Four cases of attempted self immolation were investigated. The psychiatric evaluation was done according to DSM- III-R criteria. The findings are discussed with reference to the psychological and socio-cultural perspectives.

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Patients with acute onset, non-organic psychotic states are frequently reported from India and certain other developing countries. This paper relates to an investigation of such cases in terms of their clinical history and their symptomatology examining the extent to which these are similar /dissimilar to schizophrenia and affective psychosis. 109 cases of acute psychosis fulfilling specified screening criteria were assessed on the Schedule for Clinical Assessment Acute Psychotic States (SCAAPS) and Present Slate Examination (PSE). Vie findings revealed that about 34% of all patients experienced significant strees before the onset of psychosis. About 40% of all cases presented with Catego subtype which was not indicative clearly of a specific diagnostic category. This subgroup of patients differed from the remaining 60% of patient in having greater frequency of stress before the onset of psychosis. On the whole the delusions were more commonly seen in patients from upper socioeconomic status & urban background. Limitations of classificatory provisions in the ICD-9 and catego in dealing with acute psychotic state are highlighted.

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A survey of 40 randomly selected general practitioners was carried out to find out their attitudes towards psychiatric disorders and psychiatric patients by administering a specially designed proforma which recorded sociodemographic characteristics as well as attitudes. Majority of GPs were of the opinion that psychiatric disorders are inherited, can occur in any normal person living under stress, are treatable. They had positive attitude towards psychiatric illness but showed more social distance with mentally ill-person. Results are discussed and their implications are highlighted.

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One hundred patients of Diabetes Mellitus (30 insulin dependent and 70 non-insulin dependent) were studied for frequency and severity of depressive symptoms. The subjects were evaluated on Schedule for Standardised Assessment of Affective Disorder (SADD) and Hamilton Rating Scale for Depression (HRSD). Result show that symptoms such as depressed mood-decreased work and activities and loss of weight were present in more than 60% of patients belonging to insulin and non-insulin dependent diabetics. Severity of depressive symptoms as rated on HRSD were significantly higher (P <.001) in insulin dependent patients as compared to non-insulin dependent diabetics.

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A short 6-item version of General Health Questionnaire (GHQ-6) was evaluated for its validity of a sample of STD patients in the hands of a non-psychiatrist untrained in psychiatry in comparison to independent and detail psychiatric assessment. The GHQ-6 was found to have a moderate sensitivity of 55%, but high specificity rate of 87%.

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The prevalence of HIV infection in India is likely to increase dramatically in coming years. Neuropsychiatric and psychosocial problems are common among HIV infected individuals. Therapeutic measures employing biological, psychological and social approaches are necessary for managing these problems. Strategies for reducing high-risk behavioural patterns need to be developed for preventing the spread of infection. To cope with these tasks, neurology and psychiatric personnel should possess an adequate knowledge of the various aspects of HIV infection. Reports indicate a high prevalence of misconceptions among hospital staff. The paper provides a brief review of the biological, europsychiatric, psychosocial and management aspects of HIV infection relevant to neurology and psychiatry.

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A two year prospective study of 221 consecutive inpatients undergoing cataractomy revealed the incidence of post-cataractomy delirium to be 1.8%. While in one case the delirium was due to anticholinergic toxicity, in the remaining three cases no organic cause was evident. Sensory deprivation was present in two patients. Preventive measures for the condition are discussed.

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25 in-patients, 17 males and 8 females, were administered Barnes' Scale for drug-induced Akathisia. Akathisia was found in 7 of them, 5 males and 2 females. One had pseudoakathisia and in the other, akathisia was questionable. The inter-rater reliability, assessed by weighted Cohen's kappa, was found to be high.

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Serum adrenocorticotrophic hormone (ACTH) and Cortisol were assayed in 38 males alcoholics and 24 male control subjects using radioimmunoassay (RIA) techniques. Biochemical parameters of hepatic function, depressive symptoms and severity of withdrawal were also assessed. Thirteen percent and eleven percent of the patients and elevated serum ACTH and Cortisol levels respectively. Evidence of advance liver disease was scant and significant symptoms of depression was observed in only 14% of the patients. By and large withdrawal symptoms were mild. Two patients have clinical features suggestive ofpseudo Cushing's syndrome without hypercortisolaemia.

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132 male schizophrenics who met APA-DSM 111 criteria for the diagnosis of Schizophrenia were selected. They were further subclassified into subtypes. 73 healthy normal males and 60 first degree male relatives of patients were also taken into study. They were matched for palmar flexion crease pattern. Few sub-types only differed from normals, hence heterogeneity in Schizophrenia has been noted. Implications of findings has been discussed and need for further investigation is highlighted.

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Plasma homovanillic acid (pHVA) levels were estimated in 20 cases of schizophreniform disorder, 14 cases of schizophrenia 'on medication' and 17 cases of schizophrenia 'off medication'. A bimodal distribution of pHVA was seen in schizophreniform disorder subjects, suggesting heterogenous groups in terms of dopaminergic function. No significant difference in the pHVA values was seen in the 3 groups, nor was there a relationship between the severity of the illness and the pHVA values; these results suggest plasticity of the dopaminergic system to neuroleptics.

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36 chronic schizophrenic patients meeting D.S.M. HI - R criteria were assessed by a single rater using the Positive and Negative Syndrome Scale (PANSS). Ratings were repeated 9 months later by the same rater. Negative symptoms and syndromes were much more stable over time than positive symptoms and syndromes. Only hallucinations had stability comparable to the negative symptoms. Positive and negative subtypes of schizophrenia based on the composite score were very stable. Relatively few symptoms from the general psychopathology subscale were stable over time. The implications of these findings are discussed.

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Thirty melancholic patients participated in a double blind trial comparing efficacy of modified bilateral sinewave ECT given twice or thrice weekly. Seizure was monitored on a single channel EEG tracing. All patients received ECTs in the first two weeks of the four week study period. Seizure duration estimate from EEG tracings available for 22 patients (10 patients of thrice weekly group) on all occasions of first two weeks were analysed. Seizure durations significantly reduced through the course in both the groups. Twice weekly ECTs led to significantly less decrements in the seizure duration. This differential reduction was not related to the therapeutic outcome. The improvement in depression in both groups of patients was comparable at the end of two weeks.

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Full text not available  [PDF]  [PubMed]

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