Transsexuals, who form a part in LGBT community, face a great amount of distress due to social stigma and lack of family support. This case series emphasizes the effect of family stigma in three such ...transsexuals, who presented with psychiatric complaints. A definitive need for scientific research and its application exists to address this stigma and discrimination. ICD-10 criteria were used to diagnose the psychiatric morbidities. Standard scores (Hamilton Depression Rating Scale and Suicidal Affect Behavior Cognition Scale) were used to assess the severity. Familial, individual, and interpersonal level interventions were administered. Significant improvements were seen in two patients (received family therapy) and one patient who did not receive therapy continued to be distressed. Psychological interventions resulted in reducing the family stigma and psychiatric morbidities suffered by them. This is an effort to show the need for implementation of such standard protocols in health-care facilities to address the stigma faced by transsexuals.
Background: Children of alcoholics (COAs), particularly experience life uniquely in the families of alcoholic parents. They are more likely than others to suffer from various physical, emotional, and ...mental health problems. Aims: The aim of this study is to estimate the prevalence of psychiatric morbidity among the children of alcohol-dependent patients attending our tertiary health care center, and further determine the association between clinical-sociodemographic background and psychiatric morbidities among these children. Methods: It was a cross-sectional study consisting of 100 COAs. Data collections tools used were: Pro forma for sociodemographic details, the Kiddie – Schedule for Affective Disorders and Schizophrenia for school-aged children (6–18 years) Present and Lifetime version (K-SADS PL), Learning Disability Checklist and Wechsler's Intelligence Scale for Children. The data were entered using statistical software Epi-Info (version 3.7.2.1) software package, analyzed using the SPSS software version 24.0. Results: About 60% of COAs assessed had the presence of psychiatric morbidity, with anxiety spectrum and depressive disorders being the most commonly associated diagnosis. It was noted that female gender had a positive association with anxiety spectrum disorders. Further, a history of child abuse had a positive association with evidence of psychiatric morbidity in these children. In addition, family history of antisocial personality traits had a significant association with conduct disorder in COAs. Conclusions: To conclude, psychiatric morbidities were identified in about 60% of children whose fathers were alcohol dependent. These COA's commonly manifested with two major psychiatric morbidities, namely anxiety and depression. Nearly 1/10th of these children were noted to have substance use as well.
Hypothyroidism has been associated with mood disorders, sometimes with acute psychosis, hence this report. A 45-year-old married female, working as a daily-wage laborer, was brought with marked ...irritability, suspiciousness, wandering about, decreased sleep, appetite, and personal care for the past 1½ years. She had attempted suicide three times in the initial 6 months of illness. She had an asthenic body type; dry, hairless skin; hoarse voice; and nonpitting pedal edema. Deep tendon reflexes were delayed. High thyroid-stimulating hormone levels and positive anti-thyroid peroxidase antibody led to the diagnosis of severe hypothyroidism. Based on her psychiatric evaluation, a diagnosis of organic schizophrenia-like disorder (myxedema madness) was made. She was managed with olanzapine and haloperidol along with thyroxine supplement. The patient improved significantly following thyroxine supplementation and modified electroconvulsive therapy sessions. Herewith, we present this unique case of myxedema madness with suicidal attempts for its uniqueness and rarity.
Neurocysticercosis (NCC), an infectious disease has got polymorphic clinical features. Neuropsychiatric manifestation of NCC is a rare presentation, always misleads the diagnosis. A 43-year-old male, ...nonvegetarian presented with 1-month history of visual hallucination associated with wandering, muttering to self, irritability and suicidal ideas. Onset of symptoms was sudden and progressive in nature. Mental Status Examination revealed mild cognitive impairment (MCI). Magnetic resonance imaging showed calcified lesions of size 6–7 mm in left parietal and occipital lobe in gray-white matter junction. NCC often present with neurological features of the seizure (79%) and headaches (38%). In neuropsychiatric manifestation, depression was the most common presentation. This case report has highlighted a case presenting with psychotic features, a rare phenomenon of rare neuropsychiatric manifestation of NCC. The neuropsychiatric symptoms right-sided monocular visual hallucination and the MCI were found to be related to the prominent lesions in occipito-parietal lobe of the left hemisphere. Lobar-specific neuropsychiatric manifestation can be a presenting feature of NCC without any common neurological symptoms.
Background: In spite of many progresses in treatment of psychiatric disorders, medication nonadherence plays an important role in worsening of clinical condition and affects quality of life among ...psychiatric patients. There are numerous factors contributing for medication nonadherence among patients with mental illness. So, this study was conducted to assess psychiatric patients’ adherence of medication and to improve their quality of life with psychiatric disorder. The objectives of the study were to analyze impact of pharmacophilia and pharmacophobia on medication adherence among patients with psychiatric disorders at a tertiary care hospital and to assess quality of life among pharmacophilic and pharmacophobic patients.Methods: A cross-sectional study was conducted in outpatient psychiatric department for a period of two months. After obtaining informed voluntary consent, patient’s socio-demographic details, diagnosis, and treatment were recorded from prescription slip. Patients above 18yr age with psychiatric diagnosis as per International Classification of Diseases 10 (ICD-10) and receiving at least one psychotropic medication for >1 month were enrolled in study and assessed using: Drug attitude inventory classification (DAI-10); Medication Rating Scale (MARS); Quality of life enjoyment and satisfaction Questionnaire-Short Form (Q-LES-Q-SF).Results: Among 130 patients, 116 were pharmacophilic and 14 were pharmacophobic as per DAI-10 scale. 81.9% of pharmacophilic were adherent to prescribed medication assessed using MARS scale only 14.3% were pharmacophobic. The quality of life was better in pharmacophilic compared to pharmacophobic group (p=0.002) using Q-LES-Q-SF.Conclusions: This study concluded that pharmacophilic patients have higher adherence and good quality of life index compared to pharmacophobic. Proper counselling of pharmacophobic patients by psychiatrists could improve adherence and QOL.
Introduction: Suicide is a complex social issue and a serious global health problem. Its incidence among adolescents is increasing. Understanding of risk factors helps early detection and prompt ...treatment of high-risk youngsters. Materials and Methods: It was a hospital-based case-control study carried out among 60 adolescent suicide attempters and 60 of their normal counterparts for the period of one year. Pretested structured questionnaire was used to collect information. Ethical principles were followed throughout the study. SPSS version 24 was used to do the analysis. Odd’s ratio (OR) and its 95% confidence interval (CI) were calculated as a measure of the strength of association between risk factors and suicide attempts. Results: Among the study participants, 70% were in the age group of 16 – 18 years and 45% were males. The identified risk factors for suicide attempt were, presence of psychiatric illness (OR-7.8; 95% CI: 3.3-19), substance abuse among family members (OR-4.3; 95% CI: 2-9.3), family history of attempted suicide (OR-7.2; 95% CI: 1.5-3.3), family history of completed suicide (OR-3.6; 95% CI: 1.2-1.1) and residence at rural areas (OR-2.8; 95% CI: 1.2 – 6.3). Suicide intent score was significantly correlated with various standard scoring tools for stress and depression among cases. Conclusion: The established risk factors should be considered in creating an effective intervention program and strategies with intersectoral collaboration and coordination to prevent suicide among high-risk adolescents.
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