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Future of Technology and Medicine is Interlinked Psychiatry will be a major Beneficiary 技术与医学的未来是相互关联的精神病学将是一个主要受益者
Pub Date : 2023-03-25 DOI: 10.55229/ijbs.v26i1.01
A. Tripathi
The world is in the midst of large technological expansion and innovation. Technological growth is exponential and rapid in the last few decades. It has consistently increased in reach as well as capabilities. The exponential growth in various technologies that can be useful in practice and teaching/training medical students like wearable devices, e-learning, simulated patients, virtual learning, and interaction, is immense.
世界正处于大规模的技术扩张和创新之中。在过去的几十年里,技术的发展呈指数级增长。它的覆盖范围和能力都在不断扩大。可穿戴设备、电子学习、模拟病人、虚拟学习和互动等各种技术在实践和教学/培训医学生中有用的指数级增长是巨大的。
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引用次数: 0
Profile of Patients attending the Neuropsychiatric Specialty Clinic of a Tertiary Care Teaching Hospital in North India: A Retrospective Chart Review 印度北部一家三级护理教学医院神经精神专科诊所的患者概况:回顾性图表回顾
Pub Date : 2023-03-23 DOI: 10.55229/ijbs.v26i1.06
Sujita Kumar Kar, A. Prakash, P. Dalal
Background:  Over past several decades various sub-specialities are developed in the field of mental health. Neuropsychiatry is a subspeciality of psychiatry that focuses on the mental health issues of patients that lie in the interface of neurology and psychiatry. Very few institutes in India, provide neuropsychiatric speciality care through the speciality clinics. Aims & objectives: The aim of this study is to evaluate the profile of patients attending the neuropsychiatric speciality clinic of a tertiary care teaching hospital in north India Material & Method: This is a retrospective chart review of all registered patients attending the neuropsychiatric specialty clinic of a tertiary care teaching hospital of north India. Clinical details of all the registered patients from the time of inception (January 2016) till December, 2020, were extracted and analysed after getting approval from the Institutional Ethics Committee. Result: A total of 202 patients were recruited in the study, of which 53% were males and 47% were females with age ranging from 10 years to 76 years. In the year 2020, there was more than 50% drop in the new registrations due to COVID-19 pandemic (lockdown & closure of specialty clinic). Approximately, half of the patients had neurological co-morbidities, whereas nearly 1/4th patients had no medical comorbidities. Average number of medications received at the time of initial consultation was 3.15 ± 2.09. Nearly, half of the patients had common mental disorders, whereas 1/5th patients had severe mental disorder. History of seizure disorder, head injury and meningitis/encephalitis were present in 17%, 10% and 5% respectively. Faith healing was as common as 42% among the patients attending neuropsychiatry clinic. Tobacco use disorder is the most common comorbid substance use disorder followed by alcohol and cannabis. Conclusion:  Neuropsychiatric conditions are seen in all ages, both genders. Neurological co-morbidities are the common co-morbidities and patients often receive polypharmacy. Common mental disorders are the most common presentation. History of seizure disorder, tobacco use disorder are common among neuropsychiatric patients.
