Previous History Of Psychiatric Illness Research Articles

Prevalence of post traumatic stress disorder and its predictors among road traffic accident survivors

Background: Post-traumatic stress disorder (PTSD) among road traffic accident (RTA) survivors, gets received little attention as medical experts prioritize treating physical injuries. In Pakistan, PTSD remains understudied. Therefore, this study aimed to determine the prevalence and predictors of PTSD. Methods: This cross-sectional study was performed among 128 survivors of RTA at Benazir Bhutto hospital, Rawalpindi. Data were collected via a pre-tested PTSD checklist-specific version (PCL-S) tool to screen for PTSD and a self-designed proforma. Descriptive and inferential statistics were used in the data analysis using the statistical package for the social sciences (SPSS) version 25. The p<0.05 was used set a significant. Results: The 34 (26.56%) participants of study population had PTSD. Following adjustment for potential confounding variables, the following factors were found to be significant predictors of PTSD: time since RTA (1-3 months) (AOR=0.38; 95% CI (0.18, 0.76), history of prior RTA (AOR=2.56; 95% CI (1.22, 5.47), presence of close one in the same RTA, (AOR=2.23, 95% CI (1.14, 4.46), witnessing of death of close one in the same RTA, (AOR=7.49, 95% CI (3.16, 14.68) and previous history of psychiatric illness (AOR=12.35, 95% CI (5.32, 28.29). Conclusions: Our study population had significant prevalence of PTSD (26.56%). Significant predictors of PTSD included the amount of time after the accident, the history of prior traffic accidents, presence of close one in same accident, witnessing the death of close one in same accident, and history of psychiatry disorder.

Ondansetron in the Prevention of Post Cardiotomy Delirium after Coronary Artery Bypass Grafting Surgery

Objective: To determine the efficacy of Ondansetron as a prophylctic agent in patients undergoing Coronary Artery Bypass Grafting. Study Design: Quasi-experimental study. Place and Duration of study: Adult Cardiac Surgery Department, AFIC/NIHD Rawalpindi Pakistan, from Nov 2022 to Feb 2023. Methodology: A total of 156 patients undergoing Coronary Artery Bypass Grafting Surgery irrespective of age and gender were included in the study via nonprobability consecutive sampling. Patients who had a previous history of psychiatric illness, and those in whom delirium could not be reliably tested were excluded from the study. The study population was divided into two groups (group A and group B). Those in the group A received 8mg Ondansetron intravenously on zero, first and second post-operative day. Group B did not receive any intervention. Descriptive statistics were used to measure percentages, frequencies and Mean±SD. Comparison between variables was made by Chi-square test for categorical variables and t-test for continuous variables. p<0.05 was considered statistically significant. Results: Total 156 patients were included in the study and mean age of the patients was 59.47±10.98 years. A total of 3(14.3%) patients who had been given Ondansetron compared to 18(85.7%) patients who were not given Ondansetron developed delirium (p<0.001). Other factors significantly associated with post cardiotomy delirium were age (p<0.001), hypertension (p<0.001), and diabetes (p=0.03). Conclusion: Our study revealed that Ondansetron can be used effectively to reduce the incidence of post cardiotomy delirium in patients of coronary artery bypass grafting.

Maternal infant bonding in tracheostomy dependent infants: A cross sectional study

