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“Mephentermine Abuse” an Age-old Concern with New Challenges: Review of Literature with Case Series “苯丙胺滥用”一个古老的问题与新的挑战:回顾文献与案例系列
Q4 PSYCHIATRY Pub Date : 2023-01-01 DOI: 10.4103/aip.aip_59_23
Yogender Kumar Malik, Akansha Bhardwaj, Adwitiya Ray, Bhumika Malik, Rajiv Gupta
Abstract Mephentermine, a stimulant drug, is used as vasoconstrictor to maintain blood pressure in hypotensive states and shock, but due to its stimulant effects on the central nervous system, it has also been used for performance enhancement by athletes. Here, we discuss three cases where the patients had used mephentermine to enhance their work performance. Case 1: A male in his 30’s, presented with palpitation, headache, and hypertension after 1 year of use of mephentermine which he had started using with the purpose of increasing his work performance. Case 2: A 22-year-old male presented with depressive symptoms following a 3-year history of use of mephentermine after being suggested by peers to enhance performance at gym. Case 3: A 22-year-old male with 2-year history of mephentermine, presented with withdrawal symptoms, after being introduced to mephentermine by his peers to improve physical performance and difficulty stopping its use on his own. It was found that the purpose of mephentermine abuse in all three discussed cases was to enhance performance, either at sports or workplace, which gradually lead to physical or mental complications or withdrawal symptoms. It thus seems imperative to create awareness about the harmful and addictive effects of mephentermine to masses, and simultaneously limiting its easy availability.
摘要甲芬特明是一种兴奋剂药物,作为血管收缩剂用于维持低血压和休克状态下的血压,但由于其对中枢神经系统的兴奋作用,它也被运动员用于提高成绩。在这里,我们讨论三个案例,病人使用甲芬特明,以提高他们的工作绩效。病例1:一名30多岁的男性,为了提高工作表现而开始使用甲苯丙胺,一年后出现心悸、头痛和高血压。病例2:一名22岁男性,在同伴建议其提高运动成绩后,使用了3年的甲苯丙胺后出现抑郁症状。病例3:一名22岁男性,有2年的甲苯丙胺使用史,在同伴介绍其使用甲苯丙胺以提高运动成绩后出现戒断症状,难以自行停止使用。研究发现,在上述所有三个案例中,滥用甲苯丙胺的目的都是为了提高在运动或工作场所的表现,这逐渐导致身体或精神并发症或戒断症状。因此,似乎有必要使人们认识到甲基苯丙胺对大众的有害和成瘾性影响,同时限制其容易获得。
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引用次数: 0
Telemedicine in India: COVID-19 and beyond? 印度的远程医疗:COVID-19和其他问题?
IF 0.4 Q4 PSYCHIATRY Pub Date : 2023-01-01 DOI: 10.4103/aip.aip_73_22
Shivakumar Kumar, G. Pranathi
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引用次数: 0
Psychological consequences and coping strategies of health-care workers in COVID section of a tertiary hospital: A qualitative study 三级医院新冠肺炎病区医护人员的心理后果及应对策略:一项定性研究
IF 0.4 Q4 PSYCHIATRY Pub Date : 2023-01-01 DOI: 10.4103/aip.aip_125_21
Kashish Thaper, M. Datar, J. Shetty, Anshumi Bhattacharya
Background: Health-care workers (HCWs) working in COVID care are vulnerable to various psychological stressors. The novel nature of infection and exponential increase in cases add to the workload and psychological distress. Hence, assessing the psychological consequences and methods of coping in these HCWs is important. The detection can help in devising appropriate psychological interventions for them. Aim: The aim of this study was to assess the psychological reactions, symptoms, and coping strategies of HCWs in COVID section of a tertiary hospital. Objectives: The objectives of this study were as follows: (1) to explore various psychological