Central pontine myelinolysis (CPM), is a potentially fatal neurological disorder identified by demyelination at the bottom of the pons. Osmotic stress, endothelial dysfunction, blood–brain barrier damage, and rapid correction of hyponatremia believed to be the main causes. Chronic alcoholism may influence the CPM. We report a case of chronic alcoholism and normonatremia, who presented with sudden onset of drowsiness and quadriparesis, after sudden abstinence from alcohol who was eventually diagnosed with CPM. Evidence of elevated serum ammonia level indicated encephalopathy. Our case emphasizes that CPM can manifest in patients with chronic alcoholism. CPM must be distinguished from the natural course of alcohol withdrawal delirium and Wernicke's encephalopathy, which necessitates clinical astuteness and a high level of suspicion on the part of the physician.
{"title":"A chronic alcoholic with central pontine myelinolysis: Victim of double hit","authors":"S. Pratapa, M. Spoorthy, Parul Gupta","doi":"10.4103/amh.amh_100_21","DOIUrl":"https://doi.org/10.4103/amh.amh_100_21","url":null,"abstract":"Central pontine myelinolysis (CPM), is a potentially fatal neurological disorder identified by demyelination at the bottom of the pons. Osmotic stress, endothelial dysfunction, blood–brain barrier damage, and rapid correction of hyponatremia believed to be the main causes. Chronic alcoholism may influence the CPM. We report a case of chronic alcoholism and normonatremia, who presented with sudden onset of drowsiness and quadriparesis, after sudden abstinence from alcohol who was eventually diagnosed with CPM. Evidence of elevated serum ammonia level indicated encephalopathy. Our case emphasizes that CPM can manifest in patients with chronic alcoholism. CPM must be distinguished from the natural course of alcohol withdrawal delirium and Wernicke's encephalopathy, which necessitates clinical astuteness and a high level of suspicion on the part of the physician.","PeriodicalId":36181,"journal":{"name":"Archives of Mental Health","volume":"23 1","pages":"141 - 144"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48976581","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}
Ranganath R. Kulkarni, Swapna Pandurangi, R. Patil, N. Divyashree
Asterixis (flapping tremors) is a movement disorder due to cortical or subcortical pathology that usually indicates serious underlying disease processes such as encephalopathy secondary to severe hepatic dysfunction, metabolic derangements, toxic agents, or serious adverse drug events. Mood stabilizers such as valproate and carbamazepine with or without concomitant administration of antipsychotics such as clozapine and risperidone have been implicated to induce asterixis. Lithium, a first-line mood stabilizer drug for geriatric mania, with its unique profile of side-effects due to narrow therapeutic window, is very rarely implicated to induce asterixis, especially when used as a monotherapy. We report a case of lithium-induced asterixis, ataxia, acute cognitive impairment, and altered sensorium in an elderly male with first-episode of mania, both during toxic and therapeutic serum levels of lithium. This case highlights the association between asterixis, ataxia, delirium, and lithium, substantiating the dictum “start low and go slow” in geriatric psychopharmacology.
