Previously Andhra Pradesh Journal of Psychological Medicine
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2017| January-June | Volume 18 | Issue 1
Online since
March 22, 2018
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VIEW POINT
Family models of addiction: evaluation, trends and cultural context
TP Swathi, Narayanan Gitanjali
January-June 2017, 18(1):57-60
The family context provides an important developmental platform to understand the origin, maintenance and intergenerational transmission of addictive behaviors. The current report highlights different family perspectives such as the systemic, attachment and narrative. Localizing these within the Indian context with social and cultural beliefs of substance use has been discussed. Contextualizing the family approach to addiction through an integrated framework further adds merit to this model. The report helps to sensitize researchers and clinicians to conceptualize substance use in terms of parent-child interactions, family of origin dynamics, adverse childhood experiences which, would help to develop more specific intervention plans.
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ORIGINAL ARTICLES
A study of adverse drug reactions associated with antipsychotic drugs among female patients attending outpatient psychiatry department
Hemendra Singh, K Mamatha, Santh T Rani, Sandra Magdalene, Jenny S Sabu, Reshma E Jeny
January-June 2017, 18(1):4-10
Background:
Psychiatric illnesses are the major concern across the globe. Most often major mental illnesses are treated with psychotropic drugs. Females are relatively more susceptible to develop adverse drug reactions (ADRs) to antipsychotic drugs. However, there is dearth of literature regarding pattern of ADRs among female patients attending psychiatric services.
Aims:
To study of adverse drug reactions associated with antipsychotic drugs among female patients attending psychiatric services.
Methodology:
This hospital-based prospective observational study was carried out in outpatients of the Psychiatry Department, for a period of 3 years. A total of 355 female patients who received at least one antipsychotic medication were evaluated for various parameters of ADRs by using Naranjo scale; WHO Uppsala Monitoring Centre probability scale; Modified Schumock and Thornton's Scale and Udvalg for Kliniske Undersogelser-side effect rating scale (UKU-SERS). The suspected drugs and system organ class involved in ADRs were coded according to Anatomical Therapeutic Chemical (ATC) Classification System and World Health Organization Adverse Reaction Terminology (WHO_ART) respectively.
Results:
The average age of the patients who experienced ADR was found to be 39.65 ± 16.1 years. Fifty five (15.5%) patients experienced 112 ADRs to antipsychotic drugs. Risperidone 41 (36.6%) was the most commonly implicated drug in ADR followed by Olanzapine 26 (23.2%). Weight gain 31 (27.67%) was the most commonly suspected ADR followed by akathesia 11 (9.82%). Metabolic and nutritional disorders (n=34, 30.35%) was the most common affected organ system due to ADRs. In terms of prevention of ADRs, 34 (61.81 %) suspected ADRs were probably preventable, 15 (27.27%) were not preventable and 6 (10.9%) definitely preventable.
Conclusion:
ADRs associated with antipsychotics drugs among female patients are not an uncommon presentation in clinical practice. This study emphasizes role of pharmacovigilance in psychiatric practice to detect early ADR so that appropriate preventive measures can be taken for patient safety.
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The impact of perceived social support on depression among elderly population in Kolkata
Partha Malakar, Somdatta Mukherjee, Sana Tarannum
January-June 2017, 18(1):25-30
Background:
Depression is a condition where a person feels low mood and repugnance to activity which can influence a person's mental processes, behavior as well as his or her perception toward health and prosperity (APA, 2013).
Aims:
The aim of the study is to show the impact of perceived social support on depression in elderly population.
Methodology:
Married non Bengali elderly male and female of Kolkata city with 60 to 65 years of age and having the range of educational qualification from higher secondary to masters with monthly income of Rs. (10,000-50,000) were selected as study participants. The total number of participants was about 100 people (50 males and 50 females) and an assurance was obtained from the participants that they did not suffer from severe physical and psychological problems. The Geriatric Depression Scale (GDS) and The Multidimensional Scales of Perceived Social Support were administered to the participants to assess their level of depressive symptoms and perceived social support.
Results:
The analysis of the study revealed that sex difference was significant only in depression but not in perceived social support. The analysis further revealed that elderly people differed significantly in terms of depression due to the variation in perceived social support.
Conclusion:
Therefore, it can be concluded that elderly people must be dealt with proper care and support, so that they don' t feel neglected and rejected by their fellow members either in home or in the society.
