Pub Date : 2019-07-01DOI: 10.4103/jmhhb.jmhhb_38_18
Sneh Kapoor, M. Mehta, R. Sagar
Background: The past few decades have seen great strides in the field of psychotherapy. With the advancement in technology, alternative modes of therapy dissemination such as computers, telemental health, and manuals are being explored. Obsessive–compulsive disorder (OCD) has increasingly come under the purview of these modes, particularly for the delivery of self-directed exposure and response prevention. The current study explores the effectiveness of self-help manuals (SHMs) in the management of OCD. Methods: The study employed a pre- and post-experimental design. Participants were randomly assigned to one of the three conditions (independent variable) – Therapist-directed Intervention, SHM, and Control Group. Outcome measures used (Dependent Variables) were symptom severity scores as assessed on Yale–Brown Obsessive Compulsive Scale (Y-BOCS). Sixty participants between the ages of 15–45 years were screened and assigned to one of the three conditions. The therapist-directed group received exposure and response prevention (ERP) delivered by the therapist in weekly sessions, while self-help group received the manual with progress updates on a fortnightly basis, and control group received only pharmacotherapy. Outcome assessment was conducted postintervention at 15 weeks. Results: Both therapist-directed as well as SHM groups showed significant improvement from pre- to post-intervention while was not seen for the control group. No significant difference was seen in improvements for the groups using therapist-directed or SHM approach; however, both showed significantly greater improvement on Y-BOCS scores as compared to controls. Conclusion: SHMs produce improvements comparable to that of traditional therapist-directed approaches. The findings raise important implications for the use of manuals as adjuncts or independent therapy models.
{"title":"Use of self-help manual for the management of obsessive–compulsive disorder: Effectiveness in Indian context","authors":"Sneh Kapoor, M. Mehta, R. Sagar","doi":"10.4103/jmhhb.jmhhb_38_18","DOIUrl":"https://doi.org/10.4103/jmhhb.jmhhb_38_18","url":null,"abstract":"Background: The past few decades have seen great strides in the field of psychotherapy. With the advancement in technology, alternative modes of therapy dissemination such as computers, telemental health, and manuals are being explored. Obsessive–compulsive disorder (OCD) has increasingly come under the purview of these modes, particularly for the delivery of self-directed exposure and response prevention. The current study explores the effectiveness of self-help manuals (SHMs) in the management of OCD. Methods: The study employed a pre- and post-experimental design. Participants were randomly assigned to one of the three conditions (independent variable) – Therapist-directed Intervention, SHM, and Control Group. Outcome measures used (Dependent Variables) were symptom severity scores as assessed on Yale–Brown Obsessive Compulsive Scale (Y-BOCS). Sixty participants between the ages of 15–45 years were screened and assigned to one of the three conditions. The therapist-directed group received exposure and response prevention (ERP) delivered by the therapist in weekly sessions, while self-help group received the manual with progress updates on a fortnightly basis, and control group received only pharmacotherapy. Outcome assessment was conducted postintervention at 15 weeks. Results: Both therapist-directed as well as SHM groups showed significant improvement from pre- to post-intervention while was not seen for the control group. No significant difference was seen in improvements for the groups using therapist-directed or SHM approach; however, both showed significantly greater improvement on Y-BOCS scores as compared to controls. Conclusion: SHMs produce improvements comparable to that of traditional therapist-directed approaches. The findings raise important implications for the use of manuals as adjuncts or independent therapy models.","PeriodicalId":31679,"journal":{"name":"Journal of Mental Health and Human Behaviour","volume":"24 1","pages":"104 - 112"},"PeriodicalIF":0.5,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48419952","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 : 2019-07-01DOI: 10.4103/jmhhb.jmhhb_3_19
S. Agarwal, Rakesh Biswas, Abhishek Gupta, S. Choudhary
Refeeding syndrome is an uncommon but potentially fatal condition. It occurs in a patient who consumes a large amount of calories over a brief period of time after a sustained period of starvation. This syndrome is characterized by a high risk of cardiovascular collapse secondary to electrolyte imbalance if left untreated or if there is a delay in the management. Psychiatric patients with a diagnosis of schizophrenia or severe depression are known to refuse food for a prolonged period of time, thus creating a malnourished or starved metabolic state. The purpose of this article is to bring an acute awareness and sensitize the fellow psychiatrists about refeeding syndrome, a likely fatal possibility in a starved or malnourished patient on refeeding. Prompt recognition and management in collaboration with medical colleagues can save the life of these patients.