背景:在过去的几十年里,心理健康领域发展了不同的亚专业。神经精神病学是精神病学的一个亚专科,主要研究患者的心理健康问题,是神经病学和精神病学的交叉学科。印度很少有机构通过专科诊所提供神经精神专科护理。目的与目的:本研究的目的是评估在印度北部某三级护理教学医院神经精神专科门诊就诊的患者的概况材料与方法:这是一项回顾性的图表综述,包括在印度北部某三级护理教学医院神经精神专科门诊就诊的所有登记患者。在获得机构伦理委员会批准后,提取并分析所有注册患者从成立时(2016年1月)至2020年12月的临床详细信息。结果:共纳入202例患者,其中男性53%,女性47%,年龄10 ~ 76岁。2020年,由于COVID-19大流行(专科诊所封锁和关闭),新登记人数下降了50%以上。大约一半的患者有神经系统合并症,而近1/4的患者没有医学合并症。初诊时平均服药次数为3.15±2.09次。近一半的患者有常见的精神障碍,而五分之一的患者有严重的精神障碍。癫痫发作史、颅脑损伤史和脑膜炎/脑炎史分别占17%、10%和5%。在神经精神病学诊所就诊的患者中,信仰治疗的比例高达42%。烟草使用障碍是最常见的共病性物质使用障碍,其次是酒精和大麻。结论:神经精神疾病在所有年龄、性别中均可见。神经系统合并症是常见的合并症,患者常接受多种药物治疗。常见精神障碍是最常见的表现。癫痫发作史、烟草使用障碍在神经精神病人中是常见的。
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引用次数: 0
Study Protocol of Death Anxiety, Perceived Stress, Sleep Quality, Cardiac Illness Denial and Subjective Well-being among Stable Patients with Acute Myocardial Infarction 稳定型急性心肌梗死患者死亡焦虑、感知压力、睡眠质量、心脏病否认和主观幸福感的研究方案
Pub Date : 2023-03-23 DOI: 10.55229/ijbs.v26i1.04
Sujita Kumar Kar, Abhilash Boda, A. Pradhan, A. Prakash, Ankita Saroj, A. Shankar, Ashutosh Kumar Singh, P. Vishwakarma, R. Sethi
Background: It has been seen that negative affective states (e.g., depression, anxiety, anger), social isolation, and social insecurity are specific psychosocial determinants that adversely influence ischemic heart diseases, and these patients experience higher levels of death anxiety. Hence, studying death anxiety, perceived stress, sleep quality, and illness acceptance among myocardial infarction (MI) patients will give insight into their psychosocial management. Method: The study will be conducted on patients (18-60 years) with a diagnosis of Acute MI hospitalized in the Cardiology Unit of King Georges' Medical University and clinically stable at the time of assessment. The participants will be assessed via semi-structured proforma for sociodemographic and clinical details, the scale of Death Anxiety (SDA), perceived Stress scale, single Item Sleep quality Index, Cardiac Denial of Impact Scale and WHO wellbeing index- 5. Result: This study will measure death anxiety, perceived stress, sleep quality, Cardiac Denial of Impact Scale and subjective wellbeing among stable patients with acute Myocardial Infarction (MI), to study their association with acute Myocardial Infarction (MI), and their change with time during follow up (10-12 weeks after the initial event). Conclusion: It is expected that death anxiety and perceived stress will be high among patients with acute myocardial infarction, affecting their sleep quality and subjective wellbeing.
背景:研究发现,负面情感状态(如抑郁、焦虑、愤怒)、社会孤立和社会不安全感是对缺血性心脏病产生不利影响的特定社会心理决定因素,这些患者的死亡焦虑水平更高。因此,研究心肌梗死(MI)患者的死亡焦虑、感知压力、睡眠质量和疾病接受度将有助于深入了解他们的心理社会管理。方法:研究对象为乔治国王医科大学心内科住院诊断为急性心肌梗死且评估时临床稳定的患者(18-60岁)。参与者将通过半结构化形式的社会人口学和临床细节、死亡焦虑量表(SDA)、感知压力量表、单项睡眠质量指数、心脏拒绝影响量表和世卫组织健康指数- 5进行评估。结果:本研究将对稳定型急性心肌梗死(MI)患者的死亡焦虑、感知压力、睡眠质量、心脏拒绝影响量表和主观幸福感进行测量,研究其与急性心肌梗死(MI)的相关性,以及随访期间(初始事件发生后10-12周)随时间的变化。结论:急性心肌梗死患者存在较高的死亡焦虑和感知应激,影响其睡眠质量和主观幸福感。
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引用次数: 1
Persisting Delirium as a Presenting Feature of an Underlying Myeloproliferative Neoplasm in Elderly 持续谵妄是老年人潜在骨髓增生性肿瘤的表现特征
Pub Date : 2023-03-23 DOI: 10.55229/ijbs.v26i1.09
Dr. Suresh Heijebu, Dr. Akanksha Sonal, Dr. Shrikant Srivastava
A 71 year old female presented with an unusually long course of persisting delirium and a rapid downhill functional decline. She presented with progressive symptoms over a course of year with confused behaviour, sleep disturbances, irrelevant talk and restlessness followed by difficulty in walking, falls, speech disturbances, generalized weakness of six months duration and decreased appetite with urinary and stool incontinence of 2 week duration. Her lab reports had shown consistently abnormal blood counts for 4 years before hospitalisation. The abnormalities from peripheral blood smear and GBP (general blood picture) showed elevated platelet count, total leucocyte count and decreased red blood cell count and haemoglobin level. Investigations for myeloproliferative neoplasm (MPN) included the Reflex profile (JAK mutations on qualitative RT-PCR), and bone marrow biopsy (increased megakaryocytes suggestive of Essential thrombocythemia). Patient was started on Oral Hydroxyurea along with oral anti platelet and hypolipidemic drugs. Six months post chemotherapy initiation remained asymptomatic.   Keywords: elderly, delirium, myeloproliferative, neoplasia.
