History Of Psychiatric Illness Research Articles

Association of Sexual Dysfunctions and Sociodemographic Characteristics among Married Couples

Background: Sexual dysfunction is a prevalent issue that affects the quality of life and marital satisfaction among couples. This study aims to explore the association of sexual dysfunction with various sociodemographic characteristics among married couples in Bangladesh. Methods: This cross-sectional study was conducted in Shaheed Monsur Ali Medical College Hospital, Dhaka, Bangladesh during the period from January 2015 to 31st August 2015. A total of 49 married patients with substance use disorder were selected using purposive sampling. Data were collected using a structured questionnaire, DSM-5 criteria for substance use disorder, and the Bangla version of the Arizona Sexual Experience Scale (ASEX). Statistical analyses were performed using SPSS version 25. Results: The study found that sexual dysfunction was significantly associated with age, gender, education, and occupation. Specifically, 22.22% of participants under 25 years, 44.44% of those between 25 to 40 years, and 33.33% of those over 40 years reported sexual dysfunction (p=0.025). Males reported a higher incidence (83.33%) compared to females (0%) (p=0.04). Sexual dysfunction was more common among illiterate participants (16.67%) compared to those with higher education levels (p=0.04). Farmers reported higher rates of sexual dysfunction (33.33%) compared to other occupations, though this was not statistically significant (p=0.18). Income, habitat, and family history of psychiatric illness did not show significant associations with sexual dysfunction. Conclusion: The study underscores the significant impact of sociodemographic factors on sexual dysfunction among married couples in Bangladesh. Targeted interventions addressing these specific factors are essential for improving sexual health outcomes. Further research should aim to deepen the understanding of these associations and develop culturally appropriate strategies for prevention and management.

Effect of Intravenous Dexmedetomidine Before Extubation on Emergence Delirium after Nasal Surgeries.

To investigate the role of single dose of dexmedetomidine (0.5 mcg/kg) in reducing the incidence and severity of postoperative emergence delirium (EmD). A randomised controlled trial. Place and Duration of the Study: Department of Anaesthesia, Security Forces Hospital, Riyadh, Saudi Arabia, from 1st December 2022 to 30th March 2023. Patients, aged between 18-65 years, with ASA 1-3 scheduled to undergo nasal surgeries under general anaesthesia, were inducted in the study. Exclusion criteria were patient refusal, later request for removal from the study, inability to give consent, known allergy to dexmedetomidine, body mass index (BMI) more than 35, history of obstructive sleep apnoea, history of psychiatric illness, pregnancy, and presence of liver and renal diseases. The primary outcome measure of the study was the incidence of emergence delirium in the postoperative period. The frequency of EmD after nasal surgery was 52.38% in the control group compared to 14.28% in the dexmedetomidine group (p = 0.01). Pain scores were not statistically different between the two groups. The duration of post anaesthesia care unit (PACU) stay was significantly lesser in dexmedetomidine group (p <0.001). The satisfaction score on the visual analogue scale (VAS) was also found to be higher in patients who received intravenous dexmedetomidine (p <0.001). The use of single dose dexmedetomidine before extubation in nasal surgeries reduces the EmD and improves patient satisfaction. Dexmedetomidine, Emergence delirium, Nasal surgery, Opioid consumption, Pain control.

Hcv Reinfection in Active Drug Users from Facts to Explanations and Possible Solutions

