Presumptive Stressful Life Events Scale Research Articles

Stressful Life Events in Impulsive and Non-impulsive Suicide Attempters: A Cross-sectional Study

Background: Suicide is a significant public health issue, yet it can be avoided with prompt, evidence-based, and frequently inexpensive interventions. There are distinctions between the profiles of impulsive suicide attempters (ISA) and non-impulsive suicide attempters (NISA), and a significant number of suicide attempts are impulsive. A thorough multisectoral suicide prevention strategy is necessary for an effective national response. Methods: This observational cross-sectional study was conducted at a tertiary healthcare center in Karnataka. Sixty inpatients above the age of 18 years with an alleged history of suicide attempts were enrolled in the study. Their stressful life events in the past year were assessed using the Presumptive Stressful Life Events Scale (PSLES). Impulsive and non-impulsive attempters were considered based on the time gap between the suicidal ideation and the suicidal attempt with the presence or absence of plans regarding the act. They were compared using appropriate inferential statistical tests. Results: The majority of the suicide attempts were impulsive (63.3%). The ISA and NISA did not differ in socio-demographic characteristics except for age and family type, with impulsive attempters being more common at younger ages than the non-impulsive attempters ( p = .02). The majority of ISA were from joint families (44.7%), while 72.7% of NISA were from nuclear households ( p = .04). Compared to ISA, NISA recollected a higher number of stressors. Conclusion: The ISA and NISA differ in aspects of age, family type, and stressors. Characteristic distinctions between ISA and NISA should be recognized and understood in order to design policies for suicide prevention and minimize morbidity and mortality. Exploring and addressing the stressors and helping patients to overcome them through better coping skills helps in suicide prevention.

A cross-sectional study of stressful life events and quality of life among FGID and non-FGID patients

ABSTRACT Background: Gastrointestinal disorders, both non-functional and functional, are prevalent among the general population, and understanding these in relation to psychological factors is crucial for clinicians to design effective management strategies. Psycho-social factors, including stressful life events, significantly impact disease outcomes and quality of life (QOL). Limited research has explored these factors in the context of functional gastrointestinal disorders (FGIDs) and non-functional gastrointestinal disorders (non-FGIDs), especially in culturally diverse populations. Aim: To investigate the relationship between QOL and stressful life events in patients with FGID and non-FGID. Materials and Methods: This study involved 200 participants diagnosed with FGID using ROME IV criteria and non-FGID clinically. The research utilized a socio-demographic questionnaire, the Psychological General Well-Being Index (QOL), and the Presumptive Stressful Life Events Scale (PSLES). Results: Among FGID patients, functional dyspepsia was the common diagnosis, while erosive gastritis was more prevalent among non-FGID patients. A significant association in QOL was observed between FGID and non-FGID (P < 0.001), with FGID patients exhibiting lower scores. Overall, a mild negative correlation was found between QOL and PSLES (r = -0.20, P = 0.003). Stressful life events contributed to 13% variance of QOL in non-FGID patients. Conclusion: This study highlights the impact of stressful life events on QOL in both FGID and non-FGID patients. While FGID patients experienced poorer QOL, non-FGID also showed QOL reductions with recent life events. Understanding these associations can aid clinicians in comprehensive patient care, emphasizing the importance of addressing psycho-social factors alongside clinical symptoms. Cultural nuances influencing stress perception and its relation to gastrointestinal disorders merit further investigation.

The role of life events in obsessive-compulsive disorders

Background: A small number of studies are available to assess the role of stressful life events (SLEs) in obsessive-compulsive disorder (OCD). The previous studies have reported contradictory results and they have methodological limitations. Aims and Objectives: The objectives of our study are (i) to find out the frequency of life events in patients with OCD in comparison to their matched healthy controls and (ii) to find out the impact of life events on the severity of the disorder. Materials and Methods: Sixty patients fulfilling Diagnostic and Statistical Manual of Mental Disorder, 5th edition (DSM-V) criteria of OCD were rated with Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Hamilton Rating Scale for Anxiety (HAM-A), Hamilton Rating Scale for Depression (HAM-D), and Presumptive Stressful Life Events Scale (PSLES). A group of 60 normal controls were also rated on PSLES. Finally, both groups were compared in terms of life events. Results: The frequency of life events, past 1 year (t=5.307, P=0.006) and lifetime (t=11.527, P<0.001), were significantly higher in the patient group in comparison to controls. PSLES scores showed asignificant correlation with Y-BOCS total scores, Y-BOCS obsession scores, and HAM-A scores. There was a positive correlation between past 1 year PSLES score and HAM-D scores. Step-wise linear regression analysis showed PSLES scores significantly positively predicted Y-BOCS total score, Y-BOCS obsession score, and Y-BOCS compulsion score. Conclusion: Life events were significantly more frequent in OCD patients both past 1 year and lifetime, as compared to healthy controls. The severity of obsessive compulsive symptoms was found to be directly proportional to the number of SLEs experienced in the past 1 year and lifetime.