一位71岁的女性表现出异常长时间的持续谵妄和快速下坡的功能下降。在一年的病程中,她表现出进行性症状,包括行为混乱、睡眠障碍、无关的谈话和不安,随后出现行走困难、跌倒、语言障碍、持续6个月的全身无力、食欲下降和尿便失禁持续2周。她的实验室报告显示,在住院前的4年里,她的血液计数一直异常。外周血涂片和GBP(全身血象)显示血小板计数、白细胞总数升高,红细胞计数和血红蛋白水平降低。骨髓增生性肿瘤(MPN)的检查包括反射谱(定性RT-PCR上的JAK突变)和骨髓活检(巨核细胞增加提示原发性血小板增多症)。患者开始口服羟脲,同时口服抗血小板和降血脂药物。化疗开始后6个月仍无症状。关键词:老年人,谵妄,骨髓增生性,肿瘤。
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引用次数: 0
Atypical Presentation of Anxiety in a patient with Intellectual Disability: A case report and brief review of literature 智力残疾患者焦虑的非典型表现:一例报告和文献综述
Pub Date : 2023-03-23 DOI: 10.55229/ijbs.v26i1.08
Shivangi Singh, A. Tripathi, Tripathi Singh S
OBJECTIVE: The diagnosis of psychiatric illness in patients with Intellectual Disability remains clinically challenging in several clinical situations owing to the patient’s limited intellectual functioning and adaptive behavior. Hence, this may lead to different and atypical manifestation of psychiatric symptoms and signs in these patients. METHOD: We present a case of a 17-year-old boy with moderate intellectual disability who presented to us with chief complaints of dysphagia for 2 months. Personal history indicative of delayed milestones and difficulty in learning simple tasks. Premorbid temperament revealed anxious traits in the child. On MSE affect was distressed, speech was decreased in volume, psychomotor activity was increased and thinking revealed pre-occupation with symptom. Intelligence revealed poor general fund of knowledge and poor arithmetic ability. Insight was absent (Grade I). RESULTS AND DISCUSSION: On the basis of history and MSE a provisional diagnosis of anxiety disorder, unspecified (F41.9) was kept. The patient was started on treatment Tab Mirtazapine 7.5mg ½ BD. The patient showed significant improvement following initiation of treatment. Patients with intellectual disability have difficulty in expressing their psychological symptoms in words at times and present with atypical symptoms of the underlying disorder. This delays their diagnosis and appropriate management. Due to lack of reporting of psychological symptoms patient often continues seeking treatment from general practitioners which leads to loss of time as well as money. CONCLUSION: Physicians and psychiatrists themselves need to be more watchful when evaluating a patient with intellectual disability due to the atypical presentation of symptoms.
