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Review Article
Mansi Jain, Sagar Karia, Avinash De Sousa

Clozapine-resistant Schizophrenia: Strategies for the Busy Clinician

[Year:2017] [Month:July-December] [Volumn:11 ] [Number:2] [Pages:37] [Pages No:17-23][No of Hits : 857]


ABSTRACT

Introduction: Schizophrenia is a debilitating psychiatric illness where relapse and nonrecovery are common. Clozapine has been heralded as a management option for treatmentresistant schizophrenia (TRS). The aim of the current review is to provide a clinical overview of strategies that may be used in the management of patients that fail to show an adequate response to clozapine. The term clozapine-resistant schizophrenia and its implications are discussed along with a description of various pharmacological and nonpharmacological strategies for the management of clozapine-resistant cases or partial responders to clozapine. The evidence is discussed and the strategies are presented.
There is a need for emerging strategies to augment clozapine therapy in the absence of response or in case of partial response in patients.

Keywords: Augmentation, Clozapine, Clozapine-resistant schizophrenia, Schizophrenia, Treatment-resistant schizophrenia.

How to cite this article: Jain M, Karia S, De Sousa A. Clozapineresistant Schizophrenia: Strategies for the Busy Clinician. Ind J Priv Psychiatry 2017;11(2):17-23.

Source of support: Nil

Conflict of interest: None


 
Original Article
Medhavi Gautam, Mukta Agrawal, Shiv Gautam, Manaswi Gautam

Role of Antioxidants in Depression

[Year:2017] [Month:July-December] [Volumn:11 ] [Number:2] [Pages:37] [Pages No:1-4][No of Hits : 837]


ABSTRACT

Introduction: Though there are a wide range of stress-induced disorders, depression forms the commonest stress-induced psychiatric disorder.
To combat the biochemical changes that occur as a result of stress, there is the antioxidant defence in the biological system. Secondary defence is by the nonenzymatic antioxidants like vitamin E (alpha tocopherol), vitamin C (ascorbic acid), and beta-carotene.
Therefore, the authors’ interest was aroused to examine the status of these antioxidants in the biological system of patients suffering from stress-induced psychiatric disorders.

Objectives: The study was carried out with following aims:

• To find out whether patients with depressive disorder have any differences in blood serum levels of vitamin A (betacarotene), vitamin C, and vitamin E in comparison with normal healthy control group.
• To find out whether supplementation of adequate doses of vitamin A (beta-carotene), vitamin C, and vitamin E leads to improvement in anxiety and depression and reduction in scores of the patients.

Materials and methods: Totally, 40 subjects in the age group of 20 to 60 years, who attended psychiatric clinic of a private hospital and who met inclusion and exclusion criterion of the study and consented for psychological evaluation and blood screenings for detecting the serum levels of vitamin A, vitamin C, and vitamin E were included in the study. Approval was sought from the Institutional Ethics Committee for collecting blood samples from these subjects before and after vitamin A, vitamin C, and vitamin E supplements had been given for a period of 6 weeks.

Results: It was observed that patients with depression had significantly lower levels of vitamins A, C, and E in comparison with healthy controls. After dietary supplementation of these vitamins for a period of 6 weeks, it was observed that there was significant reduction in the anxiety and depression scores of patients. A significant increase in the blood levels of antioxidants was observed in patients except that of vitamin E.

Conclusion: Findings suggest that antioxidant supplement therapy as an adjuvant therapy is useful in patients with stressinduced psychiatric disorders; the results have been discussed.

Keywords: Antioxidants, Depression, Stress.

How to cite this article: Gautam M, Agrawal M, Gautam S, Gautam M. Role of Antioxidants in Depression. Ind J Priv Psychiatry 2017;11(2):1-4.

Source of support: Nil

Conflict of interest: None


 
Review Article
Abdul Majid, Ajaz A Suhaff, Abdul Walid Khan

Psychological Autopsy: Reconstructing the Mystery of Suicide

[Year:2017] [Month:July-December] [Volumn:11 ] [Number:2] [Pages:37] [Pages No:24-25][No of Hits : 650]


ABSTRACT

The psychological autopsy is a procedure that involves the reconstruction of the motives and existential crisis of the deceased with a particular focus on suicide risk factor. In this procedure, the events and circumstances leading to death are reconstructed, and suicidal intent, risk factors, and other factors are explored thoroughly. The psychological autopsy helps in giving a lesser clouded vision of the victim profile and at times even facilitates in specifically defining the cause of death. It is at present the most direct method available for studying the relationship between particular risk factors and completed suicide. Psychological autopsy has proved to be beneficial for the masses with its systematic method to understand the psychological and contextual circumstances preceding suicide. High prevalence of mental disorders in people who have committed suicide has been found in psychological autopsy studies.

