Munish Agarwal

Biomedical Informatics Centre, Chandigarh, Chandigarh, India

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Publications (8)5.51 Total impact

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    ABSTRACT: This study aimed to evaluate the symptom threshold for making the diagnosis of catatonia. Further the objectives were to (1) to study the factor solution of Bush Francis Catatonia Rating Scale (BFCRS); (2) To compare the prevalence and symptom profile of catatonia in patients with psychotic and mood disorders among patients admitted to the psychiatry inpatient of a general hospital psychiatric unit. 201 patients were screened for presence of catatonia by using BFCRS. By using cluster analysis, discriminant analysis, ROC curve, sensitivity and specificity analysis, data suggested that a threshold of 3 symptoms was able to correctly categorize 89.4% of patients with catatonia and 100% of patients without catatonia. Prevalence of catatonia was 9.45%. There was no difference in the prevalence rate and symptom profile of catatonia between those with schizophrenia and mood disorders (i.e., unipolar depression and bipolar affective disorder). Factor analysis of the data yielded 2 factor solutions, i.e., retarded and excited catatonia. To conclude this study suggests that presence of 3 symptoms for making the diagnosis of catatonia can correctly distinguish patients with and without catatonia. This is compatible with the recommendations of DSM-5. Prevalence of catatonia is almost equal in patients with schizophrenia and mood disorders. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
    No preview · Article · Jul 2015
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    ABSTRACT: OBJECTIVE. To compare the symptoms of delirium as assessed by the Delirium Rating Scale-Revised-98 (DRS-R-98) and associated aetiologies in adult and elderly patients seen in a consultation-liaison service. METHODS. A total of 321 consecutive patients with a DSM-IV-TR diagnosis of delirium were assessed on the DRS-R-98 and a study-specific aetiology checklist. RESULTS. Of the 321 patients, 245 (76%) aged 18 to 64 years formed the adult group, while 76 (24%) formed the elderly group (≥ 65 years). The prevalence and severity of various symptoms of delirium as assessed using the DRS-R-98 were similar across the 2 groups, except for the adult group having statistically higher prevalence and severity scores for thought process abnormalities and lability of affect. For both groups and the whole sample, factor analysis yielded a 3-factor model for the phenomenology. In the 2 groups, the DRS-R-98 item loadings showed subtle differences across various factors. The 2 groups were similar for the mean number of aetiologies associated with delirium, the mean number being 3. However, the 2 groups differed with respect to hepatic derangement, substance intoxication, withdrawal, and postpartum causes being more common in the adult group, in contrast lung disease and cardiac abnormalities were more common in the elderly group. CONCLUSION. Adult and elderly patients with delirium are similar with respect to the distribution of various symptoms, motor subtypes, and associated aetiologies.
    Full-text · Article · Jun 2013
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    ABSTRACT: Limited data is available with respect to use of Electroconvulsive therapy (ECT) in the presence of glaucoma. We present a case of severe depression with psychotic symptoms who did not respond to various antidepressant trials and required ECT. His medical history showed that he was diagnosed to have open angle glaucoma and cataract in both the eyes. He had undergone bilateral trabeculectomy and cataract surgery for his ophthalmological aliments. He was safely treated with bilateral ECT, with which he achieved remission.
    No preview · Article · Apr 2013 · Indian Journal of Psychological Medicine

  • No preview · Article · Dec 2012
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    ABSTRACT: There is limited literature on the use of electroconvulsive therapy in patient with congenital heart defect. We present a case of a 24-year-old woman with diagnosis of persistent delusion disorder with depression and congenital heart defect of ostium secundum type treated successfully with a course of electroconvulsive therapies.
    No preview · Article · Jun 2012 · The journal of ECT
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    ABSTRACT: Very few studies from India have studied the phenomenology of delirium. The aim of the present study was to study the phenomenology as measured using the Delirium Rating Scale-Revised-98 (DRS-R98), the associated etiologies and the outcome of delirium among the elderly participants seen by the consultation-liaison psychiatric service in India. In addition, an attempt was made to study the factor structure of symptoms using principal components analysis. The case notes of 109 elderly patients referred to psychiatry liaison services were reviewed. The mean age of the sample was 73.35 years (SD: 7.44; range 65-95 years) and two-thirds of the sample had hospital emergent delirium. The mean DRS-R98 severity score was 18.77 and the DRS-R98 total score was 24.81. In 15 patients the DRS-R98 scores were in the subsyndromal range. Among the various symptoms present, most patients had sleep-wake cycle disturbance, disturbance in orientation, attention and short-term memory impairments, fluctuation of symptoms, temporal onset of symptoms and a physical disorder. Principal components analysis identified three factors which explained 43.5% of variance of symptomatology and it yielded a three-factor structure. Endocrine/metabolic disturbances were the commonest associated etiological category with delirium. The mean hospital stay after being referred to psychiatry referral services was 8.89 days, after which delirium improved in 58.7% of cases. The mortality rate during the inpatient stay was 16.5%. Results suggest that the symptoms of delirium as assessed by DRS-R98 separate out into a three-factor structure. Delirium is commonly associated with metabolic endocrine disturbances and about one-sixth of the patients die during the short inpatient stay.
    Full-text · Article · Jan 2012 · International Psychogeriatrics
  • Munish Agarwal · Sandeep Grover

    No preview · Article · Jan 2012 · Geriatrics & Gerontology International
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    Natasha Kate · Sandeep Grover · Munish Agarwal
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    ABSTRACT: We present two cases of treatment-resistant depression that improved with recognition and correction of the underlying medical etiology of vitamin B12 deficiency. Supplementations of vitamin B12 to the same antidepressant regimen that the patient had not responded earlier led to response. Two male subjects who were vegetarians presented with long-standing histories of depression and had not responded to three adequate trials of antidepressants. Upon investigation, the authors found that the subjects had low vitamin B12 levels. Both cases improved with supplementation of vitamin B12. Subjects with depression who do not respond to conventional antidepressants should be evaluated for nutritional factors.
    Full-text · Article · Nov 2010 · Psychiatry