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   Table of Contents - Current issue
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July-December 2020
Volume 21 | Issue 2
Page Nos. 59-121

Online since Thursday, January 14, 2021

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ORIGINAL ARTICLES  

Resilience and sociooccupational functioning among caregivers of obsessive-compulsive disorder p. 59
Nithyananda S Murthy, BP Nirmala, R Dhanasekara Pandian, Y C Janardhan Reddy
DOI:10.4103/AMH.AMH_25_20  
Context: Obsessive-compulsive disorder (OCD) is known to cause significant burden to patients and their caregivers. Variables like stress, anxiety, depression, associated psychiatric co-morbidly, functionality, quality of life, family accommodation, stigma, and social support has been studied extensively, but the caregiver functionality has been overlooked. There is limited data on resilience and psycho social functioning in caregivers of OCD. Aims: The current study examines the level of socio occupational functioning and resilience in caregivers of persons with obsessivecompulsive disorder (OCD). Settings and design: In our study 200 DSM5 OCD adult patients evaluated using Mini International Neuropsychiatric Interview (MINI) and the Yale-Brown Obsessive-Compulsive Scale (YBOCS) and their healthy primary caregivers were recruited in OCD clinic NIMHANS. Material and Methods: Caregivers were evaluated using the socio-demographic MINI, Resilience and Socio-Occupational Functioning Assessment Scale (SOFAS), in a cross-sectional interview. Statistics: Means and Standard Deviations (SD) were calculated for continuous variables; frequencies and percentages for categorical variables, for descriptive analyses. Shapiro-Wilk test was used to test the normality of data. Based on the distribution of the data, Pearson Correlation tests were used. Results: Patients had a mean YBOCS score of 25.8 (±5.4), 118/200(59%) had contamination/washing as the principle symptom. Caregivers of the OCD adult patients had varied levels of (17.22±9.09) resilience and moderate to severe impairment in (55.67±16.53) socio occupational functioning. Conclusions: Study result shows that higher the resilience better the socio occupational functioning in caregivers. Promoting a resilient coping style in caregivers would increase their socio occupational functioning.
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Coping, resilience, and hopefulness among women survivors of Intimate Partner Violence (IPV) p. 65
KS Shilpa, LN Suman
DOI:10.4103/AMH.AMH_42_20  
Context: Intimate partner violence (IPV) is the most common form of violence experienced by women. This can take the form of physical, sexual, financial, and emotional violence. The short-term as well as long-term consequences of IPV are significant. Aims: To examine trauma-specific coping self-efficacy, resilience, and hopefulness following IPV among women in short stay shelter homes. Settings and Design: The sample consisted of 30 women aged between 19 and 56 years from three shelter homes in Bengaluru, India. Materials and Methods: A sociodemographic data sheet along with four scales, Kessler's Psychological Distress Scale (K-10), Trauma Coping Self-Efficacy (CSE) Scale (CSE-T), Connor–Davidson Resilience Scale, and Adult Hope Scale (AHS), were administered to the participants of the study. Statistical Analysis Used: The data were analyzed using descriptive and inferential statistics to describe the sample and examine the interrelationships among the variables. Results: There was a significant negative relationship (r = −0.489) between level of distress and trauma CSE. A significant positive relationship (r = 0.524) was found between trauma CSE and resilience. There were also significant positive relationships (r = 0.618) among trauma CSE and goal-directed determination and pathways (AHS agency and pathways). Conclusions: The study helps in understanding the risk for psychopathology among these women as well as in indicating measures to be taken in devising psychosocial interventions for women who have experienced IPV. The details of the study and its implications are discussed.