Keywords: Interviewing, Psychiatric implication, Psychological autopsy, Suicide.

How to cite this article: Majid A, Suhaff AA, Khan AW. Psychological Autopsy: Reconstructing the Mystery of Suicide. Ind J Priv Psychiatry 2017;11(2):24-25.

Source of support: Nil

Conflict of interest: None


 
Original Article
Subhra Chandra, Jayanti Basu

Posttraumatic Stress Disorder following Sociopolitical Disaster in Nandigram, West Bengal, India: Comparison between Younger and Older Group of Women

[Year:2017] [Month:July-December] [Volumn:11 ] [Number:2] [Pages:37] [Pages No:5-10][No of Hits : 593]


ABSTRACT

Introduction: The present study purported to examine the posttraumatic stress disorder (PTSD) following the sociopolitical disaster of attempted eviction of residents of Nandigram, West Bengal, India, in 2007. The study compared the prevalence of PTSD in the younger group (YG) and older group (OG) of women in a selected sample, so that appropriate psychosocial intervention strategies could be formulated in future. Data were collected from 254 women, YG = 135, OG = 119, 1 month after exposure to trauma and from 247 women, YG = 130, OG = 117, 6 months after the trauma. A General Information Schedule (GIS) and Impact of Events Scale (IES) were administered. The mean values, standard deviations (SD) of each group were calculated for scores on IES. Student’s t-test was used to calculate the significant difference between YG and OG; 1 month after the incident 59.06% revealed PTSD of moderate degree. The YG had significantly higher prevalence as compared with the OG. After 6 months, there was still a prevalence of 49.80%; however, the YG showed noteworthy improvement, whereas there was no noticeable difference in the OG. The findings indicate that exposure to traumatic event does lead to the vulnerability for development of PTSD in women, and there exists significant age difference in coping with trauma over time.

Keywords: Older group, Posttraumatic stress disorder, Prevalence rate, Sociopolitical disaster, Trauma, Younger group.

How to cite this article: Chandra S, Basu J. Posttraumatic Stress Disorder following Sociopolitical Disaster in Nandigram, West Bengal, India: Comparison between Younger and Older Group of Women. Ind J Priv Psychiatry 2017;11(2):5-10.

Source of support: Nil

Conflict of interest: None


 
Case Report
Kshirod K Mishra, Kanika Kumar

An Interesting Case of Skin Picking in an Adolescent Girl

[Year:2017] [Month:July-December] [Volumn:11 ] [Number:2] [Pages:37] [Pages No:32-33][No of Hits : 574]


ABSTRACT

Skin picking behavior described as a form of oc spectrum disorder in DSM-5. We discuss one such case in an eighteen year old girl with long standing history and how she was managed effectively with selective serotonin reuptake inhibitor and behavioral therapy.

Keywords: oc spectrum, Self-injurious behavior, Skin picking.

How to cite this article: Mishra KK, Kumar K. An Interesting Case of Skin Picking in an Adolescent Girl. Ind J Priv Psychiatry 2017;11(2):32-33.

Source of support: Nil

Conflict of interest: None


 
Case Report
Prosenjit Ghosh, Sujit Sarkhel

Internet Gaming Addiction Presenting as Withdrawal Psychosis — An Unusual Case Report

[Year:2018] [Month:January-June] [Volumn:12 ] [Number:1] [Pages:37] [Pages No:34-37][No of Hits : 326]


ABSTRACT

Introduction: In the new generation, the Internet has become an important tool for education, entertainment, communication, and information-sharing. Easy access and anonymity are two of the several aspects of the Internet fostering addictive behavior.

Case History: We report a case of young adult addicted to online mobile gaming (IAD/IUD) for 2 years and presenting with features of withdrawal psychosis following two weeks of cutting down gaming behavior.

Discussion: There are basically five types of internet addiction- Online gaming, online gambling, online auction, online chatting and cybersex. Gaming addiction is probably the most talked about internet addiction. Probably because we are seeing so many children and adolescence losing control on this type of internet addiction.

Conclusion: Further studies are necessary to investigate the nature and course of withdrawal symptoms associated with IAD/ IUD and to compare with those of substance use disorders and other forms of behavior addiction.

Keywords: Behavioral addiction, Internet use disorder, Multiplayer online battle arena, Online gaming.