Socio-demographic correlates and psychosocial stressors among suicide attempters attending a tertiary care general hospital

Abstract Introduction: Suicide is a rapidly growing and critical public health concern in India and around the world. Interpersonal, social, familial, psychological along with genetic vulnerabilities were important risk factors for suicidal attempts. Methods: This was a hospital-based cross-sectional study done at King George Hospital, Visakhapatnam. All the suicide attempters admitted to the General Medicine department were evaluated at the psychiatric department. A total of 117 patients were included in our study with convenient sampling. Beck’s suicide intent scale, Presumptive stressful life event scale, and semi-structured proforma for socio-demographic and clinical variables were used to assess the study participants. Results: Financial struggles (19.6%) and conflict with family members (14.5%) were the stressful life events among most of the suicide attempts. Most of the study sample used pesticide consumption (20.5%) as the commonest mode of suicidal attempt. The majority of the suicide attempters (53%) had medium suicidal intent. There was a significant association between marriage and stressful life event score (p=0.001). The use of pesticides was significantly higher among men than women (p=0.002) and the use of household agents was significantly high among women than men (p=0.013). Conclusion: Psychosocial stressors also play an important role in attempting suicide and hence to prevent suicidal attempts, there is a need for the development of innovative strategies to decrease the stigma, to improve coping skills and to promote help-seeking from mental health services.

A Study of Clinical Profile and Stressors in Patients Presenting with Dissociative Disorder to a Tertiary Care Teaching Hospital

Background: Dissociative disorder is a condition characterized by disruption of the normal continuity and integration of consciousness, memory, identity, motor functioning, and behavior. Aims: The aim of the study was to study the various psychosocial factors that influence the dissociative episodes in patients. We also looked at the clinical profile and the relation between the type and levels of dissociation with levels of stress in the study sample. Materials and Methods: This descriptive, cross-sectional study with serial sampling had 50 participants who were diagnosed with dissociation as per the International Classification of Diseases-10 criteria. The study was conducted after obtaining clearance from the institutional ethics committee. Dissociative experience of the patients was measured using Severity of Dissociative Symptoms-Adult (Brief Dissociative Experiences Scale [DES-B]-Modified) and stress levels were measured using Presumptive Stressful Life Events Scale. Results: The study showed that dissociation was more common among females from urban population, who were single and among students. Dissociative convulsions were found to be the most common type of dissociation in our culture. DES-B showed moderate-to-severe types of dissociative experience in the sample. In 46% of the participants, family conflicts acted as the most common stressor precipitating episodes. There was a psychodynamic connection/explanation between the perceived stress and the presenting complaint. Conclusion: This study highlights the common dissociations, stressors, and the difference seen among males and females. There is a need to understand the stressors of a patient presenting with dissociation for better psychological management.

Life events in obsessive-compulsive disorder: A cross-sectional study

Background: Obsessive compulsive disorder (OCD) is a chronic psychiatric disorder having significant deterioration in patients’ socio-occupational functioning. Stressful life events (SLE) were noted before onset of this disorder. The previous study with Indian population found positive correlation between stressful and traumatic life events and OCD, but was with small sample size and thus result couldn’t be generalized. Aims and Objectives: The aim of the study was to examine the role of life events in patients with OCD and to find out correlation between them, if any. Materials and Methods: Consecutive 30 OPD patients fulfilling ICD-10 DCR criteria for OCD were rated with Yale Brown Obsessive Compulsive Scale (YBOCS), Hamilton Rating Scale for Depression (HAM-D), Hamilton Rating Scale for Anxiety (HAM-A), and Presumptive Stressful Life Events Scale (PSLES). A group of 30 healthy controls from unrelated patient party were also rated on PSLES. Finally, both groups were statistically compared in terms of life events. Results: Two groups were identical in distribution of age and sex. The frequency of life events, 1-year (P=0.000) and lifetime (P=0.000), were significantly higher in OCD group in comparison to healthy controls. There was significant positive correlation between PSLES scores and YBOCS scores. Step-wise linear regression analysis found positively predictability of PSLES score to OCD severity. Conclusion: OCD patients have statistically significant SLE before the onset of their disorder and total number of life events has positive correlation with severity of OCD.

