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   2015| July-September  | Volume 57 | Issue 3  
    Online since October 6, 2015

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Prolonged, longstanding, ultra-high-dose abuse of sildenafil
TS Sathyanarayana Rao, V Arun Kumar, Rajesh Raman, Chittaranjan Andrade
July-September 2015, 57(3):311-312
DOI:10.4103/0019-5545.166626  PMID:26600589
We report a 40-year-old male who self-administered sildenafil for 10 years, in progressively increasing doses from 100 mg per occasion in the 1 st year to 1300 mg per occasion in the 9 th – 10 th years of (ab)use. The frequency of abuse was 2 – 3/week. The only adverse effect of concern that was reported was transient (up to about 12 h), self-limited blurring of vision in the last 2 years, especially in the last 2 months at the highest dose. The patient was otherwise normal. This report is unique because it describes what may be the highest dose of sildenafil reported in literature, abused across a protracted period of time. We discuss issues related to dose and safety of and tolerance to the drug.
  45,612 282 2
Risk factors for suicide in elderly in comparison to younger age groups
PN Suresh Kumar, PK Anish, Biju George
July-September 2015, 57(3):249-254
DOI:10.4103/0019-5545.166614  PMID:26600577
Background: The elderly population has a significant risk of suicide when compared to any other age group. Despite this, suicide among the aged receives scant attention. Hence, identification of suicide risk factors specific to this population will help in the development of suitable prevention strategies for this group. Aims: Comparison of risk factors for attempting the suicide in the elderly versus younger suicide attempters. Materials and Methods: A total 1159 suicide attempters attended the suicide prevention clinic of IQRAA International Hospital and Research Centre. They were evaluated using a specially designed psycho-sociodemographic proforma. The group was divided into those above 65 years (elderly) and those below 65 years (younger) and all the risk factors were compared between these two groups. Results: Most suicide attempters in the elderly category were found to be married, less educated, unemployed and hailed from a rural background and joint families. They had a higher rate of family history of psychiatric illness, past psychiatric illness, concurrent medical illness and history of medical contact in the three months prior to the attempt. A significant number in the elderly group had attempted suicide more than a week after a stressor. Conclusion: The results from this study suggests that in suicide attempters from Indian geriatric population, co-morbid physical illness, mental illness (particularly depression) and family burden of psychiatric illness are important predictors in comparison to younger populations. Also, these attempters had contact with a medical professional in the three months prior to the attempt. Specific preventive interventions need to be tailored for this population to reduce the risk of suicide rather than adopting generalized suicide prevention strategies.
  5,681 706 17
QT prolongation and torsades de pointes with psychotropic agents
Nagaraj Desai, Chilkunda Raviprakash Venkatesh, Shambu Sunil Kumar
July-September 2015, 57(3):305-308
DOI:10.4103/0019-5545.166619  PMID:26600587
The unexpected and catastrophic cardiovascular effects of psychotropic drugs are well described albeit uncommon. The list of drugs which have been associated with prolonging QT interval and hence potentially causing Torsades de pointes is exhaustive. The insight into the plausible mechanisms are largely unclear. However, the practical implications of anticipating and recognizing QT prolongation cannot be overemphasized.
  5,481 335 7
Sexual disorders among elderly: An epidemiological study in south Indian rural population
TS Sathyanarayana Rao, Shajahan Ismail, MS Darshan, Abhinav Tandon
July-September 2015, 57(3):236-241
DOI:10.4103/0019-5545.166618  PMID:26600575
Background: Realizing a dearth of data on this topic, especially in the Indian context, an epidemiological study was conducted in a south Indian rural population to identify the sexual activity patterns and sexual problems among the population above 60 years of age. Objectives: (1) Assessment of sexual activity patterns among individuals above 60 years. (2) Assessment of the prevalence of sexual disorders among individuals above 60 years. Materials and Methods: The study sample consisted of 259 participants, which included both males and females above 60 years of age. Subjects who were sexually active and fulfilled the study criteria were administered Arizona Sexual Experience Scale as a screening tool, for the presence of sexual problems. Those who were found to have sexual problems were interviewed further using appropriate questionnaires. Results: Only 27.4% of the individuals above 60 years were sexually active, and it progressively dropped as age advanced and none were sexually active after 75 years of age. Among the sexually active males, erectile dysfunction (ED) was prevalent in 43.5%, premature ejaculation in 10.9%, hypoactive sexual desire disorder (HSSD) in 0.77% and anorgasmia in 0.38% of the subjects. Among females, arousal disorder was prevalent in 28%, HSSD in 16%, anorgasmia in 20% and dyspareunia in 8% of the subjects. Conclusion: The study gives us an insight into the sexual problems of the elderly and brings home the point that sexual problems are very much common among both men and women in the older population. Among elderly males, ED is the most common sexual disorder whereas in elderly females, arousal disorder is the most prevalent female sexual dysfunction, implicating biology plays an important role in men, whereas psychology plays an important role in women sexual functioning.
