Indian Journal of Psychiatry

Published by Medknow Publications
Online ISSN: 0019-5545
Publications
Article
The present study was conducted by the Department Of Psychiatry, Govt. Medical College and Hospital, Chandigarh, to investigate suicide cases during the year 2003. To assess the socio-demographic characteristics, psychosocial factors, and psychiatric and physical comorbidity associated with completed suicide. One hundred one suicide cases were assessed using semi-structured proforma for recording socio-demographic profile, psychosocial variables, and treatment details. Majority (59.4%) of suicide victims were in the age group of 20 to 29 years. Males (57.4%) slightly outnumbered females (42.57%) in this study. As many as 57.4% of the subjects had migrated from other parts of India. Hanging was the most common method used by the suicide victims (72.2%). Psycho-social stressors were found in 61 (60.3%) suicide victims. Psychiatric illness was found in 34 cases (33.6%). However, out of them only 16 (48.5%) suicide victims sought treatment prior to the attempt. As many as 57.4% of the subjects had shown behavioral change before the suicidal attempt. Our study suggests that specific focus in suicide prevention strategies should be on migrant population.
 
Article
Rediagnosing 103 ICD-9 Hysteria cases on DSM-III, the authors found Conversion Disorder and Atypical Dissociative Disorder to be the most common diagnosis. Somatization Disorder was diagnosed only in 8.7 per ant of cases. Twenty-nine per cent cases received double diagnoses. Limitations of using DSM-III on Hysteria patients are mentioned and a suggestion is made to include a new category of 'Simple Dissociative Disorder' in the DSM-III.
 
Reason for exclusion
Demographic characterstics of the sample
Diagnostic breakup of patients (N=130)
Matching of the “Provisional Diagnosis” with “Final Diagnosis”
Article
International Classification of Mental and Behavioural Disorders (ICD)-10 has been serving its purpose in the spheres of diagnosing psychiatric patients, research, and education since long. With ICD-11 is on the horizon, this is the right time to assess issues in the application of these guidelines in routine clinical practice. In this study, an effort was made to find out day-to-day difficulties in application of ICD-10. A total of 130 patients attending for the first time the outpatient Department of Psychiatry, CSMMU, Lucknow, were taken as sample for the present study. The "provisional diagnosis", which was made after the usual assessments on a single day at the clinical setting was recorded. The selected patients were later assessed in detail and a "final diagnosis was recorded for these patients. The diagnoses were matched with ICD-10 and rated on a five-point scale. The direct count and percentage analysis was done. Results show that 67.69% "provisional diagnosis" were fully matched, while 8% and 5% diagnosis had no match and some match, respectively with the "final diagnosis". There were also some cases that had significant match (1.5%) and almost match (17.69%). In a busy clinical setting, the focus of the clinicians is more on management and accurate diagnosis based on ICD-10 may be ignored.
 
Article
Social adjustment of 116 adult epileptics who had attended the out patient department of Agra Mental Hospital during a period of 3 years was studied through a follow-up investigation. Adjustment was recorded 'good' in 34.5%, fair in 19.8%, poor in 22.4% and very poor in remaining 23.3% cases.
 
Article
Despite of there being a pressing need to gauge impulsivity scores, there is no behavioral instrument in India to assess the impulsivity in adolescents. No earlier studies have been done in India to access impulsivity in adolescents. Even in western countries, no study has been done in rural setting to access impulsivity, although segment of rural population is small in western nations with major population residing in urban areas. To translate BIS-11A into Hindi from English in a culturally sensitive manner and to do preliminary study in rural and urban areas. First translation of BIS-11 (as it is meant for adults) and cultural substitution resulted in Hindi adult version. Adolescent version was derived from adult version by replacing adult activities with adolescent activities. BIS-11 English version was translated into Hindi and a back translation was made. As BIS-11 was developed for adults, answering some of the questions poses challenges for adolescents, so to be used with adolescents, questions that do not fit into adolescent age group were substituted keeping in view the activities of adolescents. Besides, questions that were not suitable as per the Indian culture were modified. Initially, these changes were made hypothetically by discussion among the authors and later a group of 48 school students were interviewed about the questions. Based on the interviews of students a final version was prepared. Translation, back translation, cultural substitution -hypothetically, and in school by discussion were carried out. The questionnaire was given to 120 urban high school students (in Jaipur, northern India) and 50 rural students (at Kanota, 25 km from Jaipur, northern India) and the scores were calculated as per the scoring method provided with original BIS-11. T-test (two-tailed, two sample unequal variance, i.e., type 3) was used. T-test (two-tailed, two sample unequal variance, i.e., type 3) found no significant difference between impulsivity scores of adolescents of urban and rural areas t 0.05(2)1 = 0.57, |t| < t 0.05(2)1, P > 0.05, P = 12.706. There were no gender related differences either. As impulsivity can lead to suicide and is implicated for substance abuse in disorders like Schizophrenia, it is important that culturally sensitive impulsivity studies are done in India on a large scale keeping in view the large size of population. Standardization of the BIS11-A Hindi version is being taken up. The work on Hindi version also generates necessity for other tasks if BIS-11(Hindi version) is to be used widely. Work on psychometric properties of Hindi version of BIS-11 A is being taken up. There is a need to devise a quick way to calculate impulsivity scores keeping in view the large population of India (1 billion out of which at least 33% is Hindi speaking, Census Survey of India, 2001). Besides, BIS-11A needs to be developed for other regional languages in India as there is a high-linguistic diversity in India.
 
