Aim: The study investigate the severity of perceived stress and wide domains of psychiatric symptoms reported on initial screening in hospitalized patients of COVID-19 with a second aim to determine the role of sociodemographic factors and coping styles in the hospitalized patients of COVID-19. Method: Total 224 patients of COVID-19 infection, hospitalized in various isolation facilities were assessed via web-based self-reported questionnaires on perceived stress scale, brief cope inventory, and DSM-5 crosscutting level-1 questionnaire. Results: Majority of the patients reported moderate level of stress followed by mild and severe. Depression and Anxiety symptoms were most common psychopathologies though the patients have reported greater severity in various domains of psychiatric symptoms. Coping styles explains most of variance (64.8%) of the perceived stress. Similarly total PSS scores, coping styles, COVID-19 status and sociodemographic factors contributed significantly to the variance of all psychiatric symptoms. Conclusion: Factors like female gender, being married, belonging to nuclear families, service class and urban domicile are the significant factors determining higher risk of stress and developing more psychopathologies. Furthermore, coping styles used by the patients have a greater moderating effect on mental health symptoms and their perceived stress which can be a major area for interventions to reduce the mental health morbidities.
Background: Women who have gone at least a year without having their monthly period are considered as menopausal. Despite the fact that it is a physiological occurrence, its psychological, bodily, and sexual effects last for the entire postreproductive period. That's why it is important to research its various aspects and the different parameters associated with their quality of life (QoL). Objective: To find the association of the QoL among menopausal women in Lucknow with various socio-demographic variables, body mass index, chronic disease status, and other lifestyle parameters. Materials and Methods: A community-based cross-sectional study was conducted from February 2020 to January 2021 among 200 Menopausal women of 45-65 years by using a pretested semi-structured questionnaire. The study was carried out in rural and urban field practice areas of the Community Medicine Department, King George's Medical University, UP, Lucknow. Results and Conclusion: The mean score of vasomotor domains was found higher in the age group of 45-49 years, who had higher education level, upper and upper middle class of socioeconomic status, and for obese study participants. The mean score of the sexual domain was found to be higher among the age group 55-59 years, married study participants, for those who were educated above secondary, and for overweight and obese. The mean scores for all domains, i.e., vasomotor psychosocial physical and sexual domains were higher for those who had chronic diseases. Overall, the menopause specific QoL score was higher for those who did not use lifestyle modification as compared to those who used lifestyle modification and the difference was found to be highly significant (P < 0.001).
Background: Dhat syndrome, a clinical condition related to semen loss in urine often found among males in India, has rarely been described as a separate clinical condition in females. Women with the syndrome complain of passing vaginal discharge and can be excessively concerned and preoccupied with it, often attributing various physical symptoms to the loss of vaginal fluids. Aims: This study aimed to assess the sociodemographic and clinical profiles of female patients with Dhat syndrome and their perceived stress, disability and sexual functioning. Methods: Sociodemographic details of 70 females with non-pathological vaginal discharge were evaluated with a semistructured sociodemographic assessment. The phenomenology of the vaginal discharge was assessed with the Scale for Assessment of Female Dhat Syndrome Questionnaire. Anxiety and depressive symptoms were measured with the Hospital Anxiety and Depression Scale. Perceived stress in the past month and disability caused by the illness were assessed with the Perceived Stress Scale and the World Health Organization Disability Assessment Scale. In addition, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Level 2 Somatic Symptoms Scale was administered to rate the severity of somatic symptoms, and sexual functioning was evaluated using the Female Sexual Function Index (FSFI) scale for women who had had sexual intercourse in the past month. Results: The mean age of onset vaginal discharge was 23.0 (6.6) years. Biological factors, such as urinary tract infection, were the commonly attributed cause of the loss of vaginal fluids. Psychiatric comorbidity and perceived moderate stress in the past month were found in 38.6% and 68.6% of female patients with Dhat syndrome, respectively. Disability scores tended to be low. Among the females having had sexual intercourse in the past month, 48.3% had FSFI scores indicative of a female sexual disorder. Conclusions: The clinical presentation of women with non-pathological vaginal discharge is similar to that of males with Dhat syndrome. It requires comprehensive assessment and management that targets the biological, social and psychological factors and cultural issues.
