Pub Date : 2019-02-02DOI: 10.32746/ijmhns.2019.v2.i1.11
E. Mathew, Antony Fernandez, L. E. Hudgins, S. Raman
Sleep disturbances contribute to a high frequency of mental health and cardiovascular diseases with significant gender differences. Women have a higher incidence than men of insomnia and are more likely than men to complain of insomnia, headache, irritability, and fatigue than the ‘‘typical’’ symptoms of loud snoring and apneas during sleep. Reproductive hormones play an important role in sleep in women. In the premenopausal age these hormones have a protective effect on sleep apnea while on pregnancy there is a higher prevalence of sleep apnea and restless legs syndrome. Cardiovascular mortality is high in women with obstructive sleep apnea and continuous positive airway pressure therapy improves outcomes in most cases of obstructive sleep apnea. The epidemiology, risk factors, diagnostic criteria, and therapies for the three most common sleep disorders (insomnia, obstructive sleep apnea, and restless leg syndrome), along with effects of menopause, pregnancy, and social factors on sleep in women, are key considerations for clinicians caring for female patients across the adult life span.
{"title":"Common sleep disorders in women","authors":"E. Mathew, Antony Fernandez, L. E. Hudgins, S. Raman","doi":"10.32746/ijmhns.2019.v2.i1.11","DOIUrl":"https://doi.org/10.32746/ijmhns.2019.v2.i1.11","url":null,"abstract":"Sleep disturbances contribute to a high frequency of mental health and cardiovascular diseases with significant gender differences. Women have a higher incidence than men of insomnia and are more likely than men to complain of insomnia, headache, irritability, and fatigue than the ‘‘typical’’ symptoms of loud snoring and apneas during sleep. Reproductive hormones play an important role in sleep in women. In the premenopausal age these hormones have a protective effect on sleep apnea while on pregnancy there is a higher prevalence of sleep apnea and restless legs syndrome. Cardiovascular mortality is high in women with obstructive sleep apnea and continuous positive airway pressure therapy improves outcomes in most cases of obstructive sleep apnea. The epidemiology, risk factors, diagnostic criteria, and therapies for the three most common sleep disorders (insomnia, obstructive sleep apnea, and restless leg syndrome), along with effects of menopause, pregnancy, and social factors on sleep in women, are key considerations for clinicians caring for female patients across the adult life span.","PeriodicalId":113988,"journal":{"name":"INDIAN JOURNAL OF MENTAL HEALTH AND NEUROSCIENCES","volume":"61 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114688228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Treatment adherence and illness may not be related only by the severity of the illness but by so many other factors which impact on seeking and continuing treatment; yet severity of the illness will be one of the major factors influencing treatment adherence. Methods: Female patients attending the psychiatric OPD, diagnosed with depression as per ICD-10 guidelines and provided informed consent participated in this questionnaire-based study. A total of 135 patients who attended the OPD in 9 months were assessed for the severity of depression and medication adherence by administering scales to assess the severity of depression and medication adherence was assessed by questioning about the drug taking and hospital attending behaviour. Out of this, thirty-one were attending for the first episode and hence were excluded from the analysis. Results: Out of the 104 female patients diagnosed with depression of more than one episode, 44 (42.3%) had mild depression, 52 (50%) had moderate depression and 8 (7.7%) had severe depression. Twenty-nine women (27.9%) were on medications and 75 (72.1%) women were not taking their medications. While greater proportion of women with mild depression were adherent to medication (51.7%), more women with moderate depression didn’t adhere to medication (54.7%), even though such difference was statistically not significant. Older age, having a paid work and married status were significantly associated with medication (antidepressants) adherence. Conclusions: Our results indicate that medication adherence is associated with factors other than severity of depression. Work and marital status played a significant role in determining the adherence to antidepressant medications among women.
