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| EDITORIAL |
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The Mental Health Legislation : An Ongoing Debate |
p. 95 |
JK Trivedi
PMID:21206553 |
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| ARTICLES |
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EEG Alpha Coherence and Psychopathological Dimensions of Schizophrenia |
p. 97 |
John P John, Sumant Khanna, N. Pradhan, C. R. Mukundan
PMID:21206554The aim of this study was to evaluate the correlation between psychopathological dimensions in recent-onset neuroleptic-naive schizophrenic patients and EEG alpha coherence in the resting state. 37 neuroleptic-naive recent-onset schizophrenic patients were assessed on the Scale for the Assessment of Negative Symptoms and the Scale for the Assessment of Positive Symptoms, and psychopathological dimension scores on reality distortion, psychomotor poverty and disorganization were calculated. EEG alpha coherence was computed across 14 intra-hemispheric and 8 interhemispheric electrode pairs in the resting eyes closed and eyes open conditions. The relationship between the psychopathological dimension scores and coherence values was assessed using Pearson's product moment correlation with Bonferroni correction for levels of significance. Significant associations between higher psychomotor poverty scores and lower inter-hemispheric coherence values were found across the central and parietal regions in the eyes closed condition and across central regions in the eyes open condition. Reality distortion and disorganization dimensions were not significantly correlated with intra- or inter-hemispheric coherences in both eyes closed and eyes open conditions. However there was a trend for an inverse correlation between disorganization dimension and intra-hemispheric coherence across left frontal, left temporo-parietal and right parieto-occipital regions in the eyes open condition. These findings suggest a possible differential pattern in the extent of brain involvement across the three psychopathological dimensions of schizophrenia in neurolepticnaive patients with recent-onset illness. |
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Psychological Intervention with Parents of Autistic Children |
p. 108 |
S. Malhotra, S. Chakrabarti, A. Nehra
PMID:21206555An important component of management of autism is the role played by parents as active collaborators in the process. The case histories of 5 children with autism are described in this report. Psychological intervention carried out with parents of these children is detailed. The treatment package included a mix of behavioural, supportive and educational techniques, delivered in 3-6 sessions of 45- 60 minute each, in the setting of a child psychiatric clinic. Results showed that on the whole parents found this brief contact helpful. They rated emotional aspects of the support offered to be the most helpful. Child psychiatric clinics are often the first point of contact for parents with autistic children, and may have an important, primarily supportive role to play at this early stage of treatment. |
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Convergent Validity of Quality of Life Interview (Qoli) in an Indian Setting : Preliminary Findings |
p. 118 |
Aprajita Lobana, Surendra K Mattoo, Debasish Basu, Nitin Gupta
PMID:21206556Quality of life research in India on patients with schizophrenia is scarce. Quality of life interview (QOLI), a commonly used instrument in the West has not been used in a developing country like India. The aim was to assess convergence validity of QOLI (modified as per the Indian cultural background). 38 clinically stable outpatients with chronic schizophrenia (as per ICD-10) were administered QOLI- Brief version. Quality of Life Scale (QLS) and WHOQOL- Bref over two interviews the latter two scales having cross-cultural applicability. Significant correlations were obtained for QOLI with QLS and WHOQOL-Bref. It can be concluded that QOLI demonstrated convergent validity with both a disease-specific (QLS) and a generic (WHOQOL-Bref) scale, which have been previously used in the Indian setting. Hence, results support the applicability of QOLI in a different sociocultural setting. |
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A Factor Analytic Study of Panic Symptoms |
p. 125 |
Iby Neerakal, K. Srinivasan
PMID:21206557We studied 94 panic subjects with a view to identify clinical subtypes of panic disorder. Principal component analysis with varimax rotation of 13 DSM-IV panic symptoms yielded four clinically meaningful factors. Factor I with hot flushes, trembling and sweating was suggestive of a general autonomic hyperactivity. Factor II had cognitive symptoms such as fear of loss of control or going crazy and derealisation. Factor III was mixed in nature but had symptoms of fear of dying and chest pain. Factor-IV had respiratory symptoms in the form of choking sensation and being short of breath. These findings are compared to earlier studies of factor analysis of panic symptoms reported from the West. Clinical implications of sub-types of panic disorder have been highlighted. |
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Motivation for Addiction Treatment-Hindi Scale : Development and Factor Structure |
p. 131 |
Surendra K Mattoo, D. Basu, A. Malhotra, R. Malhotra
