Marital and family relationships among women with severe mental illness during perinatal period admitted to a mother baby psychiatric unit, India

Background: Pregnancy and transition to parenthood is often a stressful event and brings about more profound changes than any other developmental stage of the family life cycle. Consequently, pregnancy and post-partum are times of increased vulnerability for the onset or relapse of a mental illness. The current paper aimed at understanding the marital and family relationships among women with severe mental illness during the perinatal period in India. Methods: The study included a retrospective chart review of mothers admitted to a mother-baby unit between the years January 2015 to March 2020. We included all mothers who were married and had onset of SMI in the perinatal period. Details of socio-demographic, clinical profile and descriptive understanding of relationships were collected. Results: The total sample was 149, mean age of women in years was 25.27 (SD=4.97). The clinical diagnosis included non-affective psychosis (45.5%), affective psychosis (42.2%) with 130 (87.24%) women having their first episode of SMI during the postpartum period. More than half of the women admitted to the ward reported having problems in their marital relationship, with 25% experiencing violence from their spouses and in-laws. Interpersonal issues with their in-laws in the context of violence, household chores and poor support. Conclusions: This study highlights the importance of routine assessments of the quality of marital and family relationships including domestic violence. There is a need to provide interventions aimed at helping women deal with difficulties in intimate and social relationships.

Fenestration of the posterior communicating artery.

A 21-year-old male presented with sudden onset of right-sided third nerve paresis. Angiogram showed a fenestrated posterior communication artery on the right side and no other vascular anomalies. There was no other lesion that could suggest a cause for the third nerve weakness. Fenestration of the posterior communicating artery has not been reported till date. The case is discussed and the literature on the subject is reviewed.

High-risk sexual behaviour & sensation seeking among heavy alcohol users.

BACKGROUND & OBJECTIVES: An association has been shown between alcohol use and high-risk sexual behaviour. One of the important variables that might mediate risky sexual behaviour among alcohol users is the sensation-seeking dimension of personality. This study was undertaken with the aim to assess the relationship between sensation seeking and sexual risk taking among heavy alcohol users admitted to a De-addiction centre. METHODS: To study the above association, sensation seeking was compared between subjects admitted for treatment of alcohol dependence with (n = 30) and without (n = 30) reported high-risk sexual behaviour. RESULTS: Subjects reporting high-risk sexual behaviour were found to have higher sensation seeking scores in all the domains of the sensation seeking scale compared to those without high-risk sexual behaviour. Scores on the subscale disinhibition, of the sensation seeking scale seemed to be associated with higher sexual risk taking. INTERPRETATION & CONCLUSION: Sensation seeking as a personality variable was significantly associated with sexual risk taking behaviour among heavy alcohol users. The study indicates the need for careful assessment of personality in these individuals and emphasizes the need for further studies on a larger sample.

Giant ocular nerve neurofibroma of the cavernous sinus: a series of 5 cases.

Five cases of giant cavernous sinus neurofibroma arising from the ocular cranial nerves are reported. These patients collected over a period of 5 years consisted of 3 males and 2 females with an age range of 9 to 40 years and a mean of 20.6 years. Clinically, all patients presented with ocular palsies over a long period (mean 3.4 years). All of them underwent a frontotemporal craniotomy along with an orbito-zygomatic osteotomy and excision of the tumour. In patients with extension of the tumour into the orbit, the superior orbital fissure was drilled, the tenon's capsule was cut and the intraorbital portion was excised. The management of these tumours is discussed and the literature reviewed.

Cerebellar medulloblastoma in a 65 year old Indian male.

A case of cerebellar medulloblastoma in a 65 year old male is reported. Cerebellar medulloblastoma is classically seen during childhood, and less than 25% of these tumours are found in adults below 40 years of age. Rarely, cases are reported above the age of 40 years. So far only three cases have been reported in patients aged above 64 years and none of these case reports are from India.

Depression in women--issues in evaluation and management.

Depression is probably the most common psychiatric disorder in women. Women are a vulnerable group of depression due to psychological, social and biological factors. Marital relationships, social support, roles and self esteem are factors that contribute to depression. In addition, several periods in women's life relating to the reproductive cycle are periods of increased vulnerability. Management of depression in women should consist of detailed assessment of all the above factors. Drug treatment of depression in women requires an in depth understanding of pharmacokinetics of the drugs used and possible drug interactions. Treatment of depression in women should integrate both psychosocial and biological treatment modalities.

Intramedullary spinal epidermoid cyst.

Intramedullary epidermoid cysts of the spinal cord are rare tumours, especially those not associated with spinal dysraphism. Around 50 cases have been reported in the literature. Of these, only seven cases have had magnetic resonance imaging studies. We report two cases of spinal intramedullary epidermoid cysts with MR imaging. Both were not associated with spina bifida. In one patient the tumour was located at D4 vertebral level, while in other within the conus medullaris. The clinical features, MR imaging characteristics and surgical treatment of such rare intramedullary benign tumours are discussed, and the relevant literature reviewed.