Evaluating the Experience of a Postgraduate and Faculty Study Tour Program in the Field of Mental Health: A Mixed-methods Study.

Background: Study tours are known to have an important role in enriching the knowledge of students in all fields. Our study aimed to evaluate the experience of a postgraduate and faculty study tour in the field of mental health. Methods: We obtained both quantitative and descriptive feedback from 31 participants who had taken part in the annual study tour conducted in the years 2014-2018 using a specially designed feedback pro forma. Results: All the participants reported overall satisfaction with the tour. Learning was enhanced, and most found the tour relevant to their current field of study. They particularly enjoyed the experience of traveling in a peer group without faculty supervision and learning to make decisions as a group. Their chief concerns were about the continuous travel and the limited time allotted to each center. Conclusions: A well-planned study tour during training helps trainees in the mental health field improve their knowledge, hone practical skills, and learn life lessons; it promotes bonding with peers and fosters self-directed learning and independence. The limitations were the inability to have direct face-to-face interviews with most participants and the study tour centers being limited to a small geographical area.

Evidence for perturbed metabolic patterns in bipolar disorder subjects associated with lithium responsiveness.

Bipolar disorder (BD) is multifactorial mood disorder characterized by alternating episodes of hyperactive mania and severe depression. Lithium is one of the most preferred drug used as mood stabilizer in treating BD. In this study, we examined the changes in plasma metabolome in BD subjects in the context of lithium responsiveness. Plasma samples from clinically defined, age and gender matched unrelated healthy controls and BD subjects (lithium responders and non-responders) were obtained and processed in positive and negative mode using untargeted liquid chromatography/mass spectrometry analysis. We identified significant alterations in plasma levels of dopamine along with its precursors (tyrosine and phenylalanine), branched chain amino acid such as valine and excitatory neurotransmitter glutamate between healthy control and BD subjects. Lipid molecules such as, eicosenoic acid and retinyl ester also showed distinguished patterns between control and BD individuals. Lithium responsiveness was markedly associated with significant differences in proline, L-gamma-glutamyl-isoleucine, dopamine, palmitic acid methyl ester, cholesterol sulfate, androsterone sulfate and 9S,12S,13S-triHOME levels. Altered metabolites enriched with key biochemical pathways associated with neuropsychiatry disorders. We hypothesize that BD pathogenesis and lithium responsiveness is associated with impaired homeostasis of amino acid and lipid metabolism.

Effect of video-assisted patient education on compliance with therapy, quality of life, psychomorbidity, and cost of illness in irritable bowel syndrome.

OBJECTIVE: Patient education is important in irritable bowel syndrome (IBS), but its effects on outcomes have not been studied extensively. METHODS: Patients were enrolled and prospectively divided into an interventional and usual care group. Both received standard of care, but the former additionally received video-assisted patient education. Self-administered questionnaires IBS-quality of life (QOL), Beck Anxiety-Depression Inventory II (BAI, BDI), and Hospital Anxiety and Depression Scale (HADS) were administered at baseline, 3 months, and 6 months. Compliance was defined as drug intake of >80% of the prescribed dose. COI included prospective, prevalence-based, societal perspective. RESULTS: Of the 107 patients included, 84 [78.5%; male = 66 (78.57%); median age = 44 (range 20-77 years)] completed the follow up. While the median (inter-quartile range; IQR) QOL scores decreased significantly in both the groups (p < 0.001 for either group), the final scores were significantly better in the interventional group [49 (44-52.5) versus 80 (76-103), respectively; p < 0.005]. There was a significant improvement in the BDI; p < 0.001]. However, the rest did not achieve statistical significance. At 6 months, total median (IQR) semi-annual cost per patient was INR 14,639 (8253-17,909) [US $240 (135-294]. CONCLUSION: Video-assisted patient education should be a part of the treatment of IBS since it improves the QOL and depression scores.

Social cognition intervention in schizophrenia: Description of the training of affect recognition program - Indian version.

