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   Table of Contents - Current issue
Coverpage
April-June 2019
Volume 35 | Issue 2
Page Nos. 99-154

Online since Wednesday, June 26, 2019

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EDITORIAL  

The magnitude and vicissitudes of substance use disorders in India p. 99
Siddharth Sarkar, Abhishek Ghosh
DOI:10.4103/ijsp.ijsp_50_19  
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REVIEW ARTICLE Top

The phantom syndrome Highly accessed article p. 102
Atul Kumar Goyal, Jyoti Saini
DOI:10.4103/ijsp.ijsp_63_18  
Communication technology evolved extensively in recent years and the introduction of the featured smartphones considered as the critical milestone in the mobile phone history. Unlike traditional phones, smartphones have the number of applications which keep the users engage to a greater extent of time like never before. Such unbroken psychological association of the individuals with their smartphones has led to an emergence of a new kind of psychological problem called as the phantom syndrome characterized by the frequent false feeling of ringing and vibration from the smartphones. Although the phenomenon of the phantom is widespread, only a limited number of studies are available on it. Furthermore, most of the studies available are to exploratory nature with lack of standard study designs. Keeping all such aspect into the consideration, the present review endeavors to extend the current scientific knowledge on phantom syndrome by providing a thorough understanding and new ideas for future research.
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ORIGINAL ARTICLES Top