Article
Studies on standardized mortality rates of schizophrenic patients might help to increase the life span of these patients. Such data from developing countries including India are lacking. Investigations that provide clues regarding the quality of their family lives could also be beneficial. Besides mortality and causes of death, this study was also aimed to examine the marital status of a group of schizophrenic patients over a period of 13 years. Out of 121 schizophrenic patients recruited earlier for a different purpose, 60 were re-assessed after a period of 13 years with regard to their mortality and causes of death. The proportion of those who had to remain single because the onset of their illness was before they were 25 years of age were compared with those who had a later onset. Seven deaths were recorded and the standardized mortality ratio (SMR) for all the age groups was 54.2. One patient who had absconded was not counted as a case of death. Furthermore, this trend of a high SMR persisted despite merging both the cohort and un-reassessed group (SMR 25.1) with and without known mortality. Among the deaths, the unnatural causes of death were noteworthy (28.57%)-1 accidental and another suicidal. Some deaths were probably due to poor general medical care. The proportion of patients who had to remain single because their onset of illness was before 25 years of age was significantly more than those with a later onset (p<0.001). It is speculated that strengthening the general healthcare delivery system for the mentally ill and sensitizing caregivers about the possible risky behaviours of patients might reduce the mortality.
 
Article
One hundred and fifty patients of epileptic psychosis, registered over a period of five years in neuropsychiatry clinics at NIMHANS were studied. Patients with organic causes which may produce both epilepsy and psychosis were excluded. The epileptic psychosis ratio to epilepsy was 1:23 and the epileptic psychosis ratio to psychosis was 1:75. The mean age at the onset of epilepsy was 19.4 years, while the mean age at the onset of psychosis was 29 years and thus the mean duration of epilepsy at the onset of psychosis was 9.4 years. With regard to type of seizures, 93 (62%) had grandmal, 50 (33.3%) had temporal lobe epilepsy and 7 (4.7%) had partial motor or sensory epilepsy with generalization. With regard to type of psychosis, 64 (42.7 %) had post-ictal and/or inter-ictal psychosis, 15(10%) paranoid schizophrenia, 9 (6%) mania, 2 (1.3%) depression and 60 (40%) unspecified psychoses. The mean duration of epilepsy was significantly less (p < 0.05) at the onset of acute psychosis than chronic psychosis. Family history of epilepsy and mental illness, premorbid personality and frequencies of seizures were not significantly associated with pathogenesis of epileptic psychosis.
 
Article
A brief review of literature on psychiatric morbidity associated with migration is presented, with particular emphasis on the problems of political refugees. Initial experiences with 152 Afghan nationals attending the psychiatric outpatient department of a general hospital in Delhi during a period of 18 months are described supported by retrospective data from the records. Problems encountered in adequate assessment and management of these patients are highlighted. Need for prospective and longitudinal research on this group of patients is pointed out.
 
