Indian Journal of PsychiatryIndian Journal of Psychiatry
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   2006| October-December  | Volume 48 | Issue 4  
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Psychological effects of low intensity conflict (LIC) operations
Suprakash Chaudhury, DS Goel, Harcharan Singh
October-December 2006, 48(4):223-231
DOI:10.4103/0019-5545.31553  PMID:20703341
Background: A burgeoning clinical and empirical literature has provided incontrovertible evidence that combat operations exact a heavy toll in terms of human suffering not only on combatants but also military support personnel. Though the Indian army is engaged in low intensity conflict (LIC) operations for over five decades, the psychological effects of LIC deployment on soldiers have not been adequately studied. Aims: To evaluate the psychological effects of deployment in LIC operations on service personnel. Methods: Five hundred and sixty-eight servicemen engaged in LIC operations and equal number of age- and rank-matched personnel in adjoining peace areas were evaluated with a self-made questionnaire, General Health Questionnaire (GHQ), Carroll Rating Scale for Depression (CRSD), State-Trait Anxiety Inventory (STAI), Michigan Alcoholism Screening Test (MAST), Impact of Events Scale (IES), Perceived Stress Questionnaire (PSQ), Multidimensional Fatigue Inventory (MFI), Hindi PEN inventory, Satisfaction With Life Scale (SWLS) and Locus Of Control (LOC) scale. Results: Respondents from LIC area had significantly higher scores on CRSD, MAST, GHQ, IES, and general fatigue, physical fatigue, and mental fatigue subscale of the MFI in comparison to those located in other areas. Significantly higher number of respondents from highly active LIC and with more than one-year service in LIC scored above cut-off levels on CRSD, MAST and GHQ. Conclusions: The psychological status of troops was directly related both to the duration of stay and the nature of LIC area.
  14,647 809 2
Randomized controlled trial of standardized Bacopa monniera extract in age-associated memory impairment
Sangeeta Raghav, Harjeet Singh, PK Dalal, JS Srivastava, OP Asthana
October-December 2006, 48(4):238-242
DOI:10.4103/0019-5545.31555  PMID:20703343
Background: Brahmi (Bacopa monniera) is a traditional Indian medicinal plant which causes multiple effects on the central nervous system. The standardized extract of this plant has shown enhanced behavioural learning in preclinical studies and enhanced information processing in healthy volunteers. Aim: To study the efficacy of standardized Bacopa monniera extract (SBME) in subjects with age-associated memory impairment (AAMI) without any evidence of dementia or psychiatric disorder. Methods: A double-blind, placebo-controlled randomized study design was employed. The subjects received either 125 mg of SBME or placebo twice a day for a period of 12 weeks followed by a placebo period of another 4 weeks (total duration of the trial 16 weeks). Each subject was evaluated for cognition on a battery of tests comprising mental control, logical memory, digit forward, digit backward, visual reproduction and paired associate learning. Results: SBME produced significant improvement on mental control, logical memory and paired associated learning during the 12-week drug therapy. Conclusion: SBME is efficacious in subjects with age-associated memory impairment.
