Abstract School phobias can be challenging for parents to deal with. Further, up to 5% of children experience fears about going to school. Herein, the Indian parents of a 5-year-old girl child get perturbed by her anxiety and persistent refusals about going to the newly joined school. Consequently, the parents have penned down their child’s psychology and varied emotions regarding the unfamiliar environments she faced in the configuration of a poem.
{"title":"Didaskaleinophobia: Fear of Going to School","authors":"Manish Raturi, Shalini Lal Raturi","doi":"10.4103/aip.aip_140_22","DOIUrl":"https://doi.org/10.4103/aip.aip_140_22","url":null,"abstract":"Abstract School phobias can be challenging for parents to deal with. Further, up to 5% of children experience fears about going to school. Herein, the Indian parents of a 5-year-old girl child get perturbed by her anxiety and persistent refusals about going to the newly joined school. Consequently, the parents have penned down their child’s psychology and varied emotions regarding the unfamiliar environments she faced in the configuration of a poem.","PeriodicalId":52916,"journal":{"name":"Annals of Indian Psychiatry","volume":"53 18","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134902323","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}
S. Kar, Avneendra Kumar Singh, R. Tandon, Kopal Rohatgi, B. Kumari
{"title":"Cerebral arteriovenous malformations presenting with anxiety disorder and parasomnia: A case study","authors":"S. Kar, Avneendra Kumar Singh, R. Tandon, Kopal Rohatgi, B. Kumari","doi":"10.4103/aip.aip_85_23","DOIUrl":"https://doi.org/10.4103/aip.aip_85_23","url":null,"abstract":"","PeriodicalId":52916,"journal":{"name":"Annals of Indian Psychiatry","volume":"64 1","pages":"399 - 400"},"PeriodicalIF":0.4,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139325555","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}
Background: With the increasing rates of adoption and its acceptance in India, the question of whether to tell or not about the adoption to the adoptee always remains. Disclosure is a very important phase in the life of every adoptee and the adoptive parents. Aim: The aim of the study was to learn about the views of adoptive parents about the disclosure, assumed aftermath, and role of social support. Methods: The study used a qualitative research method which included a content analysis as a method of analysis and semi-structured interview method for data collection. The study included 8 Indian adoptive parents. Results: Through the findings, it was observed that there are various consequences that emerge out of the extent of disclosure, motives behind it, preferences, and aids to disclose which was explored in the study. These decisions of disclosure were viewed to be ruled by assumed aftermath by the adoptive parents they were both negative and positive. The need of social support system was highlighted by the participants was said to be playing an important role in the process. Conclusion: Overall findings show the diversity of the preferences, motives, aids to divulge and assumed aftermath thus providing scope for further exploration with the Indian adoptive parents and impact of the disclosure on adoptees.
{"title":"Exploring adoption disclosure through Indian adoptive parents: A qualitative study","authors":"R. Kashika, N. Maheshbabu","doi":"10.4103/aip.aip_90_22","DOIUrl":"https://doi.org/10.4103/aip.aip_90_22","url":null,"abstract":"Background: With the increasing rates of adoption and its acceptance in India, the question of whether to tell or not about the adoption to the adoptee always remains. Disclosure is a very important phase in the life of every adoptee and the adoptive parents. Aim: The aim of the study was to learn about the views of adoptive parents about the disclosure, assumed aftermath, and role of social support. Methods: The study used a qualitative research method which included a content analysis as a method of analysis and semi-structured interview method for data collection. The study included 8 Indian adoptive parents. Results: Through the findings, it was observed that there are various consequences that emerge out of the extent of disclosure, motives behind it, preferences, and aids to disclose which was explored in the study. These decisions of disclosure were viewed to be ruled by assumed aftermath by the adoptive parents they were both negative and positive. The need of social support system was highlighted by the participants was said to be playing an important role in the process. Conclusion: Overall findings show the diversity of the preferences, motives, aids to divulge and assumed aftermath thus providing scope for further exploration with the Indian adoptive parents and impact of the disclosure on adoptees.","PeriodicalId":52916,"journal":{"name":"Annals of Indian Psychiatry","volume":"62 1","pages":"359 - 365"},"PeriodicalIF":0.4,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139326407","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}
S. Jaswal, J. Brar, A. Sidana, Nidhika Chauhan, M. Bajaj