reactions, stressors, psychological symptoms, and coping skills of doctors, nurses, and support staff working in COVID section of a tertiary care hospital and (2) to correlate the psychological reactions, stressors, and psychological symptoms with sociodemographic factors. Methodology: This was a qualitative study. A total of 100 HCWs including doctors, nurses, and support staff working in COVID section of hospital were interviewed for psychological consequences and their coping strategies. Their narratives were coded into themes and analyzed. Statistical Analysis: Frequency and percentages for quantitative variables were used for statistical analysis. Chi-square test was used for correlation of qualitative variables. Results: The HCWs reported various psychological reactions of worries about their own health which was significant in HCWs in intensive care unit (χ2 = 12.35, P = 0.002) and had concern of nature of work, which was a significant concern in doctors (χ2 = 9.59, P = 0.008). The stressor of uncomfortable personal protective equipment was found to be reported more significantly by support staff (chi2 = 11.1, P = 0.03), and that of long and burdensome work reported more significantly by females (chi2 = 4.64, P = 0.03). They had prominent psychological symptoms of irritability significantly reported by doctors (χ2 = 9.91, P = 0.007), sleep disturbances significantly reported by unmarried (χ2 = 6.76, P = 0.009), and by nurses (χ2 = 9.7, P = 0.008). The most common coping strategies used were acceptance, problem-solving strategies, and communicating with family members and colleagues. Conclusion: The HCWs in COVID section had stressors with psychological reactions and symptoms and used various coping strategies to deal with them.
背景:从事新冠肺炎护理工作的医护人员容易受到各种心理压力的影响。感染的新颖性和病例的指数级增长增加了工作量和心理困扰。因此,评估这些HCW的心理后果和应对方法非常重要。这种检测有助于为他们制定适当的心理干预措施。目的:本研究旨在评估三级医院COVID病房HCW的心理反应、症状和应对策略。目的:本研究的目的如下:(1)探讨在三级护理医院COVID科工作的医生、护士和支持人员的各种心理反应、压力源、心理症状和应对技能;(2)将心理反应、应激源和心理症状与社会人口学因素相关联。方法:这是一项定性研究。共有100名医务人员,包括在医院新冠肺炎病房工作的医生、护士和支持人员,接受了心理后果及其应对策略的采访。他们的叙述被编入主题并加以分析。统计分析:使用定量变量的频率和百分比进行统计分析。卡方检验用于定性变量的相关性。结果:在重症监护室的医务人员中,对自身健康的各种担忧心理反应显著(χ2=12.35,P=0.002),这在医生中是一个显著的问题(χ2=9.59,P=0.008)。支持人员对不舒服的个人防护设备的压力源的报告更为显著(chi2=11.1,P=0.03),女性报告的长时间繁重工作的心理症状更为显著(chi2=4.64,P=0.03)。医生显著报告的她们有明显的易怒心理症状(χ2=9.91,P=0.007),未婚者显著报告的睡眠障碍症状(χ2=6.76,P=0.009),护士显著报告的则有明显的睡眠障碍(χ2=9.7,P=0.008),解决问题的策略,以及与家人和同事的沟通。结论:新冠肺炎病区医务人员存在应激源,有心理反应和症状,并采用多种应对策略进行应对。
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引用次数: 0
Assessment of Psychiatric Comorbidities and Disability in Patients with a Complaint of Headache Attending Psychiatric Outpatient Department at Tertiary Care Center 三级保健中心精神科门诊主诉头痛患者的精神疾病合并症和残疾评估
Q4 PSYCHIATRY Pub Date : 2023-01-01 DOI: 10.4103/aip.aip_146_21
Shri Gopal Goyal, Prem Prakash, Suresh Parihar, K. K. Verma
