Industrial Psychiatry Journal最新文献

Background: Amputation significantly impacts an individual's physical and psychological well-being. It is essential to understand these implications of amputation as well as the coping and resilience of amputees as part of comprehensive patient care.

Aim: To study depression, anxiety, coping, and resilience among tertiary care amputee cases.

Materials and methods: Consecutive 100 amputees seeking treatment in a tertiary care hospital were included in the study with their consent after ethics committee approval. The Hospital Anxiety and Depression Scale (HADS), Brief Resilience Scale (BRS-6), and Coping Inventory for Stressful Situations (CISS-21) scale were administered. The data were analyzed using the SPSS software with the Chi-square test and Spearman's correlation.

Results: Depression affected a significant majority (67%) of patients, while anxiety was present in one-third (33%) of individuals. Certain sociodemographic factors and clinical parameters such as age group, residence, socioeconomic status, side of amputation, and duration of amputation showed statistically significant correlations with depression, anxiety, and low resilience. Emotional coping was positively correlated to anxiety (P < 0.001) and depression (P < 0.001) while task coping was negatively correlated to anxiety (P < 0.001) and depression (P < 0.001). Resilience was negatively correlated to anxiety (P < 0.001) and depression (P < 0.001).

Conclusion: There exists a significant burden of depression and anxiety in amputees. Those with positive coping and high resilience were better at adjusting to amputation than those with emotion-based coping and low resilience.

Background: The risk of COVID-19 infection and related health consequences is higher among persons with mental illnesses (PMI). Vaccines have had an impact in reducing the morbidity and mortality in patients with COVID-19 infection. Understanding the reasons for vaccine hesitancy in PMI is crucial for promoting vaccine acceptance in this population, but it remains an under-researched topic.

Aims: This cross-sectional study assessed perspectives among unvaccinated PMI regarding COVID-19 vaccination in a tertiary care teaching hospital. Factors associated with vaccine hesitancy in this population were explored.

Materials and methods: One-hundred consecutive PMI attending the psychiatric outpatient clinic who had not taken the COVID-19 vaccination were recruited after obtaining informed consent. A semi-structured questionnaire was used to elicit knowledge, attitudes, and practices regarding COVID-19 vaccination. The Oxford vaccine hesitancy scale was used to assess vaccine hesitancy; the Brief Psychiatric Rating Scale and Depression Anxiety Stress Scale-21 were administered to assess current psychopathology.

Results: A majority of the participants (62%) were unwilling for the vaccination, the most common reasons being the perception that they were not at risk of infection, and worry about the possible side effects of the vaccination. Factors associated with low vaccine hesitancy were higher levels of education, greater perception of the risk of contracting the disease, belief that vaccination was effective, and easy accessibility to the vaccine.

Conclusion: Improving awareness, providing accurate information, and ensuring better accessibility to vaccines are necessary to improve vaccine coverage among PMI. Mental health professionals need to assume an active role in providing education and clarifying misconceptions among our vulnerable patient population to help mitigate vaccine hesitancy.

Background: Marital conflict and disputes involve many issues to be settled between the couples like finance, health, assets, children, postdivorce securities, etc. The traumatic experiences of separation affect their mental health and the future of their children. Not being conscious of their legal rights and court procedures leads to long court litigation, causing distress and trauma to the couples.

Aim: The aim of the article is to find out the level of psycholegal awareness among couples in conflict, approaching forums like police and courts, and to find the difference between the two groups.

Materials and methods: A sample of 30 couples each from court and noncourt forums was taken. The demographic details were taken and a psycholegal checklist was administered. It is a cross-sectional study and exploratory research design was applied.

Results: There was a significant difference in legal awareness of couples opting for redressal in the court and those opting for counseling in noncourt resolution centers.

Conclusion: The results indicate that a lack of legal awareness among the couples in the two groups may be leading to lengthy litigation.