{"title":"Refeeding syndrome in catatonic schizophrenia","authors":"S. Agarwal, Rakesh Biswas, Abhishek Gupta, S. Choudhary","doi":"10.4103/jmhhb.jmhhb_3_19","DOIUrl":"https://doi.org/10.4103/jmhhb.jmhhb_3_19","url":null,"abstract":"Refeeding syndrome is an uncommon but potentially fatal condition. It occurs in a patient who consumes a large amount of calories over a brief period of time after a sustained period of starvation. This syndrome is characterized by a high risk of cardiovascular collapse secondary to electrolyte imbalance if left untreated or if there is a delay in the management. Psychiatric patients with a diagnosis of schizophrenia or severe depression are known to refuse food for a prolonged period of time, thus creating a malnourished or starved metabolic state. The purpose of this article is to bring an acute awareness and sensitize the fellow psychiatrists about refeeding syndrome, a likely fatal possibility in a starved or malnourished patient on refeeding. Prompt recognition and management in collaboration with medical colleagues can save the life of these patients.","PeriodicalId":31679,"journal":{"name":"Journal of Mental Health and Human Behaviour","volume":"24 1","pages":"151 - 153"},"PeriodicalIF":0.5,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41898324","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 : 2019-07-01DOI: 10.4103/jmhhb.jmhhb_66_19
O. Ravindran, G. Nandini, N. Shanmugasundaram, V. Kapil
Background and Aim: Alcohol and cannabis misuse have an impact on neurocognition. This cross-sectional study evaluated the neuropsychological performance of individuals with alcohol dependence and cannabis dependence with concomitant alcohol use. Materials and Methods: We recruited individuals with alcohol dependence (n = 21) and cannabis dependence with concomitant alcohol use (n = 17) and age being 18–60 years as per the International Classification of Diseases-10th revision criteria. Convenience sampling was done. All the participants were evaluated by a comprehensive neuropsychological battery. Comparisons involving neuropsychological measures were performed using Mann–Whitney U-test. Results: Participants with cannabis dependence with co-occurring alcohol use showed significantly poorer performance than the participants with alcohol dependence on tasks assessing processing speed, working memory, verbal learning and memory, visuospatial ability, and language skills Conclusions: Participants with cannabis dependence with co-occurring alcohol use exhibited poorer cognitive performance on several neuropsychological measures than the participants with alcohol dependence. Age, duration, and early age of cannabis use initiation have no links with cognitive performance in the cannabis + alcohol group.