Stress and psoriasis: Exploring the link through the prism of hypothalamo-pituitary-adrenal axis and inflammation

BackgroundPsoriasis is an immune-mediated, chronic inflammatory disease affecting mainly the skin. Chronic stress leads to the blunted hypothalamic-pituitary-adrenal axis (HPA) that might induce pro-inflammatory conditions. Hence, we assessed the blood levels of the HPA hormones and interleukin-17 (IL-17) and the effect of stress and emotional distress to understand the link between stress and psoriasis better. MethodsThis cross-sectional study included 45 patients with psoriasis and 45 age and gender-matched apparently healthy volunteers (n = 45). IL-17, cortisol, and adrenocorticotrophic hormone (ACTH) levels were assessed in both groups. Psoriasis Area Severity Index (PASI) was used to assess disease severity. Presumptive Stressful Life Events scale [PSLE], Perceived Stress scale [PSS] and Daily Hassles and Uplifts Scale [DHUS] scoring were used to assess stress levels and emotional distress. ResultsPatients with psoriasis had higher levels of IL-17 and ACTH and lower levels of cortisol, as compared to controls. Stress scores (PSS, PSLE & DHUS) were significantly elevated in cases, as compared to the controls. IL-17, ACTH and stress scores showed a significant positive correlation with one another and a significant negative correlation with cortisol levels. They also showed a significant positive correlation with PASI, while cortisol levels showed a significant negative correlation. ConclusionPsoriasis patients having high ACTH, IL-17 and stress scores had lower levels of cortisol, indicating a dysregulated HPA axis with the pro-inflammatory state. This might lead to exacerbation of psoriatic flares, which needs investigation in further prospective studies.

DISSOCIATIVE PHENOMENOLOGY, STRESSFUL LIFE EVENTS AND SUBJECTIVE MENTAL HEALTH AMONG YOUNG ADULTS IN HARYANA, INDIA

Background: Now a day's stress has been known as a significant health issue, which is also related to morbidity as well as mortality. Because everyone is experienced so many stressful life situations in their life which are more likely to, later on, have many succeeding psychological problems. Objective: To assess the relationship and severity between stressful life events, dissociative phenomenology and subjective mental health rating in the general population.Method: A group of 100 healthy participants from Medical College, Rohtak (Haryana), India was selected on the basis of convenience and snowball sampling techniques. Tools: Socio-demographic datasheet, General Health Questionnaire-12, Dissociative Experience Scale-28 and Presumptive Stressful Life Events Scale were used in the present study for obtained the objectives.Results: There is a significant relationship has been seen between depersonalization and education (r=-0.233, p<0.005), absorption and education (r=-0.315, p<0.001), age (r=-0.232, p<0.005). On stressful life experience, marital and sexual problem and mental health (r=-0.246, p<0.005), education-related with depersonalization and absorption (r=0.203 & r=0.235, p<0.005) respectively. Chi-Square value showedthat there is a significant difference between gender in term of mentalhealth (χ²= 5.76, p=0.01), the severity of dissociative symptoms (χ²= 9.00, p=0.003) and stressful life events (χ²= 49.52, p=0.01). Conclusion: Male participants reported more dissociative symptoms than female. Female participants reported a more mild level of traumatic events in comparison to male.

Intensity and Density of Stressful Life Events in First Suicide Attempters with Psychiatric Morbidity and Comorbidity: A Case–Control Study

