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   2014| January-June  | Volume 23 | Issue 1  
    Online since November 18, 2014

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(De-) criminalization of attempted suicide in India: A review
Rajeev Ranjan, Saurabh Kumar, Raman Deep Pattanayak, Anju Dhawan, Rajesh Sagar
January-June 2014, 23(1):4-9
DOI:10.4103/0972-6748.144936  PMID:25535437
Attempted suicide is a serious problem requiring mental health interventions, but it continues to be treated as a criminal offence under the section 309 of Indian Penal Code. The article reviews the international legal perspective across various regions of the world, discusses the unintended consequences of section 309 IPC and highlights the need for decriminalization of attempted suicide in India. The Mental Health Care Bill, 2013, still under consideration in the Rajya Sabha (upper house), has proposed that attempted suicide should not be criminally prosecuted. Decriminalization of suicidal attempt will serve to cut down the undue stigma and avoid punishment in the aftermath of incident, and lead to a more accurate collection of suicide-related statistics. From a policy perspective, it will further emphasize the urgent need to develop a framework to deliver mental health services to all those who attempt suicide.
  9,529 470 9
Establishing linkages between emotional intelligence and transformational leadership
Sanjay Kumar
January-June 2014, 23(1):1-3
DOI:10.4103/0972-6748.144934  PMID:25535436
  7,542 237 8
Efficacy of amisulpride and olanzapine for negative symptoms and cognitive impairments: An open-label clinical study
Subodh Kumar, Suprakash Chaudhury
January-June 2014, 23(1):27-35
DOI:10.4103/0972-6748.144953  PMID:25535442
Background: Negative symptoms and diminished cognitive ability are also considered as core features of schizophrenia. There are many studies in which negative symptoms and cognitive impairments are individually treated with atypical antipsychotic in comparison with either a placebo or a typical antipsychotic. There is paucity of studies comparing the efficacy of olanzapine and amisulpride on improvement of negative symptoms and cognitive impairments. Aim: To examine the effectiveness of amisulpride and olanzapine in treatment of negative symptoms and cognitive impairments in schizophrenia. Materials and Methods: Total 40 adult inpatients diagnosed as schizophrenia fulfilling inclusion/exclusion criteria were included in the study with their informed consent. These patients were recruited consecutively to one of the two drug regimen group, i.e. tab Amisulpride (100-300 mg/day) and tab Olanzapine (10-20 mg). Patients were evaluated on day 0 and day 60 with various rating scales like Scale for the Assessment of Negative Symptoms (SANS), Scale for the Assessment of Positive Symptoms (SAPS), Schizophrenia Cognition Rating Scale (SCoRS), Brief Psychiatric Rating Scale (BPRS), Calgary Depression Scale for Schizophrenia (CDSS), and three different scales to measure drug side effects. Results: The mean SANS score in amisulpride and olanzapine group at day 0 and day 60 were 83.89 (±12.67) and 21.00 (±11.82) and 84.40 (±13.22) and 26.75 (±12.41), respectively. The mean rank of SCoRS global in amisulpride and olanzapine group at day 0 and day 60 were 4.78 (±1.13) and 2.78 (±0.63) and 4.85 (±1.18) and 3.30 (±1.12), respectively. The percentage improvement in SANS, SAPS, SCoRS interviewer, and SCoRS global in amisulpride group are 74.96%, 13.36%, 54.14%, and 42.00%, respectively. Similarly in olanzapine group percentage improvement in SANS, SAPS, SCoRS interviewer, and SCoRS global are 68.30%, 30.28%, 35.22%, and 31.95%, respectively. There is significant improvement in SANS, SCoRS, SAS, BPRS, and PANSS (Insight) in both amisulpride and olanzapine groups at the two time points. However, there is no significant difference between amisulpride and olanzapine group of patients. Conclusion: Both amisulpride and olanzapine group patients showed significant improvement in negative and cognitive symptoms from baseline to endpoint, but there was no significant difference between amisulpride and olanzapine group of patients.