Social cognition refers to mental operations involved in processing of social cues and includes the domains of emotion processing, Theory of Mind (ToM), social perception, social knowledge and attributional bias. Significant deficits in ToM, emotion perception and social perception have been demonstrated in schizophrenia which can have an impact on socio-occupational functioning. Intervention modules for social cognition have demonstrated moderate effect sizes for improving emotion identification and discrimination. We describe the Indian version of the Training of Affect Recognition (TAR) program and a pilot study to demonstrate the feasibility of administering this intervention program in the Indian population. We also discuss the cultural sensibilities in adopting an intervention program for the Indian setting. To the best of our knowledge this is the first intervention program for social cognition for use in persons with schizophrenia in India.

Psychiatric evaluation in dermatology: an overview.

Psychodermatology is an exciting field which deals with the close relationship that exists between dermatological and psychiatric disorders. A combined bio-psycho-social approach is essential for effective evaluation and treatment of these conditions. This review aims to give the practicing clinician an overview of psychiatric evaluation in patients with dermatological conditions.

Relevant issues in pharmacotherapy of psycho-cutaneous disorders.

Psychiatric disorders frequently co-occur with dermatological conditions and psychotropic agents may be indicated in treating the underlying psychiatric symptoms. Use of psychotropics can be associated with significant cutaneous adverse effects as well as drug interactions with pharmacological agents used in treatment of the dermatological conditions. Knowledge of indication, contraindication, side effects, and interactions of psycho-tropics is essential for the practicing dermatologist in managing psycho-dermatological conditions. This review aims at discussing relevant issues in pharmacological management of psycho-cutaneous disorders.

Mental health consequences of the trauma of super-cyclone 1999 in orissa.

A super-cyclone hit 12 coastal districts of Orissa in October 1999 and caused over 20,000 deaths and a considerable damage to property. The psychiatric sequelae of the super-cyclone was studied using a semi-structured proforma for disaster experience, Self Reporting Questionnaire, Impact of Event Scale, Post Traumatic Symptoms Scale, Hopelessness Scale, Suicidality Screening Questionnaire, Hospital Anxiety and Depression Scale and Presumptive Stressful Life Event Scale. The coping style of the victims was also studied. It was observed that 80.4% of the subjects had probable psychiatric disorder. Posttraumatic stress disorder was found in 44.3%; anxiety disorder in 57.5% and depression in 52.7%. A considerable proportion (63.4%) of cases had comorbidity. Children and adolescents, elderly persons, lower socioeconomic status, lower educational levels, unemployment, physical injury, degree of exposure, need for evacuation, death in the family, fear of imminent death during the event, hopelessness, increased stress before disaster and past psychiatric history were associated with adverse psychological sequelae. Increase in suicidality was observed. Implications of these findings are discussed.

Predictors of outcome following alcohol deaddiction treatment : a prospective longitudinal study for one year.

The factors influencing the short-term outcome of alcohol dependence patients psychiatric set up were studied prospectively in an Indian population. Consecutive 60 patients with alcohol dependence syndrome according to the ICD 10 criteria, were studied. Positive outcome was noted in 55%, negative in 35%; and 10% were lost to follow up at the end of one year. There was no difference between the groups on educational level, marital status, economic status, religion, social support, associated physical or psychiatric diagnoses, type of treatment for deaddiction, age of regular drinking, days of previous abstinence and inpatient treatment days. However the negative outcome group were younger, and their average age for problem drinking was significantly less than the other group. They achieved many mile-stones of drinking career like onset of day drinking, development of dependence, diagnosis of dependence earlier. The negative outcome group also had higher psychosocial problem index, family history of alcoholism, more follow-up days using the mental health services. They did not come for follow up as quickly as the abstinent group after initiation of pathological drinking.The study suggested many clearly identifiable variables, which may distinguish prospectively patients with probable positive and negative outcome one year after the alcohol deaddiction treatment.