{"title":"Cognitive functions in alcohol use and cannabis use disorder: A cross-sectional study","authors":"O. Ravindran, G. Nandini, N. Shanmugasundaram, V. Kapil","doi":"10.4103/jmhhb.jmhhb_66_19","DOIUrl":"https://doi.org/10.4103/jmhhb.jmhhb_66_19","url":null,"abstract":"Background and Aim: Alcohol and cannabis misuse have an impact on neurocognition. This cross-sectional study evaluated the neuropsychological performance of individuals with alcohol dependence and cannabis dependence with concomitant alcohol use. Materials and Methods: We recruited individuals with alcohol dependence (n = 21) and cannabis dependence with concomitant alcohol use (n = 17) and age being 18–60 years as per the International Classification of Diseases-10th revision criteria. Convenience sampling was done. All the participants were evaluated by a comprehensive neuropsychological battery. Comparisons involving neuropsychological measures were performed using Mann–Whitney U-test. Results: Participants with cannabis dependence with co-occurring alcohol use showed significantly poorer performance than the participants with alcohol dependence on tasks assessing processing speed, working memory, verbal learning and memory, visuospatial ability, and language skills Conclusions: Participants with cannabis dependence with co-occurring alcohol use exhibited poorer cognitive performance on several neuropsychological measures than the participants with alcohol dependence. Age, duration, and early age of cannabis use initiation have no links with cognitive performance in the cannabis + alcohol group.","PeriodicalId":31679,"journal":{"name":"Journal of Mental Health and Human Behaviour","volume":"24 1","pages":"113 - 119"},"PeriodicalIF":0.5,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42401799","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 : 2019-01-01DOI: 10.4103/jmhhb.jmhhb_21_19
H. Kaur, A. Sidana, T. Singh
Background: Depression is a common mental illness for which guidelines recommend selective serotonin reuptake inhibitors as the first-line treatment. As per the Sequenced Treatment Alternatives to Relieve Depression trial, the first antidepressant needs to be chosen carefully so that the number of treatment changes and therefore treatment resistance can be reduced. This study compared the efficacy and tolerability of escitalopram and venlafaxine, in treatment-naïve patients with first-episode, nonpsychotic unipolar depression. Methodology: In this prospective, randomized, open-label study, 77 patients with the International Classification of Disease-10 Diagnostic Criteria for Research diagnosis of depression were inducted and randomly assigned using a computer-generated random table to receive either escitalopram (10–20 mg/day) or venlafaxine (75–225 mg/day) in therapeutic range for a period of 12 weeks. The assessments included the Hamilton Depression Rating Scale (HDRS) and physical investigations at baseline and weeks 2, 6, and 12. A total of 60 patients completed the study and were included in the final analysis. Results: Thirty patients in each group (n = 60) enrolled with comparable baseline assessment except significantly higher HDRS in the venlafaxine group (29.87 ± 10.58) compared to escitalopram group (21.80 ± 4.41). At 12 weeks, the reduction in HDRS was significantly early and higher in the venlafaxine group (26.3 ± 9.7) than the escitalopram group (21.3 ± 4.2). Common adverse effects in the venlafaxine group included Gastrointestinal (GI) activation and vivid dreams which were seen till 2 weeks; the escitalopram group included sexual dysfunction which lasted till the end of the study. Conclusions: Both the molecules lead to significant reduction in HDRS scores across assessment. However, venlafaxine demonstrated superior efficacy and transient adverse effects compared to escitalopram, despite having higher HDRS scores at baseline. The results of the current study indicate that serotonin–norepinephrine reuptake inhibitors such as venlafaxine should be prescribed more often in routine clinical practice.