Abstract Background: Stressful life events (LEs) have been pivotal to suicidal behavior in vulnerable individuals, although its quantum and clustering have remained unclear. This study aimed to estimate and compare the quantum and clustering of LEs across three time periods, three suicide intentionality–lethality categories, and three diagnostic groups in survivors of first suicide attempt (SoFSA). Materials and Methods: One hundred SoFSA were compared to 100 age- and sex-matched controls for LEs across psychiatric and/or personality comorbidity. Presumptive Stressful LE Scale, Risk-Rescue Rating Scale, Hamilton Depression- and Anxiety-Rating Scales, and structured and semi-structured clinical interviews were administered for comprehensive mental health evaluation. Results: SoFSA with age ≥30 years, male gender, schooling <10 years, middle-lower socioeconomic class, married, extended/joint family living, family history of psychiatric disorders/suicide, and concomitant depression–anxiety exhibit significantly higher undesirable, ambiguous, and total LEs across time periods. One-way analysis of variance with post hoc analysis revealed SoFSA who attempted medically serious suicide suffered higher undesirable (F[2,97] = 4.43; P = 0.014) and total (F[2,97] = 3.39; P = 0.038) LEs during recent 6 months compared to medically nonlethal group. SoFSA diagnosed with comorbid psychiatric and personality disorders experienced higher undesirable, ambiguous, and total LEs across all time periods (P < 0.0001), compared to either disorder alone. Desirable LE did not significantly differ across all time periods and diagnostic categories, but ambiguous LE was the only significant finding among SoFSA with personality disorders. Conclusion: This study sheds newer insights that quantitative estimation (intensity and density) of LEs has a potential role in suicide-risk evaluation, with clustering of total or undesirable LE (>3 within 1 year or >10 lifetimes) and ambiguous LE (≥1 within 1 year or > 3 lifetimes) posing risk for psychiatric morbidity and medically serious suicidal behavior (especially, if lifetime total LE > 10). SoFSA with comorbid psychiatric and personality disorders experience higher intensity and density of LEs than either disorder alone, across all time periods.

Psychosocial Stressors in Patients Presenting with Depression Episodes

Depression is a mood disorder characterized by aversion to activities that affects a person's thoughts, behaviour, feelings, and sense of well-being. Objective: To explore the psychosocial stressors / life events and demographic variables in patients with major depression in 1st and subsequent episodes with related sociodemographic factors in each. Methods: The sample of this study was 50 consecutive in-patients with Major Depression. Detailed open-ended interview was conducted and also administered The Presumptive Stressful Life Events Scale (PSLES) to elicit psychosocial stressors and major life events in 1st episode and in the subsequent episodes. Results: showed that of the 50 subjects, majority of subjects 32(64%) were female, 13 (26%) were 26-30 years’ age group, 33(66%) belonged to urban area, 23(46%) were suffering from 3rd and more depressive episodes, 21(42%) reported positive family history, 28(56%) were suffering for 3 months. In psychosocial stressors / life events, 26% had Death of spouse, in Marital and Sexual factors 16% patients reported relationship effect with spouse in 1st, 22% in 2nd and 30% in 3rd Depressive episode and in financial difficulties 12% patients in 1st episode, 20% and 28% in subsequent episodes. Conclusions: Study concluded that there was difference of psychosocial stressors in 1st and subsequent episodes of depression.

STUDY OF LIFE EVENTS AND PREMORBID FUNCTION IN RECENT ONSET SCHIZOPHRENIA

Background and Objectives: Stressful life events preceded onset of psychosis like schizophrenia. Factors which help to identify disease at an earlier stage enable to seek early medical care. This study aims to compare occurrence of life events in subjects presenting 1st time with schizophrenia in the preceding year and to assess premorbid function of individuals. Methods: This was a case–control study with subjects attending psychiatry outpatient department for the 1st time with schizophrenia and controls from general population. After obtaining informed consent, sociodemographic data were collected along with premorbid functioning using premorbid adjustment scale (PAS), presumptive stressful life events scale (PSLES), positive and negative syndrome scale, premorbid schizoid and schizotypal assessment scale, and global assessment functioning scale (GAF). Data analysis was done using SPSS 22 software. p<0.05 was considered significant. Results: Sixty cases and 60 controls were compared. Mean age was 30.45±9.21 years, 55% were male, 56.66% were married, 68.33% were from rural background, and 81.66% were from low socioeconomic status. Mean number of stressful life events in the preceding year, PSLES score, PAS scale, Premorbid schizoid and schizotypal traits scale, and GAF scale were all significantly higher in cases. Married men showed higher stress and life events score. Conclusion: Subjects with schizophrenia experience severe stress before onset of illness and showed more premorbid social dysfunction. Married subjects experience severe stress than others. Duration of untreated illness was less in urban subjects and those with positive family history but had no correlation with severity.