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Online gaming and its association with emotional and behavioral problems among adolescents – A study from Northeast India Highly accessed article p. 71
Abhijeet Singh, Arif Ali, Maria Choudhury, Nilesh Maruti Gujar
DOI:10.4103/AMH.AMH_20_20  
Context: Online game addiction has emerged as a public health concern. Effects of online game addiction on physical and mental health are well documented. Aim: The aim of this study was to find the prevalence of online game addiction and to see its correlation with emotional and behavioral problems among adolescents. Methods: This was a cross-sectional descriptive study conducted at two schools from Sonitpur and Kamrup districts of Assam using a convenience sampling technique. Total enumeration method was used to recruit a total of 415 respondents (standard 8th, 9th, and 10th), out of which only 409 respondents were taken for final analysis. Sociodemographic datasheet, Strengths and Difficulties Questionnaire, Online Gaming Addiction Scale, and Short Self-Regulation Scale (SSRQ) were administered. The study was approved by the Scientific Committee and Institute Ethics Committee of LGBRIMH, Tezpur. Results: Online gaming behavior was found to have a significant positive correlation with emotional problem (r = 0.392, P = 0.01), conduct problem (r = 0.484, P = 0.01), hyperactivity problem (r = 0.335, P = 0.01), peer problem (r = 0.355, P = 0.01), and difficulty score (r = 0.506, P = 0.01). Online gaming showed a negative correlation with SSRQ (r = 0.0160, P = 0.01). Emotional problem (B = 1.139, t = 3.024, P = 0.001), conduct problem (B = 2.163, t = 5.661, P = 0.001), and total difficulty score (B = 1.196, t = 11.630, P = 0.001) contributed significantly to the prediction of online gaming addiction among adolescents (F[6,402] = 27.261, P = 0.001) accounting for 2.89% of variance. Conclusion: Online gaming behavior was found to have an association with emotional and behavioral problems among adolescents. Psychosocial interventions at individual and family levels can enhance self-regulation and control online gaming addiction among adolescents.
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Stigma and discrimination among doctors toward health-care staff working at COVID-19 sites p. 77
Nirav Bhupendrabhai Chanpa, Ilesh Kotecha, Parveen Kumar, Deepak Sachinand Tiwari, Disha Alkeshbhai Vasavada, Renish Bhupenderabhai Bhatt
DOI:10.4103/AMH.AMH_48_20  
Background: Different infectious disease outbreaks such as bubonic plague, Asiatic flu, cholera, Middle East respiratory syndrome, and Ebola have been associated with polarization, racism, blame, and resultant psychological distress. Health-care providers involved in managing the COVID-19 crisis face challenges such as stigma and discrimination. Aim: The current study is aimed to explore stigma and discrimination related to COVID-19 among healthcare workers. Methods: A cross-sectional study was carried out during April and May 2020. Doctors working at health-care facility were approached and requested to fill semi-structured pro forma containing the following parts: (1) Demographic details of participants, (2) Brief Illness Perception Questionnaire 5 (BIPQ-5), (3) Physical Distance and Discrimination Questionnaire, (4) Avoidance Questionnaire, (5) feeling thermometer toward a person having COVID, HIV, TB, Swine flu. Statistical Analysis: Data entry and analysis was performed using Microsoft excel and SPSS 26 version software. Independent t-test was used to compare the mean and standard deviation of the BIPQ score, physical distance, and discrimination questionnaire score with various demographic variables and avoidance questionnaire. Results: A total of 323 doctors participated in the study. Out of which 51.39% reports that it is necessary to avoid persons and 30.60% have a problem if a person eats in mess/canteen when working in COVID-19 care. Participants living with family members have statistically significant (P < 0.001) a higher score on the BIPQ, and Physical Distancing and Discrimination Questionnaire. A significant positive correlation (r = 0.162, P = 0.004) of brief illness of perception with physical distancing and discrimination score. Conclusion: The study found a high threat perception of COVID-19 as well as stigma and discrimination within health-care staff. The stigma and discrimination for COVID-19 are more than other illnesses such as swine flu, tuberculosis, and HIV. This can result in the work compliance and management strategies of health-care workers.
