|Year : 2016 | Volume
| Issue : 1 | Page : 69-80
Abstracts of XXII Annual Conference of Indian Association for Social Psychiatry, Agra 6-8 November 2015
|Date of Web Publication||17-Feb-2016|
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
. Abstracts of XXII Annual Conference of Indian Association for Social Psychiatry, Agra 6-8 November 2015. Indian J Soc Psychiatry 2016;32:69-80
|How to cite this URL:|
. Abstracts of XXII Annual Conference of Indian Association for Social Psychiatry, Agra 6-8 November 2015. Indian J Soc Psychiatry [serial online] 2016 [cited 2022 Sep 30];32:69-80. Available from: https://www.indjsp.org/text.asp?2016/32/1/69/176774
| Symposia|| |
Development of Preventive Psychiatry Module for General Hospital Psychiatry Units (GHPUs)
Rakesh K. Chadda, Mamta Sood, Rachna Bhargava, Bichitra Nanda Patra
Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
The general hospital psychiatric units (GHPUs) provide comprehensive mental health services in the form of outpatient and inpatient clinical care, and training and facilities in mental health. GHPUs attend to patients with all kinds of mental health problems. Preventive services are grossly underdeveloped in the field of psychiatry. The subject has been grossly ignored by the mental health professionals as well as the health planners. GHPUs offer an important resource to develop such services. GHPUs have many advantages that can be used to develop a prevention model in psychiatry, which includes easy accessibility, a wide range of psychiatric disorders being served, and facility of integration with other medical disciplines. It is possible to develop primary, secondary, and tertiary preventive strategies at GHPUs. About 25% of the inpatients and outpatients in medical and surgical wards and outdoor patient departments in the general hospital have psychiatric symptoms. Primary prevention can be implemented by increasing awareness among physicians on how to prevent the development of psychiatric symptoms and disorders in patients with various physical illnesses or undergoing surgery, for example, delirium in Intensive Care Unit can be prevented/minimized by simple strategies. Mental health promotion activities can also be undertaken for patients visiting other disciplines. Secondary prevention can be implemented by training the nonpsychiatry specialists how to identify and treat, and when to refer these patients for psychiatric evaluation. Tertiary prevention services like rehabilitation of persons with chronic mental disorders and substance use disorders are grossly underdeveloped in GHPUs and are the need of the hour. A model involving the family caregivers with collaboration with voluntary organizations can be developed aimed at reducing caregiver burden and facilitating rehabilitation in the community.
Developing a prevention model in psychiatry in GHPU: Overview - Rakesh K Chadda
Primary prevention in psychiatry in GHPUs - Mamta Sood
Secondary prevention in psychiatry in GHPUs -Bichitra Nanda Patra
Tertiary prevention in psychiatry in GHPUs- Rachna Bhargava
Caregivers Education and Support Groups: National Institute of Mental Health and Neurosciences Initiatives and Experiences
Sivakumar Thanapal, Aarti Jagannathan, Avinash Waghmare 1
Department of Psychiatry, NIMHANS, Bengaluru, Karnataka, 1 Department of Psychiatry, Smt. Kashibai Navale Medical College, Pune, Maharashtra, India
In India, persons with psychiatric disorders are supported by their family members and relatives. Research has shown that family caregivers of persons with psychiatric disorders have extensive support and educational needs. To cater to these needs, research and clinical models in the form of caregiver support and/or educational groups are being conducted in the National Institute of Mental Health and Neurosciences (NIMHANS). In the last few years, need-based psychosocial/yoga/educational and/or support interventions for caregivers of persons with schizophrenia, dementia, bipolar affective disorder, and first episode psychosis have been developed, initiated, and tested for its effectiveness. One such caregiver's group model is "Caregivers Support and Education Program workshops" being conducted on third Tuesday of every month over last 2 years in Psychiatric Rehabilitation Services, NIMHANS. The program is funded by Dr. Ramachandra N. Moorthy foundation for mental health and neurological sciences. A range of issues concerning caregivers have been taken up for discussion including welfare benefits for persons with psychiatric disability, what after me, caregivers as agents of change, legal, and marital issues, living with schizophrenia and portrayal in media. Pamphlets pertaining to these issues have been released. In the symposium, we shall present NIMHANS initiatives in research, services, and models for addressing caregiver needs. We shall discuss the need to enable caregivers by forming advocacy groups, challenges, and way forward. The speakers and structure of symposium are as follows: (1) Caregivers groups and models: Research and practice from NIMHANS: Dr. Aarti Jagannathan. (2) Caregivers support and education program workshops conducted by Psychiatric Rehabilitation Services, NIMHANS: Dr. Avinash Waghmare. (3) Challenges, lessons learned, and road ahead: Dr. Sivakumar Thanapal.
Disabilities and Psycho-socio-sexual Rehabilitation: Patient and Carer Perspectives
T. S. Sathyanarayana Rao 1 , G. Prasad Rao 2 , Mrugesh Vaishnav 3
1 Department of Psychiatry, JSS Medical College, Mysore, Karanatka, 2 Asha Hospital, Hyderabad, Telangana, 3 Samvedana Psychiatric & Sex Therapy Hospital, Ahmedabad, Gujarat
Sexuality is an important component of the physical, intellectual, psychological, and social well-being of all the individuals. It may include any one or combination of sexual behavior, activity, intimacy, or sense of sexual identity. It is formed by a dynamic interaction of personality, body image, sexual intensity, and sexual functioning. The characteristics of an intimate relationship include an enduring behavioral interdependence and emotional attachment. Intimate relationships include friendships, dating, spiritual attachment, and marital relationships. The most important sort of intimacy is that which we experience in the company of another person. Intimacy may mean sex for some, for others being close and a soul-to-soul connection. Many people who complain of sexual problems are in fact not able to get intimate with their partners. Sensuality includes the experience of pleasure from one's senses, increased awareness and appreciation of one's own body. A disability may be a physical, sensory, or intellectual impairment. Individuals with disability are sexual individuals with sexual desires and concerns that require the attention of health care providers. Individuals who face a disability have a much deeper impact on their psyche and develop an attitude that "sex" and "sexuality" are no longer part of their personality which in turn leads to many sexual dysfunctions, in both men and women, at any age. Depending on the type, nature, and associated issues, one may have varied psycho-socio-sexual problems.
A purely physical cause of disability will need treatment appropriate to the problem along with psychological support. Health care professionals need to be sensitive regarding various psychosocial issues associated; individuals and partners need to understand and accept their sexual limitations. Sexual function is as important as any other aspect of functional rehabilitation from a disabling disease or injury. The quality of personal and sexual relationships before the disability also exert a great impact on a patient's self-esteem and support network. Sexuality issues should be discussed in simple language to make individuals exactly understand the facts. Clients may have varied misconceptions that sex should be spontaneous and they cannot have "real sex;" they have more pressing things to worry about and individuals in institutions should not have sex; fear of rejection/inadequate performance. Associated depression, anxiety, and personality changes need to be looked into. Change in role, caregiver vs. lover conflict, changes in speech, and communication difficulties need to be resolved. Relatively few diseases totally preclude coitus or fertility, very few destroy libidinous drive and none destroy sexual identity. The changes that may occur after the catastrophic event must be addressed in the context of the patient as well as the patient's support system. Counseling with the permission, limited information, specific suggestions, intensive therapy model by Annon, sensate focus and desensitization technique, and working through each phase of the sexual response cycle with the client are helpful. Redefining success in sexual interaction helps in removing performance pressure. In short, a holistic approach is required which touches upon the bio-psycho-social issues associated with the problem.