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Stereotypes about male sexuality in men with sexual dysfunction
Sujith Babu, Mahendra P Sharma, Nagaraja Rao
January-June 2017, 18(1):31-36
The present investigation is designed to study the stereotypes about male sexuality, in men with sexual dysfunction and normal controls. The sample of the study is composed of 25 men with sexual dysfunction and 25 men as normal controls. The normal control is matched with the control group in terms of age, education, marital status and religion. Data was collected using the Stereotypes about Male sexuality scale (Snell, 1990) and Socio-Demographic Clinical Data Sheet (SDCDS). The descriptive survey method was used as the research design. The data collected were analysed by employing the statistical techniques such as arithmetic mean, standard deviation, Karl Pearson's coefficient of correlation and ‘t’ – test. The result indicates that men with sexual dysfunction had significantly higher stereotype belief about male sexuality in comparison to normal controls.
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EDITORIAL
Biostatistics in medical research – what we need to know?
Lokeswara P Reddy
January-June 2017, 18(1):1-3
Biostatistics' use has been on the rise in the current era of evidence based medicine and medical research. There have been various studies to show that medical professionals do not have adequate knowledge of application of statistics in their research and in also interpreting the published clinical paper. So there is a need to improve their knowledge to minimise and recognise the misuse and abuse of biostatistics in medical research.
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ORIGINAL ARTICLES
Psychiatry morbidity in hemodialysis patients: A cross-sectional study at a South Indian centre
Arul R Saravanan, Arun N Pradeep, Raj R Kumar, TV Asokan, Thirunavukarasu
January-June 2017, 18(1):41-47
Background:
In India, an estimated 100-220 per million populations reach Chronic Kidney Disease (CKD) stage 5, but only 10% of them can afford to renal replacement therapy. Recent research has shown that there is increased mental health morbidity with attendant poor quality of life in this patient population. Very few studies have been done in this aspect in the Indian population.
Aims:
We aimed to study the psychiatric morbidity in hemodialysis patients, who were undergoing regular hemodialysis for CKD. The study was carried out at the Hemodialysis Unit of the Department of Nephrology, SRM Medical College Hospital, one of the largest centers in South India.
Methodology:
Study patients (n=100) were administered Mini Mental Status Examination, MINI - English version 5.0.0 for DSM IV, Hamilton Anxiety Rating Scale, Hamilton Depression Rating Scale, Beck's Scale For Suicidal Ideation, Perceived social support scale and The Kidney Disease Quality Of Life (KD-QOL)SF 36 and the results were analyzed.
Results:
Seventy eight percent (78%) of patients suffer more than one psychiatric morbidity. Depression (74%) was the most common psychiatric morbidity followed by anxiety (59%). Elderly male patients living in nuclear family, undergoing hemodialysis had significant depression, anxiety and cognitive impairment. 83% reported poor quality of life while coping with regular hemodialysis.
Conclusion:
Our results show that psychiatric disorders are highly prevalent in hemodialysis patients, with attendant poor quality of life. An integrated approach between medical and mental health professionals will help improve the quality of life.
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THE STALWARTS
Edward John Mostyn Bowlby
Nagasowmya Garapati
January-June 2017, 18(1):69-70
Edward John Mostyn Bowlby was a British psychiatrist who had contributed to the field of childhood and developmental psychiatry. His early loss of a ‘mother figure’ left an impression which has laid foundations for his future work on attachment theory. Initially he became a surgeon and later joined the institute of psychoanalysis and worked on delinquent children. The work of John Bowlby has influenced, and been the foundation of, several other theories in behavioral psychology.
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CASE REPORTS
Paraneoplastic cerebellar degeneration and psychosis in uterine malignancy
Arul R Saravanan, Rajkumar Ramanathan, TV Asokan
January-June 2017, 18(1):61-63
Paraneoplastic Neurological Syndromes (PNS) are a group of rare disorders that occur in people with malignancies due to autoimmune mediated mechanisms affecting the central or peripheral nervous system. These effects are not due to the direct or local effects of the primary neoplasm or its secondaries. They are due to cross reaction of antibody or cell mediated immune factors affecting specific cells of the body. Sometimes these even ante-date the clinical presentation of the specific malignancy, there by leading to the search and discovery of the said malignancy. Paraneoplastic Cerebellar Degeneration (PCD) is a rare manifestation noted more commonly in breast cancer, ovarian cancer and small cell cancer of the lung. Very few are reported occurring due to uterine carcinoma. Here we report a rare case where Paraneoplastic Cerebellar Degeneration was preceded by psychosis in a female patient with uterine malignancy.