Background and Aims: Perpignan (in south of France) was 600 000 people very low-income area. Main sociological characteristics associated, many homeless and drugs users local insecurity therefore low-price cocaine, national attractiveness for consumers and traffickers, overconsumption with these lower price, local manufacture of cannabis and road transport effects redistribution of drugs purchased in Spain. This was the only place where coke rail was sold under 5 dollars, 50% lower than the price in the rest of France. Mobile hepatitis team (MHT) was created in 2013 and cured about 1000 HCV patients in an outreach and test to cure approach. MHT used HCV POCT, HCV real time viral load, liver fibrosis measure by FIBROSCAN and nurse DAA prescription. For 2 years, MHT observed increase of reinfections. Method: Observational and Sociological Study of HCV Reinfections. Results: In 2023, MHT (nurses (44%) and hepatologist (56%) prescriptions) treated 89 HCV patients: men 68%, mean age 46 years, reinfection rate 21%. This rate was higher (31%) in patients treated by nurses. They were younger, more often homeless, and active drugs users. A clinical psychological study by patients’ interview showed than reinfected patients were younger, lower educational level, more often homeless, with history of psychiatric illnesses and prison. There was no correlation with precariousness score. More the patient thinks that he was responsible for his illness, the more impulsive he was (dimension urgency emotional impulsiveness). More the patient was aware of the consequences of his illness, the more impulsive he was (dimension urgency emotional impulsivity). The more impulsive the patient was (total score, emergency emotional impulsivity dimension), higher the neuroticism score (negativist personality trait). We individualized 2 specific groups of reinfected patients : gypsies in prison and homeless in the city. More the patient participates in harm reduction workshops, the more he feels responsible for his illness and the consequences of his illness, with magical thoughts about his contamination. The paradoxical outcome was people reinfected had more risk and harm reduction sessions after first infection. There was no fear about DAA treatment as HCV interferon and ribavirin treatment. DAA are always well tolerated and efficient, even in reinfection. Conclusion: Direct-acting antivirals are an effective tool for the treatment of hepatitis C virus, enabling the elimination of the virus. However, some patients who have been successfully treated with direct-acting antivirals are at risk of reinfection. Our findings showed that the risk of reinfection was highest among people with ractive injection drug use..In low-income population exposed to cocaine and other low price drugs, HCV reinfection was a trivialized life event. For reduce it, MHT had set up 3 specific projects: 1. home screening in gypsy women and neighborhood 2. Peers fingersticks HCV screening in homeless people and orientation of HCV positive patients to MHT 3. Prison zero hepatitis program with all HCV inmates same time treatment. Combination of these projects reduced to 22% rate of HCV reinfection in active drugs users during first quarter of their deployment.

Non-prescribed Ritalin use among medical students and its association with depression: A study in Iran

BackgroundMethylphenidate, a nervous system stimulant, is the active ingredient in the brand-name medication Ritalin. The non-medical consumption of this drug is on the rise worldwide, particularly among medical students who belong to an at-risk group. However, misusing this drug can have adverse effects such as depression. In this study, we sought to evaluate the relationship between arbitrary use of Ritalin and the incidence of depression and explore associated factors. MethodsIn this descriptive cross-sectional study, we examined 100 medical students enrolled at (XXX) Medical School (XXX) who reported taking at least one dose of Ritalin in the past month. We gathered participant data, including demographics such as age, education, residence status, history of psychiatric illness, and history of psychiatric medication use. Additionally, we collected information related to depression and anxiety using a questionnaire design based on the Hamilton scoring system in which a score range of 10–13 indicates mild depression, a score range of 14–17 signifies mild to moderate depression, and a score exceeding 17 indicates moderate to severe depression. ResultsSeveral noteworthy findings emerged from our study. We observed that the average age of female (26.45 ± 4.55, n = 39) participants was significantly higher than that of their male (24.26 ± 3.71, n = 61) counterparts (p = 0.01). Moreover, the average final depression score for students was determined to be 18.19, with a median score of 16. The data analysis revealed that 45% of students exhibited moderate to severe depression, whereas 55% experienced either no depression or only mild symptoms. ConclusionsOur study indicates that depression is indeed a significant side effect of Ritalin use among medical students.

Prevalence of imposter phenomenon and its correlates among undergraduate medical students of a government medical college, West Bengal, India

