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   2014| July-December  | Volume 23 | Issue 2  
    Online since February 18, 2015

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A study of sociodemographic clinical and glycemic control factors associated with co-morbid depression in type 2 diabetes mellitus
Hritu Singh, M. S. V. K. Raju, Vaibhav Dubey, Ravindra Kurrey, Shaifali Bansal, Mustafa Malik
July-December 2014, 23(2):134-142
DOI:10.4103/0972-6748.151687  PMID:25788803
Context: Diabetes affects 9.2% of adults in India. About 8-16% of its population also suffer from depression. Both diseases pose a serious health challenge at individual and system level. The prevalence of depression in diabetes is much higher than in the general population. Undiagnosed and untreated depression puts people at higher morbidity and mortality risk. Aim: To study the prevalence of depression in diabetes and to identify associated risk factors. Settings and Design: Case control study carried out in an outpatient setting of a tertiary hospital in central India. Materials and Methods: One hundred and nine type 2 diabetes patients and 91 healthy controls formed the subjects of the study. Sociodemographic data were obtained on seven parameters. Comprehensive clinical data were obtained by means of standard procedures. Blood sugar levels and glycosylated hemoglobin levels were measured to assess glycemic control. Data of diabetic patients and controls as well as that of depressed and nondepressed diabetics were subjected to statistical analysis. Results: About 42.2% of diabetes patients and only 4.39% of controls had depression. About 19% of diabetics had peripheral neuropathy but had much higher neuropathic symptoms. Depression was not related to any sociodemographic or clinical factors but was strongly associated with poor glycemic control. Conclusion: Depression is highly prevalent in diabetes. Physical symptoms mask depression. Special attention needs to be paid to diagnose depression in diabetes and treat it appropriately along with effective glycemic control. Diabetes patients need to be treated collaboratively by physicians and psychiatrists.
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Oxidative stress and psychological functioning among medical students
Rani Srivastava, Jyoti Batra
July-December 2014, 23(2):127-133
DOI:10.4103/0972-6748.151684  PMID:25788802
Background: Oxidative stress has gained attention recently in behavioral medicine and has been reported to be associated with various psychological disturbances and their prognoses. Objectives: Study aims to evaluate the oxidative stress (malonylaldehyde (MDA) levels) and its relation with psychological factors (dimensions of personality, levels of anxiety, stress, and depression) among medical/paramedical students of 1 st and 3 rd year). Materials and Methods: A total of 150 students; 75 from 1 st year (2010-2011) and75 from 3 rd year (2009-2010); of medical and paramedical background were assessed on level of MDA (oxidative stress) and personality variables, that is, level of anxiety, stress, and depression. These psychological variables were correlated with the level of their oxidative stress. Results: Findings revealed that both groups are influenced by oxidative stress and their psychological variables are also compatible in order to confirm their vulnerabilities to stress. Conclusions: Stress in 3 rd year students was significantly higher and it was noted that it adversely affects the psychological parameters. Hence, special attention on mental health aspect in these students may be given.
  2 2,133 69
Mental health of survivors of 1984 Bhopal disaster: A continuing challenge
R Srinivasa Murthy
July-December 2014, 23(2):86-93
DOI:10.4103/0972-6748.151668  PMID:25788796
Bhopal disaster is an important milestone in Indian Industrial Psychiatry. The disaster was not only the biggest industrial disaster but also one in which complex forces have joined hands to demy the mental health needs of the population. Though the biggest general population epidemiological study over 5 years was carried out to understand the mental health impact of the disaster, the findings of this study did not get reflected in mental health care for the population. Furthermore, the needed longitudinal studies and evaluation of the interventions were not undertaken. There was no sharing of information with the survivors about the impact of the disaster on their health and well-being and sharing of skills for self-care. A result of these factors is the extreme degree of dissatisfaction in the population. Looking back, it would have met the needs of the Bhopal population, if the mental health services were community based and reaching the population, rather than the clinic-based approaches, there was a wide range of services, especially rehabilitation, continuous research into the changing mental health needs of the population and the effectiveness of interventions and most importantly, there was a continuous dialogue with the population and sharing of information with the general population. These are the tasks for the immediate future to reorganize the focus of mental health initiatives in Bhopal. Many lessons can be learnt from the Bhopal disaster and the continuing tragedy for the population.
