Indian Journal of PsychiatryIndian Journal of Psychiatry
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   2008| January-March  | Volume 50 | Issue 1  
    Online since April 2, 2008

 
 
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ORIGINAL ARTICLES
Evaluation of antioxidant deficit in schizophrenia
Gora Dadheech, Sandhya Mishra, Shiv Gautam, Praveen Sharma
January-March 2008, 50(1):16-20
DOI:10.4103/0019-5545.39753  PMID:19771301
Aim: Oxidative stress is a state in which there is disequilibrium between pro-oxidant processes and the antioxidant defense system in favor of the former and occurs as a consequence of increased production of free radicals or when the antioxidant defense system is inefficient or a combination of both events. A disturbance in the antioxidant defense system, including antioxidant enzymes superoxide dismutase (SOD) and glutathione peroxidase (GSHPx), due to free radical-induced oxidative injury has also been implicated in various neuropsychiatric disorders. Hence the role of these antioxidant enzymes and the changes in their level in blood and correlation with oxidative stress and the overall mechanism of defense were studied in a common psychiatric illness, schizophrenia. Materials and Methods: Fifty subjects of either sex ranging in age from 18 to 60 years, divided into two age groups (<40 years and >40 years), diagnosed for schizophrenia; and 50 age- and sex-matched normal subjects as controls were included in the study. Blood samples were collected for the determination of malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (GSHPx), and reduced glutathione (GSH). Results: Significantly lower levels of the two antioxidant enzymes were found in schizophrenics compared to normal controls, with an increased oxidative stress as indicated by high blood MDA levels. The condition worsened with advancing age, smoking, among literate masses, and in chronic schizophrenics; whereas gender did not show any effect. Conclusion: It can be concluded that an imbalance in the antioxidant defense system, along with enzymatic antioxidants, occurs in schizophrenia due to the persistent oxidative stress. Modern life style perhaps also contributes to the condition.
  23 8,067 627
Experiences of stigma and discrimination endured by people suffering from schizophrenia
Santosh Loganathan, Srinivasa R Murthy
January-March 2008, 50(1):39-46
DOI:10.4103/0019-5545.39758  PMID:19771306
Objective: It is important to understand stigma in India, given its varied culture and mixture of rural and urban populations. Information from western literature cannot be applied without considering the sociocultural differences. Aims: The research aimed to study the subjective experiences of stigma and discrimination undergone by people suffering from schizophrenia in rural and urban environments in India. Settings and Design: Patients were selected from the outpatient services of six adult psychiatric units of the National Institute of Mental Health and Neurosciences (NIMHANS), India, and from the six outreach centers located in rural areas. Materials and Method: Two hundred patients diagnosed with schizophrenia were selected from rural and urban areas. The experiences of stigma and discrimination were assessed using a semi-structured instrument. Statistical Techniques: Both quantitative and qualitative analyses were done. Results: Significant differences were seen between rural and urban respondents. Urban respondents felt the need to hide their illness and avoided illness histories in job applications, whereas rural respondents experienced more ridicule, shame, and discrimination. The narratives provide direct views of patients, supporting the key findings. Conclusion: Mental health programs and policies need to be sensitive to the consumers' needs and to organize services and to effectively decrease stigma and discrimination.
  9 10,098 1,005
CASE REPORTS
Levofloxacin-induced acute psychosis
Nagaraja Moorthy, N Raghavendra, PN Venkatarathnamma
January-March 2008, 50(1):57-58
DOI:10.4103/0019-5545.39762  PMID:19771310
A wide range of drugs can cause mental status changes.Fluoroquinolones are one among them and are underrecognised.The CNS side effects of levofloxacin like headache, dizziness, restlessness, tremor, insomnia, hallucinations, convulsions, anxiety and depression are well documented. We report a rare case of middle aged diabetic male admitted to hospital with multiple infections who developed acute psychosis following levofloxacin administration.