  6,330 174 3
Allelic variants of ADH, ALDH and the five factor model of personality in alcohol dependence syndrome
SK Salujha, S Chaudhury, PK Menon, K Srivastava, A Gupta
January-June 2014, 23(1):44-51
DOI:10.4103/0972-6748.144956  PMID:25535445
Background: The etiology of alcohol dependence is a complex interplay of biopsychosocial factors. The genes for alcohol-metabolizing enzymes: Alcohol dehydrogenase (ADH2 and ADH3) and aldehyde dehydrogenase (ALDH2) exhibit functional polymorphisms. Vulnerability of alcohol dependence may also be in part due to heritable personality traits. Aim: To determine whether any association exists between polymorphisms of ADH2, ADH3 and ALDH2 and alcohol dependence syndrome in a group of Asian Indians. In addition, the personality of these patients was assessed to identify traits predisposing to alcoholism. Materials and Methods: In this study, 100 consecutive males with alcohol dependence syndrome attending the psychiatric outpatient department of a tertiary care service hospital and an equal number of matched healthy controls were included with their consent. Blood samples of all the study cases and controls were collected and genotyped for the ADH2, ADH3 and ALDH2 loci. Personality was evaluated using the neuroticism, extraversion, openness (NEO) personality inventory and sensation seeking scale. Results: Allele frequencies of ADH2*2 (0.50), ADH3*1 (0.67) and ALSH2*2 (0.09) were significantly low in the alcohol dependent subjects. Personality traits of NEO personality inventory and sensation seeking were significantly higher when compared to controls. Conclusions: The functional polymorphisms of genes coding for alcohol metabolizing enzymes and personality traits of NEO and sensation seeking may affect the propensity to develop dependence.
  5,841 97 3
Analysis of variables affecting drug compliance in schizophrenia
Shakeel Ansari, Shakila Mulla
January-June 2014, 23(1):58-60
DOI:10.4103/0972-6748.144968  PMID:25535447
Context: As compliance of the patient during management of schizophrenia is crucial, the current study was conducted to find out the factors that affected compliance. Aims: The aim of the study was to analyze the prevalence of noncompliance and to find out different factors affecting compliance in schizophrenic patients. Materials and Methods: Observational cross-sectional study was conducted on 100 adult schizophrenic patients. Noncompliance was assessed using the rating of medication influence (ROMI) scale. Severity of illness was measured using positive and negative syndrome scale (PANSS). Results: Prevalence of noncompliance was 37%. Using ROMI scale; positive relationship with psychiatrist, family pressure for taking medications, stigma, and substance abuse were found to be significant factors. Severity of illness was also found as determining factor. Conclusion: To improve the compliance in schizophrenia patients, roles of both psychiatrists and family members are crucial.
  5,380 128 3
An unusual case of xylophagia (paper-eating)
Mahesh Gowda, Bhavin M Patel, S Preeti, M Chandrasekar
January-June 2014, 23(1):65-67
DOI:10.4103/0972-6748.144972  PMID:25535449
Xylophagia is a condition involving the consumption of paper and form of eating disorder known as pica. Pica is an unusual craving for ingestion of either edible or inedible substances. Inhalants are volatile substances, which produce chemical vapors that can be inhaled to induce a psycho-active or mind altering effect. Although, pica is not linked to solvent abuse, here we report an adolescent case of paper-eating with solvent dependence.
  5,267 126 1
Psychiatric morbidities among mentally ill wives of Nepalese men working abroad
Dhana Ratna Shakya
January-June 2014, 23(1):52-57
DOI:10.4103/0972-6748.144957  PMID:25535446
Introduction: Husband working abroad may have not only favorable outcomes for wives and other family members but also adverse consequences, including psychological problems. Present study intended to look into psychiatric morbidity profiles of the Nepalese female psychiatric patients and the stressors related with their husband working abroad. Materials and Methods: This is a hospital-based descriptive study with convenient sampling method. Hundred consecutive female psychiatric patients, with the particular stressor, coming into the contact of the investigating team were enrolled within the study period of 12 months. The psychiatric morbidities/diagnoses were sorted out according to the International classification of disease and infirmity, 10 th edition (ICD-10) criteria. Results: Average age of the enrolled cases was 29 years. Nearly half of the women were illiterate or barely literate. Some other stressors, besides the one of husband working abroad were found to precipitate the illness in about 60%, main being relational and health problems. Common presenting complaints were mood, anxiety, and physical symptoms. Almost 30% of the subjects had some mental illness in their past too and similar proportion had in their blood relatives. About one-third admitted to use substances, mainly alcohol and cigarettes. The common psychiatric diagnoses were mood, anxiety, neurotic, and stress-related disorders. Nearly 10% had presented for suicide attempt. Conclusions: The status of husband working abroad may have adverse consequences in mental health of women. Mood affect, anxiety, and stress-related disorders are common psychiatric illness among them.
