Current Issue Volume 11, Number 2 , July-December 2017

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]



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


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]



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


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]



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


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]



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


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]



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


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]



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


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]



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


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]



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
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]



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


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]



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


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