Background: Obsessive–compulsive disorder (OCD) is a common, chronic debilitating disorder. A detailed neuropsychological assessment at baseline might help us to identify the various neuropsychological predictors for response and nonresponse. Aim: The identification of neuropsychological predictors for response and nonresponse in patients with OCD. Materials and Methods: Patients with a diagnosis of OCD (Diagnostic and Statistical Manual 5th edition), first episode, and treatment naïve were evaluated for neuropsychological functioning with the National Institute of Mental Health and Neurosciences Neuropsychological Battery-2004, and the severity of OCD on the Yale-Brown Obsessive–Compulsive Scale (YBOCS). After baseline assessment, patients received either sertraline or fluvoxamine at a maximum tolerable therapeutic dose and were reassessed after 12 weeks for a response. Results: A total of 50 patients (25 in sertraline and 25 in the fluvoxamine group) were included in the 12 weeks study. The majority of the patients had adequate baseline neuropsychological functioning except for inadequacy in the category and verbal fluency, and the mean baseline total Y-BOCS score was 23.48 (standard deviation = 6.29). Out of 50 patients, 36 (72%) patients showed a response to the treatment. The correlation analysis showed that except for the N-1 hits variable, in the Verbal N Back test for working memory, which correlated significantly with a reduction in YBOCS score across 12 weeks, none of the other neuropsychological domain scores were correlated with the outcome. Conclusion: The index study concludes that working memory is significantly correlated with the response at 12 weeks. However, there are no other neuropsychological predictors for response and nonresponse in patients with OCD.
{"title":"Are there neuropsychological predictors for response and nonresponse in first-episode drug naïve patients with OCD? A 12 weeks interventional study","authors":"S. Jaswal, J. Brar, A. Sidana, Nidhika Chauhan, M. Bajaj","doi":"10.4103/aip.aip_110_22","DOIUrl":"https://doi.org/10.4103/aip.aip_110_22","url":null,"abstract":"Background: Obsessive–compulsive disorder (OCD) is a common, chronic debilitating disorder. A detailed neuropsychological assessment at baseline might help us to identify the various neuropsychological predictors for response and nonresponse. Aim: The identification of neuropsychological predictors for response and nonresponse in patients with OCD. Materials and Methods: Patients with a diagnosis of OCD (Diagnostic and Statistical Manual 5th edition), first episode, and treatment naïve were evaluated for neuropsychological functioning with the National Institute of Mental Health and Neurosciences Neuropsychological Battery-2004, and the severity of OCD on the Yale-Brown Obsessive–Compulsive Scale (YBOCS). After baseline assessment, patients received either sertraline or fluvoxamine at a maximum tolerable therapeutic dose and were reassessed after 12 weeks for a response. Results: A total of 50 patients (25 in sertraline and 25 in the fluvoxamine group) were included in the 12 weeks study. The majority of the patients had adequate baseline neuropsychological functioning except for inadequacy in the category and verbal fluency, and the mean baseline total Y-BOCS score was 23.48 (standard deviation = 6.29). Out of 50 patients, 36 (72%) patients showed a response to the treatment. The correlation analysis showed that except for the N-1 hits variable, in the Verbal N Back test for working memory, which correlated significantly with a reduction in YBOCS score across 12 weeks, none of the other neuropsychological domain scores were correlated with the outcome. Conclusion: The index study concludes that working memory is significantly correlated with the response at 12 weeks. However, there are no other neuropsychological predictors for response and nonresponse in patients with OCD.","PeriodicalId":52916,"journal":{"name":"Annals of Indian Psychiatry","volume":"1 1","pages":"303 - 309"},"PeriodicalIF":0.4,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70646904","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}
Rachit Sharma, Harpreet Singh, K. Chatterjee, Pookala Shivaram Bhat, K. Srivastava, R. Saini
Background: Parents of the children and adolescents with intellectual disability (ID) are prone to psychological distress than as compared to parents of normally developing children and adolescents. Various biopsychosocial factors affect the perception and manifestation of this stress and influences difference in quality and severity in psychological outcomes. When a couple faces stress of caregiving as a unit, it is worthwhile to know and assess distribution pattern amongst the primary care giver and the other parent. Aim: The aim of the study is to evaluate the proportional distribution of depression and anxiety in primary care giver and the other parent in parents of children and adolescents with ID. Materials and Methods: Using a Cross-sectional observational study design, 99 parents (99 fathers and 98 mothers) of 99 children and adolescents (up to 18 yrs of age) with Intellectual Disability were assessed for Depressive and Anxiety symptoms using Hospital Anxiety and Depression Scale (HADS). Comparison of proportional distribution of psychiatric morbidity among fathers and mothers (primary care giver) was done using 2 independent sample proportion tests. Results: The mothers were found to be the primary care givers. 35.4% of fathers and 66.3% of mothers had significant depressive symptoms. 57.6% of fathers and 91.8% of mothers had significant anxiety symptoms. In 33 couples, fathers did not report anxiety or depressive symptoms but corresponding 27 mothers reported significant anxiety or depressive symptoms or both. In rest of the couples in whom fathers reported anxiety and/or depressive symptoms, the corresponding mothers also reported. In six couples where mothers did not report anxiety or depression, the fathers also did not report any anxiety or depressive symptoms. Conclusion: Depressive and Anxiety symptoms are very prevalent in parents of children with ID. Their proportion is significantly high in primary care giver (mother) as comparedto corresponding other parent (father). There is unequal distribution of anxiety and depression in these parents with a skew towards mother.
