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   2019| January-June  | Volume 28 | Issue 1  
    Online since December 11, 2019

 
 
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REVIEW ARTICLE
Management of stuttering using cognitive behavior therapy and mindfulness meditation
Monica Mongia, Anindya Kumar Gupta, Aishwarya Vijay, Raja Sadhu
January-June 2019, 28(1):4-12
DOI:10.4103/ipj.ipj_18_19  PMID:31879440
Stuttering is a speech fluency disorder with varied etiological explanations. It is important to identify symptoms early so that adequate and timely intervention can be delivered with focus on management and recovery. Stuttering, besides affecting speech fluency, might have a number of negative psychosocial consequences for the sufferer that may lead to immense anxiety, besides other symptoms. Therefore, it is thus imperative to include multiple dimensions in the holistic treatment of stuttering. Cognitive behavior therapy and mindfulness equip the client with the skills to manage the problems that occur as a result of stuttering. Since the rate of relapse in this condition is high, the chosen therapeutic paradigm must involve booster sessions over a long term. Periodic, detailed assessment would update the therapist about the barriers in treatment and would help in devising appropriate methods to get rid of these hindrances.
  2,169 39 -
ORIGINAL ARTICLES
Psychiatric morbidity, cognitive dysfunction and quality of life in drug-naive patients with Parkinson's disease: A comparative study
Subhendu Shekhar Dhar, Jitendra Jeenger, Vikas Singroha, Manu Sharma, Devendra Mohan Mathur
January-June 2019, 28(1):13-18
DOI:10.4103/ipj.ipj_64_19  PMID:31879441
Background: To better understand the psychiatric disorders and cognition in Parkinson's disease (PD) and its impact on quality of life (QoL), patients need to be studied soon after diagnosis, before initiation of dopamine replacement therapy. Aim: This study aims to compare the nature and frequency of psychiatric morbidity, cognitive dysfunction, and quality of life in drug-naive patients with PD and healthy controls. Materials and Methods: The cross-sectional, comparative study was conducted in tertiary care center. Fifty drug-naive PD patients and fifty healthy controls were included and assessed on Modified Hoehn and Yahr scale, PD Questionnaire 8, Kolkata cognitive screening battery, General Health Questionnaire-12, and Hamilton Anxiety and Depression Rating Scale (HAM-A and HAM-D). Results: The mean scores of HAM-A and HAM-D of patients with PD were significantly higher than that of the comparison group. The patients with PD had statistically significant impairment in verbal fluency, Mini-Mental State Examination, calculation, memory immediate recall, visuoconstructional ability, and memory (delayed recall and recognition) in comparison to patients without PD. No statistically significant difference was observed with respect to object naming between the two groups. Conclusion: QoL of a PD patient is adversely affected by both the motor and nonmotor symptoms of the disease such as depression, anxiety, apathy, sleep disturbances, and cognitive impairment. The link between nonmotor symptoms and reduced QoL has important implications for the management of PD because the nonmotor symptoms often appear before patients are given anti-parkinsonian therapy. Screening of nonmotor symptoms in early stage of disease will decrease the morbidity and mortality and improve the QoL.
  1,484 51 -
Gaming disorder among medical college students from India: Exploring the pattern and correlates
Swarndeep Singh, Neha Dahiya, Aakanksha Bharti Singh, Rajesh Kumar, Yatan Pal Singh Balhara
January-June 2019, 28(1):107-114
DOI:10.4103/ipj.ipj_96_18  PMID:31879456
Background: In the extant literature, apart from few published case reports describing patients with severe form of gaming disorder (GD), there is a lack of studies describing the pattern and correlates of GD existing in the Indian settings. Thus, the present study aimed to explore the extent and pattern of gaming behavior in a sample of medical college students from India and explore its association with the sociodemographic, psychological (depressive symptoms), and Internet gaming characteristics. Materials and Methods: This Internet-based cross-sectional study was conducted as an online survey among 306 medical students by the Behavioral Addictions Clinic at a tertiary care teaching college in India. The severity of problematic gaming behavior and depressive symptoms was assessed using the Internet GD Scale-Short Form (IGDS9-SF) and Patient Health Questionnaire-9 (PHQ-9). A semi-structured questionnaire was used to collect information regarding sociodemographic and Internet gaming characteristics of the participants. Statistical analysis was done using SPSS software version 21.0, with two-tailed P < 0.05 taken as significant and P < 0.01 as highly significant results. Results: We identified 173 (55.6%) current gamers, with 11 (3.6%) Internet GD gamers based on the Diagnostic and Statistical Manual of Mental Disorders -5 criteria in the current study sample. A preference for multiplayer online gaming pattern (β =0.17, P= 0.005), spending greater amount of time in playing digital games (β = 0.53, P < 0.01), and higher PHQ-9 scores (β =0.25, P < 0.01**) representing greater depressive symptom severity were associated with statistically significantly greater scores on the IGDS9-SF, indicative of a higher risk for having GD. Conclusions: GD is a cause of concern among medical students in India. There is an urgent need to create awareness about it among students and concerned authorities. Further, there is a need to develop effective screening and treatment strategies suited for our population. The risk factors identified in the current study can be utilized to screen those at high risk of developing the same.