{"title":"A cross-sectional study of factors associated with anti-depressant medication adherence in women attending an out patient psychiatry department","authors":"Mrinalini Reddy, Pallavi Abhilasha, Thirunavukarasu Manikam, Rajkumar Ramanathan, Suresh Kumar","doi":"10.32746/ijmhns.2019.v2.i1.10","DOIUrl":"https://doi.org/10.32746/ijmhns.2019.v2.i1.10","url":null,"abstract":"Introduction: Treatment adherence and illness may not be related only by the severity of the illness but by so many other factors which impact on seeking and continuing treatment; yet severity of the illness will be one of the major factors influencing treatment adherence. Methods: Female patients attending the psychiatric OPD, diagnosed with depression as per ICD-10 guidelines and provided informed consent participated in this questionnaire-based study. A total of 135 patients who attended the OPD in 9 months were assessed for the severity of depression and medication adherence by administering scales to assess the severity of depression and medication adherence was assessed by questioning about the drug taking and hospital attending behaviour. Out of this, thirty-one were attending for the first episode and hence were excluded from the analysis. Results: Out of the 104 female patients diagnosed with depression of more than one episode, 44 (42.3%) had mild depression, 52 (50%) had moderate depression and 8 (7.7%) had severe depression. Twenty-nine women (27.9%) were on medications and 75 (72.1%) women were not taking their medications. While greater proportion of women with mild depression were adherent to medication (51.7%), more women with moderate depression didn’t adhere to medication (54.7%), even though such difference was statistically not significant. Older age, having a paid work and married status were significantly associated with medication (antidepressants) adherence. Conclusions: Our results indicate that medication adherence is associated with factors other than severity of depression. Work and marital status played a significant role in determining the adherence to antidepressant medications among women.","PeriodicalId":113988,"journal":{"name":"INDIAN JOURNAL OF MENTAL HEALTH AND NEUROSCIENCES","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114427107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-07-14DOI: 10.32746/ijmhns.2018.v1.i1.7
Sridhar Vaitheswaran
Geriatric Psychiatry deals with specific issues and challenges that arise in the assessment and management of mental health problems in elderly. As a specialty it has not received much attention in developing countries until recently. Elderly will soon be major consumers of mental health care in developing countries. Common psycho-social issues among the elderly and their impact on the mental health in the developing regions of the world and the complex interplay between physical health and mental health in the elderly are described. Dementia and depression are described in some detail focussing on relevant research to highlight the challenges in developing countries. Potential solutions to address the challenges of elderly mental health in developing countries are discussed.
{"title":"Elderly Mental Health in Developing Countries","authors":"Sridhar Vaitheswaran","doi":"10.32746/ijmhns.2018.v1.i1.7","DOIUrl":"https://doi.org/10.32746/ijmhns.2018.v1.i1.7","url":null,"abstract":"Geriatric Psychiatry deals with specific issues and challenges that arise in the assessment and management of mental health problems in elderly. As a specialty it has not received much attention in developing countries until recently. Elderly will soon be major consumers of mental health care in developing countries. Common psycho-social issues among the elderly and their impact on the mental health in the developing regions of the world and the complex interplay between physical health and mental health in the elderly are described. Dementia and depression are described in some detail focussing on relevant research to highlight the challenges in developing countries. Potential solutions to address the challenges of elderly mental health in developing countries are discussed.","PeriodicalId":113988,"journal":{"name":"INDIAN JOURNAL OF MENTAL HEALTH AND NEUROSCIENCES","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124614927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-07-14DOI: 10.32746/10.32746/ijmhns.2018.v1.i1.1
S. Tirupati
People with severe mental disorders experience difficulty in functioning in several domains of life that are all not related to the illness and the symptoms. Medical management for severe mental disorders leads to improvement in symptoms and distress that may not always correlate with functional improvement. A comprehensive rehabilitative care is necessary to reengage the person in life activities and full participation in mainstream life. The Rehabilitation interventions are to be person centered with supports from the environment and removal of barriers to progress recovery. Rehabilitative care should be enhanced by integrated recovery-orientated practices that sustain hope, promote self-agency. This paper discusses the definition of psychiatric rehabilitation and a model of the processes involved.