{"title":"Comparison of efficacy and tolerability of escitalopram and venlafaxine in treatment-naïve patients with unipolar nonpsychotic depression: Is there a need to revisit the prescription patterns?","authors":"H. Kaur, A. Sidana, T. Singh","doi":"10.4103/jmhhb.jmhhb_21_19","DOIUrl":"https://doi.org/10.4103/jmhhb.jmhhb_21_19","url":null,"abstract":"Background: Depression is a common mental illness for which guidelines recommend selective serotonin reuptake inhibitors as the first-line treatment. As per the Sequenced Treatment Alternatives to Relieve Depression trial, the first antidepressant needs to be chosen carefully so that the number of treatment changes and therefore treatment resistance can be reduced. This study compared the efficacy and tolerability of escitalopram and venlafaxine, in treatment-naïve patients with first-episode, nonpsychotic unipolar depression. Methodology: In this prospective, randomized, open-label study, 77 patients with the International Classification of Disease-10 Diagnostic Criteria for Research diagnosis of depression were inducted and randomly assigned using a computer-generated random table to receive either escitalopram (10–20 mg/day) or venlafaxine (75–225 mg/day) in therapeutic range for a period of 12 weeks. The assessments included the Hamilton Depression Rating Scale (HDRS) and physical investigations at baseline and weeks 2, 6, and 12. A total of 60 patients completed the study and were included in the final analysis. Results: Thirty patients in each group (n = 60) enrolled with comparable baseline assessment except significantly higher HDRS in the venlafaxine group (29.87 ± 10.58) compared to escitalopram group (21.80 ± 4.41). At 12 weeks, the reduction in HDRS was significantly early and higher in the venlafaxine group (26.3 ± 9.7) than the escitalopram group (21.3 ± 4.2). Common adverse effects in the venlafaxine group included Gastrointestinal (GI) activation and vivid dreams which were seen till 2 weeks; the escitalopram group included sexual dysfunction which lasted till the end of the study. Conclusions: Both the molecules lead to significant reduction in HDRS scores across assessment. However, venlafaxine demonstrated superior efficacy and transient adverse effects compared to escitalopram, despite having higher HDRS scores at baseline. The results of the current study indicate that serotonin–norepinephrine reuptake inhibitors such as venlafaxine should be prescribed more often in routine clinical practice.","PeriodicalId":31679,"journal":{"name":"Journal of Mental Health and Human Behaviour","volume":"24 1","pages":"15 - 22"},"PeriodicalIF":0.5,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45797417","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 : 2019-01-01DOI: 10.4103/jmhhb.jmhhb_40_18
S. Bansal, A. Sidana, Shivang Mehta
Background: Magnitude of the menace of opioid dependence syndrome (ODS) is ever escalating especially in Northern India. However, no studies have been attempted to study the pathways to care and reasons for treatment-seeking behavior in patients with ODS. Aim: This study aims to investigate the pathways to care and reasons for treatment seeking in patients with ODS attending the community outreach clinic and de-addiction outpatient department (OPD) of a tertiary care teaching hospital. Materials and Methods: In a cross-sectional, exploratory study, a total of 40 patients diagnosed with ODS as per International Classification of Diseases-10 criteria who visited the psychiatry OPD and community outreach clinic were included. In addition to the sociodemographic and clinical variables, semi-structured questionnaires were developed by the Department of Psychiatry, Government Medical College and Hospital (GMCH), Chandigarh, India, for this study. These were first used in a pilot study and then used for the assessment of reasons for seeking treatment and pathways to care from a particular setting that is either community outreach clinic or OPD. Results: Index study found out that 25% ODS patients attended OPD directly for the first time ever in their life for treatment and 55% attended community outreach clinic run by the Department of Psychiatry, GMCH, Chandigarh, India. For 30% and 35% of the individuals attending OPD and Community outreach clinic, respectively, the first point of contact ever in life since the first use of opioid was any other tertiary care center. Alternative medicine practitioners were consulted by about 20% of the patients seeking help for the first time from OPD and none amongst those attending community outreach clinic. Referral rate was also very low in OPD attending sample (20%) while absolute zero in the community sample. Whereas among reasons for seeking treatment, increasing drug cost was the most cited reason by OPD attending patients and ill-health effects by community clinic attending patients (35% each) in personal reasons, while family-related reasons were poor interpersonal relationships with family members in OPD treatment-seeking patients (45%) and family property dispute in community clinic attending patients (35%). Conclusion: It can be concluded from the study that <50% of patients with substance use disorders visit the psychiatrist for treatment on the first contact. It means that a large number of patients go to different places/people/services for advice/treatment. However, the cost of the drug was one of the main reasons for treatment-seeking behavior in this population. Community clinic attending patients are more aware about the treatment facility available in the vicinity of their dwelling place, thereby preferring a place nearby to their home for treatment.