  4,036 370 7
Female sexual dysfunction: A comparative study in drug naive 1st episode of depression in a general hospital of South Asia
Payel Roy, Shivananda Manohar, Rajesh Raman, TS Sathyanarayana Rao, MS Darshan
July-September 2015, 57(3):242-248
DOI:10.4103/0019-5545.166623  PMID:26600576
Background: Women's sexual dysfunction is found to be highly prevalent in western and Indian literature. Limited studies are available on drug naive depression in western literature and in Indian population. Aim: To determine the prevalence rate and symptom profile of female sexual dysfunctions in patients with untreated depression. Design: A cross-sectional study in the psychiatry out-patient department of general hospital in South India. Materials and Methods: Following written informed consent female sexual functioning index (FSFI) and Arizona Sexual Experience Scale (ASEX) – female version and Hamilton Depression Rating Scale (HAMD - 17 item) on 30 cases and 30 controls was administered. Sociodemographic data, pattern and type of sexual dysfunctions were enquired. Data were analyzed using descriptive statistics, contingency co-efficient analysis and stepwise multiple regression. Results: The mean score of HAMD 17 item in study group was 19.13. The study showed that female sexual dysfunction was 70.3% in study group compared to 43.3% in control FSFI scores above 16 in HAMD had dysfunction of 76% with FSFI in study group. With ASEX-F sexual dysfunction was 73.3% in study compared to 20% in control. Scores above 16 in HAMD had 80% of sexual dysfunction with ASEX-F in study group. Conclusion: The study found that ASEX-F co-related better with HAMD 17 item. Following the onset of depression, the incidence of sexual dysfunction started at an early age in women.
  3,728 351 7
Persistent genital arousal disorder: Successful treatment with leuprolide (antiandrogen)
Kamala Deka, Neha Dua, Monali Kakoty, Rina Ahmed
July-September 2015, 57(3):326-328
DOI:10.4103/0019-5545.166633  PMID:26600597
  3,918 153 5
Facial emotion recognition deficits: The new face of schizophrenia
Rishikesh V Behere
July-September 2015, 57(3):229-235
DOI:10.4103/0019-5545.166641  PMID:26600574
Schizophrenia has been classically described to have positive, negative, and cognitive symptom dimension. Emerging evidence strongly supports a fourth dimension of social cognitive symptoms with facial emotion recognition deficits (FERD) representing a new face in our understanding of this complex disorder. FERD have been described to be one among the important deficits in schizophrenia and could be trait markers for the disorder. FERD are associated with socio-occupational dysfunction and hence are of important clinical relevance. This review discusses FERD in schizophrenia, challenges in its assessment in our cultural context, its implications in understanding neurobiological mechanisms and clinical applications.
  3,322 431 16
The birth of national mental health program for India
Narendra Nath Wig, Srinivasa R Murthy
July-September 2015, 57(3):315-319
DOI:10.4103/0019-5545.166615  PMID:26600591
The adoption of the National Mental Health Programme (NMHP) in August 1982 was a milestone in the history of Indian psychiatry. Such an ambitious program was formulated at a time where there were <1000 psychiatrists is a triumph of need for mental health care in the country. The story of the NMHP, both in terms of the technical forces and the personalities needs to be recorded for posterity. The current article recalls the community mental health initiatives of Bengaluru and Chandigarh centers providing the reason for integrating mental health care with general health care and the support of the World Health Organization, along with the role of mental health professionals and the health administrators. The lesson that come through is the value of working together with different professionals for the common good. Recording the events for posterity is especially timely in view of the formulation of a new mental health policy and the revision of the national health policy during the last few months.
