Clinical and neuropsychological characterization of SuperAgers residing in Delhi and National Capital Region of India-A cross-sectional study.

Introduction: SuperAgers (SA) are older adults who exhibit cognitive capacities comparable to individuals who are three or more decades younger than them. The current study aimed to identify the characteristics of Indian SA by categorizing 55 older adults into SA and Typical Older Adults (TOA) and comparing their performance with a group of 50 younger participants (YP) (aged 25-50). Methods: A total of 105 participants were recruited after obtaining informed written consent. The cognitive abilities of the participants were assessed using Wechsler Adult Intelligence Scale (WAIS)-IVINDIA, Color Trails Test, Boston Naming Test (BNT), and Rey Auditory Verbal Learning Test. Results: SA outperformed TOA in all cognitive assessments (P < 0.001) and surpassed YP in BNT and WAIS-IV. SA's delayed recall scores were notably higher (12.29 ± 1.51) than TOA (6.32 ± 1.44). Conclusion: SA excelled in all cognitive domains demonstrating resilience to age-related cognitive decline. This study highlights Indian SuperAgers' exceptional cognitive prowess.

Feasibility Trial of a Newly Developed Brief Psychological Trauma Intervention for Children Surviving Sexual Abuse in India.

Given the alarming increase in incidences of child sexual abuse (CSA), the present study was conceived to conduct a feasibility trial for a brief CSA-focused cognitive-behavioral intervention for children. A quasi-experimental single-group pre-post design with convenient sampling was adopted. The intervention module was administered to 20 children aged 7-13 years (M = 10.4, SD = 1.3) with a CSA history. The intervention was spread across a minimum of six required sessions and a maximum of 12 sessions held weekly for approximately 90 to 120 minutes' duration to restore the child's functioning and to assist the child in processing and managing trauma effectively along with initiating the process of growth. Child PTSD Symptom Scale (CPSS), Children's Impact of Events Scale-13 (CRIES-13), Developmental Psychopathology Checklist (DPCL), Multidimensional Scale for Child Sexual Abuse (MSCSA) and Children's Global Assessment Scale (CGAS) were used to measure the impact of the intervention on the children. Estimation of improvement was done using Wilcoxon signed rank test, effect size and subjective feedback from children. Feasibility assessment was done across five parameters: recruitment, data collection, attrition, adherence and improvement. We found that the intervention led to significant improvement in scores of all scales with a large effect size of .50 for MSCSA and CRIES-13 and medium effect size for CGAS, CRIES-13 (Intrusion & Avoidance), CPSS, and DPCL. Feasibility was estimated to be high across all five parameters of the assessment. Thus, the newly developed intervention was found to be helpful in restoring the child's functioning, and assisting the child in processing, and managing trauma effectively.

Comparative evaluation of isoflurane and desflurane for postoperative cognitive decline in elderly patients: A prospective observational pilot study.

BACKGROUND: Approximately 16%-62% of patients undergoing non cardiac surgeries develop postoperative cognitive dysfunction. We compared the incidence of postoperative cognitive dysfunction in older adults aged 60-80 years who underwent open abdominal surgeries under general anaesthesia using isoflurane or desflurane and correlated it with the serum concentration of interleukin 1, interleukin 6, tumour necrosis factor alpha, amyloid ß and S100 on postoperative day 3. METHOD: Forty American Association of Anesthesiologists Physical Classification I or II patients were included after acquiring institutional ethics committee approval, registering in the Clinical Trials Registry - India, and informed written consent. They underwent open abdominal surgery under general anaesthesia and epidurals between 2017 and 2019. Patients with substance abuse or any disorder affecting cognition were excluded. Postoperative cognitive dysfunction was assessed by Stroop test, Wisconsin Card Sorting Test, Trail making test - B, Porteus Maze test, PGI memory scale, mini-mental state examination, and Bender Gestalt test the day before surgery and on the third postoperative day along with blood samples. RESULTS: Thirty-seven percent of the patients developed postoperative cognitive dysfunction. The risk was similar to isoflurane in comparison with desflurane (risk ratio: 0.65, 95% confidence interval: 0.30, 1.40). A significant percentage increase in reaction time for Porteus Maze test and Trail making test - B was noted with isoflurane (6.69 (4.20-8.94) and 8.01 (2.08-12.5), respectively) in comparison with desflurane group (13.01 (9.09-17.33), p = 0.003 and 11.62 (7.5-17.5), p = 0.017, respectively). CONCLUSION: Isoflurane and desflurane had a similar impact on the elderly for developing postoperative cognitive dysfunction and no correlation with any of the biomarkers used in the study on postoperative day 3.

