Socio-occupational Dysfunction Research Articles

Premenstrual Dysphoric Disorder and Its Relationship with Stress: A Study on Medical and Allied Medical Science Students at a Tertiary Care Center

Abstract Background: Premenstrual dysphoric disorder (PMDD), now classified under mood disorders, is characterized by a group of cognitive, affective, and physical symptoms and is associated with socio-occupational dysfunction with poor quality of life. Most of the women in their reproductive ages suffer from discomfort before the onset of menses and this severe discomfort may also lead to stress. Aim: The aim of the study is to study the prevalence of PMDD among medical and allied medical science students and assess the stress associated with it. Materials and Methods: This cross-sectional, comparative study was conducted at a tertiary care cente in Jaipur, Rajasthan. One hundred and eighty-one students were enrolled from medicine, clinical dietetics, and physiotherapy branches. The study tools used for data collection included a semi-structured self-reporting questionnaire, a premenstrual symptom screening tool (PSST), and a perceived stress scale (PSS). The data were analyzed using SPSS software. The recorded data were evaluated and presented based on mean, standard deviation, and proportion. Results: One hundred and eighty-one students were enrolled with the average age of 20.4 ± 1.54 years. On screening by PSST, 29 qualified for PMDD, 43 students met the criteria for premenstrual syndrome (PMS), and the remaining 109 had no to mild premenstrual symptoms. Students with PMDD and moderate-to-severe PMS had significantly more stress as compared to students with no to mild premenstrual symptoms. Conclusion: Our study is a step forward in understanding the stress experienced by students suffering from PMS/PMDD. As students suffering from PMS or PMDD have higher stress levels, colleges or universities can give special focus to address these issues.

Successful Resolution of Messianic Delusion following Bi-temporal Modified Electroconvulsive Therapy in a Patient with Treatment-resistant Schizophrenia

Messianic delusion comprises a delusional system centered on the patient’s conviction that he has been selected by God for a special task or mission and has unique abilities to carry it out. The present case report describes a case of Treatment-Resistant Schizophrenia (TRS) with Messianic delusion in a 23-year-old unmarried male who presented to the Emergency Department with complaints of muttering to himself, decreased sleep, suspiciousness, socio-occupational dysfunction, aggressive behaviour, and a recent suicide attempt. Key interventions offered during the ward stay included rapid tranquilisation, antipsychotics, and benzodiazepines. The patient completely recovered with the concurrent use of clozapine and Modified Electroconvulsive Therapy (MECT). The patient received 16 sessions of MECT. He achieved both short-term and long-term remission with the therapy, as observed during regular follow-ups in the next six months. The present case emphasises the need for a multidisciplinary approach to the management, early detection, and adequate treatment of this challenging illness.

Successful Resolution of Messianic Delusion following Bi-temporal Modified Electroconvulsive Therapy in a Patient with Treatment-resistant Schizophrenia

Messianic delusion comprises a delusional system centered on the patient’s conviction that he has been selected by God for a special task or mission and has unique abilities to carry it out. The present case report describes a case of Treatment-Resistant Schizophrenia (TRS) with Messianic delusion in a 23-year-old unmarried male who presented to the Emergency Department with complaints of muttering to himself, decreased sleep, suspiciousness, socio-occupational dysfunction, aggressive behaviour, and a recent suicide attempt. Key interventions offered during the ward stay included rapid tranquilisation, antipsychotics, and benzodiazepines. The patient completely recovered with the concurrent use of clozapine and Modified Electroconvulsive Therapy (MECT). The patient received 16 sessions of MECT. He achieved both short-term and long-term remission with the therapy, as observed during regular follow-ups in the next six months. The present case emphasises the need for a multidisciplinary approach to the management, early detection, and adequate treatment of this challenging illness.

A Study to Assess Burden on Caregivers of Opioid Use Disorder

Abstract Background: Substance use disorder is global problem associated with significant socio-occupational dysfunction. It has been increasingly realized that it should be conceptualized as affecting a family and not just an individual. This study aimed at assessing the caregivers’ burden in opioid dependence in a Tertiary Care Teaching Hospital in Punjab. Materials and Methods: This was a cross-sectional study where the sample comprised 50 patients diagnosed with opioid dependence, as per the International Classification of Diseases-10 criteria and their 50 caregivers. The caregivers’ burden was assessed with the help of the Montgomery Borgatta Caregiving Burden Scale, which is a subject-rated scale. Results: Most of the patients (54%) as well as the caregivers (30%) were 21–30 years of age, with male predominance and belonged to rural area, were unmarried, living in a nuclear family, and had a middle socioeconomic status. Most of the patients (88%) reported consuming “Heroin” and 64% reported using two or more than two substances. The mean age of first use of opioid was found out to be 21.8 years, the mean duration of the illness was 8.04 years, and the mean number of relapses was 2.94. About 58% of caregivers had moderate objective burden, 98% had severe subjective burden, and 78% had severe subjective demand burden. Conclusions: There is an urgent need to target the community awareness programs at the adolescent age group and a need to focus on the family rather than the individual patient, in the backdrop of the findings of this study.