To report the current state of maternal infant bonding (MIB) in mothers of tracheostomy-dependent infants and identify demographic factors associated with MIB. A cross-sectional study was conducted at a pediatric tertiary care hospital. Mothers of tracheostomy-dependent children below the age of two, seen during the 24 months prior to June 2021, were recruited to participate. The exclusion criteria consisted of clinical instability of the infant at the time of recruitment or lack of custody. The Maternal Infant Bonding Questionnaire (MIBQ) was administered to biological mothers. The possible range of scores was 0-24 with higher scores indicating poorer bonding. Mean MIBQ scores, as well as elevated MIBQ scores (greater than 0), were evaluated with respect to patient demographic and clinical characteristics. Of 46 eligible participants, the response rate was 6 7% (n=31). The median maternal age was 30 (IQR:8.5), and the median infant age was 15 months (IQR: 7.5). The mean MIBQ score in the tracheostomy-dependent infant population was 1.38 (SD: 1.96), and 45% had a score greater than 0. The mean MIBQ of our cohort was not statistically different from the control group of healthy infants. Elevated MIBQ scores signaling poorer bonding were seen in caregivers of infants with bronchopulmonary dysplasia and older caregivers. Preliminary evidence suggests that caregivers of infants with mechanical ventilation and neurologic comorbidities may have improved bonding compared to other tracheostomized infants. MIBQ scores were not associated with other sociodemographic or clinical characteristics, such as gestational age at birth, previous history of psychiatric illness, admission status or sociodemographic characteristics. We observe a mean MIBQ score of 1.38 in mothers of tracheostomy-dependent infants. Efforts to improve bonding may aid infant development and maternal affect.

Burning mouth syndrome: Analysis of diagnostic delay in 500 patients.

To assess the diagnostic delay, the number and type of referrals and the clinical and psychological profile in a wide sample of patients with Burning Mouth Syndrome (BMS). Data on the disease onset, oral symptoms, type and number of practitioners consulted, misdiagnoses, and the presence of medically unexplained extraoral physical symptoms were recorded in 500 BMS patients. Potential predictors of diagnostic delay were also evaluated. The mean diagnostic delay was 29.71 ± 47.19months. An average of 2.61 ± 1.65 practitioners were consulted by each patient, the most frequent being the general physicians (287; 57.4%), maxillofacial surgeons (111; 22.2%), and otolaryngologists (104; 20.8%). The mean number of misdiagnoses was 3.54 ± 1.85. Nonspecific stomatitis, candidiasis, and gastroesophageal reflux were the most common misdiagnoses. Higher age, low education, the presence of dysgeusia, and a previous history of psychiatric illness were predictors of a longer diagnostic delay (p-value: 0.028, 0.050, 0.007, 0.034, respectively). The lack of knowledge among specialists, the high rate of misdiagnosis, and the diagnostic delay of BMS highlight the need to introduce educational interventions in all medical specialties in order to promote an early and appropriate diagnosis, thereby improving the prognosis and quality of life of the patients.

The "Healthcare Workers' Wellbeing [Benessere Operatori]" Project: A Longitudinal Evaluation of Psychological Responses of Italian Healthcare Workers during the COVID-19 Pandemic.

Background: COVID-19 forced healthcare workers to work in unprecedented and critical circumstances, exacerbating already-problematic and stressful working conditions. The “Healthcare workers’ wellbeing (Benessere Operatori)” project aimed at identifying psychological and personal factors, influencing individuals’ responses to the COVID-19 pandemic. Methods: 291 healthcare workers took part in the project by answering an online questionnaire twice (after the first wave of COVID-19 and during the second wave) and completing questions on socio-demographic and work-related information, the Depression Anxiety Stress Scale-21, the Insomnia Severity Index, the Impact of Event Scale-Revised, the State-Trait Anger Expression Inventory-2, the Maslach Burnout Inventory, the Multidimensional Scale of Perceived Social Support, and the Brief Cope. Results: Higher levels of worry, worse working conditions, a previous history of psychiatric illness, being a nurse, older age, and avoidant and emotion-focused coping strategies seem to be risk factors for healthcare workers’ mental health. High levels of perceived social support, the attendance of emergency training, and problem-focused coping strategies play a protective role. Conclusions: An innovative, and more flexible, data mining statistical approach (i.e., a regression trees approach for repeated measures data) allowed us to identify risk factors and derive classification rules that could be helpful to implement targeted interventions for healthcare workers.