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Frontal lobe meningioma presenting as mania
S Mithun, Divya Hegde, Priya Sreedaran
January-June 2017, 18(1):66-68
Frontal meningiomas may present with psychological symptoms without any neurological signs. Diagnosis of frontal lobe tumours are often delayed due to the insidious nature of the symptoms and psychiatric symptoms being the initial presentation rather than neurological picture. We describe a patient with right frontal lobe meningioma near the pre-motor area presenting with manic symptoms and persistent visual hallucinations. Organicity always needs to be ruled out despite patients present with only psychiatric complaints.
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ORIGINAL ARTICLES
A comparative study of andropause individuals and normal controls on stress, anxiety, depression and quality of life
Venkata C Suresh, Venkata C Subbaiah, Mamatha Settivari
January-June 2017, 18(1):53-56
Background:
Recent advances in medicine and public health care have made illnesses less fatal. This combined with better standards of living, has resulted in substantial increases in the population of older people in India. The life expectancy of an Indian male in 1950 was just 40 years. Today, it is 63 years and by 2025 it is expected to go up to 84 years. As a method of scientific enquiry, the natural sciences do not provide answers to questions such as “why do we age?” All systems of human body are subjected to aging changes. But the rate of ageing differs among the system. The pattern of ageing in reproductive system differs between the sexes. Unlike in female reproductive system where the changes are abrupt, there is a gradual change in reproductive system of ageing male.
Aims:
This study was designed to assess the levels of stress, anxiety, depression and quality of life among andropause individuals and normal controls.
Methodology:
The sample consisted of 30 andropause individual and 30 normal controls. The two groups matched for age, socio economic status, occupation and educations were administered AMS, PSS, BAI, BDI, and WHO-QOL (brief).
Results:
The results shows there is a significant difference between andropause individuals and normal controls in AMS, PSS, BAI, BDI, and WHO QOL (brief). As the physical symptoms of andropause, symptoms are increases, the individual become more anxious and depressed.
Conclusion:
And it can be concluded that psychological factors play a major role in the exacerbation of symptoms of andropause and affecting their quality of life.
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Depression in medically ill geriatric patients – A study of predictive factors
Harshitha Rao, PS Murthy
January-June 2017, 18(1):18-24
Background:
Depression in old age is an important public health problem responsible for considerable morbidity and disability worldwide and most often causes for depression are multi-factorial and often preventable. A major factor in the context of evaluating depression in the elderly is the role of medical problems, where the under recognition and under treatment of depression is especially common.
Aims:
To study the prevalence and the possible predictive factors associated with depression in medically ill elderly population.
Methodology:
A cross sectional study was done among 100 elderly with medical illness attending the tertiary care hospital in Nandyal for a period of 1year September 2012 to September 2013. A semi structured proforma for various sociodemographic factors was administered by interview method and depression was assessed by GDS- Short version. Other scales used were Katz index for ADL, MMSE, and Presumptive stress scale. Descriptive statistics, Chi square, Fisher's exact test, Multiple Logistic regression by SPSS 14.
Results:
The prevalence of depression in the current study has been found to be 45%. Geriatric depression was more among those from nuclear families [p=0.028] and lower socioeconomic class V and IV [35.5% and 28.8% respectively]; [p=0.024].It was also observed that as the number of co-morbid medical illnesses increase, the depression morbidity increases. [p=0.047]. Diabetes Mellitus type-2 and Cerebrovascular disorders too were significantly associated with depression. [p=0.022 and p=0.009 respectively]. Certain life events and ADL [p=0.015] were observed to be significant predictive factors for depression.
Conclusion:
The results reaffirm that there is a high prevalence of depression among the geriatric population and adequate measures to detect and control this psychiatric disorder in elderly by specialized gero-psychiatric services are needed.
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CASE REPORTS
Maniac psychosis and erythematous dermatitis induced by disulfiram
Naveen D Kumar
January-June 2017, 18(1):64-65
Disulfiram is the drug prescribed for the treatment of alcohol dependence syndrome for few decades, and transient functional psychosis has been reported as one of its side effects. Skin erythematous reaction is another adverse effect reported simultaneously as a rare combination. This report discusses a case of acute psychosis (affective) and skin rash in a patient on disulfiram and caution should be considered personal and familial antecedents of vulnerability.