  8 6,666 413
ORIGINAL ARTICLES
Suicidal behavior amongst adolescent students in south Delhi
Rahul Sharma, Vijay L Grover, Sanjay Chaturvedi
January-March 2008, 50(1):30-33
DOI:10.4103/0019-5545.39756  PMID:19771304
Objective: To study the prevalence of suicidal behavior and its epidemiological correlates amongst adolescent students in south Delhi. Settings and Design: A cross-sectional study in three schools and two colleges in south Delhi. Participants: A total of 550 adolescent students aged 14 to 19 years selected by cluster sampling. Statistical Analysis: Proportions, chi square test, bivariate logistic regression. Results: About 15.8% reported having thought of attempting suicide, while 28 (5.1%) had actually attempted suicide, both being more in females than in males. Statistically significant associations were observed with the age of the student, living status of parents, working status of mother, and whether the student was working part-time. The two variables found significant on multivariate analysis were female gender and the number of role models the student had ever seen smoking or drinking. Conclusion: The prevalence of suicide-risk behavior was found to be quite high and is a matter that should evoke public health concern.
  6 6,593 874
Psychological autopsy of 101 suicide cases from northwest region of India
BS Chavan, Gurvinder Pal Singh, Jaspreet Kaur, Reshma Kochar
January-March 2008, 50(1):34-38
DOI:10.4103/0019-5545.39757  PMID:19771305
Background: The present study was conducted by the Department Of Psychiatry, Govt. Medical College and Hospital, Chandigarh, to investigate suicide cases during the year 2003. Aim: To assess the socio-demographic characteristics, psychosocial factors, and psychiatric and physical comorbidity associated with completed suicide. Materials and Methods: One hundred one suicide cases were assessed using semi-structured proforma for recording socio-demographic profile, psychosocial variables, and treatment details. Results: Majority (59.4%) of suicide victims were in the age group of 20 to 29 years. Males (57.4%) slightly outnumbered females (42.57%) in this study. As many as 57.4% of the subjects had migrated from other parts of India. Hanging was the most common method used by the suicide victims (72.2%). Psycho-social stressors were found in 61 (60.3%) suicide victims. Psychiatric illness was found in 34 cases (33.6%). However, out of them only 16 (48.5%) suicide victims sought treatment prior to the attempt. As many as 57.4% of the subjects had shown behavioral change before the suicidal attempt. Conclusions: Our study suggests that specific focus in suicide prevention strategies should be on migrant population.
  5 7,893 932
BRIEF COMMUNICATION
Serotonin transporter gene polymorphism and treatment response to serotonin reuptake inhibitor (escitalopram) in depression: An open pilot study
Mushtaq A Margoob, Dhuha Mushtaq, Imtiyaz Murtza, Huda Mushtaq, Arif Ali
January-March 2008, 50(1):47-50
DOI:10.4103/0019-5545.39759  PMID:19771307
Background: Blocking of the serotonin transporter is the main mechanism of action of SSRIs; therefore, the gene encoding this protein is a strong candidate for a possible genetic influence on the treatment response. Aim: To evaluate relationship between serotonin transporter gene promoter region polymorphism and the efficacy of SSRI (escitalopram) treatment in depression. Materials and Methods: Fifty-seven consecutive patients with unipolar depressive episode (DSM IV criteria) were genotyped for the SERT gene polymorphism and treated with escitalopram 20 mg/day. Weekly assessment (HAM-D-21) was made for treatment response up to 6 weeks. Results: Significant (P > 0.0001) difference between groups (ll vs. ss or ls) in response to treatment by escitalopram was revealed by our study. However, no difference with respect to age, gender, or onset of illness was observed between genotype subgroups. Conclusion: The study suggests that serotonin transporter gene polymorphism may have an influence on the effectiveness of SSRI treatment in depressive disorders, irrespective of clinical variables. Further controlled studies are required to validate these results
  4 5,304 427
CASE REPORTS
Hyperprolactinaemia with amisulpride
Rajnish Raj, Balwant Singh Sidhu
January-March 2008, 50(1):54-56
DOI:10.4103/0019-5545.39761  PMID:19771309
Amisulpride, a substituted benzamide derivative, is a second-generation antipsychotic that preferentially binds to D2/D3 receptors in limbic rather than striatal structures. High dosage preferentially antagonizes postsynaptic receptors, resulting in reduced dopamine transmission; and low dosage blocks presynaptic receptors, resulting in enhanced transmission. Hyperprolactinaemia may occur in patients receiving amisulpride at low dose of 50 mg/day and results in galactorrhoea, amenorrhea and sexual dysfunction. The symptom ameliorates on withdrawing the drug, switching to non-prolactin-elevating drugs, and timely management with dopamine agonist.