Abstract- Poster

Introduction:Malignant catatonia is a life-threatening psychomotor syndrome which presents along with symptoms of catatonia like stupor, waxy flexibility, catalepsy, mutism, negativism, posturing, stereotypy, agitation, grimacing, echolalia and echopraxia, it can also include autonomic instability like fever, hypertension and tachycardia, which makes it difficult to differentiate from other disorders like delirium, neuroleptic malignant syndrome.Case Description:A 24yr old female patient who was 5weeks postpartum with no previous history of psychiatric illness and no significant family history presented with postpartum psychosis. Symptoms included over religiosity, decreased need for sleep, talking and laughing to self, anger and irritability, and not taking care of her new born baby for 1 week before presenting to the op. At the time of presentation patient was unkempt, uncooperative, agitated and non-verbal. She also developed waxy flexibility, negativism, catalepsy and grimacing, she stopped drinking water and eating for 2days. Patient showed no response to Olanzapine. With this Lorazepam challenge was done and patient showed slow response making catatonia as a differential. Later she developed fever and autonomic instability and elevated creatine kinase with her symptoms Modified ECT was initiated to treat Malignant catatonia. She responded well to 4 sessions of ECT with complete resolution of symptoms. She was maintaining well on low dose of lorazepam, mood stabilizer and antipsychotic for maintenance of her mood and psychotic symptoms.Conclusion:In severe cases of catatonia like in Malignant catatonia ECT has to be initiated as soon as possible as Malignant catatonia has higher rate of response to ECT than treatment with Lorazepam alone.

Prevalence of depression, stress, anxiety among information technology professionals during COVID-19 lockdown, 2020 in Kerala

Background: COVID-19 pandemic has completely changed the work pattern of information technology professionals who had to shift from the work from office to work from home pattern. The comforts of home, that they used to enjoy, was now taken up by an office space at home and this has potentially altered the mental health status of these professionals.Methods: A cross sectional study was conducted among IT professionals within the age group 21-45 years working in Kerala. 218 subjects were included in the study. A self-prepared structured questionnaire was used to collect basic demographic information and depression anxiety and stress scale (DASS 21) scale was used to assess depression anxiety and stress among IT professionals using Google form. Informed consent was obtained in the beginning of the questionnaire. The data was entered in Microsoft Excel and analysed using SPSS software.Results: Out of the total study participants 50.5% (110) were males and 49% (108) were females. 42.7% were married and 57.3% were unmarried and none of them were divorced or living separated. Most of the study participants (62.8%) had monthly income below 50,000. Out of the total study participants, 72 (33%) of them were working in IT field for less than 2 years, 52 were working for last 2-4 years, 51 were working for last 4-8 years and only 43 individuals were working for more than 8 years. 67% of them had their working hours raised during COVID lock down. In our study while 21.6% had a previous history of psychiatric illness for which they have consulted a doctor/psychologist. Out of all the study subjects, 4.1% were mildly depressed, 6.9% were moderately depressed, 5.5% were severely depressed and 1.8% had extremely severe depression. Most of the study subjects (81.7%) were not anxious, 9.2% were mildly anxious, 6.8% were moderately anxious, 2.3% were severely anxious. 76.9% had no stress, 6.1% were mildly stressed, 11.5% were moderately stressed, 4.6% were severely stressed and 0.9% had extremely severe stress. Depression among IT professionals during COVID-19 lockdown was found to be significantly associated with past history of psychiatric illness. Anxiety was found to be significantly associated with past history of psychiatric illness and unmarried relationship status. The stress among IT professionals during lockdown was found to be significantly associated with previous history of psychiatric illness and unmarried relationship status.Conclusions: 18.3% of the IT professionals had some degree of depression and 23.1% was facing stress 18.3% was anxious. Past history of psychiatric illness was associated with increased depression anxiety and stress. Unmarried relationship status was associated with associated with increased anxiety and stress.