Laboratory Investigations at baseline and after 6 weeks of treatment 
Article
Aripiprazole is a new anti psychotic with a unique receptor binding profile that combines partial agonistic activity at D2 receptor and 5-HT 1A receptor and potent antagonism at 5-HT 2A receptor. This receptor profile makes it possible for it to act as a dopamine system stabilizer. Based on various short term and long term studies, aripiprazole has been found to be effective in schizophrenia and has no significant adverse effect on QTc prolongation, prolactin, serum lipids, and has a low potential for weight gain. Present study aims to evaluate the efficacy and tolerability of aripiprazole (10-15mg/day) in the treatment of Indian patients of schizophrenia and to see its effect on QTc interval, prolactin levels, serum lipids, plasma sugar and weight gain in these patients. Outpatients with an ongoing/newly diagnosed ICD-10 Schizophrenia (n=136) were randomly assigned to 10 or 15 mg dose of Aripiprazole for a period of six weeks. Clinical response was evaluated by the Positive And Negative Symptoms Scale (PANSS), Clinical Global Impression (CGI) scale and safety was evaluated by observing spontaneously reported adverse events and changes in various laboratory parameters. Switching schizophrenic patients to aripiprazole (10/15 mg) from both conventional and atypical anti-psychotics was safe and well tolerated. Six weeks after switching to aripiprazole, patients showed improvements in PANSS scores (P< 0.001), EPS, prolactin levels and weight over the baseline levels. No difference was seen in the 10 or 15mg dose groups. One hospitalization was reported (due to hepatitis E). Common side effects reported were insomnia, somnolence, nausea, vomiting and diarrhea. Aripiprazole is a safe and effective anti psychotic in Indian patients - both in newly diagnosed, as well as, in patients not responding to or intolerant to other available typical and atypical antipsychotics.
 
Article
BR-16A is a herbal preparation with several putative psychotropic effects. Recent work has suggested that it facilities certain aspects of cognition and that it ameliorates ECT-induced amnesia in animal models. The present study sought to assess whether it affects noradrenergic and dopaminergic functioning in the central nervous system. Adult male Sprague-Dawley rats received BR-16A (200mg/kg) or vehicle for one month. The animals were subsequently challenged with clonidine (100 mg/kg I.P.), apomorphine (2mg/kg I.P.), or saline in a factorial design, and motility of the animals was immediately thereafter assessed using a small open field. BR-16A neither attenuated clonidine induced alpha-2 noradrenergic receptor-mediated hypomotility nor accentuated apomorphine-induced dopamine postsynaptic receptor-mediated hypermotility, suggesting that it does not interfere with alpha-2 noradrenergic and dopamine postsynaptic receptor functioning.
 
Article
For centuries it has been a common belief that any abnormality of physique is an accompaniment of mental illness. Recently interest has been focussed on the degree of masculinity or conversely feminity in the constitution. An index of this parameter called 'androgynae' can be derived from Taner's formula. Physique acts as a manifestation of the gene complex mediated possibly through endocrines and hence should reflect on the excretion pattern of 17 ketosteroids. Personality being a constitutional variation, it ought to be related to physique and in turn to the androgenic activities. M-f profile of the MMPI should locate such variation in that case. Present work was planned to find out implication of each of these parameters and to see if there is any correlation between them. It was seen that the psychiatric patients had low androgynae scores than the normals but the 17 ketosteroid excretion was higher. This was unexpected. M-f profile of the patients did not show any significant difference from the control. Results are discussed in the light of available literature.
 
Scree plot showing factors with Eigen value more than one
Receiver Operator Characteristic curve with subjective perception as gold-standard
Item-total correlation of 25-item domestic violence questionnaire
Rotated component matrix of the 20-item domestic violence questionnaire after factor analysis and item reduction
Sensitivity and specificity of the 20-item questionnaire at different total scores, as derived from ROC curve
Article
Intimate partner violence against women is seen in all cultures. It has wide-ranging effects on the physical and psychological health of women. In the local language, available questionnaires are either too exhaustive or inadequate to assess domestic violence comprehensively. To develop a Domestic Violence Questionnaire in Malayalam and validate it for married women aged 18-55 years in the local population. Descriptive study - Validation of questionnaire. A 29-item questionnaire, to identify domestic violence over the past 1 year, was developed in the local language, by selecting items from two other questionnaires and based on expert opinion. Item reduction was done after pilot testing. Then, this 25-item questionnaire was administered to 276 married women aged 18-55 years. Reliability and validity were estimated. Factor analysis was done for item reduction. Poor-loading, wrong-loading and cross-loading items were removed from the questionnaire. Taking the subjective perception of the participants regarding themselves experiencing domestic violence as the gold standard, a Receiver Operator Characteristic curve was drawn to decide the cut-off score with optimum sensitivity and specificity. The final questionnaire had 20 items - 13 items for psychological and 7 items for physical violence. Internal consistency reliability was 0.92. At a cut-off score of 5, sensitivity was 89.5% and specificity 87.2%. The Domestic Violence Questionnaire in Malayalam has adequate psychometric properties to identify intimate partner violence against women in the local population.
 