  3,247 450 4
The establishment of a mother-baby inpatient psychiatry unit in India: Adaptation of a Western model to meet local cultural and resource needs
Prabha S Chandra, Geetha Desai, Dharma Reddy, Harish Thippeswamy, Gayatri Saraf
July-September 2015, 57(3):290-294
DOI:10.4103/0019-5545.166621  PMID:26600584
Background: Several Western countries have established mother-baby psychiatric units for women with mental illness in the postpartum; similar facilities are however not available in most low and medium income countries owing to the high costs of such units and the need for specially trained personnel. Materials and Methods: The first dedicated inpatient mother-baby unit (MBU) was started in Bengaluru, India, in 2009 at the National Institute of Mental Health and Neurosciences in response to the growing needs of mothers with severe mental illness and their infants. We describe the unique challenges faced in the unit, characteristics of this patient population and clinical outcomes. Results: Two hundred and thirty-seven mother-infant pairs were admitted from July 2009 to September 2013. Bipolar disorder and acute polymorphic psychosis were the most frequent primary diagnosis (36% and 34.5%). Fifteen percent of the women had catatonic symptoms. Suicide risk was present in 36 (17%) mothers and risk to the infant by mothers in 32 (16%). Mother-infant bonding problems were seen in 98 (41%) mothers and total breastfeeding disruption in 87 (36.7%) mothers. Eighty-seven infants (37%) needed an emergency pediatric referral. Ongoing domestic violence was reported by 42 (18%). The majority of the mother infant dyads stayed for <4 weeks and were noted to have improved at discharge. However, 12 (6%) mothers had readmissions during the study period of 4 years. Disrupted breastfeeding was restituted in 75 of 87 (86%), mother infant dyads and mother infant bonding were normal in all except ten mothers at discharge. Conclusions: Starting an MBU in a low resource setting is feasible and is associated with good clinical outcomes. Addressing risks, poor infant health, breastfeeding disruption, mother infant bonding and ongoing domestic violence are the challenges during the process.
  3,263 367 21
Prevalence and risk factors for depression among community resident older people in Kerala
Anisha Nakulan, TP Sumesh, Sebind Kumar, PP Rejani, KS Shaji
July-September 2015, 57(3):262-266
DOI:10.4103/0019-5545.166640  PMID:26600579
Background: Depression is the most common mental health problem in late-life. We need more information about the incidence and prevalence of major and minor syndromes of depression in older people. This will help in service development. Aims: To estimate the prevalence of depressive disorders among community resident older people in Kerala, India and to identify factors associated with late-life depression. Materials and Methods: Two hundred and twenty community resident older subjects were assessed for depression by clinicians trained in psychiatry. They used a symptom checklist based on International Classification of Diseases Tenth Revision (ICD-10) Diagnostic criteria for research for Depression and Montgomery Asberg Depression Rating Scale for assessment of symptoms. A structured proforma was used to assess sociodemographic characteristics and medical history. The point prevalence of depression was estimated. Univariate analysis and subsequent binary logistic regression were carried out to identify factors associated with depression. Results: Prevalence of any ICD-10 (World Health Organization, 1992) depressive episode was 39.1% (95% confidence interval [CI] 32.6–45.9). There was significant correlation between depression and female gender (odds ratio [OR] 2.33; 95% CI 1.07–5.06) and history of a significant life event in the previous year (OR 2.39; 95% CI 1.27–4.49). Conclusion: High prevalence rate of late-life depression is indicative of high burden due to depression among older people in the community. Better awareness among primary care clinicians can result in better detection and management of late-life depression.