Background: The prevalence of imposter phenomenon (IP) is more among students, engineers, health-care-professionals, and researchers. Medical students are particularly predisposed to IP due to stressors like a highly competitive environment both preceding and during medical education. Aims and Objectives: The aims and objectives of the study are to find out the prevalence of IP among undergraduate medical students of a Medical College of Eastern India and to elicit the relationship between background factors and IP. Materials and Methods: One hundred and thirty medical students were selected by stratified random sampling from all four semesters. Twenty point Clance IP scale was used to measure IP. It contains 20 questions, each of them having five options. A score between “60 and 80” indicates frequent imposter syndrome and a score higher than 80 indicates intense imposter feeling. After conducting descriptive analysis, ordinal logistic regression was conducted. Results: Among the study subjects 37.7% had frequent imposter feelings and 10.8% had intense imposter feelings. High level of IP (frequent and intense combined) is more common among second-semester students, females, middle class, those who sleep &gt;56 h/week, who perceived their school performance was good, who have a family history of psychiatric illness, and who take some kind of chronic medication. As per Ordinal regression, second-semester, middle class, good school performance, and history of chronic medication were found to be significant predictors of higher degree IP. Conclusion: The prevalence of IP is alarming among medical students and it is high time to address this before it turns into graver psychiatric morbidity.

Retrospective Chart Analysis of Psychiatry Referrals for Hospitalized COVID-19 Patients in a Dedicated COVID Hospital in a Metropolitan City in India

Abstract Background: The COVID-19 pandemic has been associated with multiple psychiatric problems in the general population as well as in those admitted with the infection. Studies done so far have mainly focused on the general population. It is important to address the needs and gaps in mental and psychological aspect of health of patients admitted with the infection to improve their overall prognosis. This study was undertaken with the aim to study the pattern of psychiatric referrals of hospitalized COVID-19 patients and to find out if there is any association between their socio-demographics, severity of COVID-19 infection, inflammatory markers, and co-morbidities. Materials and Methods: A descriptive, retrospective chart analysis of the record of 160 psychiatry referrals for COVID-19 patients seen by the on-call psychiatrist from May 2020 to October 2020 in a tertiary care hospital was undertaken. Sociodemographic data, severity of COVID-19 infection, blood investigation reports, psychiatric symptoms, diagnosis and management were recorded, tabulated, and analyzed using SPSS 20. Results: Referrals were more for individuals having moderate-to-severe COVID-19 infection, in elderly patients and in males. The most common reason for referral was disorientation (27.5%) and insomnia (27.5%), followed by the patient having a preexisting psychiatric illness (15%). The most common psychiatric diagnosis was delirium secondary to general medical condition, (28%), followed by anxiety and depressive spectrum disorders (23.75%). 32.5% of the patients referred had a past history of psychiatric illness, the most common being substance use disorder, followed by major depressive disorder and mixed anxiety depression. With the increase in the age of the individuals, the number of referrals for males was significantly more as compared to females (P = 0.00). No statistically significant association was found between age (P = 0.83), gender (P = 0.99), and psychiatric diagnosis. No significant association was found between the severity of COVID-19 and psychiatric diagnosis (P = 0.69). Conclusion: It is essential to screen for psychiatric disorders in patients admitted for COVID, as it goes a long way in reducing the overall morbidity and improves patient cooperation for various procedures which could be life-saving.

Breastfeeding in primiparous women with congenital heart disease − a register study

BackgroundThe number of pregnant women with congenital heart disease (CHD) is rising, and the disease poses increased risks of cardiovascular and obstetric complications during pregnancy, potentially impacting breastfeeding success. This study aimed to investigate breastfeeding in primiparous women with CHD compared to primiparous women without CHD, and to examine potential hindering factors for breastfeeding in women with CHD.MethodsThe data were gathered between 2014 and 2019 and obtained by merging the Swedish Congenital Heart Disease Register (SWEDCON) with the Swedish Pregnancy Register. Primiparous women ≥ 18 years of age with CHD (n = 578) were matched by age and municipality to 3049 women without CHD, giving birth after 22 gestational weeks. Multivariable logistic regression analysis was used to identify factors associated with non-breastfeeding in women with CHD.ResultsFewer women with CHD breastfed than women without CHD two days (94% vs. 97%, p = 0.001) and four weeks after birth (84% vs. 89%, p = 0.006). When all women were analysed, having CHD was associated with non-breastfeeding at both two days and four weeks after birth. For women with CHD, body mass index (BMI) ≥ 30 (OR 3.1; 95% CI 1.4, 7.3), preterm birth (OR 6.4; 95% CI 2.1, 19.0), self-reported history of psychiatric illness (OR 2.4; 95% CI 1.2, 5.1), small for gestational age (OR 4.2; 95% CI 1.4, 12.2), and New York Heart Association Stages of Heart Failure class II − III (OR 6.0; 95% CI 1.4, 26.7) were associated with non-breastfeeding two days after birth. Four weeks after birth, factors associated with non-breastfeeding were BMI ≥ 30 (OR 4.3; 95% CI 2.1, 9.0), self-reported history of psychiatric illness (OR 2.2; 95% CI 1.2, 4.2), and preterm birth (OR 8.9; 95% CI 2.8, 27.9).ConclusionsThe study shows that most women with CHD breastfeed, however, at a slightly lower proportion compared to women without CHD. In addition, factors related to the heart disease were not associated with non-breastfeeding four weeks after birth. Since preterm birth, BMI ≥ 30, and psychiatric illness are associated with non-breastfeeding, healthcare professionals should provide greater support to women with CHD having these conditions.