  4,423 60 1
Prevalence of stress level among Bank employees in urban Puducherry, India
S Ganesh Kumar, N Deivanai Sundaram
January-June 2014, 23(1):15-17
DOI:10.4103/0972-6748.144938  PMID:25535439
Background and Objective: Stress is an important health area of concern among bank employees. The study aims to assess the stress level and its associated factors among bank employees. Materials and Methods: A cross-sectional study was conducted among 192 bank employees in urban Puducherry, India. Stress level was assessed by Cohen's Perceived Stress scale and classified into low (0-11), average (12-15), high (16-20), and very high (21 and above) based on the stress scores. Collected data were analyzed by using univariate analysis. Results: Majority of them had high and very high level of stress (75.5%, confidence interval: 69.4-81.6%). The variables that include age group, sex, category of work, smoking and alcohol use were not found to be significantly associated with the stress level (P > 0.05). With respect to question items, handling personal problems and things were going their way were answered as fairly often and very often by the majority of the subjects. Conclusion: Stress level among bank employees is high, which necessitates intervention measures for this vulnerable group.
  4,139 153 3
Assessment of sleep quality in post-graduate residents in a tertiary hospital and teaching institute
Vasantmeghna Srinivasa Murthy, Ajita Sunil Nayak
January-June 2014, 23(1):23-26
DOI:10.4103/0972-6748.144952  PMID:25535441
Objectives: To evaluate subjective sleep quality, day-time sleepiness, prevalence of substance use, satisfaction with life among residents at our institute. To evaluate association of sleep qualitywith satisfaction with life and day-time sleepiness. To compare the findings between residents in clinical and para-clinical departments. Materials and Methods: Eighty-four residents filled questionnaires to obtain socio-demographic information and use of substance (s). Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and Satisfaction With Life scale (SWLS) were also used. Association between sleep quality and sleepiness and satisfaction with life was evaluated. From the data collected, comparisons were made between the clinical and para-clinical department residents. Results: A significant number of residents belonging to the clinical faculty were poorsleepers; reported high levels of abnormal day-time sleepiness and less satisfaction with life compared to residents in para-clinical faculties. The differences in correlation between sleepiness and satisfaction with life with sleep quality among the two groups were not found to be significant. A larger percentage of clinical residents reported use of at least one substance during the residency period compared to the para-clinical residents. Conclusions: Poor sleep quality is perceived greatly by the resident doctors in our public hospital, especially among clinical faculties. Interventions are thus necessary in order to ensure adequate sleep among them.
  3,662 225 2
Suicidal behavior among alcohol dependents: Relationship with anger and personality dimensions
Manoj Kumar Sharma, Anusha Salim
January-June 2014, 23(1):61-64
DOI:10.4103/0972-6748.144971  PMID:25535448
Background: Alcohol dependents have high percentage of nonfatal suicidal behaviors. There is no substantial data on anger and personality correlates of suicidal behaviors among alcohol users. The present work explored the relationship of anger and personality with suicidal behaviors among alcohol-dependent individuals. Materials and Methods: Sociodemographic data sheet, State Trait Anger Expression Inventory (STAXI), and Neo Five-Factor Inventory (NFFI) were administered on 30 subjects who had lifetime history of suicidal attempt. Results: A total of 80% attempted suicide in the intoxicated states, 56.7% were high on trait anger, and 60% were high on anger expression outward. A significant negative correlation was found between expressing feelings (verbally/physically) openness, conscientiousness, and agreeableness. A significant positive correlation was found between anger expression inward and neuroticism. Conclusions: It helped in understanding the psychological variables associated with suicidal behavior among alcohol-dependent individuals and has implications for addressing neuroticism openness, conscientiousness, and agreeableness for bringing change in anger expression.
  3,676 101 1
Munchausen syndrome: Playing sick or sick player
Jyoti Prakash, RC Das, K Srivastava, P Patra, SA Khan, R Shashikumar
January-June 2014, 23(1):68-70
DOI:10.4103/0972-6748.144975  PMID:25535450
Munchausen syndrome is rare factitious disorder which entails frequent hospitalization, pathological lying and intentional production of symptoms for sick role. Management requires collateral history taking, sound clinical approach, exclusion of organicity and addressing psychological issues. A case which presented with unusual symptoms of similar dimension is discussed here. The case brings out finer nuances in evaluation and management of this entity .
  3,690 83 -
Central registry in psychiatry: A structured review
Jyoti Prakash, TS Ramakrishnan, RC Das, K Srivastava, Suresh Mehta, R Shashikumar
January-June 2014, 23(1):10-14
DOI:10.4103/0972-6748.144939  PMID:25535438
Background: Central registry in psychiatry is being practiced in few countries and has been found useful in research and clinical management. Role of central registry has also expanded over the years. Materials and Methods: All accessible internet database Medline, Scopus, Embase were accessed from 1990 till date. Available data were systematically reviewed in structured manner and analyzed. Results: Central registry was found useful in epidemiological analysis, association studies, outcome studies, comorbidity studies, forensic issue, effective of medication, qualitative analysis etc., Conclusion: Central registry proves to be effective tool in quantitative and qualitative understanding of psychiatry practice. Findings of studies from central registry can be useful in modifying best practice and evidence based treatment in psychiatry.