EVALUATION OF STRESSFUL LIFE EVENTS AND SUICIDAL INTENT IN PATIENTS WITH DELIBERATE SELF HARM

Background: Deliberate Self Harm (DSH) is a psychiatric emergency. Stressors in life, suicidal intent and social variables like marital status, family, and social support are among the many determinants of DSH and have shown to be strongly associated with suicide. Aim was Methodology to evaluate stressful life events and suicidal intent in those who attempted DSH. Sixty consecutive patients admitted with attempted suicide were interviewed. Deliberate Self Harm Inventory, Beck Suicidal Intent Scale and Presumptive Stressful Life Event Scale were used along with a semi structured proforma during interview. Data was analysed using appropriate statistical tests. The demographical mean age of the Results participants was 25.2 years and 63% of participants were females.71.1% of the patients had stressful life event score between 101 and 200. About 66.7% had medium intent and 88.3% participants had self harm through poisoning. Patients of a Conclusion ttempted suicide had medium suicidal intent and poisoning was the commonly preferred method of self harm. This study implies that suicide attempters should be specically looked for suicidal intent and their coping styles, so as to plan appropriate psychiatric therapy to prevent future suicide attempt.

Post-COVID presumptive stressful life-events and depression among faculties

Introduction: Stress is an inhabitable component in a doctor’s life. Apart from the personal life, working environments add a huge components of stress in life, which later convert into depression. The unprecedent event of COVID act as top up in adding various stressful events among healthcare professionals. Objectives: The aim of this study was to measure the post-COVID amount of presumptive life stress and depression among the faculties in a tertiary care institute. Methods: It was a cross-sectional study conducted at SCB Medical College, Cuttack for the period of 6 months, i.e. January’21 to June’21. Faculties of all the departments of SCB medical college was considered as study participants and by stratified sampling 72 faculties were considered for this study. Presumptive stressful life event scale (PSLE) was used to measure the stress and Zung self-assessment depression scale (SDS) was used for the measurement of depression among the study participants. The analysis was done “R” software version 4.0.3. Results: A total of 72 faculties were included in this study. Among them, 51(70.83%) were from clinical, 13(18.05%) from para-clinical and 8(11.12%) from non-clinical departments, females (52.8%) and males (47.2%).

To study the effectiveness of mindfulness-based meditation in the functional outcome of osteoarthritis knee and perceived stress scores and markers of obesity in postmenopausal women

Background: The global burdens of cardiovascular diseases (CVDs) and obesity are rising, producing enormous losses of life and disability-adjusted life-years in both developed and developing nations. Stress is a modifiable risk factor for the development of CVD. Postmenopausal women with osteoarthritis (OA) of knee joint may often report episodes of knee instability limiting their daily activities and this causes an added stress. Aims: To evaluate the effects of mindfulness-based meditation on functional outcome of OA knee and to study the effect of mindfulness-based meditation on perceived stress scores (PSSs) and markers of obesity in postmenopausal women. Materials and Methods: This interventional study was conducted on forty postmenopausal women in a tertiary care hospital of Eastern India after taking institutional ethical clearance and informed consent of the patients. Presumptive stressful life events scale (PSLES) scores and PSSs of the patients were assessed. Patients with PSLES scores more than 200 were included in the study. They were all on nonvegetarian diet and came from the middle socioeconomic class. Patients were randomly allocated into two groups and received either balancing exercises and mindfulness-based meditation (Group A) or balancing exercises (Group B). Patients of both groups were age matched. Body mass index (BMI) and waist/hip ratios were measured. The outcome measures were visual analog scale (VAS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores. Results: There was no significant difference in age, PSLES and PSS scores, and WOMAC and VAS scores between the two groups before intervention. AGE Group A 62.4 ± 4.16 versus Group B 62.15 ± 3.75, P = 0.85; BMI Group A 26.6 ± 1.97 versus Group B 26.2 ± 1.002, P = 0.41; waist/hip Group A 0.833 ± 0.033 versus Group B 0.832 ± 0.03, P = 0.96; PSLES Group A 296.3 ± 34.95 versus Group B 291.8 ± 25.2, P = 0.65; PSS Group A 33.38.1 ± 1.97 versus Group B 32.8 ± 2.86, P = 0.185. PSS scores (20.75 ± 1.9 vs. 27.1 ± 1.65; P < 0.0001) and waist/hip ratio were significantly less in Group A as compared to Group B following intervention. Group A had significantly lower WOMAC (38.1 ± 4.03 vs. 50.8 ± 3.78; P < 0.0001) and VAS (4.35 ± 0.77 vs. 5.75 ± 0.68; P < 0.0001) scores as compared to Group B after practice of balancing exercises along with mindfulness-based meditation. Waist/hip ratio was significantly less in the group practicing mindfulness-based meditation (Group A) as compared to Group B. Conclusion: The results of the present study indicate that balancing exercises when practiced along with stress relaxation exercises are more effective in improving the functional ability of OA knee in postmenopausal women.