  1,248 85 -
EDITORIAL
Occupation-related suicide
Kalpana Srivastava, Suprakash Chaudhury, PS Bhat, Jyoti Prakash
January-June 2019, 28(1):1-3
DOI:10.4103/ipj.ipj_77_19  PMID:31879439
  1,279 52 -
ORIGINAL ARTICLES
Perceived stress, anxiety, and coping states in medical and engineering students during examinations
Nihal K Balaji, PS Murthy, D Naveen Kumar, Suprakash Chaudhury
January-June 2019, 28(1):86-97
DOI:10.4103/ipj.ipj_70_18  PMID:31879453
Aim: This study aims to study the factors associated with stress, anxiety, and coping states in students of 1st and 2nd year in medical and engineering colleges during examinations. Materials and Methods: This prospective, longitudinal study was conducted on 200 undergraduate medical and engineering students from 1st to 2nd year (50 in each year), after obtaining ethical approval from the institutional ethics committee. All the participants gave written informed consent. All students filled a questionnaire which consisted of a general information sheet, perceived stress scale, Hamilton Anxiety Rating Scale, brief COPE inventory, and sources of stress questionnaire 1 month before and 1 month after their university examinations. Data were analyzed using t-test, Mann–Whitney U-test, Kruskal–Wallis test, and Chi-square test as appropriate. Results: In medical students, perceived stress was significantly higher in those in the management quota (both years), living in shared accommodation and from nuclear family (1st year) and male (2nd year). Only accommodation had a statistically significant relationship with perceived stress in 2nd year engineering students. A statistically significant association of perceived stress and anxiety with academic performance was observed. Anxiety in students was significantly more before the examination compared to after the examination. The association of all the coping strategies used, with the academic performance, was statistically significant. Conclusions: In both medical and engineering students, there was a significant association of perceived stress and anxiety with academic performance. Both medical and engineering students used active coping a little more than avoidant coping strategies during the examination time. The association of all the coping strategies used, with the academic performance, was statistically significant, thereby proving the importance of coping states in academic performance.
  1,155 34 -
Eyeing computer vision syndrome: Awareness, knowledge, and its impact on sleep quality among medical students
Ashwini Patil, Bhavya, Suprakash Chaudhury, Smiti Srivastava
January-June 2019, 28(1):68-74
DOI:10.4103/ipj.ipj_93_18  PMID:31879450
Background: Computer vision syndrome (CVS) encompasses a constellation of ocular and extraocular symptoms in computer users who either habitually or compulsively use computers for long periods of time. Electronic devices such as computers, smart phones, and tablets emit blue light (400–490 nm) from their light-emitting diodes and produce electromagnetic fields, both of which interfere with the circadian rhythm. Aim: This study aims to assess the awareness, knowledge, and impact on sleep quality of CVS among medical students. Materials and Methods: This study included 500 medical students. All participants anonymously filled up a pro forma including sociodemographic details and three questionnaires that (a) tested for awareness and knowledge about CVS, (b) tested for CVS, and (c) the Pittsburgh sleep quality index (PSQI), respectively. Data from 463 complete questionnaires were analyzed. Results: The mean (±standard deviation) age of the 463 individuals was 19.55 (±1.04) years. The prevalence of CVS was 77.5%. The prevalence was higher in boys (80.23%) compared to girls (75.87%), but the difference was not statistically significant. Only 34.1% of the medical students were aware of CVS. Good knowledge regarding various aspects of CVS was observed in 22.46% individuals, while 53.99% and 23.56% had average and poor knowledge, respectively. Poor sleep quality was present in 75.49% of individuals with CVS compared to 50.96% of students without CVS; the difference was statistically significant (odd's ratio [95% confidence interval]: 0.338 [0.214–0.531]). All the components of PSQI score, except components 1 and 6, had statistically significantly (P < 0.05) higher values in individuals with CVS as compared to individuals without CVS. Conclusions: There is high prevalence but low level of awareness and knowledge about CVS among medical students. CVS is significantly associated with poor sleep quality in medical students.