Deliberate self-harm among pediatric psychiatric inpatients in China: A single-center retrospective study.

For children and adolescents, deliberate self-harm (DSH) is becoming a mental health problem of concern. Despite several studies on the prevalence and factors of DSH in the world, there is little information on DSH among children and adolescents in China. This study explores the prevalence, types, associated risk factors and tendency of DSH in pediatric psychiatric inpatients in China. To understand the situation of DSH among hospitalized children and adolescents and its related factors. In this study, we retrospectively studied 1414 hospitalized children and adolescents with mental illness at Xiamen Mental Health Center from 2014 to 2019, extracted the demographic and clinical data of all patients, and analyzed clinical risk factors of DSH. A total of 239 (16.90%) patients engaged in at least one type of DSH in our study. Cutting (n = 115, 48.12%) was the most common type of DSH. Females (n = 171, 71.55%) were more likely to engage in DSH than males (n = 68, 28.45%). DSH was positively associated with depressive disorders [OR = 3.845 (2.196-6.732); P < 0.01], female [OR = 2.536 (1.815-3.542); P < 0.01], parental marital status [OR = 5.387 (2.254-12.875); P < 0.01] and negative family history of psychiatric illness [OR = 7.767 (2.952-20.433); P < 0.01], but not with occupation, substance use and history of physical abuse. Our findings suggest that for patients with depression, females, an abnormal marriage of parents, and no history of mental illness, attention should be paid to the occurrence of DSH.

Prevalence of depressive and anxiety symptoms and perceived stress in hospitalised patients with COVID-19.

COVID-19 infection is associated with significant depressive and anxiety symptoms and stress. We examined the prevalences of depressive and anxiety symptoms and perceived stress among patients with COVID-19. Clinically stable patients with COVID-19 aged 18 to 60 years who were admitted between April 2021 and September 2021 to the MES Medical College in Kerala, India were prospectively recruited. They were assessed using the Montgomery-Asberg Depression Rating Scale, the Hamilton Anxiety Scale, and the Perceived Stress Scale. Of 112 patients screened, 103 were included in the analysis. Depression scores were higher in patients of lower socio-economic status (p = 0.04), of unemployed (p = 0.01), and with longer hospital stays (p < 0.001). Anxiety scores were higher in patients aged 31 to 40 years (p = 0.04), of lower socio-economic status (p = 0.01), with a history of psychiatric illness (p = 0.006), and with a history of self-harm (p = 0.019). Perceived stress scores were higher in patients of lower socio-economic status (p = 0.02), with a history of psychiatric illness (p = 0.001), and with a history of self-harm (p = 0.022). Socio-economic status, employment status, a history of psychiatric illness, and duration of hospital stay are associated with depression, anxiety, and stress among patients with COVID-19.