  3,041 449 10
Flibanserin: Approval of a controversial drug for a controversial disorder
TS Sathyanarayana Rao, Chittaranjan Andrade
July-September 2015, 57(3):221-223
DOI:10.4103/0019-5545.166630  PMID:26600572
  3,136 280 4
The study of primary psychotic disorders with concurrent substance abuse in terms of their diagnostic stability
Ankit Singal, PS Bhat, K Srivastava, Jyoti Prakash
July-September 2015, 57(3):224-228
DOI:10.4103/0019-5545.166638  PMID:26600573
Background: Co-morbid substance use is common among individuals presenting with symptoms of psychosis. There is a paucity of research in this area. Aim: To study the longitudinal follow-up of patients over 1-year of first episode psychosis with concurrent substance use in terms of their diagnostic stability. Materials and Methods: Fifty patients having at least one symptom of psychosis at first admission at a General Hospital Psychiatric Unit along with concurrent substance abuse were included and followed up for 1-year. International Classification of Disease-10, diagnostic criteria were used for diagnosis. Semi-structured sociodemographic performa to assess the sociodemographic profile. Brief Psychiatric Rating Scale and Alcohol Use Disorder Identification Test as rating scales were used for the assessment at 6 and 12 months. Results: Of 50 patients, 31 patients who had a diagnosis of primary psychosis retained their diagnosis at follow-up. The mean age of cases in substance-induced psychosis group was 37.47 years, which was significantly higher than in primary psychosis group at 31.52 years. However, 7 patients of the substance-induced psychosis group required a change in diagnosis to primary psychosis group. The primary psychosis group patients were significantly younger, less educated, had less family support, had greater family mental illness, had more severe symptoms, and less hallucinations. Conclusion: The present study is a forerunner in this area. Salient differences indicated in the study can help in differentiating the diagnosis and in the management of cases. This is particularly relevant in the management setting and for long-term intervention purpose.
  2,851 372 -
Schizophrenia in identical twins
Choudhary Laxmi Narayan, Deep Shikha, Shivendra Shekhar
July-September 2015, 57(3):323-324
DOI:10.4103/0019-5545.166635  PMID:26600594
  2,869 307 3
Do SADQ and AUDIT identify independent impacts of alcohol abuse - clinical and biochemical markers respectively?
R Johnson Pradeep, Andrew M Dhilip, Ashok Mysore
July-September 2015, 57(3):278-283
DOI:10.4103/0019-5545.166629  PMID:26600582
Background and Objectives: We have analyzed extant data to see if Alcohol Use Disorder Identification Test (AUDIT) and Severity of Alcohol Dependence Questionnaire (SADQ) assess overlapping aspects of alcoholism, and how they relate to lab measures of alcoholism. Materials and Methods: Consecutive male patients between 20 and 50 years were recruited from varied departments of a general hospital. AUDIT and SADQ, as well as liver function tests, were part of the data obtained. Results: Despite, a significant correlation between total scores of SADQ and AUDIT (ρ = 0.188, P < 0.021) and some of their sub-scores. SADQ scores alone were significantly correlating with clinical variables of alcoholism such as family history and age of onset; AUDIT did not. On the other hand, AUDIT total scores correlated with total and conjugated bilirubin, while SADQ did not. Interpretation and Conclusion: Our data suggests that the two scales, AUDIT and SADQ may be tapping into two different outcomes of increased alcohol use namely clinical and biochemical markers, respectively. SADQ could be useful in studies looking at withdrawal related severity and clinical aspects of alcoholism; while AUDIT could be more suitable for studies looking at alcoholism-related medical morbidity. This needs to be confirmed in larger unselected samples from different community and clinical settings.
  2,803 316 2
Childhood autism in India: A case-control study using tract-based spatial statistics analysis
Zarina Abdul Assis, Bhavani Shankara Bagepally, Jitender Saini, Shoba Srinath, Rose Dawn Bharath, Purushotham R Naidu, Arun Kumar Gupta
July-September 2015, 57(3):272-277
DOI:10.4103/0019-5545.166622  PMID:26600581
Context: Autism is a serious behavioral disorder among young children that now occurs at epidemic rates in developing countries like India. We have used tract-based spatial statistics (TBSS) of diffusion tensor imaging (DTI) measures to investigate the microstructure of primary neurocircuitry involved in autistic spectral disorders as compared to the typically developed children. Objective: To evaluate the various white matter tracts in Indian autistic children as compared to the controls using TBSS. Materials and Methods: Prospective, case-control, voxel-based, whole-brain DTI analysis using TBSS was performed. The study included 19 autistic children (mean age 8.7 years ± 3.84, 16 males and 3 females) and 34 controls (mean age 12.38 ± 3.76, all males). Fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity (AD) values were used as outcome variables. Results: Compared to the control group, TBSS demonstrated multiple areas of markedly reduced FA involving multiple long white matter tracts, entire corpus callosum, bilateral posterior thalami, and bilateral optic tracts (OTs). Notably, there were no voxels where FA was significantly increased in the autism group. Increased RD was also noted in these regions, suggesting underlying myelination defect. The MD was elevated in many of the projections and association fibers and notably in the OTs. There were no significant changes in the AD in these regions, indicating no significant axonal injury. There was no significant correlation between the FA values and Childhood Autism Rating Scale. Conclusion: This is a first of a kind study evaluating DTI findings in autistic children in India. In our study, DTI has shown a significant fault with the underlying intricate brain wiring system in autism. OT abnormality is a novel finding and needs further research.