{"title":"Pathways to care and reasons for treatment-seeking behavior in patients with opioid dependence syndrome: An exploratory study","authors":"S. Bansal, A. Sidana, Shivang Mehta","doi":"10.4103/jmhhb.jmhhb_40_18","DOIUrl":"https://doi.org/10.4103/jmhhb.jmhhb_40_18","url":null,"abstract":"Background: Magnitude of the menace of opioid dependence syndrome (ODS) is ever escalating especially in Northern India. However, no studies have been attempted to study the pathways to care and reasons for treatment-seeking behavior in patients with ODS. Aim: This study aims to investigate the pathways to care and reasons for treatment seeking in patients with ODS attending the community outreach clinic and de-addiction outpatient department (OPD) of a tertiary care teaching hospital. Materials and Methods: In a cross-sectional, exploratory study, a total of 40 patients diagnosed with ODS as per International Classification of Diseases-10 criteria who visited the psychiatry OPD and community outreach clinic were included. In addition to the sociodemographic and clinical variables, semi-structured questionnaires were developed by the Department of Psychiatry, Government Medical College and Hospital (GMCH), Chandigarh, India, for this study. These were first used in a pilot study and then used for the assessment of reasons for seeking treatment and pathways to care from a particular setting that is either community outreach clinic or OPD. Results: Index study found out that 25% ODS patients attended OPD directly for the first time ever in their life for treatment and 55% attended community outreach clinic run by the Department of Psychiatry, GMCH, Chandigarh, India. For 30% and 35% of the individuals attending OPD and Community outreach clinic, respectively, the first point of contact ever in life since the first use of opioid was any other tertiary care center. Alternative medicine practitioners were consulted by about 20% of the patients seeking help for the first time from OPD and none amongst those attending community outreach clinic. Referral rate was also very low in OPD attending sample (20%) while absolute zero in the community sample. Whereas among reasons for seeking treatment, increasing drug cost was the most cited reason by OPD attending patients and ill-health effects by community clinic attending patients (35% each) in personal reasons, while family-related reasons were poor interpersonal relationships with family members in OPD treatment-seeking patients (45%) and family property dispute in community clinic attending patients (35%). Conclusion: It can be concluded from the study that <50% of patients with substance use disorders visit the psychiatrist for treatment on the first contact. It means that a large number of patients go to different places/people/services for advice/treatment. However, the cost of the drug was one of the main reasons for treatment-seeking behavior in this population. Community clinic attending patients are more aware about the treatment facility available in the vicinity of their dwelling place, thereby preferring a place nearby to their home for treatment.","PeriodicalId":31679,"journal":{"name":"Journal of Mental Health and Human Behaviour","volume":"24 1","pages":"8 - 14"},"PeriodicalIF":0.5,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43649606","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 : 2019-01-01DOI: 10.4103/jmhhb.jmhhb_54_19
Yonas Tesfaye, Liyew Agenagnew
Background: Youths in colleges have special and complex needs, with extremely high rates of sexual behaviors, mental health problems, and drug misuse. Despite this, the causal relations remain to be elucidated. Objective: The aim of this study was to assess the association between risky sexual behaviors (RSBs) and substance use among Jimma University students, Ethiopia, 2016. Materials and Methods: A quantitative cross-sectional study was conducted among 700 sampled students. Participants were drawn using a multistage stratified random sampling technique. Data were collected using a pretested, self-administered questionnaire. Alcohol use disorder identification test tool was used to assess alcohol use and for RSBs, and Khat uses questionnaires that were developed after an extensive review of the literature. Data were entered into Epi-data data management software and exported to SPSS version 20 for statistical analysis. Multivariable logistic regression was used for analysis and Variables at P < 0.05, and a 95% confidence level was used to declare statistical association. Results: The prevalence of RSB among students was found 30.2%. The odds of RSB were nearly three times higher among those who had probable alcohol use disorder than their counterpart (adjusted odds ratio [AOR] 2.9, 95% confidence interval [CI]: 1.4–6.1); similarly, the odds of RSB were nearly three times higher among those who had to chew Khat 2–4 times a month than never chewed counterpart (AOR 2.8, 95% CI: 1.1–7.7). Conclusion: The prevalence of RSB and substance use among Jimma University students was high and positively associated.