Network analysis of psychiatric symptoms in schizophrenia: Findings from the Research on Asian Psychotropic Prescription Patterns for Antipsychotics (REAP-AP).

Schizophrenia is a major mental disorder with a wide range of psychiatric symptoms. This study explored the structure of psychiatric symptoms of schizophrenia using network analysis in a large representative Asian sample based on a survey of clinical features and treatment used in schizophrenia patients across 15 countries/territories in Asia. Data on the demographic characteristics and psychiatric symptoms in schizophrenia patients were extracted from the dataset of the fourth Research on Asia Psychotropic Prescription for Antipsychotics (REAP-AP) project. The presence of the following psychiatric symptoms including delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, negative symptoms, social/occupational dysfunction, verbal aggression, physical aggression, and affective symptoms were analyzed. A total of 3681 patients were included. The network analysis revealed that verbal aggression, hallucinations, and social/occupational dysfunction were the most central symptoms, while the connections between social/occupational dysfunction and verbal aggression, and between hallucinations and disorganized speech were the two strongest edges. There were significant gender differences in the network structure based on the network structure invariance test (M=0.74, P=0.03) and invariant edge strength test. The positive correlation between verbal aggression and hallucinations was significantly stronger in the female network than that in the male network (P=0.03), while a negative correlation between affective symptoms and negative symptoms was found in the female, but not the male network (P<0.01). Central symptoms including verbal aggression, hallucinations, and socio-occupational dysfunction should be addressed in developing targeted treatment strategy for schizophrenia patients.

Rare occurence of amennorrhea associated with olanzapine : a case report

IntroductionAmenorrhea secondary to hyperprolactinemia is one of the frequent adverse effects associated with the use of atypical antipyschotics. It is often neglected but can interrupt the compliance of treatment. Several studies indicate that olanzapine does not significantly affect serum prolactin levels in the long term, although contrary has been observed in few case reports.ObjectivesTo report a case of olanzapine-induced amenorrhea due to hyperprolactinemia.MethodsA 27-year-old woman with history of stillbirth 5 months prior, presented to OPD with hallucinatory behaviour and socio-occupational dysfunction for 5 months. She was on tianeptine 12.5 mg, escitalopram 10 mg and alprazolam 0.5 mg at presentation and was having regular menses. On assessment, she was diagnosed with unspecified psychosis. Her ongoing medications were stopped and she was started on Olanzapine (optimized to 20 mg/day) after which she reported significant improvement however developed amenorrhea within next 2 months hence advised to consult Obgyn. Urine pregnancy test came out negative and prolactin level was found to be 64.2 ng/ml. Other investigations including MRI were within normal limit. Olanzapine was cross tapered with Aripiprazole (maintained at 10 mg/day). Clonazepam was advised SOS for anxiety.ResultsAfter 1 month of aripiprazole treatment, monthly menses resumed and prolactin level returned to normal range. No biological dysfunction or other side effects were reported by the patient.ConclusionsOlanzapine-induced amennorhea secondary to hyperprolactinemia, is a rare but possible event. We report a case in which olanzapine induced amenorrhea normalized after switching to aripiprazole. Baseline prolactin level should be obtained as they help in the management of patients with neuroleptic-induced hyperprolactinemia.DisclosureNo significant relationships.

Prevalence of adult ADHD in patients with substance use disorder in North East India.