目的:由于智力残疾患者的智力功能和适应性行为有限,在临床上对精神疾病的诊断仍然具有挑战性。因此,这可能导致这些患者出现不同的和非典型的精神症状和体征。方法:我们报告了一个17岁的中度智力障碍男孩的病例,他向我们提出了吞咽困难的主诉2个月。个人历史表明里程碑延迟和学习简单任务困难。发病前的气质显示了孩子的焦虑特征。MSE患者情绪低落,言语量减少,精神运动活动增加,思维表现为症状前占。智力表现出一般知识基础差和算术能力差。没有洞察力(I级)。结果和讨论:根据病史和MSE,暂时诊断为焦虑症,未明确(F41.9)。患者开始使用米氮平7.5mg½BD。患者在开始治疗后表现出显著改善。智力障碍患者有时难以用语言表达其心理症状,并表现出潜在障碍的非典型症状。这延误了他们的诊断和适当的管理。由于缺乏心理症状的报告,患者往往继续寻求全科医生的治疗,导致时间和金钱的损失。结论:医生和精神科医生在评估由于非典型表现而导致的智力残疾患者时需要更加警惕。
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引用次数: 0
Perspective of Teachers on the Mental Health of Students: A Mental Health Literacy Survey 教师对学生心理健康的看法:心理健康素养调查
Pub Date : 2023-03-23 DOI: 10.55229/ijbs.v26i1.07
Shilpa Aggarwal, Palasha Parikh
Improving mental health literacy in teachers can help in early identification of mental health problems in children and adolescents and facilitate help-seeking behaviour. Objective: A mental health literacy survey was undertaken in a school located in Bijnor district, Uttar Pradesh to assess baseline knowledge and beliefs about mental health issues in teachers. Method: A questionnaire based on Mental Health Literacy and Capacity Survey For Educators was administered in 39 teachers in an English medium school in Bijnor, Uttar Pradesh. Results: Impulse control difficulties, family and stress related issues, anger issues and bullying were the most common problems that teachers faced with the students in three months preceding the survey. The four commonest measures teachers used to deal with the problems included meeting with the parents (82%), talking with the students to understand the problem and offering support (75%), changing their style of interaction with the student (75%) and reaching out to the administration of the school for support (33%). Increased training opportunities and promotion of collaborative problem solving techniques were some of the measures suggested by teachers to improve mental health literacy. Additional measures such as encouraging students’ to participate in extracurricular activities were suggested to support the mental health needs of the students better. Conclusion: Mental health literacy evaluation in teachers and structured programmes to improve mental health literacy can help teachers in supporting the mental health needs of students.
提高教师的心理健康素养有助于及早发现儿童和青少年的心理健康问题,并促进寻求帮助的行为。目的:在北方邦比杰诺尔地区的一所学校进行心理健康素养调查,以评估教师对心理健康问题的基本知识和信念。方法:采用《教育工作者心理健康素养与能力调查》问卷对北方邦比杰诺尔一所英语学校的39名教师进行调查。结果:冲动控制困难、家庭压力问题、愤怒问题和欺凌是教师在调查前3个月面对学生时最常见的问题。教师在处理问题时最常用的四种措施包括与家长会面(82%)、与学生交谈以了解问题并提供支持(75%)、改变与学生互动的方式(75%)和向学校行政部门寻求支持(33%)。增加培训机会和促进协作解决问题的技巧是教师建议的提高心理健康素养的一些措施。建议采取鼓励学生参加课外活动等措施,更好地支持学生的心理健康需求。结论:教师心理健康素养评价及提高心理健康素养的结构化方案有助于教师支持学生的心理健康需求。
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引用次数: 0
A Randomized Controlled Single-blind Trial of Transcranial Direct Current Stimulation as Early Augmentation in Major Depressive Disorder: Protocol of a Proof-of-Concept Study 经颅直流电刺激作为重度抑郁症早期增强治疗的随机对照单盲试验:一项概念验证研究方案
Pub Date : 2023-03-23 DOI: 10.55229/ijbs.v26i1.05
B. Kumari, Sujita Kumar Kar, Ashutosh Kumar Singh, A. Tripathi, V. Agarwal
Background: Transcranial direct current stimulation (tDCS) used for augmentation improves depressive symptoms in patients who have a partial or poor response to antidepressant medications. However, its role and effectiveness as an early intervention have not been studied much. This study aims to determine the efficacy and safety of add-on tDCS as an early augmentation strategy in drug-naive patients with major depressive disorder.Methods: A total of 40 patients will be enrolled in the study, randomized into two groups (active and sham), and receive