Aripiprazole is the new generation class of antipsychotic. Chemically, aripiprazole is a quinolinone derivative. Aripiprazole gives its action through the partial agonist mechanism at dopamine D2 and 5- HT1A receptors, and is also an antagonist at 5-HT2A receptors. Preclinical and placebo controlled trials of aripiprazole have evaluated 2A that aripiprazole is effective in the treatment of schizophrenia. Comparative trials of aripiprazole with typical and atypical antipsychotics have shown that aripiprazole has similar efficacy as haloperidol and olanzapine. Data also suggest that aripiprazole is safe and its tolerability profile is good. This molecule is also showing promising results in the treatment of bipolar disorders but the evidence is still inadequate. This article critically examines the various clinical trials conducted in various countries regarding the therapeutic profile of aripiprazole.
Hyperprolactinaemia has for decades been an inevitable and neglected side-effect of antipsychotic medication. The recent introduction of prolactin-sparing antipsychotic agents makes a re-examination of this problem timely. This article aims to review the literature on antipsychotic induced hyperprolactinaemia and its consequences. A literature search was made for key articles, supplemented by cross referencing. During antipsychotic treatment prolactin concentrations can rise to ten times normal levels or above and existing data indicate that a large number of female patients have amenorrhoea with or without galactorrhoea. Survey data, however, suggest that clinicians underestimate the prevalence of these conditions. Antipsychotic-induced hyperprolactinaemia should become a focus of interest in the drug treatment of psychiatric patients.
Pregnancy has traditionally been considered a time of emotional well-being for women conferring protection against psychiatric disorders. But depression during pregnancy affects nearly 20% of women. Depression experienced by obstetric patients frequently remains unrecognized and untreated. Lack of adequate management of depression during pregnancy may result in a potentially devastating consequences that impact upon both mother and baby. So clinicians and patients need up-to-date information to assist with decisions about depression treatment during pregnancy
Expressed emotion (EE) is currently among the most thoroughly investigated psychosocial research constructs in psychiatry. Expressed emotion (EE) is the general re?ection of the family's attitude towards the patient as a precursor to relapse in major psychiatric disorders. On the basis of recent research on EE many family intervention programmes have been developed to reduce EE of the family and consequent relapse of illness
Post traumatic Stress Disorder are the disorders caused in reaction to occurrence of some unacceptable, unpleasant incidence leading to intolerable stress/anxiety. It may be natural or manmade like war, disaster, rape, torture etc. These disorders are found 1–3 percent in general population. All most seventy percent people of the general population experiences PTSD any time in their life time. Persistent avoidance of stimuli causing trauma is main feature of this entity. It can occur any time in life but most common in young adults. Most people do not experience the post traumatic catastrophic symptoms after passing the traumatic phase or some time after trauma the recovery starts taking place. However, significant number of people continuously experiences such symptoms and needs specialized intervention. The personality of the individual also plays a vital role on experiencing trauma and its recovery.
Post traumatic stress disorder (PTSD) is a condition marked by the development of symptoms after exposure to traumatic life events. The person reacts to this experience with fear and helplessness, persistently relives them, and tries to avoid being reminded of it.
Researches investigating cross-cultural and ethnic group differences on projective tests are relatively scarce. However, significant differences in relation to acculturation, socialization, and the very different cultural subgroups process cognitively and emotionally, had documented. A number of studies have shown that popular responses are associated with cultural background, which is likely to reflect common contribution of the group. This study provides information on how Indian adult non patients’ gives variety of popular responses on the Rorschach test administered and scored by following Beck system. The present research is an effort to generate normative data for proper responses in Indian context.
Background: The cognitive dimension most widely studied in schizophrenia is executive function. Some of the specific abilities that fall under this rubric include abstraction, planning, mental flexibility, response inhibition, self monitoring, evaluation and decision making. There is strong evidence that neuropsychological impairment is related to deficits in everyday functioning abilities among persons with schizophrenia.
Aim: The present study attempts to measure executive dysfunctions in patients with schizophrenia.
Method: By using purposive sampling technique, 30 patients of schizophrenia were chosen according to ICD 10 DCR criteria alongwith a normal control group of 30 subjects. GHQ-12 was used as screening tool for normal control subjects and participants who scored below 2 were included in normal control group. Executive functioning was assessed among all the participants of experimental group as well as normal control group by using CTMT, WCST and Cognitive Symptoms Checklist (Executive Function Scale).