  2,684 336 3
Sexual dysfunction in women with epilepsy
Vivek Karan, S Harsha, BS Keshava, R Pradeep, TS Sathyanarayana Rao, Chittaranjan Andrade
July-September 2015, 57(3):301-304
DOI:10.4103/0019-5545.166616  PMID:26600586
Background: Sexual functioning and variables that influence sexual functioning have not been studied in Indian women with epilepsy. Materials and Methods: In a pilot study, female (age, 18–45 years) outpatients with epilepsy who were in a stable sexual relationship for at least 1-year were screened using the mini international neuropsychiatric interview. Those without anxiety or depressive disorders (n = 60) were studied using the female sexual function index (FSFI; higher scores indicate better functioning). Findings were compared with age- and sex- matched sample of healthy control women drawn from the same sociodemographic population. Results: Women with epilepsy had significantly poorer sexual functioning on all FSFI subscales (desire, arousal, lubrication, orgasm, satisfaction, pain), as well as on the total scale scores, and >70% of these women were rated as dysfunctional on individual FSFI subscales and on the total scale. In multivariate analysis, use of clobazam and phenobarbitone, and longer time after the last seizure were each associated with significantly higher FSFI scores; and longer duration of epilepsy was associated with significantly lower FSFI scores. Conclusion: There is a substantial impairment of sexual functioning in women with epilepsy. This study demonstrates the need for increased awareness of the problem, better case identification, and improved seizure control.
  2,734 252 4
Depressive symptoms in late life in urban and semi-urban areas of South-West Greece: An undetected disorder?
Konstantinos Argyropoulos, Christos Bartsokas, Argyro Argyropoulou, Philippos Gourzis, Eleni Jelastopulu
July-September 2015, 57(3):295-300
DOI:10.4103/0019-5545.166617  PMID:26600585
Objective: The objective of this study was to estimate the prevalence and probable under-diagnosis of depressive symptoms in elderly of an urban and semi-urban area in Greece. Materials and Methods: A cross-sectional study was conducted among the members of 4 days care centers for older people (KAPI), three in the municipality of Patras, West-Greece, and in one in Tripolis, Peloponnese, Greece. A total of 378 individuals took part in the study, aged >60 years. A questionnaire was developed to collect basic demographic data, including three questions from the European Health Interview Survey, regarding self-reported or by a physician-diagnosed depression. Moreover, to all participants the Greek validated version of the Geriatric Depression Scale-15 (GDS-15) was applied, to screen for depressive symptoms. Results: According to GDS-15, 48.1% of the studied population screened positive for depressive symptoms (38.6% moderate, 9.5% severe), whereas having ever been affected with chronic depression reported 19.0% by themselves. In 162 members of KAPI of Patras and in 106 of Tripolis, who never reported have been affected by depression and depressive symptoms were observed in 27.7% and 44.7%, respectively. In 28 individuals from Patras, who reported not to know if they have depression and in 10 from Tripolis, depressive symptoms were observed in 60.7% and 90%, respectively, applying the GDS-15. Conclusion: Except the high prevalence, the present study reveals a remarkable under-detection of depressive symptoms in older adults. Various interventions in primary care are necessary so as to increase detection rates of depression among the elderly.