How to cite this article: Ghosh P, Sarkhel S. Internet Gaming Addiction Presenting as Withdrawal Psychosis: An Unusual Case Report. Ind J Priv Psychiatry 2018;12(1):34-37.

Source of support: Nil

Conflict of interest: None


 
Original Article
Priya Puri, Prasanta K Roy, Partha S Biswas

Cognitive-emotional Processing in Borderline Personality Disorder—A Comparative Study

[Year:2018] [Month:January-June] [Volumn:12 ] [Number:1] [Pages:37] [Pages No:7-14][No of Hits : 149]


ABSTRACT

Background: Individuals having borderline personality disorder (BPD) show impulsive behaviors, intense and unstable emotional regulation with a disturbance in interpersonal relations and unstable sense of self. Studies show that emotional processes can influence various neuro-cognitive functions such as information processing and Decision making. However, there is a dearth of studies examining the role of these processes in BPD. This study aimed to examine the emotional biases of cognitive processes and decision-making ability of patients with BPD.

Materials and methods: A sample of 40 adult individuals (20 BPD patients and 20 nonpsychiatric controls), males and females, were selected. They were assessed using the emotional stroop test (EST) and the Iowa gambling task (IGT).

Results: Findings indicated that though the study group had an overall slow information processing and poor response inhibition, they had greater emotional biases towards stimuli laden with negative affect which was reflected as greater interference on the negative EST. Findings from the IGT indicated impulsivity and poor decision-making ability in the study group. Further analysis revealed that the study group had slow feedback utilization.

Conclusion: From the present study, it can be concluded that individuals with BPD do have certain deficits in cognitiveemotional processing.

Keywords: Borderline personality disorder (BPD), Decision making, Emotional processing, Response inhibition

How to cite this article: Puri P, Roy PK, Biswas PS. Cognitiveemotional Processing in Borderline Personality Disorder: A Comparative Study. Ind J Priv Psychiatry 2018;12(1):7-14.

Source of support: Nil

Conflict of interest: None


 
Brief Communication
Anil K Agarwal

Private Practice in Psychiatry in India — Development and Seasonal Variations

[Year:2018] [Month:January-June] [Volumn:12 ] [Number:1] [Pages:37] [Pages No:15-19][No of Hits : 144]


ABSTRACT

Sixteen years records of a private practice clinic have been analyzed. A total number of patients increased to three times while new patients increased to one and a half times. The reasons for a steady increase have been highlighted. The clinicians will need to improve communication as well as care for the needs and sensitivities of the patients. Seasonal variation was observed at the time of change of season. Lowest attendance was seen in February. There is a need to develop a database so that future clinicians could be guided properly.

Keywords: Development, India, Private practice, Psychiatry.

How to cite this article: Agarwal AK. Private Practice in Psychiatry in India-Development and Seasonal Variations. Ind J Priv Psychiatry 2018;12(1):15-19.

Source of support: Nil

Conflict of interest: None


 
Case Report
Akshit Mahajan, Manish Bathla, Shazia Anjum, Saminder Panchal

Prolonged Abuse of Vasograin Tablets

[Year:2018] [Month:January-June] [Volumn:12 ] [Number:1] [Pages:37] [Pages No:27-28][No of Hits : 137]


ABSTRACT

Migraine is a primary headache disorder characterized by moderate to severe recurrent headaches. We describe the case of a 33-year-old male who had been using vasograin tablets in dose of 2 to 3 tablets per day for a period of 16 years without any regular medical advice. In the absence of dose, he experienced various physical and psychological withdrawal symptoms, which were similar to migraine. Patient was managed medically with substitution and supportive therapy. Clinical importance of such cases in medical practice is discussed.

Keywords: Chronic headache, Migraine, Vasograin.

How to cite this article: Mahajan A, Bathla M, Anjum S, Panchal S. Prolonged Abuse of Vasograin Tablets. Ind J Priv Psychiatry 2018;12(1):27-28.

Source of support: Nil

Conflict of interest: None


 
Case Report
Shorouq Motwani, Sagar Karia, Nilesh Shah, Avinash De Sousa

Kleptomania Like Features in a Case of Schizophrenia Following Age-Related Cortical Atrophy

[Year:2018] [Month:January-June] [Volumn:12 ] [Number:1] [Pages:37] [Pages No:31-33][No of Hits : 119]


ABSTRACT

Kleptomania is a disorder of impulse control characterized by the impulse to steal objects that are not of much personal use or monetary value and the inability to control that impulse. Though there is a dearth of imaging studies of kleptomania, the literature suggests thatdamage of the orbitofrontal cortex and the orbitofrontal subcortical circuits may be implicated in kleptomania. The following case report presents a case of schizophrenia that developed frontal lobe ischemic changes with age resulting in the genesis of kleptomania like symptoms.