A study of anxiety, depression and stress symptoms among Fayoum medical students during COVID-19 lockdown, Egypt

BackgroundThe widespread pandemic of COVID-19 virus carries not only physical hazards, but also major psychological effects especially among medical students. The aim was to investigate the psychological effects of COVID-19 on medical students and the factors affecting them. The study was carried out with an online questionnaire distributed through Google Forms for medical students at Faculty of Medicine, Egypt. The questionnaire included socio-demographic questions, validated psychometric tools for the assessment of depression, anxiety and stress (Depression Anxiety Stress Scales DASS-21) and the Impact of Event Stress Scale-Revised (IES-R) were applied.ResultsThe total number of participants was 282 students. Percentage of participants with clinically significant depression was 75.2%, anxiety was 56.4% and stress was 52.9%. Those showed PTSD probability was 54.3%. The multivariate regression analysis revealed that IES remained significantly associated with gender and previous road accidents, depression and anxiety remained significantly associated with personal history of psychiatric illness, while stress remained significantly associated with gender and previous road accidents.ConclusionsMedical students were highly depressed, anxious and stressed during period of COVID-19 pandemic. Being a female, having previous history of psychiatric illness and previous road accident were highly associated with increasing the psychological impact of COVID-19.

Prevalence of Social Phobia and Depression among Adolescent girls in selected schools in rural areas of Panipat, Haryana

Background and objectives: The term social phobia was first coined by Janet (1903) to describe the patient who feared being observed while speaking, playing, or writing, symptoms of shyness, social anxiety and social avoidance had been describe as early as the time of Hippocrates (1969). Aim: Against this background the following study aim of to determine the Prevalence of Social Phobia and Depression among Adolescent Girls. Materials and methods: This study is a Non - Experimental study. Sample size of was 120 adolescent girls. Sample was selected by using Non- Probability Convenience technique. Social phobia inventory (SPIN) and Beck depression inventory II (BDI II) on social phobia and depression among adolescent girls. Data analysis was done with the help by the mean of descriptive and inferential statistics. Results: The study finding reveals that majority of the subjects 77(64.2%) had very mild / no social phobia. Majority of the subjects in this study had moderate depression 54(45%). The chi – square value of social phobia and previous history of psychiatric illness was 6.386. The ‘P’ value is 0.041. which shows a statistically significant association. The correlation coefficient value between social phobia and depression was 0.264 which shows a mild positive correlation. Conclusion: The study concluded adolescent girls had depression more when compare with social phobia.

Pandemic Takes Toll on Those Who Grieve

Pandemic Takes Toll on Those Who Grieve

Neurological and mental health consequences of COVID-19: potential implications for well-being and labour force.

Recent case studies show that the SARS-CoV-2 infectious disease, COVID-19, is associated with accelerated decline of mental health, in particular, cognition in elderly individuals, but also with neurological and neuropsychiatric illness in young people. Recent studies also show a bidirectional link between COVID-19 and mental health in that people with previous history of psychiatric illness have a higher risk for contracting COVID-19 and that COVID-19 patients display a variety of psychiatric illnesses. Risk factors and the response of the central nervous system to the virus show large overlaps with pathophysiological processes associated with Alzheimer’s disease, delirium, post-operative cognitive dysfunction and acute disseminated encephalomyelitis, all characterized by cognitive impairment. These similarities lead to the hypothesis that the neurological symptoms could arise from neuroinflammation and immune cell dysfunction both in the periphery as well as in the central nervous system and the assumption that long-term consequences of COVID-19 may lead to cognitive impairment in the well-being of the patient and thus in today’s workforce, resulting in large loss of productivity. Therefore, particular attention should be paid to neurological protection during treatment and recovery of COVID-19, while cognitive consequences may require monitoring.