{"title":"Lithium-induced bilateral flapping tremors (asterixis) in geriatric mania","authors":"Ranganath R. Kulkarni, Swapna Pandurangi, R. Patil, N. Divyashree","doi":"10.4103/amh.amh_200_21","DOIUrl":"https://doi.org/10.4103/amh.amh_200_21","url":null,"abstract":"Asterixis (flapping tremors) is a movement disorder due to cortical or subcortical pathology that usually indicates serious underlying disease processes such as encephalopathy secondary to severe hepatic dysfunction, metabolic derangements, toxic agents, or serious adverse drug events. Mood stabilizers such as valproate and carbamazepine with or without concomitant administration of antipsychotics such as clozapine and risperidone have been implicated to induce asterixis. Lithium, a first-line mood stabilizer drug for geriatric mania, with its unique profile of side-effects due to narrow therapeutic window, is very rarely implicated to induce asterixis, especially when used as a monotherapy. We report a case of lithium-induced asterixis, ataxia, acute cognitive impairment, and altered sensorium in an elderly male with first-episode of mania, both during toxic and therapeutic serum levels of lithium. This case highlights the association between asterixis, ataxia, delirium, and lithium, substantiating the dictum “start low and go slow” in geriatric psychopharmacology.","PeriodicalId":36181,"journal":{"name":"Archives of Mental Health","volume":"23 1","pages":"139 - 141"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47353379","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}
{"title":"Bridging the gap by strengthening the MHGAP: Integrating mental health care into primary health care in Nigeria","authors":"A. Adekeye","doi":"10.4103/amh.amh_34_22","DOIUrl":"https://doi.org/10.4103/amh.amh_34_22","url":null,"abstract":"","PeriodicalId":36181,"journal":{"name":"Archives of Mental Health","volume":"23 1","pages":"148 - 148"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43368989","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}
Sampurna Chakraborty, Prakriti Sinha, Alok Pratap, B. Das, Vikas Kumar
Background: COVID-19 pandemic has exacerbated symptoms in existing diagnosed cases of anxiety. Its impact on people with mental illness is expected to be significant, leading to an increase in relapse rates and expectedly inducing or exacerbating death anxiety. Aims & Objectives: This study aimed to assess the impact of Covid 19 fear on general anxiety and wellbeing and death anxiety and compare people with anxiety spectrum disorders on perceived fear, autonomic anxiety symptoms, and death anxiety with those without these disorders. Materials & Methods: We recruited 36 participants with anxiety spectrum disorder (generalized anxiety disorder (n=6), obsessive-compulsive disorder (n=17), panic disorder (n=5) and mixed anxiety and depression (n=8) and 36 individuals free from any psychiatric illness. Tools used include General Health Questionnaire, Fear of COVID-19 Scale, Perceived Stress Scale, Beck Anxiety Inventory and Multidimensional Fear of Death Scale. Results: A statistically significant correlation was noted between many variables in both the study groups. The regression analysis showed a significant difference in general well-being and anxiety & death anxiety in the clinical group. Study outcomes indicated that the current pandemic has triggered significant fear and anxiety in anxiety patients and among healthy controls and has triggered significant death anxiety in the clinical and healthy control group. Conclusion: The study showed that fear of covid-19 is a predictive factor for stress, death anxiety, and general well-being. These findings may be helpful to plan preventive measures, tailored intervention focusing on death anxiety and relapse plans effectively.
{"title":"Impact of COVID-19 on death anxiety in patients with anxiety spectrum disorders: A case–control study","authors":"Sampurna Chakraborty, Prakriti Sinha, Alok Pratap, B. Das, Vikas Kumar","doi":"10.4103/amh.amh_2_22","DOIUrl":"https://doi.org/10.4103/amh.amh_2_22","url":null,"abstract":"Background: COVID-19 pandemic has exacerbated symptoms in existing diagnosed cases of anxiety. Its impact on people with mental illness is expected to be significant, leading to an increase in relapse rates and expectedly inducing or exacerbating death anxiety. Aims & Objectives: This study aimed to assess the impact of Covid 19 fear on general anxiety and wellbeing and death anxiety and compare people with anxiety spectrum disorders on perceived fear, autonomic anxiety symptoms, and death anxiety with those without these disorders. Materials & Methods: We recruited 36 participants with anxiety spectrum disorder (generalized anxiety disorder (n=6), obsessive-compulsive disorder (n=17), panic disorder (n=5) and mixed anxiety and depression (n=8) and 36 individuals free from any psychiatric illness. Tools used include General Health Questionnaire, Fear of COVID-19 Scale, Perceived Stress Scale, Beck Anxiety Inventory and Multidimensional Fear of Death Scale. Results: A statistically significant correlation was noted between many variables in both the study groups. The regression analysis showed a significant difference in general well-being and anxiety & death anxiety in the clinical group. Study outcomes indicated that the current pandemic has triggered significant fear and anxiety in anxiety patients and among healthy controls and has triggered significant death anxiety in the clinical and healthy control group. Conclusion: The study showed that fear of covid-19 is a predictive factor for stress, death anxiety, and general well-being. These findings may be helpful to plan preventive measures, tailored intervention focusing on death anxiety and relapse plans effectively.","PeriodicalId":36181,"journal":{"name":"Archives of Mental Health","volume":"23 1","pages":"113 - 117"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47158859","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}
Locked-in syndrome (LiS) is a rare condition characterized by quadriplegia, lower cranial nerve paralysis, and mutism with preservation of consciousness, vertical gaze, and upper eyelid movement. Here, we present a case that had initial mild neurological symptoms, stupor, fully conscious state, and computed tomography-brain showing old cerebral infarcts. There was a rapid deterioration of the condition into LiS and magnetic resonance imaging (MRI) brain showing infarcts bilaterally in the cerebellum, pons, midbrain, and thalami and finally leading to death. Relevant studies for discussion are presented. This case highlights the importance of MRI brain at the earliest even for cases with initial mild neurological symptoms and stupor to make an early diagnosis.