Epidural Hematoma (EDH) is a common condition of traumatic brain injury. It has a good prognosis if prompt surgical intervention is conducted. There is a dearth of studies on neuropsychological assessment of executive functioning exclusively in post-operative EDH patients. Moreover, age as a variable in determining executive functions in patients post-head injury, has been studied mostly in the older adults. This cross-sectional case-control study assessed Executive Functions (EF) in 62 post-surgery patients with EDH and compared 57 healthy controls (HC) using standardized assessment tools of sustained attention, speed, working memory, fluency, set-shifting, perseveration, planning, and response inhibition. Further, executive functions in two phases of adulthood, viz. Early Adulthood (20-39 years) and Middle Adulthood (40-60 years) were compared in the EDH group (E-EDH and M-EDH) and HC (E-HC and M-HC). A two-way Analysis of Variance (ANOVA) and correlational analysis was conducted. Results showed a trend where the M-EDH group performed significantly poorer on executive function tests (viz a viz., time taken, errors, and correct responses), followed by E-EDH, M-HC, and E-HC. The main effect of age was found significant on Digit Symbol, Color Trail 1, N-Back 2, Animal Naming, and Stroop Effect (p < 0.01 level) while N-Back 1, WCST-PE, and Tower of London (p < 0.05 level). The findings have significant clinical and therapeutic implications. In addition, it gives guidance regarding planning specific neuropsychological tests and rehabilitation targeting specific areas of executive functions decline due to age in EDH post-surgery patients.
INTRODUCTION: The role of increased oxidative stress and alterations to the nitric oxide (NO) pathway have been implicated in major depressive disorder (MDD). The two pathways interact closely with each other but have not been studied simultaneously in MDD. This study aimed to assess and compare the levels of oxidative and nitrosative stress in the neutrophils (PMNs) of drug-naive MDD patients and their first-degree relatives. METHODS: 29 drug-naive MDD patients and 27 healthy first-degree relatives and healthy controls aged 18-45 years were included in this study. An assessment of the levels of reactive oxygen species (ROS), nitrites, neuronal NO synthase (nNOS), and myeloperoxidase in PMNs, and cortisol in serum was carried out. RESULTS: Compared to healthy controls, the generation of free radicals, myeloperoxidase activity, and nNOS mRNA expression in PMNs, and cortisol level in serum were significantly higher in drug-naive depression patients. Indeed, increased levels of myeloperoxidase and serum cortisol were also noted in first-degree relatives. The total nitrite content in the PMNs and plasma however was significantly lower in both patients and first-degree relatives. Interestingly, a positive correlation was established in the ROS levels in the PMNs, plasma and neutrophil nitrite, and the serum cortisol level between MDD patients and their first-degree relatives. CONCLUSION: The results of this study contribute towards a better understanding of the familial association of depressive disorder, and demonstrate for the first time that neutrophil ROS/RNS, plasma nitrite, and serum cortisol levels are positively correlated between MDD patients and their first-degree relatives. However, further studies in larger, more diverse samples are needed to extend these pathways as potential biomarkers to identify persons at high risk for psychopathology at an early stage.
BACKGROUND: The occupation of police personnel is known to be enormously stressful. The occupational stress research shows that coping strategies and social support have a buffering effect on stress and a protective role on mental health. The present research study was set out to investigate the role of coping strategies and social support as moderating factors of the relationship between occupational stress and mental health in police personnel of Uttar Pradesh in terms of their ranking. METHODOLOGY: The present cross-sectional study was conducted using standardized questionnaires. The sample comprised a total of 300 male police personnel. Hundred constables, 100 inspectors, and 100 officers were incidentally selected from six districts of Uttar: Lucknow, Varanasi, Meerut, Raebareli, Ghaziabad, and Noida. RESULTS: Study results showed coping strategies and social support to have a moderating effect on the relationship between stress and mental health in inspectors and officers but failed to show such relationship in constables. CONCLUSION: There is the implication for the training in terms of teaching-specific active and adaptive coping strategies for the management of workplace-related stress and promotion of health and well-being in the police personnel.
