All medical interventions need informed consent of the patient, which is obtained after providing all the relevant information to him in a comprehensible form resulting in meaningful decision making. Psychiatric patients, on some occasions, lack the capacity to take decisions on their mental health care and treatment. Utmost care should be taken in dealing with such patients, to proceed for their treatment after obtaining consent from their relatives/friends as per the legal provisions. The recently introduced Mental Health Care Bill – 2013 contains elaborate provisions regarding informed consent, which is to be obtained from persons with mental illness, and/or his nominated representative. Full informed consent is mandatory from all participants before proceeding to carry out any research project. Persons with mental illness who lack capacity to give consent should be included in a research study, only if there is likelihood of benefit for them or if it is intended to promote the health of the population represented by the potential subject.
Depression Index (DEPI) is one of the specific Rorschach Index developed as a part of the Comprehensive System. There has been a lot of research on Depression Index which identifies individuals who may be emotionally distraught, cognitively pessimistic, lethargic or self defeating. However, there are evidences which show inconsistent results about the depression index when they are used for the purpose of diagnosis of depressive disorder. The main aim of this paper is to study the Depression Index in patients suffering from moderate and severe level of depression. The sample consisted of 30 patients with depression and 30 normal subjects selected by using purposive sampling technique. Beck Depression Inventory (BDI) was administered on the patient group to assess the severity of depressive symptoms and Rorschach Inkblot Test was administered on patients and normal subjects to assess the structure of the personality. General Health Questionnaire-12 (GHQ) was administered as a screening tool in the group of normal control subjects. Results show difference on Depression Index variables among the two groups. No significant correlation was found between BDI scores and DEPI. The diagnostic efficacy was found to be low for DEPI. In conclusion, it can be said that the DEPI has not been found to be very effective in diagnosing depression.
Background: There is a major concern all over the world regarding the rise in attempting suicide in certain population especially among the young. Wide variations have been found in suicidal attempt among different cultures, societies and countries. The rate of attempted suicide is 8-10 times more than the completedsuicide. Coping is most often conceptualized as a response to the demands of specific stressful situations. Though deliberate self-harm encompasses a wide variety of medical and social disciplines some of the important psychosocial variable such as social support, coping strategies, and quality of life has not yet been explored in depth in India.
Aims: The aim was to analyze and compare the coping strategies, social support, and quality of life of suicide attempters versus matched normal controls, and to identify the risk factors leading to suicide.
Settings and Design: The study was conducted in the Department of Psychiatry, Agartala Govt. Medical College & GBP Hospital, Agartala, Tripura. The samples for the study were recruited from different outpatient & indoor facilities of the GBP Hospital after application of the inclusion and exclusion criteria (n = 100) cases of suicide attempters and healthy controls (n = 100) were included in the study.
Materials and Methods: A total of 100 consecutive suicide attempters were compared with same number of age, sex, and marital status matched healthy controls using Social Support Questionnaire, Bengali version of ways of coping Quissionare (Susan Folkman and Richard S. Lazarus) and WHO QOL-Bref. Statistical analysis was done by using SPSS - 20,
Results: Attempters experienced significantly less Social support. Most common Coping strategies used by the suicide attempters were confronting coping (72.5%) followed by distancing (60%) and predominant coping strategies used by the control groups were seeking social support (60%), accepting responsibility (52) and self-controlling (45%). Positive coping, and of QOL were significantly lower in attempters. Among all risk factors good education and good social support were protective against suicide.
Conclusion: Suicide attempters were differentiated from healthy controls basedon lower social support, less healthy coping, and poor QOL. However, it is difficult to pinpoint a single factor responsible for suicidal behavior. It is the complex interplay of various interrelated factors and the resultant buffering effect, which is protecting the individual against deliberate self-harm.
The modern gadgets and technology have become predominant determinants of socioeconomic status and not only is restricted to teenagers but is spreading fast across generations. Addiction to technology is causing significant loss of productivity as well as problems in interpersonal relationships. It has been postulated that rather than a separate entity, internet addiction is a manifestation of a variety of depression, anxiety, impulse control disorders or pathological gambling. There have been rehabilitative measures to correct internet overuse. Technophobia is the fear or dislike of modern technology particularly computers. Let us welcome the technological revolutions with a widespread awareness of its potential danger. The generation of today needs to move ahead with bright vision and better tomorrow.
Dr Aniket Shukla,
Dr Anweshak Das,
Dr Prakash Behere
Patients with structural brain lesions may sometimes present with a variety of psychiatric symptoms for a prolonged period of time without any neurologic symptoms and signs. In such cases the underlying pathology of such clinical picture can be easily misinterpreted to be functional in origin and can delay actual diagnosis as well as alter the prognosis. This report presents a case of elderly gentleman who presented with sudden onset atypical psychiatric manifestations with alteration in mood and behaviour which was diagnosed later on secondary to brain tumour involving both frontal lobes and corpus callosum. Hence we suggest that any atypical psychiatric manifestation in elderly patients warrants a detailed evaluation accompanied by neuro-imaging to rule out possible organic cause including tumours.
Suicide is one of the major public health problems in Sikkim and the State has been facing the dramatic rise in suicide cases. According to the National Crime Records Bureau (NCRB) report, 2008 Sikkim had the highest suicide rate and in 2009, Sikkim (39.9) was recorded as second highest state in the country in terms of suicide. The major cause of concern in Sikkim is the unusually high rate of suicide. Alcohol use is traditionally prevalent among Sikkim's population. National Family Health Survey-2, Government of India, has also highlighted a significant prevalence of alcohol use in Sikkim-32% and 17% among above 15 years of age males and females, respectively. From their observations prevalence of alcohol use is more common in rural areas than urban and negatively related to level of education and socioeconomic condition. These rough estimates make it obvious that alcohol use has become an important public health issue in Sikkim. As a result, abuse of opioids including heroin and other synthetic opioids have been reported from treatment centers. Similarly injection drug use (IDU) behavior has also been reported. Therefore, this is an early attempt to address the problem of substance abuse and mental Health problem in Sikkim.