Homelessness in pregnancy

ObjectivesTo evaluate the association, if any, of homelessness or refuge accommodation on delivery and short term perinatal outcomes in an Irish tertiary maternity hospital. MethodsA retrospective cohort study of 133 singleton pregnancies in women reporting to be homeless or living in refuge at their booking antenatal appointment between 2013 and 2022. Analysis compared sociodemographic characteristics and perinatal outcomes in this cohort to a reference population of 76,858 women with stable living arrangements. ResultsWomen in the homeless/refuge population were statistically more likely to be single (75.2 % vs 39.5 %, p < 0.001), have an unplanned pregnancy (73.7 % vs 27.2 %, p < 0.001), report a history of psychiatric illness (42.9 % vs 22.4 %, p < 0.001), domestic violence (18.8 % vs 0.9 %, p < 0.001) alcohol consumption in pregnancy (3.0 % vs 0.8 %, p < 0.001) or smoking in pregnancy (41.3 % vs 9.7 %, p < 0.001).They were significantly more likely to have a preterm birth (adjusted OR 1.71 (1.01–2.87) p = 0.04). They also had a significantly lower median birth weight compared to the reference population (birthweight 3270 g vs 3420 g, p < 0.001). ConclusionWomen in the homeless and refuge population are more likely to experience poorer perinatal outcomes compared to women with stable living arrangements.

Assessing the Efficacy of Buffered Versus Nonbuffered Lidocaine in Dental Extractions: A Double-Blinded Randomized Controlled Trial

Injections using buffered lidocaine may decrease discomfort, have a quicker onset, and be a more efficacious local anesthetic. Previous studies have been inconclusive in the oral context. To address if bicarbonate buffered 2% lidocaine can decrease pain from the use of local anesthesia, has a quicker onset time, and is more efficacious. The design was a single-center double-blinded randomized control trial, set in an outpatient oral and maxillofacial clinic housed in the University of Cincinnati Medical Center. Inclusion criteria for the study were patients requiring a single tooth extraction due either to caries or periodontal disease. The predictor variable was the local anesthetic used either nonbuffered 2% lidocaine with 1:100,000 epinephrine (control) or bicarbonate buffered 2% lidocaine with 1:100,000 epinephrine (study) was randomly assigned. Primary outcome variables were injection pain score, and postoperative pain, time to anesthetic onset, and the number of rounds of injections required to achieve adequate anesthesia. The covariates were jaw involved, age, sex, and race, American Society of Anesthesiologists score, body mass index, current tobacco use, history of psychiatric illness, chronic pain, and preoperative pain score. Test statistics were calculated using Wilcoxon rank-sum test, Kruskal-Wallis test, Spearman rank correlation test, χ2 test for bivariate analyses, and Fisher's exact test. P values≤.05 were considered statistically significant. The final sample was 114 subjects. The mean age of the sample was 42.97years, standard deviation ±13.43years. The sample was 39.47% male. The racial demographics were Caucasian (62.28%) and African American (33.33%). Buffered lidocaine did not have a statistically significant relationship with any of the outcomes. The jaw involved had a statistically significant association to the injection pain score (P value=.006), and the number of rounds of anesthetic required (P value=.047). Age showed a statistically significant association to injection pain score (P value=.032), and the number of rounds of anesthetic required (P value=.027). Finally, preoperative pain had a statistically significant relationship with injection pain score (P value= < .001). In this study, bicarbonate buffered lidocaine did not exhibit any discernible advantages over nonbuffered lidocaine for any study outcomes.

Evaluation of anxiety and hopelessness levels in emergency service workers during the COVID-19 pandemic in Turkey

Background/Aim: The COVID-19 pandemic led to a significant threat to the lives of individuals, particularly frontline healthcare workers. This brought about negative emotions, such as anxiety and hopelessness. Despite the existence of research evaluating psychiatric symptoms among healthcare personnel during the COVID-19 pandemic, this study is also significant in terms of evaluating and emphasizing the common negative emotions experienced by frontline healthcare workers during the pandemic. This study aimed to evaluate anxiety and hopelessness levels in emergency service workers during the COVID-19 pandemic and to examine these levels in terms of specific variables. Methods: This cross-sectional study was conducted among emergency service healthcare workers, including doctors, nurses, and healthcare officers working in a training and research hospital from July 10 to August 10, 2020 during the pandemic. Participants completed a survey that included a sociodemographic information form, the State and Trait Anxiety Inventory (STAI), and the Beck Hopelessness Scale (BHS). A total of 135 personnel without a history of psychiatric illness or use of psychiatric medication were included in the study. Results: Of the 135 participants in the study, 67 were female, and 68 were male. The mean state anxiety score for all participants was 44.5 (12.6), trait anxiety score was 44.2 (7.3) and hopelessness score was 7.1 (5.2). It was found that the anxiety of emergency service workers during the pandemic was at a moderate level and their hopelessness was at a mild level. In the study, higher scores were found in hopelessness and state-trait anxiety measurements in married individuals compared to single participants (P=0.040, P=0.003, P=0.001, respectively). Trait anxiety scores were significantly higher among those with chronic diseases compared to those without chronic diseases, and in those living with families compared to those living alone (P=0.039 and P=0.017, respectively). A positive and moderate relationship was observed between hopelessness levels and state-trait anxiety levels (P&lt;0.001 for all, r=0.457, r=0.425, respectively). Conclusion: During the COVID-19 pandemic, increased levels of anxiety and hopelessness were detected among healthcare workers in emergency services. It was observed that as the working time in the emergency department increased, hopelessness and state anxiety levels of the employees also increased.

