K Nagaraja Rao

J.J.M. Medical College, Shimogga, Karnātaka, India

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Publications (10)1.57 Total impact

  • Ranganath R Kulkarni · K Nagaraja Rao · Shamshad Begum
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    ABSTRACT: Comorbid psychiatric and personality disorders in suicide attempters pose greater estimated risk of suicide than psychiatric disorders alone. The current study aimed to evaluate prevalence and pattern of psychiatric and/or personality morbidity and comorbidity in first-time suicide attempters in comparison to the age and sex matched community sample. Socio-demographic variables, family background, psychiatric morbidity and comorbidity in survivors of first suicide attempt were compared to age and sex matched community controls. Structured (Mini International Neuropsychiatric Interview plus) and semi-structured (International Personality Disorder Examination) clinical interviews were utilized to evaluate for axis-I and axis-II (personality) diagnosis. Risk-rescue rating was administered to assess medical seriousness of suicide attempt. Individuals who made a first suicide attempt showed significantly lower educational achievement (P<0.0001; OR 1.56; 95% CI 0.89-2.74), but no significant difference in other socio-demographic variables compared to the controls. Cases had high family history of psychiatric illnesses (31% vs. 7%; P<0.0001; OR 5.97; 95% CI 2.48-14.35); high prevalence of psychiatric disorders (89% vs. 25%; P<0.0001; OR 24.27 95% CI 11.21-52.57), personality disorders (52% vs. 24%; P<0.0001; OR 3.43; 95% CI 1.88-6.28), comorbidity of psychiatric and personality disorders (51.6% vs. 19.5%; P=0.022; OR 3.01; 95% CI 1.14-7.92), and high overall prevalence of any axis-I and/or axis-II (personality) morbidity (93% vs. 41%; P<0.0001; OR 19.12; 95% CI 8.05-45.43), compared to controls. Survivors of first suicide attempt are at nineteen times increased odds of having psychiatric morbidity and/or comorbidity, especially with personality disorders. Personality evaluation and management in such individuals may result in better comprehensive approach to health care.
    10/2013; 6(5):410-6. DOI:10.1016/j.ajp.2013.05.004
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    ABSTRACT: Background: Attempted suicide is a common clinical problem in a general hospital setting. It has a serious clinical and socio-economical impact too. Aims: To study the psychosocial, psychiatric, and personality profile of the first suicide attempters in a general hospital. Settings and Design: Cross-sectional, hospital-based, descriptive study. Materials and Methods: All the consecutive cases of first suicide attempt ( n=100) treated in a general hospital were studied to know the clinical profile. Variables related to socio-demographic characteristics, family background, suicide characteristics, psychiatric morbidity, and comorbidity were analyzed. Risk-Rescue rating was applied to know the medical seriousness of the suicide attempt. Presumptive stressful life event scale was utilized to calculate life events score. Structured clinical interview (MINI Plus) and semi-structured clinical interview (IPDE) were used for axis-I and axis-II (personality) diagnoses. The results were analyzed using appropriate statistical measures. Results: Family history of psychiatric illnesses (31%) and suicide (11%) were noted. Insecticides and pesticides were the most common agents (71%) employed to attempt suicide. Interpersonal difficulties (46%) were the most frequent stressor. Overall medical seriousness of the suicide attempt was of moderate lethality. 93% of the suicide attempters had at least one axis-I and/or axis-II psychiatric disorder. Most common diagnostic categories were mood disorders, adjustment disorders, and substance-related disorders, with axis-I disorders (89%), personality disorders (52%), and comorbidity of psychiatric disorders (51.6%). Conclusion: Individuals who made first suicide attempt were young adults, had lower educational achievement; overall seriousness of the suicide attempt was of moderate lethality, high prevalence of psychiatric morbidity, personality disorders, and comorbidity, and had sought medical help from general practitioners.
    Indian Journal of Psychological Medicine 04/2013; 35(1):75-9. DOI:10.4103/0253-7176.112210
  • V Vijayanath · K. Nagaraja Rao · G.M. Raju · M.R. Anitha
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    ABSTRACT: Although rare, suicide using caustic substances in psychiatric practice is not infrequent. Such circumstances involve important forensic and psychiatric issues. In this case report, death due to sulfuric acid ingestion in a patient with major depressive disorder is reported. The legal issues concerning suicide in a patient with mental illness, autopsy findings, forensic issues, and pathophysiology concerning death by acid ingestion have been discussed.
    The American journal of forensic medicine and pathology: official publication of the National Association of Medical Examiners 02/2012; 33(2):156-8. DOI:10.1097/PAF.0b013e3182474ec8 · 0.70 Impact Factor
  • Shamshad Begum · K Nagaraja Rao · C Y Sudarshan