Role of culture, faith, and spirituality in nonpharmacological strategies
U. C. Garg 1 , Ashutosh Gupta 2 , Kabir Garg 3 , Sujit Kumar Kar 3
1 Garg Medical Complex, Agra, Uttar Pradesh, 2 Gupta Psychiatric Centre, Rohtak, Haryana, 3 Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh
The topics of spirituality and psychotherapy have often been controversial in the literature on psychiatric treatment. However, current research indicates many potential benefits of integrating issues of religion and spirituality into psychotherapy for individuals. Similarly, culture as an abstraction reflects the sum of practices in a given societal unit. The culture of a population has a unique effect on the psyche and thus, the mental health of the individuals belonging to that society. Studies which have focused on the demographic factors, cultural factors influencing the presentation of illness, diagnosis of the illness-culture bound syndromes, influence of the cultural factors, and the belief system on psychopathology have found significant correlations. Yet, what is surprising is that majority of psychiatric practices, even in the Eastern cultures and more so in India, are guided by the Western concepts of mental health and illness, largely ignoring the role of religion, family, eastern philosophy, and medicine in understanding and managing the psychiatric disorders. The current symposium aims to review the role of culture and religion, with emphasis on the subcontinent, over the incidence, presentation and management of psychiatric illnesses, and to bring forth their contributions in the nonpharmacological management of psychiatric disorders.
- Dr. U. C. Garg (Agra): Religion and spirituality in psychiatry
- Dr. Ashutosh Gupta (Agra): Indian mental health concepts
- Dr. Kabir Garg (Lucknow): Religious texts and psychotherapy
- Dr. Sujit Kumar Kar (Lucknow): Indian cultural contribution to psychotherapy.
Stigma in Severe Mental Illness: Concept, Impact, and Possible Interventions
Sandeep Grover, Shubh Mohan Singh, B. N. Subodh
Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
Stigma is a complex multidimensional phenomenon that is highly relevant to the various fields of study and management of severe mental disorders. The concept of stigma has evolved over time from an individual, personal experience to a more dynamic, interactive, and social phenomenon. Among other things, stigma can lead to emotional turmoil, delay in treatment seeking, and neglect of illness with deleterious consequences. Interventions targeting stigma are in a nascent stage. Standardized interventions are difficult given the complex nature of the problem. However, interventions will need to be multipronged and comprehensive in approach. Aim of the Symposium: To discuss the concept, extent, implications, and possible interventions for Stigma associated with severe mental disorders.
Dr. Sandeep Grover will discuss the concept of stigma and the extent of stigma perceived by patients with severe mental disorders and their caregivers.
Dr. B. N. Subodh will focus on the implications of stigma on the treatment seeking, management, course and outcome of severe mental disorders.
Dr. Shubhmohan Singh will discuss the intervention strategies at various levels, which can be implemented in reducing the stigma associated with severe mental disorders.
Stigma and Mental Disorders: What Happens when Psychiatric Disorders and Substance Use Disorders Co-occur?
Yatan Pal Singh Balhara, Rohit Verma, Siddharth Sarkar
Department of Psychiatry, National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, India
Mental disorders, including psychiatric disorders and substance use disorders, have been associated with stigma across various settings and countries. The same is true for the developing countries such as India. Interestingly, little emphasis has been placed on the stigma associated with co-occurring psychiatric disorders and substance use disorders. The current symposium is aimed at exploring the impact of co-occurring psychiatric disorders and substance use disorders on stigma.
Stigma and Psychiatric Disorders - Dr. Rohit Verma: The first presentation shall focus on stigma with respect to psychiatric disorders. The various facets of stigma associated with psychiatric disorders shall be discussed. An overview of Indian research on stigma among individuals with psychiatric disorders and its impact shall be presented. Stigma and Substance Use Disorders - Dr. Siddharth Sarkar: The second presentation shall focus on stigma with respect to substance use disorders. The various facets of stigma associated with substance use disorders shall be discussed. An overview of Indian research on stigma among individuals with psychiatric disorders and its impact shall be presented. Stigma and Dual Disorders - Dr. Yatan Pal Singh Balhara: The final presentation shall focus on stigma in the context of co-occurring psychiatric disorders and substance use disorders. This shall discuss various aspects of dual disorders with regards to stigma. The existing research and understanding on the theme shall be discussed.
Vocational Rehabilitation and Employment: "A Conduit To Recovery in Chronic Mental Illness"
B. S. Chavan, Shikha Tyagi, Subhash Das
Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India
Psychiatric rehabilitation warrants individualized treatment which has to be embedded in a comprehensive and coordinated system of rehabilitative services. Rehabilitation services for persons with chronic mental illness usually comprise of social skills training, neurocognitive training, vocational training, etc. Vocational rehabilitation programs provide a series of graded steps to promote job entry or re-entry of mentally ill persons. The confidence that persons with mental illness gain after enrollment in vocational rehabilitation programs promotes recovery. Many studies, however, have documented that vocational training and employability of persons poses myriad of obstacles like lack of motivation on the part of patient/family, restrictions because of the symptomatology, stigma (both in enrolling patients in a vocational training program and in giving employment), nonavailability of evidence-based programs, etc. Various settings and approaches used in vocational rehabilitation include clubhouse model, transitional employment, social firms, sheltered workshops, etc. In India, vocational rehabilitation and employability of persons with chronic mental illness continue to remain a road less traveled by mental health professionals. In Chandigarh, Department of Psychiatry, Government Medical College and Hospital is running Disability Assessment, Rehabilitation and Triage (DART) services since 2012. Through this symposium, the department would like to share the working model for vocational rehabilitation and employment of persons with chronic mental illness running within the ambit of DART services. Besides sharing this model, the presenters will share their experiences of the strategies that can be used in overcoming the barriers faced in achieving the desired outcome for vocational rehabilitation.
Menace of Stigma in Psychiatry
Suja Kurian, Pankaj Sheoran 1 , Sujata Sethi 1
Department of Psychiatry, CMC, Vellore, Tamil Nadu, 1 Department of Psychiatry, PGIMS, Rohtak, Haryana, India
Despite major breakthroughs and advances in our knowledge about various psychiatric disorders, stigma toward psychiatry continues to prevail. The stigmatization of people with mental illnesses has been recognized by the international agencies such as the World Health Organization and the World Psychiatric Association as an important public health and human rights problem. Individuals with mental illness are devalued and are treated unfairly by others because of their mental health condition. It is not only the general public that views psychiatry and psychiatrists negatively, but medical students, health professionals other than psychiatrists, families of patients, and media also have similar views. These negative attitudes not only lead to a delay in seeking professional help for the patients but also discriminate against patients and their families, and hinder in the deserved placement of patients in the society. All these further adversely affect the outcome of psychiatric disorders. This symposium addresses these issues as well as measures to combat and prevent stigmatization of psychiatry.