  14,234 1,111 9
Anti-amnestic properties of Brahmi and Mandookaparni in a rat model
Chittaranjan Andrade, J Suresh Chandra
October-December 2006, 48(4):232-237
DOI:10.4103/0019-5545.31554  PMID:20703342
Background: We had previously demonstrated that a complex herbal formulation (Mentat; Himalaya Drug Company, Bangalore) attenuated anterograde and retrograde amnesia induced by electroconvulsive shocks (ECS) in rats. We later showed that a simplified formulation (Memorin; Phyto Pharma, Kolhapur) had similar effects. Aims: In an attempt to identify the ingredients (of the complex formulation), which purveyed the cognitive benefits, we studied two of the constituent herbs, Brahmi and Mandookaparni, separately and together. The experiments included both active (piracetam) and inactive (vehicle) controls. Methods: Adult, male, Sprague-Dawley rats (n=8 per group) were randomized to receive Brahmi, Mandookaparni, a combination of these two herbs (A300), piracetam, or vehicle from days 1 to 15. On days 11 and 12, the rats were trained in a T-maze using a food-driven paradigm. On days 13 and 14, half the rats in each group received 2 ECS (60 mC charge) per day, 5 hours apart. On day 15, recall of pre-ECS learning was assessed. On day 16, transfer of learning was assessed. Results: None of the active treatments facilitated pre-ECS learning or influenced ECS seizure duration; however, all showed varying but generally favourable profiles in the attenuation of ECS-induced retrograde and anterograde amnesia. The combination of Brahmi and Mandookaparni showed no especial advantage over the individual herbs. Conclusion: Brahmi and Mandookparni do not in themselves improve learning; however, each attenuates the amnestic effects of ECS without showing synergism in this beneficial action. Exercises in research and development are indicated to further investigate the anti-amnestic properties of these herbs, and to identify the specific chemical constituents which have procognitive effects.
  7,961 669 4
The course of bipolar disorder in rural India
Mohit P Chopra, KV Kishore Kumar, DK Subbakrishna, Sanjeev Jain, R Srinivasa Murthy
October-December 2006, 48(4):254-257
DOI:10.4103/0019-5545.31559  PMID:20703347
Aim: To examine the naturalistic course of bipolar disorder in a rural, community-based, partially treated cohort. Methods: All patients diagnosed with bipolar disorder during an epidemiological survey (n=34) in a rural area in India were followed longitudinally using standardized instruments, and the life-chart method used to examine their course. Results: Seven (26%) of the 27 patients evaluated directly had not received any treatment whatsoever. Four patients (15%) had experienced rapid-cycling at some time; patients without rapid-cycling had experienced a mean 0.22 episodes/year. Episodes of mania accounted for 72% of all episodes. None of the variables examined appeared to predict the total number of episodes experienced by individual patients, although rapid-cycling occurred significantly more often if the patients had not received any psychopharmacological treatment. Conclusions: A mania-predominant course was observed in this small cohort, similar to reports from other developing countries.
  6,564 515 3
Body dysmorphic disorder, dysmorphophobia or delusional disorder-somatic subtype?
VK Aravind, VD Krishnaram
October-December 2006, 48(4):260-262
DOI:10.4103/0019-5545.31561  PMID:20703349
Excessive concern about the appearance of one's body is the hallmark of body dysmorphic disorder (BDD). A case with recurrent intrusive preoccupation and concern about the appearance of the face, ritualistic behaviours associated with this preoccupation, resulting in social and interpersonal difficulties is presented. The difficulty to draw a discrete boundary between BDD and a delusional disorder of somatic type is highlighted.