Stressful life events and quality of life in patients with somatoform disorders p. 108
Ramesh Ammati, Anil Kakunje, Ravichandra Karkal, Ganesh Kini, Jeyaram Srinivasan, Dilshana Nafisa
DOI:10.4103/ijsp.ijsp_24_18  
Background: Stressful life events are associated with somatoform disorders. Somatoform disorders can influence the quality of life (QOL). These factors are culture-specific and less studied in the Indian population. Objective: The objective of this study was to evaluate the stressful life events and QOL in patients with somatoform disorders. Materials and Methods: This cross-sectional observational study was done by examining the life events and QOL of 112 consecutive patients who were diagnosed with somatoform disorders. Mini Neuropsychiatric Interview Plus, Presumptive Stressful Life Events Scale (PSLES), and WHO Quality of Life-Bref scales were administered. Results: The study sample had undifferentiated somatoform disorder (32.1%), persistent somatoform pain disorder (26.7%), and somatization disorder (25.9%). The common stressful life events experienced by somatoform disorder patients were financial issues (27.7%), marital conflicts (20.5%), family conflicts (18.7%), and illness in family members (16%). Males reported predominantly financial and job-related stressors, whereas females reported stress in family and interpersonal domain. The mean stress score using PSLES among the participants was 114.9, and the score of mean life events experienced by the participants was 2.03. QOL scores in domains such as physical, psychological, social relationship, and environment were 44.3, 41.4, 46.6, and 47.7, respectively. These were low when compared to population norms. There was a significant positive correlation between the duration of the somatoform disorder and the stress scores and a negative correlation which was not significant between the duration of illness and QOL. Conclusions: There is a difference between stressors experienced between the two genders, the knowledge of which would help in tailoring individual needs in management. There is significant impairment in the QOL in people with somatoform disorder.
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A study of sociodemographic profile, birth risk factors, and social support in personality disorders p. 114
Sanjeet Kour, Zaid Ahmad Wani, Shabir Ahmad Dar
DOI:10.4103/ijsp.ijsp_32_18  
Background: Personality disorders (PDs) comprise deeply ingrained and enduring behavioral patterns, manifesting themselves as inflexible responses to a broad range of personal and social situations. We aimed to study sociodemographic profile, birth risk factors, and social support in PDs in Kashmir. Materials and Methods: It was an observational study conducted in the Department of Psychiatry, Government Medical College, Srinagar. There were forty one subjects in both the groups-cases and controls. Structured Clinical Interview developed II (SCID II); Oslo 3-item Social Support scale and the Childhood Trauma Questionnaire were used for assessing pattern, social support, and birth risk factors in personality disorders. Results: Mean age of patients and controls was 22.41 ± 4.14 and 22.52 ± 4.15 years, respectively. Majority of the participants were females in both the groups. Most of the cases and controls were single and from nuclear families. Maximum number of patients and healthy controls fitted into the upper-middle socioeconomic class. About 70.73% of cases had good social support while 29.27% of cases had minimal social support. About 99.4% of controls had good and only 1 (0.6%) had minimal social support. Majority of our patients had a borderline PD (35) followed by histrionic PD (3). Other forms of PD seen were avoidant/anxious PD in one patient. Birth complications were seen in 9.76% of cases and none of the controls, therefore, were statistically significant. Conclusion: Most of the cases were borderline, unmarried, from nuclear families belonging to upper-middle socioeconomic class with good social support.
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Feasibility of using “Google Translate” in adaptation of survey questionnaire from English to Bengali: A pilot study p. 119
Himel Mondal, Shaikat Mondal, Sarika Mondal
DOI:10.4103/ijsp.ijsp_39_18  
Background: Questionnaires are forward-translated and then back-translated by human translators during adaptation of a survey questionnaire in the local language. The machine translation method is now available free from “Google Translate” website and it can be used for translation from English to Bengali and vice versa. Using machine translation method may save researchers from investing money and time in translation by human experts. Aim: The aim of this pilot study was to test the feasibility of “Google Translate” in forward-translation and back-translation during adaptation of a survey questionnaire from English to Bengali. Materials and Methods: A survey questionnaire, originally developed in English, was forward-translated to Bengali and then back-translated to English by machine translation method and manual translation method. Both the versions were checked for errors expressed in subjective sentence error rate (SSER). Back-translated English questionnaire obtained from machine translation and manual translation was checked for equivalence with the original questionnaire. Results: SSER for forward-translated Bengali questionnaire by machine translation method was 66.60 ± 4.04 and manual translation method was 117.20 ± 1.30 (P < 0.001). SSER for back-translated English questionnaire by machine translation method was 61.20 ± 5.02 and manual translation method was 116.20 ± 2.77 (P < 0.001). Equivalence between back-translated questionnaire and original questionnaire by machine translation method was 48.40 ± 6.02 and by manual translation method was 112.40 ± 3.29 (P < 0.001). Conclusion: The machine-translated questionnaire showed higher error than manually translated questionnaire. Machine-translated questionnaire also showed lower equivalence with the original questionnaire. Hence, the use of machine translation (from English to Bengali) offered by “Google Translate” should be used with caution.
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Caregiving experience and marital adjustment in spouses of patients with schizophrenia p. 125
Shipra Singh, Deoraj Sinha, Nitin B Raut
DOI:10.4103/ijsp.ijsp_49_18  
Background: Schizophrenia has far-reaching consequences for both – patients, and spouses as caregivers. Perception of caregiving and marital adjustment appears to depend on various factors and also on each other. Objective: To study caregiving experiences and marital adjustment in spouses of patients having schizophrenia. Materials and Methods: A cross-sectional study was done with spouses of 100 consecutive patients having schizophrenia in a tertiary care teaching institute. Scales used included Experience of caregiving inventory (ECI), Dyadic adjustment scale (DAS), Multidimensional scale of perceived social support (MSPSS) and Positive and negative syndrome scale (PANSS). Statistical analysis was done using SPSS-20 software using correlation, regression analysis, t-test and descriptive statistics as applicable. Results: Mean average of total positive score of ECI was higher (2.56) than a negative score; and for DAS, it was highest for consensus (3.07) and minimum for affect expression scale (1.66). Better dyadic adjustment (P-value < 0.001), more age of spouse currently and at the time of marriage, and high social support were positively correlated with positive caregiving experiences (P-value = 0.010, r = 0.257; P-value = 0.04, r = 0.202, P < 0.001, r = 0.610 respectively). Negative caregiving experiences were related to joint family system, higher PANSS scores and higher number of hospitalizations. Conclusion: Factors affecting caregiving experience and marital relationship in schizophrenia need to be identified, and targeting them through psychiatrists or other informal sources, might improve the overall quality of life of spouse as a caregiver and also the patients.
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BRIEF COMMUNICATIONS Top