  2 2,977 76
Psychological aspects of peacekeeping operations
M. S. V. K. Raju
July-December 2014, 23(2):149-156
DOI:10.4103/0972-6748.151693  PMID:25788805
Peacekeeping operations are but one aspect of the systems of peace that have evolved over the past seven decades in a world that is riven with violence of all kinds. With the end of cold war in the late eighties of the last century we have come to see much intrastate violence, in addition to usual interstate hostilities and war, arising out of religious, political, ethnic and economic differences between people. In the changed scenario peacekeeping operations have become complex politico-military-humanitarian efforts. A soldier, trained for conventional military operations, is obliged to participate in the unconventional operations of waging peace in alien lands often in volatile and violent situations and in the process he stands to get exposed to widely variable demands for adjustment that have the potential to bring to the fore many maladaptive responses. Peacekeeping operations also have the potential to offer opportunities for growth and resilience. India is a major player in peacekeeping activities for well over sixty years all over the world. It is necessary for the commanders and mental health professionals to understand the multifarious factors that impinge on the peacekeeping soldier's mind and the emerging patterns of responses thereof for effective management trained manpower and fulfillment of mission objectives
  1 2,761 53
Virtual reality applications in mental health: Challenges and perspectives
Kalpana Srivastava, RC Das, S Chaudhury
July-December 2014, 23(2):83-85
DOI:10.4103/0972-6748.151666  PMID:25788795
  1 4,536 79
Study of attitude of interns toward psychiatry: A survey of a tertiary level hospital in Ahmedabad
Nimesh C Parikh, Prateek S Sharma, Pradhyuman J Chaudhary, Hitendra A Gandhi, Girish H Banwari
July-December 2014, 23(2):143-148
DOI:10.4103/0972-6748.151690  PMID:25788804
Background: Worldwide, multiple studies demonstrate a negative attitude of interns toward psychiatry. Scenario in Gujarat state has never been looked upon. The objective of this study is to identify the situation in this region by studying the attitude of interns toward various areas of psychiatry and to study the gender differences if any. Materials and Methods: For study, all 122 interns who attended psychiatry posting for the 1st time in their internship, over a period of 8 months were approached amongst which 100 (56 males and 44 females) consented to be a part. Attitude was measured with 30 items attitude toward psychiatry (ATP 30) questionnaire on the 1st day of their posting. The data thus collected were analyzed by SPSS version 20. Result: The results showed a neutral to the negative attitude in major areas of psychiatry. Most neutral responses were seen regarding contribution of psychiatric hospitals in the treatment, regarding psychiatric patients considered to be interesting and psychiatry enabling people to have rewarding relationships. Negative attitude toward areas on scientific information in psychiatry and psychotherapy's validity were obtained. While attitude was positive in areas of psychiatric knowledge and teaching, but female interns were lagging behind their male counterparts. Psychiatric treatment lessens worries and psychiatric illness should be considered at par with other medical illnesses, were most common positively viewed attitude. Conclusion: Interns overall shared a neutral to negative ATP. Adequate rectification is required in existing medical curriculum, and more exposure to the subject is essential to improve the attitude of interns toward mental health
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Cross-sectional study of self-reported ADHD symptoms and psychological comorbidity among college students in Chandigarh, India
Ishani Jhambh, Priti Arun, Jasmin Garg
July-December 2014, 23(2):111-116
DOI:10.4103/0972-6748.151679  PMID:25788800
Background: Existence of attention deficit hyperactivity disorder (ADHD) in adults is scantily researched in India. There is dearth of information on prevalence of ADHD in college students worldwide. Further, fewer studies in the past have evaluated the impact of ADHD on the psychological well-being of college students. Aims: To study the prevalence of ADHD among college students and psychological problems related to ADHD. Design: Cross-sectional study. Subjects and Methods: A total of 237 students were recruited from various medical, engineering, and commerce and arts colleges of Chandigarh, India. They were administered the Adult ADHD Self Report Scale v1.1(ASRS) and the Wender Utah Rating Scale (WURS) to diagnose adult ADHD. To assess comorbidities; General Health Questionnaire-12 (GHQ); Zung Depression Rating Scale (ZDRS); Rosenberg's Self-Esteem Scale (RSES);and questions on emotional stability, social problems, and substance use (alcohol, tobacco, and cannabis) were administered on all participants. Results: A total of 13 students (5.48%) fulfilled the criteria for adult ADHD. These students experienced significantly higher emotional instability and low self-esteem than those without ADHD (N = 224). The occurrence of psychological problems, depression, social problems, and substance abuse was comparable in students with and without ADHD. Conclusions: ADHD is prevalent among the college students studying in the most competitive institutes as well. Students with ADHD experience higher emotional instability and poor self-esteem than others. It has little effect on their psychological well-being and social adjustment. Prompt detection and management of ADHD in college students may help them deal with these problems effectively.