{"title":"Anxiety and depression in parents of children and adolescents with intellectual disability","authors":"Rachit Sharma, Harpreet Singh, K. Chatterjee, Pookala Shivaram Bhat, K. Srivastava, R. Saini","doi":"10.4103/aip.aip_197_22","DOIUrl":"https://doi.org/10.4103/aip.aip_197_22","url":null,"abstract":"Background: Parents of the children and adolescents with intellectual disability (ID) are prone to psychological distress than as compared to parents of normally developing children and adolescents. Various biopsychosocial factors affect the perception and manifestation of this stress and influences difference in quality and severity in psychological outcomes. When a couple faces stress of caregiving as a unit, it is worthwhile to know and assess distribution pattern amongst the primary care giver and the other parent. Aim: The aim of the study is to evaluate the proportional distribution of depression and anxiety in primary care giver and the other parent in parents of children and adolescents with ID. Materials and Methods: Using a Cross-sectional observational study design, 99 parents (99 fathers and 98 mothers) of 99 children and adolescents (up to 18 yrs of age) with Intellectual Disability were assessed for Depressive and Anxiety symptoms using Hospital Anxiety and Depression Scale (HADS). Comparison of proportional distribution of psychiatric morbidity among fathers and mothers (primary care giver) was done using 2 independent sample proportion tests. Results: The mothers were found to be the primary care givers. 35.4% of fathers and 66.3% of mothers had significant depressive symptoms. 57.6% of fathers and 91.8% of mothers had significant anxiety symptoms. In 33 couples, fathers did not report anxiety or depressive symptoms but corresponding 27 mothers reported significant anxiety or depressive symptoms or both. In rest of the couples in whom fathers reported anxiety and/or depressive symptoms, the corresponding mothers also reported. In six couples where mothers did not report anxiety or depression, the fathers also did not report any anxiety or depressive symptoms. Conclusion: Depressive and Anxiety symptoms are very prevalent in parents of children with ID. Their proportion is significantly high in primary care giver (mother) as comparedto corresponding other parent (father). There is unequal distribution of anxiety and depression in these parents with a skew towards mother.","PeriodicalId":52916,"journal":{"name":"Annals of Indian Psychiatry","volume":"31 1","pages":"334 - 338"},"PeriodicalIF":0.4,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139328691","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}
N. Pramoda, V. A. Turankar, M. Thakre, Sudhir Laludeo Mahajan, Sunil M. Mahakalkar, A. Shetty, Sandeep M. Sasi
Context: Schizophrenia is mostly treated with atypical antipsycotics, which may be required for lifetime. Olanzapine is commonly used in this condition, whereas levosulpiride is approved in India for the same. Knowing the effect of these drugs on psychomotor function helps in choosing a suitable drug to a particular patient based on his daily activities. Aims: The aim is to compare the effect of levosulpiride and olanzapine on psychomotor performance, efficacy, and adherence in patients with schizophrenia. Settings and Design: This was open-label, parallel arm, prospective observational study carried out in a tertiary care hospital of central India from December 2019 to December 2021. Subjects and Methods: Thirty-six patients visiting psychiatry OPD, diagnosed by treating psychiatrist as schizophrenia were assessed by CFFT, hand steadiness test (HST), arithmetic ability test, and reaction time (RT) for psychomotor function, and symptoms were scored on positive and negative syndrome scale (PANSS) and brief negative symptom scale (BNSS) rating scales at the first visit, end of 4 and 8 weeks. Adherence was assessed by the Medication adherence rating scale at 8 weeks. Results: Statistically significant increase in RT was seen in both levosulpiride (P = 0.04) and olanzapine (P = 0.0065) groups, whereas only the olanzapine group had a significant change in CFFT (P = 0.04) and HST (P = 0.01) at 8 weeks. On head-to-head comparison, a statistically significant worsening in HST score (P = 0.01) was seen in olanzapine group. Both the groups had significant decreases in all PANSS (P < 0.001) and BNSS (P < 0.001) scores. When change in PANSS and BNSS scores were compared with each other, the levosulpiride group had a significantly more decrease in scores on PANSS negative scale (P = 0.03). Patients in both groups were adherent to treatment. Conclusions: Our study concluded that levosulpiride is better than olanzapine on its fine motor control. Both the drugs increase RT while only olanzapine worsened fine motor control and CFF. Both the drugs were effective for schizophrenia with 8 weeks treatment, while levosulpiride is superior to olanzapine in improving negative symptoms of schizophrenia.