| Workshops|| |
Psychotherapy for the Indian Setting: The Process of Assessment and Conduct of Individual Dynamic Psychotherapy
V. K. Varma 1 , Nitin Gupta 2
1 Indiana University School of Medicine, Indianapolis, USA, 2 Department of Psychiatry, Government Medical College and Hospital, Chandigarh
Background and Need: "It is inevitable that cross-cultural differences… must be taken into account in ascertaining the suitability of and in adapting psychotherapy for a particular culture (Varma, 1985)." Traditional cultures, like those of South Asia, revolve around primary support groups, like the family. As opposed to the West, in the traditional societies of South Asia, all relationships are multidimensional, subserving a myriad of functions. The same applies to the healer-patient relationship, the healer being a friend, philosopher and guide, a wise person, a village elder, and a benevolent senior, as also a family member. His objective is to help in all possible ways, to total growth, development and actualization, and not just in the narrow confines of the illness. Adapting psychotherapy for the traditional societies, such as that of India requires taking into account differences in the sociocultural and religious variables, such as, dependence versus autonomy, psychological sophistication, the introspective and verbal ability, the need for confidentiality, the nature of dyadic relationship, the personal responsibility in decision-making, the nature of guilt and shame, and the social distance between the patient and the healer. Psychotherapy may accordingly be made more active, open and direct, briefer, crisis-oriented, supportive and flexible, with greater activity on the part of the healer, and with the involvement of the larger family and social matrix. It also needs to be tuned to and blend itself to the religious belief system. Furthermore, on account of trained manpower constraints, expertise of professionals of various backgrounds may be utilized.
However, there is no model available for the practice of psychotherapy in India. The facilitators have identified various factors and processes that seem to be the key and extremely helpful in the conduct of psychotherapy in the Indian setting and would like to share the same with the participants. Objectives: Train mental health professionals in the practice of individual psychodynamically oriented psychotherapy: (a) Discuss the rationale for adopting Western-model psychotherapy for traditional societies, taking into account sociocultural variables, (b) discuss the methodology of selection of cases and assessment for psychotherapy, (c) discuss the process of psychotherapy from symptoms to conflicts to defense mechanisms to interpretation to working through, (d) illustrate the conduct of psychotherapy, giving case vignettes, and using role-play involving the participants. Format (Combined Lecture and Interactive): Lecture-Based: Cultural aspects (Traditional vs. Western) - Overview of Basic Psychodynamic Defense Mechanisms; Assessment for Psychotherapy. Interactive/Practical: Clinical assessment of a case, psychodynamic formulation. Role Plays: Conducting a psychotherapy session. Duration: 4 h.
Workshop on Caregivers of Persons with Intellectual Disabilities
B.S. Chavan 1 , Rachna Bhargava 2 ,Jitender Aneja 1
1 Department of Psychiatry, Government Medical College and Hospital, Chandigarh, 2 Department of Psychiatry, All India Institute of Medical Sciences, New Delhi
Background: Family members are the most important caregivers for children and adults with intellectual disabilities (IDs) worldwide as well as in Indian setup. Caregiving is a challenging task for caregivers and is highly influenced by culture and value system of a community. Various themes which are central to caregiving in persons with ID have been categorized into unavoidable caregiving responsibilities (namely daily care, study assistance, emotional support, and rehabilitation), worries about future of their ward (like managing finances, marriage, etc.), compromised quality of life (viz., trapping own ambitions, damaging social relations, daily emotion, and well-being), support from the government and respite care services (rehabilitation of the affected person, provision of professional, care and social welfare services). Though psychiatrists are taught about various aspects of ID during their training, but evidence in literature shows that most of them have poor skills in dealing with issues related to caregiving in persons with ID. Aim: The aim of the workshop will be imparting information and hands-on training of the participants in the areas of caregiving in persons with ID. For this purpose, the workshop will have following three subthemes: (1) Learn to disclose the news of "ID in a child. (2) How to guide the parents, with a previous child with ID, when planning for next child. (3) Learn to address this common concern of caregivers "What after us?" Methodology: The workshop will be conducted by a team of three experts in this field. There will be one team leader who will initiate the session, and other two experts will actively support in achieving aims of this workshop. The brainstorming educational activities of the workshop will include the presentation of clinical case vignettes, role play, and open discussion. Duration: Two hours 30 min.
Restitution of Conjugal Rights in Married Women with Mental Illness: Which is the Right Way?
Indira Sharma 1 , Ashutosh Kumar 2
1 Department of Psychiatry, Banaras Hindu University, Varanasi, 2 Gupta Psychiatric Centre, Rohtak, Haryana
Duration: One hour.
Introduction: Dr. Ashutosh Kumar: Five minutes. Presentation of Vignettes - Case 1: Women with bipolar disorder by Prof. Indira Sharma - 5 min. Discussion on Vignette - 10 min. Case 2: Women with mild mental retardation by Dr. Ashutosh Kumar: - 5 min. Discussion on Vignette - 10 min. Case 3: Women with schizophrenia by Prof. Indira Sharma - 5 min. Discussion on Vignette - 10 min. Concluding Remarks: Prof. Indira Sharma - 10 min.
| Free Papers|| |
Evaluation of Interleukin-6 and Serotonin as Biomarkers to Predict Response to Fluoxetine
Aarthi Manoharan, Ravi Philip Rajkumar 1 , Rajan Sundaram, Abialbon Paul 2 ,Deepak Gopal Shewade
Department of Pharmacology, 1 Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, 2 Department of Clinical Pharmacology, Apollo Hospitals Enterprise Limited, Madurai, Tamil Nadu, India
Aim: Only 30% of major depressive disorder (MDD) patients achieve a complete remission with a serotonergic antidepressant (selective serotonin reuptake inhibitor). The aim of the study is to investigate the potential of a serotonergic (5-hydroxytryptamine (5-HT)) and an immunologic (interleukin-6 (IL-6)) parameter to serve as functional biomarkers of response to fluoxetine. Objective: To compare serum IL-6 and serotonin (5HT) pre- and post-treatment (at 6 weeks) in MDD patients classified as responders and nonresponders based on Hamilton Depression Scale-17 (HAMD-17) scoring and in normal controls. To correlate plasma fluoxetine and norfluoxetine levels at steady-state with treatment response and percentage of decrease in 5-HT posttreatment. Results: The levels of IL-6 were found to be significantly higher in MDD patients when compared to controls (P < 0.01) and levels of 5-HT were significantly lower in nonresponders compared to controls (P = 0.0131). Pre- and post-treatment levels of both the candidate biomarkers individually and in combination did not significantly differ between responders and nonresponders. A significant correlation was seen between the percentage change in IL-6 and percentage change in HAMD score in responders. Fluoxetine and norfluoxetine concentrations were not significantly different in responders and nonresponders, and there was no correlation between fluoxetine concentrations and percentage reduction in 5-HT from week 0 to week 6. Conclusion: 5-HT and IL-6 may not serve as useful markers of response to fluoxetine in patients with MDD.