PMID:21206558Motivation for Addiction Treatment-Hindi scale was developed as a 'generic' scale applicable across different substances of abuse. This 46-item self-report Likert scale was administered to 262 treatment-seeking men with a diagnosis of alcohol or opioid dependence as per International Classification of Diseases-10th revision. Factor analysis generated 15 factors that covered all 46 items and explained 63.7% of the total variance. Factors I (12 items) and II (6 items), reflected acceptance and rejection of the existence of the problem of addiction and the treatment offered and, explained 20.7% and 7.6% of the variance respectively. Test-retest reliability and measures of internal consistency yielded satisfactory results. While the whole scale but not Factors I & II differentiated alcohol and opioid dependent groups, Factors I & II but not the whole scale differentiated relapsed from non-relapsed cases at>6 month follow-up. With some limitations, this scale presents a new tool to assess motivation for addiction treatment in Hindi speaking population in terms of two global dimensions of acceptance and rejection of the problem of addiction and the treatment offered. |
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The Enigma of Craving |
p. 138 |
Anju Dhawan, Ramesh Kumar, Seema Yadav, B. M. Tripathi
PMID:21206559Craving is considered to play an important role in the persistence of drug use and relapse of drug use. Very few studies have looked into the subjective experience of this phenomena. This study attempts to study craving comprehensively as described by the subjects. In the present study 30 patients of heroin dependence syndrome were assessed (using a semi-structured questionnaire) for the subjective experience of craving and its various dimensions. All subjects reported having experienced craving. Majority of subjects (90%) described craving as a strong desire to use the substance. About 77% reported that intensity of craving could vary while others described it as a strong urge. Majority (83.3%) reported that only heroin or other opiates could satisfy the craving they experienced for heroin. During craving, thoughts of using the drug by all means would preoccupy their mind. Withdrawal symptoms (70.0%), increased respiration (56.7%) and palpitation (53.3%) were the common physical symptoms and anger (83.3%), tension (63.3%), anxiety (50.0%) were the common emotions experienced during craving. Craving was described as difficult to control and resulted in consumption of heroin on an average of 76.7% occasions. All subjects reported multiple cues that induced craving. Frequency of craving decreased with increase in length of period of abstinence. After being abstinent for 3 months, 90% subjects did not experience craving or experienced it once in a day. Socio-cultural factors do not appear to have prominent influence on subjective experience of craving. |
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Physiological Assessment of Male Alcoholism |
p. 144 |
S Chaudhury, P Bhardwaj, R Bhardwaj, NL Dinker, SK Das, BS Mishra, B Ukil
PMID:21206560In 100 consecutive male inpatients with alcohol dependence and an equal number of age, sex, occupation and regional background matched controls, the value ofgamma-glutamyl transpeptidase (GGT), serum glutamic oxaloacetic transaminase (SGOT), serum glutamic pyruvic transaminase (SGPT), mean corpuscular volume (MCV) and serum triglycerides were statistically significantly raised among alcoholics on admission as compared to controls. After five weeks of enforced abstinence in hospital the values of GGT, SGOT and SGPT showed significant reduction among alcohol consumption, these objective laboratory tests can be used to support the clinical diagnosis of alcohol dependence. Electrocardiographic abnormalities viz. Sinus tachycardia, intraventricular conduction defects, T wave abnormalities and QTC prolongation occurred significantly more frequently in alcohol dependence patients as compared to normal controls. |
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Age at Onset Typology in Opioid Dependent Men : An Exploratory Study |
p. 150 |
Biswajit De, K. Surendra, Debasish Basu
PMID:21206561This study attempted to apply age at onset typology in ICD-10 diagnosed opioid dependence. The sample comprised 80 men seeking treatment at an addiction clinic. The measures included socio-demographic and clinical profile, Severity of Opioid Dependence Questionnaire, Modified Sensation Seeking Scale, Multiphasic Personality Questionnaire (MPQ) and Family History Assessment Module. A cut-off age of 20/21 years for an early-onset late-onset typology of opioid dependence was obtained using two methods - the modal age at onset method and one-third sample by age at onset method. The early onset group showed significant differences in terms of it being more often younger, urban, unmarried, wage earning or students, using oral opioids (not heroin or injectables), showing higher lifetime use and dependence of sedatives, earlier onset of use and dependence of sedatives and tobacco, and higher global psychopathology in terms of MPQ. The early onset group also showed statistically insignificant trends for lesser use and dependence of alcohol, higher severity of opioid dependence, more legal and less social complications, higher sensation seeking (except boredom susceptibility), and more frequent substance dependence in first degree relatives. The age at onset typology in opioid dependence appears to be feasible and having some similarities to similar typology in alcoholism. |
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A Study to Assess Depression, Its Correlates and Suicidal Behaviour in Epilepsy |
p. 161 |
Rajesh Jacob, M. Suresh Kumar, R. Rajkumar, V. Palaniappun