{"title":"Comparative assessment of effect on psychomotor performance efficacy and adherence of levosulpiride and olanzapine in patients with schizophrenia: A parallel, open-label, prospective observational study","authors":"N. Pramoda, V. A. Turankar, M. Thakre, Sudhir Laludeo Mahajan, Sunil M. Mahakalkar, A. Shetty, Sandeep M. Sasi","doi":"10.4103/aip.aip_35_23","DOIUrl":"https://doi.org/10.4103/aip.aip_35_23","url":null,"abstract":"Context: Schizophrenia is mostly treated with atypical antipsycotics, which may be required for lifetime. Olanzapine is commonly used in this condition, whereas levosulpiride is approved in India for the same. Knowing the effect of these drugs on psychomotor function helps in choosing a suitable drug to a particular patient based on his daily activities. Aims: The aim is to compare the effect of levosulpiride and olanzapine on psychomotor performance, efficacy, and adherence in patients with schizophrenia. Settings and Design: This was open-label, parallel arm, prospective observational study carried out in a tertiary care hospital of central India from December 2019 to December 2021. Subjects and Methods: Thirty-six patients visiting psychiatry OPD, diagnosed by treating psychiatrist as schizophrenia were assessed by CFFT, hand steadiness test (HST), arithmetic ability test, and reaction time (RT) for psychomotor function, and symptoms were scored on positive and negative syndrome scale (PANSS) and brief negative symptom scale (BNSS) rating scales at the first visit, end of 4 and 8 weeks. Adherence was assessed by the Medication adherence rating scale at 8 weeks. Results: Statistically significant increase in RT was seen in both levosulpiride (P = 0.04) and olanzapine (P = 0.0065) groups, whereas only the olanzapine group had a significant change in CFFT (P = 0.04) and HST (P = 0.01) at 8 weeks. On head-to-head comparison, a statistically significant worsening in HST score (P = 0.01) was seen in olanzapine group. Both the groups had significant decreases in all PANSS (P < 0.001) and BNSS (P < 0.001) scores. When change in PANSS and BNSS scores were compared with each other, the levosulpiride group had a significantly more decrease in scores on PANSS negative scale (P = 0.03). Patients in both groups were adherent to treatment. Conclusions: Our study concluded that levosulpiride is better than olanzapine on its fine motor control. Both the drugs increase RT while only olanzapine worsened fine motor control and CFF. Both the drugs were effective for schizophrenia with 8 weeks treatment, while levosulpiride is superior to olanzapine in improving negative symptoms of schizophrenia.","PeriodicalId":52916,"journal":{"name":"Annals of Indian Psychiatry","volume":"9 1","pages":"339 - 344"},"PeriodicalIF":0.4,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139330729","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}
YABA, also known as “Nazi speed” is a relatively newer stimulant drug with abusive potential that contains methamphetamine and caffeine in various proportions and mostly available in Bangladesh and its subcontinent and relatively rare in Indian states. Here, we report a case of a 30-year-old male with history of Yaba abuse for the past 4 years currently complaining of withdrawal symptoms palpitation, dry mouth, irritability, and mood symptoms that managed symptomatically and with topiramate tablets to prevent future relapse.