Development of a Brief Psychological Trauma Intervention for Child Sexual Abuse in India.

Despite the alarming increase in incidences of child sexual abuse (CSA) in India, intervention research remains preliminary and generic. Although Cognitive Behavior Therapy (CBT) has been found to be consistently effective in addressing the adverse consequences of CSA, none of the cultural adaptations of CBT have been evidenced in India so far. Hence, the present study was conceived to develop a CSA-focused brief CBT intervention for children between 7 and 13 years of age. Intervention development progressed through four steps: 1) a systematic review of literature; 2) a qualitative study, including focused group discussions, conducted with 19 mental health professionals; 3) development of the intervention; 4) expert evaluation and finalization. We developed the intervention with three key elements: restoring the child's functioning, assisting the child in processing, and managing trauma effectively and initiating the process of growth. The intervention predominantly followed the CBT framework while integrating culturally specified techniques. The intervention contains 8 modules and 18 sub-modules structured around three phases of intervention. The intervention is spread across a minimum of 6 required sessions and a maximum of 12 session held twice weekly for approximately 90-120 min duration. A list of 35 activities corresponding to each phase and sub-module of the present intervention has been designed as an intervention workbook. In conclusion, the newly developed intervention is a manualised, culturally competent, psychological intervention developed within the CBT framework for children aged 7-13 years with experience of CSA. The next phases include piloting intervention for feasibility.

Adverse Childhood Experiences, Aggression, Empathy, and Psychopathology in Adult Males Accused of Rape.

Background: Investigating the underlying psychosocial factors is a cornerstone of planning need-based intervention for adult males accused of rape. Unresolved debates on its etiology, mediation, or interaction among causal psychosocial variables fuel curiosity to scrutinize it further. Hence, we studied potential influence of and relation between adverse childhood experiences, aggression, empathy, and psychopathology in adult males accused of rape in India and investigated the risk factors for the same. Methods: With a correlational research design, 40 literate and consenting adult males medically confirmed for rape were recruited using convenient sampling. The assessment was done on Adverse Childhood Experiences, Aggression Questionnaire, Symptom Checklist-90, and Interpersonal Reactivity Index. Descriptive statistics, Pearson's product-moment correlation, and stepwise linear regression analysis were calculated. Results: Approximately 75% of the participants experienced at least one category of Adverse Childhood Experiences. Scores above cut-off points were obtained on anger, hostility, fantasy, and personal distress. Significant correlations were obtained between adverse childhood experiences and psychopathology; between hostility and psychopathology, perspective taking, and personal distress; and in case of indirect aggression, with perspective taking and empathetic concerns. Regression analysis revealed that an increase in Symptom Checklist-90 global scores increases hostility and that lower personal distress predicts higher scores on hostility on Aggression Questionnaire. Conclusions: Adverse childhood experiences, aggression, and psychopathology play a critical role and, therefore, should be included as core components of the prevention of rape or relapse prevention programs at the community level.

Adaptation of the Patient Reported Outcome Measurement Information System (PROMIS) tool for childhood cancer in India: A qualitative study.

BACKGROUND: To fill the gap in patient-reported outcome (PRO) assessment in children with cancer in India, we planned to adapt domains from the HealthMeasures Patient Reported Outcomes Measurement Information System (PROMIS) tool. This study attempted to identify and pool outcomes relevant to children with cancer and their caregivers in Northern India. METHODS: The study was qualitative and conducted through focussed group discussions (FGDs) and in-depth interviews of children with cancer and their caregivers. Content analysis of transcripts from the sessions was done. The collected themes were collated with existing item banks of the PROMIS tool and new concepts unique to our population were compiled. RESULTS: A set of three FGDs and 14 interviews each for children and their caregivers were conducted. Following content analysis, 121 themes were identified including 10 new concepts. Themes pertaining to the physical domain were cited most. The theme distribution across the three domains was similar among children and caregivers. In the survivor cohort, the relative frequency of mention of psychological and social themes was higher compared to the whole cohort. Themes pertaining to mobility, cognitive dysfunction and peer relationships were more common among survivors. CONCLUSIONS: This qualitative study in children with cancer and their caregivers in India has facilitated a better understanding of the issues pertaining to cancer care that are of most importance to its stake holders. The themes collected may be used to formulate a PRO tool uniquely tailored for use in this population.