Result: The schizophrenic patients demonstrated executive functioning deficits in comparison to normal control subjects on Comprehensive Trail Making Test as they took more time to complete all the trails and on Wisconsin Card Sorting Test as they produced lesser number of correct response, committed more errors, exhibited high number of perseverative responses, perseverative errors and non perseverative errors, low number of conceptual responses, took more trails to complete first category and were not able to maintain set. Impairment was also found on other domains of executive functioning related to activities of daily living like processing speed, initiation, sequencing, planning and reasoning.
Conclusion: In comparison to normal participants, schizophrenia patients exhibited significant dysfunction in executive functioning and hence in activities of daily living.
Background: Memory refers to the process by which information is stored in the brain. It includes encoding, storage and recall of information. Memory encapsulates sense of personal identity, culture and the meaning of individuals’ life. Schizophrenia patients consistently show performance deficits on memory tasks, whether the material in question is verbal or nonverbal, recently learned items or older material. Aim: The study has been designed to assess the memory deficits in schizophrenic patients and it's comparison with the normal control group. Method: The sample consists of 100 subjects, out of which 50 schizophrenia patients diagnosed as per ICD-10DCR criteria and 50 normal control subjects have been included in the study. Wechsler Memory Scale and GHQ- 12 have been used in the study. Result: Schizophrenia patients performed poor in comparison to normal control subjects on subtests of Wechsler Memory Scale. It has further been found that schizophrenic patients were having problems of immediate, recent and remote memory. They were having impaired logical memory in terms of conceptualizing themes of the story and had difficulty in learning and remembering the information. Conclusion: Patients with schizophrenia exhibited impaired information and orientation, disturbed logical memory and had problems in conceptualizing the themes.
Anxiety disorders are the most common group of psychiatric disorders in children and adolescents. Anxiety disorders in children and adolescents can be chronic and disabling, and they can increase the risk of comorbid disorders. Anxiety is associated with substantial negative effects on children's social, emotional and academic success. Identifying and treating children and adolescents with anxiety disorders would reduce the burden of this disorder and may help in better management of the co-morbid conditions in these patients.
Background: Parenting refers to the aspects of raising a child in terms of physical, social, emotional as well as over all development of the child aside from the biological relationship.
Aim: The present study has been undertaken with the aim to assess parenting stress in the parents of mentally retarded children and parents of normal healthy children.
Methods: A total of 100 respondents (50 parents of mentally retarded children and 50 parents of normal children) were selected by using purposive sampling technique. Further socio-demographic data sheet, General Health Questionnaire- 12 and Parenting Stress Index Scale were administered.
Results: Parents of mentally retarded children showed parenting stress in comparison to parents of normal children. Parents of mentally retarded children had feeling of inability to handle things very easily. They feel trapped by their responsibilities as a parent. Parents of mentally retarded children showed parental distress and found to be having feeling that they are unable to do new and different things, they almost were unable to do things the way they like to do. They used to perceive that child rarely does things for them which make them feel good. They used to perceive that their child cry more than other children and generally wakes up in a bad mood and easily gets upset over the small things.
Conclusions: Parents with mentally retarded children showed stress in the areas related to defensive response, parental distress, parent child dysfunctional interaction and difficult child in comparison to parents of normal children.
Mir Shahid Ali,
Background: Caregivers play an important role in the support, management, recovery and care of schizophrenia patients throughout life. Caregivers not only manage the patient in home situation but also help in improving the condition and prevent from further relapse. While supporting the patients emotionally, financially and socially it often results in feelings of burden in caregivers. This affects the caregiver's overall life and specifically their quality of life adversely.
Objective: The present study is an attempt to explore the quality of life in the caregivers of inpatient and outpatient schizophrenia patients.
Method: A total of 40 schizophrenia patients, 20 inpateint and 20 outpatient, along with their caregivers were selected by using purposive sampling technique from PGIBAMS, Raipur (C.G). Brief Psychiatric Rating Scale (BPRS) was administered on the patient to assess the severity of the symptoms and WHO-Quality of Life-Bref was administered on the caregivers to assess the quality of life.