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    ABSTRACT: Emotional problems in school children may result in low level of scholastic performance. The recognition of these disorders needs effective screening tools. The choice lies between self assessment tools or observation based tools. Majority of studies use screening tools based on parental or teachers' observation. This study was designed to compare a self-assessment based screening tool (general health questionnaire; GHQ) with a parental observation based screening tool (CPMS-Childhood Psychopathology Measurement Schedule). Two hundred and eighteen school children were selected through multistage random sampling. The study was conducted in three stages. In the first stage, all the students were administered six-item version of GHQ to screen for emotional problems. Raven's Progressive Matrices was administered to evaluate IQ. In the second stage, parents assessed their child's behavior using CPMS. In the third stage, all students were subjected for detailed clinical work-up. Criterion validity of the tools used and their comparison. GHQ had high sensitivity and specificity compared to CPMS in relation to clinical interview. It is found that GHQ is a better screening tool than CPMS in children aged between 13 and 14 years.
    Indian Journal of Psychiatry 01/2010; 52(1):57-9. DOI:10.4103/0019-5545.58896
  • K Nagaraja Rao · C Y Sudarshan · Shamshad Begum
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    ABSTRACT: A case series of self-injurious behavior (SIB) encountered in a General Hospital setting has been described. Limitations of current definition of SIB are explained. SIB is not a single clinical entity and it occurs in various psychiatric syndromes with wide range of psychopathology. Based on clinical criteria, a classification of SIB into three groups has been proposed viz 1) Mild and isolated form, 2) Moderately severe and repetitive form, and 3) Very severe and isolated form. Psychodynamic, cognitive and neurochemical explanations of SIB have been reviewed. Frustration, aggression and impulsivity appearing in helpless situation appear to be a common script across most of these models of explanations. Severity of injury seems to be determined by severity of psychopathology. Site of injury appear to have symbolic significance for a particular patient. Understanding some of these clinicopsychopathological issues helps in management of these cases.
    Indian Journal of Psychiatry 10/2008; 50(4):288-97. DOI:10.4103/0019-5545.44754
  • M Anupama · K Nagaraja Rao · S Dhananjaya
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    ABSTRACT: Ganser syndrome is a rare dissociative disorder. It has been reported in association with various functional psychiatric disorders and organic states, most often in patients with head injury and stroke, especially those involving the frontal lobes. The present case of Ganser syndrome had features of hysterical dissociation but was found to have haemorrhage in the temporoparietal region of the dominant hemisphere. The complexities of Ganser syndrome in the presence of an organic lesion with an overwhelming emotional component are discussed.
    Indian Journal of Psychiatry 04/2006; 48(2):123-5. DOI:10.4103/0019-5545.31605
  • C.Y. Sudarshan · K Nagaraja Rao · S V Santosh
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    ABSTRACT: The majority of cases of genital self-mutilation reported in the literature have been in patients with psychosis. We report an unusual case of genital self-mutilation in erectile disorder. It is suggested that genital self-mutilation may be a pathway out of diverse psychological disorders and in non-psychotic cases it could be an expression of a psychotic solution to a conflict and may be influenced by cultural factors.
    Indian Journal of Psychiatry 01/2006; 48(1):64-5. DOI:10.4103/0019-5545.31623
  • K Nagaraja Rao · C.Y. Sudarshan · Preethi Pai
    Indian Journal of Psychiatry 07/2005; 47(3):175-8. DOI:10.4103/0019-5545.55946
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    K Nagaraja Rao · G Bharathi · Sameeran Chate
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    ABSTRACT: Genital self-mutilation is a rare severe form of self-injurious behaviour usually described in psychotic disorders with delusions & hallucinations. It has been ascribed to sexual conflicts, body image distortion, internalized aggression and suicidal intent. This phenomenon has been described in schizophrenia, affective psychosis, alcohol intoxication and personality disorders. In the present case genital self-mutilation in a case of Major-Depressive Disorder in an 82 yrs old male is being reported and psychosocial factors are discussed. This case has some unusual features.
    Indian Journal of Psychiatry 07/2002; 44(3):297-300.
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    ABSTRACT: Children of alcoholics are at higher risk for physical injuries and malnutrition. In this study nutritional neglect and physical abuse in children of alcoholics has been compared with children of non-alcoholics in a General Hospital attached to a Medical College. 72 children of alcoholics were compared with 81 normal controls. 86.1% in case group and 49.4% in control group had malnourishment of various grades. 45% of the children of alcoholics had physical injuries in contrast to 23.4% of children of non-alcoholics. Malnutrition co-existed in almost all injured children of alcoholics. Alcoholism in parents of malnourished and injured children are frequently ignored in routine clinical evaluation. If the risk children are identified early some of the morbidity can be avoided.
    The Indian Journal of Pediatrics 10/2001; 68(9):843-5. DOI:10.1007/BF02762109 · 0.87 Impact Factor