Keywords: Frontal lobe damage, Kleptomania, Orbitofrontal cortex, Schizophrenia

How to cite this article: Motwani S, Karia S, Shah N, Sousa AD. Kleptomania like Features in a Case of Schizophrenia following Age-related Cortical Atrophy. Ind J Priv Psychiatry 2018;12(1):31-33.

Source of support: Nil

Conflict of interest: None


 
Review Article
Hemendra Singh

Suicide in Schizophrenia Spectrum Disorders: A Review of Socio-Demographic and Clinical Correlates

[Year:2018] [Month:January-June] [Volumn:12 ] [Number:1] [Pages:37] [Pages No:20-26][No of Hits : 117]


ABSTRACT

Suicide is the most common cause of mortality among patients with schizophrenia. Literature shows that about 20 to 40% of schizophrenic patients make suicide attempts. Studies show that a history of past suicide attempts is a strong predictor of future suicide and increases the risk of future suicide. Suicide rates among patients with schizophrenia spectrum disorders (SSDs) range between 5 and 13%. There are various associated risk factors for suicide risk assessment, such as genetic vulnerability, gender, hopelessness, depression, underlying substance use, early phase of illness, and duration of untreated psychosis (DUP). However, the role of psychotic symptoms is also equally important while assessing for suicide risk. Hence, future research is required from appropriate risk assessment and suicide prevention among patients with SSD.

Keywords: Psychotic symptoms, Schizophrenia spectrum disorders, Suicide, Suicide attempt, Suicide prevention.

How to cite this article: Singh H. Suicide in Schizophrenia Spectrum Disorders: A Review of Sociodemographic and Clinical Correlates. Ind J Priv Psychiatry 2018;12(1):20-26.

Source of support: Nil

Conflict of interest: None


 
Original Article
Prosenjit Ghosh, Shruti Sharma

Impairment of Executive Function in Alcohol Dependent Persons

[Year:2018] [Month:January-June] [Volumn:12 ] [Number:1] [Pages:37] [Pages No:1-6][No of Hits : 114]


ABSTRACT

Aims: To compare the executive dysfunction of alcoholic dependent cases with age-matched controls.

Methods: Fifty alcohol dependent cases along with fifty healthy relatives of the patients selected randomly were included in this single interview cross-sectional hospital-based study. The executive function of all the cases and control were tested by applying the frontal assessment battery (FAB).

Results: On making a comparison of the scores of the FAB between the cases and the controls, it was found that the mean score of the cases was 10.02 with a standard deviation of 2.64 indicating more executive dysfunction whereas that of the controls was 16.96 with a standard deviation of 1.56 showing better executive functioning.

Conclusion: Regular and long-term alcohol intake significantly impairs the executive functions.

Keywords: Alcohol dependence, Cognitive functions, Executive function, Frontal lobe functions, Neocortex.

How to cite this article: Ghosh P, Sharma S. Impairment of Executive Function in Alcohol Dependent Persons. Ind J Priv Psychiatry 2018;12(1):1-6.

Source of support: Nil

Conflict of interest: None


 
Case Report
Dhananjay Chaudhari, Ganesh Shanker, Kunjan Gupta

Two Cases of Blonanserin Induced Dyskinesia

[Year:2018] [Month:January-June] [Volumn:12 ] [Number:1] [Pages:37] [Pages No:29-30][No of Hits : 112]


ABSTRACT

Blonanserin is an atypical antipsychotic with favorable outcome especially for negative symptoms of schizophrenia, and it also has some beneficial effects on cognition. It is well known that atypical antipsychotics have favorable adverse effect profile as compared to typical and conventional antipsychotics. As blonanserin is a relatively newer compound, so there is dearth of studies related to its side effect profile. Here we are reporting two cases of blonanserin induced dyskinesia.

Keywords: Blonanserin, Dyskinesia, Tardive Dyskinesia.

How to cite this article: Chaudhari D, Shanker G, Gupta K. Two Cases of Blonanserin Induced dyskinesia. Ind J Priv Psychiatry 2018;12(1):29-30.

Source of support: Nil

Conflict of interest: None


 
Editorial
Gautam Saha

Insurance Coverage of Mental Illness: A Good Beginning but a Long Way to Go!