  3 6,241 339
BRIEF COMMUNICATION
Antidepressant-like activity of tramadol in mice
Bhupinder Singh Kalra, Vandana Tayal, Shalini Chawla
January-March 2008, 50(1):51-53
DOI:10.4103/0019-5545.39760  PMID:19771308
Objective: To evaluate antidepressant-like effect of tramadol in mice. Materials and Methods: Tramadol was administered at three different doses (10, 20, and 40 mg/kg, i.p.) once daily for 7 days to Swiss albino mice of either sex. The immobility period of control and drug-treated mice was recorded in forced swim test (FST). The antidepressant effect of tramadol was compared to that of fluoxetine (20 mg/kg, i.p.), administered for seven successive days. Results: Tramadol produced significant antidepressant effect at all the three (10, 20, and 40 mg/kg) doses, as indicated by reduction in immobility times of drug-treated mice compared to control mice. The efficacy of tramadol at doses of 10 and 20 mg/kg was comparable to that of fluoxetine, but antidepressant activity in animals administered with tramadol 40 mg/kg was significantly less as compared to fluoxetine-pretreated mice. Conclusion: The results of the present study indicate antidepressant-like activity of tramadol.
  2 4,785 356
ORIGINAL ARTICLES
Prevalence and pattern of mental disability using Indian disability evaluation assessment scale in a rural community of Karnataka
S Ganesh Kumar, Acharya Das, PV Bhandary, Shashi Joyce Soans, HN Harsha Kumar, MS Kotian
January-March 2008, 50(1):21-23
DOI:10.4103/0019-5545.39754  PMID:19771302
Background: In the present era, mental disability is a major public health problem in the society. Many of the mental disabilities are correctable if detected early. Objectives: To assess the prevalence and pattern of mental disability. Setting and Design: Community-based cross-sectional study. One thousand subjects in all age groups were randomly selected from four villages in Udupi district, Karnataka. Materials and Methods: The study was conducted by making house-to-house visits, interviewing, and examining all the individuals in the families selected with pre-designed and pretested questionnaire. Statistical Analysis: Proportions, chi-square test. Results and Conclusion: The prevalence of mental disability was found to be 2.3%. The prevalence was higher among females (3.1%) than among males (1.5%). The prevalence was higher among the elderly age group and illiterates. There is ample scope for community-based rehabilitation of the mentally disabled.
  2 10,671 1,234
CME
Deficit schizophrenia: Concept and validity
Sandeep Grover, Parmanand Kulhara
January-March 2008, 50(1):61-66
DOI:10.4103/0019-5545.39764  PMID:19771312
  1 6,914 807
EDITOR SPEAKS
Goals, dreams and deadlines
TS Sathyanarayana Rao
January-March 2008, 50(1):1-1
DOI:10.4103/0019-5545.39748  PMID:19771296
  1 2,926 286
BOOK REVIEW
Tobacco use: Health and behavior - R. C. Jiloha
MS Bhatia
January-March 2008, 50(1):75-75
  - 1,952 243
CASE REPORTS
Primary insomnia treated with Zolpidem in an 18-month-old child
Tushar Bhat, Sheryl John Pallikaleth, Nilesh Shah
January-March 2008, 50(1):59-60
DOI:10.4103/0019-5545.39763  PMID:19771311
This report describes a case of an 18-month-old child who was treated for primary insomnia with Zolpidem. To the best of our knowledge, the published literature is devoid of any information on use of Zolpidem in infants and children.
  - 4,263 238
EDITORIAL
Wake up call from 'Stars on the Ground'
TS Sathyanarayana Rao, V.S.T Krishna
January-March 2008, 50(1):2-4
DOI:10.4103/0019-5545.39749  PMID:19771297
  - 5,835 358
GUEST EDITORIAL
Are we over-dependent on pharmacotherapy?
Roy Abraham Kallivayalil
January-March 2008, 50(1):7-9
DOI:10.4103/0019-5545.39750  PMID:19771299
  - 4,191 391
HISTORY AND PSYCHIATRY
Private psychiatric care in the past: With special reference to Chennai
O Somasundaram
January-March 2008, 50(1):67-69
DOI:10.4103/0019-5545.39765  PMID:19771313
The 'madhouse' managed by Connolly and Dalton, situated in Chennai, prior to the opening of the Madras Lunatic Asylum in 1871 is described. The status of the private madhouses of England that existed before the county asylums were established in 1845 is briefly touched upon. A legitimate criticism of the shortcomings of this system along with the need for reorganization was forcibly brought by writers such as Defoe and others. Their suggestions find a place in subsequent mental health legislations. The legislation covering these aspects incorporated in the Mental Health Act 1987 form the basis for the licensing of our private mental health care centres.