Results: Caregivers of inpatient schizophrenia patient showed disturbances in social functioning in terms of impaired interpersonal relationships and poor social support than caregivers of outpatient schizophrenic patients. Severity of symptoms has been found to be negatively correlated with physical health area of the caregivers indicating lack of energy, fatigability, impaired work performance, disturbed sleep and inability to get relaxed.
Conclusion: The study highlights that the caregivers of inpatient schizophrenic patients face problems in the social functioning area, personal relationships and support system in comparison to the caregivers of outpatient schizophrenic patients. Caregivers also exhibited problems in their physical health as the severity of symptoms in schizophrenic patients increase.
Sex is basic primary instinct inherited into human being and all other animals too. It is inseparable part of life of living creatures. However, time to time the concept of sex and sexuality was changing. Sex work has always raised a concern all over the world. However if its focus of concern changed over time that is to say, it was about social morality in olden time and it changed into mainly a health issue in current scenario in India, Government funds through NACO is executed through its states. However the main focus is not the prevention of sex work but rather change of sex behavior to prevent AIDS and STD. Organizations have been focusing on the rehabilitation of women involved in commercial sex work for years however the main focus of rehabilitation was on occupational rehabilitation, rare concern was recorded regarding the psychological wellbeing as well as rehabilitation.
Aim: The present study aim to focus on the psychiatric morbidity among those women, involved in commercial street sex work.
Method: 30 women actively involved in commercial street sex work and 30 women who are not involved in any form of commercial sex work were drawn as the sample from Ernakulam district of Kerala state, India, for the study. They were administered with MCMI-III to identify the psychiatric morbidity
Results: The study resulted in revealing the different psychiatric morbidity found with those involved in commercial sex workers such as anxiety, dysthymia, alcohol dependence, drug dependence, post traumatic stress disorder and major depression.
Background: Aripiprazole, a novel antipsychotic, is an effective and safe agent in psychotic disorders of adults but with limited evidence of use in pediatric patients. This study compares efficacy and safety of aripiprazole monotherapy with haloperidol for schizophrenia and related psychotic disorders in children and adolescents.
Methods and Materials: Total 30 patients with ICD-10 DCR diagnosis of schizophrenia and acute psychotic disorders, were assigned to receive either aripiprazole (10-15 mg/day) or haloperidol (10-15mg/day) for four weeks, with each group containing 15 patients respectively. Primary outcome measure was Positive and Negative Syndrome Scale for Schizophrenia (PANSS) while secondary outcome measures were three PANSS subscales and Clinical Global Impressions-Severity of Illness (CGI-S). Assessments were done at baseline and then on weekly basis until endpoint. Extrapyramidal side effects and akathisia were rated weekly by Simpson-Angus Scale (SAS) and Barnes Akathisia Scale (BAS). Body weight and serum prolactin were measured and electrocardiogram recorded at baseline and at end point.
Results: Endpoint improvement for the aripiprazole group was not significantly different from haloperidol group on PANSS total score, and PANSS positive and negative subscale scores. Haloperidol produced significantly greater improvement in PANSS general psychopathology subscale score and CGI-S score at endpoint. Aripiprazole produced significantly less extrapyramidal side effects and weight gain. Haloperidol produced significantly greater elevations in serum prolactin levels while QT(c) changes were nonsignificant in both groups.
Conclusions: This trial shows that aripiprazole therapy was as efficacious as haloperidol in improving both positive and negative symptoms of psychotic disorders in children and adolescents but demonstrated better tolerability
Paediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) is a unique syndrome which is associated with a recent infection caused by the group A b-haemolytic streptococcal bacteria. Although b-haemolytic streptococcal infection is prevalent in India, we are less aware of cases of PANDAS from the Indian subcontinent. We report a case of OCD who presented to us with features of PANDAS.
Association of pica and iron deficiency anaemia have been reported in literature. An unusual but completely reversible form of pica in the form of sponge eating is reported as an odd manifestation in a case of iron deficiency anemia. Medical practice is full of challenges and complexity; and clinicians need to be vigilant all the timein their practice to appreciate unusual and rare manifestations of common clinical conditions iron deficiency anaemia.