  3,328 96 2
Clozapine response and pre-treatment EEG-is there some kind of relationship
Amresh Shrivastava, Megan Johnston, Nilesh Shah, Larry Stitt, Shivanshu Shrivastava, Avinash De Sousa
January-June 2014, 23(1):18-22
DOI:10.4103/0972-6748.144951  PMID:25535440
Background: Clozapine has been used widely in the management of treatment-resistant schizophrenia. The present study aims at determining whether pre-treatment electroencephalography (EEG) abnormalities would serve as a marker for response to clozapine treatment. Subjects and Methods: This was a cross-sectional study done in a tertiary care center in Mumbai where patients diagnosed with schizophrenia using DSM-IV criteria and resistant schizophrenia using Kane criteria were assessed using EEG prior to starting clozapine treatment. They were rated for symptomatic improvement using the Positive and Negative Syndrome Scale (PANSS) along with Clinical Global Improvement for Severity (CGI-S). The results were statistically analysed and presented. Results: 55 out of the 80 patients in the study showed baseline EEG abnormalities. The mean duration of illness in the patients were 2.65 years. Slow wave and background EEG abnormalities were common in pre-treatment EEG. 36.4% patients in the study showed clinical response. Patients with negative symptoms and baseline EEG abnormalities showed better response. Conclusions: The study was circumscribed and had many limitations due to a small sample size. The relation between pre-treatment EEG abnormalities and clozapine response could not be statistically correlated and it could not be ascertained to be a marker for response to clozapine therapy.
  3,313 72 1
Cerebral hemi atrophy as a consequence of cerebral insult in infancy: Is it difficult to diagnose?
Daniel Saldanha, Bushan Chaudhari, Suresh Kumar Mehta, Archana Narender Javadekar, Amit Kharat
January-June 2014, 23(1):71-73
DOI:10.4103/0972-6748.144978  PMID:25535451
  3,291 59 -
Role models and occupational ambitions of in-school male adolescents
Suhail Ahmad Azmi, Anees Ahmad, Najam Khalique, Zulfia Khan
January-June 2014, 23(1):36-39
DOI:10.4103/0972-6748.144954  PMID:25535443
Background: A role model is perceived as worthy of imitation, their selection can indicate significant elements of psychosocial health and self-projection in adolescents. Patterns of behavior and lifestyle choices established during adolescence can have immediate and lasting effects on health. Materials and Methods: Cross-sectional study was undertaken in the schools of Aligarh, Uttar Pradesh, India. The sample frame was 2347, out of which a sample of 390 students was studied. Data collected were entered and analyzed by SPSS for Windows version 10%). Results: Majority (62.7%) of adolescents revealed that their role models were Film Star (34.8%) and their Teachers (27.9%), Parents (14.3%), Sportsman (12.0%). Politicians as the role models were opted by least proportion (1.2%). Desire of future occupation was Businessmen (27.9%), Doctor (18.6), and Engineer (14.4%). Conclusion: Nearly all adolescents had a role model. There is greater impact of cinema on the minds of adolescents, which resulted in choosing film actors as their role model. Aspiration of future occupation was not related to the characteristics of the role model.
  3,232 75 -
Crosssectional study of quality of life after renal transplant in end stage renal disease
RC Das, Kalpana Srivastava, Jayadev Tudu, AK Hooda
January-June 2014, 23(1):40-43
DOI:10.4103/0972-6748.144955  PMID:25535444
Background : End stage renal disease (ERD) is a psychologically debilitating illness with considerable emotional morbidity. There is variation in quality of life and mental health status among recipients and donor at different stages of kidney transplantation. Materials and Methods: The study is an observational analytic study. Sample for the study comprised of forty (40) consecutive patients including 20 recipients and 20 donors of 20 kidney transplantations, male and female, and who themselves/whose relatives provided written informed consent were included in the study. Both recipients and donors were followed-up from 2 weeks prior to transplant surgery to 6 months post-operatively by phone and when they came for review in Nephrology Out-Patient Department (OPD). Quality of life and mental health status was compared between the two groups. Results: Study groups were homogeneous on age, education, gender and marital status. After transplantation recipient's mean score in all parameters had increased and all changes were statistically significant (<0.05). Conclusion: In this study significant changes in quality of life (QOL), and mental health status in recipients and donors before and after transplantation were noted. It is recommended to evaluate mental health related aspects of both donors and recipients.
  3,069 73 5
Silverman revisited: A relook at some of the pitfalls and challenges in suicide nomenclature and few suggestions
Vikas Menon
January-June 2014, 23(1):73-74
DOI:10.4103/0972-6748.144979  PMID:25535452
  2,160 73 -