  1,116 41 -
Personality traits and its correlation to burnout in female nurses
KJ Divinakumar, Pookala Shivaram Bhat, Jyoti Prakash, Kalpana Srivastava
January-June 2019, 28(1):24-28
DOI:10.4103/ipj.ipj_52_19  PMID:31879443
Background: Few Indian studies have deliberated on the role of personality traits in perceived stress and burnout among female nurses employed in the government sector. Materials and Methods: A cross-sectional questionnaire-based survey was conducted among 600 female nurses employed in 30 government hospitals of India. Two hundred and ninety-eight valid questionnaires received with demographic data, NEO Five-Factor Inventory scores, Perceived Stress Scale-10, and Copenhagen Burnout Inventory scores were analyzed using linear regression analysis. Results: Trait neuroticism scores had modest positive correlation for personal burnout (R2: 0.32, F: 138.68), work-related burnout (R2: 0.22, F: 84.09), and overall burnout scores (R2: 0.30, F: 128.09). Extraversion scores had low negative correlation with personal burnout (R2: 0.08, F: 27.22, P < 0.00), work-related burnout (R2: 0.09, F: 28.81), and overall burnout scores (R2: 0.10, F: 31.68). Scores on agreeableness trait had weak negative correlation with personal burnout (R2: 0.09, F: 32.98), workrelated burnout (R2: 0.06, F: 20.96), patientrelated burnout (R2: 0.06, F: 21.27), and overall burnout scores (R2: 0.10, F: 33.43). Openness to experience had no significant correlation to personal, work-related, patient-related, or overall burnout scores. Conscientiousness scores had low negative correlation with the scores on personal burnout (R2: 0.12, F: 41.96), work-related burnout (R2: 0.09, F: 27.88), and overall burnout scores (R2: 0.10, F: 31.80). Neuroticism had modest positive correlation with perceived stress scores (R2: 0.33, F: 145.61). Extraversion, agreeableness, and conscientiousness were weakly negatively correlated with perceived stress scores. Conclusions: Trait neuroticism increased the vulnerability to perceived stress and burnout, whereas traits of extraversion, conscientiousness, and agreeableness were protective against perceived stress and burnout in the sample of female nurses surveyed.
  876 30 -
Prevalence of smartphone addiction and its effects on sleep quality: A cross-sectional study among medical students
Vivek Arun Kumar, Vigneshvar Chandrasekaran, Hema Brahadeeswari
January-June 2019, 28(1):82-85
DOI:10.4103/ipj.ipj_56_19  PMID:31879452
Aims: The study aims to assess the prevalence of smartphone addiction and its effects on sleep quality among medical students. Study Setting and Design: A cross-sectional study was carried out by convenience sampling of medical students at a tertiary care hospital in South India. Materials and Methods: Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision axis I disorders research version was used for screening past and current psychiatric illness. A semi-structured pro forma was used to obtain demographic details. Smartphone Addiction Scale-Short Version was used to assess smartphone addiction in the participants. Sleep quality was assessed using Pittsburgh's Sleep Quality Index (PSQI). Results: Among 150 medical students, 67 (44.7%) were addicted to smartphone usage. Despite the preponderance of male students (31 [50%]) being addicted, there was no statistically significant gender difference in smartphone addiction (P = 0.270). The PSQI revealed poor sleep quality in 77 (51.3%) which amounts to half of the participants. Smartphone addiction was found to be statistically significantly associated with poor sleep quality (odds ratio: 2.34 with P < 0.046). Conclusions: The prevalence of smartphone addiction among younger population is higher compared to those of contemporary studies. No gender difference in smartphone addiction could be made out in the current study. Smartphone addiction was found to be associated with poor sleep quality. The findings support screening for smartphone addiction which will be helpful in early identification and prompt management.
  808 55 -
Correlates of worry and functional somatic symptoms in generalized anxiety disorder
Vijaya Kumar, Ajit Avasthi, Sandeep Grover
January-June 2019, 28(1):29-36
DOI:10.4103/ipj.ipj_31_19  PMID:31879444
Background: Worry and functional somatic symptoms (FSS) are important clinical features of generalized anxiety disorder (GAD). Although there is literature on the prevalence of worry and FSS in GAD, there is limited data on psychological correlates of worry and somatic symptoms in patients with GAD. Objective: The purpose of this research was to evaluate the relationship of worry and FSS with somatosensory amplification, health anxiety (hypochondriasis), and alexithymia in patients with GAD. Methods: Forty patients with the diagnosis of GAD were assessed with Penn State Worry Questionnaire, Bradford Somatic Inventory (BSI), GAD-7 Scale, somatosensory amplification Scale (SSAS), Whiteley Index (WI), and Toronto Alexithymia Scale-20 Hindi version (TAS-H-20). Results: Worry had significant positive correlation with total scores of BSI, GAD-7 scale, TAS-H-20 subscale 1, SSAS, and WI. Younger age of onset was associated with higher FSS as assessed on BSI. BSI total score had positive correlation with total scores of GAD-7 scale, TAS-H-20 and its subscales, SSAS, WI, and with the severity grades of BSI and GAD. Conclusion: Worry and FSS are associated with somatosensory amplification and hypochondriasis. In addition, somatic symptoms are associated with alexithymia.