Assessment of Body Image Disturbance, Self-Esteem and Quality of Life among Adolescents and Young Adults with Acne in a Tertiary Care Facility of India.

Background: Impact of acne on the psychological aspect among adolescents and young adults is poorly understood and many times goes unnoticeable. Aim: To assess body image disturbance, self-esteem, quality of life among adolescents and young adults with acne. Materials and Methods: A cross sectional survey on 250 adolescents and young adults aged 13-25 years in Dermatology OPD of a tertiary care hospital, was performed. Severity of acne, body image disturbance, self-esteem, and quality of life were assessed using standardized tools like IGA scale, BIDQ, RSES, and TAQOL respectively. Results: A majority of the participants, 163 (65%), were aged 20-25 years, in which 141 (56.4%) were male, 237 (94.8%) were unmarried, 192 (76.8%) were residing in urban area, 142 (56.8%) were graduate/post-graduate, 173 (69.2%) were students and 113 (45.2%) belonged to upper middle class of socio-economic status. More than half, 137 (54.8%), had a family history of acne, 228 (91.2%) had oily skin, 166 (67.4%) had normal nutritional status, 154 (61.6%) had moderate form of acne whereas 80 (32%) had severe acne. The mean BIDQ score was 3.05 (SD = 0.89); 169 (67.60%) had normal self-esteem and 174 (69.64%) had mild impairment in quality of life. Severity of acne had significant association with body image disturbance (P = 0.007) and quality of life (P = 0.001) but not related with self-esteem. Conclusion: The results revealed body image disturbance and impaired quality of life among adolescents and young adults with acne which draws the attention of dermatologists towards unidentified psychological aspects of acne during treatment. However, the majority of them revealed normal self-esteem in the study.

Patient Satisfaction Scale for Hospitalized COVID-19 Patients: Development and Psychometric Properties.

Objective: Patients' appraisal of health care delivery system and services during COVID-19 could be an important yardstick for hospital administration and policy makers. The study attempted to develop and test the psychometric properties of a new patient satisfaction scale for COVID-19 patients. Methods: A total of 446 COVID-19-hospitalized COVID-19 patients in a tertiary care designated COVID-19 care hospital constituted the sample. Factor structure of scale was obtained using exploratory factor analysis (EFA). Internal consistency, split-half reliability, and validity (e.g., content, convergent, and divergent) were also evaluated. Results: Item reduction resulted in a 21-item scale consisting of three factors, namely COVID-19-focused treatment facility, COVID-19-appropriate hospital facility, and COVID-19-specific daily needs service facility. It demonstrated excellent internal consistency and reliability (Cronbach's alpha [α]: 0.93; Split-half reliability: 0.90), excellent content validity, and adequate convergent and divergent validity. The scale had no floor effects. Inter-index correlations were significant. To our knowledge: this scale is the first such psychometrically robust self-rated scale for patients' perception about hospital services during COVID-19. Available in both Hindi and English languages, the scale provides a quick measure of patient experience regarding CCOVID-19-specific hospital services.

Resilience in Children and Adolescents Survived Psychologically Traumatic Life Events: A Critical Review of Application of Resilience Assessment Tools for Clinical Referral and Intervention.

Psychological traumatic life events (TLEs) and resilience, both are multidimensional, complex, and share salient features. Both are products of individual, familial, and environmental (socio-cultural-political contextual) variables, which is very crucial in children and adolescents. This systematic review used Boolean search strategies in electronic databases, namely, PubMED, PsycNET, JStor, and Google scholar. All researches not studying resilience per se but similar or related constructs such as life strengths, hardiness, protective/risk factors, social support, self-efficacy, social-emotional adjustment, and so on were excluded. A total of 12 resilience tools meant for children between 5 and 18 years were reviewed. The scale characteristics were analyzed in terms of targeted age-group of sample; purpose (i.e. screening and profiling for intervention); number of items; purpose/type of scale; year, country, and domain wise distribution; response format, standardization sample profile; psychometric properties; and availability of manual with norms of cutoff score. Although no scale was originally developed for children and adolescent population with history of TLEs particularly various forms of abuse and trauma, Child and Youth Resilience Measure and Connor-Davidson Resilience Scale had small samples of children from welfare homes. Neither did any scale tested the divergent validity against absence of any psychopathology or global functioning or poor quality of life Nor did Majority of scales provide a cutoff value for institutionalized children and adolescents with history of TLEs; therefore, using an existing scale for this purpose should be carefully examined. Trauma-focused multidimensionality in resilience needs to be explored more rigorously through mixed methods.