[Year:2018] [Month:January-June] [Volumn:12 ] [Number:1] [Pages:37] [Pages No:iv][No of Hits : 83]


ABSTRACT

The Mental Healthcare Act received the nod of the president in April 2017 and became the new Act replacing the old Mental Health Act of 1987. One of the important provisions in the Act is the provision of insurance facilities for the mentally ill. According to section 21(1) of the Act,1 “Every person with mental illness shall be treated as equal to persons with physical illness in the provision of all health care.”


 
ORIGINAL ARTICLE
Gopala S Poduri

Psychiatrists’ Perception of Continuing Medical Education

[Year:2018] [Month:July-December] [Volumn:12 ] [Number:2] [Pages:27] [Pages No:46-49][No of Hits : 7]


ABSTRACT

Background: The number of continuing medical education (CME) programmes is becoming increasingly more in recent times and there were no formal reported studies among psychiatrists in India.

Objective: To find out psychiatrist’s general opinion about CME.

Materials and methods: Data were collected from a representative sample of psychiatrists in active practice about CMEs attended in the last 5 years using a proforma through email and representative contacts. The general impression about CME and faculty was collected apart from personal data. The opinion regarding CME credit hours for renewal of medical council of India (MCI) registration was obtained by a question. Data were analysed using descriptive statistics and Cronbach’s alpha was computed for reliability, validity and to know the data adequacy of the test to perform

Results: In all responses from 202 participants were analysed. Majority of responders were below 40 years (64%). More than half were in the profession for less than 10 years. Two-fifth conducted CME and nearly a third were office-bearers mostly in city associations. Sixty-six percent attended because of topic while 34% for faculty and 21% for MCI renewal. Thirty-six percent were either partly or fully sponsored by pharmaceutical companies. While 58% participants and 74% faculty found CME favorably, on the unfavourable side the figure were 21% and 51% respectively. More than half (55%) were against the need of CME for renewal of registration.

Conclusion: An unconditional positive regard may be good for psychiatric therapy but the same cannot be said of CME.

Keywords: Acceptance, Continuing medical education, Psychiatrists opinion.

How to cite this article: Poduri GS. Psychiatrists’ Perception of Continuing Medical Education (CME). Ind J Priv Psychiatry 2018;12(2):46-49.

Source of support: Nil

Conflict of interest: None


 
CASE REPORT
Tanupreet Kaur, Harneet Kaur, Sakshi Gupta, Subhash Das

A Rare Case of Drug-induced Eosinophilia Following Reintroduction of Clozapine

[Year:2018] [Month:July-December] [Volumn:12 ] [Number:2] [Pages:27] [Pages No:59-61][No of Hits : 5]


ABSTRACT

Clozapine, an atypical antipsychotic agent commonly used for treatment-resistant schizophrenia (TRS) is well known to cause blood dyscrasias among many other common side effects like sedation, sialorrhoea, weight gain and some rare side effects such as eosinophilia. Clozapine-induced eosinophilia though rare has received extensive attention and may preclude its use in the patients who may otherwise be responding well to the treatment. Although there has been evidence in the literature highlighting the rare presentation of eosinophilia in patients receiving clozapine. Here we present a rare case of undif-ferentiated schizophrenia who received clozapine in the past and tolerated it well but developed transient eosinophilia on its re-introduction.

Keywords: Clozapine, Eosinophilia, Schizophrenia.

How to cite this article: Kaur T, Kaur H, Gupta S, Das S. A Rare Case of Drug-induced Eosinophilia Following Reintroduction of Clozapine. Ind J Priv Psychiatry 2018;12(1):59-61.

Source of support: Nil

Conflict of interest: None


 
Editorial
Gautam Saha

E-learning in Psychiatry: How Effective is it?

[Year:2018] [Month:July-December] [Volumn:12 ] [Number:2] [Pages:27] [Pages No:iv][No of Hits : 4]


ABSTRACT

In today’s era, the busy clinicians often lack time to pore over thick and lengthy books to look for the information they require. For example, while writing a prescription, they have doubts regarding the safety of a psychotropic drugs in a particular medical condition. They are more likely to Google it using their smartphones rather than reach out for a book in their clinics which may or may not contain the information they require.


 
ORIGINAL ARTICLE
Prosenjit Ghosh, Jayanta Kurmi

Study of Sociodemographic and Clinical Profile of Admitted Patient Leaving Against Medical Advice from Psychiatry Ward of a Teaching Hospital

[Year:2018] [Month:July-December] [Volumn:12 ] [Number:2] [Pages:27] [Pages No:39-45][No of Hits : 4]


ABSTRACT

Introduction: Leaving against medical advice (LAMA) meaning a patient choosing to leave the hospital before the treating physician recommends discharge may result into inadequate treatment, relapse and prolonged duration of illness.

