A study of psychiatric morbidity among school going adolescents.

AIM: This study aims to study the prevalence of psychiatric morbidity among adolescents and compare its distribution in the urban and rural areas. STUDY DESIGN: This was a cross-sectional study. MATERIALS AND METHODS: One thousand adolescents aged 11 to 16 years studying in various private and government schools in urban and rural areas in district Patiala, Punjab were studied. Stratified cluster sampling was used considering the type of school as strata and sections of each standard as clusters. The study was conducted in two steps; in the first step, self-designed sociodemographic questionnaire and socioeconomic status scale, Parekh's method of socioeconomic classification for rural area, and Kuppuswamy's revised method of social classification for urban areas. To study the psychiatric morbidity, the strength and difficulties questionnaire (SDQ) self-report version and parent version was used. Students who scored borderline or abnormal on SDQ, were further evaluated in second stage by clinical interview, detailed case history, and mental state examination; psychiatric disorders were diagnosed following International Classification of Diseases-10 (ICD-10) criteria. STATISTICAL ANALYSIS USED: Chi-square, Student's t-test. RESULTS: The prevalence ranges from 17.94 in the private school in the urban area and 20.96% in government schools in the urban area to 20.61% in private schools in the rural area and 22.17 in government school of the rural area. The overall prevalence of psychiatric disorders is higher among adolescents in the rural area (21.38%) as compared to the urban area (19.43%). Rural adolescents had significantly higher rates of somatoform disorders (4.45%), conduct disorder (3.78%), dysthymia (1.11%), and other mood disorders (0.89%) whereas higher rates of depression (3.88%), anxiety (3.67%), and hyperkinetic disorders (3.02%) were found in urban counterparts. CONCLUSION: An alarming number of adolescents suffer from different emotional and behavioral problems, but there is no excess of formal mental illness reaching the psychiatrist. This should help us formulate a rational basis for deploying our resources for the treatment and prevention of mental illness in tomorrow's adults.

Tourette's disease with impulse control disorder.

We report a case of Tourette's disease (TD) with impulse control disorder which is rare;these type of patients are prone to rage attack and explosive outbursts in the childhood and adolescence which can be detrimental. Hence, a case is reported to understand the phenomenology of its co-morbidity in TD.

Quality of life in post-traumatic orthopedically handicapped patients.

OBJECTIVES: The study was planned to assess quality of life (QOL) and factors affecting it in post-traumatic orthopedically handicapped patients. MATERIALS AND METHODS: This is hospital-based cross-sectional study which involves 68 patients with traumatic orthopedic handicapped injury in the Department of Orthopaedeics, Rehabilitation center and Psychiatry, Government Medical College, Patiala between May 07 and Aug 08. Details of injury were taken on semistructured proforma. All patients underwent detailed psychiatric assessment using International Classification of Disease-10 (ICD-10) and divided into two groups. Group A contains handicapped patients with psychiatric morbidity and remaining patients without psychiatric morbidity were included in Group B. Further, both groups were subjected to Quality Of Life Scale (QOLS) to assess QOL. RESULTS: QOL was poor in handicapped patients and was affected by severity of injury. Temporal association was seen between psychiatric morbidity and QOL in handicapped patients. CONCLUSION: The QOL must be assessed at every stage of treatment for better adjustment of handicapped patients.

Hyperprolactinaemia with amisulpride.

Amisulpride, a substituted benzamide derivative, is a second-generation antipsychotic that preferentially binds to D2/D3 receptors in limbic rather than striatal structures. High dosage preferentially antagonizes postsynaptic receptors, resulting in reduced dopamine transmission; and low dosage blocks presynaptic receptors, resulting in enhanced transmission. Hyperprolactinaemia may occur in patients receiving amisulpride at low dose of 50 mg/day and results in galactorrhoea, amenorrhea and sexual dysfunction. The symptom ameliorates on withdrawing the drug, switching to non-prolactin-elevating drugs, and timely management with dopamine agonist.