 2009, 51(3):216-221
DOI:10.4103/0019-5545.55095  PMID:19881054
  1 2,219 444
Drooping genes v/s dancing genes
TS Sathyanarayana Rao, KS Jagannatha Rao, MR Asha
July-September 2009, 51(3):167-168
DOI:10.4103/0019-5545.55080  PMID:19881041
  1 2,196 473
Prescribing practices of clozapine in India: Results of a opinion survey of psychiatrists
Amresh Shrivastava, Nilesh Shah
July-September 2009, 51(3):225-226
DOI:10.4103/0019-5545.55097  PMID:19881056
  1 1,878 293
Neuro syphilis: Portrayals by Sir Arthur Conan Doyle
O Somasundaram
July-September 2009, 51(3):235-237
DOI:10.4103/0019-5545.55103  PMID:19881059
The developments in neuro syphilis in the 19 th century are integral parts of the history of psychiatry. The delineation of various aspects of neuro syphilis by Sir Arthur Conan Doyle in three of his stories is discussed in brief.
  1 2,051 208
Inter-rater reliability of Hamilton depression rating scale using video- recorded interviews - Focus on rater-blinding
M Krishna Prasad, K Udupa, KR Kishore, J Thirthalli, TN Sathyaprabha, BN Gangadhar
July-September 2009, 51(3):191-194
DOI:10.4103/0019-5545.55085  PMID:19881046
Background: Hamilton depression rating scale (Ham-D) is the most widely used clinician rating scale for depression. There has been no Indian study that has examined the inter-rater reliability (IRR) of video-recorded interviews of the 21-item Ham-D. Aim: To study the IRR of scoring video-recorded interviews for 21-item Ham-D. Materials and Methods: Eighteen subjects with major depressive disorder involved in a larger study were interviewed using the semi-structured clinical interview of the 21-item Ham-D by a primary rater after informed consent. These interviews were video-recorded and portions edited to ensure rater blinding. Subsequently, the video-recorded interviews were rated by a "blind" rater. Both rated the different sub-domains of Ham-D according to Rhoades and Overall (1983). IRR was evaluated using intra-class correlation coefficient. Results: Excellent IRR was observed (0.9891) between the two raters. This was true for each of the primary factors and super-factors. Conclusion: Video recorded 21-item Ham-D has excellentIRR. Video-recorded interviews of Ham-D can be reliably used to blind raters in research.
  1 3,810 409
Postgraduate corner: Continuing medical education: Psychopharmacology
Chittaranjan Andrade
July-September 2009, 51(3):222-224
DOI:10.4103/0019-5545.55096  PMID:19881055
  1 1,701 362
Concise textbook of child and adolescent psychiatry
Vineet Kumar, Sandeep Grover
July-September 2009, 51(3):229-230
  - 1,494 292
Obsessive compulsive disorder: Current understanding and future directions
MV Ashok
July-September 2009, 51(3):231-232
  - 2,067 475
Spirituality and mental health: Reflections of past, applications in present, projections for future
BR Ravi Shankar Rao
July-September 2009, 51(3):233-234
  - 1,437 423
Rapid and spontaneous recovery in autistic disorder
Prabhat Sitholey, Vivek Agarwal, Amol Pargaonkar
July-September 2009, 51(3):209-211
DOI:10.4103/0019-5545.55092  PMID:19881051
Recovery in autistic disorder is rare. There are few reports of recovery from autistic disorder after a few years of therapeutic intervention. We report here a case of autistic disorder who recovered spontaneously without any intervention in 13 days.
  - 2,296 334
Truth telling and communication skills
SK Chaturvedi
July-September 2009, 51(3):227-227
DOI:10.4103/0019-5545.55098  PMID:19881057
  - 1,315 237
Use of milnacipran in patients suffering from poststroke depression
Harish Arora, Rajdeep Kaur
July-September 2009, 51(3):228-228
DOI:10.4103/0019-5545.55099  PMID:19881058
  - 1,465 211
G Swaminath
July-September 2009, 51(3):171-172
DOI:10.4103/0019-5545.55082  PMID:19881043
  - 4,681 800