Descriptive study of patients related to COVID-19 pandemic attending psychiatric clinic in Gwalior city

Background: The COVID-19 pandemic and subsequent lockdown has adversely affected the lives and livelihood of millions in our country. This has played havoc on the psychological health of a large section of our population. It is not known, however, whether this has led to an increase in the number of patients of psychiatric disorders. With this aim, this study was planned.Methods: An observational study was done on 100 participants who visited the private psychiatric outpatient clinic of Gwalior district between mid-May to mid-September. Data entry and statistical analysis was done in MS-Excel Software.Results: Out of 926 patients with no previous history of psychiatric illness who attended the clinic for the first time, 100 (10.8%) patients had illness as a direct consequence of stress of COVID 19 and subsequent lockdown. The majority were Hindu (87%), males (65%), general category (63%) and 96% were residing in urban areas. 56%, 13% and 10% of patients had Moderate depression, Panic disorder and Anxiety disorder respectively. The precipitating reason for their illnesses turned out to be: fear of viral infection (56%), uncertainty of the situation (90%), losing their source of income (61%), Frustration, boredom and lack of social contact.Conclusions: In our study, young male participants emerged as risk group. Maximum participants were facing fear of infection, fear of loss of career, uncertainty, frustration due to boredom and lack of social contact as factors of psychiatric health concern.

Factors of psychiatric morbidity during perinatal period

The presence of psychiatric disorders during perinatal period imposes negative and long-term effect on maternal health and child development as well as normal family environment. The purpose of our study was to investigate the socio-demographic factors associated with psychiatric morbidity during perinatal period. It was a descriptive cross-sectional study conducted among purposively selected 197 perinatal women attending the Obstetrics & Gynaecology Outpatient Department (OPD) of Bangabandhu Sheikh Mujib Medical University and Dhaka Medical College Hospital, Dhaka from August 2012 to July 2013. Data were collected through face-to-face interview by administering a semistructured questionnaire, containing socio-demographic and other variables and translated Bangla version of Structured Clinical Interview for DSM-IV Axis-I Disorders – Clinician Version (SCID-CV). Majority (79.7%) of the women were included in the age group of 20-34 years. The mean (±SD) age of the respondents were calculated as 24.60 (±4.88) years. Rural habitat was predominant (53.6%). A good number (5.1%) of respondents with psychiatric disorders had positive family history of psychiatric illness which was found statistically significant. Majority (7.6%) of the respondents with psychiatric disorders had previous history of psychiatric illness. Women in perinatal period with the risk factors for developing psychiatric disorders need proper psychiatric evaluation to prevent and treat perinatal mental illness.Bang J Psychiatry December 2015; 29(2): 53-58

DEPRESSION;

Background: Acute kidney injury (AKI) in pregnant women is commonly seen indeveloping countries. It is associated with significant morbidity, social and personal implications.We conducted a study to assess the prevalence and severity of depression in patients withpregnancy related AKI (PRAKI) in a tertiary care center. Methodology: Patients with PRAKIadmitted from 1-16 to 6-16 under Nephrology service, Jinnah Hospital, Lahore were included inthis cross-sectional study. The Hamilton Rating scale for depression (HAM-D) version translatedand adapted in Urdu, was used to assess the study population. These patients were interviewedwith the HAM-D questionnaire on their first encounter with Nephrology department. Previoushistory of psychiatric illness was excluded. The diagnosis of AKI was based on the classificationof the Acute Kidney Injury Network group. Results: The mean age of the patients was 24±5years. Seventeen (57%) patients were multipara and 13(43%) patients were primigravida. Of the30 patients with AKI, 8 (27%) presented before 28 weeks and 22 (63%) presented after 28 weeksof gestation. The causes of AKI included postpartum hemorrhage in 9 (30%), sepsis in 8 (27%),preeclampsia/eclampsia in 6(20%), shock in 4 (13%) and coagulopathy in 3 (10%) patients.Alive and healthy fetus was found in only 15 (50%) patients. Twenty-one (70%) patients receivedaverage of 5-8 hemodialysis sessions during their hospital stay. Twenty-three (76%) had nodepression (0-7 score), 2 (7%) had mild (8-13 score), 3 (10%) had moderate (14-18 score) and2 (7%) had severe (19-22 score) depression according to HAM-D score. Conclusions: Ourstudy depicted considerable depression of varying degrees in women with PRAKI, increasedawareness and effective monitoring for depression should be integrated into regular maternalcare to decrease morbidity associated with it.

