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| EDITORIAL |
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Need for Family Interventions in Schizophrenia |
p. 199 |
JK Trivedi
PMID:21206573 |
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| ARTICLES |
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Mind in Ayurveda |
p. 201 |
A Venkoba Rao
PMID:21206574Ayurveda now among the alternative complementary systems of medicine is over 5000 years old. Its origin and the compilation of Caraka Samhita are noted. The nature of mind as a sensory and a motor organ, its structure and functions are discussed. The concept of Thdosha theory and Trigunas are explained besides the so-called master-forms of Doshas namely Prana, Tejas and Ojas. The constituional and tempermental types depending upon the doshas are described. These determine diagnoses and guide treatment. Ayurveda is highlighted as a holistic system with its concern for prevention of disease and promotion of health. Disease denotes failure of prophylaxis. Some methods of Ayurvedic therapy are mentioned. |
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CSF Amines and their Metabolites in First Episode Drug Naive Schizophrenic Patients and their Correlations with Dimensions of Schizophrenia |
p. 212 |
Anand I, Sunitha T.A, Sumant Khanna
PMID:21206575There has been great interest in the neurobiological substrate of the different dimensions of schizophrenia. This has largely focused on structural and functional changes while it has been acknowledged that there is a relation between pharmacological response and neurotransmitter alteration on these dimensions. Atypical anti psychotics which affect both positive and negative symptoms mediate their action predominantly through dopaminergic and serotonergic receptors. The current study extends this further looking at CSF amines. 37 drug naive first episode psychosis patients with the duration of illness less than 2 years were included. Patients were assessed with SAPS (Scale for Assessment of Positive Symptoms) and SANS (Scale for Assessment of Negative Symptoms). Lumbar puncture was done under sterile conditions and CSF was analyzed by HPLC for dopamine, serotonin and their metabolites. Mean CSF 5- HIAA was 25.35ng/dl. Mean CSF 5 HT was 7.72 ng/dl. Mean CSFHVA was 36.99 ng/dl. Mean CSF 5-DA was 3.06 ng/dl. There was significant positive correlation between CSF5-HIAA and Negative and Disorganization dimensions. There was significant negative correlation between CSF HVA and Psychosis dimension. There is evidence to support that the implication of serotonin in Negative and Disorganization dimensions and the Serotonin- Dopamine interaction and dimensions of schizophrenia. |
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Burden and Coping in Caregivers of Persons with Schizophrenia |
p. 220 |
Anupama Rammohan, Kiran Rao, DK Subbakrishna
PMID:21206576Caring for a family member with schizophrenia is an enduring stressor and causes considerable amount of burden. The aim of the present study was to examine burden and coping in parents and spouses of persons with schizophrenia. The sample comprised of 24 parents and 24 spouses. Patients were assessed on the Global Assessment Scale (GAS), and caregivers were assessed on the Burden Assessment Schedule (BAS) and the Coping Checklist (CCL). Spouses reported greater emotional burden. Parents used more of denial as a coping strategy, while spouses used more of negative distraction strategies. On stepwise regression analysis, patient's age, educational level, and level of functioning and caregiver's use of denial as a coping strategy emerged as significant predictors of caregiver burden. The study highlights the fact that family intervention programs need to address the specific concerns of caregivers. |
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ECT in Neurological Counditions |
p. 228 |
K Girish, BN Gangadhar, N Janakiramaiah
PMID:21206577It is a myth that electroconvulsive therapy (ECT) produces greater side effects and worsens the neurological condition when used in neurologically ill patients. With the advancement and sophistication in ECT practice standards and modification procedures, it can be safely administered either to treat selected neurological conditions or the co-morbid psychiatric illnesses without additional risks. However ECT should be administered only after thorough evaluation of risks and benefits in such individuals. |
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A Clinical Genetic Study of Adult Obsessive Compulsive Disorder from India |
p. 240 |
R Guruswamy, Pankaj Relan, Sumant Khanna
PMID:21206578Objective: The current study aims to replicate western reports of a familial excess of syndromal and sub-syndromal Obsessive Compulsive Disorder (OCD) in OCD probands in an Indian population. Method: 148 relatives of OCD probands were compared with 151 normal subjects, based on evaluation on Schedule for Clinical Assessment for Neuropsychiatry (SCAN). Results: There were no clinically significant differences in the prevalence of psychiatric disorders between the two samples. Conclusion: In an Indian setting, the absence of familial loading in adult OCD is being reported. Whether subgroups of OCD are familial, or other factors play a role in the pathogenesis of OCD in India needs to be explored. |
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A Study of Panic Patients with and without Depression |
p. 246 |
K Srinivasa, Iby Neerakal