Attention deficit and hyperactive disorder (ADHD) often co-exist with substance use disorders (SUD) both in adolescents and adults. Untreated ADHD can lead to multiple relapses, sociooccupational dysfunction and may worsen the outcome of SUD. ADHD is often underdiagnosed in the adult population. Therefore, the present study was intended to determine the types, patterns, and factors related to drug dependence among different age groups and to estimate the prevalence of adult ADHD in SUD patients in North East India. This is a cross-sectional hospital-based study carried out in patients diagnosed with SUD as per the Diagnostic and Statistical Manual Disorders, 5th Edition. Adult ADHD Self-Report Scale (v1.1) Symptom Checklist was applied to screen for symptoms of adult ADHD in the patients. In the age group of 18-29 years, 82.7% of patients were diagnosed with opioid use disorder (OUD), while 63.9% of the subjects in the age group of 30-49 years patients suffered from Alcohol Use Disorder (AUD). All patients of age 50 years and above were AUD. Our study showed that 24.3% of the total study population had the presence of adult ADHD. Symptoms of Adult ADHD were found in a higher proportion among OUD (28.7%) in comparison to OUD (11.5%). The association of adult ADHD with OUD has been around three times than the AUD group. Hence young people (18-29 years) diagnosed with OUD need to be screened for adult ADHD and should be treated for the same for better abstinence and to prevent complications.

Abstract- Poster

INTRODUCTIONBuprenorphine, a semi-synthetic opiate alkaloid derivative used for treatment of opioid dependence(1). Pruritis has been reported as a side effect with intramuscular and supra-dermal patch of buprenorphine and less common with oral/sublingual use of Buprenorphine.CASE REPORT19 years male presented to OPD of a tertiary care center with history of consuming smack in a chasing pattern for past 9 years, associated with tolerance, withdrawal, inability control the urge, craving and significant socio-occupational dysfunction due to opioid use. He had past history of conduct disorder. Patient was diagnosed with Mental and behavioral disorder due to opioid use, dependent pattern (ICD-10). For opioid substitution he was initiated with tablet buprenorphine sublingual (4 mg), after 1 day later he developed skin reaction- itching and erythema and then vesicular lesion. Consultation liaison with Dermatology department was done for evaluation of the allergic reaction and a drug re-challenge trial to assess for hypersensitivity was done with informed written consent of patient. There was increase in eosinophil counts from a differential count of 5% to 15% after re-administration of sublingual Buprenorphine suggestive of opioid related allergic dermatitis. The symptoms of intermittent itching was reported and managed with Tablet cetirizine 10 mg and local applicant Mometasone and Fusidic acid combination. However, on discontinuation of tablet buprenorphine new lesion didn't erupt whereas old lesion gradually healed. His Buprenorphine was discontinued and symptomatic management was done for withdrawal symptoms.DISCUSSIONThe aetiology of opioid-induced itching is unknown but may be due to either a direct central effect or to histamine release. Reports of allergic contact dermatitis are common with Buprenorphine patch, though uncommon with sublingual Buprenorphine use.CONCLUSIONThe present report describes allergic dermatitis is an uncommon drug reaction with sublingual Buprenorphine use and hence should be dealt vigilantly.

Integrating Rehabilitation and Psychoanalysis in the Form of Object Relation Therapy in a Case with Marital Disharmony

Psychoanalysis and psychiatric rehabilitation are two vastly different theoretical concepts in psychiatry which can be used in patient’s interest when the resources are scarce. This case was approached with the objective of studying a case and its management using the psychoanalytic approach towards psychosocial rehabilitation in the low resource countries. A 37-year-old female presented with the chief complaint of stress and severe IPR issues with husband resulting in the socio-occupational dysfunction. Via psychoanalysis, the issues were resolved, and couple was rehabilitated in society with restoration of normal functioning. This study puts forward the concept of applying and integrating psychoanalysis as an approach towards rehabilitation.

Management of obsessive–compulsive disorder with virtual reality-based exposure

Little information is available about use of virtual reality exposure for management of obsessive compulsive disorder (OCD). We present a patient with OCD, who presented with significant dysfunction related to his OC symptoms and was managed with virtual reality based exposure therapy. A 27-year-old male, presented with a history suggestive of OCD for last 8 years. His symptoms were characterized by obsessive images of known people, leading to significant anxiety and distress. To get rid of his anxiety and distress, he would repeat the acts at hand, multiple times till these images would subside or till he would be able to replace these images by desirable images. These symptoms led to marked socio-occupational dysfunction. The treatment history was suggestive of minimal response to adequate trials of multiple selective serotonin reuptake inhibitors and he was on capsule fluoxetine 80 mg/day at the time of presentation. Exposure and Response therapy was tried in the past by using imaginal exposure, but this was unsuccessful, as the patient would avoid imagining the anxiety-provoking images. Hence, he was exposed to the anxiety provoking images by using virtual reality which involved presenting him with videos containing pictures of known and unknown people arranged randomly, along with the anxiety-provoking images. Over a period of 2 months, 60 sessions of ERP were carried out and the whole hierarchy was completed. This case demonstrates that virtual reality can be used in behaviour therapy for OCD, by using virtual reality techniques, and there is a need to develop software and programs for assessment and management of OCD.