Free Papers Compiled

Background:Life event research is the cornerstone for assessment of psychosocial factors causing stress and illness. Somatoform disorder is a chronic debilitating illness and stress increases disability in it. Yet, studies in this area is sparse.Aim of the study:The aim of this study was to assess if there is an association of stress with depression in patients of somatoform disorder.Materials and methods:A hospital based cross sectional study was conducted in a tertiary healthcare setup of Assam. The sociodemographic and clinical variables of patients of somatoform disorder diagnosed as per ICD-10 were collected. Stress was assessed using the presumptive stressful life events scale and severity of depression was evaluated in patients with co-morbid depression using HAM-D scale.Results:Majority were between 50-60 years of age (32%), home-maker (28%), from rural area (58%) and had presented with a duration of illness between 0-5yrs (43%) and 30% belonged to the somatization disorder group. Depression was present in 55% and mild depression was most common. Financial stress was most commonly reported stressful life event; stress was found to have a strong positive correlation to presence and severity of depression (p-value<0.01). ‘Presence of unmarried adult son/daughter’ as a self-reported life stressor was a novel finding in this study.Conclusion:Presence of stress amplifies the chances and severity of depression in patients of somatoform disorder. Thus, management of stress is an integral part in management of these patients.

Free Papers Compiled

BACKGROUND:In DSM-5Gender dysphoria defined as marked in congruence between one’s experienced/expressed gender and assigned gender. It often accompanied by dissatisfaction with physical appearance and body image problems, go beyond sex characteristics .An in congruent physical appearance may result in more difficult psychological adaptation and in more exposure to discrimination and stigmatization.. Several preliminary studies have shown benefits of hormone treatment and gender affirming surgery. However the impact of gender affirming treatment is lacking, hence this study tries to reveal impact of gender affirmity treatment method.AIMS:1. To identify impact of gender affirmity treatment (both medical and surgical) in gender congruence ,body satisfaction in our transgender populationMETHOD:83 transgender people(both male to female & female to male) who attend transgender op in Govt.Rajaji hospital, Madurai without psychiatric illness, substance abuse were taken to the study, In which 43 were received gender affirmity treatment (both medical & surgical), and 40 were not yet received treatment. Transgender congruence scale, Body image scale, Gender congruence and life satisfaction scale, WHO Quality of life scale, Presumptive stressful life event scale were administered to both groups.RESULTSThere is significant of improvement in gender congruence, body image, quality of life after gender affirmity treatment.CONCLUSIONGender affirmity treatment improves gender congruence, body image in transgenders.

Prof M. Murugappan Poster Award

Background:Adverse childhood experiences (ACEs) like physical and emotional abuse or neglect are known to influence personality development and contribute to various psychopathologies, including depression.This study provides data on the presence of ACEs among patients of clinical depression with residual symptoms. Although this relationship has been studied worldwide, it has not been sufficiently explored among the Indian rural population.Objectives:The primary objective was to correlate the types of early life stressors with residual depressive symptoms.Method:Data was collected in the psychiatry OPD of a rural hospital in central India. 152 patients of depression on treatment were included. Adverse Childhood Experiences – International Questionnaire, the Hamilton Depression Rating Scale, and the Presumptive Stressful Life Event Scale were applied. According to the HAM-D scores, 64 participants were in clinical remission and 88 showed mild symptoms.Results:Among the participants, 52% were female, mean age was 38±14.71 years and 67.8% were married. An average of 3.78±2.2ACEs were endured by the participants. Significant correlations were seen between residual depressive symptoms and emotional abuse (OR=1.01, 95% CL=0.49-2.07), physical neglect (OR=1.17,95% CL=0.59-2.3) and substance abuse among household members (OR=1.21,95% CL=0.47-3.12) but the strongest association was shown with mothers being treated violently (OR=2.24,95% CL=1.08-4.67). Of the total sample population, 54% perceived themselves to be withstanding severe stress in the current day-to-day life.Discussion:Emotional abuse and physical neglect suffered in childhood are common findings among psychiatric patients, including those of depression. Similar results have been reflected in this study. Witnessing violence at home has shown great influence on this sample. Majority of study populations report experiencing at least one early life stressor. These circumstances influence their mental health in later life.Conclusion:This data strengthens the need to recognise and address these issues at the root. Evaluating ACEs in all individuals could help identify and treat patients sooner, hence reducing the overall burden of the disorder.