A parent-child conjoint psychological intervention for children in maintenance phase of acute lymphoblastic leukemia: Feasibility and preliminary outcomes from a randomized control pilot trial.

OBJECTIVE: To develop and test a brief Composite Intervention Module for Pre-adolescents with Acute Lymphoblastic Leukemia (CIMPALL). DESIGN: Single-center randomized controlled design. SETTING: A tertiary care center of national importance PARTICIPANTS: A total of 36 children with acute lymphoblastic leukemia in the maintenance phase of the treatment. INTERVENTION: A five-session (540 min) brief, multidomain, audiovisually aided, therapist-facilitated conjoint intervention module for children with cancer and their parents. MAIN OUTCOME MEASURES: Standardized psychological tools for children including CBCL, CPSS (Child Posttraumatic Stress Disorder Symptoms Scale), PedsQol (Pediatric Quality of Life), and NIMHANS (National Institute of Mental Health and Neurosciences) neuropsychological battery and parents including PTSD CC (Posttraumatic Stress Disorder Civilian Checklist), CHIP (Coping Health Inventory for Parents), CBS (Caregiver Burden Scale), and SRQ (Self-Reporting Questionnaire). RESULTS: A total of 36 patients were randomized to an experimental or a control group. Over 80% agreement was observed on indices of expert evaluation; 100% of participants found the sessions to be helpful, useful, appropriate in terms of time, duration, and place, and interventionist. The participation rate in the sessions was 94% and the study flow was smooth; 97.3% eligible candidates agreed to participate. Furthermore, 100% agreement on performance of activities was observed and the attrition rate was 5.26%. CONCLUSION: This pilot study presents the CIMPALL, which to the best of our knowledge is the first of its kind in India. The data suggest that the CIMPALL intervention is feasibly delivered by a clinical psychologist and that the CIMPALL intervention has an impact on important psychosocial variables for children with acute lymphoblastic leukemia and their parents.

Validity and Reliability of the Hindi Version of the Patient Assessment of Constipation Quality of Life Questionnaire in Cancer Patients on Opioids for Pain Management at Tertiary Care Center, India.

BACKGROUND: Opioid-induced constipation (OIC) causes a significant worsening of quality of life (QOL). The patient assessment of constipation QOL questionnaire (PAC-QOL) is a validated scale in English language to assess the QOL in patients with chronic constipation and guide the management by measuring response to a targeted therapy. OBJECTIVE: The objective of the study was to evaluate the validity and reliability of PAC-QOL questionnaire after translation in Hindi language for Indian cancer patients with OIC. MATERIALS AND METHODS: This was a prospective observational cross-sectional study. Three hundred and thirteen adult cancer patients receiving opioid treatment for pain and experiencing self-reported symptoms of constipation were evaluated. The severity of constipation was assessed at baseline and at an interval of at least 2 weeks by the physician using constipation scoring system (CSS) and self-reported Hindi version of PAC-QOL questionnaire. RESULTS: The data obtained from 313 patients were taken for analysis. The internal consistency of the tool was established with the favorable value of Cronbach's alfa coefficient (i.e., >0.70) obtained for all four subgroups and overall score. The intraclass correlation coefficient value of >0.70 also established good correlation between overall and subgroups scores of Hindi version of PAC-QOL, obtained at 1st and 2nd visit. It was observed from the result that a significant correlation existed between the overall and subgroups scores of Hindi version of PAC-QOL and CSS, thus establishing concurrent validity. CONCLUSION: It was concluded from the study results that Hindi version of PAC-QOL is both reliable and valid to assess the QOL in patients with OIC.

Caregiver Burden and Quality of Life among Family Caregivers of Cancer Patients on Chemotherapy: A Prospective Observational Study.

AIM: Informal caregivers of cancer patients have extensive burdens. They are susceptible for deterioration of their quality of life (QOL). We aimed to assess caregiver burden and QOL of family caregivers of cancer patients receiving chemotherapy admitted in the ward/intensive care unit/high-dependency unit. MATERIALS AND METHODS: This prospective observational study including 178 caregivers was carried out in a tertiary care hospital. The assessment of caregiving burden was done using the Zarit Burden Interview and its impact on QOL using the WHO BREF QOL questionnaire. RESULTS: The mean age and mean Zarit Burden score of caregivers were 38.98 ± 10.53 and 30.697 ± 8.96, respectively. Of the total, 70.22% of caregivers reported mild-to-moderate burden and 21.38% reported moderate-to-severe burden. On assessment of QOL WHO BREF, the mean general score was 5.79 ± 1.84, physical health score was 49.65 ± 16.07, psychological health 51.85 ± 20.43, social relations 59.38 ± 21.43, and environmental 58.73 ± 17.51. The QOL scores were slightly better in mild-to-moderate burden compared to moderate-to-severe burden but not statistically significant except for social relations (P = 0.053). We did not find any difference in burden scores or QOL between male and female caregivers. CONCLUSION: Mild-to-moderate burden was seen in 70.22% of caregivers and 21.38% had moderate-to-severe burden.

