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2014| January-June | Volume 19 | Issue 1
Online since
November 3, 2014
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ORIGINAL ARTICLES
Assessment and comparison of the memory profile in traumatic brain injury and subarachnoid hemorrhage patients
Ashima Nehra, Avantika Sharma, Swati Bajpai, V Sreenivas
January-June 2014, 19(1):19-23
DOI
:10.4103/0971-8990.143885
Background:
Traumatic brain injury (TBI) and Subarachnoid Hemorrhage (SAH) are the leading cause of death and disability in both developed and developing countries. They have significant cognitive and behavioral consequences, affecting the quality of life of both patients and their families.
Aim:
To compare the memory functioning of TBI and SAH and study the effect of demographics on the same through a retrospective study.
Materials and Methods:
A sample of 210 patients clinically diagnosed as TBI (
N
= 165;
M
= 145/
F
= 20) and SAH (
N
= 45;
M
= 35/
F
= 10) were using post graduate institute of memory scale (PGI-MS) which assesses 10 memory domains.
Results:
Odds Ratio (OR) was calculated by categorizing the scores as average and impaired on PGI-MS, the percentage of impaired cases of SAH were significantly less as compared to TBI (8.9% vs. 22.4%; OR = 0.34) Moreover, only two domains were found to have significant results, i.e. delayed recall and recognition. When the scores were adjusted for age, education and gender, memory impairment was found to be statistically significant in domains of remote memory (OR = O.10) recent memory (OR = 0.32), delayed recall (OR = 0.26), immediate memory (OR = 0.30), new learning ability (OR = 0.38), and recognition (OR = 0.17).
Conclusion:
A primary prevention (awareness program about risk factors) and tertiary prevention (holistic rehabilitation) would play a crucial role in improving the quality of life of both patients as well as the population at risk.
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341
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INTERNATIONAL PERSPECTIVE: REVIEW ARTICLE
Community mental health service: an experience from the East Lille, France
Jean Luc Roelandt, Nicolas Daumerie, Laurent Defromont, Aude Caria, Paula Bastow, Jugal Kishore
January-June 2014, 19(1):10-18
DOI
:10.4103/0971-8990.143884
Over the past 30 years in the Eastern Lille Public Psychiatric sector, there had been progressive development of set up in community psychiatry. This innovative set up conforms to WHO recommendations. The essential priority is to avoid resorting to traditional hospitalisation, and integrating the entire health system into the city, via a network involving all interested partners: users, carers, families and elected representatives. The ambition of this socially inclusive service is to ensure the adaptation and non-exclusion of persons requiring mental health care and to tackle stigma and discrimination. It gives a new perception to psychiatry that is innovative and experimental, and observing human rights, i.e. citizen psychiatry. This experiment also provides lesson to India for effective implementation of its national mental health program.
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ORIGINAL ARTICLES
Concept and understanding of premature discharge in Indian patients
BS Chavan, Abhijit R Rozatkar, Jaspreet Kaur, Preeti Singh, Chandra Bala
January-June 2014, 19(1):24-28
DOI
:10.4103/0971-8990.143886
Introduction:
Due to lack of formal sex education in India, the unpleasant past sexual experiences and at times normal physiological activities can lead to various myths and sexual beliefs. Base on their beliefs, individuals seeking treatment for early ejaculation have their set of expectations. Premature ejaculation (PME) in Indian population thus, has personal meaning and there is no common agreement on it.
Materials and
Methods:
With the help of semi-structured questionnaire, we surveyed the sexual activity, sexual beliefs and past sexual experiences of those seeking treatment for early ejaculation (
n
= 62) and compared them with an age-matched control (
n
= 50).
Results:
Those seeking treatment for early ejaculation expected more number of strokes (39.1 vs. 32.6) in lesser time (11.5 min vs. 16.3) during sexual encounters i.e. more rapid thrusting. Significantly more of those seeking treatment for early ejaculation felt that masturbation was not a normal activity and that both male and female partners must climax simultaneously for satisfactory sexual experience. Also, significantly more of those seeking treatment for early ejaculation reported their first sexual experience to be unsatisfactory.
Conclusion:
In the cultural context of India, those seeking treatment for early ejaculation may be distressed due to their inability to meet their own expectations in addition to distress of inability to hold ejaculation as desired. It is essential to re-educate such individuals before considering the diagnosis of PME. Various diagnostic criteria for PME have not emphasized the exclusion of cultural factors as contributors to distress of PME.
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CASE REPORTS
Self-mutilation of nose in schizophrenia
Divya Sharma, Swapnil Agrawal, Devendra K Sharma, Devendra K Vijayvergia
January-June 2014, 19(1):37-38
DOI
:10.4103/0971-8990.143890
Self-mutilation is not a single clinical entity and occurs in various psychiatric syndromes. Major self-mutilation is rare and catastrophic complication of severe mental illness. Patients with command hallucinations, religious preoccupations, substance abuse and social isolation are the most vulnerable. We report and discuss a case of complete self-mutilation of nose in a patient with schizophrenia.
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7,795
362
3
ORIGINAL ARTICLES
Assessment of subjective well-being status of elderly people in old age homes in Kolkata in relation to their perceived physical health and cognitive functioning
Jharna Bag, Debashish Sanyal, Liza Thankam Daniel, Asima Chakrabarti
January-June 2014, 19(1):32-34
DOI
:10.4103/0971-8990.143888
Introduction:
There is a limited data on the subjective well-being of elderly people living at old age homes in India. It is needed for planning better maintenance of physical health as well as cognitive function for their overall well-being.