Free Papers Compiled

Introduction:Bipolar disorder (BD) is a mental illness which leads to serious struggles and challenges. The neurobiology of BD has complex underpinnings of gene–environment interactions. One such environmental factor, stressful life events (SLEs) can have adverse impacts on the course and prognosis of BD, however this is underexplored.Aims and objectives:1) To estimate the frequency of SLEs in patients with BD-current episode depression2) To study the association of severity of depression with SLE, sociodemographic and illness related factors.Methods:This is a cross sectional study done on 100 consecutive patients diagnosed to have BD-current episode of depression (ICD10), attending Psychiatry OPD & IPD at Pushpagiri Institute of Medical Sciences, Thiruvalla. Semi-structured proforma, Hamilton Rating Scale for Depression, Presumptive Stressful Life Events Scale and Brief Psychiatric Rating Scale were used.Results:About 73% of patients reported SLEs–of which 65 had mild/moderate and 8 had severe stress. Statistically significant association was found between stressful life events and ‘very severe’ depressive episode. Having a middle socio-economic status, past suicide attempt, 1st episode as depression and presence of dyslipidaemia also showed statistically significant association with severity of depression.Conclusion & Recommendations:Understanding the association of stressful life events and BD will help in predicting further relapses and complications like suicide. It will aid in developing adequate therapeutic measures, thereby helping in both symptom reduction and improving quality of life in patients.

Free Papers Compiled

BACKGROUND:In India,elderly persons constitute 8.6% of total population which is projected to reach 19% by 2050.There is lack of information on the magnitude of depression among elderly population in India.Depression is among the leading causes of disability adjusted life years in the world and a serious health problem among older adults.AIM AND OBJECTIVES:To study the prevalence of depression in geriatric patients and to assess the severity and risk factors for depression in geriatric population.METHODOLOGY;This is a cross-sectional study done in 150 geriatric patients attending Geriatric OPD in Government Rajaji Hospital,Madurai who are above 65 years in three months study period and are assessed using Semi-structured proforma to collect information regarding socio-demographic profile,Mini Mental status examination,Geriatric Depression Scale and Presumptive Stressful life events scale and ICD-10 diagnostic criteria to diagnose depression.RESULTS:Prevalence of depression was 29% of which 20% are mildy depressed.Older adults are less likely to endorse cognitive –affective symptoms of depression including dysphoria,worthlessness and guilt.Sleep disturbance ,fatigue,loss of interest ,hopelessness,poor memory are more common.CONCLUSION:The study revealed high prevalence of depression among geriatric patients attending tertiary care hospitals,Sociodemographic,clinical and psychosocial variables as risk factors for depression.But its undiagnosed and overlooked.Prevention of risk factors and early diagnosis may reduce the morbidity ,mortality and improve quality of life.

Dissociative Experiences and Stressful Life Events in Dissociative Disorders - A Cross Sectional Study

Background: Unconscious defenses and dissociative experiences have always been related to stressful life events. A stressful life event has a role to play both in normative and pathological dissociation. These events can be desirable and undesirable and both acute and chronic events can lead to dissociative phenomena Aims: To assess the dissociative experiences and type of stressful life events and also to correlate the events with dissociative disorders. Methodology: A detailed history was obtained along with the application of Dissociative Experiences Scale (DES) and Presumptive Stressful Life Event Scale (PSLES) to know the type of dissociative experiences and the type of stressors. Their correlation was studied using SPSS-20 software. The scores of dissociative experiences and stressful life events were also calculated to find any relation between the scores and the type of dissociative presentation. Results: The majority of people diagnosed with dissociative disorders were females, although there is no gender difference in the DES scores. The mean age of presentation is 25.21±9.12 years. We found out that any subtype of patients can have any score on DES scale. The PSLES scores did not determine the type of dissociative presentation (subtype). Conclusion: Dissociative experiences are related to stressful events in last year, and it acts as a precipitating factor for people with poor coping mechanisms. The scores do not predict the subtype of dissociation.