{"title":"Exploring the association between risky sexual behaviors and substance use among Jimma university students, Ethiopia","authors":"Yonas Tesfaye, Liyew Agenagnew","doi":"10.4103/jmhhb.jmhhb_54_19","DOIUrl":"https://doi.org/10.4103/jmhhb.jmhhb_54_19","url":null,"abstract":"Background: Youths in colleges have special and complex needs, with extremely high rates of sexual behaviors, mental health problems, and drug misuse. Despite this, the causal relations remain to be elucidated. Objective: The aim of this study was to assess the association between risky sexual behaviors (RSBs) and substance use among Jimma University students, Ethiopia, 2016. Materials and Methods: A quantitative cross-sectional study was conducted among 700 sampled students. Participants were drawn using a multistage stratified random sampling technique. Data were collected using a pretested, self-administered questionnaire. Alcohol use disorder identification test tool was used to assess alcohol use and for RSBs, and Khat uses questionnaires that were developed after an extensive review of the literature. Data were entered into Epi-data data management software and exported to SPSS version 20 for statistical analysis. Multivariable logistic regression was used for analysis and Variables at P < 0.05, and a 95% confidence level was used to declare statistical association. Results: The prevalence of RSB among students was found 30.2%. The odds of RSB were nearly three times higher among those who had probable alcohol use disorder than their counterpart (adjusted odds ratio [AOR] 2.9, 95% confidence interval [CI]: 1.4–6.1); similarly, the odds of RSB were nearly three times higher among those who had to chew Khat 2–4 times a month than never chewed counterpart (AOR 2.8, 95% CI: 1.1–7.7). Conclusion: The prevalence of RSB and substance use among Jimma University students was high and positively associated.","PeriodicalId":31679,"journal":{"name":"Journal of Mental Health and Human Behaviour","volume":"24 1","pages":"44 - 50"},"PeriodicalIF":0.5,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41800107","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 : 2019-01-01DOI: 10.4103/jmhhb.jmhhb_40_19
D. Bharath, Poornima Rao, V. Kale, S. Panigrahi, M. Krishna, Steven Jones, S. Majgi
Introduction: Increasing mephedrone use is a major public health concern in India. There are limited data on sociodemographic determinants and psychiatric comorbidity associated with stimulant use disorder (mephedrone) (SUD-M) from India. Aim: The primary objective of this study was to report the clinical and social correlates of SUD-M among those presenting to specialist mental health services in Mumbai, India. Methods: Patients with SUD-M were recruited from a clinical setting. Standardized culturally validated assessments were carried out to obtain information about sociodemographics and mental health: comorbid psychopathology Brief Psychiatric Rating Scale, Hamilton Anxiety Rating Scale, Hamilton Depression Rating Scale, and Minnesota Multiphasic Personality Inventory-2 for personality traits and a clinical assessment for diagnosis of mental disorder using DSM-5. Results: SUD-M was more common among young men from the low socioeconomic position. The most common reasons for choosing mephedrone over other substances were better high from the drug and peer pressure. There were no associations between sociodemographic factors with the severity of SUD-M. Around 40% of the patients with SUD-M had psychiatric comorbidity. Psychotic disorders and anxiety symptoms were most common. Family history of substance use, comorbid substance use, and comorbid psychiatric disorders were directly related to the severity of SUD-M. Conclusions: This was a cross-sectional study with a relatively smaller sample size of self-nominating participants limiting the generalizability of findings to a wider population. Therapeutic implication of this finding is that prompt attention and treatment of the comorbid psychiatric disorder is essential while treating patients with SUD-M. Further population-based studies are recommended for a better understanding of the burden of SUD-M.