{"title":"The Principles and Practice of Psychiatric Rehabilitation","authors":"S. Tirupati","doi":"10.32746/10.32746/ijmhns.2018.v1.i1.1","DOIUrl":"https://doi.org/10.32746/10.32746/ijmhns.2018.v1.i1.1","url":null,"abstract":"People with severe mental disorders experience difficulty in functioning in several domains of life that are all not related to the illness and the symptoms. Medical management for severe mental disorders leads to improvement in symptoms and distress that may not always correlate with functional improvement. A comprehensive rehabilitative care is necessary to reengage the person in life activities and full participation in mainstream life. The Rehabilitation interventions are to be person centered with supports from the environment and removal of barriers to progress recovery. Rehabilitative care should be enhanced by integrated recovery-orientated practices that sustain hope, promote self-agency. This paper discusses the definition of psychiatric rehabilitation and a model of the processes involved.","PeriodicalId":113988,"journal":{"name":"INDIAN JOURNAL OF MENTAL HEALTH AND NEUROSCIENCES","volume":"27 5","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114043359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-07-14DOI: 10.32746/10.32746/ijmhns.2018.v1.i1.6
Arun Vangili
Introduction: Children with developmental disorders are more prone for mental disorders and suicidality. Suicidality often indicates a psychiatric emergency and it is crucial to have an understanding for more effective and efficient inter-vention. However there is scant literature on the prevalence, risk factors and other characteristics associated with sui-cidality in this population all over the world and especially in India. Content: In this article we highlight the factors related to suicidality in 3 children with developmental disabilities who were admitted to a tertiary care inpatient psychi-atric facility (NIMHANS). Discussion; All three children had multiple psychiatric diagnoses and greater psychosocial adversities. Conclusion: there is a need for reliable screening instruments and routine screening and clinician awareness on this aspect of caring for children with DD.
{"title":"A Case Series of Children with Developmental Disabilities with Suicidality","authors":"Arun Vangili","doi":"10.32746/10.32746/ijmhns.2018.v1.i1.6","DOIUrl":"https://doi.org/10.32746/10.32746/ijmhns.2018.v1.i1.6","url":null,"abstract":"Introduction: Children with developmental disorders are more prone for mental disorders and suicidality. Suicidality often indicates a psychiatric emergency and it is crucial to have an understanding for more effective and efficient inter-vention. However there is scant literature on the prevalence, risk factors and other characteristics associated with sui-cidality in this population all over the world and especially in India. Content: In this article we highlight the factors related to suicidality in 3 children with developmental disabilities who were admitted to a tertiary care inpatient psychi-atric facility (NIMHANS). Discussion; All three children had multiple psychiatric diagnoses and greater psychosocial adversities. Conclusion: there is a need for reliable screening instruments and routine screening and clinician awareness on this aspect of caring for children with DD.","PeriodicalId":113988,"journal":{"name":"INDIAN JOURNAL OF MENTAL HEALTH AND NEUROSCIENCES","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123860534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-07-14DOI: 10.32746/10.32746/ijmhns.2018.v1.i1.3
P. Kandasamy
Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder, with increasing prevalence globally. Early intervention has been shown to improve the core deficits and result in a favorable outcome in children with ASD. Various interventional methods, novel mechanisms, and approaches are being widely researched. Though accelerating interventional research in ASD is observed globally, evidence from Indian setting is sparse. Given the uniqueness of cultural, socio-economic conditions, population statistics, existing health care and referral system, it is pivotal to develop and test interventional methods that are applicable and acceptable to the indigenous population. This paper reviews the currently available evidence-based treatment modalities in the Indian settings, with a specific focus on the behavioral interventions. Early diagnosis is seldom seen to translate into early intervention. In the background of the existing challenges, strategies to translate research into practice in terms of developing sustainable methods of service delivery, capacity building, training of trainers, need for liaison between experts and role of health care policy makers are discussed. Improving awareness among parents, medical professionals and stakeholders is the first step forward, towards translating research into practice.