  2,607 214 7
Descriptive epidemiology and high risk behavior of male prescription opioid abusers: Cross-sectional study from Sikkim, North East India
D Datta, S Pandey, S Dutta, Y Verma, Amit Chakrabarti
July-September 2015, 57(3):284-289
DOI:10.4103/0019-5545.166631  PMID:26600583
Background: Sikkim is emerging as an important area for prescription opioid abuse with frequent news of seizures and arrests due to possession of prescription opioids. However, till date there is a little information on descriptive epidemiology and high risk behavior of prescription opioid abusers from Sikkim. Aims: The aim was to describe demographic (age, sex, religion, marital status, community, occupation, etc.); socioeconomic (income, education, family information etc.); and high risk behavior (e.g., injection sharing, visit to commercial sex workers [CSWs], homosexuality etc.) among treatment-seeking prescription opioid abusers in Sikkim. Materials and Methods: Epidemiological data were collected by administering predevised questionnaires from n = 223 prescription opioid abusers (main problem prescription opioids) reporting for treatment at five different drug abuse treatment centers across Sikkim. Results: The mean age of prescription opioid abusers in Sikkim was 27 years; all were male, of Nepalese ethnicity and single/never married, school dropout and/or illiterate, earning < Rs. 10,000/month with most spending almost Rs. 5000 a month on prescription opioids. Most (57.4%) prescription opioid abusers belonged to the urban community. Commonly abused prescription opioids were dextropropoxyphene and codeine. Injection sharing was more in urban areas whereas syringe exchange was observed equally among rural and urban prescription opioid abusers. Among urban injectors visits to CSWs, and multiple sex partners were also common in spite of knowledge about AIDS. Limited condom use was observed among rural respondents. Incidences of arrests, public intoxication, and violence under the influence of prescription opioids were also reported. Conclusion: Both the rural and urban areas of Sikkim show increasing rates of prescription opioid abuse among males. It is more prevalent among school dropouts and unemployed youth. Trends of injection drug use, unsafe injection, high risk behavior have also been observed.
  2,545 267 1
Psychological correlates and psychiatric morbidity in patients with Dhat syndrome
Sandeep Grover, Sunil Gupta, Ajit Avasthi
July-September 2015, 57(3):255-261
DOI:10.4103/0019-5545.166637  PMID:26600578
Aim: The aim of this study was to examine psychological factors in the form of somatosensory amplification, alexithymia and hypochondriasis in patients with Dhat syndrome. Secondary aims of the study were: (1) To evaluate the influence of psychiatric comorbidity on the psychological correlates; (2) to compare the prevalence of psychological correlates in those with Dhat syndrome and in those with depression and somatoform disorders. Materials and Methods: A total of 106 subjects diagnosed with Dhat syndrome as per International Classification of Diseases-10 (ICD-10) criteria were assessed on Toronto Alexithymia Scale (TAS-20), Somatosensory Amplification Scale (SSAS) and Whitely Index (WI). Psychiatric comorbidity was diagnosed as per ICD-10. Data on 50 patients with depression and 119 patients with somatoform disorder was used for comparison. Results: The age at onset of Dhat syndrome was 22.54 (standard deviation [SD] - 7.5) years, and duration of illness was 5.04 (SD - 4.2) years. Depressive disorders were diagnosed in 13.2%, anxiety disorders in 15.1%, erectile dysfunction in 14.2% and premature ejaculation in 17% of cases. The mean SSAS total score was 23.12 (SD - 7.99), mean total TAS-20 score was 63.3 (SD - 13.3) and mean WI score was 8.23 (SD - 2.7). About two third of the patients had alexithymia (n = 67; 63.2%) and hypochondriasis (n = 69; 65.1%). Comparison of the psychological correlates between those with Dhat syndrome alone (n = 59) and those with comorbid psychiatric disorder (n = 47) revealed no significant differences. Patients with only Dhat syndrome had significantly higher scores for somatosensory amplification when compared with those with somatoform disorders, but no difference was seen between those with depression and Dhat syndrome alone. Compared to patients with Dhat syndrome alone, those with depression had higher prevalence of alexithymia and hypochondriasis. Conclusion: There are differences in the prevalence of somatosensory amplification, hypochondriasis and alexithymia between those with Dhat syndrome alone and those with depression and somatoform disorders.