uniform medication Escitalopram 10 mg per day. A total of 10 sessions of tDCS will be given within 2 weeks. Assessments will be done using scales Hamilton Anxiety Rating Scale (HAM-A), Hamilton Depression Rating Scale (HAM-D) and Beck’s Depression Inventory (BDI) at baseline, week 2, and week 4 of the study. After each session of tDCS, a side effects checklist will be applied to monitor side effects. The trial has been registered in the Clinical Trials Registry, India(CTRI/2022/01/039123).Result: After data collection, statistical analysis will be done using a computerized statistical program, Statistical Package for Social Sciences. Mean changes in the rating scale scores will be compared after each assessment and between the groups. Conclusion: The findings will help to assess the efficacy of tDCS in the early augmentation of depressive disorder
背景:经颅直流电刺激(tDCS)用于增强抗抑郁药物部分或不良反应的患者的抑郁症状。然而,其作为早期干预的作用和有效性尚未得到过多的研究。本研究旨在确定附加tDCS作为一种早期增强策略在未用药的重度抑郁症患者中的有效性和安全性。方法:40例患者将被纳入研究,随机分为两组(活跃组和假手术组),并统一给予艾司西酞普兰10mg / d。两周内将举行10次tDCS。在研究的基线、第2周和第4周,将使用汉密尔顿焦虑评定量表(HAM-A)、汉密尔顿抑郁评定量表(HAM-D)和贝克抑郁量表(BDI)进行评估。在每次tDCS治疗后,将使用副作用检查表来监测副作用。该试验已在印度临床试验登记处注册(CTRI/2022/01/039123)。结果:数据收集后,将使用计算机统计程序进行统计分析,统计软件包为社会科学。将在每次评估后和组间比较评定量表得分的平均变化。结论:本研究结果有助于评价tDCS在抑郁症早期增强中的作用
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引用次数: 0
Utility of Brief Illness Perception Questionnaire for Assessing the Acute Impact of COVID-19 Infection: A Psychometric Study 简短疾病感知问卷在评估COVID-19感染急性影响中的应用:一项心理测量学研究
Pub Date : 2023-03-22 DOI: 10.55229/ijbs.v26i1.03
A. Lahiri, R. Sutar, Gaurav Singh
Background: The coronavirus disease-19 (COVID-19) pandemic has created mental health repercussions in the lives of many individuals. It is important to understand emergent perceptions of this illness among patients with a recent diagnosis of COVID-19. Due to its good psychometric properties, the brief illness perception questionnaire (BIPQ) has been widely used for various illnesses and in different languages. Its application in recently diagnosed COVID-19 patients is an area worth exploring in an Indian setting.Aim We aim to understand the patient’s perception of COVID-19 illness using the hindi adaptation of BIPQ and validate for its further use in a similar type of acute setting.Method This tool was customized by three subject experts for its application in recently diagnosed COVID-19 patients. A customized tool was circulated to nine subject matter specialists for the computation of the content validity index. The tool link was shared with patients. A total of 112 patients responded. Factor analysis and reliability analysis were also conducted.Result Item content validity index for all items in the BIPQ scale was in the acceptable range (value above 70%). Scale-content validity index/universal agreement was 88.8%. Bartlett’s test was significant (p < 0.001) and the Kaiser-Meier-Olkin measure of sampling adequacy was 0.777. The factor loading threshold was fixed at a value above 0.40. Eight Likert scale items of BIPQ based on factor analysis were regrouped in two. Items one, two, four, five, and eight were in group one, which depicted “concrete perception,” and items three, six, and seven were in group two which depicted “gestalt perception” of recently diagnosed COVID-19 patients. Cronbach’s alpha of the scale was found to be high at 0.808.Conclusion Results depicted a two-factor structure of BIPQ with satisfactory validity and reliability. We suggest regrouping of existing items of BIPQ into two domains, namely “concrete perception” and “gestalt perception” for recently diagnosed patients with COVID-19. 