Article
This report describes a case of an 18-month-old child who was treated for primary insomnia with Zolpidem. To the best of our knowledge, the published literature is devoid of any information on use of Zolpidem in infants and children.
 
Article
The aim of our study was to investigate whether the tandem repeat polymorphism in D18S452 microsatellite marker at locus 18p11.2 is a risk factor of bipolar affective disorder (BPAD) in Kashmiri population. The repeat polymorphism in D18S452 was evaluated by polymerase chain reaction (PCR) analysis of in 74 diagnosed BPAD patients and 74 controls subjects. Tandem repeat (300 bp*) allele frequency was found to be 1.35% in controls and 8.108% in cases. The tandem repeat (250 bp*) allele frequency was found to be in 91.89% in cases and 98.65% in controls. The 252 bp/252 bp genotype was found to be present in 89.18% of cases and 98.64% of controls, the 300 bp/300 bp genotype in 5.40% of cases and 1.35% of controls and the 252 bp/300 bp variant in 5.40% of cases and none among the controls. Although the proportion of patients homozygous for tandem repeat (300 bp/300 bp) was higher in cases than in controls, the difference was not statistically significant when 252 bp/252 bp genotype was taken as reference (odds ratio [OR]=4.4242; 95% confidence interval [CI] 0.4822-40.5924); P=0.1529). However, when the frequency of heterozygous genotype (252 bp/300 bp) was compared with 252 bp/252 bp statistical significance was observed (OR=8.0603; 95% CI 1.1112-58.4646; P=0.0383). This is the first study reporting a significant association between D18S452 maker with tandem repeat polymorphism in heterozygous condition (252 bp/300 bp) and the development of BPAD in Kashmiri population.
 
Article
The murder trials of 1968 in Tamil Nadu totalling 526 are studied and assessed on the pattern of the U. K. Home Office study. The results showed that there were six psychotic murderers, 16 murderers who attempted suicide, 483 'normal' male murderers, 20 female murderers and 6 youthful murderers. Age, sex, method of killing and motives of the murderers are discussed. The implications of the study with reference to the penal institutions and prevention of crime are dealt with.
 
Article
The Mental Health Act, 1987 came into force in 1993. Mental Health Authorities that were created by this Act are useful, but the present situation of not having Government Mental Hospitals under the scrutiny of these authorities is a shortcoming. The high capital needed for upgradation of Government mental hospitals; is likely to be found, only with the intervention of Mental Health Authorities Creation of a funding agency of Government of India is also needed Denying profoundly retarded persons access to a psychiatric hospital is a hard situation. Psychiatric patients in general hospitals' having to face the hassles of mental hospital admission is against the spirit of the act and needs to be remedied Courts' directly determining the presence of psychiatric illness in persons is not serving the end of justice. They should do this on the basis of evidence Several avoidable hardships that may be caused by having the act in the present form has to be corrected This could be done by amendment of the act in certain cases by approaching the High Court in certain others and by thoughtfully framing the State Mental Health Rules in a quite a few other situations. The success of Mental Health Act, 1987 is in its effectiveness to ensure basic human rights of mental patients. A set of Mental Health Rules, that incorporates adequate provisions to protect human rights of patients, in all respects, can go a long way to strengthen the Mental Health Act.
 
Article
A super-cyclone hit 12 coastal districts of Orissa in October 1999 and caused over 20,000 deaths and a considerable damage to property. The psychiatric sequelae of the super-cyclone was studied using a semi-structured proforma for disaster experience, Self Reporting Questionnaire, Impact of Event Scale, Post Traumatic Symptoms Scale, Hopelessness Scale, Suicidality Screening Questionnaire, Hospital Anxiety and Depression Scale and Presumptive Stressful Life Event Scale. The coping style of the victims was also studied. It was observed that 80.4% of the subjects had probable psychiatric disorder. Posttraumatic stress disorder was found in 44.3%; anxiety disorder in 57.5% and depression in 52.7%. A considerable proportion (63.4%) of cases had comorbidity. Children and adolescents, elderly persons, lower socioeconomic status, lower educational levels, unemployment, physical injury, degree of exposure, need for evacuation, death in the family, fear of imminent death during the event, hopelessness, increased stress before disaster and past psychiatric history were associated with adverse psychological sequelae. Increase in suicidality was observed. Implications of these findings are discussed.
 
