ABSTRACT
BACKGROUND: Suicide and suicidal attempt are an important cause of mortality and denotes severe morbidity among the population. Successful suicide attempt is associated with previous suicide attempts. Identifying factors in suicide attempters will help in formulating a comprehensive response to these issues. OBJECTIVE: To identify the sub group who are more vulnerable and the factors associated with this group. SETTING AND DESIGN: A cross sectional observational study of this sub group was carried out. MATERIAL AND METHODS: study was conducted on patients who were referred to the Psychiatry department for attempted suicide. They were assessed to identify those with high suicidal intent and study the factors associated with high suicidal intent. STATISTICS: Epiinfo by CDC was used to analyze the results. RESULTS: High intent was associated with history of psychiatric illness, history of previous attempts and family history of suicidal attempts. CONCLUSIONS: A sub group was identified which had a high intent and possibly higher chance of repeating an attempt.
ABSTRACT
INTRODUCTION: Law governs the admission and management of involuntary admissions of mentally ill persons who are admitted under the provisions of the mental health act. The court directs the doctor to take charge of such persons. In the further dealings of such person the medical officer of the psychiatric facility comes across legal terms, which require understanding so that patients could be dealt with properly. Various terms such as accused, under police custody, judicial custody, remand prisoner, or under trial prisoner are used to denote their legal status. It is imperative for the medical officer to understand the nuances in the meanings of these terms. There are many times when the relevant section under which the admission is ordered is not found in the reception order. In these cases the terminology by which the patient is mentioned throws a light on the status of the patient. Towards this aim a study was carried out to assess the awareness and understanding of such terms by the faculty and post- graduates of a tertiary care hospital that deals with the admission and care of such patients. METHOD: They were administered a questionnaire containing these terms and asked to provide the meaning of these terms. RESULTS: The results showed that nearly half the faculty and students were not having clarity in awareness or understanding of the terms. DISCUSSION: Hence these terms and their meanings were gleaned from various judgments. The proper meaning of these terms and their use in judicial process and their importance is discussed.
ABSTRACT
BACKGROUND: Mentally ill prisoners, when requiring admission in a psychiatric facility, have to be admitted only by a reception order of a judicial magistrate and convicts by warrants issued by the Government to jail superintendents and the superintendent of the hospital. Both can be only under Section 27 of The Mental Health Act, 1987. MATERIALS AND METHODS: A study of the contents of reception order and warrants regarding the acts and section under which they were issued over 1 year period for the admission of the patients in the criminal ward of the Institute of Mental Health was carried out. RESULTS: Only three reception orders quoted Section 27 out of 54 patients admitted under a reception order. Nineteen patients were admitted by the jail superintendents. DISCUSSION: Various issues that were found in the reception order and their consequences are discussed, and a possible response to these issues is mooted. CONCLUSION: Almost none of the reception orders were found to be proper. This deficit needs to be rectified by sensitizing the various authorities.
ABSTRACT
AIMS: To study insight correlates in schizophrenia and bipolar mood disorder in remission among out-patients attending the Psychiatry Department of a Tertiary Care Hospital. SETTINGS AND DESIGN: In a cross-sectional, naturalistic study, adult patients with schizophrenia and bipolar mood disorder in remission (n = 80; schizophrenia-40, mania-20, bipolar depression-20) were compared on insight measures and clinical correlates. MATERIALS AND METHODS: Scale to Assess the Unawareness of Mental Disorders (SUMD) was used as the main tool to assess current and past measures of insight. Hogan's Drug Attitude Inventory was used to assess the drug attitude and compliance. Positive and Negative Symptom Scale for Schizophrenia, Young's Mania Rating Scale, and HAMD were used to rate psychopathology. Clinical Global Improvement was used as a screening tool for remission. STATISTICAL ANALYSIS: For comparison of the three clinical groups, analysis of variance and Chi-square test were used. In the post-hoc analysis, the Ryan-Einot-Gabriel-Welsch test was used to find the group difference. RESULTS: About 40% in the schizophrenia group were unaware of their mental illness as against none in the bipolar group. The awareness of mental disorder for the current period, the awareness of the achieved effects of medications, and the awareness of social consequence was better in the bipolar group. The drug attitude (compliant positive attitude) increased as the SUMD item scale decreased or in other words, as the insight improved. CONCLUSIONS: Insight, both current and retrospect, showed significant differences between the schizophrenia and bipolar patients. Insight is significantly correlated with the observed compliance and drug attitude of the patient groups.