  832 15 -
Correlation of motivations for selfie-posting behavior with personality traits
Bhushan Laxman Chaudhari, Jaideep Kishore Patil, Adnan Kadiani, Suprakash Chaudhury, Daniel Saldanha
January-June 2019, 28(1):123-129
DOI:10.4103/ipj.ipj_30_19  PMID:31879458
Background: The widespread popularity of selfie-posting behavior has led to increasing academic interest in exploring psychological determinants for this behavior. Aim: The study aimed to evaluate sociodemographic factors, personality traits, and psychological motivations associated with selfie-posting behavior and to evaluate the association of psychological motivations for selfie-posting with personality traits. Materials and Methods: This cross-sectional study assessed 727 medical and physiotherapy students with a semi-structured questionnaire consisting of information about sociodemographic factors, selfie-posting, and editing behavior, the Big Five Inventory and motivations for selfie-posting scale. Results: There was a positive correlation of female gender, extraversion, and agreeableness with selfie-posting and editing and a negative correlation of neuroticism with both types of behavior. Communication was the most common motivation for selfie-posting followed by attention seeking. Extraverted people post selfies for attention seeking, communication, and archiving motive while agreeable individuals post them only for communication and archiving. Conclusion: Females as well as individuals with high extraversion and agreeableness engage in selfie-posting and selfie-editing more frequently while neurotic individuals tend to avoid engaging this behavior. Motivation for posting selfies most commonly was for communication followed by attention seeking. Individuals with different personalities use selfies differently to fulfill their inner psychological needs.
  780 10 -
Family psychoeducation with caregivers of schizophrenia patients: Impact on perceived quality of life
Pankaj Kumar Verma, Tejvir Singh Walia, Suprakash Chaudhury, Smiti Srivastava
January-June 2019, 28(1):19-23
DOI:10.4103/ipj.ipj_2_19  PMID:31879442
Background: Schizophrenia is a devastating and chronic mental illness. Considering the nature of illness along with routine psychiatric care, various supportive therapies are recommended. Family psychoeducational approach has been developed to increase patients' as well as their caregivers' knowledge and insight into their illness. It is postulated that this increased knowledge and insight will enable people with schizophrenia and their caregivers to cope in a more effective way with the consequences of their illness, thereby improving prognosis. Aim: The aim of this study is to assess the efficacy of family psychoeducation intervention on the caregivers of schizophrenia patients with respect to their perceived quality of life. Materials and Methods: A total of 30 caregivers of male schizophrenia patients were selected through purposive sampling technique. Patients were divided into two groups, namely, experimental and control group. Family psychoeducation intervention was given on twice-monthly basis for 6 months to the experimental group caregivers. Baseline assessment was carried out with the help of WHO Quality of Life-BREF followed by intervention and then posttherapeutic assessment was done with same tool. Results: Most of the caregivers were above 40 years of age group, married, and male. Following family psychoeducation, significant improvement in overall quality of life scores was observed in experimental group caregivers compared to control group caregivers where no such intervention was provided. Conclusion: Family psychoeducation is feasible and useful in our clinical population.
  748 21 -
Cognitive behavioral skill-based training program for enhancing anger control among youth
Ameer Hamza, Manoj Kumar Sharma, P Marimuthu, Sowmya Murli
January-June 2019, 28(1):37-43
DOI:10.4103/ipj.ipj_28_17  PMID:31879445
Background: Anger expression and its control among youth is a major concern for the health professionals. There is dearth of intervention-based study in Indian context. The present work aims to evolve an intervention module for management of anger among youth in India. Materials and Methods: The present module has been validated on 100 individuals with inclusion criteria of age from 18 to 25 years and the individuals with dependence on psychoactive drugs and refusal to participate were excluded from the study. The Anger data sheet, Buss–Perry Aggression Questionnaire, and State Trait Anger Expression Inventory were administered at baseline as well as at 1-month interval after 6 sessions of intervention. The 82 participants completed postassessment and 18 participants were dropouts of the follow-up sessions. Results: Pre-post cognitive therapy based anger management intervention program showed the difference in the domains of resilience; clinical anger, state and trait anger and anger control in. Conclusions: The study implies the need for community-based sensitization for issues related to anger expression and facilitation of approaches to promote adaptive anger control among youth.
  726 32 -
Comparison between baclofen and topiramate in alcohol dependence: A prospective study
Nimmi A Jose, Pooja Yadav, Abhishek Kapoor, Ved Pal Mahla
January-June 2019, 28(1):44-50
DOI:10.4103/ipj.ipj_57_19  PMID:31879446
Introduction: Baclofen and topiramate are GABAergic drugs, and both have been recommended for the treatment of alcohol dependence as anticraving agent. Several studies have demonstrated the effect of baclofen and topiramate as anticraving, but none has compared them. The main aim of the current study was to assess the baclofen and topiramate as anticraving agent in alcohol dependence during 1 month follow-up. Methodology: After 1-week detoxification protocol, 94 patients were randomly assigned to either baclofen (n = 49) or topiramate (n = 45) for 1-month follow-up. Patients were assessed with clinical institute withdrawal assessment at baseline, and at 1 week, the Addiction Severity Index, ready to change questionnaire at baseline and weekly assessed with Obsessive and Compulsive drinking scale (OCDS) for craving. At every follow-up, adverse effects were also assessed to check tolerability. Results: A marked improvement was observed with baclofen in OCDS in each assessment as compared to topiramate. With baclofen, 61.22% of patients became complete abstinence, as compared to 37.78% in topiramate group. Baclofen was better tolerated as 24.49% patients were dropped out in baclofen group as compared to 33.33% in topiramate group. Conclusion: Baclofen has better efficacy and tolerability as compared to topiramate.