{"title":"Social and clinical correlates of stimulant use disorder (mephedrone) in a tertiary mental health setting in Mumbai: A pilot exploratory study","authors":"D. Bharath, Poornima Rao, V. Kale, S. Panigrahi, M. Krishna, Steven Jones, S. Majgi","doi":"10.4103/jmhhb.jmhhb_40_19","DOIUrl":"https://doi.org/10.4103/jmhhb.jmhhb_40_19","url":null,"abstract":"Introduction: Increasing mephedrone use is a major public health concern in India. There are limited data on sociodemographic determinants and psychiatric comorbidity associated with stimulant use disorder (mephedrone) (SUD-M) from India. Aim: The primary objective of this study was to report the clinical and social correlates of SUD-M among those presenting to specialist mental health services in Mumbai, India. Methods: Patients with SUD-M were recruited from a clinical setting. Standardized culturally validated assessments were carried out to obtain information about sociodemographics and mental health: comorbid psychopathology Brief Psychiatric Rating Scale, Hamilton Anxiety Rating Scale, Hamilton Depression Rating Scale, and Minnesota Multiphasic Personality Inventory-2 for personality traits and a clinical assessment for diagnosis of mental disorder using DSM-5. Results: SUD-M was more common among young men from the low socioeconomic position. The most common reasons for choosing mephedrone over other substances were better high from the drug and peer pressure. There were no associations between sociodemographic factors with the severity of SUD-M. Around 40% of the patients with SUD-M had psychiatric comorbidity. Psychotic disorders and anxiety symptoms were most common. Family history of substance use, comorbid substance use, and comorbid psychiatric disorders were directly related to the severity of SUD-M. Conclusions: This was a cross-sectional study with a relatively smaller sample size of self-nominating participants limiting the generalizability of findings to a wider population. Therapeutic implication of this finding is that prompt attention and treatment of the comorbid psychiatric disorder is essential while treating patients with SUD-M. Further population-based studies are recommended for a better understanding of the burden of SUD-M.","PeriodicalId":31679,"journal":{"name":"Journal of Mental Health and Human Behaviour","volume":"24 1","pages":"36 - 43"},"PeriodicalIF":0.5,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43888836","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 : 2019-01-01DOI: 10.4103/jmhhb.jmhhb_1_19
Abhishek Ghosh, D. Basu, C. Pradeep, B. Subodh
The literature on disulfiram induced psychosis showed, it was either associated with delirium or preceded by a prescription of a higher dose. We report two cases of psychosis in clear sensorium developing in individuals with alcohol dependence without any familial loading following a short duration of a therapeutic dose of disulfiram. Before the onset of psychosis, the patients were abstinent from alcohol for about a month, which made substance-induced psychosis unlikely. Psychosis resolved following discontinuation of disulfiram. Hence, the diagnosis of disulfiram-induced psychosis was considered. A plausible mechanism of such association has been discussed. Disulfiram-induced psychosis though unusual could be disruptive and severe. Close surveillance following disulfiram is important for early identification and management of such condition.
