Postpartum psychosis (PPP) is a severe psychiatric condition requiring rapid restoration of health in view of significant risks to both mother and the infant. Electroconvulsive therapy (ECT) is often used for treatment of severe PPP. The aims of the study were to describe the indications for ECT among women admitted with PPP to a psychiatric hospital in India. It also aimed at assessing whether women with PPP who received ECT differed in their clinical history, diagnosis, severity of illness, psychopathology, drug dosage, and duration of hospital stay, compared to women who did not receive ECT. Infants of mothers who were breast-feeding their infants while receiving ECT were assessed for adverse effects. This was a naturalistic prospective study of 78 women admitted with PPP, 34 (43.6 %) of whom received ECT. Presence of catatonia, augmentation of medications, and suicidality were common indications for ECT. Catatonic symptoms were significantly higher among women who received ECT. There was no significant difference in duration of hospitalization or severity of psychopathology between women who did and did not receive ECT. Transient side effects to ECT were observed in few women, with no adverse effects noted in infants who were breast-fed. The current study supports the use of ECT as an effective and safe treatment for women with severe PPP.

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Dextropropoxyphene (DPP), a weak opioid, is often abused as a psychoactive substance. In this retrospective chart review to document, characterize and put in perspective the often-obtained history of epileptic seizures in patients with DPP abuse, we analyzed the case files of all patients with DPP abuse registered in our center (a tertiary-care drug de-addiction clinic in north India) from May 1, 2001 until April 30, 2007 and those with use of other opioids during the same period. Non-drug-related seizures were excluded from analysis. Out of 312 patients with DPP abuse, 63 (20.2%) had epileptic seizures related to DPP use, in contrast to 0.4% -4.2% of other opioid users. The seizures were mostly characterized as generalized tonic-clonic seizures (87.3%), occurring around two hours following a higher-than-usual dose of DPP. Those with seizures had significantly greater duration of DPP use and higher rates of medical comorbidity compared to patients without seizure. Age, duration of use and medical comorbidity were better predictors of seizure than dosage of drug or use of multiple drugs. Thus, DPP-induced epileptic seizures are common (one in five), and much more frequent than seizures in patients using other opioids. The awareness of this phenomenon has implications for diagnosis and management, as well as for drug regulation policy.

Lithium is well recognized mood stabilizer and state of the art treatment for bipolar affective disorder. Monitoring serum levels of lithium is recommended for long-term lithium prophylaxis. There are reports of lithium induced neurotoxicity at therapeutic doses. We describe a case report of a lady with bipolar affective disorder who was maintaining well for 4 years on lithium and sub-acutely developed myeloradiculopathy for which extensive work up revealed normal serum lithium with reduced vitamin B12 and Folate.

Background: Personality disorders (PDs) are often influenced by early circumstances such as parenting. Parenting remains a subjective experience which has not been well studied in the context of PDs from the perspectives of parents and their children. Aims: This study examined the parenting styles in the form of perceived parenting in youth with borderline PD (BPD) and parenting experiences of their parents. Settings and Design: We employed a mixed-methods cross-sectional study design to assess youth aged between 16 and 24 years diagnosed with BPD and their parents, who sought treatment at a tertiary care psychiatric hospital. Methods: Youth (n = 5) and their parents (n = 8) were assessed on the Structured Clinical Interview for DSM 5 for PD, MINI International Neuropsychiatric Interview 7.0.2, and the Parenting Styles and Dimensions Questionnaire – Short Form. Two youth and two parents from the primary sample were selected for a semi-structured interview on parenting. Statistical Analysis: Parenting style scores were analyzed through descriptive statistics. Thematic analysis was used to interpret the interview data. Results: Youth with BPD perceived parenting as authoritarian and scored their parents lowest on the autonomy-granting dimension of authoritative parenting style. Verbal hostility was scored highest for parents. Parents of youth with BPD perceived their parenting style as authoritative, viewing themselves as warm and supportive. In the interviews, youth reported high criticality; they expressed dissatisfaction with parenting styles and need for support. The parents reported the negative influence of marital discord on parenting styles, and the need for open communication. Conclusions: Parenting styles are perceived differently by youth with BPD and their parents. Presence of psychopathology and individual personality traits of both youth and parents seem to play an important role in determining parenting, which needs further exploration.