Abstract Background: Headache is one of the most common complaints seen among the patients attending the psychiatric outpatient department. Psychiatric comorbidities worsen the headache and there is a vicious cycle of headache and psychiatric symptoms, aggravating each other. This further complicates headache management so it is better to explore psychiatric symptoms whenever we come across a headache patient. Aims and Objectives: The aim and objective of the study are to assess the psychiatric comorbidities and disability among the patients complaining of headaches. Materials and Methods: This was a cross-sectional study carried out at a tertiary care center. Patients attending the outpatient department with complaints of headaches were enrolled. Psychiatric comorbidities were assessed by using patient health questionnaire-9, generalized anxiety disorder-7 scale, depression, anxiety, and stress 21 scale along with allodynia symptom checklist-12. Disability in the past 3 months was assessed by Migraine Disability Assessment Scale (MIDAS) scale. A semi-structured Performa was used to record sociodemographic details and clinical variables. Results: Majority of the patients (69%) were of the age group 20–40 years. Females (75%) predominated in the study. The average severity of headaches reported by 63% of patients was moderate over Likert’s scale. Temple area (73%) was the main location. Throbbing (81%) was the main type of headache. One-third of the patients got compelled to wake at night due to headache attacks. The main premonitory symptoms were depression, irritability, and sensitivity to sound. Other associated symptoms during headache attacks were sensitivity to sound, anxiety, and irritability. Psychological stress was the main provoking factor. The majority of patients (75%) show mild disability in the past 3 months over the MIDAS scale. 25% of the patient-reported moderate depression over the patient health questionare-9 scale. The majority of the patients (85%) reported moderate-to-severe anxiety and nearly half of the patients reported severe stress. Conclusion: Patients with headaches have high chances of associated psychiatric comorbidities that make worse outcomes of each other so it is better to do detailed psychiatric workup and treat them efficiently keeping in view of psychiatric symptoms.
背景:头痛是精神科门诊患者最常见的主诉之一。精神疾病的合并症加重了头痛,头痛和精神症状相互加重,形成恶性循环。这进一步使头痛管理变得复杂,所以当我们遇到头痛患者时,最好是探索精神症状。目的和目的:本研究的目的和目的是评估主诉头痛患者的精神合并症和残疾。材料和方法:这是一项在三级保健中心进行的横断面研究。以头痛为主诉到门诊就诊的患者被纳入研究。采用患者健康问卷-9、广泛性焦虑障碍量表-7、抑郁、焦虑和压力量表- 21以及异常性疼痛症状检查表-12对精神疾病共病进行评估。用偏头痛残疾评定量表(MIDAS)评定过去3个月的残疾。使用半结构化的Performa记录社会人口学细节和临床变量。结果:大多数患者(69%)年龄在20 ~ 40岁之间。在研究中,女性占75%。根据李克特量表,63%的患者报告的头痛的平均严重程度为中度。寺庙区(73%)为主要区域。搏动(81%)是头痛的主要类型。三分之一的患者因头痛发作而不得不在夜间醒来。主要的先兆症状是抑郁、易怒和对声音敏感。头痛发作时的其他相关症状是对声音敏感、焦虑和易怒。心理压力是主要诱发因素。大多数患者(75%)在过去3个月的MIDAS量表中表现为轻度残疾。25%的患者在患者健康问卷9中报告了中度抑郁。大多数患者(85%)报告中度至重度焦虑,近一半的患者报告严重压力。结论:头痛患者伴发精神疾病的可能性高,相互影响预后,应结合精神症状进行详细的精神检查和有效的治疗。
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引用次数: 0
Chronic Mania: A Case Series 慢性躁狂症:一个病例系列
Q4 PSYCHIATRY Pub Date : 2023-01-01 DOI: 10.4103/aip.aip_109_21
Priyanka Hooda, Bhupendra Khobragade, Ananya Mahapatra, Shipra Singh
Abstract Chronic mania is a known but underexplored entity and still lacks nosological status. Earlier reports of chronic mania have found distinct symptomatology, course, outcome, and treatment challenges. Three cases of chronic mania are presented with challenges in treatment, variable response to drugs and different outcomes along with a synopsis of review of literature in this context. There is a need for longitudinal follow-up studies of patients with diagnosis suggestive of chronic mania for better understanding of treatment response and outcome.