Article
The study of cannabis use and psychopathology remains an interesting area from both academic and pragmatic perspectives. This article provides an update on the progress made in this area over the past decade or so. Psychopathology and psychiatric syndromes associated with cannabis use that have received research attention in recent years include cannabis withdrawal, cannabis and psychotic disorders (especially schizophrenia), depression, anxiety, and cognitive impairment. Status of a specific cannabis withdrawal syndrome and a specific 'cannabis psychosis' remains controversial. Current evidence indicates that there is a clinically significant association between cannabis use disorders and psychotic syndromes, depression, anxiety and possibly mild cognitive impairment. However, the nature of this association is often not clear. Several hypothesis related to the cannabis-schizophrenia association are examined. Cannabis use might be casually related to the later development of schizophrenia in an indirect way in a few heavy users, but more commonly, its use may precipitate disorders in persons who are vulnerable to developing psychosis and worsen the course of the disorder.
 
Article
The 2nd Indo-US Health Care Summit held in January 2009 was a forum to discuss collaboration between physicians in the US and India on medical education, health care services and research. Six specialties were represented including Mental Health (MH). Using Depression as the paradigmatic disorder, the following objectives were developed. Objective I - Leadership and Public Education: Linkage with like-minded agencies and organizations. The core message should be simple. Major Depression is a brain disorder. Depression is treatable. Timely treatment prevents disability and suicide. Objective II - Medical Education: To improve psychiatric education, it was proposed that (1) relations between US/UK and Indian mid-level institutions be established, (2) teaching methods such as tele-psychiatry and online courses be pursued, (3) use models of teaching excellence to arouse student interest, and (4) develop core curricula for other branches of medicine, and CME. Objective III - Reduce Complications of Depression (Suicide, Alcoholism): Goals include (1) decriminalizing attempted suicide, (2) improving reporting systems, and including depression, psychosis, alcoholism, and suicide in the national registry, (3) pilot studies in vulnerable groups on risk and interventions, and (4) education of colleagues on alcoholism as a link between psychiatric and medical disorders. Objective IV - Integrating MH Treatment& Primary Health Care: The focus should be on training of general practitioners in psychiatry. Available training modules including long distance learning modules to be suitably modified for India. Collaborations and specific project designs are to be developed, implemented and monitored by each specialty group and reviewed in future summits.
 
Article
Cases diagnosed as general paralysis of insane at the psychiatric services of NIMHANS for 23 years from 1955 to 1977 were studied to analyse the trends of age distribution, sex proportion, annual admission rate and clinical categories. It was found that the mean age and the proportion of females did not show any impressive change during these years. Among the clinical categories the simple dementia type showed a considerable rise over the years. The acute confusional type showed a definite decrease during this period. A less impressive but definite decrease was found in the expansive type. Depressive form of GPI found in a considerable proportion of cases earlier has rarely been seen over the last one decade. The schizophrenic type has not shown any significant change. These findings are discussed in comparison with the earlier studies both in India and abroad. The possible causes of these trends are outlined.
 
Article
To study the presence of personality disorder in cases of deliberate self harm (DSH) in young (15-24 years) and elderly (45-74 years) and compare. Deliberate self harm cases admitted in Medical and surgical departments and cases attending psychiatry department of R.G. Kar Medical College, Kolkata were studied. For diagnosis of personality disorder ICD 10 International Personality Disorder Examination (IPDE) questionnaire was used. Percentage of elderly patients having personality disorder (64%) was higher compared to young DSH patients (58.5%). In young group, most common disorder was emotionally unstable personality disorder (28.6%) and in elderly group most common was anankastic type of personality disorder (36%). Schizoid, dissocial, histrionic, and anxious-avoidant personality disorders were found in small percentages of cases. Among DSH patients, the most common personality disorder found in young age was Emotionally unstable (Impulsive and Borderline) personality disorder, but most common personality disorder found in elderly patients was Anankastic personality disorder.
 