{"title":"Stupor resolving into rapidly deteriorating locked-in syndrome: Early magnetic resonance imaging brain in diagnosis","authors":"B. Anand","doi":"10.4103/amh.amh_43_21","DOIUrl":"https://doi.org/10.4103/amh.amh_43_21","url":null,"abstract":"Locked-in syndrome (LiS) is a rare condition characterized by quadriplegia, lower cranial nerve paralysis, and mutism with preservation of consciousness, vertical gaze, and upper eyelid movement. Here, we present a case that had initial mild neurological symptoms, stupor, fully conscious state, and computed tomography-brain showing old cerebral infarcts. There was a rapid deterioration of the condition into LiS and magnetic resonance imaging (MRI) brain showing infarcts bilaterally in the cerebellum, pons, midbrain, and thalami and finally leading to death. Relevant studies for discussion are presented. This case highlights the importance of MRI brain at the earliest even for cases with initial mild neurological symptoms and stupor to make an early diagnosis.","PeriodicalId":36181,"journal":{"name":"Archives of Mental Health","volume":"23 1","pages":"72 - 74"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48549027","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: Alcohol use disorders (AUDs) have adverse effects on physical and psychosocial health and results in marital problems with reduced quality of life in partners. Aims and Objectives: The aims and objectives of the study are to investigate the relationship between domestic violence (DV), marital satisfaction, and well-being in partners of AUD patients. Materials and Methods: This was a cross-sectional study on patients with AUD and their partners. We administered the Severity of Alcohol Dependence Questionnaire to the participants and DV questionnaire, marital satisfaction scale, coping questionnaire, and the World Health Organization (WHO-5) well-being index scales to the partners. Statistical Analysis Used: Descriptive statistics were depicted using frequency tables, and linear regression analysis was performed. Results: DV was reported by 36.98% of the partners, and the marital satisfaction rate was 62.58%. The WHO-5 well-being was 33.88%, engaged coping was 38.60%, tolerant coping was 23.60%, withdrawal coping being 6.18%, and total coping was 72.76%. The severity of alcohol dependence syndrome (ADS) negatively correlated with well-being (r = 0.24) and marital satisfaction (r = 0.17). Furthermore, DV showed a negative correlation with the marital satisfaction (r = 0.32; P = 0.02) and well-being (r = 0.50; P = 0.0001) with statistical significance. Conclusions: The majority of the partners experienced DV, marital dissatisfaction, and poor well-being.
{"title":"A cross-sectional study on domestic violence, marital satisfaction, and quality of life among partners of patients with alcohol use disorder","authors":"Divija Bunga, R. Bipeta, Umashankar Molanguri","doi":"10.4103/amh.amh_77_21","DOIUrl":"https://doi.org/10.4103/amh.amh_77_21","url":null,"abstract":"Introduction: Alcohol use disorders (AUDs) have adverse effects on physical and psychosocial health and results in marital problems with reduced quality of life in partners. Aims and Objectives: The aims and objectives of the study are to investigate the relationship between domestic violence (DV), marital satisfaction, and well-being in partners of AUD patients. Materials and Methods: This was a cross-sectional study on patients with AUD and their partners. We administered the Severity of Alcohol Dependence Questionnaire to the participants and DV questionnaire, marital satisfaction scale, coping questionnaire, and the World Health Organization (WHO-5) well-being index scales to the partners. Statistical Analysis Used: Descriptive statistics were depicted using frequency tables, and linear regression analysis was performed. Results: DV was reported by 36.98% of the partners, and the marital satisfaction rate was 62.58%. The WHO-5 well-being was 33.88%, engaged coping was 38.60%, tolerant coping was 23.60%, withdrawal coping being 6.18%, and total coping was 72.76%. The severity of alcohol dependence syndrome (ADS) negatively correlated with well-being (r = 0.24) and marital satisfaction (r = 0.17). Furthermore, DV showed a negative correlation with the marital satisfaction (r = 0.32; P = 0.02) and well-being (r = 0.50; P = 0.0001) with statistical significance. Conclusions: The majority of the partners experienced DV, marital dissatisfaction, and poor well-being.","PeriodicalId":36181,"journal":{"name":"Archives of Mental Health","volume":"23 1","pages":"18 - 22"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43102114","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}
