Introduction: Worldwide, the morbidity of psychiatric illnesses is on the rise. Quality in-patient services are a part of quality mental health services provision. Knowledge about the pattern of illness among patients admitted to the ward could help the service providers to plan better and provide better services. This study was undertaken to explore the clinico-demographic profile of patients admitted to psychiatric ward at BPKIHS..Material And Method: This is a hospital based retrospective and cross-sectional study. After ethical approval from the Institutional Review Committee, the data of all patients admitted to Psychiatry Ward from 1st January 2007 to 31st December 2016 were collected from the data-base of Medical Records Section. The diagnoses were made according to the ICD-10 criteria. 3687 admissions were processed for the analysis.Results: Of the 3687 admissions, 2183(59.2%) were male and 1504 (40.8%) were female. The age range was 4-92 years with mean age of 32.4(±12.6) years. The majority of the admissions (62.5%) were from Sunsari (1159,31.4%) and surrounding districts (1147,31.1%). Mood disorders were the commonest diagnoses 1788(48.5%) followed by schizophrenia, schizotypal and delusional disorders 829(22.5%) and psychoactive substance use disorders 813(22.1). 92% of patients admitted were improved on discharge and three cases expired in the ward. Out of 3687 admissions, 957(26%) were readmissions.Conclusion: Mood disorders were the commonest diagnosis among the admitted patients. Outcome of hospital stay was good with 92% discharged in improved condition and only three mortalities in 10 years duration. Address seems to significantly affect the service utilization. J Psychiatrists’ Association of Nepal Vol. 6, No. 2, 2017, Page: 15-21

Introduction:The length of stay among psychiatric in-patients is usually longer than that of others. Inpatient management is costly and longer length of stay can lead to catastrophic costs. We conducted this study to explore about the length of stay of psychiatric admissions and factors affecting it. Methods:We collected the data of all the patients admitted to the psychiatric ward of B. P. Koirala Institute of Health Sciences from 1 st January 2007 to 31 st December 2016 from the database of the medical records section after ethical approval. The sociodemographic and clinical variables were analyzed using SPSS 20.0 version. Length of stay more than 3 weeks was considered as long stay. Bivariate and multivariable logistic regression analyses were conducted to identify factors associated with length of stay.Results: There were 3687 admissions during the study period. The average length of stay was 19.36 (±13.14) days. On logistic regression, the factors associated with shorter length of stay were: male gender (aOR= 0.79, 95%CI: 0.68-0.93), being self employed (aOR= 0.17, 95%CI: 0.12-0.22), homemakers (aOR= 0.18, 95%CI: 0.14-0.24), farmers (aOR= 0.20, 95%CI: 0.15-0.27) and students (aOR= 0.23, 95%CI:0.17-0.32). Similarly, factors associated with longer length of stay were: being from other Eastern Terai districts(aOR=1.37, 95%CI: 1.11-1.70), other Eastern Hill districts (aOR= 1.68; 95%CI: 1.29-2.20), diagnosis of schizophrenia and related disorders (aOR=4.01, 95%CI: 1.34-12.0), having medical co-morbidity (aOR= 3.47; 95%CI: 2.49-4.84) and being readmitted (aOR= 1.23, 95%CI: 1.03-1.47). Conclusions:There was significant association of length of stay with gender, age, address, occupation, diagnosis and readmission. _______________________________________________________________________________________

Introduction: Nicotine dependent individuals among the tobacco users are in greater risk of having tobacco related disease and psychiatric co-morbidities. There is little information about the tobacco use and nicotine dependence among psychiatric patients in developing countries including Nepal. This study was done to estimate the prevalence of tobacco use, the level of nicotine dependence among the users and the psychiatric disorder specific prevalence among tobacco users admitted in psychiatry ward.Material And Method: A cross-sectional study was conducted in In-patient setting of Department of Psychiatry, BPKIHS. Ninety cases (size) were enrolled. The Fagerström Test for Nicotine Dependence (FTND) was applied to assess the level of nicotine dependence and the Mini International Neuropsychiatric Interview (M.I.N.I.) for diagnosis of Psychiatric disorders.Results: The prevalence of tobacco use was 62.2%. Tobacco use was more common among males (p value< 0.05).Smokeless form was the commonest form of tobacco. Majority of tobacco users had moderate nicotine dependence and had started the use in adolescence and in their 20s. Psychotic disorders were the most common diagnosis among the admitted patients.Conclusion: Tobacco use is common in patients with psychiatric disorders. Nicotine dependence should be looked into for holistic management. Treatment approaches should be tailored in tobacco users with comorbid psychiatric disorders, as this specific population has high prevalence of tobacco use and higher nicotine dependence. J Psychiatrists’ Association of Nepal Vol. 6, No. 2, 2017, Page: 54-59

Wilson's disease is an autosomal recessive disease of abnormal copper metabolism. Psychosis is a rare manifestation of Wilson's disease. Few cases of misdiagnosing Wilson's disease as an etiology of psychosis were reported in the literature. We report a case of a 42-year-old patient, who was diagnosed with a schizoaffective disorder and treated with antipsychotics for 3 years with no significant improvement. On reevaluation, we the patient was diagnosed to have Wilson's disease. The patient's symptoms improved significantly with chelation therapy.

Background: Assessment of nicotine dependence among tobacco users is essential as highly dependent individuals have greater risk of developing tobacco related physical and psychiatric problems. There is little information about the tobacco use and nicotine dependence among psychiatric patients in developing countries, including Nepal. Objectives: To estimate the prevalence of tobacco use, the level of nicotine dependence and the psychiatric disorder specific prevalence among tobacco users visiting a psychiatry out-patient department. Materials and methods: A cross-sectional study was conducted in Out-patient setting of Department of Psychiatry, B. P. Koirala Institute of Health Sciences (BPKIHS). Ninety cases (calculated sample size) were enrolled. The Fagerström Test for Nicotine Dependence (FTND) was applied to assess the level of nicotine dependence and the Mini International Neuropsychiatric Interview (MINI) for diagnosis of Psychiatric disorders. Results: The prevalence of tobacco use was 55.6%. Tobacco use was more common among males (pvalue < 0.05). Smokeless form was the common form of tobacco. Majority of them had started their consumption in their adolescence. Most users had moderate nicotine dependence. Major depressive disorder and Alcohol dependence were the most common diagnoses among tobacco users. Conclusion: More than half of the psychiatry out-patients consumed tobacco. Future studies that help to understand the relationship and possible mechanism of increased tobacco use in patients with psychiatry disorders are required. Tobacco control and prevention strategies should be initiated targeting vulnerable populations such as male gender and adolescent.