Article
57% of a group of 35 patients treated with Lithium Carbonate at dosages predicted by the nomogram suggested by Cooper et al (1973) failed to reach therapeutic levels of serum lithium. This finding casts serious doubts on the usefulness of the claim by Cooper et al (1973 & 1976) that 24 hour serum lithium level after a test dose of 600 mg. lithium can predict the daily lithium dose.
 
Article
26 married males with premature ejaculation and secondary impotence were subjected to behavior therapy. Relaxation, graded tasks, semans exercise, the squeeze technique, desensitization and thought stopping were the techniques employed. 15 (58%) of the patients improved. Factors contributing to success or failure are studied and the results compared with those of others using Behaviour Therapy.
 
Article
A 31 years old man with history of familial psychiatric disorder was investigated. Chromosomal analysis in peripheral lymphocyte blood culture showed normal karyotype with 46, XY chromosomal complement. However, the cells treated with 5-Fluoro-deoxy-uridine (FUdR) and Caffeine showed fragile Xq-27 (4.0%) and nonspecific autosomal breakages (42.0%). The present case suggests a probable association between chromosomal fragility and non-mental retardation psychopathology. Further cytogenetic studies in cases with familial psychiatric disorders will enable us with a better understanding of the pathogenesis and further help in counselling the families.
 
-Educational status Education Number of Patients 
-Parental Lack 
-Duration of illness 
Article
A clinical study of 276 patients diagnosed as Hysteria in the Department of Psychiatry, Unit-2, Christian Medical College, Vellore, during the period of 1970—1974 is described. This group of 276 patients formed 10.81% of the total new consultations during this period. 61.2% of these were females. The peak age of onset was 10-20 years. The majority were married. 75% of them had conversion symptoms, 20.3% had dissociative states, and 4.7% had both features. 52.5% showed possible precipitating factors. 66.0% h i d features of extraversion in their personality make up. 14.1% showed evidence of parental deprivation. There was over-representation of the early born. Somatic symptoms (aches and pains) was the most common mode of presentation. The other common clinical manifestations were fainting attacks, “fits”, vomiting, involuntary movements and paralysis of limbs. The immediate follow up showed that 11 patients recovered, 120 improved, 3 were unchanged and 1 patient became worse. Only 93 patients could be contacted for the final follow up. Among these, 28 recovered completely; 50 were improved; 2 became worse and 2 died. It is emphasized that Hysteria continues to remain a clinical entity.
 
Article
Twenty-eight cases of obsessive compulsive neurosis were treated with a behaviour therapy package and good results were obtained in 15 (53.6%). Relaxation, thought-stopping, implosion, modelling, response prevention, electrical aversion and positive reinforcement wei; the techniques employed. Chronicity, previous treatments, follow-up data, drop-outs and the use of behaviour therapy in our setting are discussed in this paper.
 
Article
Previous studies have shown an association between the T102C polymorphism of the serotonin-2A receptor gene and schizophrenia. In addition, an association of this polymorphism with clinical phenotypes in schizophrenia such as treatment response and cognitive impairment has been observed. In this case-control study conducted in Turkish Caucasians, we compared T102C polymorphism genotype and allele frequencies in 76 schizophrenic patients and 165 healthy controls. We also investigated interaction of this polymorphism with clinical and cognitive variables in patients. No significant difference was observed in the distribution of the three genotypes (T/T, T/C and C/C) and in the allele frequencies in controls and patients with schizophrenia. No evidence of association was detected at various clinical phenotypes including symptom severity, suicidality, treatment response, age of disease onset, number of hospitalizations and history of violence (in co-dominant, dominant, or recessive models). However, as compared to the C/C genotype, patients with 1 or 2 copies of the T allele were characterized by better stroop test performances and less "motor coordination" soft neurological signs. Further research is needed to elucidate the impact of T102C polymorphism on neurocognitive functions in both healthy and patient populations.
 