Writing Your Way Through Feelings: Therapeutic Writing for Emotion Regulation

Difficulties in emotion regulation underlie many psychiatric disorders, are associated with poor socio-occupational functioning and poor outcomes in treatment; hence from a core focus in psychotherapy. Although writing tasks are part of many psychotherapy interventions, evidence is sparse regarding the effects of writing on emotion regulation. This case report presents the use of therapeutic writing for emotion regulation, as an adjunct to psychotherapy. The client had a long history of emotionally unstable personality disorder, and persisting clinical risk and socio-occupational dysfunction despite several previous stints of psychotherapy. In addition to thrice-weekly in-person sessions, structured daily writing tasks were designed for her, with suitable probes and questions postulated to help with specific aspects of emotion regulation. Following four weeks of intervention (30 writing sessions and 17 in-person sessions), improvements in emotion regulation were noted [Difficulties in Emotion Regulation Scale scores 128 (pre) and 93 (post); reappraisal sub scale of Emotion Regulation Questionnaire 11 (pre) and 23 (post)]. The benefits and putative processes involved in such a writing intervention as experienced by this client are discussed. Despite limitations to generalizability from case report findings, therapeutic writing shows promise as an adjunct to psychotherapy in addressing emotion regulation. Therapeutic writing may have potential advantages in providing a way to internalize the skills, enhancing clients’ agency and clinical outcomes, reducing burden on healthcare systems; and bears further research as a stand-alone intervention.

A Qualitative Study Exploring the Lived Experience of Unemployment Among People with Severe Mental Illness.

Background:Severe mental illnesses lead to deterioration in the life skills of the patient, resulting in socio-occupational dysfunction and low rates of employment. The purpose of this study was to explore attitudes, knowledge, and barriers to employment as experienced by patients and their caregivers in India.Method:Patients with schizophrenia or bipolar affective disorder, aged between 18 and 60 and undergoing inpatient treatment and their caregivers, were approached for written informed consent and recruited for focus group discussions. A total of eight focus groups were conducted until saturation of themes was seen to have been achieved. The data were transcribed, coded, synthesized, and organized into major findings and implications for practice.Results:Role expectations based on gender were seen to influence the decision to work. The possible recurrence of illness due to excess stress and unsupportive working environments was cited as the most common problem that could arise related to employment. Stigma and faulty attributions related to the illness were the most cited barriers to employment. Most participants felt that psychosocial rehabilitation and family and community support were essential for facilitating work. Most participants did not consider mental illness as a disability and were unaware of government schemes for the mentally ill.Conclusion:Considering gender-based role expectations, avenues for self/family employment and improving the awareness of benefits for mental illness both among consumers and health care professionals are essential to enhance economic productivity in people with severe mental illness.

PRELIMINARY STUDY ON THE EFFECT OF REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION ON NEGATIVE SYMPTOMS IN PATIENTS WITH SCHIZOPHRENIA

Back Ground: Negative symptoms of schizophrenia have been demonstrated to be the most relevant predictor of increased future socio-occupational dysfunction and poorer quality of life which is linked to impaired functioning of the prefrontal cortex, mainly reduced activation of the dorsolateral prefrontal cortex. Repetitive Trans-cranial Magnetic Stimulation (rTMS) is a relatively safe and non-invasive tool to modulate neuronal activity. High-frequency rTMS might have role in improvement of negative symptoms of schizophrenia. Aim of work: The Aim of this study to explore the effects of highfrequency rTMS stimulation to the DLPFC on negative symptoms observed in schizophrenia patients. Patients and Methods: 40 patients with schizophrenia who accept and there guardians to participate in the study and sign the written informed consent were assessed by Positive and Negative Syndrome Scale for Schizophrenia (PANSS), before the rTMS sessions and after the sessions. Meanwhile the operator allocated the subjects to active or sham group then the subjects of the study received active or Sham rTMS . The rTMS was delivered for 3 sessions /week during six weeks, each session lasts for 13 minutes. Results: There was a statistical significance between active and sham group as regard PANSS Negative subdomain scale, used before and after the rTMS sessions (P value= 0.001 ) Also there was a statistical significant difference among active group before and after the rTMS stimulation( P value<0.001). Conclusion: This study suggests that high frequency rTMS applied to DLPFC may be of benefit in alleviating negative symptoms in schizophrenic patients. A larger sample size is needed to confirm our findings.