{"title":"Methamphetamine abuse in the form of yaba pills","authors":"Disha Mukherjee, Soumily Ghosh, Arijit Mondal","doi":"10.4103/aip.aip_143_21","DOIUrl":"https://doi.org/10.4103/aip.aip_143_21","url":null,"abstract":"YABA, also known as “Nazi speed” is a relatively newer stimulant drug with abusive potential that contains methamphetamine and caffeine in various proportions and mostly available in Bangladesh and its subcontinent and relatively rare in Indian states. Here, we report a case of a 30-year-old male with history of Yaba abuse for the past 4 years currently complaining of withdrawal symptoms palpitation, dry mouth, irritability, and mood symptoms that managed symptomatically and with topiramate tablets to prevent future relapse.","PeriodicalId":52916,"journal":{"name":"Annals of Indian Psychiatry","volume":"1 1","pages":"389 - 391"},"PeriodicalIF":0.4,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70647774","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}
Priyanka Jog, S. Shelke, Ashish Chepure, A. Subramanyam, Mansi P. Somaiya, Surabhi Rathi, A. Kondekar
Introduction: Intelligence in children with autism has been a challenge for long. Previous studies have reported an uneven performance on intelligence tests. Better performance on Raven's Progressive Matrices (RPM) as compared to Wechsler's intelligence scale for children III (WISC-III) has been found in some studies. RPM is quick and easy to administer. Hence, there is a need to understand if RPM is a comparable test to tap the intelligence in children with autism. Aims and Objectives: To find the percentile intelligence quotient (IQ) scores of children with autism and neurotypical children using RPM and WISC III and to compare the performance of these two groups on IQ tests. Materials and Methods: A cross-sectional study including 15 children with autism and normal (neurotypical) children was done after institutional ethics committee approval. The subjects were subjected to WISC-III and RPM. Results: The study shows that neurotypical children perform better on intelligence tests than children with autism. Both tests can be used to measure intelligence in children with autism fairly owing to their correlation. However, RPM showed better scores than WISC-III, for children with autism. Conclusions: RPM can be used as an alternative and an even better test to measure intelligence in children with autism just as the standard WISC-III. Further studies in a larger population of children with autism are warranted to validate our findings.
{"title":"A pilot study on comparison of intelligence in children with autism and controls: Raven's progressive matrices and wechsler intelligence scale-III","authors":"Priyanka Jog, S. Shelke, Ashish Chepure, A. Subramanyam, Mansi P. Somaiya, Surabhi Rathi, A. Kondekar","doi":"10.4103/aip.aip_34_22","DOIUrl":"https://doi.org/10.4103/aip.aip_34_22","url":null,"abstract":"Introduction: Intelligence in children with autism has been a challenge for long. Previous studies have reported an uneven performance on intelligence tests. Better performance on Raven's Progressive Matrices (RPM) as compared to Wechsler's intelligence scale for children III (WISC-III) has been found in some studies. RPM is quick and easy to administer. Hence, there is a need to understand if RPM is a comparable test to tap the intelligence in children with autism. Aims and Objectives: To find the percentile intelligence quotient (IQ) scores of children with autism and neurotypical children using RPM and WISC III and to compare the performance of these two groups on IQ tests. Materials and Methods: A cross-sectional study including 15 children with autism and normal (neurotypical) children was done after institutional ethics committee approval. The subjects were subjected to WISC-III and RPM. Results: The study shows that neurotypical children perform better on intelligence tests than children with autism. Both tests can be used to measure intelligence in children with autism fairly owing to their correlation. However, RPM showed better scores than WISC-III, for children with autism. Conclusions: RPM can be used as an alternative and an even better test to measure intelligence in children with autism just as the standard WISC-III. Further studies in a larger population of children with autism are warranted to validate our findings.","PeriodicalId":52916,"journal":{"name":"Annals of Indian Psychiatry","volume":"12 1","pages":"351 - 358"},"PeriodicalIF":0.4,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139326516","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}
Shawn Serrao, Suhas Chandran, Avinash Kamath, G. K Sarma
Autoimmune disorders are now widely recognized as playing a larger role in encephalitis than previously thought. The most common disorder appears to be anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis. Psychological symptoms, memory difficulties, and autonomic instability are all part of the complicated presentation and are being considered an important differential diagnosis for children presenting with acute behavioral disturbances. We present the case of a 17-year-old girl, who presented with a 1.5-year history of psychiatric symptoms such as pervasive low mood, decreased ability to concentrate on her studies, academic decline, memory disturbances along with poor social interaction, decreased self-esteem, and ideas of guilt. This was accompanied by altered biological functions. Within a week, the symptoms changed dramatically, with labile mood, over familiarity, over identification, déjà vu, auditory hallucinations and anxiety symptoms, nonspecific somatic symptoms such as fever, vomiting, and neurological symptoms including seizures and dyskinesia. Diagnosis of anti-NMDAR encephalitis was made by electroencephalography and serum antibody testing. Symptom improvement was noted with five cycles of plasmapheresis and injection of rituximab. Psychiatric manifestations are common, and child and adolescent psychiatrists are frequently the first to be contacted for patients with anti-NMDAR encephalitis. There is, therefore, an increasing need for them to become aware of the disorder and consider it in their differential diagnosis. A better prognosis can be achieved with appropriate evaluation by a multi-disciplinary team.