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ORIGINAL ARTICLES
A cross-sectional study of stress and personality factors in patients with bronchial asthma
Lakshmi P Prasuna, Radha Krishna C Krishna, Laxminarayana I Reddy, D Padmavathy
January-June 2017, 18(1):48-52
Background:
Bronchial asthma is one of the earliest disorders which is thought to be a psychosomatic illness in which in most cases there will be a strong prevalence of psychosocial factors which initiate and maintain the frequency of asthmatic attacks. Psychological and emotional factors that impede caretaking behaviour may in some cases cause crucial detrimental influences on the course of the disease.. This study concentrates on identifying and defining the role and the nature of stressors experienced adopted and personality factors of asthmatic individuals.
Aims:
To study the levels of psychological stress and personality factors in patients with bronchial asthma and compare them with normal subjects.
Methodology:
The levels of psychological stress were measured using Psychological Stress Measuring scale and personality factors were assessed using Eysenck's personality inventory.
Results:
In total 50 subjects in each group were taken into the study and it was found that stress levels were significantly higher in subjects with bronchial asthma. On personality dimensions, patients with bronchial asthma were significantly scored less on extraversion score and higher on neuroticism score compared to normal subjects.
Conclusion:
The higher levels of stress in patients with bronchial asthma and personality factors predispose these patients to perceived stress which are to be addressed for comprehensive management.
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Role of cognition in cancer and its effect on the patients' experiences
Chandril C Ghosh, Vishwani Duhan
January-June 2017, 18(1):37-40
Background:
Previous research has shown psychosomatic aspects of cancer. Also, some have also illustrated cognition as a mediator between stress and illness. This study is extending the existing literature thus aimed to investigate the role of information-seeking behavior, psychological inflexibility and belief in spiritualism towards affective balance, happiness and life satisfaction of cancer patient.
Methodology:
A total of 12 recently diagnosed cancer patients and 15 healthy participants were recruited. Their mean age was 54.2 years. Data on information-seeking behavior was measured by Miller Behavioral Style Scale (MBSS), Psychological Inflexibility in Pain Scale (PIPS) was used for psychological inflexibility. Belief in spiritualism was measured through Revised Paranormal Belief Scale. Additionally, satisfaction with life scale measured global cognitive judgments of one's life satisfaction, subjective happiness scale measured subjective happiness and Bradburn scale of psychologic wellbeing measured Affect Balance. Correlational measures and t-test demonstrated relations are complying expectations to an extent.
Results:
Results were being discussed regarding clinical implications. We also propose that psychotherapy in addition to meditation may help to improve the recovery and aid in the treatment and also prevention of cancer.
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A study of methods used by adolescent suicide attempters in rural South Inida
Ravi S Kumar, Keya Das, Uzma Hashim
January-June 2017, 18(1):11-17
Background:
As per the World Health Organization, India has one of the highest suicide rates in the world.
Aims:
Our study aims to explore the characteristics of child and adolescent suicides, focussing on common methods used, and the socio-economic and literacy status of this particularly vulnerable population.
Methodology:
It was a retrospective, explorative-descriptive, cross-sectional, case register study of paediatric inpatients admitted between January 2013 to December 2015. Medico-legal records of paediatric inpatients aged between 12 to 18 years with a diagnosis of suicide attempt were studied (n-80). Descriptive statistics were performed using SPSS version 16 and the correlation between age, socio-economic and educational status each with methods used for attempting suicide was analysed using chi square test for statistical significance.
Results:
The most common modes of suicide attempted were organo-phosphorous compound poisoning (47.5%), unknown compound poisoning (13.8%) followed by overdose of prescription medications (12.5%), and hanging (6.8%). The majority of the suicide attempters were females (60%) and belonged to the lower socio-economic status (66.6%). The mean age of the attempters was 15.35 years. The largest group belonged to those studying in high school ( 33.8%) , followed closely by school dropouts/illiterates(25%).
Conclusion:
Our study concluded that in a South Indian rural adolescent population the most common methods employed for suicide attempts are poisonings, with the majority of the attempters belonging to the female gender, lower socioeconomic status and high school students or school dropouts and illiterates.
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Online since 8
th
March 2018