Aim and objectives: The aim of this study was to assess the prevalence, reasos for LAMA, sociodemographic variables and clinical profile of such patients.

Materials and methods: Retrospectively data were obtained from indoor register of a Psychiatry department of a teaching hospital for patients opting LAMA, during a period of 18 months from January 2017 up to June 2018. International Classification of Disease (ICD)-10 criteria was used for the diagnosis purpose.

Results: Out of 569 patients admitted during the study period total 60 patients fulfilled the criteria for LAMA. The frequency of LAMA was found to be 10.5%. LAMA was found to be more common in those below age 40 years (85%), in those from non-urban background (75%), who were educated up to high school (71%), who were suffering from neurotic, and psychotic and substance abuse disorders. The commonest reason cited for LAMA was going to faith healer and most of the LAMA occurred within first four days of hospitalization.

Conclusion: Leaving against medical advice (LAMA) is a frequent problem in psychiatric inpatients and is a matter of great concern for the treating doctors.

Keywords: Faith healer, Leaving against medical advice, Substance abuse.

How to cite this article: Ghosh P, Kurmi J. Study of Sociodemographic and Clinical Profile of Admitted Patient Leaving Against Medical Advice from Psychiatry Ward of a Teaching Hospital. Ind J Priv Psychiatry 2018;12(2):39-45.

Source of support: Nil

Conflict of interest: None


 
CME
Imon Paul

Newer Updates in Psychiatry: Focus on Vortioxetine

[Year:2018] [Month:July-December] [Volumn:12 ] [Number:2] [Pages:27] [Pages No:62-65][No of Hits : 3]


ABSTRACT

Vortioxetine is the new antidepressant on the block which has been described to have a novel mechanism of action-it directly works on multiple receptors of the neurotransmitter serotonin and it also inhibits serotonin reuptake. It has been shown to have promising antidepressant, antianxiety and pro-cognitive action especially during treatment of major depression. This article gives a brief overview of vortioxetine-its clinical use, pharmacological profile, and safety and tolerability. Most of the studies till date have found vortioxetine to be clinically efficacious, and it also improved the cognitive profile in patients with depression. It has a favorable adverse effect profile- it has been shown to be tolerated well by most subjects in clinical trials where nausea was the most frequently reported side effect, and it also showed the added advantage of comparatively less incidence of unwarranted sexual adverse effects.

Keywords: Adverse events, Major depressive disorder, Vortio-xetine.

How to cite this article: Paul I. Newer Updates in Psychiatry: Focus on Vortioxetine. Ind J Priv Psychiatry 2018;12(2):62-65.

Source of support: Nil

Conflict of interest: None


 
Obituary
Mrugesh Vaishnav

Obituary

[Year:2018] [Month:July-December] [Volumn:12 ] [Number:2] [Pages:27] [Pages No:66][No of Hits : 3]


ABSTRACT

It takes education and knowledge to become a good psychiatrist and to be clinically sound to become a good and successful medical practitioner. But to be a pioneer and leading frontman in a field which in the 1980s was a stigma is a life time achievement only few would be worthy of acquiring.


 
REVIEW ARTICLE
Krishna M Singh, Regina R Khakha, Roshan V Khanande

Antioxidants Used in the Treatment of Various Psychiatric Disorders

[Year:2018] [Month:July-December] [Volumn:12 ] [Number:2] [Pages:27] [Pages No:50-54][No of Hits : 3]


ABSTRACT

Aim: To review the place of antioxidants in the treatment of psychiatric disorders, and to weigh it against the criticism for such treatments.

Background: Oxidative stress leads to aging, and antioxidant use (naturally available in food and supplementations) is one of the dietary modality for health promotion with major benefits. Antioxidants have also been used in treatment and prevention of many medical disorders. Brain, one organ using oxygen abundantly, and for its high lipid content suffers from oxidative stress. Even postmortem studies of brains of individuals with psychiatric disorders show degenerative changes possibly due to long-term damage by oxidative stress. Hence, the use of antioxidants in treating psychiatric disorders is one of the new areas of research in psychiatry.

Review results: Many agents have been used in the treatment of psychiatric disorders. Gingko biloba, Selegiline, omega-3-triglycerides, vitamin E, and N-acetyl cysteine have been found useful as adjuncts in the treatment of schizophrenia. Similarly, the usefulness of adjunct N-acetyl cysteine and ethyl-eicosapentaenoic acid (EPA) treatment in bipolar depression is reported. omega-3-triglycerides have also been used in the treatment of dementia as an adjunct with mixed results. Ubiquinol has shown promise in treating autism.

