A Study of the association of neurocognition with relapse and quality of life in patients of alcohol dependence.

Background: Alcohol is a widely consumed substance associated with around 5.6% of all causes of death. Alcohol use disorder (AUD) is a chronic relapsing and remitting illness and has been known to be associated with impaired executive functions, processing speed, memory, attention, and fluency. It is also associated with impaired quality of life (QoL), which in turn can affect overall prognosis. Aim: To assess neurocognition in patients with alcohol dependence and correlate it with QoL and relapse. Materials and Methods: This study was a prospective, longitudinal study of sixty alcohol dependence patients from January 2020 to June 2021 after appropriate ethical approval. Participants were assessed for baseline alcohol dependence, neurocognition (focused, sustained and divided attention; processing speed; verbal and category fluency; working memory; response inhibition; verbal comprehension; verbal learning and memory; visuospatial construction; visual learning and memory) and QoL using Alcohol Use Disorders Identification Test (AUDIT), National Institute of Mental Health and Neurosciences (NIMHANS) battery for neurocognition and WHO-BREF (WHO-Quality of Life-short-form scale) World Health Organization-scale, respectively. A follow-up was conducted in three months to assess relapse in the patients. Statistical analysis was conducted by International Business Machines Statistical Package for the Social Sciences (IBM SPSS) v16. Results: Mean age of the study participants was 41.3 ± 5.03 years, mean age of onset of alcohol use was 20.88 ± 4.27 years, mean duration of alcohol use of 16.6 ± 7.92 years, and average 14.55 ± 4.86 drinks per day. The mean AUDIT score of the study population was 25.21 ± 7.18. There was significant positive correlation between duration of use and CTT-2; 37 out of 57 participants relapsed to alcohol (three participants had died in follow-up) with mean 37.48 ± 23.27 days of relapse, mean 3.32 ± 1.2 drinking days per week, and mean 6 ± 1.2 drinks per drinking day. There was negative and positive correlation between neurocognition and relapse and between neurocognition and QoL. Conclusion: Alcohol use also resulted in impaired cognitive function of the study participants. There was also significant difference in score for neurocognition test between relapse and abstinent group. The significant correlation between neurocognition and QoL as well as neurocognition and relapse proves the deleterious effect of alcohol in every aspect of life.

Academic stress in high school students during the transition from online to offline exams: A retrospective study from post-COVID-19 era.

Background: Stress is a common phenomenon. Everyone faces stress, albeit of different intensity and due to different reasons. Stress in students can be due to many reasons-non-academic and academic. Academic stress is a major deciding factor in the fluctuation in academic achievements. It has also been implicated in mental illnesses like depression, anxiety, sleep disorders, and even suicide, and physical illnesses like hypertension, obesity, etc., Additionally, post-COVID-19 pandemic in 2020, there have been adverse effects on the education sector due to the offline-online mode of classes. Aim: To assess academic stress in high school students, to compare stress between male and female students, and to find the correlation of academic stress with the 10th standard's result, i.e. percentage. Material and Methods: A retrospective study was designed by the Department of Psychiatry, of a medical college of Madhya Pradesh in schools of Khandwa and nearby areas from June 2022 to August 2022. A total of 162 high school students were selected as per inclusion and exclusion criteria. Perception of Academic Stress (PAS) scale and Scale for Assessing Academic Stress (SAAS) were used to assess academic stress. Statistical analysis was done by SPSS version 25 using the Student t-test and Pearson correlation tests. Results: The mean age of the study participants was 15.82 ± 0.81 years. There was a significant difference in the mean percentage of the 9th and 10th standard. Both genders differed significantly in class percentages, but not the mean SAAS score. Most students had moderate stress. Only the cognitive indicator of SAAS was found to be significantly correlated with 10th standard percentages. Conclusion: Academic stress is ubiquitous. External factors like the transition from online to offline exams in addition to anticipation of the exams themselves can add to the stress. Prompt identification of stress can alleviate the emergence of future psychiatric illnesses.

Sociodemography, pattern, and response inhibition in suicide survivors: A case-control study.