Factors Affecting the Level of Depression Among Thai Elderly

Background: The fertility rate in Thailand is decreasing; one of its implications is an increase in the elderly population. Thailand is among the Southeast Asian countries with the highest number of elderly population. Among those illnesses affecting the elderly that is given less attention is depression. Methodology: This study was conducted to identify the prevalence rate, level of depression and factors affecting depression among the elderly in the community. This descriptive study was conducted with 150 elderly respondents aged 65 and above with no previous history of psychiatric illness. A pre-tested questionnaire (Geriatric Depression Scale) was used to identify the level of depression.Results: The prevalence of depression among the elderly is 68%, with female respondents accounting for 45.33 percent and 22.6 percent from men. In terms of level of depression, 46.67% were found to have mild depression, 17.33% with moderate and only 4% with severe depression. Using the 0.05 margin of error of Chi-square test (x2) the factors significantly affecting the level of depression that had been identified were Marital status (12.59), Occupation (23.68) and Underlying disease (23.68). Other factors such as age, gender, educational background and support system were not found to be significant.Conclusion: Therefore, the prevalence rate of depression in the community is high and must be given enough attention by community health leaders in order to adopt preventive interventions including health teaching for chronic illness, social activities, behavior modification and sensory stimulating activities.

Long term adverse drug reaction to Efavirenz in a HIV infected adolescent

Efavirenz is one of the medications used in combined antiretroviral therapy (ART) for the management of HIV infection in adolescents. Various central nervous system adverse reactions have been reported in patients commencing antiretroviral therapy with a regimen containing Efavirenz. These reactions tend to be acute, commonly occurring in the first six months of therapy. Adverse reactions following long term use of Efavirenz for ART is rare among adults and rarer still among children and adolescents. There is only one published case of serious adverse reaction to Efavirenz in an adolescent after long-term use. The case of a male HIV Positive Nigerian patient aged 13 years. He presented with five-day history of Difficulty sleeping, abnormal dreams, inability to concentrate, restlessness, irrational behavior and long-term memory loss. There was no previous history of psychiatric illness and no suggestive social or family history. Patient was on Efavirenz containing regimen about 6.5 years till presentation with adverse reaction mainly affecting behavior, thought processes and memory. After discontinuing Efavirenz and replacing with Nevirapine in his combined ART regimen, all neuropsychiatric manifestations ceased .He regained his memory, no longer had bad dreams or demonstrated any irrational behavior or attitude. Physicians who are involved in the care of HIV infected patients need to be aware of the possibility of adverse Drug reactions occurring in patients who have been on antiretroviral drugs for years. This possibility should not be excluded from possible differential diagnosis. KEY WORDS: Adolescent; Efavirenz; HIV Infection; Reactions; Adverse drug; Psychomotor Agitation; Long term

Risk factors of maternal depression and anxiety in El-Fayum city

Objective The aim of this study was to determine the risk factors of maternal depression and/or anxiety among women attending the primary health care facilities in El-Fayum city. Background Women suffering from depression and/or anxiety during pregnancy are at an increased risk for postpartum depression throughout the perinatal period. Patients and methods This study was a nested case-control cross-sectional survey conducted among women attending primary health care centers in El-Fayum city. Results The strongest risk factors of maternal depression and/or anxiety were presence of previous history of psychiatric illness (including antenatal and postnatal depression) to the woman or one of her family members, stressful life events or physical problems during pregnancy and early postpartum, and low levels of social support. History of abortion or miscarriage showed statistically significant results and was considered as an important risk factor (52% of the depressed cases had a previous history of abortion in comparison with controls). Logistic regression analysis was used to determine significant risk factors of maternal depression where the main risk factors for maternal depression and/or anxiety were history of abortion or miscarriage (odds ratio 4.1) and history of previous psychiatric illness (odds ratio 2.7) (including antenatal depression and postnatal depression). Conclusion Investigating perinatal stress and depression and identification of risk factors of these conditions may reduce the risk for postpartum chronic anxiety or undiagnosed depression.