  1 2,425 87
Management challenges in a case of gender identity disorder
Anubhav Rathi, Manjeet Singh Bhatia
July-December 2014, 23(2):157-159
DOI:10.4103/0972-6748.151696  PMID:25788806
Gender identity disorder (GID) is a complex disorder and can be defined as a group of disorders whose common feature is a strong and persistent preference for living as a person of the other sex. It is associated with significant impairment in social, occupational, interpersonal, and other areas of functioning. We describe the case of an adolescent, biologically male who was brought to our outpatient department primarily with symptoms of adjustment disorder with GID and the management provided. The role of a psychiatrist in the management, ethical and legal issues involved is also discussed.
  - 2,169 63
Seasonal obsessive-compulsive disorder
Prakriti Sinha, Ajay Kumar Bakhla, Ashok Kumar Patnaik, Suprakash Chaudhury
July-December 2014, 23(2):160-162
DOI:10.4103/0972-6748.151701  PMID:25788807
A case of obsessive-compulsive disorder (OCD) with seasonal variation in symptoms of 10-years duration is reported because of its rarity. The phenomenology of the observed disorder was obsessions related to dirt and contamination resulting in washing compulsions with onset in October and complete resolution in April-May every year. The patient responded to phototherapy along with exposure and response prevention therapy and pharmacotherapy.
  - 1,980 48
Catatonia versus neuroleptic malignant syndrome: the diagnostic dilemma and treatment
Manoj Kumar Sahoo, Sanjay Agarwal, Harshita Biswas
July-December 2014, 23(2):163-165
DOI:10.4103/0972-6748.151703  PMID:25788808
Catatonia is a syndrome, comprised of symptoms such as motor immobility, excessive motor activity, extreme negativism, and stereotyped movements. Neuroleptic is able to induce catatonia like symptoms, that is, the neuroleptic malignant syndrome (NMS). In NMS, patients typically show symptoms such as an altered mental state, muscle rigidity, tremor, tachycardia, hyperpyrexia, leukocytosis, and elevated serum creatine phosphorous kinase. Several researchers have reported studies on catatonia and the association between catatonia and NMS, but none were from this part of the eastern India. In our case, we observed overlapping symptoms of catatonia and NMS; we wish to present a case of this diagnostic dilemma in a patient with catatonia, where a detailed history, investigation, and symptom management added as a great contribution to the patient's rapid improvement.
  - 3,525 67
The efficacy of electroencephalogram neurofeedback training in cognition, anxiety, and depression in alcohol dependence syndrome: A case study
Tulika Ghosh, Masroor Jahan, Amool R Singh
July-December 2014, 23(2):166-170
DOI:10.4103/0972-6748.151705  PMID:25788809
Electroencephalogram (EEG) neurofeedback's efficacy in reducing the symptoms of patients with alcohol dependence syndrome is well-documented in previous literature. Here, a case is being described who presented with alcohol dependence syndrome was given EEG neurofeedback training. After 10 sessions of EEG neurofeedback training program, a significant reduction was found in the cognitive deficits, anxiety, and depression of the patient. Furthermore, noticeable improvement was found in his memory and neurological functioning. He also showed a significant reduction in his alcohol intake on follow-up.
  - 2,328 51
Delusion of dhat: The quandary of the form-content dichotomy!
Suravi Patra, Ajeet Sidana, Nitin Gupta
July-December 2014, 23(2):171-172
DOI:10.4103/0972-6748.151708  PMID:25788810
  - 1,411 50
Psychological profile of women with infertility: A comparative study
Shuvabrata Poddar, Nilanjana Sanyal, Urbi Mukherjee
July-December 2014, 23(2):117-126
DOI:10.4103/0972-6748.151682  PMID:25788801
Background: An endeavour to probe into the psychological profile of infertile women in a comparative stance with the fertile women is not very common. This study is an attempt to explore the possible non-apparent personality factors which contribute to the unexplained pain of infertility. Methods: The main objectives of the present study were (a) to examine whether infertile women are different from fertile women in terms of selected psychological variables- narcissistic components, dimensions of attachment style and uses of defensive manoeuvres; and (b) whether the primary infertile women (n=18) are different from the secondary infertile women (n=12) with respect to those variables. A total of 60 individuals (30 infertile women and 30 matched fertile women) were assessed through Attachment Style Questionnaire (ASQ), Narcissistic Personality Inventory (NPI) and Defense Style Questionnaire (DSQ-40). General Health Questionnaire (GHQ) was administered on to the fertile women to rule out the psychiatric morbidity. Results: Findings revealed that infertile women group differed from fertile women group with respect to narcissism, dimensions of attachment style and uses of defense mechanism. The primary infertile group also showed marked difference from the secondary infertile group with respect to those variables. Conclusions: This study endeavours to enrich the knowledge regarding the personality dynamics of infertile women to design psychotherapeutic programme to aid their well-being, help them to cherish the flavour of parenthood and improve their quality of life.