Psychological Morbidity Among Parents with Specific Learning Disorder
Anamika Sahu, Vaibhav Patil, Rachna Bhargava, Rajesh Sagar
Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
Aims and Objectives: The aim of this study was to examine psychological morbidity among parents with specific learning disorder (SLD). Methodology: A descriptive cross-sectional study was done involving 20 parents of children with SLD and 20 parents of normal healthy controls (either mother or father) selected using purposive sampling. Parental stress, psychological distress, and psychiatric co-morbidity were assessed using semi-structured questionnaire, parental stress index, General Health Questionnaire-36, and Mini International Neuropsychiatric Interview, respectively. Results: The data obtained were statistically analyzed using parametric and nonparametric tests for comparison and correlations. Significant differences emerged in the level of psychological stress among parents with SLD in comparison to normal healthy controls. Conclusions: SLD impacts child's learning and makes it a painful process for parents leading to stress. It may lead to deficits in coping. The present study has identified important domains and facets of parental perspective that need to be addressed in intervention for improving overall parental adjustment and problem solving. In addition, this would also help to plan remediation and rehabilitation for their children with SLD.
A Comparative Study of Secularism and Social Maturity Among Hindu and Muslim Male Postgraduate Students
Anand Kumar, Sadique Razaque
Department of Psychology, Vinoba Bhave University, Hazaribag, Jharkhand, India
Background: Secularism creates equality, justice, freedom, peace, and democracy. On the other hand, social maturity balances total well-being of ourselves, others, and the environment. Both are basic elements to build a well society that is surrounded by unity. Aim: The present study was conducted with an aim to compare secularism and social maturity among Hindu and Muslim male postgraduate students to improve the knowledge about secularism and social maturity. Methods: Fifty Hindu male and 50 Muslim male, age between 22 and 26 years from Vinoba Bhave University, Hazaribag, Jharkhand, have been included purposively as a sample of the study. Sociodemographic details schedule along with secular attitude scale (Mehra and Sinha) and Rao's Social Maturity Scale were used for data collection. Data collected were analyzed using Statistical Package for Social Sciences (SPSS version 20). Result: On secularism, no significance difference was found among Hindu and Muslim adults and on social maturity significance difference was found. Conclusion: Hindu and Muslim both religions are having characteristics of secularism in the present era, but maturity is varying in term of social.
Burnout and Coping Strategies in Health Care Professionals Working in Tertiary Care Centre
Atul Kumar Rai, Anil Gupta, Vipin Koushal
Department of Hospital Administration, Post Graduate Institute of Medical Education and Research, Chandigarh, India
Introduction: Role of health care professionals in tertiary care center has been widely acknowledged throughout the globe. The work carried out by these health care professionals has been phenomenal. In health care professionals, career burnout has turned into a common phenomenon in recent times. The basic reason is that every profession is susceptible to exhaustion and mental strain. To deal effectively with this problem, people need to differentiate normal stress from more serious issues that cause career burnout and found to be poor coping strategies with these kinds of problems. Aim and Objective: The aim of the present study is to assess the burnout and coping strategies in health care professionals in the tertiary care center. Methods: This study is carried out at the PGIMER, Chandigarh. The study will be a cross-sectional, hospital-based, and the sample will be selected through purposive sampling technique. The sample will consist of 60 health care professionals those who are working in the tertiary care center. The sample will be selected as per the inclusion and exclusion criterion of the study. Written informed consent will be taken from the samples of either group before starting data collection. The sociodemographic sheet and Copenhagen Burnout Inventory and coping orientations to problems experience will be applied on the selected sample. Results and Conclusion: The results of the study will be discussed at the time of presentation.
"Activity Scheduling" on the Negative Symptoms of Patients with Schizophrenia in Psychiatry Ward, Nehru Hospital, PGIMER, and Chandigarh
A. Kaur, M. Dogra, K. Das, A. Avasthi
Department of Psychiatry, National Institute of Nursing Education, PGIMER, Chandigarh, India
Introduction: Schizophrenia is among the top 10 disabling conditions worldwide for young adults. The "negative symptoms" is much more pervasive and persistent and has a much greater effect on a patient's quality of life. Negative symptoms represent a reduction of emotional responsiveness, motivation, socialization, speech, and movement. Objective and Methodology: The present study was undertaken with the objective to see the effect of activity scheduling on negative symptoms of patients suffering from schizophrenia. The study was conducted during the months of July and August on six patients who were admitted in psychiatry ward of Nehru Hospital, PGIMER, and Chandigarh. These six patients were matched with another set of six patients, that is, the control group, who were previously admitted in the ward. Results: Both the groups were found to be homogenous as median score of case study versus control group was compared with respect to negative symptoms at 3 points of time (at baseline, week 1, and week 2), both the groups were found to be comparable as there was statistically no significant difference on applying Mann-Whitney U-test (P value 0.05, 0.23, 0.75, respectively). When the statistical analysis of overall trend in negative symptoms from baseline to week 2 as well as interaction of negative symptoms score trends in two study groups was using nonparametric Friedman repeated measure test, the results clearly indicated that negative symptom score (mean ± standard deviation [SD]) showed a significant overall downward trend from baseline (23.67 ± 8.26) to week 1 (19.08 ± 6.97) and then week 2 (15.25 ± 7.01) P < 0.0001). On further analyzing the trend for negative symptom scores in two study groups, the above analysis demonstrating that there also was a significant interaction between two study groups, that is, two study groups differed statistically in their decrease in negative symptom score over three time periods (P = 0.028). The change of overall negative symptom score from baseline (23.67 ± 8.26) to week 1 (19.08 ± 6.97) was highly significant (P = 0.002) and from week 1 to then week 2 (15.25 ± 7.01) was again highly significant statistically (P < 0.0001). However, trends of negative symptoms scores in two study groups were similar, that is, both groups showed a similar decrease in negative symptom scores from baseline to week 1 (P = 0.15) while fall in negative symptom scores was marginally significantly more fall in case group than control groups (P = 0.076). When the significance of fall in negative symptom score was observed between two successive time points in cases, as well as controls using Wilcoxon signed ranks test for paired data, the result showed that mean (±SD) fall in negative symptom scores in case study group from baseline to week 1 was 6.33 (±5.39) (P = 0.027) and from week 1 to week 2 was 5.33 (±2.88) (P = 0.027) in the control group the mean (±SD) fall in negative symptom scores from baseline to week 1 was 2.88 (±1.17) (P = 0.027) and from week 1 to week 2 was 2.33 (±2.34) (P = 0.078). The fall in negative symptoms may be slightly more in cases than from controls from baseline to week first despite large 6.33 difference as compared to 2.88 in controls but is clearly more in case study group from week 1 to week 2 as shown by lower SD values of negative symptoms scores (2.88 from 5.39). The findings of the study provide empirical evidence on the usefulness of the individualized activity scheduling for the patients with schizophrenia. Conclusion: Both groups showed a decrease in negative symptom scores from baseline to week 1 and then from week 1 to week 2.
Psychosocial and Clinical Profile of a Juvenile in Conflict with Law: A Case Study
D. Bhattacharya, R. Bhargava, A. Dhawan, R. Sagar
Department of Psychiatry, National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, India
Aims and Objective: In India, the rate of crime committed by adolescents is rising high. There has been 10.5% increase in juvenile IPC crime from 2010 to 2011 (NCRT, 2011). Because of the lack of treatment seeking behavior, research on this particular population has taken a backseat in India. The objective of the study was to explore the sociodemographic factors, personality factors, and clinical profile of an adolescent in conflict with the law. Methodology: A case of adolescence was examined in depth from an institutional setting. Details of sociodemographic were taken in a semi-structured interview schedule. His intellectual functioning was evaluated using Wechsler Intelligence Scale for Children-IV Indian Edition. Mini-KID was used to assess the clinical profile. The administration of Buss-Perry Aggression Inventory, Barret Impulsiveness Scale, Difficulties in Emotional Regulation Scale and Rosenberg Self-Esteem Questionnaire was done to assess aggression, impulsivity, emotional regulation, and self-esteem, respectively. Result: The results show social factors such as domestic violence, peer pressure, and conflict with peers as well as psychological factors such as impulsivity and low self-esteem to play a significant role. Conclusion: The role of psychosocial factors toward the development of delinquent behavior will be discussed.