背景:冠状病毒病-19 (COVID-19)大流行对许多人的生活造成了心理健康影响。重要的是要了解最近诊断为COVID-19的患者对这种疾病的新看法。摘要疾病感知问卷由于其良好的心理测量特性,已被广泛应用于各种疾病和不同语言。它在最近确诊的COVID-19患者中的应用是一个值得在印度环境中探索的领域。目的:我们的目标是通过使用印度版BIPQ来了解患者对COVID-19疾病的感知,并验证其在类似类型的急性环境中的进一步使用。方法该工具由3名学科专家定制,用于新冠肺炎确诊患者。将定制的工具分发给9位主题专家,用于计算内容效度指数。该工具链接与患者共享。总共有112名患者有反应。并进行了因子分析和信度分析。结果BIPQ量表各项目内容效度指标均在可接受范围内(70%以上)。量表-内容效度指数/普遍一致性为88.8%。Bartlett检验具有显著性(p < 0.001), Kaiser-Meier-Olkin抽样充分性测量值为0.777。因子加载阈值固定在0.40以上。将基于因子分析的8个Likert BIPQ量表项目重组为2个。第1、2、4、5、8项是描述“具体感知”的第1组,第3、6、7项是描述新冠肺炎患者“完形感知”的第2组。量表的Cronbach’s alpha值较高,为0.808。结论双因子结构具有良好的信度和效度。我们建议将新冠肺炎患者现有的BIPQ项目重组为“具体感知”和“格式塔感知”两个领域。
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引用次数: 0
District Mental Health Program: Inception, Evolution and Challenges 地区精神健康计划:开始、演变和挑战
Pub Date : 2023-03-22 DOI: 10.55229/ijbs.v26i1.02
Vipul Singh
In 1982, National Mental Health Program (NMHP) was launched in India. In order to suffice its aim and objectives and effective coverage of mental health care, a district level program was suggested and for which NIMHANS did a pilot project in between 1985-90 and finally District Mental Health Program (DMHP) was started in Bellary district of Karnataka. Since then, the DMHP has been running in entire nation for fulfilling its aim and objectives and delivering mental health care services. In the span of almost three decades, the Program has been monitored and assessed periodically in terms of its effectiveness by keeping the vision of fulfillment of its goals. In this article we are reviewin  theachievements of DMHP and how far we have reached to achieve the goals.
1982年,印度启动了国家精神卫生方案(NMHP)。为了实现其宗旨和目标并有效覆盖精神保健,提出了一项地区一级的方案,NIMHANS为此在1985- 1990年期间开展了一个试点项目,最后在卡纳塔克邦的Bellary地区启动了地区精神保健方案。从那时起,DMHP一直在全国范围内运行,以实现其宗旨和目标,并提供精神卫生保健服务。在近三十年的时间里,通过保持实现其目标的远见,对该方案的有效性进行了定期监测和评估。在本文中,我们将回顾DMHP的成就以及我们为实现目标所取得的成就。
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引用次数: 0
Perceived Social Support and Attitude towards Modernization among Performing Arts Students 演艺学生社会支持感与现代化态度
Pub Date : 2022-10-31 DOI: 10.55229/ijbs.v25i2.05
Pramod R Gupta, Lokesh Kumar Ranjan, Nilesh Maruti Gujar
AbstractBackground: The effect of modernization can be different aspects of a person`s life. Modernization has been seen through education, communication and social support of individuals in the community. Young adults especially college students approach modernization from experiences during the academic period.Aim: To study the perceived social support and attitude towards modernization among performing arts students.Materials and Methods: A cross-sectional study was conducted among college students of Indira Kala Sangit Vishwavidyalaya, Khairagarh, Chhattisgarh, India. A total of 540 students were selected for the study through the enumeration method. Students were assessed through the semi-structured socio-demographic datasheet, the modernization scale, and multidimensional scale of perceived social support.Results: Perceived social support found a significant positive correlation with attitude towards modernization. In regression analysis, overall perceived social support (family, friend and other support) strongly contributes to the variance on attitude towards modernization among performing arts students. Family support, other support, overall perceived social support and attitude towards modernization were more in female as compared to male with performing arts students.Conclusions: Perceived social support strongly contributes and positive significant correlation to the variance on attitude towards modernization.
摘要背景:现代化的影响可以体现在一个人生活的方方面面。现代化是通过社区个人的教育、交流和社会支持来实现的。年轻人,尤其是大学生,从学术时期的经历中接近现代化。目的:研究演艺专业学生的社会支持感知与现代化态度。材料与方法:以印度恰蒂斯加尔邦Khairagarh的Indira Kala Sangit Vishwavidyalaya的大学生为研究对象进行横断面研究。通过枚举法选取540名学生作为研究对象。学生通过半结构化社会人口统计数据表、现代化量表和多维感知社会支持量表进行评估。结果:感知社会支持与现代化态度显著正相关。在回归分析中,整体感知的社会支持(家庭、朋友和其他支持)对演艺学生对现代化态度的差异有重要影响。表演艺术系学生中,女生在家庭支持、其他支持、整体感知社会支持和对现代化的态度方面高于男生。结论:感知社会支持对现代化态度差异有显著影响,且呈显著正相关。
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引用次数: 0
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Indian Journal of Behavioural Sciences
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