  - 5,400 305
LETTERS TO EDITOR
Reflex neurosis (NEAD)
V.A.P Ghorpade
January-March 2008, 50(1):71-72
DOI:10.4103/0019-5545.39767  PMID:19771316
  - 3,098 151
Carisoprodol-induced amnestic state
Arun Gupta, K Sreejayan, Prabhat Chand, Vivek Benegal, Pratima Murthy
January-March 2008, 50(1):72-73
DOI:10.4103/0019-5545.39769  PMID:19771317
  - 3,583 135
Non-compliance of prescriptions by the patients
C Shamasundar
January-March 2008, 50(1):73-74
DOI:10.4103/0019-5545.39770  PMID:19771318
  - 2,053 207
LITERARY PSYCHIATRY
As I lie sleepless this night……
TM Raghuram
January-March 2008, 50(1):70-70
DOI:10.4103/0019-5545.39766  PMID:19771314
  - 1,984 146
A Pining
Kurien George
January-March 2008, 50(1):70-70
DOI:10.4103/0019-5545.39772  PMID:19771315
  - 1,516 94
ORIGINAL ARTICLES
A cross-sectional comparison of disability and quality of life in euthymic patients with bipolar affective or recurrent depressive disorder with and without comorbid chronic medical illness
Hema Tharoor, Ashutosh Chauhan, Podila Satya Venkata Narasimha Sharma
January-March 2008, 50(1):24-29
DOI:10.4103/0019-5545.39755  PMID:19771303
Background: There are major health care implications of quality of life (QOL) and disability in long-standing disorders such as bipolar affective disorder (BAD) and recurrent depressive disorder (RDD). Objectives: To compare the inter-episode QOL and disability in patients with the diagnosis of BAD or RDD in remission with and without comorbid chronic medical illness. Materials and Methods: Cross-sectional assessments of the four groups were carried out. Euthymic bipolar or RDD subjects with chronic comorbid medical illnesses were included in the study. QOL assessment was carried out using the World Health Organization (WHO)-QOL - Bref Kannada version. Disability was assessed using the Schedule for Assessment of Psychiatric Disability (SAPD), which is an Indian modification of the WHO Disability Assessment Schedule-II. Results: Eighty patients were enrolled into the study (20 patients in each group). The mean disability scores in the BAD group was significantly more in 'social role' (P = 0.038), and in the RDD group it was more in 'home atmosphere' (P = 0.001) in the two groups (n = 40) with chronic comorbid medical illness. In the other group without comorbid chronic medical illness (n = 40), the BAD group had significantly more disability in 'overall behavior' (P = 0.002) and 'social role' (P = 0.001), and the RDD group had significantly more disability in 'assets and/or liabilities' (P = 0.004) and 'home atmosphere' (P = 0.001). The QOL measures did not differ significantly between the two disorders. Conclusions: The presence of chronic comorbid medical illness did not cause a difference in the QOL between the two groups in periods of euthymia. However, disability measures differed significantly between the groups.
  - 4,586 597
PERISCOPE: ASSISTANT EDITORS COLUMN
Cough up for just a cup of coffee: Pharmacoeconomics of depression
G Swaminath
January-March 2008, 50(1):5-6
DOI:10.4103/0019-5545.39751  PMID:19771298
  - 3,109 280
REVIEW ARTICLE
The conscious access hypothesis: Explaining the consciousness
Ravi Prakash
January-March 2008, 50(1):10-15
DOI:10.4103/0019-5545.39752  PMID:19771300
The phenomenon of conscious awareness or consciousness is complicated but fascinating. Although this concept has intrigued the mankind since antiquity, exploration of consciousness from scientific perspectives is not very old. Among myriad of theories regarding nature, functions and mechanism of consciousness, off late, cognitive theories have received wider acceptance. One of the most exciting hypotheses in recent times has been the "conscious access hypotheses" based on the "global workspace model of consciousness". It underscores an important property of consciousness, the global access of information in cerebral cortex. Present article reviews the "conscious access hypothesis" in terms of its theoretical underpinnings as well as experimental supports it has received.
  - 11,077 609