Disulfiram, an FDA-approved medication for treating alcohol dependence syndrome (ADS), is often used surreptitiously, resulting in severe adverse drug reactions such as disulfiram-induced psychosis (DIP). DIP presents diagnostic challenges, despite being perceived as common; however, there is limited literature available on DIP in India. We describe four cases with a history of psychosis in the background of disulfiram exposure. Our four male patients, aged 30-46 years old, had a history of ADS ranging from 7 to 16 years. They developed DIP after 5-15 days of exposure to disulfiram in doses ranging from 500 to 750 mg. In all cases, disulfiram was administered surreptitiously based on advice from non-experts. Predominant symptomatology included delusion, followed by perceptual disturbances. Naranjo adverse drug reaction probability scale was applied to establish disulfiram as the probable cause of psychosis in all cases. All patients responded to disulfiram discontinuation and a brief period of low-dose antipsychotic therapy within 7 days. The probability of DIP should be explored in a case of ADS presenting with an acute psychotic episode. Disulfiram, though an effective agent, should be used cautiously in selected cases at the recommended dose. Awareness building among family members may prevent and aid in the early detection of DIP.

Background: A large proportion of persons with schizophrenia are either abandoned by their family members in mental hospitals or do not have any family members to look after them. Therefore, almost 2/3^rd of hospital beds are occupied by chronic schizophrenic patients. Very few beds are available for the treatment of acute mental patients who need urgent hospitalization.

Aim: To assess the impact of a comprehensive socio-vocation rehabilitation package on the work productivity and social behavior of persons with chronic schizophrenia.

Materials and methods: Sixty chronic schizophrenic inpatients were included in the present study. Sociodemographic and clinical details were collected on a specially designed Performa for the study. Each patient was rated on a job-up-to-date form at baseline, 3 months, and 6 months after intervention. Data related to the vocational outcome were collected on the supervisor's evaluation form at the end of the first month and then after every month till the end of 6 months after intervention. The patient's social behavior was measured on the Social Behavior Schedule at baseline, 3 months, and 6 months after intervention.

Results: Significant improvement was found in the area of vocational outcomes when a comparison was made from the 1^st month to the 6^th month. Marked improvement was also noticed in their social behaviors after social and vocational rehabilitation.

Conclusion: The overall results suggest that chronic schizophrenic inpatients can be properly rehabilitated if opportunity is provided to them.

Background: Excessive alcohol use leads to a spectrum of liver disease. While physicians treat liver disease, the cause, i.e. alcohol, often remains untreated. This portends a poor overall outcome as such patients may continue to consume alcohol for the want of appropriate treatment directed at alcohol dependence or abuse.

Aim: To assess the prevalence and severity of alcohol dependence among patients with Alcoholic Liver Disease (ALD).

Materials and methods: A cross-sectional observational study was conducted among patients with varying severity of ALD (steatosis, hepatitis, and cirrhosis) where 75 were included. They were evaluated for alcohol dependence using clinical interview and M.I.N.I 6.0. The severity of dependence was rated using the SADQ (Severity of Alcohol Dependence Questionnaire). Appropriate statistical tests were applied to identify correlations.

Results: All the patients of ALD met the criteria of Alcohol Dependence Syndrome (Clinical interview and ICD 10 criteria). Among them, 40% were severely dependent (SADQ >30). Among those with ALD, 57.3% had alcoholic hepatitis, 18.7% had steatosis, and 24% suffered cirrhosis. Patients with cirrhosis had higher median SADQ scores compared to those with steatosis or hepatitis.

Conclusions: All the patients with ALD suffered from Alcohol Dependence Syndrome. Those with the most severe ALD had a higher severity of dependence. To ensure effective treatment and lasting outcomes, there is a need for greater awareness of this fact among physicians. Psychiatric referral of those suffering from ALD will ensure concurrent treatment of Alcohol Dependence Syndrome.

Rasmussen's encephalitis (RE) is a rare neurological disorder characterized by drug-resistant focal epilepsy, progressive hemiplegia, and cognitive decline. While the neurological aspects of RE have been extensively studied, its psychiatric manifestations are often overlooked. This case series presents four illustrative cases of RE with prominent psychiatric symptoms. All cases exhibited a combination of longstanding seizures, developmental delays, and recent-onset psychiatric symptoms, including behavioral disturbances, psychotic features, and altered behavior. Neurological examination revealed characteristic findings such as weakness, tremors, and abnormal reflexes, alongside magnetic resonance imaging evidence of hemicerebral atrophy consistent with RE. Treatment involved a multidisciplinary approach including antiepileptic drugs, antipsychotics, and immunomodulatory therapy. Significant improvements were observed in seizure control and psychiatric symptoms following treatment. Psychiatric manifestations in RE are often attributed to seizure activity and immune responses. RE presents a complex clinical picture with both neurological and psychiatric manifestations. This case series highlights the importance of recognizing and managing psychiatric symptoms in RE to provide comprehensive care to affected individuals.