Characteristics of Functional Hyperthermia Detected in an Outpatient Clinic for Fever of Unknown Origin

Background: Functional hyperthermia (FH) is characterized by hyperthermia resulting from sympathetic hyperactivity rather than inflammation, and it is frequently overlooked by medical practitioners due to the absence of abnormalities in a medical examination. Although FH is an important differential diagnosis for fever of unknown origin (FUO), the literature on FUO cases in Japan lacks information on FH. In this study, we aimed to uncover the population of FH patients hidden in FUO cases. Methods: An outpatient clinic for FUO was established at Okayama University Hospital, and 132 patients were examined during the period from May 2019 to February 2022. Results: A diagnosis of FH was made in 31.1% of the FUO cases, and FH predominantly affected individuals in their third and fourth decades of life with a higher incidence in females (68.3%). The frequency of a history of psychiatric illness was higher in patients with FH than in patients with other febrile illnesses. Although the C-reactive protein (CRP) is generally negative in FH cases, some obese patients, with a body mass index ≥ 25 had slightly elevated levels of CRP but were diagnosed with FH. Conclusions: The results showed the importance of identifying FH when encountering patients with FUO without any organic etiology.

The Impact of the COVID-19 Pandemic on Self-Harm Attempts Observed in a Hospital Emergency Department

Suicide is a significant public health concern, with one million lives lost to it every year. Suicidal ideation and attempts are markers of high risk. The COVID-19 pandemic has had a negative psychological impact on the population. This study aims to describe and analyze the clinical and sociodemographic characteristics of patients who have received medical attention for self-harm attempts in a hospital emergency department, comparing the period before and after the COVID-19 pandemic. This is a descriptive, retrospective study that collected data from medical records of patients who received care for self-harm attempts in the emergency department. The data included cases from 1 January 2018 to 31 December 2022. In total, 529 cases of self-harm attempts were identified, of which 62.8% were female. The number of post-pandemic self-harm attempts significantly increased compared to the period before the pandemic. The most used method for self-harm was medication ingestion. This study revealed that over one-third of the participants had previously attempted suicide. Most self-harm attempts were made by women in the 10–20 or 41–50 age groups, with a history of psychiatric illness and multiple medications. The study results also highlighted an increase in self-harm attempts during the COVID-19 pandemic.

Psychosocial characteristics of potential and actual living kidney donors

The psychosocial assessment is an essential component of the living kidney donor (LKD) evaluation. However, it remains uncertain how specific psychosocial factors impact LKD eligibility. We performed a retrospective chart review of LKD candidates who initiated the evaluation process and who had completed a required, in-person licensed social work (LSW) visit. LSW notes were reviewed for frequency of psychosocial factors that may impact the success of LKD candidate approval by the selection committee. 325 LKD candidates were included in the study: 104 not-approved and 221 approved. Not-approved LKD candidates were more likely to receive a negative family reaction to wanting to donate than approved LKD candidates (8.7% vs 1.4%, p < 0.01). On multivariate analysis, Black race, history of psychiatric illness, highest level of education being high school, and high psychosocial risk score assignment were all associated with a lower odds ratio of being approved. The majority of not-approved LKD candidates were disqualified for medical reasons (N = 76, 73.1%). In conclusion, psychosocial factors impact donation even after LKD candidates make it to an in-person evaluation.