{"title":"Early intervention of Autism Spectrum Disorder: translating research into practice","authors":"P. Kandasamy","doi":"10.32746/10.32746/ijmhns.2018.v1.i1.3","DOIUrl":"https://doi.org/10.32746/10.32746/ijmhns.2018.v1.i1.3","url":null,"abstract":"Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder, with increasing prevalence globally. Early intervention has been shown to improve the core deficits and result in a favorable outcome in children with ASD. Various interventional methods, novel mechanisms, and approaches are being widely researched. Though accelerating interventional research in ASD is observed globally, evidence from Indian setting is sparse. Given the uniqueness of cultural, socio-economic conditions, population statistics, existing health care and referral system, it is pivotal to develop and test interventional methods that are applicable and acceptable to the indigenous population. This paper reviews the currently available evidence-based treatment modalities in the Indian settings, with a specific focus on the behavioral interventions. Early diagnosis is seldom seen to translate into early intervention. In the background of the existing challenges, strategies to translate research into practice in terms of developing sustainable methods of service delivery, capacity building, training of trainers, need for liaison between experts and role of health care policy makers are discussed. Improving awareness among parents, medical professionals and stakeholders is the first step forward, towards translating research into practice.","PeriodicalId":113988,"journal":{"name":"INDIAN JOURNAL OF MENTAL HEALTH AND NEUROSCIENCES","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130621935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-07-14DOI: 10.32746/10.32746/ijmhns.2018.v1.i1.5
V. Menon
Depression is a heterogeneous illness and depression with co-morbid physical illness may represent a phenotype of depression. Concurrent medical illness in depression is associated with greater functional and social impairment and significantly higher health care costs. A variety of mechanisms including lifestyle factors, immune-inflammatory pathways, medications and psychological factors have been proposed to explain the association between depression and physical illness. However, each of these pathways engenders unique challenges in managing such patients. Of utmost importance is to establish the nature of the underlying medical or psychological cause(s) which will inform customized management plans. This article initially reviews the prevalence of depression in medical conditions and vice versa. Subsequently, we move on to discuss specific approaches to diagnosis of depression in the context of medical co-morbidity. Finally, we describe evidence based pharmacological and psychosocial intervention strategies with some recommendations for common clinical scenarios. Evidence based care models to manage depression with physical illness are described which may be adapted for use in low resource settings.
{"title":"Challenges in management of Major Depression in patients with co-morbid medical conditions","authors":"V. Menon","doi":"10.32746/10.32746/ijmhns.2018.v1.i1.5","DOIUrl":"https://doi.org/10.32746/10.32746/ijmhns.2018.v1.i1.5","url":null,"abstract":"Depression is a heterogeneous illness and depression with co-morbid physical illness may represent a phenotype of depression. Concurrent medical illness in depression is associated with greater functional and social impairment and significantly higher health care costs. A variety of mechanisms including lifestyle factors, immune-inflammatory pathways, medications and psychological factors have been proposed to explain the association between depression and physical illness. However, each of these pathways engenders unique challenges in managing such patients. Of utmost importance is to establish the nature of the underlying medical or psychological cause(s) which will inform customized management plans. This article initially reviews the prevalence of depression in medical conditions and vice versa. Subsequently, we move on to discuss specific approaches to diagnosis of depression in the context of medical co-morbidity. Finally, we describe evidence based pharmacological and psychosocial intervention strategies with some recommendations for common clinical scenarios. Evidence based care models to manage depression with physical illness are described which may be adapted for use in low resource settings.","PeriodicalId":113988,"journal":{"name":"INDIAN JOURNAL OF MENTAL HEALTH AND NEUROSCIENCES","volume":"195 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114973978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-07-14DOI: 10.32746/10.32746/ijmhns.2018.v1.i1.9
D. Srinivasan, Kannan Gk, J. Menon
The domains of Psychiatry and Neurosciences have progressed from being poor cousins of Medicine to becoming one of the frontier fields in modern medicine, incorporating cutting edge science and research initiatives and influencing diverse areas like management, humanities, conflict resolution, development, organisational systems, astronomy, sports etc. After the decade of the brain, it seems the field has taken off to hitherto unimagined heights. Needless to say, we are in exciting times.