PMID:21206562Fifty subjects with seizure disorder were compared with thirty subjects with bronchial asthma and assessed for depression and suicidal behaviour. 34% of the epilepsy group had a diagnosis of major depressive episode compared to 13.3% of Bronchial Asthma group, which demonstrated a significant difference. Complex partial seizures and use of phenobarbitone had significant association with depression. 16% of the epilepsy group had a history of atleast one suicidal attempt in the previous year with 88% using anticonvulsants. 20% of the group also expressed current suicidal ideation, which correlated with Hamilton Depression Rating Scale total scores. |
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Psychiatric Thoughts in the Tamil Culture |
p. 165 |
O Somasundaram
PMID:21206563The significance of psychiatric thoughts in Tamil culture is brought forth with relevant historical and literary evidences: psycho-physiological aspects of emotions, descriptions of severely disturbed individuals, attitude of the society towards the mentally ill and epigraphic material describing hospital care of psychiatric patients in the first millennium are alluded. These references unravel the advanced psychiatric medical knowledge in the Ancient Tamil system of Medicine namely the Siddha system. The mythical origin of Siddha Medicine, attributes of the Siddhars (knowledgeable persons) and short biographical notes of eminent siddhars like Agathiyar, Bogar, Therayar and Thirumoolar are cited. Ancient theories of etiopathogenesis, namely the Panchaboothas and Tridoshas are detailed. Agathiyar's deschptions, classification and treatment of mental illnesses and Yogi Siddhar's contribution to psychiatry require significant mentioning. Siddha system has proved its potential effect by displaying promising results in treating HIV and Hepatitis-B. Likewise the author encourages similar discoveries in Siddha Medicine with relevance to psychiatry. |
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Stevens Johnson Syndrome in a Bipolar Patient Treated with Lamotrigine |
p. 170 |
Yvonne Da Silva Pereira, Hina Lal, M.F.M Miranda, John Fernandes
PMID:21206564A male patient with bipolar disorder who developed Stevens Johnson Syndrome following treatment with a combination of sodium valproate and lamotrigine is reported. This case report emphasises the importance of being cautious when such a combination is used in patients with associated medical conditions. |
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Intravenous Valproate : A New Perspective in the Treatment of Manic Symptoms |
p. 173 |
Harpreet S Duggal, K. Jagadheesan, Subhash Gupta, Soumya Basu, Sayeed Akhtar, Haque S Nizamie
PMID:21206565Over the last few years, the use of valproate in psychiatry has increased considerably. With the advent of oral loading dose strategy, its role in rapid treatment of acute mania has been demonstrated. The intravenous formulation of valproate, while retaining the rapidity of action of oral loading, also avoids some of the adverse effects of the oral preparation. Moreover, reports are pouring in that intravenous valproate loading may be more efficacious than oral valproate loading in the treatment of acute mania. We report two patients whose manic symptoms showed a dramatic response to intravenous valproate without adverse effects. The pharmacology of intravenous valproate and its clinical relevance to psychiatry are discussed. |
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Transsexualism and Schizophrenia : A Case Report |
p. 177 |
Subhash C Bhargava, Sujata Sethi
PMID:21206566Delusion of sex change is not uncommon as a pan] of the schizophrenic illness. But the coexistence of gender identity disorder (GID) and schizophrenia is rare and show differential response to treatment with antipsychotics. |
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Catatonia in Obsessive Compulsive Disorder |
p. 179 |
K. Jagadheesan, Haque S Nizamie, Anupam Thakur
PMID:21206567Catatonia occurs in a wide range of neuropsychiatric conditions. Among the psychiatric disorders, occurrence of catatonia has rarely been documented in obsessive-complsive disorder. Given the paucity of reports, we report two cases of obsessive compulsive disorder that presented as catatonia. |
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Catatonic Syndrome as a Complication of Enteric Fever |
p. 183 |
Hema Tharoor, Nilamadhab Kar, VS Kumar, Purushottam Mishra
PMID:21206568A person with enteric fever who developed neuropsychiatric complication of catatonia after the fever subsided is presented. The catatonic symptoms were not associated with any depressive or psychotic symptoms. The relevant literature is discussed. |
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| LETTERS TO EDITOR |
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Let Us Learn the Right Lessons from Erwadi |
p. 186 |
James T Antony
PMID:21206569 |
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The Surreptitious Administration of Clozapine: Critical Issues |
p. 189 |
N Pfizer, Chittaranjan Andrade
PMID:21206570 |
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Repetitive Tattooing in Borderline Personality and Obsessive-Compulsive Disorder |
p. 190 |
Harpreet S Duggal, Barry Fisher
PMID:21206571 |
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Rational Use of Psychotropic Drugs by General Practitioners |
p. 192 |
Rajul Tandon, Harish Kalra
PMID:21206572 |
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| BOOK REVIEWS |
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Concise Textbook of Psychiatry  |
p. 193 |
| Niraj Ahuja |
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Freedom from Stress |
p. 195 |
| I Sharma |
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Defeat Depression |
p. 197 |
| Mukul Sharma |
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