Indian Journal of Mental Health and Neurosciences

The research interface between psychiatry and medicine: Evolving paradigms and their implications

2024-03-29T19:51:28+00:00

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Prevalence and sociodemographic correlates of depression and anxiety among secondary school students in Chennai, South India: A cross-sectional study

2024-03-29T19:51:28+00:00

Background: Anxiety and depression are common mental disorders affecting adolescents worldwide and in India. Various factors are associated with the prevalence of anxiety and depression among adolescents, which vary between geographic, socio-cultural, and economic backgrounds. Hence, the aim of the study was to estimate the prevalence of depression and anxiety and assess the socio-demographic factors associated with them among secondary school students in Chennai, south India.

Materials and methods: A cross-sectional study was conducted among grade 9 students from four schools in Chennai. Written informed consent was obtained from the parents/guardian and assent from the students before recruitment into the study. The following tools were used to collect data: semi-structured proforma to collect the socio demographic details, perception of stress by Cohen’s Perceived Stress Scale, mental wellbeing by The World Health Organisation- Five Well-Being Index (WHO-5) and anxiety and depression assessed using General Anxiety Disorder (GAD-7) and Patient Health Questionnaire (PHQ-9), respectively.

Results: A total of 569 students (323 (56.8%) boys, 246 (43.2%) girls) participated in the study. Prevalence of anxiety and depression among study participants was 46.3% and 39.6%, respectively. On the multivariate analysis, it was observed that students whose father had a blue-collar job and higher perceived stress were significantly more likely to have anxiety and depression.

Impact of COVID-19 outbreak on mental health of undergraduate and postgraduate medical students.

2024-03-29T19:51:28+00:00

Background: The COVID-19 pandemic, the largest crisis of modern era has subjected medical students and healthcare workers to immense amount of stress due to myriad problems like exposure risk, health concerns and subsequent economic repercussions. Aim: The aim of this study was to estimate the prevalence of depressive symptoms among medical students studying in the sub-continent and in foreign medical universities during the height of the COVID-19 pandemic. Setting and design: This was a cross sectional study.

Materials and methods: A web-based survey was conducted using a specially constructed questionnaire pertaining to COVID-19 pandemic. Depressive symptoms were assessed using DASS-21 questionnaire and sleep quality with Pittsburgh Sleep quality index (PSQI), respectively. Statistical analysis: Chi-square tests was used for proportions. Pearson’s correlation analysis was done to evaluate the correlation between study DASS-21 subscales and PSQI. Multiple logistic regression was done to assess the association between study variables and the likelihood of having depressive symptoms.

Results: Postgraduate medical students and those studying in foreign universities had a significantly higher prevalence of depression than undergraduates and students studying in Indian universities, respectively. These two sub-groups also had poorer sleep quality (P<0.001). A statistically significant correlation (P<0.001) was observed between depressive symptoms and sleep quality. On multiple logistic regression, post-graduate medical students (OR=3.4), lockdown duration (OR=4.3), poorer PSQI(OR=1.2) and female gender (OR=4.1) had significantly higher odds to exhibit depression.

Conclusion: Post-graduate medical students and those studying in foreign medical universities had significantly higher prevalence of depression during the COVID-19 lockdown.

Economic burden in patients with dementia attending a geriatric care clinic in Chennai: A cost of illness study

2024-03-29T19:51:28+00:00

Background: Dementia is one of the major causes of dependency and disability among the elderly. With an increase in life expectancy, the burden of dementia is also on the rise especially in countries like India. There are economic concerns to the family as health expenses are majorly borne by them. There are few cost of illness studies for dementia from low- and middle-income countries. Our study aims to estimate the burden of costs of dementia in patients attending a geriatric clinic in a private hospital setting.

Methods: This retrospective observational study assessed the economic burden of dementia by estimating both direct and indirect costs of illness from the caregiver's perspective.

Results: Direct costs from medical services and social costs are higher when compared to indirect costs. Not all people have incurred social costs as many are provided care by the families and their inputs are not paid or accounted. The costs of informal care were under evaluated in the study.

Conclusion: The direct health care cost of illness of Dementia from caregiver perspective is more than one seventh of the per-capita income of Indian population provided indirect costs and direct social costs are not included. Evaluating various costs incurred in various health care settings is important to understand the economic burden of Dementia. There is a need for well-designed prospective studies to inform policy decisions towards better service development for persons with dementia.

Manganese toxicity presenting as acute psychosis- A case report

2024-04-05T18:17:30+00:00

Manganese poisoning is a toxic condition due to excessive exposure to manganese which can present with neurological or psychiatric symptoms. Here is a case report of a 51 years old male with occupational history, brought to the Emergency Room with two days history of acute onset behavioural disturbances. There was a history of taking Siddha medications for the last 4 months for polyarthralgia with minimal improvement. A diagnosis of organic psychotic disorder due to Manganese intoxication was made. MRI Brain plain and contrast were normal. The heavy metal screen was suggestive of high Manganese of 42 mg/ml and Cobalt of 4.4 ng/ml EEG was suggestive of generalized epileptiform abnormality. The patient was asked to refrain from further exposure to heavy metals and treated with Sodium valproate and neuro vitamins with gradual improvement in symptoms. This case report emphasizes the need for detailed evaluation and ruling out other medical conditions in a case presenting with the first episode of psychosis.

Atropine induced delirium in young female with unknown snake bite : Case report

2024-03-29T19:51:28+00:00

Venomous snakebites account for many deaths in developing countries. Administration of an Acetylcholinesterase Inhibitor (ACEI) has been recommended by WHO as a part of neurotoxic snakebite treatment. With atropine being used to reduce the undesirable muscarinic effects of ACEIs, adverse effects like delirium can occur. Delirium is characterized by acute decline in level of consciousness and cognition involving perceptual disturbances, abnormal psychomotor activity, and sleep cycle impairment. This case report describes a 17-year-old female with unknown snakebite who developed atropine induced delirium despite being under the cover of ACEIs and at a lower dose (4.5 mg) than usual for the drug to cause delirium. Though there are reports in literature about atropine induced delirium in organophosphate poisoning, to our knowledge none were reported snakebite cases. Hence, clinicians need to be cautious while encountering with such patients and should always consider the possibility of atropine induced delirium even in snakebite cases.