  637 29 -
Is obesity a risk to depression? A cross-sectional study
Rajat Garg, Sachin Kumar Saxena, Sabreen Bashir
January-June 2019, 28(1):130-134
DOI:10.4103/ipj.ipj_59_19  PMID:31879459
Background: Depression and obesity are disorders of stress with a dose dependent relationship between the both. The adverse health and social consequences are significant, when depression and obesity co-exist. This study aimed to examine the prevalence of depression among overweight and obese patients in a large station of Armed Forces and associate other risk factors of depression. Methods: This cross sectional descriptive study was conducted in the general OPD of large Station medicare centre (SMC) on overweight and obese personnel. Data was collected by self-administered Patient Health Questionnaire (PHQ-9) to assess the risk for depression over a period of one month. Results: In this study, out of 106 individuals, 71 (67%) were overweight and 35 (33%) were obese, as per WHO criteria. Of the individuals assessed, 13 (12%) individuals were found to have risk of moderate depression, 58 (54%) for mild depression and 35 (33%) individuals had no risk for clinically significant depression. The likelihood of depression was most strongly associated with BMI followed by age, status of living with family and habit of drinking alcohol. Conclusion: Obesity and depressive disorders are common comorbidities with overlapping pathophysiology whose co-existence leads to exponential adverse health outcomes. The outcome of depression and obesity is to be managed comprehensively by psychological counseling and life style modification.
  650 15 -
CASE REPORTS
Risperidone-induced retrograde ejaculation and lurasidone may be the alternative
Natarajan Shanmugasundaram, J Nivedhya, Murugan Selvaraj Karthik, Sathianathan Ramanathan
January-June 2019, 28(1):152-154
DOI:10.4103/ipj.ipj_8_19  PMID:31879463
Medication adherence with antipsychotics is adversely impacted by the burden of untoward adverse effects. In particular, sexual side effects are often underreported by patients, which may interfere with drug compliance. Presented here is the case of a 35-year-old male with schizophrenia, previously treated with risperidone following which he developed sexual dysfunction and hence was stopped. He was admitted to our psychiatric inpatient ward after a second psychotic exacerbation of the disorder after being drug free for about 6 months. On admission, treatment with risperidone was restarted, following which he developed retrograde ejaculation on oral risperidone therapy at a dose of 8 mg/day, with resolution of symptoms after cross tapering risperidone with lurasidone. Pharmacological interventions that may reduce antipsychotic-induced sexual dysfunction include changing the type of medication and administering other medications that are known to improve sexual dysfunction. This case emphasizes the need for routine inquiry into sexual dysfunction during atypical antipsychotic therapy.
  617 15 -
ORIGINAL ARTICLES
A comparative study of psychosocial determinants and mental well-being in chronic kidney disease patients: A closer look
Waheed Abdul Khan, Shahbaz Khan Ali, Swetanka Prasad, Aruna Deshpande, Shagufta Khanam, DS Ray
January-June 2019, 28(1):63-67
DOI:10.4103/ipj.ipj_23_19  PMID:31879449
Background: Depressive illness in chronic kidney disease (CKD) is an independent risk factor for morbidity and mortality. The relation between depressive illness and quality of life (QoL) in this vulnerable group is complex. We attempted to study the burden of depressive illness, the QoL in patients of CKD on hemodialysis (HD), and peritoneal dialysis (PD) as well as those who were not on any dialysis but on conservative medical management only. Materials and Methods: Observational study with cross-sectional analytical controlled design. Statistical Methods Used: Chi-square statistic or Fisher's exact test for categorical variables and t-test and ANOVA for continuous variables. Correlational analysis was done using Spearman's correlation coefficient. P <0.05 was considered as statistically significant. Results: Depressive symptoms were present significantly across all 3 groups of CKD patients. Depressive disorder was significantly higher in the HD group. Mean QoL was significantly better in patients of CKD on PD. Discussion: There is huge hidden burden of depressive symptoms and depressive illness in patients of CKD whether on dialysis or on conservative medical management. The study found significantly higher burden of depressive illness and lower QoL among the HD vis a vis PD patients, even though the majority of our CKD who require dialysis are on HD. Conclusion: Depressive burden is the hidden factor behind poor QoL, poor overall satisfaction as well as treatment outcome in patients of CKD whether or not on dialysis. To address this hidden depressive burden comprehensively, close cooperation between nephrologist and psychiatrist is called for.