Introduction: Suicide is a global phenomenon. Psychiatric disorders are estimated to contribute to a large proportion of suicides; however, impulsive suicide is also common. Among the ages of 15-29 years, suicide was the second leading cause of death worldwide and has been hypothesized to have reduced response inhibition and decision-making abilities as contributing factors, which directly relate to impaired executive functioning and suicidal behavior. Aim: This study aimed to study sociodemography, method, and pattern of suicide, and response inhibition in suicide survivors. Material and Methods: A case-control study was designed in a tertiary medical center in Madhya Pradesh using convenient sampling of suicide survivors and controls from the general population over 3 months. Data collection was semi-structured pro forma, and response inhibition was assessed using the Stroop test. Statistical analysis was performed using IBM Statistical Package for the Social Sciences (SPSS) Windows version 25.0. Independent-samples Student's t-test, Chi-square test, and Mann-Whitney U-test were used for analyzing means of continuous data, nominal data, and ordinal data, respectively. The level of significance was at P < 0.05. Result: A total of 126 suicide survivors and 99 controls were assessed after the end of the study period. Age (mean age for cases 25.4 ± 9.16; controls 23 ± 7.9), gender (F ~ M), and socioeconomic status were used to match cases and controls. 85.7% of suicide survivors had no history of suicide, but the majority had precipitating factors. Anomic suicide was the most common type, and poisoning was the most common method of suicide. Response inhibition between cases and control was significantly different. Conclusion: The majority of suicide attempts were impulsive in youth, with no gender discrimination. Response inhibition seemed to play a role in a suicide attempt.

Prevalence of internet gaming addiction and its association with sleep quality in medical students.

Background: In Asia, there are approximately 2.3 billion internet users. Addiction to internet gaming takes a multifaceted toll on an individual's physical and mental well-being, casting a long shadow over their daily endeavors and also their sleep cycle. Aim: To study the prevalence of internet gaming addiction and how it affects sleep quality in medical students. Materials and Methods: A cross-sectional study was performed with a sample size (n = 112) in the Government Medical College, Datia (M.P.), and data were collected using a semi-structured proforma including the Internet Gaming Disorder Scale and Mini Sleep Questionnaire in the study population. Results: In the study population with age group 18-28 years (mean age: 21 ± 1.7 years), the majority of them belong to the Hindu religion (91.1%), nuclear family (66.1%), and urban community (75.9%). Most students (n = 74) had mild to moderate sleep difficulty related to internet gaming addiction, that is, 65.1%. The most common response was "sometimes" on the Internet Gaming Disorder Scale. A significant association was observed between gaming disorder and parameters of sleep mainly in waking up too early, daytime sleepiness, snoring, feeling tired, and headache upon waking up with gaming disorder. Conclusion: Among medical students, gaming addiction is significantly associated with poor sleep quality. Steps need to be taken to promote healthy internet use to improve sleep quality and mitigate negative effects to avoid long-term health impacts.

Psychiatric presentation in undiagnosed intracranial space-occupying lesions: A case series.

Intracranial space-occupying lesions (SOLs) account for about 5-10 deaths per 100,000 in India. They present with physical symptoms such as headache, nausea, vomiting, and weakness; neurological symptoms such as seizures, and focal neurological deficit; and behavioral changes manifesting as depression (15-20%), anxiety (30-50%), psychosis (<5%), and personality changes (16-76%). Therefore, it is necessary to do an appropriate general, neurological, and behavioral examination for proper diagnosis and management. A series of four cases who reported to psychiatric outpatient with behavioural complaints and no focal neurological deficits were reported. The most common presentation of SOLs is seizure, headache, vomiting, and loss of consciousness. Along with this complaint, some patients may present with abnormal behavior. However, it is very rare for a SOL to present solely with psychiatric or behavioral complaints. Therefore, it becomes imperative to keep a close watch on the symptoms and send for timely investigations.

Prevalence of medical comorbidity in early onset versus late-onset depression in Vindhya region.

BACKGROUND: Late-onset depression differs significantly from early-onset depression according to clinical features, physical comorbidities, cognitive impairment, and cerebrovascular abnormalities, which suggest that these might have differing etiopathological pathways toward the depressive phenotype. AIM: The aim of the study was to identify comorbid physical disorders with late-onset depression. METHODS: The present cross-sectional study was conducted in inpatients of the Department of Psychiatry during a period of 18 months. A study consisted of 60 patients of first depressive episode diagnosed using International Classification of Diseases-10 criteria, segregated 2 different groups of Early onset depression (between 40 and 65 years) and late-onset depression (LOD) (>65 years) with 30 patients each. RESULTS: In LOD group, predominant comorbidities were hypertension 56.6%, cerebrovascular disease 36.6%, diabetes 33.3%, cardiovascular disease 23.3%, and anaemia 23.3%, followed by respiratory illnesses, arthritis, benign prostatic hyperplasia and cirrhosis. While, in early-onset depression group, common comorbidities were hypertension (13.3%), anemia (10%), arthritis (10%), and diabetes (6.6%). CONCLUSIONS: Hypertension cerebrovascular disease, diabetes, and cardiovascular disease were the predominant comorbidities in late-onset as well as early onset depression.