Emotional and behavioral disorders in children with epilepsy.

This cross sectional study was done to observe the prevalence of emotional and behavioral disorders in children with epilepsy, in the Department of Psychiatry, Pediatrics and Neurology, of Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh from July 2007 to June 2008. In this study, information about psychiatric disorders of 50 epileptic children, age ranging from 5-17 years with mean±SD (11.1±1.43) years, and 50 age, sex and socio-demographic status matched controls children (age ranging from 5-18 years with mean±SD (11.6±1.82) years were enrolled by parent, teacher and self version of Development And Well-Being Assessment (DAWBA) (Validated Bangla Version). Emotional disorders are more prevalent than behavioral disorders among epileptic children. Forty four percent (44%) of children with epilepsy had psychiatric disorder and this rate was significantly higher than that of healthy control (p>0.05). Disorders include major depressive disorder (20%), obsessive compulsive disorder (25%), other anxiety disorders (25%), specific phobia (15%), separation anxiety disorder (10%) and panic disorder with agoraphobia (5%).

Depressive and Anxiety Disorders among the Parents of Autism in Bangladesh: A Cross-Sectional Study.

Repeated studies found that the presence of a child with autism spectrum disorder in the family raises the psychological burden among other members, especially parents. This study was conducted to find the burden of depressive and anxiety disorders among the parents of children with Autism. This cross-sectional study was conducted at the department of Psychiatry, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from January 2016 to September 2017. A total of 227 parents of children with Autism attended at above mentioned centers were consecutively included. Data were collected through face to face interview using the questionnaire for socio-demographic variables, SCID-I CV and DASS-21 Bangla. Data were processed and analyzed using SPSS, version 17.0. The mean age of the respondents was 35.5±6.7 years; over half (54.2%) of the respondents were 30-40 years old; 62.1% were female; 37.0% were housewife. The overall 60.35% of care givers had either depressive and or anxiety disorders where 31.7% depressive disorder and 28.6% had anxiety disorders. Major depressive disorder was the most common specific diagnosis and depressive disorders were significantly higher in mother. Of the depressed parents, 11.0% had moderate, 8.4% severe and 6.2% extremely severe depression whereas in terms of anxiety disorders, 9.0% had moderate, 3.1% severe and 1.3% extremely severe anxiety. The study found about 60.0% of the care givers had at least one depressive or anxiety disorders which warrants the need for early psychological assessment as well as early intervention like psychological, familial and social support to improve the quality of life of the parents of Autism Spectrum Disorder children.

Subtypes of dissociative (conversion) disorder in two tertiary hospitals in Bangladesh.

Dissociative (conversion) disorders are common among the patients attending in and out patients of Psychiatry Department of tertiary hospitals in Bangladesh. This study was done to see the subtypes of dissociative (conversion) disorder according to International Classification of Diseases, Tenth Revision (ICD-10). This is a descriptive, cross sectional study done on 100 consecutive patients from the Departments of Psychiatry, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka and Dhaka Medical College Hospital (DMCH). Study period was July 2005 to June 2006. Among the patients of dissociative (conversion) disorder, mixed dissociative (conversion) disorder was found highest 34%, followed by dissociative convulsion 33%, dissociative motor disorders 19%, dissociative anaesthesia and sensory loss 5%, dissociative amnesia 4%, dissociative fugue 3%. However, the researcher did not find any multiple personality disorder which is relatively common in North America. This finding reflected that there are differences in prevalence of sub types of dissociative disorders in Bangladesh and Western countries.

Psychotic Symptoms in Dissociative (Conversion) Disorder in Two Tertiary Care Hospitals in Bangladesh.

Dissociative (conversion) disorder (DCR) has a long and controversial history. Some authors wish to classify it with somatoform disorders separate from dissociative disorders; many researchers keep it with DCR. Symptoms pattern also varies in different cultures. This study used the criteria of International Classification of Diseases Tenth Edition (ICD-10). Study was aimed to see the presenting symptom profile of dissociative (conversion) disorder more focusing on psychotic symptoms in tertiary care hospital in Bangladesh. This cross sectional observation was carried out in two different tertiary care hospitals in Dhaka city with preformed pretested questionnaire. Data were collected from 100 consecutive patients from July 2005 to June 2006 and data were analyzed by Statistical Package of Social Science (SPSS) 16.0. Pattern of dissociative (conversion) disorder indicated that symptoms presentations are different in Bangladesh which is difficult to categorize using existing criteria of ICD-10. Among 100 consecutive patients diagnosed as dissociative (conversion) disorder 13 patients had psychotic symptoms. Psychotic presentation of conversion disorder often creates doubts among the clinicians. Careful history taking, identifying the underlying psychosocial stressors will help clinicians to diagnose them accurately. It should be noted that the pattern of presentation in South Asia may be different due to role of culture on symptoms presentation in this region.

Prevalence of psychiatric ailments among patients with sexually transmitted disease.

A cross-sectional descriptive study conducted on 250 sexually transmitted disease patients was carried out in two teaching institutes and their tertiary hospitals. These subjects constitute a special group of population for psychiatric diagnosis by using Structured Clinical Interview for Diagnostic and Statistical Manual IIIR. The study was done in the dermatology and venereology outpatient department of two tertiary hospitals of Dhaka, between January 1998 and January 1999. The findings show that 34% of total sexually transmitted disease patients had psychiatric disorders. Anxiety disorders (11.2%) were found to be the most common disorder among these psychiatric patients; this was followed by depressive disorder (8.4%), psychoactive substance use disorder (6.8%), sexual dysfunction (6.8%), bipolar mood disorder (0.4%), and schizophrenia (0.4%). Four percent of anxiety disorder was associated with psychoactive substance use disorder and sexual dysfunction. Similarly 3.6% of depressive disorder was found with psychoactive substance use disorder and sexual dysfunction while 1.6% of sexual dysfunction was associated with substance use disorder. Most of the patients in the sexually transmitted disease population recruited in the present study had both anxiety disorder and depressive disorder though majority of them were undetected and untreated. These findings underscore that special attention needs to be given to the mental health component of our health care delivery system.

Excitatory aminoacid neurotransmitters in schizophrenia.

The study presents for the first time the blood level of glutamate and aspartate in schizophrenic patients and in normal subjects in Bangladeshi population. The serum level of glutamate and aspartate were measured in thirty newly diagnosed schizophrenic patients and the same number of subjects matching age was taken from non-schizophrenic control. The age group of the patient was between 15 and 45 years and the male female ratio was 2.7:1. Serum concentration of glutamate (598.83 +/- 574.48 nmol/ml) was significantly higher (p < 0.001) in schizophrenic group compared to control (196.16 +/- 171.31 nmol/ ml). The serum asparate concentration was also significantly higher in schizophrenic cases (282.91 +/- 299.94 nmol/ml) as compared to control (33.89 +/- 42.68 nmol/ml, p < 0.001). The correlation coefficient between serum glutamate and asparate was significant (p < 0.001). The increased serum glutamate and asparate levels may be the causative or contributing factor in the pathogenesis and progression of schizophrenia.