  567 23 -
CASE REPORTS
Application of transtheoretical model in management of individual with alcohol dependence: A case study
Romalin Pattanaik, Narendra Nath Samantaray, Jashobanta Mohapatra
January-June 2019, 28(1):148-151
DOI:10.4103/ipj.ipj_50_17  PMID:31879462
Studies have focused on the efficacy of transtheoretical model in the management of substance dependence, but not much have focused on the changes with respect to the patient's mood, life skills, and interpersonal relationship issues that take place during the therapy. The present study explores a case by using motivational interviewing and relapse prevention strategies to qualitatively record the applicability of the transtheoretical model in terms of readiness to change, action taken, relationship conflicts, assertiveness, and depression in an individual with alcohol dependence. The intervention was carried out over 3 months for ten sessions followed by follow-up for 8 months. The results indicated improvement in the patient in the dimensions of level of action taken for increasing abstinence period, decreasing the level of depression, enhancing readiness to change, and improving assertiveness and improvement in marital adjustment with spouse, which were observed and reported during the post follow-up sessions.
  575 10 -
ORIGINAL ARTICLES
Effect of psychotic symptoms on cognitive impairment in patients with bipolar disorder
Rashmin Mansukh Achalia, Bhargavi Nagendra, Garimaa Achalia, Mahesh Chopade, Abhijit Sable, Ganesan Venkatasubramanian, Naren P Rao
January-June 2019, 28(1):115-122
DOI:10.4103/ipj.ipj_1_19  PMID:31879457
Background: A considerable proportion of patients with bipolar disorder (BD) have psychotic symptoms during the illness. This subset of BD due to its genetic susceptibility and family segregation has considerable overlap with schizophrenia. However, the extent to which BD patients with psychotic symptoms and without psychotic symptoms differ on neurocognitive functions is still not completely clear. Aim: The aim of this study was to examine the neurocognitive functions in BD patients with psychotic symptoms and BD without psychotic symptoms in comparison with healthy volunteers (HVs). Materials and Methods: Thirty patients with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition BD (16 with psychotic symptoms) and thirty age- and sex-matched HVs were recruited in the study. Clinical severity was assessed using structured rating scales. The presence of psychotic symptoms was assessed using the Lifetime Dimensions of Psychosis Scale (LDPS). All patients underwent tests, namely continuous performance test, Stroop Word-Color interference test, and Wisconsin Card Sorting Test, to measure executive functions. Differences between groups were examined using analysis of covariance with age and sex as covariates. Results: There was a significant difference between groups on the performance of all the three tests, with patients performing poorer than HVs. While the HVs differed from both BD with psychotic symptoms and without psychotic symptoms, there was no difference between BD patients with and without psychotic symptoms. There was no significant correlation between LDPS score and scores on neurocognitive tests. Conclusion: The study findings, at least with respect to cognitive function, suggest that BD with psychotic symptoms may not be a categorically distinct subtype of BD. Cognitive functions need to be assessed in all patients with BD, regardless of psychotic symptoms, and remediation interventions need to be provided.
  551 6 -
Relation between temperament dimensions and attention-deficit/hyperactivity disorder symptoms
Nidhi Chauhan, Ruchita Shah, Susanta Padhy, Savita Malhotra
January-June 2019, 28(1):58-62
DOI:10.4103/ipj.ipj_74_19  PMID:31879448
Introduction: The relation between temperament and attention-deficit/hyperactivity disorder (ADHD) is complex and understood in different ways, with the most common being risk model and spectrum model. However, the evidence is mixed and emerging. Aim: To assess the relationship between ADHD symptoms and temperament dimensions in a clinical sample of school-aged children. Methods: A retrospective assessment of temperament of 50 children with ADHD was done on temperament measurement schedule. The mean and standard deviation was computed for continuous variables and frequency and percentage for discontinuous variables and correlation and regression analysis was computed. Results: Children with ADHD were high on activity level, intensity of reaction, approach, and distractibility and low on persistence and threshold of responsiveness. The strength of significant correlations between temperamental dimensions and ADHD symptoms (P < 0.05) ranged from 0.32 to 0.41. On regression analysis, temperament could explain 22% variance of inattention subscale and around 20% variance in hyperactivity/impulsivity subscale. Conclusion: This moderate level of relation suggests that though certain temperamental traits are related to symptoms of ADHD, temperament and ADHD are phenotypically separate constructs, further favoring the risk model.