Exploration of Nomophobia Among Professionals at Workplace
H. K. Gupta
Background: Recent years have seen increase in mobile phone use for meeting day to day needs, leisure as well as for professional purpose. Besides these usages, it is also used for chatting, visiting adult sites, involvement in the online relationship, gambling, shopping, games, and web surfing. It usage pattern has shown a compulsion to carry the mobile as well as subjective manifestation of anxiety for not carrying/losing the mobile phone. There is not published work for its exploration at the workplace in Indian context. The present study assessed the pattern of mobile phone use as well as assessment of nomophobia at the workplace. Materials and Methods: Two hundred and fifty (males/females) were assessed using background datasheet, problematic phone questionnaire, as well as screening questions for assessment of nomophobia. The administration was carrying in a group setting. Results: It indicated the presence of problematic use of mobile phone and 167 acknowledgment of the presence of anxiety for not carrying the mobile/losing the mobile as well as postponing important offline activities for accessing a mobile phone. Majority carry the mobile with them during the night and check their mobile as first activities after waking up. Conclusion: The study showed the presence of nomophobia and had implications for the promotion of alternative offline leisure activities.
Assessing the Prevalence of Depressive Disorder, Anxiety Disorder, Perceived Stress, Burden of Care, and Quality of Life in Mothers of Children with Attention-deficit Hyperkinetic Disorder, Pervasive Developmental Disorder, and Learning Disability
Karuna Sandra Thomas, K. Sreekumar 1
Department of Psychiatry, MOSC Medical College, Kolenchery, 1 Department of Psychiatry, Amrita Institute of Medical Sciences, Kochi, Kerala, India
Aims and Objectives: (1) To assess the prevalence of anxiety and depression in the mothers of children with the attention deficit hyperkinetic disorder (ADHD), pervasive developmental disorder (PDD), and learning disability (LD). (2) To assess perceived stress (PS), burden of care (BOC), and quality of life (QOL) in these mothers. (3) To study the correlation between the intensity of depression/anxiety in the mother with the severity of symptoms in the child. Methodology: It was a cross-sectional study with 336 mothers who were assessed for anxiety/depression using International Classification of Diseases 10 research criteria and rated on the Beck inventory. The mothers rated their child's problems on the strengths and difficulties questionnaire. The PS, BOC, and QOL were scored. Results: Significant proportion of the mothers included in the study had anxiety (35%) and depression (37%) (P < 0.05). A significant association was found between the mother's anxiety/depression and the severity of the child's symptoms (P < 0.05). The statistical difference between the child's diagnosis and the PS score, BOC score and QOL score in the mothers was significant (P < 0.05). Conclusions: Having a child with ADHD, PDD, or LD puts a psychological strain on the mothers and makes them vulnerable to stress-related psychiatric disorders. Hence, regular screening of these mothers for anxiety and depression is important.
Resilience and Quality of Life Among the Mental Health Professional
Manasi Rani Panda, A. M. Wankhar 1
Psychiatric Social Work, 1 Clinical Psychology, Central Institute of Psychiatry, Kanke, Ranchi, Jharkhand, India
Introduction: Being mental health professionals to deal with mental health issues, it requires strong desire and strength as they were overwhelmed by various responsibilities. To promote positive mental health, maintain balance in day to day life as well as in workplace, resilience plays a vital role and also support to perceived quality of the individual's day leaving. Aim and Objective: The present study aimed to assess and compare the resilience and quality of life (QOL) among the both genders of mental health workers. Participants and Methods: Forty (20 males and 20 female) mental health professionals from Central Institute of Psychiatry will be selected for the study within the age range between 20 and 50 years. Sociodemographic data sheet, Bharthiar University Resilience Scale, and WHO QOL will be measured and will be analyzed using appropriate statistical analysis. Results and Conclusion: The finding of this study will be discussed at the time of presentation.
Functional and Neuropsychological Outcome Following Geriatric Traumatic Brain Injury: A Prospective Study from a Tertiary Care Hospital in North India
Manju Mohanty, Nasib Iqbal Kamali, M. K. Tewari
Department of Neurosurgery, PGIMER, Chandigarh, India
Introduction: Geriatric trauma is an emerging cause of concern these days. As the elderly population continues to expand, it results in increasing mobility and active lifestyles which put them at greater risk for traumatic injuries. It is well-established that outcomes after geriatric injury are significantly worse as compared to younger, resulting in disproportionate healthcare costs, increased mortality, and long-term morbidity. Aim: To assess functional and neuropsychological outcome following geriatric traumatic brain injury (TBI). Methods: One hundred and forty-three patients above the age of 55 years admitted to Advanced Trauma Center, PGIMER, Chandigarh following TBI were included. Informed consent was obtained either from the patient or relatives. At the time of admission, demographic and clinical details were obtained. They were assessed using global outcome scale-extended and mini-mental state examination (MMSE) at 3 months postdischarge. Results: The mean age was 63.7 (standard deviation = 7.6). Majority were males, 43 (30.1%) had a comorbid illness, 29 (20.3%) had associated injuries. The most common mode was road traffic accident. At 3 months, only 39 (27.3%) reported good functional outcome, 34 had died, 4 were in vegetative state, and 66 had moderate to severe disability. Only 93 patients completed MMSE as a patient in the vegetative state, having a prior history of psychiatric illness or neurological illness were excluded. Forty-five (48.4%) patients reported good neuropsychological outcome, whereas 20 (21.5%) had mild impairment and 28 (30.1%) had severe impairment. Factors associated with the outcome will be discussed.
A Study of Stigma Toward HIV Infection/AIDS Among Healthy Population
Meha Jain, Sujita Kumar Kar 1 , Mamta Yadav 1 , Reema Sinha 1
Department of Pediatrics, Integral Institute of Medical Sciences and Research, Lucknow, 1 Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
Background: HIV-related stigma is present at all levels of the society which act as critical barriers for provision of care. This also influences the uptake and under- or non-participation in treatments available. Aims: In view of this the present study was aimed to assess the stigma toward HIV infection/AIDS in otherwise healthy individuals of the community. Methods: The study was conducted on 100 healthy individuals (caregivers of patients with medical or psychiatric illnesses). Their responses were taken on self-designed semi-structured questionnaire. Results: The results showed that there is more perceived stigma in compared to enacted stigma. 46% individuals feel that HIV-infected persons should be blamed for their illness and 41% individuals feel that they will feel ashamed if they will have HIV. It was also seen that older adults (between 46 and 55 years) had more stigma as compared to the younger adults (between 16 and 25 years). Most of the individuals would like to tell their partner if they were diagnosed with HIV. Conclusion: Stigma related to HIV infection/AIDS is commonly prevalent in the society. Sociodemographic variables have a varied attribution to stigma. This needs to be addressed for prevention and better management of HIV infection/AIDS.