Associations of rumination, behavioral activation, and perceived reward with mothers' postpartum depression during the COVID-19 pandemic: a cross-sectional study.

The COVID-19 pandemic has led to increased social isolation for mothers, and rumination exacerbates postpartum depression in mothers with poor social support. Although behavioral activation can help to decrease their depressive symptoms, the mechanism by which behavioral activation reduces postpartum depression remains unclear. We examined the effects of rumination and behavioral activation on depression in postpartum women by examining a model mediated by subjective reward perception. A questionnaire was administered to 475 postpartum women (Age: Mean = 30.74 years, SD = 5.02) within 1 year of childbirth using an Internet survey. The measurements included perinatal depression, rumination, and behavioral activation, and we assessed environmental reward. To control for confounding variables, we assessed psychiatric history, social support, parenting perfectionism, and COVID-19 avoidance. Eighty-four (17.68%) mothers had possible postpartum depression. The covariance structure analysis showed that not only was there a direct positive path from rumination to postnatal depression but also a negative path via reward perception. This finding indicated that the COVID-19 pandemic could have increased depression in many of the mothers. Rumination not only directly relates to postpartum depression, but it could also indirectly relate to postpartum depression by decreasing exposure to positive reinforcers. In addition, having a history of psychiatric illness increases the effect of rumination on postpartum depression. These findings suggest that psychological interventions are needed to reduce rumination and increase contact with positive reinforcements to reduce postpartum depression, especially for high-risk groups.

Neuroinflammation in comorbid depression in Alzheimer's disease: A pilot study using post-mortem brain tissue

Comorbid depression and Alzheimer's disease (AD) is associated with poorer prognosis than either condition alone. Neuroinflammation has been implicated in the pathogenesis and progression of both depression and AD, but much of the existing research has been based on peripheral blood immune markers. Relatively little is known about the neuroinflammatory environment when these conditions occur simultaneously and using immune measures directly in the brain tissue. This pilot study aimed to examine brain inflammatory marker changes in AD cases comparing those with and without comorbid depression.Post-mortem brain tissue from AD cases with depression (n = 23) and AD cases with no history of psychiatric illness (n = 25) were analyzed for a range of inflammatory markers, including markers of microglial function (Iba1, P2RY12, CD64 and CD68 measured by immunohistochemistry); endothelial inflammatory markers (ICAM-1 and VCAM-1 measured by ELISA); and cytokine levels (IFN-γ, IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12p70, IL-13, and TNF-α measured using Mesoscale Discovery Multiplex Assays).Brains of AD cases with comorbid depression, compared with AD alone, had increased IL-4 in the superior frontal gyrus and increased TNFα & IL-12p70 in the insula. Levels of all other inflammatory markers including markers of microglial function and endothelial inflammation were similar between the two groups.We found no consistent changes in cytokines between the two brain regions in individuals with comorbid depression in AD. Further work in larger cohorts is needed to understand brain region specificity of immune marker alterations and the relationship of these changes with pre-mortem clinical outcomes.

Determinants of delirium in elderly in-patients in a general ward setting in a teaching hospital: A case control study

Background: There is a dearth of research on risk factors of delirium among elderly inpatients in nonintensive low resource settings. Aim: To determine the risk factors of delirium in elderly inpatients in a nonintensive care unit setting. Materials and Methods: Sixty two elderly patients with delirium (cases) and 62 patients without delirium (controls) were administered a semi-structured proforma with socio-demographic variables and putative predisposing and precipitating risk factors and the Vellore screening instrument for dementia. Results: On univariate analysis, factors such as past cognitive impairment, history of nocturnal confusion and delirium, diminished daily living activities, severe medical illness, history of psychiatric illness, presence of dementia, infection, fever above 1000F, abnormal electrolytes abnormal RFT, leukocytes in urine, hypoxia, anticholinergics and benzodiazepines, emergency admission, use of physical restraints, bladder catheterization, more than routine investigations, intensive care unit admission, surgery, and duration of hospital stay more than 10 days were found to be significantly associated with delirium. On multivariate analysis with binary logistic regression, bladder catheterization (odds ratio [OR] = 13.85; confidence interval [CI] = 1.44-133.14), abnormal electrolytes (OR = 5.12; CI = 1.11-23.69), and hypoxia (OR = 75.52; CI = 4.64-1.134E3) were detected to be independently associated with delirium. Conclusion: Acute modifiable rather than long-term factors were risk factors for delirium among the elderly. An awareness of modifiable risk factors has the potential of developing targeted interventions for the early mitigation of delirium.