  507 22 -
Psychiatric and cognitive correlates of quality of life among persons with primary brain tumors
Shruti Srivastava, Manjeet S Bhatia, Aman Gaur, Gurubachan Singh
January-June 2019, 28(1):141-147
DOI:10.4103/ipj.ipj_72_19  PMID:31879461
Background: Quality of life (QoL) in primary brain tumour (PBT) is often the main outcome measure in an otherwise incurable disease. The impact of psychiatric, cognitive correlates on quality of life in primary brain tumours is less well studied. Aims and objectives: The primary objective was to find out the association of psychiatric morbidity, cognitive functions with quality of life in patients with primary brain tumours. The secondary objective was to study whether any association exists with tumour grading, laterality, location and psychiatric morbidity. Materials and Methods: 100 consecutive patients of PBT were screened in the Neuro-behavioural Clinic. Age, gender matched 52 healthy subjects were taken for comparison. Quality of life (qol) measure (EORTC), Hospital Anxiety Depression Scale (HADS), GHQ (12 item) and Mini Mental State Examination (MMSE) were administered. Results: 52 PBT cases were included, out of which 17.30% had Organic Anxiety Disorder (F06.4), 23.07% had Organic Mood disorder (F06.3%).Statistically significant association was found in EORTC qol scores and anxiety scores (p 0.001), depressive scores (p 0.029), psychiatric morbidity (p0.000) .Significant association with tumour laterality , depression scores (p0.041) was found. PBT patients had poor quality of life as compared to matched healthy volunteers (p <0.001). Significant negative correlation between EORTC B-20, cognitive scores using Spearman's Rho (p0.005; r - 0.385), implying more symptoms with poor cognitive function scores. Psychiatric morbidity, cognitive dysfunction, poor qol were noted, though no association with tumour grading, location. Conclusion: Regular assessments, early intervention will help in improving quality of life in PBT.
  507 12 -
Evaluation of sexual dysfunction and quality of life in patients with severe mental illness: A cross-sectional study from a tertiary care center in Chhattisgarh
Deepak Ghormode, Pramod Gupta, Devendra Ratnani, Jitender Aneja
January-June 2019, 28(1):75-81
DOI:10.4103/ipj.ipj_16_19  PMID:31879451
Background: Sexual dysfunctions (SDs) are common and lead to psychological distress and impair quality of life (QOL). However, little attention has been paid to explore SD in severe mental illnesses (SMIs). Hence, this study aimed to evaluate the occurrence of SD and its impact on the QOL in persons suffering from schizophrenia, bipolar disorder, and depression and compare it with healthy controls. Materials and Methods: In this cross-sectional study, 79 clinically stable patients and 50 healthy controls underwent evaluation for SD on the Arizona Sexual Experience Scale, and their QOL was measured using the WHO QOL-BREF scale. Chi-square test was used for the categorical variables, whereas comparison of continuous variables was done by t-test with post hoc corrections. Results: Compared to healthy controls, patients with depression had significantly higher rates of SD in the domain of obtaining penile erection (P = 0.019), ability to reach orgasm (P = 0.03), and satisfaction from orgasm (P = 0.01). Patients with schizophrenia had higher rates of problems in achieving arousal (P < 0.01), penile erection (P = 0.03), and satisfaction from orgasm (P = 0.03), whereas those with bipolar disorder only differed significantly on the domain of ability to reach orgasm (P = 0.03). However, patients fared better than the controls on various domains of QOL (except social domain). Conclusion: A significant number of patients with SMI suffer from SD. Hence, it should be made a routine practice to evaluate and address the problem of SDs in patients with SMI.
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Psychosocial correlates of medication adherence in patients with depressive illness
Jyoti Prakash, YK Yadav, Kalpana Srivastava, T Madhusudan
January-June 2019, 28(1):135-140
DOI:10.4103/ipj.ipj_78_19  PMID:31879460
Introduction: Nonadherence to medication is common in depressive illness and the same may lead to increased risk of relapse, morbidity, burden of care, and avoidable health cost. Factors which may cause nonadherence are multiple. Methodology: A study was undertaken to appreciate the role of various psychosocial factors in adherence to various antidepressant medication in the patients of depressive disorder. One hundred and fifty patients after due consent were subjected to medico-psychosocial-structured per forma, Beck's Depression Inventory, The Belief About Medicines Questionnaire, and the Morisky Medication Adherence Scale. Results: Nonadherence to antidepressant medication in our study was 73.33%. Characteristics of the disease, disease therapies, patient-associated aspects including beliefs, and social and economic support did affect medication adherence. Conclusion: Nonadherence to medication was common in patients with depressive illness. Finding emphasizes the need to sensitize the patients about the importance of proper adherence.