JACOBSON'S PROGRESSIVE MUSCLE RELAXATION (JPMR) TRAINING TO REDUCE ANXIETY AND DEPRESSION AMONG PEOPLE LIVING WITH HIV

Abstract: Background: The term AIDS refers only to the last stage of the HIV infection. AIDS can be called as our modern pandemic affecting both industrialized and developing countries. Objectives: To assess the anxiety and depression among people living with HIV as measured by HADS (Hospital Anxiety and Depression Scale), to determine the effectiveness of JPMR in terms of reduction in the mean posttest anxiety and depression scores, to find the association of anxiety and depression among people living with HIV with selected demographic and disease specific variables. Materials and Methods: one group pre test and post test design was used. 30 people living with HIV who were admitted at ART center, District Hospital, Udupi were selected and different scales on anxiety and depression scale for people living with HIV were administered. Purposive sampling technique was used for the study. Results: Out of 30 subjects, 13.30% (4) experienced abnormal anxiety and 16.7% (5) abnormal depression. There was significance difference between mean difference of pretest and post test scores of anxiety (t=8.471, df=29, p=0.001) and depression (t=6.811, df=29, p=0.001). Anxiety is independent of the selected variables (Demographic and disease specific). Depression is dependent on previous history of psychiatric illness (÷2=6.584, df =2, p=0.037). Conclusion: JPMR is a simple non-invasive, cost effective method. The result showed that JPMR training had a positive effect in reducing the anxiety and depression and JPMR can be used as an effective alternative therapy.

Recent trends in the sociodemographic, clinical profile and psychiatric comorbidity associated with posttraumatic stress disorder: a study from kashmir, India.

To estimate the Prevalence of post-traumatic stress disorders (PTSD) among adults in field practise areas of Government Medical College, Srinagar, India. The present study was cross-sectional in nature and was conducted in field practice areas of Government Medical College Srinagar. Three blocks of field practise areas of Government Medical College, Srinagar comprising of various villages were selected. Further 10 per cent of these villages were selected by the method of randomization sampling and then 10 per cent of household were taken again by systemic random sampling. In the selected household all adult population (18 years and above) were selected and screened by using General health questionnaires(GHQ). The patients who screened positive for PTSD (post-traumatic stress Disorders) were assessed and diagnosed. From the line listing the positive cases, the prevalence rates were calculated. Of the total 3400 subjects (age≥18 years), the prevalence of posttraumatic stress disorders among general population was found to be 3.76%. Prevalence was found to be more in females (Chi-square test=2.086, p>0.05 (Insignificant). Most of cases were found to be in the age group 0-40 years. Most of the cases were unmarried, illiterate and belong to lower socioeconomic class. Death of near one comprised the major traumatic event. Acute onset Posttraumatic stress disorder was the commonest type, previous history of psychiatric illness was found in 12 % of patients and drug abuse was present in 22.6%. Our findings clearly indicates that posttraumatic stress disorders (PTSD) is a prevalent disorder in the developing world, especially in disaster prone regions and in areas of political unrest. Resilience to various traumatic events in Kashmir has developed over the years and this might explains the lower prevalence of Post-traumatic disorder (PTSD) in our study.

Anti-NMDA receptor encephalitis: Psychiatric presentation and diagnostic challenges from psychosomatic medicine perspective

We describe two cases of confirmed anti-NMDA receptor encephalitis; one patient initially presented with a clinical picture that resembled delirium and later appeared to present with a conversion reaction and the second patient presented with a first psychotic break followed by the clinical picture of neuroleptic malignant syndrome with catatonia. Neither patient had a previous history of psychiatric illness or recreational drug use. These cases illustrate the diagnostic and treatment challenges associated with this neuropsychiatric condition and underscore the role of psychosomatic medicine psychiatrists in diagnosing anti-NMDA receptor encephalitis.