PMID:21206579In a sample of 94 panic patients, 43 patients (45.7%) had comorbid depression. In majority of patients, the comorbid depression was severe enough to be diagnosed as major depression. Panic patients with depression were more severely functionally impaired and had more generalized anxiety symptoms as compared to pure panic patients. There were no significant differences between panic patients with primary and secondary depression on any of the clinical variables. Findings from the present study are in agreement with earlier studies in that panic disorder comorbid with depression is a much more severe illness than pure panic disorder. |
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Response of Carbamzepine in Bipolar Disorder : Kindlers Versus Non-Kindlers |
p. 253 |
Subhash Chandra Das, Subhash Chandra Gupta, Soumya Basu, Daya Ram
PMID:21206580Based on carbamazepine's hypothesized ability to stabilize temporal lobe seizures and behavioral disorders and its ability to inhibit limbic system excitability in models such as kindling, we undertook this study with the aims of finding out the response of carbamazepine in kindler and non kindler groups and to see the relationship of socio-demographic and clinical variables in kindler and non-kindler bipolar mood disorder with response to carbamazepine. Simple random sampling was done and patients (over a period of one and a half year) between 18-50 years who had a diagnosis of Bipolar Affective Disorder, current episode mania as per lCD-10 and who had history of at least three manic or depressive episode in the past were taken. The total sample was divided into two groups i. e. kindler and non-kindlers. Kindlers were defined as patients with 3 or more affective episodes in less than equal to 1 year apart. Non-kindlers were defined as patients with at least 3 episodes in the past with inter episodic period of more than 1 year. All the patients included in this study were followed up for 6 months and were given carbamazepine in adequate dosages. Fifty -five patients completed the 6 months follow up. Results showed that there was no significant difference between the two groups based on sex, past history of substance intake, type of mood (irritable versus elated), number of relapses during the follow-up and improvement on carbamazepine. Our study does not support the kindling hypothesis. |
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A Comparative Study of the Efficacy and Safety of Mirtazapine Versus Amitriptyline in the Treatment of Major Depression |
p. 260 |
Anand Mathur, Ashok Chowdhary, Mahendra Jain
PMID:21206581A clinical trial was undertaken to evaluate the Anti depressant efficacy of Newer Antidepressant Mirtazapine in the treatment of major Depression in 39 patients in an O.P.D. setup. In addition to this clinical acceptability and safety profile of Mirtazapine as compared to that of Amitriptyline was also assessed. Mitazapine usually described as Noradrenergic and specific serotonergic Anti depressant (NaSSA). Patients aged 18-65 years who fulfilled the diagnostic criteria for a single or recurrent major Depressive disorder (as defined by DSM IV) for a minimum of 2 weeks were enrolled at our study centre. Patient assessment were conducted at screening, baseline, end of week 1, week 2, week 3, week 4, week 5 & end of week 6 for the efficacy & safety Parameters; HRSD, CGI, Adverse event follow up, BP & Pulse. Three level statistical analysis were performed on all efficacy measures including ANOVA (An Analysis of variance). The result indicates that mirtazapine is effective in the treatment of major depression at the dosages range of 15-45 mg/day and it has efficacy equivalent to that of the standard TCA Amitriptyline, albeit, with a substantially better tolerability profile. |
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Risk Factors in Delirious Geriatric General Medical Inpatients |
p. 266 |
Paramjeet Singh Khurana, P.S.V.N Sharma, Ajit Avasthi
PMID:21206582The present study was carried out on the hospitalized geriatric general medical patients with the aim to identify the possible risk factors associated with delirium in the elderly. The assessment of the patients was carried out using Mini Mental Status Examination (MMSE), Delirium Symptom Interview (DSI), Delirium Rating Scale (DRS) and ICD-10 Diagnostic Criteria for Research for delirium Details of medical records were collected. An overall rate of delirium of 27% was found in the 100 patients who constituted the sample. Pre-existing cognitive deficits, neurological illnesses, urinary tract infections, visual impairment, hearing impairment, current proteinuria, leukocytosis, raised blood ammonia, hyponatremia and potassium level disturbances were the risk factors identified. |
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Study of Spirometry and Airway Reactivity in Patients on Disulfirm for Treatment of Alcoholism |
p. 273 |
RB Galgali, K Srinivasan, George A D'Souza
PMID:21206583The aim of our study was to examine the short term effect ofdisulfiram on pulmonary functions of alcohol dependent subjects, who were chronic smokers J/Ve compared FEV1 % values on spirometry and airway reactivity to histamine challenge in alcohol dependent subjects at baseline and after 2 weeks of treatment with disulfiram. Disulfiram did not significantly alter FEVI values and airway reactivity during the treatment period and can thus be used safely in alcohol dependent subjects who are current smokers. |