Perceived Social Support and Care of Burden of the Caregivers of Patients with Adolescent Psychosis, Epilepsy, and Normal Controls
Narendra Kumar Singh, Nishant Goyal, Dipanjan Bhattacharjee, Sanjay Munda, Basudeb Das
Department of Psychiatry, Central Institute of Psychiatry, Kanke, Ranchi, Jharkhand, India
Background: Epilepsy and psychosis are two neuropsychiatric conditions that know no geographic, social, or racial boundaries occurring in men and women and affecting people of all ages. Psychosis and epilepsy are two major neuropsychiatric disorders with a chronic course which makes it critical for caregivers to provide appropriate care which is often found to be a cumbersome task. To maintain the continuity and objective of the quality of caregiving for a long-term, it is really essential to take into account the social support and burden of illness for the patient and caregivers which indeed is a daunting task. Objectives: To examine the social support and burden of caregivers in early onset psychosis, epilepsy, and normal controls and to compare the differences in theses the groups. Methodology: The study sample will have 90 subjects, 30 caregivers of patients with early onset psychosis, epilepsy, and normal controls, respectively, in each group. Any illness starting between the ages of 13 and 18 years will be considered as the inclusion criteria. A caregiver will be defined as a relative who has been staying with the patient for at least 2 years with continuous contact and is actively involved in his/her care. Age, sex, income, and education of the caregivers for the groups will be matched. After obtaining basic sociodemographic and clinical details on an especially designed performa, Social Support Questionnaire, Family Burden Interview Schedule, and General Health Questionnaire-12 will be applied. Data will be analyzed using appropriate statistical measures for comparisons and correlation. Results and Discussion: Results of the study will be discussed at the time of presentation.
A Case-Control Study of Marital Adjustment and Life Satisfaction Among Spouses of Patients with Alcohol Dependence and Normal Healthy Control
Nazish Fatima, Rishi Panday, Abid Rizvi 1
Department of Psychiatric Social Work, Ranchi Institute of Neuro Psychiatry and Allied Sciences, Ranchi, Jharkhand, 1 Department of Psychiatry, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
Introduction: Alcohol dependence is associated with domestic violence, which in turn aggravates the physical and emotional distress of the family. Alcohol dependence also leads to decrease in social support not just for the affected individual but for the family. Various studies revealed a low level of life satisfaction and among the family members of patients with alcohol dependence. Aim: To compare marital adjustment and life satisfaction among the spouses of patients with alcohol dependence with normal healthy control. Methods: It was cross-sectional study conducted at Ranchi Institute of Neuro-Psychiatry and Allied Sciences, Ranchi. Thirty patients with alcohol dependence syndrome with their spouses and 30 age and socioeconomic status matched healthy control with their spouses were inducted in the study based on inclusion and exclusion criteria. Spouses of the two groups were compared for their life satisfaction and marital adjustment using life Satisfaction Scale and Marital Adjustment Questioner, respectively. Results: There was a significant difference in respect to life satisfaction among the spouses of individual with alcohol dependence syndrome and normal healthy control. Life satisfaction as well as marital adjustment was better in spouses of normal healthy control as compared to spouses of patients of alcohol dependence.
A Gender-Based Comparative Study on Social Support and Stigma of the Individuals with Bipolar Affective Disorder
Neha Roy, Raja Upadhyay, Narendra Kr Singh, Dipanjan Bhattacharjee
Department of Psychiatric Social Work, CIP, Ranchi, Jharkhand, India
Background: Stigma is a risk factor leading to negative mental health outcomes. It is responsible for treatment seeking delays and reduces the likelihood that a mentally ill patient will receive adequate care. It is evident that delay due to stigma can have devastating consequences. Stigma is universally experienced, isolates people, and delays treatment of mental illness, which in turn causes great social and economic burden with poor social support. Aims and Objectives: To assess and compare the social support and stigma toward individuals with bipolar affective disorder in terms of gender difference. Methods: Sixty individuals (30 male individuals and 30 female individuals) have been included from outpatients department unit of the CIP in a purposive manner as sample of the study. Semi-structured sociodemographic data sheet will be used to collect the relevant sociodemographic information followed by Social Support Questionnaire and Stigma Scale. Data collected will be analyze using Statistical Package for Social Sciences (SPSS version 16). Results: Results and implications will be discussed during the time of presentation.
Efficacy of Psychoeducation on the Children with Autism
Nupur Kumari, Anuradha Balsavar 1 ,Triptish Bhatia 2 , Smita N. Deshpande
Department of Psychiatry, 1 Central Council for Research in Ayurveda and Siddha, 2 GRIP-NIH Project, PGIMER, Dr. R.M.L. Hospital, New Delhi, India
Background: Families of children with autism have important service needs. The involvement of parents in implementing intervention strategies designed to help these children has long been accepted as helpful. The potential benefits are increased skills and reduced stress for parents as well as children. Aim: The aim of the present study is to explore the efficacy of parental psychoeducation training on the parents of children with autism. Methods: The study was conducted at PGIMER-Dr. R.M.L. Hospital. Children with autism were included in the study, and their parents were recruited for psychoeducation after informed consent. Parents of all the participants attended six bi-monthly psychoeducational intervention sessions. They were assessed on the Indian Scale for Assessment of Autism, Maladaptive Behavior Checklist, and the developmental disability-Children's Global Assessment Scale before and after 1 month of psychoeducation. Results: The age ranged between 3 and 18 years. There was n = 18 with autism. Appropriate statistical tests were used to compare pre- and post-intervention on various assessment tools. Conclusion: Psychoeducation has a wide use across various developmental disorders. Results of the study are discussed.
Social Work in Outdoor Patient Department
Medical Social Worker, Department of Critical Care Medicine, SGPGIMS, Lucknow, Uttar Pradesh, India
Background: Medical social work is one of the core areas of social work practice. The objective of medical social work is to make patients and their families self-sustaining through building their capacities. Outdoor patient department (OPD) is an important part of a hospital, dealt with patient with a health problem not required hospitalization due to their illness and receive hospital services in a regular basis by time to time medical social worker can provide social services in OPD. Medical social workers remain important role in smooth functioning of OPD and try to modify and upgrade the OPD services to fulfill patient expectation. Hence, this paper will be based on the experiences about issue and concern of the patient and their family member and formulate the role of medical social worker in the OPD in Indian setting. Results and Conclusions: This paper will be discussed in the description about OPD and highlighting the issues and concern of patients and their family in OPD. However, this will also be described the role and skills of a medical social worker in OPD.
To Examine the Disability in the Patients with Mental Disorders: A Gender Based Comparative Study
Department of Clinical Psychology, CIIMHANS Hospital, Rajnandgaon, Chhattisgarh, India
Background: Mental illness is a term that describes a broad range of mental and emotional conditions. Mental illness also refers to one portion of the broader Americans with Disabilities Act term mental impairment and is different from other covered mental impairments such as mental retardation, organic brain damage, and learning disabilities. Mental health services have been hampered by the absence of high-quality, country-specific data for the prevalence, treatment, and associated disability of different types of mental disorders. Therefore, this study will look the disability of the patients with a mental disorder in Indian setting. Objective: To examine the difference in disability between the male and female of patients with mental disorder. Research Design and Methods: The study will be a cross-sectional, hospital based and the samples will be selected through purposive sampling technique. The sample will consist of sixty (30 males and 30 females) patients with the diagnosis of mental disorder as per International Classification of Diseases-10 diagnostic criteria for research. Age of the male and female will be more than 18 years. Age, education, and family income will be matched in the both groups. Sociodemographic data and Indian Disability Evaluation and Assessment Scale will be used for the data collection. Results and Conclusion: The results of the study will be discussed at the time of presentation.