Psychosocial burden of lichen planus pigmentosus is similar to vitiligo, but greater than melasma: A cross-sectional study from a tertiary-care center in north India.

BACKGROUND: Lichen planus pigmentosus can have a negative impact on the quality of life; however, this has not been studied in detail. OBJECTIVES: To study the quality of life in patients with lichen planus pigmentosus and compare it with patients with vitiligo and melasma. METHODS: This was a cross-sectional study conducted in a tertiary-care center in north India from January 2018 to May 2019. Patients ≥ 18 years of age with lichen planus pigmentosus (n = 125), vitiligo (n = 113) and melasma (n = 121) completed the Dermatology Life Quality Index (DLQI) questionnaire and answered a global question on the effect of disease on their lives. In addition, patients with vitiligo completed the Vitiligo Impact Scale (VIS)-22 questionnaire, while those with lichen planus pigmentosus and melasma filled a modified version of VIS-22. RESULTS: The mean DLQI scores in patients with lichen planus pigmentosus, vitiligo and melasma were 10.9 ± 5.95, 9.73 ± 6.51 and 8.39 ± 5.92, respectively, the difference being statistically significant only between lichen planus pigmentosus and melasma (P < 0.001). The corresponding mean modified VIS-22/VIS-22 scores were 26.82 ± 11.89, 25.82 ± 14.03 and 18.87 ± 11.84, respectively. This difference was statistically significant between lichen planus pigmentosus and melasma, and between vitiligo and melasma (P < 0.001 for both). As compared to vitiligo, patients with lichen planus pigmentosus had a significantly greater impact on "symptoms and feelings" domain (P < 0.001) on DLQI, and on "social interactions" (P = 0.02) and "depression" (P = 0.04) domains on VIS-22. As compared to melasma, patients with lichen planus pigmentosus had significantly higher scores for "symptoms and feelings," "daily activities," "leisure" and "work and school" domains of DLQI, and all domains of VIS-22. Female gender was more associated with impairment in quality of life in patients with lichen planus pigmentosus, while lower education, marriage, younger age and increasing disease duration showed a directional trend. LIMITATIONS: Use of DLQI and modified version of VIS-22 scales in the absence of a pigmentary disease-specific quality-of-life instrument. CONCLUSION: Patients with lichen planus pigmentosus have a significantly impaired quality of life. The psychosocial burden of lichen planus pigmentosus is quantitatively similar to that of vitiligo, but significantly greater than melasma.

Multidimensional scale for child sexual abuse (MSCSA): Development and psychometric properties.

BACKGROUND: In recognition to the rising incidences of child sexual abuse in India, various challenges of existing trauma measures and absence of indigenous efforts at development of comprehensive impact assessment scale, present study was conceptualized. OBJECTIVE: To develop and establish psychometric properties of Multidimensional Scale for Children with Sexual Abuse. PARTICIPANTS AND SETTINGS: Outpatient department of government hospitals, non-governmental organizations and child care institutes were primary data setting from which a total of 457 participants were sampled. METHODS: The scale development process consisted of identifying impact themes from 59 qualitative research participants and item pooling from available scales; item writing followed by content and face validity analysis from 18 experts; and pilot testing on 30 children. The scale was then applied to 200 children with CSA and 150 children without sexual abuse. The factor structure of the scale was obtained using exploratory factor analysis. Internal consistency, split-half reliability, and validity (convergent, divergent, discriminant) were evaluated. Cut-off scores were obtained using the receiver operating characteristics curve and percentile analysis. RESULTS: The scale consisted of 62 items across 5 domains. It has high reliability (Cronbach's α 0.93; split-half reliability 0.89), high content, and discriminant validity. Convergent and divergent validity are satisfactory. Scale cut-off score of 31 has high sensitivity. CONCLUSION: To our knowledge, this scale is the first such psychometrically robust self-rated scale for young children with sexual abuse in the Asian country. Available in both Hindi and English language, the scale provides a quick measure of trauma across multidimensional functioning.