REASONS FOR NON-INCLUSION IN STUDY 
RELATIONSHIP OF P300 LATENCY AND AMPLITUDE TO VARIOUS CLINICAL FEATURES 
CORRELATION BETWEEN P300 LATENCY AND AMPLITUDE WITH VARIOUS CLINICAL FEATURES 
Article
P300 component of the event related potential (ERP) provides one neurophysiological index of cognitive dysfunction in depression. Forty subjects fulfilling DSM-III criteria for depression were compared to 40 age and sex matched normal controls. The P300 was recorded using the auditory odd-ball paradigm. Depressives had a significantly prolonged P300 latency and reduced P300 amplitude as compared to the controls. The P300 latency showed a significant positive correlation with age of the patient and severity of depression while P300 amplitude showed a significant negative correlation with age. The clinical subcategory of depression, duration of illness and sex did not show any relationship with P300 abnormality. Twelve out of 40 depressives (30%) had an abnormal P300. The mean Hamilton Rating Scale for Depression (HRSD) score was significantly high in those with an abnormal P300.
 
Article
The study comprises of 34 cases, who developed psychiatric illness following childbirth. The diagnostic breakup reveals that 50% cases were of schizophrenia, 35.4% of affective disorder, 11.7% of organic confusional state and 2.9% of hysteria. Age of the patients ranged from 17 to 35 years, average being 24.2 years. 20.5% cases gave history of psychiatric illness in 1st degree relatives. All cases of organic psychosis, 41.6% of the affective disorder and 29.4% of the schizophrenia group had one or more of the physical complications during pregnancy, around delivery or during post-partum period. 25.2% of the cases had previous psychiatric illness following childbirth. 52.9% of the cases developed psychiatric illness in the 1st fortnight after delivery. The result of the treatment was highly satisfactory, showing improvement of all the patients included in this study.
 
Article
Detailed family history obtained from 361 cases of severe mental retardation revealed that more than one sib was affected in a majority of the cases where consanguinity was present in more than one generation. The need for studies in general population is indicated for purposes of evolving strategies for genetic counselling.
 
Article
After the Delhi High Court judgment on reading down Section 377 Indian penal code, many individuals of alternate sexuality are wanting to come out to themselves and significant others in their lives. In this process, they often turn to psychiatrists seeking help. However the past of this specialty wherein homosexuality and other sexualities were considered a disease still haunts it with anecdotal reports of reorienting treatments continuing in certain parts of the country. While it is important to not continue with this unethical practice, at the same time, it is also important to be supportive to the issues that this and various other marginalized sexualities in our country face. This viewpoint is an attempt to reiterate certain steps that are to be followed by psychiatrists who find themselves in such clinical consultations.
 
Article
Eliciting cerebral seizure during electroconvulsive therapy (ECT) is essential for therapeutic purposes. When it exceeds beyond 120 seconds (Freeman, 1995) i.e., prolonged, it adds to adverse effects of ECT. Estimating seizure duration using 'cuff method' alone has limitations. This study examined the merits of electroencephalographic (EEG) monitoring in routine ECT practice on a large representative sample. Modified ECT either unilateral or bilateral electrode placement, was administered to 485 patients under EEG monitoring at first ECT session. Ninety one (18.8%) patients had prolonged seizures of which only 59 would have been detected if 'cuff method' alone was used. Twenty nine (6%) patients had inadequate motor seizures but had adequate EEG seizure duration. Twenty five (5.2%) of them had no motor seizure and two such patients even had prolonged seizures. The prolonged seizure was unpredictable in majority. In conclusion, EEG monitoring during ECT is essential to detect both adequacy of cerebral seizure in patients having no or inadequate motor seizures and a/so to detect prolonged seizures.
 
Article
Several studies have reported decreased platelet 5-HT uptake in patients of major depression. The mechanism of antidepressant action of ECT is not clear. The present work was undertaken with the aim to study the active platelet 5-HT uptake and the effect of ECT on it in patients of major depression. 15 patients of major depression (DSM-lll-R) and equal number of age and sex-matched controls were included in the study. Active platelet 5-HT uptake was determined before ECT, after a course of ECT and 7 days after last ECT. Platelet 5-HT uptake was. significantly lower in der essives than normal controls. After ECT treatment there was significant increase in 5-HT uptake which came down to pretreatment level after 1 week of last ECT. The effect of ECT on serotonergic system is discussed.
 
Top-cited authors
Rao Tss
  • JSS Medical College, Mysore
Sandeep Grover
  • Postgraduate Institute of Medical Education and Research
Ajit Avasthi
  • Postgraduate Institute of Medical Education and Research
Chittaranjan Andrade
  • National Institute of Mental Health and Neuro Sciences
Bn Gangadhar
  • National Institute of Mental Health and Neuro Sciences