Relationship Between Supernatural and Religious Beliefs Among Older Adults
Prashant Srivastava, Manisha Kiran 1
Department of Social Work, Jamia Millia Islamia, New Delhi, 1 Department of Psychiatric Social Work, RINPAS, Ranchi, Jharkhand, India
Background: Supernatural and religious causes of events are common in Indian society. Sometimes, older adults are more likely to turn to supernatural and religious explanations for difficult events in their lives from aging to dying. As mental health involves finding a balance in all aspects of life physically, mentally, emotionally, and spiritually but this attribution disturbs their mental health and leads them to mental illness. Therefore, this study was planned to see the relationship between supernatural and religious beliefs among older adults. Aim: The present study aimed to see the relationship between supernatural and religious belief among older adults aged 60 years and more. Methods: Sixty years older adults giving written informed consent and fulfilling inclusion/exclusion criteria were included through purposive sampling. They were evaluated on Supernatural Attitude Questionnaire and Religiosity Scale. Results: Statistically significant positive correlation was found between supernatural and religiosity beliefs among both the study groups.
A Study on the Concept of Intellectual Disability - Level of Intelligence in Different Intellectually Disabled Children: Among the Parents of Intellectually Disabled Children
K. R. Ranjith, Sunita Sharma, B. S. Chavan
Department of Psychiatry, Government Medical College and Hospital, Chandigarh
Intellectual disability is one of the irreversible developmental disorders which has a negative impact on the family. The concept of intellectual disability needs to be explored in order to find out the differences among the parents on intellectually disabled children and parents of normal children as it can lead to unscientific practices in rearing the disabled child. The objective of the study was to compare the concept of intellectual disability among parents of intellectually disabled children and parents of children without intellectual disability. A descriptive research design was employed in the present study. Thirty subjects, who met the inclusion and exclusion criteria, were enrolled purposively for the study. Subjects were selected with convenient sampling method, and 15 samples were selected from parents of intellectually disabled children and 15 from parents of children without intellectual disability. Respondents from both the groups were interviewed using the semi-structured interview schedule, which has been developed after extensive review of the literature and expert opinion from professionals from the field of nursing, psychiatry, and psychology. The interview was audio recorded and later the verbatim was analyzed by extracting the meanings and clubbing into themes. The themes are then analyzed with frequency and percentage in each group and describing each theme in detail. Both the groups were homogenous with respect to the sociodemographic data. Most of the themes identified were similar in both the groups in addition to few entirely different themes.
A Gender-Based Study on Depression, Anxiety, and Stress Among School Going Adolescents
P. Rishi, S. Prashant 1 , F. Nazish
Department of Psychiatric Social Work, RINPAS, Ranchi, Jharkhand, 1 Ph.D. Scholar Maulana Azad Medical College, CDC, Jamia Millia Islamia, New Delhi, India
Background: Adolescence is a stage of development that leads a person from childhood to adulthood. It is one of the important stages in the lifespan of a human being when very rapid changes take place both physically as well as psychologically. It starts from about twelve years of age and continues through nineteen years. Adolescence is characterized by a number of cognitive, emotional, physical, and attitudinal changes, which can be a cause of conflict on hand and positive personality development on the other. Aim: To study the gender difference on depression, anxiety, and stress among school going adolescent. Materials and Methods: The sample for the study will be based on random sampling technique. The study will be carried out at the school in Ranchi District. Total number of sixty respondents (30 girls and 30 boys) in the age range of 13-17 years will select for this study. Results: Detailed results will be discussed at the presentation.
Exploring the Relationship of Quality of Life and Attitudes of Caregivers with the Quality of Care they Provide to their Children with Mental Retardation
Department of Psychiatric Social Work, CIP, Ranchi, Jharkhand, India
Background: Developmental disabilities present in the early childhood are characterized by limitations in socio-adaptive functioning and intellectual abilities. While caregiving is a normal part of being a parent, providing the high level of care required by a child with long-term functional limitations can become burdensome and may impact both physical and psychological health of caregivers. Caregiving and its related attitudes are considered to be an important aspect in determining the quality of life of caregivers. This could reflect the quality of care received by the patients in general, and in particular, the disabled. Until now, numerous researchers have assessed the quality of life and attitudes of caregivers of patients with various illnesses and ailments, including intellectual disabilities. However, by far, no research has been conducted on the quality of care received by patients including the children with mental retardation. Aim: The aim of the present study was to explore the relationship between attitude and quality of life of parents/caregivers with the quality of care they provide to their children with mental retardation. Methods: A purposive sample of 45 caregivers of children with mental retardation was taken. It comprised of 15 caregivers (both male and female) of children belonging to each category of mental retardation, i.e. mild, moderate, and severe were included. Data were analyzed using Statistical Package for Social Sciences (SPSS), version 16.0. Statistics like mean, and standard deviations along with Pearson product moment correlation, ANOVA, post hoc, and logistic regression were used for analysis. Results and Conclusions: Results indicated a positive but slight correlation of emotional over-involvement and warmth domains of attitude. A negative relationship was found between quality of care and number of critical comments, hostility, and dissatisfaction domain. A positive correlation was found between all domains quality of life and quality of life. The psychological domain, however, appeared non-significant. The variance of most subdomains of attitude occurred within the mild and severe categories of mental retardation. No significant variance was observed between the domains of emotional over involvement and dissatisfaction among the three categories of mental retardation. Analysis of variance between different categories of mental retardation and quality of life (subdomains) of their caregivers revealed that caregivers of children of different categories of mental retardation had differences in assessment of their well-being in physical, psychological, social, and environmental domains of quality of life. The variance was found in physical and environmental significant between mild and severe groups of mental retardation. In the psychological and social domains, significant variances were found among all the categories of mental retardation. The quality of life of caregivers seemed to be affected by the level of mental retardation in the child. Similarly, the quality of care provided by the caregiver was related to the category of mental retardation the child belongs to. The variance was found significant between mild and severe groups of mental retardation. Similar quality of care was provided by the caregivers of children belonging to mild and moderate categories and moderate and severe categories of mental retardation. It was also found that the attitude did not predict the quality of care provided to the child with mental retardation. However, the overall prediction of quality of life to the provision of quality of care was found to be 24.1%.