BACKGROUND: Caregivers of patients with schizophrenia often experience high burden of care and have deterioration in the quality of their life. This study attempted to assess the efficacy of a brief psychosocial intervention (BPI) on the burden of care and quality of life (QOL) of key relatives of patients with schizophrenia and its subsequent effect on QOL of their patients (if any). METHODS: A total of 66 patients and their key relatives were included in the study. Patients were assessed for psychopathology (by applying Positive and Negative Syndrome Scale and World Health Organization QOL scale [WHOQOL-BREF]) and relatives were assessed on Burden Assessment Schedule and WHOQOL scale (WHOQOL-100). Thirty-three patients and their key relatives were randomly allocated to BPI group and nonspecific control intervention group. RESULTS: There was a statistically significant reduction in burden of care (P = 0.004) and improvement in QOL of relatives (P = 0.024) as well as in QOL scores of patients (P = 0.0028) in the BPI group. CONCLUSION: BPI is associated with a significant improvement in QOL as well as burden of care of key relatives of patients with schizophrenia, which, in turn, results in improvement in QOL of their patients.
BACKGROUND: Poor mental health of the mother affects her physical health and the neonate's health and development. Studies from Southern India place different estimates of perinatal mental ill-health. Cultural variables affect health-seeking behaviour and are thus important to study in perinatal women with psychiatric morbidity. METHODS: A total of 281 perinatal women were screened on Edinburgh Postnatal Depression Scale (EPDS), Perinatal Anxiety Screening Scale (PASS) and Mini International Neuropsychiatric Interview version 6.0 (MINI), assisted with a clinical interview to identify psychiatric illnesses. The cultural formulation interview (CFI) of DSM-5 was applied on perinatal women having psychiatric illnesses and their caregivers. RESULTS: A psychiatric diagnosis was present in 10.3% of perinatal women. Depression and anxiety disorders were seen in 7.12% and 1.41%, respectively. Marital discord (P < 0.0001), psychosocial stressors (P < 0.0001), and past history of psychiatric disorder (P < 0.001) were significantly higher in perinatal women with a current psychiatric diagnosis. On CFI work-related stress, the gender of the infant, low education and conflict across generations were identified as the negative aspects of the culture associated with psychiatric illness during and after pregnancy. Religion and social support were the major coping strategies, while stigma and financial problems were the major barriers to help-seeking. CONCLUSION: The high prevalence of psychiatric disorders and the strikingly low help-seeking are noteworthy. These findings can help in planning treatment and prevention programs for timely detection and intervention for perinatal psychiatric disorders.
PURPOSE: Disability associated with schizophrenia affects every aspect of life. In India, persons with schizophrenia are eligible for disability benefits. Only a handful of patients are aware and able to avail the benefits. We intended to assess disability in clinically stable patients of schizophrenia as even though they are stable but are disabled and may benefit from disability benefits and rehabilitation. METHODS: Sixty-two clinically stable patients of schizophrenia were assessed on the Mini-International Neuropsychiatric Interview, Positive and Negative Syndrome Scale (PANSS), and Schizophrenia Cognition Rating Scale. Disability was assessed on the Indian Disability Evaluation and Assessment Scale (IDEAS). RESULTS: Nearly one-fourth of the "stable patients" had moderate-to-severe disability (22.6% - moderate and 1.6% - severe), i.e., certifiable disability as per IDEAS. Disability had a significant correlation with all three domains of PANSS as well as total PANSS score. The correlation was stronger with negative than with positive symptom scores. Disability also strongly correlated with cognitive impairment. "Work," "communication and understanding," and "interpersonal relationship" domains of IDEAS had a strong correlation with cognitive impairment. CONCLUSION: Nearly 25% of the stable patients had certifiable disability. The "work" domain of IDEAS was most affected. It demonstrates that the rehabilitation of this population may contribute to reducing disability.