慢性躁狂症是一种已知但未充分开发的实体,仍然缺乏分类学地位。早期的慢性躁狂症报告发现了不同的症状、病程、结果和治疗挑战。三例慢性躁狂症在治疗方面面临挑战,对药物的不同反应和不同的结果,并在此背景下综述文献。有必要对诊断为慢性躁狂症的患者进行纵向随访研究,以更好地了解治疗反应和结果。
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引用次数: 0
Efficacy of Clozapine in Patients with Schizophrenia – A 3-Month follow-up Study from North India 氯氮平对精神分裂症患者的疗效——一项来自北印度的3个月随访研究
Q4 PSYCHIATRY Pub Date : 2023-01-01 DOI: 10.4103/aip.aip_89_23
Paramvir Singh, Yesh Chandra Singh, Abhinav Pandey, Chitrakshee Singh, Nirali Muchhala, Sagar Karia
Abstract Background: Treatment-resistant schizophrenia (TRS) is one of the most disabling forms of schizophrenia. The Indian population being different in its sociodemographic factors, clinical profiles, and family structures, the experience of the efficacy of clozapine here is insufficient. Aim: The aim of the study is to explore the efficacy of clozapine in TRS over 3 months of drug use. Materials and Methods: It was an open-label interventional 12-week follow-up study, with 30 consenting adults with TRS determined as per modified Conley and Kelly’s criteria of treatment resistance. The patient’s sociodemographic and clinical details were recorded. Oral clozapine was initiated with gradual up-titration after preclozapine workup. The Positive and Negative Syndrome Scale (PANSS) score was assessed at baseline and reviewed at 4 weekly intervals. Results: By the end of 12 weeks, on an average dose of 494 ± 113.83 mg/day, 36.67% of patients reported 25%–50% improvement in PANSS score. The maximum improvement was seen in the positive symptoms subscale followed by the general and negative symptoms subscale. Conclusion: This study enlightens the dosage differences and efficacy of clozapine in the management of TRS in the Indian population.
背景:难治性精神分裂症(Treatment-resistant schizophrenia, TRS)是致残性最强的精神分裂症之一。印度人口的社会人口因素、临床概况和家庭结构不同,氯氮平在印度的疗效经验不足。目的:探讨氯氮平治疗3个月以上TRS的疗效。材料和方法:这是一项为期12周的开放标签干入性随访研究,有30名同意TRS的成年人根据修改的Conley和Kelly的治疗耐药标准确定。记录患者的社会人口学和临床细节。口服氯氮平在氯氮平前检查后逐渐增加剂量。在基线时评估阳性和阴性综合征量表(PANSS)评分,并每4周进行一次复查。结果:12周结束时,平均剂量为494±113.83 mg/天,36.67%的患者报告PANSS评分改善25%-50%。改善最大的是阳性症状量表,其次是一般症状量表和阴性症状量表。结论:本研究揭示了氯氮平在印度人群TRS治疗中的剂量差异和疗效。
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引用次数: 0
Guilt: The concept and facets seen in clinical practice 有罪:临床实践中的概念和方面
IF 0.4 Q4 PSYCHIATRY Pub Date : 2023-01-01 DOI: 10.4103/aip.aip_81_23
A. De Sousa
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引用次数: 0
Sertraline induced Stevens-Johnson syndrome - A case series 舍曲林诱导的史蒂文斯-约翰逊综合征-一个病例系列
IF 0.4 Q4 PSYCHIATRY Pub Date : 2023-01-01 DOI: 10.4103/aip.aip_29_23
Ankit Halder, N. Ravindran, Dinobandhu Naga, Sarthak M. Keshri
Stevens-Johnson syndrome is an acute, rare, and potentially fatal skin reactions involving loss of skin and, in some cases, mucosal membranes. Medications are causative in majority of them. Here in the 3 cases, we found sertraline being the causative agent. Majority of the reports on drug induced SJS in our field is related to lamotrigine and only one case report on sertraline causing such manifestation was found in literature. Immunological modifications are proposed reasons behind the same. So, while prescribing comparatively safer agents like sertraline a clinician should carefully monitor such complications.