Kannappa V. Shetty, N. Janardhana, S. Math, P. Marimuthu, R. Rajkumar
Background: Caregivers are generally the main support system for people with schizophrenia in India. Materials and Methods: The study aimed to evaluate the efficacy of psychosocial intervention (PSI) of knowledge about schizophrenia among the caregivers of persons with schizophrenia (PWS). Eighty caregivers of PWS were categorized into two groups: one group received routine care and the other group received additional PSI. The PSI program consisted of ten sessions with separate methodology and techniques. The Knowledge about Schizophrenia Interview, Mini-International Neuropsychiatric Interview 6.0, and sociodemographic interview schedule were used. Results: There was a significant change in pre- and postscores of the intervention group (PSI) on caregivers' knowledge (t = ‒16.64; P = 0.000) about schizophrenia. Conclusion: Study results indicate that caregivers in the experimental group (PSI) were having better knowledge about the illness than those in the control group (treatment as usual). PSI intervention was found to be effective in increasing caregivers' scientific knowledge on the illness.
{"title":"Empowering the caregivers of persons with schizophrenia – A psychosocial approach","authors":"Kannappa V. Shetty, N. Janardhana, S. Math, P. Marimuthu, R. Rajkumar","doi":"10.4103/amh.amh_67_21","DOIUrl":"https://doi.org/10.4103/amh.amh_67_21","url":null,"abstract":"Background: Caregivers are generally the main support system for people with schizophrenia in India. Materials and Methods: The study aimed to evaluate the efficacy of psychosocial intervention (PSI) of knowledge about schizophrenia among the caregivers of persons with schizophrenia (PWS). Eighty caregivers of PWS were categorized into two groups: one group received routine care and the other group received additional PSI. The PSI program consisted of ten sessions with separate methodology and techniques. The Knowledge about Schizophrenia Interview, Mini-International Neuropsychiatric Interview 6.0, and sociodemographic interview schedule were used. Results: There was a significant change in pre- and postscores of the intervention group (PSI) on caregivers' knowledge (t = ‒16.64; P = 0.000) about schizophrenia. Conclusion: Study results indicate that caregivers in the experimental group (PSI) were having better knowledge about the illness than those in the control group (treatment as usual). PSI intervention was found to be effective in increasing caregivers' scientific knowledge on the illness.","PeriodicalId":36181,"journal":{"name":"Archives of Mental Health","volume":"23 1","pages":"30 - 34"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48851502","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}
Pavan Kumar Kadiyala, PPrasanth Dayala, N. Duggirala, Sukeerthi Busi
{"title":"Nomophobia among medical students before and after COVID-19 – A propensity score-matched study","authors":"Pavan Kumar Kadiyala, PPrasanth Dayala, N. Duggirala, Sukeerthi Busi","doi":"10.4103/amh.amh_115_22","DOIUrl":"https://doi.org/10.4103/amh.amh_115_22","url":null,"abstract":"","PeriodicalId":36181,"journal":{"name":"Archives of Mental Health","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70674007","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}
{"title":"Porencephalic cyst with ipsilateral cerebral hemiatrophy presenting with generalized tonic–clonic seizures and neuropsychiatric features: A case report with literature review","authors":"B. Anand, M. Chandra, Neilofer Hussain","doi":"10.4103/amh.amh_176_21","DOIUrl":"https://doi.org/10.4103/amh.amh_176_21","url":null,"abstract":"","PeriodicalId":36181,"journal":{"name":"Archives of Mental Health","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70674501","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}
{"title":"A cross-sectional study of attitude toward suicide among medical and nonmedical groups from South India","authors":"S. Godi, P. Neredumilli","doi":"10.4103/amh.amh_99_21","DOIUrl":"https://doi.org/10.4103/amh.amh_99_21","url":null,"abstract":"","PeriodicalId":36181,"journal":{"name":"Archives of Mental Health","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70677694","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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