Postpartum depression and its clinico-social correlates - A community-based study in aligarh.

Context: Postpartum depression (PPD) is onset of depressive symptoms in postpartum period from 2 weeks to 1 year. It causes maternal morbidity and long-term negative effects on growth and development of infant and child. It is often unreported and underdiagnosed. Aims: (1) To estimate the prevalence of PPD, (2) To determine socio-demographic, clinical, and obstetric correlates of the same. Settings and Design: A cross-sectional study was done in urban and rural areas of District Aligarh. Methods: A total of 304 females between 6 weeks and 6 months' postpartum period giving consent were included in this study. Sociodemographic, obstetric, and clinico-social factors were recorded using predesigned, pretested questionnaire. Edinburgh Postnatal Depression Scale (EPDS) score ≥10 was used to screen for PPD and International Classification of Disease (ICD-10) criteria for confirmation. Statistical Analysis Used: Correlates of PPD were determined using logistic regression analysis. Results: The prevalence of PPD was 9.5% using EPDS and was confirmed by ICD-10 criteria. History of abortion (adjusted odds ratio [AOR]: 6.0, 95% Confidence Interval [CI] 2.2-16.5), poor relationship with in-laws (AOR: 5.1; 95% CI 1.3-20.5), marital conflict (AOR: 13.3; 95% CI 2.2-77.6), and substance abuse in husband (AOR: 3.1; 95% CI 1.1-9.0) were found to be significant correlates for PPD. Conclusions: About one in every 10 postpartum females suffered from depression but did not seek health care for the same. Women facing social pathologies such as substance abuse in husband, marital conflict, and poor relationship with in-laws are more at risk of PPD. Screening for PPD should be included in the maternal and child health care programs to ensure early diagnosis and treatment.

Effect of antidepressants on various periodontal parameters: A case-control study.

BACKGROUND: Various medications are used in the treatment of chronic systemic diseases that affect the periodontium. Antidepressants in mentally depressed patients are prescribed for a long term, but their effect on the periodontium has not been studied adequately. A case-control study was conducted to know the effect of two commonly prescribed antidepressants - venlafaxine (serotonin-norepinephrine reuptake inhibitor [SNRI]) and fluoxetine (selective serotonin reuptake inhibitor [SSRI]). These drugs have been shown to possess anti-inflammatory properties but do not protect the periodontium from insults caused by these medications, which are significantly associated with the presence of destruction of the periodontium. The aim of this study was to clinically evaluate the effect of antidepressants on various periodontal parameters. MATERIALS AND METHODS: The study sample consisted of 182 depressed patients divided into three study groups: Group I - the control group diagnosed as depressed on the first visit, Group II - depressed patients taking fluoxetine 20 mg/day, and Group III - patients taking venlafaxine 75 mg/day. Patients in Groups II and III were on isolated antidepressant medication at least for a period of 3 or more months. Mental depression in patients was assessed with the Patient Health Questionnaire-based Hamilton Depression Rating Scale with scoring of ≤16. All the depressed patients were assessed for periodontal health on the basis of the clinical periodontal parameters. RESULTS: The commonly prescribed antidepressants such as fluoxetine and venlafaxine do not protect the periodontium from destruction in spite of possessing anti-inflammatory properties; therefore, these drugs may be considered as a risk factor for periodontal health. The comparative periodontal indices on nonusers of antidepressants or control group (Group I), users of SSRI (fluoxetine) (Group II), and users of antidepressants-SNRI (venlafaxine) (Group III) showed increased periodontal parameters, especially debris index (DI), calculus index (CI), gingival index (GI), periodontal pocket depth (PD), and loss in clinical attachment level. There was no significant difference for CI and GI, probing PD, and clinical attachment levels except DI which was significantly different (P ≤ 0.001). CONCLUSION: The depressed patients receiving fluoxetine or venlafaxine should be regularly evaluated for periodontal health status as these drugs are risk factors for normal periodontal tissues. Further, these medications did not protect the periodontium from periodontal inflammation, although possessing anti-inflammatory properties.

Assessment of psychological problems in schoolgoing adolescents of Aligarh.

BACKGROUND: Adolescence is a period of physical, nutritional, and sexual transition, also remarkable for the accompanying psychological changes. Worldwide, 20% of children and adolescents suffer from a disabling mental illness. Therefore, knowledge of the prevalence of these disorders can be used to design intervention strategies. The present study was conducted in the 13-15 years' age group schoolgoing adolescents, with the objective to estimate the prevalence of psychological morbidity, employing Strength and Difficulties Questionnaire (SDQ). MATERIALS AND METHODS: A cross-sectional analytical study was conducted in three different schools of Aligarh, in the 13-15 years' age group, with a prior permission from the school authorities. The study was approved by a multidisciplinary Institutional Ethics and Research Advisory Committee. RESULTS: A total of 1456 students were sampled for the study. The prevalence of psychological morbidity on the basis of total difficulties score was found to be 9.75% (95% confidence interval - 8.33-11.39). The prevalence of emotional, conduct, hyperactivity, peer, and prosocial problems was 5.42%, 5.56%, 3.78%, 4.40%, and 4.26%, respectively. CONCLUSIONS: Psychological problems are fairly common in the adolescent age group. Despite the need, there is a dearth studies conducted in this crucial age group in India. Of the studies available, a wide variance is reported either due to the difference in diagnostic tools or due to the types of psychological disorders considered in different researches. For the purpose of uniformity and comparability, SDQ stands as a good option.