{"title":"Heralding a new era","authors":"D. Srinivasan, Kannan Gk, J. Menon","doi":"10.32746/10.32746/ijmhns.2018.v1.i1.9","DOIUrl":"https://doi.org/10.32746/10.32746/ijmhns.2018.v1.i1.9","url":null,"abstract":"The domains of Psychiatry and Neurosciences have progressed from being poor cousins of Medicine to becoming one of the frontier fields in modern medicine, incorporating cutting edge science and research initiatives and influencing diverse areas like management, humanities, conflict resolution, development, organisational systems, astronomy, sports etc. After the decade of the brain, it seems the field has taken off to hitherto unimagined heights. Needless to say, we are in exciting times.","PeriodicalId":113988,"journal":{"name":"INDIAN JOURNAL OF MENTAL HEALTH AND NEUROSCIENCES","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129275365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-07-14DOI: 10.32746/ijmhns.2018.v1.i1.2
V. Raghavan
Background: With the growth of early intervention services for psychosis worldwide, it is imperative to understand the current knowledge on first-episode psychosis (FEP) from Indian context. Hence, the purpose of this review is to comprehensively examine the research studies on FEP from India. This would help to compare and contrast with other countries, develop specialist early intervention services and enlist research priorities pertaining to FEP. Methods: A Boolean search of articles published from January 1990 to March 2018 in electronic database of PubMed and Google Scholar was carried out and original research studies done on first-episode psychosis in India were incorporated in the current review. Case reports and review articles were excluded. Results: A total of 31 research studies were included for the review and classified into different subheadings of convenience. Conclusion: Even though the number of studies in Indian context pertaining to FEP is comparatively less than other western literature, the available results indicate certain characteristic similarities and differences in FEP from other parts of the world. We have also discussed on the importance of early intervention in FEP and the necessity for the creation of specialist early intervention services for mental health disorders.
{"title":"First-episode psychosis research in India: A review","authors":"V. Raghavan","doi":"10.32746/ijmhns.2018.v1.i1.2","DOIUrl":"https://doi.org/10.32746/ijmhns.2018.v1.i1.2","url":null,"abstract":"Background: With the growth of early intervention services for psychosis worldwide, it is imperative to understand the current knowledge on first-episode psychosis (FEP) from Indian context. Hence, the purpose of this review is to comprehensively examine the research studies on FEP from India. This would help to compare and contrast with other countries, develop specialist early intervention services and enlist research priorities pertaining to FEP. Methods: A Boolean search of articles published from January 1990 to March 2018 in electronic database of PubMed and Google Scholar was carried out and original research studies done on first-episode psychosis in India were incorporated in the current review. Case reports and review articles were excluded. Results: A total of 31 research studies were included for the review and classified into different subheadings of convenience. Conclusion: Even though the number of studies in Indian context pertaining to FEP is comparatively less than other western literature, the available results indicate certain characteristic similarities and differences in FEP from other parts of the world. We have also discussed on the importance of early intervention in FEP and the necessity for the creation of specialist early intervention services for mental health disorders.","PeriodicalId":113988,"journal":{"name":"INDIAN JOURNAL OF MENTAL HEALTH AND NEUROSCIENCES","volume":"73 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115070795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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