Evaluation of depression and quality of life in mothers of Indian children with autism spectrum disorders p. 131
Apoorva Deshpande, Nandini Mundkur, Anusha Jayaraman
DOI:10.4103/ijsp.ijsp_51_18  
Background: Parents of children with autism spectrum disorders (ASDs), especially mothers, tend to ignore or deny depression and suboptimal quality of life (QoL), and seldom seek help. In this study, we evaluated the primary caregiver depression and QoL in mothers of Indian children with ASD that are enrolled in our center for intervention programs. Methods: Children with ASD were enrolled in our center's therapist-based intervention (TI) or parent-based intervention (PI) programs. As opposed to the TI mothers, the PI mothers not only actively participated in their children's intervention but also underwent weekly sessions targeting their well-being. We assessed and compared 48 mothers (33 from TI and 15 from PI) before and at least 6 months after the start of their children's intervention programs. Results: Before the start of intervention for their children, 73% of mothers showed varying degrees of depression. At the end of 6-month intervention for their children, only 25% of mothers showed signs of depression, with no severe and extreme depression cases. Moreover, after 6 months, significant improvements were observed in 5/8 items in the short form-36 (SF-36) scale. In addition, we observed significantly better performance by PI mothers than TI mothers in 4/5 items in the SF-36 scale showing significant improvement. Conclusions: Our results showed an overall better outcome for the PI mothers than the TI mothers. This suggests that along with the positive feedback of the improvement seen in their children, additional programs specifically targeting the mental well-being of mothers would be beneficial for mothers and their children with ASD.
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Internet gaming disorder and psychiatric symptoms in Bengaluru, India: Treatment implication for promotion of user mental health p. 135
R Archana, Manoj Kumar Sharma, Keshav J Kumar, Palaniappan Marimuthu
DOI:10.4103/ijsp.ijsp_42_18  
Background: Psychological distress has been seen among internet users with gaming. There is a need to evaluate the effect of internet gaming on psychological well-being. The present study assessed the depression, anxiety, and stress among users with internet gaming disorder (IGD). Methodology: Sixty users (58 males and 2 females) in the age group of 16–18 years were screened using IGD test for cases with disordered gaming. They were administered background data sheet as well as depression anxiety stress scale. Majority of them were playing multiplayer online battle arena game and first person shooter game. Results: The pattern of use was from 10 to 14 h a day. About 6.8% individuals had lifetime psychiatric history. There was significant positive relationship between the internet gaming and depression (0.412 at 0.05 level), anxiety (0.408 at 0.001 level), and stress (0.308 at 0.05 level) scale. Conclusion: It also implies the need to evolve intensive intervention program to manage internet gaming as well as other psychosocial dysfunctions.
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PERSPECTIVE Top

Hypomania: A clinician's perspective p. 137
Avneet Sharma
DOI:10.4103/ijsp.ijsp_46_18  
Hypomania as a syndrome retains a central place in diagnosis of milder forms of bipolar illnesses, especially bipolar II. This article highlights some of the challenges that the clinicians are faced with and lists strategies that they could use while diagnosing hypomania and bipolar illnesses.
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COMMENTARY Top

“Bullying in Incognito Mode”: The evolution of sibling bullying p. 142
Suhas Chandran, SN Prakrithi, KV Guru Prakash, MD Kishor
DOI:10.4103/ijsp.ijsp_44_18  
Sibling bullying, the lesser known counterpart of bullying is an unexplored entity, but the little research that exists has shown that it is almost as common as bullying by peers. Personality factors, interpersonal relationships, home environments and parental styles influence the development of bullying behaviors. The normalisation of certain actions by parents may lead to many bullying behaviours going unnoticed. In these cases, the feeling of security usually attached to the familial context is also lost in the victims. It has also been noted to spill over into other environments such as peer bullying and other modes, like cyber bullying. In addition to this arises the bully-victim situation, where the victim becomes the perpetrator, leading to a self propagating vicious cycle. The long term consequences include a higher risk for depression, anxiety, emotional dysregulation and even antisocial behaviour. In fact, multiple neurobiological correlates have also been established, such as alteration in hypothalamic-pituitary-adrenal axis activity, raised C-reactive protein levels and abnormal immune functions. To prevent these long term adverse effects, interventions should be initiated early, starting with parental guidance and sensitisation, peer support groups and anti bullying programs in schools.
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MOVIE REVIEW Top

Next Floor p. 148
Sabornee Karmakar, Amrita Mitra
DOI:10.4103/ijsp.ijsp_28_18  
Over the past few decades, movies have ventured into the area of meaningful portrayal of societal constructs and resulting consequences of overconsumption. Next Floor is a short film which aims to highlight the upcoming void owing to depletion of resources followed by a downfall in civilization. This is depicted in the movie in the form of a banquet hall with people from the Proletariat class catering to people from the Bourgeoisie class. Using the method of content analysis, various perspectives are generated centered on the theme of overconsumption and resulting degradation of civilized behavior.
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CASE REPORT Top

Treatment of phobia using modified form of exposure and response prevention p. 151
BS Chavan, Tanupreet Kaur, Navneet Kaur
DOI:10.4103/ijsp.ijsp_56_18  
Exposure therapies are based on the premise that fears are acquired through associative learning (classical or operant conditioning). Commonly used behavior therapies are flooding and systematic desensitization in patients of phobia. However, in our index case, we could not introduce any of these modes of therapy due to patient-limited factors; thus, we introduced modified exposure and response prevention in which we tried to overcome the limitations of commonly used behavioral therapy techniques. She underwent 12 sessions and showed good and quick results.
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