  460 17 -
Stress: Prevalence and correlates among residents of a suburban area
Archana Singh, Manisha Arora, Vishal Sharma, Atul Kotwal
January-June 2019, 28(1):98-102
DOI:10.4103/ipj.ipj_33_18  PMID:31879454
Background and Objectives: Stress is a major concern in the present scenario as it is occurring in a big way involving all age groups. The objectives of this study were estimating the prevalence of stress, assessing the associated stress factors, and symptoms of stress among residents of suburban community. Materials and Methods: The community-based cross-sectional study was conducted in a suburban area in Delhi from June to August 2017. Adults and children aged 14 years and above permanently residing (1 year or more) in the area were included in the study. A sample size of 384 was calculated with the alpha error set to 05% and absolute error 05%, and to cater for refusals, a total of 400 participants were approached. A structured questionnaire was used for the study by interview method. To estimate the prevalence of stress, a standardized scale, depression, anxiety, and stress scale 21 was used. Results: The mean age of the participants in the study was 36.31 (±15.10), with 51.2% of males and 48.8% of females. Among the children, the leading factors associated with stress were studies (41.2%), poverty (22.1%), and competitions (16.2%). Among the adults, the leading factors were financial problems (35.2%) and children's studies (23.1%). The most common reported somatic symptom during stress was headache (59.8%) and psychological symptom was “unable to sleep” (47.5%). The prevalence of stress was 26% in a subset of sample in this study. There was a statistically significant association of stress with family size, the level of stress decreased with an increase in family size. Conclusion: The study emphasizes the need for effective prevention and management of stress in the community and schools.
  433 12 -
Assessment of quality of life before and after successful percutaneous transvenous mitral commissurotomy in patients with severe mitral stenosis
Prashant Bhardwaj, Suprakash Chaudhury, Aradhana Aneja, Vinay Jetley, Tejvir Singh Walia, Swaleha Mujawar
January-June 2019, 28(1):51-57
DOI:10.4103/ipj.ipj_4_19  PMID:31879447
Background: Rheumatic mitral stenosis (MS) is a significant cause of morbidity and mortality in India. Percutaneous transvenous mitral commissurotomy (PTMC) has become the procedure of choice for severe MS with pliable leaflets. Despite a wealth of literature on the technical aspects of PTMC, there is a dearth of literature addressing the impact of PTMC on the quality of life (QOL). Aim: The aim of the study is to assess the impact of PTMC on clinical status and QOL of patients with severe MS. Materials and Methods: Twenty-five consecutive patients with severe MS undergoing PTMC were included in the study with their informed consent. All patients were subjected to routine blood tests, electrocardiogram, chest X-ray, two-dimensional and color echocardiography, treadmill test (TMT), and World Health Organization (WHO) QOL scale. The echocardiography, TMT, and WHOQOL scale were repeated after the procedure. Results: The procedural success was 98%. The mean (range) mitral valve area preprocedure was 0.82 (0.59–0.92) cm2 and postprocedure was 1.61 (1.51–1.76) cm2. The difference was statistically significant (t = 5.02; P < 0.01). The mean (range) of TMT preprocedure was 4.05 (3.0–7.0) METS and postprocedure was 8.52 (6–12) METS. The difference was statistically significant (T = 3.08; P < 0.01). The mean (range) of QOL assessment pre- and post-procedure on physical domain was 8.83 (8.3–10.1) which increased to 11.11 (10–12.7); on social relationship domain from 9.17 (7.5–12.4) to 11.37 (9.4–12.0); on personal relationship from 11.6 (11–13) to 12.52 (12–13); on environment domain from 10.78 (10.2–11.7) to 11.56 (10.8–12); and on level of independence from 9.02 (8–10) to 12.29 (11.0–13.6). All the differences were statistically significant (Wilcoxon signed-rank test z = −4.376; −4.379; −4.234; −4.200; −4.375; respectively, all P < 0.001 highly significant). Conclusions: PTMC resulted in a significant improvement in the QOL of patients with severe MS. The significant improvement in QOL post-PTMC may be an indication for offering PTMC at an earlier stage to those patients whose QOL is severely compromised.
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Psychopathology and personality factors in first-degree relatives of patients with schizophrenia
Nitisha Verma, Deoraj Sinha, Malay Dave, Ravindra M Kamath
January-June 2019, 28(1):103-106
DOI:10.4103/ipj.ipj_54_17  PMID:31879455
Background: Schizophrenia is a chronic mental illness which has far-reaching consequences not only on patients but also on relatives. These relatives are at an increased risk for developing schizophrenia, depression, and substance dependence. Psychopathology may be related to personality factors. This study was planned to assess psychopathology and personality factors in first degree relatives of patients with schizophrenia and to evaluate any relation between them. Materials and Methods: This was a cross-sectional study conducted at psychiatry out- and in-patient clinic at a tertiary care teaching hospital. One hundred and fifty patients who were first-degree relatives of patients diagnosed with schizophrenia on the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition were enrolled in this study. Psychopathology was assessed on “Symptom Checklist 90-Revised.” “Big Five Inventory” (BFI) was used to study the personality factors. The two variables were compared to look for any relation between them. Results: Eighty-two of 150 (54.67%) first-degree relatives were diagnosed to have significant psychopathology. Among them, 42 (i.e., 58.5%) had either somatization or depression. Those relatives who had psychopathology scored higher on neuroticism (P = 3.51E-04) and lower on agreeableness (P = 0.029) domains of BFI. Conclusion: Relatives of patients with schizophrenia should be screened for psychopathology regularly, also relation between personality and psychopathology needs to be explored further.
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