史蒂文斯-约翰逊综合征是一种急性、罕见、潜在致命的皮肤反应,涉及皮肤脱落,在某些情况下,还包括粘膜。大多数是药物引起的。在这三个病例中,我们发现舍曲林是致病因子。本领域关于药物性SJS的报道多与拉莫三嗪有关,文献中仅发现一例舍曲林引起SJS的报道。免疫修饰被认为是其背后的原因。因此,在开舍曲林等相对安全的药物时,临床医生应该仔细监测这些并发症。
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引用次数: 0
Prevalence of Depression and Anxiety in Patients with Diabetes Mellitus at a Secondary Level Government Health-Care Facility in Northern India 印度北部二级政府卫生保健机构中糖尿病患者抑郁和焦虑的患病率
Q4 PSYCHIATRY Pub Date : 2023-01-01 DOI: 10.4103/aip.aip_145_21
Manpreet Singh, Gagandeep Singh Shergill, Garima Bhatt, Zoya Gill
Abstract Background: Diabetes is one of the largest global health emergencies of the 21 st century. As per the International Diabetes Federation (IDF) in 2020, 463 million people have diabetes in the world and 88 million people in the Southeast Asia region. Seventy-seven million out of 88 million belong to India. The prevalence of diabetes in the population is 8.9%, according to the IDF. There exists a bidirectional association between diabetes and depression/anxiety, with both worsening each other’s prognosis. The prevalence rates of depression could be up to three times higher in patients with type 1 diabetes and twice as high in people with type 2 diabetes, while anxiety disorders are seen in 40% of the patients with type 1 or 2 diabetes mellitus. Although no single cause has been identified for the positive correlation between diabetes and depression and anxiety, it is widely accepted that hypothalamic–pituitary–adrenal dysfunction, pro-inflammatory cytokines, and a host of other epigenetic factors are responsible for the increased prevalence. This study was undertaken to check the prevalence of anxiety and depression in patients with diabetes mellitus attending the outdoor clinics of internal medicine department at a district hospital, Fatehgarh Sahib, Punjab. Materials and Methods: Four hundred patients were included in our study. A semi-structured pro forma was used to collect demographic details, and anxiety and depression were screened using the Hamilton Anxiety and Depression Rating Scales, respectively. Data collected were subjected to statistical analysis. Results: Fifty-eight percent of the sample population had depression and 27% had anxiety, with a vast majority having mild symptoms. Gender and duration of diabetes were statistically significant variables affecting prevalence and severity, with females having a higher mean scores of depression and anxiety than males and higher scores with greater duration of the illness. Conclusions: This study implies need for routine screening of depression and anxiety symptoms in patients with diabetes mellitus and treating them at the earliest.
背景:糖尿病是21世纪全球最大的突发卫生事件之一。根据国际糖尿病联合会(IDF)的数据,到2020年,全球有4.63亿人患有糖尿病,东南亚地区有8800万人患有糖尿病。8800万人中有7700万人属于印度。根据IDF的数据,糖尿病在人口中的患病率为8.9%。糖尿病与抑郁/焦虑之间存在双向关联,两者相互恶化预后。抑郁症在1型糖尿病患者中的患病率可能高达3倍,在2型糖尿病患者中的患病率可能高达2倍,而焦虑障碍在1型或2型糖尿病患者中占40%。虽然没有单一的原因确定糖尿病与抑郁和焦虑之间的正相关,但人们普遍认为,下丘脑-垂体-肾上腺功能障碍、促炎细胞因子和许多其他表观遗传因素是导致患病率增加的原因。进行这项研究是为了检查在旁遮普省Fatehgarh Sahib一家地区医院内科室外诊所就诊的糖尿病患者的焦虑和抑郁患病率。材料与方法:本研究纳入400例患者。使用半结构化的形式来收集人口统计细节,并分别使用汉密尔顿焦虑和抑郁评定量表筛选焦虑和抑郁。收集到的数据进行统计分析。结果:58%的样本人群患有抑郁症,27%的人患有焦虑症,绝大多数人都有轻微的症状。性别和糖尿病病程是影响患病率和严重程度的统计学显著变量,女性在抑郁和焦虑方面的平均得分高于男性,病程越长,得分越高。结论:本研究提示有必要对糖尿病患者的抑郁和焦虑症状进行常规筛查并尽早治疗。