Impact of Psychosocial Intervention on Therapeutic Compliance, Social, and Occupational Functioning in Persons with Chronic Schizophrenia
Department of Clinical Psychology, PGIMER, Dr. RML Hospital, New Delhi, India
Aims and Objectives: The aim of the present study was to develop a psychosocial intervention package and to examine the effectiveness of psychosocial intervention in context to the therapeutic compliance in persons with chronic schizophrenia. The sample comprised of 100 discharged patients of schizophrenia who were diagnosed according to the International Classification of Diseases-10 (diagnostic criteria for research). From the sample size, the experimental and control groups were randomly assigned to 50 subjects each. Purposive sampling technique was applied. The pre- and post-assessment experimental design was applied. The patients and caregivers were assessed at the baseline and after 3 and 6 months of follow-up in the outdoor patient department. Tools used were sociodemographic and clinical data sheet, scale for the assessment of negative symptoms, and scale for the assessment of positive symptoms, social functioning scale, personal functioning scale, and occupational functioning scale. Chi-square was computed to see the statistically significance levels of both the groups. Results: There was a significant improvement experimental group, in positive symptoms, negative symptoms, in social functioning, personal functioning, and employment as compared to control group. Conclusion: The psychosocial intervention plays a significant role in helping the patient to maintain his day to day behavior, better therapeutic compliance, and helps in maintaining a better quality of life to both patient and family.
A Study Comparing Patients with Schizophrenia and Obsessive Compulsive Disorder on Suicidal Ideation, Level of Depression, and Quality of Life
Sobia Ansari, Piyush Prakash Singh
Department of Psychiatry, JN Medical College, AMU, Aligarh, Uttar Pradesh, India
Introduction: Schizophrenia is a chronic, severe, and disabling brain disorder that has affected people throughout history. People with this disorder may hear voices that other people do not hear. They may believe that other people are reading their minds, controlling their thoughts, or planning to harm them. This can terrify people with the illness and make them withdrawn or extremely agitated. Obsessive-compulsive disorder (OCD) is described as an anxiety disorder and has two main parts: Obsessions and compulsions. Obsessions are unwelcomed thoughts, images, urges, or doubts that repeatedly appear in patients mind. Compulsions are repetitive activities that patients feel that they have to do. Aims and Objectives: The aims and objectives of the study are to compare patients with schizophrenia and OCD on suicidal ideation, level of depression, and quality of life. Materials and Methods: Purposive sampling method was used to collect the data, and the study comprises of one hundred patients from which fifty were diagnosed as schizophrenia and fifty diagnosed as OCD with the age range lying between 18 and 60 years from inpatient/outpatient Department of Psychiatry, JNMCH, AMU. Yale-brown obsessive compulsive scale and positive and negative syndrome scale were used to assess the severity of symptoms. Columbia Suicide Inventory, Beck Depression Inventory, and WHO-quality of life were administered to assess the suicidal ideation, level of depression, and quality of life between the two groups of patients. Results and Conclusion: Will be discussed at the time of conference.
The Study of Adolescent Peer Victimization and Psychosocial Maladjustment of Tribal Santhal Children of West Bengal
Consultant, National Institute of Public Cooperation and Child Development, New Delhi, India
India is a country of diversified ethnicity about (650) tribes are present in our country. The total population of 84,326,240 tribes constitutes 8.2% of the total population of our nation. Santhals are the third largest tribes in India. In West Bengal Santhal represents, 54.2% of tribal population and are found in vast area of Purba and Paschim Medinipur, Bankura, and Purulia. The Santhal lives in remote places and is characterized by poverty and illiteracy and nutritional problem. The health status of the community remains unreported. The present study builds upon previous research (e.g., Hodges and Perry, 1999) that suggests that longitudinal relations between victimization and negative psychosocial outcomes, as well as between psychosocial maladjustment and the consequential experience of peer victimization, may be moderated by social or interpersonal factors. A total of 20 student and 7 th class who were assessed on measures of four negative personal factors (aggression/depression, withdrawal, aggression, and lack of physical strength), four interpersonal factors (peer acceptance, peer rejection, a number of reciprocated best friends, and a number of reciprocated enemies), and victimization. As expected, interpersonal factors moderated many of the longitudinal associations between the personal factors and victimization. Most notably, victimization predicted increases in internalizing behaviors (anxiety/depression and withdrawal) only under higher levels of peer rejection and number of reciprocated enemies and lower levels of peer acceptance. In addition, anxiety/depression predicted increases in victimization over time, again only under high levels of the negative interpersonal factors. These results underscore the importance of recognizing social contextual factors that promote the cyclical relations between peer victimization and psychosocial maladjustment.
Why Patients are Unwilling for Admission in a Psychiatry Ward
Sushmita Bhattacharya, B. S. Chavan
Department of Psychiatry, GMCH, Chandigarh, India
Objective: Psychiatric patients sometimes require in-patient management in view of unmanageable symptoms, or risk of suicide or homicide. But it is commonly seen that patients are afraid of admission and often refuse to get admitted in a psychiatry ward. Lack of insight into illness is although an important factor, but there are many other pertinent factors that influence a patient's perception about psychiatry ward. This study was conducted in the Department of Psychiatry, GMCH, Chandigarh to explore the reasons why patients are unwilling to get admitted in a psychiatry ward. Methods: Study was done on 15 patients visiting the psychiatry outdoor patient department who were suffering from a psychiatric illness (according to International Classification of Diseases 10 diagnosis). Eight of them were never admitted and seven had been admitted previously in psychiatry ward (in GMCH or any other in hospital). Separate questionnaires were prepared for both groups of patient. For those who have not been admitted previously, their perception about a psychiatry ward was assessed using the questionnaire. For those already admitted, the level of care received, the problems encountered during period of admission, and overall satisfaction with the ward stay was assessed. Results: Out of the eight patients who had never been admitted, six patients (75%) thought that psychiatry ward would be hostile due to the presence of other violent patients, they may have negative influence after staying with other patients, and family members may not be allowed to visit them. Five patients (62.5%) thought that they might be kept locked in a room, optimum care may not be provided, other people might become critical of them due to their admission, or they would be given medications forcefully. Four patients (50%) were of the opinion that psychiatry ward would be a dull and frightful place, they might be admitted for lengthy periods, and doctors may not give sufficient time to them. Three patients (37.5%) thought that they will miss love and affection of family members, or the treatment given to them might be painful. Two (20%) patients thought that they would be given electroconvulsive therapy and hence did not want to get admitted. Similar number of patients thought that the quality of food or cleanliness may not be up to the mark, or it would be an invasion into their privacy. Some other reasons that were stated by 12.5% (n = 1) patients were nonavailability of phone, etc., denial of illness, blaming it on family, or shortage of time/financial issues. Among the seven patients who had been previously admitted in a psychiatry ward, 4 (57%) were satisfied with the ward stay but expressed minor dissatisfaction related to confinement and not being allowed regular paroles, and lengthy periods of stay. Among those who were moderately to completely unsatisfied, the various reasons given were unclean washrooms, prolonged admission, negative impact after seeing other patients, sleep disturbance, use of physical, or chemical restraint. Twenty percent of patients (n = 2) reported that they had difficulty getting back to their normal routine after their discharge and hence would not want to get admitted. A similar number of patients thought that others were critical of them because of their psychiatry admission. Conclusion: Despite people coming forward for treatment, there are still a lot of myths and misconceptions regarding psychiatric illnesses and treatments, which affects the patient's decision to get admitted even if clinical needs warrants admission. Apart from reducing the stigma associated with illness, there is also a need to dispel some false beliefs that are present in the society regarding admission in psychiatry ward. Moreover, during admission, the staff needs to be more cautious in providing optimal care and support to these patients and their families because this can go a long way in determining and changing people's opinion about psychiatry as a whole. Doctors also need to ensure that, apart from symptom improvement, these patients get enough support so that they can adjust with their daily routine as smoothly as possible post discharge.