{"title":"Pediatric anti-NMDA receptor autoimmune encephalitis masquerading as depression: A case report from a tertiary care center in South India","authors":"Shawn Serrao, Suhas Chandran, Avinash Kamath, G. K Sarma","doi":"10.4103/aip.aip_170_22","DOIUrl":"https://doi.org/10.4103/aip.aip_170_22","url":null,"abstract":"Autoimmune disorders are now widely recognized as playing a larger role in encephalitis than previously thought. The most common disorder appears to be anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis. Psychological symptoms, memory difficulties, and autonomic instability are all part of the complicated presentation and are being considered an important differential diagnosis for children presenting with acute behavioral disturbances. We present the case of a 17-year-old girl, who presented with a 1.5-year history of psychiatric symptoms such as pervasive low mood, decreased ability to concentrate on her studies, academic decline, memory disturbances along with poor social interaction, decreased self-esteem, and ideas of guilt. This was accompanied by altered biological functions. Within a week, the symptoms changed dramatically, with labile mood, over familiarity, over identification, déjà vu, auditory hallucinations and anxiety symptoms, nonspecific somatic symptoms such as fever, vomiting, and neurological symptoms including seizures and dyskinesia. Diagnosis of anti-NMDAR encephalitis was made by electroencephalography and serum antibody testing. Symptom improvement was noted with five cycles of plasmapheresis and injection of rituximab. Psychiatric manifestations are common, and child and adolescent psychiatrists are frequently the first to be contacted for patients with anti-NMDAR encephalitis. There is, therefore, an increasing need for them to become aware of the disorder and consider it in their differential diagnosis. A better prognosis can be achieved with appropriate evaluation by a multi-disciplinary team.","PeriodicalId":52916,"journal":{"name":"Annals of Indian Psychiatry","volume":"37 1","pages":"382 - 385"},"PeriodicalIF":0.4,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139330862","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}
Mutism is the absence or marked paucity of verbal output due to functional or organic causes. Selective mutism is commonly seen in children with anxiety disorder. In psychiatric literature, long-standing mutism is most commonly associated with catatonic syndrome in adults. Although less commonly reported, long-standing mutism has also been associated with noncatatonic schizophrenia and posits a treatment challenge. Here, we describe two cases of long-standing noncatatonic mutism secondary to Schneiderian first rank symptoms, which were poorly responsive to conventional antipsychotic treatment and had good response to the combination of antipsychotics and electroconvulsive therapy (ECT). ECT is an underutilized treatment modality in patients with schizophrenia and is usually limited to catatonic states. The case series, thus, highlights the need for the development of an evidence base for the use of ECT in patients with noncatatonic mutism.
{"title":"A case series of noncatatonic mutism with poor response to conventional treatment approach","authors":"Jagriti Yadav, Akansha Bhardwaj, Purushottam Jangid, Priti Singh, Rajiv Gupta","doi":"10.4103/aip.aip_108_21","DOIUrl":"https://doi.org/10.4103/aip.aip_108_21","url":null,"abstract":"Mutism is the absence or marked paucity of verbal output due to functional or organic causes. Selective mutism is commonly seen in children with anxiety disorder. In psychiatric literature, long-standing mutism is most commonly associated with catatonic syndrome in adults. Although less commonly reported, long-standing mutism has also been associated with noncatatonic schizophrenia and posits a treatment challenge. Here, we describe two cases of long-standing noncatatonic mutism secondary to Schneiderian first rank symptoms, which were poorly responsive to conventional antipsychotic treatment and had good response to the combination of antipsychotics and electroconvulsive therapy (ECT). ECT is an underutilized treatment modality in patients with schizophrenia and is usually limited to catatonic states. The case series, thus, highlights the need for the development of an evidence base for the use of ECT in patients with noncatatonic mutism.","PeriodicalId":52916,"journal":{"name":"Annals of Indian Psychiatry","volume":"1 1","pages":"371 - 374"},"PeriodicalIF":0.4,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139326148","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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