  6,629 385 -
A profile of substance abusers using the emergency services in a tertiary care hospital in Sikkim
Akhil Bhalla, Sanjiba Dutta, Amit Chakrabarti
October-December 2006, 48(4):243-247
DOI:10.4103/0019-5545.31556  PMID:20703344
Background: Sikkim, a state in Northeast India with a population of more than 500,000 and inhabited by indigenous population of Lepchas, Bhutias and Nepalis, lies in the foothills of the Himalayas sharing borders with Tibet, Nepal and Bhutan. Northeast India is a major source of injection drug users (IDUs) and associated HIV/AIDS. Alcohol use is traditionally prevalent in Sikkim and recently, IDU behaviour has also been reported, although systematic information on epidemiology and treatment availability of substance abuse in Sikkim is not available. Aim: To study the sociodemographic and drug use profile of substance abusers using the emergency services in a tertiary care hospital. Methods: A retrospective chart review was used. Patients with history of current drug use seeking emergency services for any medical or surgical consequence incident to substance abuse from July 2000 to June 2005 (60 months) were included in the study. Data were generated from emergency case register, hospital records and case sheets. SPSS 10.0 was used for data analysis. Results: Out of 54 patients seeking emergency services with substance abuse (1.16% of all psychiatric consultations), alcohol abusers were 77.8% and other opioid abusers 14.8%. Prevalence of IDU was 16.66%. Common opioids abused were dextrpropoxyphene and pentazocine, both analgesics. A significant number of patients (46.3%) had a history of >20 days/month frequency of abuse. Median of duration of abuse with all drugs was 12 years, while that with IDU population was 3 years. Alcohol withdrawal was the commonest cause (57.4%) of reporting to the emergency. Psychiatric comorbidity was found among 7.4%. Commonest medications used were chlordiazepoxide and clonidine, for withdrawal and naltrexone, for substitution. No standardized treatment protocol for substitution treatment was available. Conclusions: This is an initial attempt to study the sociodemographic and drug use profile of substance abusers in Sikkim. Demographic and socioeconomic characteristics of substance abusers seeking emergency services are not significantly different from treatment-seeking substance abusers in other parts of India. IDU behaviour has been detected and low median duration of use suggests an emerging problem and need for urgent harm reduction. Alcohol withdrawal was the commonest cause of seeking emergency services, which is related to high prevalence of alcohol abuse in Sikkim. No standardized substitution treatment is available for substance abusers, which may lead to higher rates of relapse.
  5,530 470 2
Study of childhood onset schizophrenia (COS) using SPECT and neuropsychological assessment
Savita Malhotra, Nitin Gupta, Anish Bhattacharya, Mehak Kapoor
October-December 2006, 48(4):215-222
DOI:10.4103/0019-5545.31552  PMID:20703340
Background: In recent years, the development of positron emission tomography (PET) and single-photon emission computed tomography (SPECT) imaging has enhanced our understanding of the physiological functioning of the intact brain. Aim: To study cerebral cortical perfusion defects in patients with childhood onset schizophrenia (COS) and to assess their neuropsychological functioning. Methods: This cross-sectional study comprised 14 patients with COS with onset at or before 14 years of age, diagnosed as per ICD-10 DCR criteria, attending a tertiary care centre in North India. All the patients were assessed on sociodemographic, clinical profile sheet, Positive and Negative Symptom Scale (PANSS) and Edinburgh Handedness Inventory (EHI). The Wisconsin Card Sorting Test (WCST) was used to assess their neuropsychological functioning. All patients underwent SPECT. A control group of 10 healthy subjects was studied with SPECT for comparison. Results: Nine patients (64.3%) showed perfusion anomaly on SPECT scan specifically in the left temporal and frontal areas of the brain. On WCST score these 9 patients showed a higher percentage of total errors (64.49%9.42%) as compared to the other 5 patients (48.54%12.70%) who showed no abnormality on SPECT scan. All normal control subjects showed no abnormality on SPECT. Conclusion: The results from WCST show that COS patients have difficulty in executive functioning. Also, patients had perfusion anomaly in the left temporal, frontal and parietal areas. Deficits found in COS are similar to those found in adult onset schizophrenia (AOS). In view of the findings, the nature of COS and its relationship with AOS are discussed.
  5,252 400 3
Starvation in obsessive-compulsive disorder due to scrupulosity
Dinesh Dutt Sharma, Ramesh Kumar, Ravi Chand Sharma
October-December 2006, 48(4):265-266
DOI:10.4103/0019-5545.31563  PMID:20703351
This report describes an unusual presentation of obsessive-compulsive disorder (OCD) with predominant religious obsessions and compulsions (scrupulosity) in which the patient starved himself by keeping fast excessively to the extent of emaciation and extreme weakness even in walking and became bedridden.