Psychiatric Morbidity and Assessment of its Severity in Gynaecologic Oncology Patients: A Cross-sectional Study

Introduction: Several psychological and social factors influence the incidence, treatment, and outcome of cancer patients. Depressive symptoms are more common in cancer patients, particularly in late stages. Women in Indian settings often exhibit delayed treatment-seeking behaviour. Aim: To assess the prevalence, type, and severity of psychiatric morbidity as well as the duration, type, and stage of illness in gynaecological oncology patients. Materials and Methods: This cross-sectional study was conducted among 100 gynaecological oncology patients aged 18 to 65 years, who were attending the gynaecologic Outpatient Department (OPD) and ward at a tertiary care hospital. The study took place at Government Rajaji Hospital, Madurai, between May 2013 and November 2013. Data was collected using a semistructured questionnaire from the patient and a reliable informant, after obtaining informed consent. The data was entered into Microsoft Excel and analysed using Statistical Package for Social Sciences (SPSS) software version 20.0. Central values, dispersion, and Chi-square tests were calculated. Results: The sample comprised 100 gynaecological oncology patients, with 30 (30%) diagnosed with malignancy, 43 (43%) with a benign condition, and 27 (27%) under investigation. Among the 100 patients assessed, 34 (34%) had psychiatric morbidity. There was a significantly higher prevalence among older patients, those with more than six months’ duration of gynaecological morbidity, and those exhibiting non fatal suicidal behaviour. Conclusion: Psychiatric morbidity is highly prevalent in gynaecological oncology patients. Depression was found to be more frequent and severe in patients with cancer. A previous history of suicidal attempts and a family history of psychiatric illness are important predictors of psychiatric morbidity in this population. Future studies on a larger population should explore the biological relationship between gynaecological oncology and psychiatric illness.

Assessment of Quality of Life among Terminally Ill Cancer Patients Receiving Palliative Care at Hospice Centre, Ahmedabad City, India.

Cancer has been the leading cause of death worldwide, and palliative care is an approach that improves the quality of life (QoL) of patients and their families facing the problem associated with life-threatening illness. Hospice care helps patients and their family to cope with the change from treating the cancer to living life as fully as possible through their final days. This study aimed to (1) assess the sociodemographic and clinical profile of terminally ill cancer patients, (2) assess the QoL among terminally ill cancer patients receiving palliative care, and (3) study various determinants affecting their QoL. A cross-sectional study was conducted among terminally ill cancer patients receiving palliative care at the Hospice Centre, Community Oncology Centre, Ahmedabad. Based on previous years' admission data, a sample size of 360 was taken. Patients who are seriously ill up to the extent that they were unable to respond and had a previous positive history of psychiatric illness before the diagnosis of cancer were excluded. Institutional ethical committee (IEC) permission was obtained before the study. Statistical analysis was performed using the Chi-square test in Statistical Package for the Social Sciences (SPSS) software. The mean age of participants was 48.1 ± 13.0 years. The gender distribution of participants was males and females (226 (62.8%) and 134 (37.2%)), respectively. On studying, the involvement of various anatomical sites as "primary site of cancer" revealed that head and neck carcinoma had the highest (63.3%) involvement and hematological cancer had the lowest (0.6%) involvement. Of total, 62% of participants had "below-average QoL," followed by 34.9% of participants having "significantly poor QoL." There was a significant association between different age groups, time lag in cancer diagnosis, and treatment initiation and QoL. Spearman's rank correlations between the majority of factors fell in "low partially positive" category except for the physical well-being (factor 2) and psychosocial well-being (factor 3) with optimism and belief (factor 7), where they were in "low partially negative" category.