BACKGROUND: Presence of enormous stress gives birth to a higher prevalence of mental health difficulties. Globally, the job of police personnel is full of stress. Coping strategies and social support have a crucial role to play in the management of stress and mental health. OBJECTIVE: The objective of this study was to study stress, social support, coping, and mental health in the police personnel of Uttar Pradesh. METHODOLOGY: The sample comprised 300 male police personnel including 100 constables, 100 inspectors, and 100 officers being incidentally selected from six districts of Uttar Pradesh viz. Lucknow, Varanasi, Meerut, Raibareilly, Ghazipur, and Noida. The mean age of the sample was 40 years and average experience of 15 years of police service. They were assessed by using Occupational Stress Questionnaire (OSQ, Gmelch and Chan, 1994), Brief COPE Scale (Carver, 1997), Social Support Scale (Cohen et al. 1985), and Mental Health Inventory (Jagdish and Srivastava, 1983). The results obtained were analyzed statistically, the mean score was calculated, and the independent t-test was applied. RESULTS: Among the police personnel, inspectors scored highest mean occupational stress score (39.89 ± 13.17) with the lowest mean score of active coping (17.40 ± 7.37), adaptive coping (23.81 ± 8.59), and the highest mean score in maladaptive coping (21.43 ± 7.89). Mental health of inspectors was most adversely affected with highest mean score (97.81 ± 24.49). CONCLUSION: The study concludes that the amount of stress experienced by all echelons of police is extremely high and almost of similar level except for inspectors showing highest among the three groups, thus emphasizing the use of healthy coping mechanisms and modification in work environment promoting health and well-being.
Intracranial calcification may result from disturbances in calcium metabolism. It often remains asymptomatic, but may present with symptoms like seizure and neurological deficits. Correction of the underlying metabolic disturbance before damage of neuronal tissues due to intracranial calcification may be useful in preventing irreversible neurological deficits. This window period may be the crucial period that needs a thorough clinical evaluation and urgent intervention. We highlight the case of an adult woman with Fahr's disease presented with generalised tonic-clonic seizure. The management priorities were also discussed along with review of literature.
Background & objectives: Sexual functioning is a strong determinant of quality of life. Sexual dysfunction has been widely reported due to depressive disorder as well as selective serotonin reuptake inhibitors. Thus, treatment with antidepressants can culminate in a double-edged sword, leading to drug discontinuation and symptom relapse. The objective of this study was to assess the sexual functioning of sexually active females with depression, currently in remission, receiving escitalopram and to compare with healthy controls. Methods: Fifty female patients with depression, currently in remission, with self-reported normal pre-morbid sexual function and receiving escitalopram for at least three months, were assessed on female sexual function index (FSFI) questionnaire and compared with healthy controls. Results: Half of the patients (n=25, 50%) in group A were found to have sexual dysfunction (FSFI score <26.55), while, 90 per cent (n=45) had decreased desire, 86 per cent (n=43) had decreased arousal, 54 per cent (n=27) had decreased lubrication, 68 per cent (n=34) had decreased orgasm, 62 per cent (n=31) had decreased satisfaction and 32 per cent (n=16) had pain during sexual activity. Patients receiving escitalopram had significantly higher sexual dysfunction as compared to healthy controls in mean total FSFI score (P < 0.001) and all mean domain scores of FSFI except pain. Interpretation & conclusions: A significant proportion of sexually active females with depression currently in remission, receiving escitalopram, reported dysfunction in all domains of sexual function; thus, routine screening for sexual dysfunction during follow up is advisable for early identification and prompt treatment.
Depressive Disorder/drug therapy , Selective Serotonin Reuptake Inhibitors/adverse effects , Sexual Behavior/drug effects , Sexual Dysfunction, Physiological/pathology , Adolescent , Adult , Antidepressive Agents/administration & dosage , Antidepressive Agents/adverse effects , Citalopram/administration & dosage , Citalopram/adverse effects , Depressive Disorder/complications , Depressive Disorder/pathology , Female , Humans , India/epidemiology , Middle Aged , Quality of Life , Selective Serotonin Reuptake Inhibitors/administration & dosage , Sexual Dysfunction, Physiological/chemically induced , Sexual Dysfunction, Physiological/epidemiology , Surveys and Questionnaires , Young Adult