Conclusion: The results of adjunct antioxidant treatment in psychiatry have been mixed with at times conflicting results. Much research is required to establish their place as a treatment modality in psychiatry.

Clinical significance: Use of antioxidants in the treatment of psychiatric disorders, at Max, currently, is of adjunct value only; even the cost-effectiveness of such treatments has to weighed against the useful clinical utility.

Keywords: Antioxidants, Gingko biloba, Omega-3-triglycerides, Psychiatry, N-acetyl cysteine.

How to cite this article: Singh KM, Khakha RR, Khanande RV. Antioxidants Used in the Treatment of Various Psychiatric Disorders. Ind J Priv Psychiatry 2018;12(2):50-54.

Source of support: Nil

Conflict of interest: None


 
CASE REPORT
Seshadri S Chatterjee, Guru S Gowda, Soumitra Das, Adesh K Agrawal

Klein Levin Syndrome and Cavum Verge: A Midline Rarity

[Year:2018] [Month:July-December] [Volumn:12 ] [Number:2] [Pages:27] [Pages No:55-56][No of Hits : 3]


ABSTRACT

Klein Levin syndrome (KLS) is rare triad of episodic hypersom-nolence, hyperphagia, and hypersexuality. Cavum verge (CV), although, mainly reported as a non-pathological, incidental, neuro-radiological abnormality by itself, may sometimes be associated with behavioral and psychiatric abnormalities. We here present a case of KLS with the magnetic resonance imaging (MRI) finding of Cavum verge. We then discuss the current literature of both the disorders and try to find some heuristic associations, if any, between the two.

Keywords: Cavum verge, Hypersomnia, Klein Levin syndrome.

How to cite this article: Chatterjee SS, Gowda GS, Das S, Agrawal AK. Klein Levin Syndrome and Cavum Verge: A Midline Rarity. Ind J Priv Psychiatry 2018;12(2):55-56.

Source of support: Nil

Conflict of interest: None


 
CASE REPORT
Subir Bhattacharjee, Sujit Sarkhel

Very Early Onset Mania with Hypersexuality in a 4.5-Year-Old Child: A Case Report

[Year:2018] [Month:July-December] [Volumn:12 ] [Number:2] [Pages:27] [Pages No:57-58][No of Hits : 1]


ABSTRACT

Bipolar mood disorder (BPD) may manifest as the first episode of mania as early as below 6 years old. There are controversies regarding its diagnoses as because of sharing of symptoms with disruptive mood dysregulation disorder (DMDD), attention deficit hyperactivity disorder (ADHD) and conduct disorder. Hypersexuality was found to be a prominent feature in early-onset bipolar disorder (EOBD). Here is a case report of first episode mania in a child of 4.5 years old with a prominent feature of hypersexuality who responded well with valproate and risperidone.

Keywords: Childhood hypersexuality, Childhood mania, Very early onset mania.

How to cite this article: Bhattacharjee S, Sarkhel S. Very Early Onset Mania with Hypersexuality in a 4.5-Year-Old Child: A Case Report. Ind J Priv Psychiatry 2018;12(2):57-58.

Source of support: Nil

Conflict of interest: None


 
Case Report
Avinash De Sousa

Isolated Sleep Paralysis in a Case of Panic Disorder

[Year:2017] [Month:July-December] [Volumn:11 ] [Number:2] [Pages:37] [Pages No:36-37][No of Hits : 481]


ABSTRACT

We present herewith a case of isolated sleep paralysis (ISP) which entails a transient, generalized inability to move or speak, i.e., usually seen during the patient’s transitions between sleep and wakefulness. We report the case of a 33-year-old man with recurrent ISP and panic disorder. The patient sought help after nearly 6 years of symptoms as he thought that the symptoms were part of his nocturnal panic attacks. Isolated sleep paralysis is seen in conjunction with multiple anxiety disorders and the symptoms may mimic anxiety, thereby confounding the diagnosis. It is prudent that clinicians keep in mind sleep paralysis as a differential diagnosis in anxiety disorders as all cases of freezing at night may not be nocturnal panic attacks.

Keywords: Panic attacks, Panic disorder, Sleep, Sleep paralysis.

How to cite this article: De Sousa A. Isolated Sleep Paralysis in a Case of Panic Disorder. Ind J Priv Psychiatry 2017;11(2):36-37.