{"title":"Disulfiram-induced psychosis at a therapeutic dose and in clear sensorium: Two case demonstrations","authors":"Abhishek Ghosh, D. Basu, C. Pradeep, B. Subodh","doi":"10.4103/jmhhb.jmhhb_1_19","DOIUrl":"https://doi.org/10.4103/jmhhb.jmhhb_1_19","url":null,"abstract":"The literature on disulfiram induced psychosis showed, it was either associated with delirium or preceded by a prescription of a higher dose. We report two cases of psychosis in clear sensorium developing in individuals with alcohol dependence without any familial loading following a short duration of a therapeutic dose of disulfiram. Before the onset of psychosis, the patients were abstinent from alcohol for about a month, which made substance-induced psychosis unlikely. Psychosis resolved following discontinuation of disulfiram. Hence, the diagnosis of disulfiram-induced psychosis was considered. A plausible mechanism of such association has been discussed. Disulfiram-induced psychosis though unusual could be disruptive and severe. Close surveillance following disulfiram is important for early identification and management of such condition.","PeriodicalId":31679,"journal":{"name":"Journal of Mental Health and Human Behaviour","volume":"24 1","pages":"57 - 59"},"PeriodicalIF":0.5,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42980971","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 : 2019-01-01DOI: 10.4103/jmhhb.jmhhb_53_19
S. Sarkar, G. Kaloiya
{"title":"Family-based interventions for substance use disorders must look at the local needs and service delivery","authors":"S. Sarkar, G. Kaloiya","doi":"10.4103/jmhhb.jmhhb_53_19","DOIUrl":"https://doi.org/10.4103/jmhhb.jmhhb_53_19","url":null,"abstract":"","PeriodicalId":31679,"journal":{"name":"Journal of Mental Health and Human Behaviour","volume":"24 1","pages":"1 - 3"},"PeriodicalIF":0.5,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49446954","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 : 2019-01-01DOI: 10.4103/jmhhb.jmhhb_62_19
A. Sidana, Raveena Saroye, A. Agrawal
Background: Despite the availability of adequate indoor treatment facility for patients with substance use disorders (SUDs), a substantial number of patients do not undergo complete detoxification process. Incomplete detoxification leads to premature termination of treatment and relapse. Aims and Objectives: To see the association of various sociodemographic and clinical variables with completion of detoxification in hospitalized patients with SUDs. Materials and Methods: Case record files of patients with SUDs as per ICD-10, who were admitted in the de-addiction ward of a tertiary care teaching hospital of North India from January 1, 2019, to August 31, 2019, were retrieved and analyzed for various sociodemographic and clinical variables. Results: A total of 85 patients with SUDs were admitted during an 8-month period; majority of the patients were male with a mean age of 32 years, middle economic status, and from Punjab. Major substances of abuse were opioid (43.5%), followed by alcohol (37.6%) and nicotine and cannabis (5.9%). The most common route of administration was oral, followed by injecting, chasing, and smoking. Overall, 32 patients completed the detoxification during hospitalization. Age of the patient, withdrawal severity, and duration of stay in the ward are good predictors of completion of detoxification. Conclusion: It can be concluded from the study that older patients, increased severity of withdrawals, and longer duration of stay are good predictors of successful detoxification.
{"title":"Predictors of inpatient completion of detoxification in patients with substance use disorders","authors":"A. Sidana, Raveena Saroye, A. Agrawal","doi":"10.4103/jmhhb.jmhhb_62_19","DOIUrl":"https://doi.org/10.4103/jmhhb.jmhhb_62_19","url":null,"abstract":"Background: Despite the availability of adequate indoor treatment facility for patients with substance use disorders (SUDs), a substantial number of patients do not undergo complete detoxification process. Incomplete detoxification leads to premature termination of treatment and relapse. Aims and Objectives: To see the association of various sociodemographic and clinical variables with completion of detoxification in hospitalized patients with SUDs. Materials and Methods: Case record files of patients with SUDs as per ICD-10, who were admitted in the de-addiction ward of a tertiary care teaching hospital of North India from January 1, 2019, to August 31, 2019, were retrieved and analyzed for various sociodemographic and clinical variables. Results: A total of 85 patients with SUDs were admitted during an 8-month period; majority of the patients were male with a mean age of 32 years, middle economic status, and from Punjab. Major substances of abuse were opioid (43.5%), followed by alcohol (37.6%) and nicotine and cannabis (5.9%). The most common route of administration was oral, followed by injecting, chasing, and smoking. Overall, 32 patients completed the detoxification during hospitalization. Age of the patient, withdrawal severity, and duration of stay in the ward are good predictors of completion of detoxification. Conclusion: It can be concluded from the study that older patients, increased severity of withdrawals, and longer duration of stay are good predictors of successful detoxification.","PeriodicalId":31679,"journal":{"name":"Journal of Mental Health and Human Behaviour","volume":"24 1","pages":"23 - 26"},"PeriodicalIF":0.5,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49525891","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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