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Psychiatric morbidity in elderly patients attending OPD of tertiary care centre in western region of Nepal
Prakash Thapa, Prasanta K Chakraborty, Jai B Khattri, Krishnamurthy Ramesh, Bhaskkar Sharma
July-December 2014, 23(2):101-104
DOI:10.4103/0972-6748.151673  PMID:25788798
Context: Aging of population is currently a global phenomenon. At least one in 5 people over the age of 65 years will suffer from a mental disorder by 2030. Study of psychiatric morbidities in this age group is essential to prepare for upcoming challenges. Aims: To find out the prevalence of different psychiatric morbidities in elderly population and to find out if there are any age and gender specific differences. Settings and Design: Retrospective review; Psychiatric outpatient department of Manipal Teaching Hospital, Pokhara, Nepal. Materials and Methods: Data for patients ≥ 65 years of age attending the psychiatric outpatient department of Manipal Teaching Hospital, Pokhara, Nepal, from 1 st January 2012 to 15 th January 2013 were collected retrospectively in a predesigned proforma. Statistical Analysis Used: Risk of having different psychiatric disorders was estimated using odds ratio. Results: The mean age of 120 patients included in this study was 69.67 (SD = 5.94) years. Depressive disorder (26.7%) was the most common diagnosis. There was no statistically significant difference in psychiatric disorders in >75 years compared with ≤75 years except for dementia [odd ratio (OR) (≤75 years/>75 years)=0.055, 95% confidence interval (CI)=0.016; 0.194]. Alcohol dependence syndrome [OR (male/female)=7.826, 95% CI = 1.699;36.705] and dementia [OR (male/female)=3.394, 95% CI = 1.015;11.350] was more common in males. Conclusions: Depressive disorder was the most common psychiatric morbidity among the elderly patients. The odds suffering from dementia increased with increasing age. The odds of having alcohol related problems and dementia were more in males compared with females.
  - 2,232 92
Inclination to speeding and its correlates among two-wheeler riding Indian youth
Rajeev J Michael, Manoj K Sharma, Seema Mehrotra, Humera Banu, Rajesh Kumar, Paulomi M Sudhir, Neelima Chakrabarthy
July-December 2014, 23(2):105-110
DOI:10.4103/0972-6748.151676  PMID:25788799
Context: Concerns about road safety have been increasingly associated with two-wheeler riding and especially with young commuters in India. Aims: The study was designed to explore inclination to speeding and to profile the driving behaviors in two-wheeler riding young men and women who reported a tendency to ride faster than their peers. Design: A cross-sectional survey design was used. Materials and Methods: On the basis of three focus group discussions and review of literature, a survey was prepared to tap domains such as affect states associated with riding/speeding, factors contributing to speeding, inclination for competing, perceived speed and safety, etc. The study sample comprised of 961 two-wheeler riding college-going young men and women in Bangalore. Statistical Analysis: Descriptive and inferential statistical procedures were used including Chi-square, Spearman's rank correlation, and independent sample t-test. Results: The sample was divided into two subgroups on the basis of self-report of greater speeding than one's peers. A subgroup of 349 participants endorsed the item regarding inclination to ride faster than one's peers, whereas, the remaining 612 participants did not endorse it. The profiles of these two subgroups were obtained in terms of sociodemographic variables, riding behaviors, and associated domains. Significant differences between the subgroups emerged on domains such as motives for riding fast, tendency for competing, perceived safety and frequency of minor accidents while riding. Conclusions: Several correlates of the tendency to speeding among young two-wheeler riders emerged that have implications for enhancing safe riding.
  - 2,130 77
Psychological interventions in pervasive developmental disorder: An overview
Shuvabrata Poddar, Noufal T Hameed, Jyoti Mishra Pandey, Sayantanava Mitra, Urbi Mukherjee
July-December 2014, 23(2):94-100
DOI:10.4103/0972-6748.151671  PMID:25788797
Pervasive developmental disorders (PDDs) are characterized by several impairments in the domains of social communication, social interaction and expression of social attachment, and other aspects of development like symbolic play. As the role of drugs in treating these impairments is extremely limited, a variety of psychological interventions have been developed to deal with them. Some of these have strong empirical support, while others are relatively new and hence controversial. Though it may prove to be a daunting task to begin with, the final reward of being able to improve the life of a child with PDD is enormous and hugely satisfying. Therefore, knowledge of these psychological interventions is important for a mental health professional, in order to be effective in the profession. Present paper presents an overview of these techniques in the management of PDD.
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