Implementing and validating a care protocol for older adults with cancer in resource limited settings with a newly developed screening tool.

BACKGROUND: Cancer in the aging population presents manifold challenges. In the resource-limited settings of developing countries, concrete steps to optimize care for older adults with cancer are required. MATERIALS AND METHOD: This prospective, observational study was divided in two parts. In the first part, older adults (≥60 years) with a tissue diagnosis of cancer underwent a preliminary, detailed assessment of relevant geriatric domains. The patients were followed up at 4, 12 and 24 weeks, and their survival status was recorded. In the second part a newly developed screening tool, "SCreening of the Older PErson with Cancer", Version1 (SCOPE-C) was validated on patients with similar characteristics. RESULTS: 419 participants were enrolled in the study. The mean age of the participants was 66.6 ± 6.2 years, 75% had functional impairment, 35% had malnutrition, and 64% had more than one co-morbidity. The median survival time was 22 weeks from the index visit. Male gender, functional decline, cognitive impairment, malnutrition, and treatment modality were found to be independently associated with survival. Individual Scores on the SCOPE-C Version1 scale were correlated with survival status at 24 weeks, and a cutoff score of 64 had a 72.2% sensitivity and 77.3% specificity for better prognosis. CONCLUSION: The present study is a comprehensive attempt to assess older adults with cancer with limited resources in a busy health system. A preliminary assessment with a prognostic screening tool may streamline care in resource-limited settings and aid clinicians in making treatment decisions.

Techno stress among medical freshmen: An exploratory study.

INTRODUCTION: Use of technology and ICT tools is ubiquitous among college students including medical students. However overuse or misuse may lead to many physical and psychological problems including the risk of harming professional standing in the long term. The purpose of this study was to explore techno stress among freshmen at a medical institute and to suggest measures to reduce problematic use of technology pertaining to internet. OBJECTIVES: (i) To explore the extent of technology use including internet among medical freshmen, (ii) To identify the content of usage (iii) To quantify the extent of techno stress and iv. To suggest measures to reduce problematic use of technology. MATERIALS AND METHODS: The sample comprised all the freshmen at a medical institute (n = 61). A semi structured questionnaire was used to collect socio demographic details of students and their patterns of technology usage. Perceived Stress Scale was used to measure stress. RESULTS: The mean age of the sample was 18.34 (±0.58) years comprising 68% males and 32% females. Students spent a mean time of 3.96 h/day on the technology tools (standard deviation = 4.99). Ninety-two percent of the students used technology for educational purposes followed by entertainment (89%), social networking (77.78%), watching films (70.37%), communication (66.67%) and watching pornography (46.3%). 11.47% had symptoms suggestive of problematic internet use. One percent had craving suggestive of addiction. All these had stress out of which 43% had high and 57% had moderate levels of stress. DISCUSSION: Considering the students' present usage of social media, it can serve as a potent academic tool. However, awareness is required to be raised with regard to its use as a medical professional. CONCLUSION: Use of technology is crucial in the current academic world and restrictions on usage may neither be practical nor feasible. However, understanding patterns of usage among students is a preliminary step that can enable educators and administrators to formulate guidelines to channelise their usage in more productive ways.

Association of menstruation cycle with completed suicide: a hospital-based case-control study.

The purpose of the study was to determine the phases of the menstrual cycle in the reproductive age group of females who committed suicide as compared with a control group of females who died from causes other than suicide. The study included 86 cases in the suicidal group and 80 cases in the non-suicidal group. The menstrual phase was decided by the gross and histological examination of the uterus and ovary at autopsy. Deaths were more common during the secretory phase (56.9%) in the suicidal group, while in the non-suicidal group, death occurred more commonly in the proliferative phase (66.3%). In reference to proliferative phase, deaths were more in the secretory phase and menstrual phase in the suicidal group, adjusted odd's ratio (OR) being 3.7 (p = 0.042) and 4.7 (p = 0.032), respectively. Corpus luteum was present in the right ovary of 43 and 14 victims of suicidal and non-suicidal deaths, respectively, while it was in the left ovary of 3 and 11 victims of suicidal and non-suicidal death, respectively. Odd's ratio was 10.3 for corpus luteum to be in the right ovary in comparison with the left ovary for the suicidal group (p = 0.001). This study revealed that suicidal chances in a woman are significantly more in the menstrual phase and the secretory phase of the menstrual cycle. The presence of corpus luteum in the right ovary is associated with an increased risk of suicide, but the reason is not known.