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引用次数: 0
Evaluation of smartphone usage as a predictor of social jetlag in university students 大学生使用智能手机预测社交时差的评估
IF 0.4 Q4 PSYCHIATRY Pub Date : 2023-01-01 DOI: 10.4103/aip.aip_24_22
Karan Mehta, Neeraj Mahajan, Dishant B. Upadhyay, Taxashil Jadeja, Rajkumar J Sevak
Background: Individual sleep and activity patterns show large variations and are interfered considerably by social schedules. Social jetlag (SJL) is the difference between intrinsic circadian rhythm and extrinsically enforced sleep-wake cycle. However, little is known about the variables affecting the severity of SJL. Methodology: We evaluated whether sleep- or smartphone-related variables affected the severity of SJL among college students in India. A total of 1175 students from medicine, dental, engineering, paramedical, and other colleges in Gujarat, India, completed a web-based survey. The survey included demographic questions and questions from the Smartphone Addiction Scale-Short Version (SAS-SV), reduced Horne and Ostberg Morningness-Eveningness Questionnaire (rMEQ), and Munich Chronotype Questionnaire (MCTQ). The responses to the MCTQ determined SJL scores. Results: Outcomes from multiple linear regression analysis indicated that the sleep length on free-day (B = 0.42), chronotypes (B = 0.44, B2 = 0.40) maximum smartphone usage time after waking up (B = 0.92), smartphone addiction severity (B = ‒0.01) and free-day sleep onset range (B = ‒0.02) significantly predicted SJL scores (P < 0.03). The SJL severity was 0.42 and 0.40 units greater in individuals with morning-type and evening-type, respectively, compared to the neutral-type rMEQ category. The SJL severity was 0.92 units greater in individuals whose smartphone usage was maximum right after waking up compared to those whose usage was maximum during other times of the day. Every unit increase in SAS score decreased SJL by 0.01 units. Conclusion: These results indicate that SJL severity is affected by several factors, which can be targeted for developing interventions for reducing SJL among college students in India.
背景:个体的睡眠和活动模式表现出很大的差异,并受到社会作息的极大干扰。社会时差(Social jetlag, SJL)是内在昼夜节律和外在强迫性睡眠-觉醒周期之间的差异。然而,对影响SJL严重程度的变量知之甚少。方法:我们评估了与睡眠或智能手机相关的变量是否会影响印度大学生SJL的严重程度。来自印度古吉拉特邦医学、牙科、工程、辅助医学和其他学院的1175名学生完成了一项基于网络的调查。该调查包括人口统计问题和智能手机成瘾量表-短版本(SAS-SV)的问题,简化的霍恩和奥斯伯格晨昏性问卷(rMEQ)和慕尼黑时间类型问卷(MCTQ)。MCTQ的回答决定了SJL的分数。结果:多元线性回归分析结果显示,自由日睡眠时长(B = 0.42)、睡眠类型(B = 0.44, B2 = 0.40)、起床后最大智能手机使用时间(B = 0.92)、智能手机成瘾严重程度(B = -0.01)和自由日睡眠开始范围(B = -0.02)对SJL评分有显著预测作用(P < 0.03)。晨型和晚型个体的SJL严重程度分别比中性型个体高0.42和0.40个单位。起床后使用智能手机最多的人的SJL严重程度比在一天中的其他时间使用最多的人高0.92个单位。SAS评分每升高1个单位,SJL降低0.01个单位。结论:这些结果表明,SJL的严重程度受多个因素的影响,可以有针对性地制定减少印度大学生SJL的干预措施。
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引用次数: 0
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Annals of Indian Psychiatry
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