  4,973 322 -
Self-awareness of depression and life events in three groups of patients: Psychotic depression, obsessive-compulsive disorder and chronic medical illness in North India
Anjali Gupta, Indu Bahadur, KR Gupta, Dinesh Bhugra
October-December 2006, 48(4):251-253
DOI:10.4103/0019-5545.31558  PMID:20703346
Background: Depression is a common experience across cultures although not all languages have words describing depression. Aim: To identify patients' perception and awareness of depression as an illness. Methods: Sixty psychiatric patients (each with depression or obsessive-compulsive disorder [OCD]) were compared with 30 medical patients with chronic physical illness and assessed on levels of awareness of depression in relation to life events. Results: Life events were more in patients with OCD compared to other two groups. All the three groups of patients had major depression. Conclusion: Absence of help-seeking for depression in patients with OCD and physical illness possibly indicate low level of awareness of depression in these patients. The findings are discussed in context of clinical practice.
  4,681 500 -
Responsibility of psychiatrists: Need for pragmatic idealism
Nimesh G Desai
October-December 2006, 48(4):211-214
DOI:10.4103/0019-5545.31551  PMID:20703339
  3,777 311 1
Angioneurotic oedema with tadalafil: A rare case report
Rajnish Raj, Balwant Singh Sidhu
October-December 2006, 48(4):263-264
DOI:10.4103/0019-5545.31562  PMID:20703350
A case is reported where the patient developed angioneurotic oedema of the lip after the use of tadalafil. 1. On withdrawal of tadalafil, complete remission was obtained through required symptomatic treatment. Clinicians should be aware of the possibility of development of angioneurotic oedema in patients undergoing treatment with tadalafil.
  3,752 227 -
Use of humour in psychiatric practice: Can we do it properly?
G Prasad Rao
October-December 2006, 48(4):267-268
DOI:10.4103/0019-5545.31564  PMID:20703352
  3,528 279 1
Conduct disorder-A sequelae of viral encephalitis
Kamala Deka, Dhrubajyoti Bhuyan, PK Chaudhury
October-December 2006, 48(4):258-259
DOI:10.4103/0019-5545.31560  PMID:20703348
An 11-year-old girl presented with a behavioural problem of 2 years' duration, which developed following an attack of viral encephalitis. Her behavioural changes had manifested as conduct disorder and were treated with pharmacotherapy as well as behavioural therapy.
  3,519 249 -
Professional's progress: Learning from life and mistakes
C Shamasundar
October-December 2006, 48(4):248-250
DOI:10.4103/0019-5545.31557  PMID:20703345
  3,242 220 1
Awakening the kundalini of humour
Harish Shetty
October-December 2006, 48(4):268-269
DOI:10.4103/0019-5545.31565  PMID:20703353
  3,060 225 -
Ravinder Lal Kapur (1938-2006)
Ajit V Bhide
October-December 2006, 48(4):277-278
  3,085 131 -
'Humour-ability' of mental health professionals
Nimesh G Desai, SN Sengupta, Deepak Kumar, Rupali Shivalkar, Saurabh Mehrotra
October-December 2006, 48(4):270-271
DOI:10.4103/0019-5545.31567  PMID:20703355
  2,797 237 -
Indicators of suicidal attempt in depression
Arunima Chatterjee, Rudraprosad Chakraborty, Suprakash Chaudhary
October-December 2006, 48(4):276-276
DOI:10.4103/0019-5545.31572  PMID:20703360
  2,508 361 -
Historicizing Indian Psychiatry
Debashis Chatterjee
October-December 2006, 48(4):272-273
DOI:10.4103/0019-5545.31568  PMID:20703356
  2,285 230 -
Author's response-I
Shridhar Sharma
October-December 2006, 48(4):273-274
  2,270 164 -
The case for humour: Moving one step further
Chittaranjan Andrade
October-December 2006, 48(4):269-270
DOI:10.4103/0019-5545.31566  PMID:20703354
  2,232 176 -
Author's response-II
Amit Ranjan Basu
October-December 2006, 48(4):274-274
  1,454 92 -
Author's response-III
Paul Hoff
October-December 2006, 48(4):275-275
  1,380 90 -