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The Significance of Attempted Suicide in Armed Forces |
p. 277 |
PK Chakraborty
PMID:21206584The Indian Armed Forces with a closely knit community, life of their own provides a unique opportunity to study the adaptive and maladaptive characteristics of his actions. In this study thirty two percent of attempted suicide in the Armed Forces achieved discharge from service is a testament to the urgency and intensity of the need to get out of the service. Twently-two percent of control psychiathc in-patient who sought environmental change also achieved premature discharge from service, further highlights the intensity of the need of these patients to change their environment. The intensity of these patients need to change their environment is coupled with a marked sense of isolation. They find themselves not only friendless but also incapable of making friends. |
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Amnesia for Autobiographical Memory : A Case Series |
p. 283 |
RK Chadda, N Singh, D Raheja
PMID:21206585Functional amnesia for autobiographical memory is a rare but pathognomic sign of dissociative disorders. Amnesia for part of one's personal history is sometimes also seen in other functional disorders like depression and schizophrenia but autobiographical amnesia in these disorders is relatively rare. Phenomenologically the autobiographical memory loss, amnesia for events during the amnestic episode and change of identity (as in fugae and dissociative identity disorder) are all expressions of altered memory organisation. This paper reports three cases of autobiographical amnesia with clinical diagnoses of dissociative disorder unspecified type, dissociative amnesia and schizophrenia that were treated successfully. The phenomenon of autobiographical amnesia is
discussed in the background of these cases. |
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Charles Bonnet Syndrome : Neurobiological Insights |
p. 289 |
Harpreet S Duggal, Joseph N Pierri
PMID:21206586A case of Charles Bonnet syndrome in an elderly patient with occipital lobe lesion is described. Authors have highlighted the complex interplay of various neurobiologicat factors such as cortical blindness, structural brain lesion and epileptiform brain activity in the pathophysiology of this syndrome. The impact on the clinical presentation of brain changes on aging and those following cortical blindness and peripheral visual loss is also discussed. |
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Internet Delusion Responsive to Cognitive Therapy |
p. 293 |
Harpreet S Duggal, Jagadheesan K, Haque S Nizamie
PMID:21206587Delusions are known to be influenced by the popular media, the sociopolitical undercurrents and also by the scientific innovations. Internet is one such modern communication tool, which can easily be incorporated into the delusional system of patients by virtue of its semblance to some psychopathological phenomena. We describe a patient with paranoid schizophrenia who developed a delusion about the Internet controlling him but showed a good response to cognitive therapy. |
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Genital Self - Mutilation in Depression : A Case Report |
p. 297 |
K Nagaraja Rao, Bharathi G, Sameeran Chate
PMID:21206588Genital 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. |
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Stevens Johnson Syndrome During Treatment with Lithium and Valproate in Mood Disorder : A Report of Two Cases |
p. 301 |
B.N Misra, P.K Mohapatra, D Roy
PMID:21206589Very rarely Stevens Johnson Syndrome develops following drug therapy particularly Lithium and Valproate. Worldwide, the reports regarding Lithium and Valproate induced Stevens Johnson Syndrome are very few. Here, we present two cases of Stevens Johnson Syndrome following treatment with Lithium and Valproate for Mood Disorder. |
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Episodic Obsessive Compulsive Disorder : A Case Report |
p. 303 |
Ajeet Sidana, Rishi Singal, Rakash Pal Sharma
PMID:21206590An uncommon case of Obsessive Compulsive Disorder (OCD) with episodic course and complete remission in the inter-episodic period is reported here. The patient, a middle aged women had 12 year history of about 10 episodes of OCD, each lasting for about 15-20 days and responds well to anti-obsessional drugs each time in a short period. |
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Hypomelanosis of ITO : A Case Report |
p. 305 |
Monisha Gupta, Vinay Gupta
PMID:21206591A twelve year old female child presented with learning disability. Detailed physical examination revealed anomalies involving the nervous and musculoskeletal system. In addition she had linear and whorled. hypopigmented lesions along the lines of Blaschko distributed over the upper limb, trunk and face on the left side of the body. She fulfilled the diagnostic criteria for Hypomelanosis of Ito, even in the absence of chromosomal studies and advanced histopathological studies. |
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| BOOK REVIEWS |
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Child Care in Ancient India from the Perspectives of Developmental Psychology and Paediatrics |
p. 309 |
| Prabhat Sitholey |
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Alcohol Related Problems : A Manual for Medical Officers |
p. 311 |
| PK Dalal |
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