Noninvasive brain stimulation in obsessive-compulsive disorder.

Obsessive–compulsive disorder (OCD) is a complex neuropsychiatric disorder with a chronic course, contributing to significant socio-occupational dysfunction. Forty percent of patients remain treatment refractive despite mainstream treatment options such as serotonin-reuptake inhibitors and cognitive behavior therapy. Noninvasive brain stimulation approaches such as transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) have piqued interest as add-on treatment options in OCD. This review focuses on summarizing the TMS and tDCS studies in OCD with respect to their study design and stimulation parameters and key findings. We also briefly discuss the limitations and future directions noninvasive brain stimulation in OCD.

Disability and socio-economic impact of mental disorders in the state of Punjab, India: Findings from national mental health survey, 2015-2016.

Mental illness results in a plethora of distressing issues, has tremendous socio-economic impact and causes socio-occupational dysfunction in the individual as well as the caregivers. There is a felt need to explore the disability caused by mental illness and the associated socio-economic impact at the population level in a developing nation like India. To elucidate the disability and socio-economic impact associated with mental illness at the individual and household levels for the state of Punjab in India. This was a multisite cross-sectional study carried out during 2015-2016 (as a part of the National Mental Health Survey of India) in three districts and one urban metro area of Punjab. The sample was selected using multi-stage, stratified, random cluster sampling technique, with random selection based on Probability Proportionate to Size (PPS) at different stages. A validated set of questions was used to assess the socio-economic impact of mental illness and the Sheehan Disability Scale was used to document self-perceived disability among individuals with mental morbidity. Median (IQR) and proportions were used to summarize quantitative and qualitative data, respectively Results: Subjects with any mental morbidity reported disability of varying severities across different domains of life; family life was affected the most (70.1%). One in every six persons reported that their mental illness interfered with their daily activities to a large extent. Economic burden was high and a typical family would spend about INR 1500/month (US$23) towards the treatment of its member with mental morbidity. Family members had to forego their work for at least 7 days in 3 months to take care of their relative with mental illness. Mental illness causes disability in the individual and has tremendous socio-economic impact on the family, incapacitating a family's productivity to a large extent and thus affecting the society.

Predictors of Symptom Severity and Functioning in First Episode Psychosis

There is dearth of studies on the role of critical socio-demographic and clinical variables on psychopathology and functional outcome in persons with first episode psychosis (FEP), especially from lower and middle income countries. Therefore, we studied the predictors of psychiatric symptom severity and socio-occupational dysfunction among persons with non-affective FEP in India. Using multiple linear regression models, we examined the role of gender, previous admission, psychiatric co-morbidity, duration of psychosis, and duration of untreated psychosis (DUP) on psychiatric symptom severity and socio-occupational dysfunction among 71 persons with non-affective FEP. The participants were recruited from a tertiary mental health center in South India. The Brief psychiatric Rating Scale (BPRS) and Social Occupational Functioning Scale (SOFS) were used measure symptom severity and socio-occupational dysfunction respectively. Gender (male), presence of co-morbid psychiatric illness, higher duration of psychosis, and longer DUP significantly increased psychiatric symptoms and socio-occupational dysfunction. The independent variables predicted 40% variance on psychiatric symptoms and 37% variance on socio-occupational dysfunction. Both regression models were significant at p < 0.001 level. The study is helpful to understand the common predictors of symptoms and functioning in FEP. However, future studies need to examine the role of other critical mediating variables on psychopathology and functions to evolve a comprehensive pathway model.

A rare case report of alektorophobia in an adult male

Alektorophobia is a term specific to fear of chickens/hens. It is a type of ornithophobia (fear of birds) which comes under specific phobia, animal type. Alektorophobia is derived from the Greek word ”Alektor” which means ”rooster” and ”phobos” meaning ”fear.” Specific phobia is a type of anxiety disorder and is relatively common in females, children, and adolescents. Although specific phobias are common type of anxiety disorder, alektorophobia is a rare entity. In our case report, we discuss a 32-year-old gentleman with a specific phobia for cocks and hens, who presented with significant distress and socio-occupational dysfunction. He was successfully treated with a combination of pharmacological agent selective serotonin reuptake inhibitors and nonpharmacological strategies (systematic desensitization) and remained symptom-free even after 9-month follow-up. This is the first case of alektorophobia reported in adult male to the best of our knowledge. This case emphasizes the need for understanding the role of psychological processes in the development of phobia and role of nonpharmacological strategies in the management.