Materials and Methods:
A descriptive survey was conducted. The data were collected from 50 elderly people who were selected by total enumeration sampling from two different old age home in Kolkata. They were assessed using Subjective Well-being Inventory and a self developed checklist for perceived physical health problems. Cognitive function was assessed by using Mini Mental State Examination.
Results:
More than half (52%) of the elderly people have reported high subjective well-being status. Regression analysis showed that perceived physical health problem (
P
< 0.001) and having children (
P
= 0.010) were statistically significant predictors of subjective well-being.
Conclusion:
In order to improve the quality of life of elderly people health workers should give more emphasis on psychosocial aspects of this population. Improved psychosocial aspects can increase perceived physical health hence subjective well-being.
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DR. BUCKSHEY AWARD PAPER
Stigmatizing experiences of patients with psychiatric disorders and their caregivers
Rohit Garg, BS Chavan, Priti Arun
January-June 2014, 19(1):4-9
DOI
:10.4103/0971-8990.143883
Background:
There has been extensive research on the stigma experienced by patients with psychiatric disorders and their family members. However, very few studies have attempted to compare both the perspectives.
Aim:
To measure and compare the stigma experienced by patients with psychiatric disorders and their caregivers.
Materials and Methods:
A total of 143 patients suffering from various psychiatric disorders (including substance use disorders) who visited at the psychiatry out-patient clinic were included, along with their family members. In addition to the sociodemographic and clinical variables, they were assessed using a stigma scale (Hindi version).
Results:
Patients with psychiatric disorders scored significantly higher than their caregivers on the total stigma scale score as well as on the subscales for discrimination, disclosure and positive aspects. Patients with substance dependence as well as their caregivers had highest total stigma score. The mean difference among the patients and caregivers was highest among the obsessive compulsive disorder subgroup (
P
= 0.012) and lowest among the schizophrenia subgroup (
P
= 0.045).
Conclusion:
Stigma and discrimination are deeply rooted among patients and their caregivers. Tackling stigma and discrimination should form an integral part of the therapeutic process.
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EDITORIAL
Stigma and community interventions: Has enough been done?
Rajesh Sagar, Raman Deep Pattanayak
January-June 2014, 19(1):1-3
DOI
:10.4103/0971-8990.143882
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317
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ORIGINAL ARTICLES
Use of alcohol among treatment seeking illicit drug users in India
Hem Sethi, Sonali Jhanjee
January-June 2014, 19(1):29-31
DOI
:10.4103/0971-8990.143887
Introduction:
Concomitant multiple substance use by clients in drug abuse treatment settings has been recognized as an important treatment issue for many years, and remains under-researched in Indian context.
Aim:
To examine the patterns and prevalence of concomitant alcohol and illicit drug use among the patients seeking treatment for illicit drug use.
Materials and Methods:
A total of 110 patients attending the National drug dependence treatment centre having multiple drug use were included for the present study. Data was collected by face-to-face structured interview on a semi-structured proforma.
Results:
It was observed that overall 38.2% of the illicit drug users had concomitant alcohol use. Concomitant use of alcohol was found to be 37.1%, 45.5% and 44.4% among heroin, cannabis users and Doda (opium) users respectively. The maximum quantity of alcohol consumption was reported by patients who used opium (Doda) (mean = 703.13 ml/day). A multinomial logistic regression analysis showed that middle aged males and those with lower educational levels, were at greater risk for concomitant exposure to alcohol and illicit drugs.
Conclusion:
Many people use alcohol in combination with illicit drugs. Clinicians should warn every patient about alcohol-drug interactions, especially those at high risk for concomitant exposure. These findings have implications for prevention, as well as clinical risk for adverse consequences of concomitant alcohol and illicit drug consumption.
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BRIEF COMMUNICATION
Assessment for prevalence and pattern of depression in cancer patients
Dwipen Kalita, Manigreeva Krishnatreya, Bhaskar Sarma Neog, Kabindra Bhagabati, Amal Chandra Kataki, Gayatri Gogoi, Nazmul Hoque
January-June 2014, 19(1):35-36
DOI
:10.4103/0971-8990.143889
The study aimed to assess the prevalence and severity of depression in cancer patients and to look for any association with sociodemographic profile. Patients registered for various cancers at a regional cancer centre were followed-up between July 2013 to October 2013. Depression in cancer patients was screened using the Mini International Neuropsychiatric Interview (MINI) questionnaire and administered the Hamilton Depression Rating Scale (HDRS) for severity of depression. Out of 183 cancer patients screened, 44 (24%) patients were identified to have depression using MINI. Mild to moderate depression was seen in 68% of married patients, and severe to very severe depression in unmarried and widowed group, severe to very severe depression was more prevalent in the illiterate group of patients (33%), and there was no association of subjective economic inequalities with degrees of depression. Further studies on larger sample size without selection bias will reveal the prevalence of depression in cancer patients.
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CASE REPORTS
Delusion of twin delivery in a post-menopausal woman: Another dimension of delusional procreation syndrome
Ajeet Sidana, Rajan Jain
January-June 2014, 19(1):39-40
DOI
:10.4103/0971-8990.143891
Delusional procreation syndrome (DPS) consists of sequential delusions in every possible stage of procreation such as having spouse/partner, getting pregnant, having delivered a child (labour and childbirth), and becoming parents/grand-parents and so on. Till now, only few case reports have been reported and that is from the southern part of India only. Here the authors reported a case of a post-menopausal woman having delusion of twin delivery and propose twin dimension of DPS.
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© Journal of Mental Health and Human Behaviour | Published by Wolters Kluwer -
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Online since 28 Mar, 2014