  2,393 291 3
Subacute sclerosing panencephalitis presenting with hypersexual behavior
S Manoj, Arindam Mukherjee, K. V. S. Hari Kumar
July-September 2015, 57(3):321-322
DOI:10.4103/0019-5545.166632  PMID:26600593
  2,351 105 -
Association of single-nucleotide polymorphism of cholecystokinin receptor A gene with schizophrenia in an Eastern Indian population
Jayanta K Rout, Anindya Dasgupta, Omprakash Singh, Ushasi Banerjee, Anupam Basu
July-September 2015, 57(3):267-271
DOI:10.4103/0019-5545.166634  PMID:26600580
Context: Cholecystokinin A receptor (CCK-AR) gene polymorphism is being increasingly reported in schizophrenia. It varies among different population groups but is associated with several complications of schizophrenia. Aims: The present study was undertaken to assess whether the CCK-AR polymorphism is stabilized and is more consistently associated with schizophrenia in an Eastern Indian sub-population. Settings and Design: It was carried out as a cross-sectional, observational, hospital-based study on 95 schizophrenia patients and 138 control subjects selected by the method of convenience. Materials and Methods: Single-nucleotide polymorphisms located in the regulatory region of the CCK-AR gene were assessed by restriction fragment length polymorphism (RFLP) in the polymerase chain reaction (PCR) amplified product of CCK-AR gene in study subjects. RFLP was done by the digestion of the PCR product by the restriction enzyme Pst-1 followed by gel electrophoresis. Statistical Analysis: Assessment of the stability of C/T polymorphism in the study population was done by applying Hardy–Weinberg equilibrium rule. The significance of difference in the allelic distribution between case and controls was analyzed by Chi-square (χ2) test and odds ratio (OR) analysis. Result: CCK-R polymorphism was in Hardy–Weinberg equilibrium in both groups. Distribution of the C allele of this gene was significantly higher in schizophrenia patients (χ2 = 4.35, OR = 1.51; confidence interval at 95% =1.04–2.20). Conclusion: C/T polymorphism of the CCK-R gene is a stable polymorphism in our study population. Moreover, the C allele is significantly more abundant in schizophrenia patients imparting them a greater risk of development of complications like auditory hallucination.
  1,929 154 -
Disulfiram-induced seizures with convulsions in a young male patient: A case study
Santosh Shanbhog Vrishabhendraiah, CM Gopal Das, M Kasi Jagadeesh, N Mruthyunjaya
July-September 2015, 57(3):309-310
DOI:10.4103/0019-5545.166625  PMID:26600588
Disulfiram is the aversive therapeutic agent which has been used to treat alcohol dependence more than 50 years. It causes the complications like neurological toxicity, postural hypotension, circulatory collapse, mental confusion, etc. The aim of our study was to report a rare case of disulfiram-induced seizures in a patient of alcohol dependence syndrome. This case study is about a 35-year-old male patient who had one episode of seizures during treatment with disulfiram.
  1,928 150 1
Safety and efficacy of ketamine infusion in late onset depression, and conversion to treatment response
Shrikant Srivastava, Radhey S Gangwar, Ambrish Kumar
July-September 2015, 57(3):328-329
DOI:10.4103/0019-5545.166627  PMID:26600598
  1,782 131 8
A simple rearrangement can improve visual understanding of a Forest plot
Nilesh Shah, Chittaranjan Andrade
July-September 2015, 57(3):313-314
DOI:10.4103/0019-5545.166620  PMID:26600590
  1,679 157 3
A rare association of schizophrenia and Mayer-Rokitansky-Küster-Hauser syndrome
Roshan Bhad, Rakesh Chadda, Nand Kumar, Prashant Goyal
July-September 2015, 57(3):324-325
DOI:10.4103/0019-5545.166636  PMID:26600595
  1,505 85 2
Author's reply
Chittaranjan Andrade, TS Sathyanarayana Rao
July-September 2015, 57(3):329-330
  1,447 79 -
Late onset neutropenia due to clozapine
Zeynep Baran Tatar, Sema Yeşilyurt
July-September 2015, 57(3):325-326
DOI:10.4103/0019-5545.166639  PMID:26600596
  1,436 81 -
"Marathon Boy": The use of film in problem-based learning in child psychiatry
Asad Ghiasuddin, Selene Luk, Earl Hishinuma, Himal Shrestha, Allison Lawler
July-September 2015, 57(3):320-321
DOI:10.4103/0019-5545.166624  PMID:26600592
  1,375 94 -
Developments in psychiatry in India: Clinical, research and policy perspectives
Ananya Mahapatra
July-September 2015, 57(3):331-332
  1,293 143 -