Folate, vitamin B12, and negative symptoms in schizophrenia

Introduction Negative symptomatology has been demonstrated to be the most relevant predictor of increased future socio-occupational dysfunction and poorer quality of life. Negative symptoms and functional outcomes have consistently been linked, with several studies reporting worse functional outcomes in individuals with more prominent negative symptoms. Folate deficiency has been identified as a risk factor for schizophrenia and its negative symptoms. Aim The aim of this study was to assess the serum levels of folate and vitamin B12 in a sample of schizophrenic patients and their relation to negative symptoms in these patients. Patients and methods It is a cross-sectional study aiming to assess the serum level of folate and vitamin B12 in schizophrenic patients. All patients were recruited from the Kuwait Center for Mental Health after taking approval from the scientific and ethics committee of the hospital. The study was conducted in the period from January 2016 to April 2016; the total number of patients was 41 after applying the inclusion and exclusion criteria. We applied the Positive and Negative Syndrome Scale and the Scale for the Assessment of Negative Symptoms; serum levels of vitamin B12 and folate were measured by radioimmunoassay technique. Results About 41.5% of the patients have low folate level and about 39% of the patients have low B12 level. There are significant positive correlations between severity of negative symptoms and duration of illness and number of hospital admissions. Also there are significant positive correlations between serum levels of vitamin B12 and folate. There are significant negative correlations between serum levels of vitamin B12. All negative symptoms were assessed by the Scale for the Assessment of Negative Symptoms (affective flattening, alogia, attention, aviolation, and anhedonia). We cannot find a significant correlation between serum levels of folic acid and negative symptoms. Conclusion Folate and vitamin B12 deficiency may be a risk factor for schizophrenia and negative symptoms; so we suggest to evaluate the serum vitamin B12 and folate levels for schizophrenic patients followed by dietary supplementation for patients with low vitamin B12 or folate.

Internet Addiction among Junior Doctors: A Cross-sectional Study.

Background:The number of Internet users in India crossed 205 million in October 2013. Excessive internet use has been attributed to socio-occupational dysfunction, and this study is targeting the junior doctors on whom not many studies have been done till date.Objective:The objective of this study was to analyze the proportion of junior doctors with internet addiction and whether there is any relation between increased internet use and psychological distress, assessed using General Health Questionnaire (GHQ).Materials and Methods:One hundred postgraduate students and house surgeons were requested to fill out the specially prepared pro forma, Internet Addiction Test Questionnaire and GHQ, and the data were analyzed. P < 0.05 was considered statistically significant.Results:Among the 100 study participants, 13% were found to have moderate addiction and none were in severe addiction range. Internet addiction was more common among those from urban areas (P = 0.011). A significant association was found between GHQ score and internet addiction test score (P = 0.031).Conclusion:The Internet is a double-edged social revolution. Further studies are required to delineate the specific effects on human behavior.

Social cognition of patients with schizophrenia across the phases of illness - A longitudinal study

AimThis longitudinal study aimed to evaluate social cognition of patients with schizophrenia at two points, i.e., during the symptomatic phase and clinical remission phase. Additional aim was to evaluate the relationship of social cognition with psychopathology and functional outcome. MethodologyFifty-one patients (N=51) were evaluated on Social Cognition Rating Tools in Indian Setting (SOCRATIS), Positive and Negative Syndrome Scale (PANSS), Global Assessment of Functioning (GAF), Socio-occupational functioning scale (SOFS) and Indian Disability Evaluation and Assessment Scale (IDEAS) during the symptomatic phase of illness. These patients were followed-up longitudinally for achieving clinical remission. Out of the 51 patients, 32 patients underwent second assessment after a mean duration of 143 (SD 34.9) days, while in clinical remission. Data of 111 healthy controls was used for comparison. ResultsSocial cognitive deficits were present in both the phases of illness. However, when the baseline and follow-up data was compared, it was evident that the severity of social cognition deficits is lower during the clinical remission phase. Higher levels of social cognitive deficits in both phases of illness are associated with higher socio-occupational dysfunction and higher disability. ConclusionPresent study suggests that impairment in social cognition in patients with schizophrenia is present both in symptomatic and remission phase, with higher level of deficits during the symptomatic phase. Social cognition impairments are associated with poor social and occupational functioning and higher level of disability.