Background: Preliminary studies suggest a multidimensional relationship of mood pathology with endocrine disturbances. Studies have found an increased risk of mood disorders in polycystic ovary syndrome (PCOS), and conversely, many of the medications commonly used in the treatment of bipolar affective disorder (BPAD) can have deleterious effects on blood levels of reproductive hormones and consequently on the hypothalamic–pituitary–gonadal (HPG) axis and reproductive function. Furthermore, there is evidence of reproductive dysfunction in women with BPAD before treatment. Objectives: To assess the comorbidity of PCOS in patients of BPAD and to study risk factors associated with this comorbidity. Materials and Methods: Two hundred female patients with the Diagnostic and Statistical Manual of Mental Disorders, 4 th Edition diagnosis of BPAD, between ages of 15 and 45 years, were evaluated by an endocrinologist. Patients reporting menstrual disturbances or having any stigmata of PCOS were further subjected to hormonal analysis, which included luteinizing hormone, follicle-stimulating hormone, prolactin, and testosterone, in the early follicular phase of menstrual cycle. Diagnosis of PCOS was made as per the NIH criteria. Results: Of 200 patients, 46 (23%) were diagnosed as having PCOS. Forty-five percent ( n = 90) reported menstrual disturbances while 27% ( n = 54) had polycystic ovaries on ultrasonography. 19.2% of the patients diagnosed as PCOS had a history of valproate intake while 27.90% patients had no such history ( P = 0.15). No significant difference ( P = 0.07) was found in the prevalence of PCOS among various drug groups (including group on multiple mood stabilizers). Conclusion: A higher prevalence of PCOS is seen in BPAD, irrespective of pharmacotherapy, suggesting a common link between the disorders which might be in the form of disturbance in HPG axis.
Background: Conversion (functional neurological symptom) disorder refers to patients who have neurological symptoms in the absence of neurological disease, encompassing one or more symptoms of altered voluntary motor or sensory function. Aim of the study was to study the demographic and clinical characteristics of patients with conversion disorder.Methods: The study population comprised all the patients (both inpatients and outpatients) of conversion disorder attending department of psychiatry, government medical college Srinagar over a period of 6 months who fulfilled the inclusion criteria of the study were evaluated on a semi-structured proforma for demographic variables and clinical characteristics.Results: A total of 76 patients of conversion disorder were included in our study. Conversion disorder is more common in age group of 20-29 years (52.6%), females (93.4%) and among students (71.1%) belonging to rural background. Motor symptoms were the predominant presentation with pseudo seizure (69.7%) being the commonest. A majority of the patients had an obvious psychosocial stressor, of which family-related (36.8%) and relationship- related (15.8%) problems accounted for the major types.Conclusions: Conversion disorders are commonly seen in young adult females, students and in those from rural background. They are mostly preceded by psychosocial stressors.
Background: Hepatitis B and C are chronic diseases with mental and social impacts which can result in poor quality of life. The routes of transmission and lack of education among the masses may cause stigmatisation of the affected patients. The aim of the study was to document the stigmatisation among chronic hepatitis B and C positive patients. Methods: The 242 patients suffering from hepatitis B and C were included in the study. Stigma experienced from relatives, friends, spouse and health care providers was assessed using a semi structured questionnaire. Results: Majority of the patients were males 174 (72%). The 162 (67%) were hepatitis B infected and 76 (32%) were Hepatitis C infected and 4 were dual infected. Male patients were significantly more affected than females in term of changes in lifestyle (86% versus 61%) and changes in relationship with the spouse (89% versus 16%). Significantly more females than males reported feelings of loneliness and isolation (64% versus 30%). Stigma was marked in terms of disease transmission, with 170 (70%) of patients fearing that they could transmit the infection to others. Marital relationships were affected for 52% of married patients. Around 80% unmarried patients were experiencing delay in getting married. Conclusions: Patients comments showed a sense of family and societal discrimination resulting in feelings of disappointment which could be changed by educational interventions, effective patient and family centric awareness and scientific models of approach.
BACKGROUND: Intentional self-harm (ISH) is one of the most important entities of consultation-liaison psychiatry. This study aimed to assess the clinical profile of individuals with intentional self-harm referred to consultation-liaison (CL) psychiatric services in a tertiary care hospital. MATERIALS AND METHODS: The present study was a cross-sectional hospital-based study, in which purposive sampling was done for sample selection. A total of 60 subjects of ISH referred for evaluation in a tertiary care psychiatry hospital on specified days were recruited to the study after obtaining informed consent. Demographic and clinical details such as the nature of the self-harm attempt, method of attempt, number of attempts, the reason for the attempt, and regret/remorse about the attempt were documented using the semi-structured proforma. RESULTS: A total of 60 subjects were included in the study. About 80% of them were below the age of 30 years. The majority (80%) were females, 65% were from a rural background, 56.7% were married. The most common method of ISH was self-poisoning. Interpersonal conflicts with family members (50%), followed by interpersonal conflicts with the spouse/partner (21.7%) were the commonest reason/precipitating factors that lead to intentional self-harm. Also, 45% of our study population did not have any diagnosable psychiatric illness at the time of assessment, and the most common psychiatric diagnosis was personality disorders (20%). CONCLUSION: Intentional self-harm is common in young married females from rural backgrounds. Self-poisoning is the most common method of deliberate self-harm. More than half of the individuals were diagnosed with the psychiatric illness at presentation.
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