Source of support: Nil

Conflict of interest: None


 
Review Article
Preeti Gupta, Shrikant Srivastava

Use of Pupillometry in Dementia: A Review of Published Literature

[Year:2017] [Month:July-December] [Volumn:11 ] [Number:2] [Pages:37] [Pages No:26-31][No of Hits : 420]


ABSTRACT

Introduction: Diagnosis of Alzheimer’s disease is based on clinical symptomatology supplemented with neuroimaging findings. While there are invasive techniques like lumbar puncture and expensive techniques like positron emission tomography/ single photon emission computed tomography (PET)/SPECT imaging available for diagnosis, none of these are totally accurate. Thus, there is a need for a cheap and noninvasive technique for diagnosing Alzheimer’s dementia. Pupillary light reaction or pupillometry is one such technique based on the hypothesis that the pupillary size and reaction are governed by the cholinergic system of the brain, which is deficient in Alzheimer’s dementia.
A review of the studies showed that pupillary measures have been studied in patients with or without mydriatic/miotic agents and in those receiving anticholinergic esterase medications. These studies are discussed in detail in this review.

Keywords: Alzheimer’s disease, Light reaction, Parkinson’s disease, Pupillometry. How to cite this article: Gupta P, Srivastava S. Use of Pupillometry in Dementia: A Review of Published Literature. Ind J Priv Psychiatry 2017;11(2):26-31.

Source of support: Nil

Conflict of interest: None


 
Editorial
Gautam Saha

Using smartphones in Psychiatry for service delivery

[Year:2017] [Month:July-December] [Volumn:11 ] [Number:2] [Pages:37] [Pages No:iv-v][No of Hits : 343]


ABSTRACT

The number of mobile phones in India just crossed 1 billion; 323 million accessed internet in 2016, which happens to be 23.4% of total population.1 India is supposed to have more users than USA. Sometimes it is jokingly said that there are mobile phones in the family but no toilets. Even village teenagers are using smart phones with both front and rear camera. This is one thing that is advantageous in use of technology in delivering mental health care. Most of the population is young and techsmart. Mental health morbidity in India is 10.6% with 6% showing suicidal risk. Treatment gap is 85% for common mental disorders and 95% for substance use disorders (NIMHANS SURVEY).2 This huge gap can be bridged through use of appropriate technology particularly digital technology.3


 
Case Report
Udayan Majumder, YR Niranjan Hebbar, Amit K Gupta, RK Lenin Singh

Rare Association of Schizophrenia in a Patient with Multiple Exostoses

[Year:2017] [Month:July-December] [Volumn:11 ] [Number:2] [Pages:37] [Pages No:34-35][No of Hits : 330]


ABSTRACT

We report the case of a patient who suffered from schizophrenia with multiple exostoses (osteochondromatosis) and admitted in our psychiatric ward and argue about the possible role of exostosin (EXT) gene and its nearly chromosomal loci in further genetic studies of schizophrenia.
Only three cases have been reported till date which tried to associate coexistence of multiple exostoses and schizophrenia, thereby guiding further studies in genetic etiology of schizophrenia.

Keywords: Genetics, Multiple exostoses, Osteochondromatosis, Schizophrenia.

How to cite this article: Majumder U, Hebbar YRN, Gupta AK, Singh RKL. Rare Association of Schizophrenia in a Patient with Multiple Exostoses. Ind J Priv Psychiatry 2017;11(2):34-35.

Source of support: Nil

Conflict of interest: None


 
Review Article
Alka A Subramanyam, Shipra Singh

“Double Patients”: Managing Psychological Symptoms in Caregivers of Patients with Dementia

[Year:2017] [Month:July-December] [Volumn:11 ] [Number:2] [Pages:37] [Pages No:11-16][No of Hits : 327]


ABSTRACT

Caregivers of patients with dementia are a vulnerable population themselves. They go through various phases of roles, based on the stage of the illness. There is a phase of acquiring the caregiving role, defining the quantum of involvement, and also finally dealing with eventual loss and the re-defining the role once the loss is final. This put the caregivers through a lot of stress, and makes them vulnerable to a host of psychological concerns themselves.

Through a series of cases, this article attempts To understand caregiver issues, and find a way to help, as well as shown how a lot of hand-holding at each stage aids the caregiver from reaching burn out and at times depression.

Keywords: Burn out, Caregiver, Dementia, Role transition.

How to cite this article: Subramanyam AA, Singh S. Double Patients”: Managing Psychological Symptoms in Caregivers of Patients with Dementia. Ind J Priv Psychiatry 2017;11(2):11-16.

Source of support: Nil

Conflict of interest: None



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