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Depression and quality of life among family caregivers of Stroke Survivors in Ghana: The role of social support p. 83
Doreen Asantewa Abeasi
DOI:10.4103/AMH.AMH_21_19  
Introduction: Stroke is a concern for global health policymakers because surviving stroke negatively affects the survivors and their caregivers. A good proportion of its survivors are left to battle with residual functional impairments, who often require long-term support care from family members who are usually ill-prepared for their caregiving role. Thus, this study examined depression and quality of life (QOL) among family caregivers of stroke survivors and the role of social support. Methods: A sample of 50 caregivers and 50 noncaregivers were conveniently selected using a cross-sectional research design at the Korle-Bu Teaching Hospital. Depression, QOL and social support were measured using Beck Depression Inventory-II, WHOQOL-BREF, and the Multidimensional scale of perceived social support. Multiple analyses of variance, independent t-test, and Pearson's r test were used to analyze data. Results: Caregivers of stroke patients reported higher levels of depression (M = 8.94, standard deviation [SD] = 5.34) than noncaregivers (M = 3.48, SD = 4.81) which was statistically significant at ρ < 0.05. Caregivers also reported poorer QOL (M = 79.52, SD = 12.04) compared to noncaregivers (M = 88.70, SD = 11.19) which was statistically significant at ρ < 0.05. There was a strong relationship between depression and QOL (r (48) = −0.66, ρ < 0.05), social support and depression (r (48) = −0.60, ρ < 0.05), social support and QOL (r (48) = 0.56, ρ < 0.05). Conclusion: Caregivers experienced significant depressive symptoms and low QOL than noncaregivers. There was a significant relationship between depression, quality of life, and social support.
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Stressors among medical college undergraduates p. 90
N Gyan Nihal, Pramod K. R. Mallepalli, Ravulapati Sateesh Babu, Manjula Sakamudi
DOI:10.4103/AMH.AMH_15_20  
Background: Medical colleges are accountable for training medical students to have sound knowledge and ability before they take up the professional responsibilities. Therefore, medical colleges typically use a curriculum of orations, simulations supervised practice, mentoring, and hands-on experience to enhance undergraduate's skill. In such a process unfortunately few areas of the training process have unintentional negative effects on student's physical and mental health. Aims and Objectives: The aim of this study is to assess stressors among medical undergraduate students. The objectives of this study are i. To compare stressors among government medical college. Undergraduates and private medical college undergraduates. ii. To compare stressors among gender. iii. To compare stressors among various years of study. Materials and Methods: This cross-sectional study consisted a sample size of 1568 participants who are undergraduate students from various medical colleges across India. The samples were drawn using convenience sampling method. The Medical Student Stressor Questionnaire (MSSQ) was the tool used to collect data for this study. Results: Academic Related Stressors (Mean score = 2.156) was higher in medical college undergraduates followed by teaching and learning related stressors, group activities related stressor, Interpersonal and intrapersonal related stressors, social related stressors and Drive and desire related stressors with mean scores of 1.711, 1707, 1.599, 1.385 and 1.243 respectively. Conclusions: Academic stress was the most broadly source of stress found and thus most often contributed to overall stress scores. Females show more stress as compared to males. Private medical college undergraduates had more medical stress compared to government medical undergraduates. Final year undergraduates had more medical stress followed by first year. This needs attention towards curriculum change process in medical education.
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Assessment of psychiatric variables in geriatric patients diagnosed with different types of osteoarthritis: Radiographic-based evidences p. 95
Shravani Komuravelly, Surishika Reddy Chevireddy, Ramkumar Reddy Katam, Sharavanabhava Bandaru, Vasudevamurthy Sindgi, Venkateshwarlu Eggadi
DOI:10.4103/AMH.AMH_35_20  
Context: Osteoarthritis (OA) is the most prevalent musculoskeletal condition in the world and is the most common cause of joint disability in approximately 15% of the total world population. The severity of the disease increases with age. It can have adverse effects on mental stability and is associated with poor clinical prognosis. Aim: The aim of the study is to assess psychiatric variables (depression, anxiety, and perceived stress) in geriatric patients diagnosed with OA based on radiographic evidence and the item(s)/question(s) from questionnaires influencing their emotional instability. Settings and Design: The prospective observational study was conducted in a tertiary care Mahatma Gandhi Memorial Hospital, Warangal. Subjects and Methods: The study conducted for a period of 6 months and encompasses 158 elders with different types of OA. Standardized questionnaires were used to assess psychiatric variables. Statistical Analysis Used: Statistical analysis was conducted using Microsoft Excel 2019 and IBM SPSS Statistics for Windows, Version 22.0. (IBM Corp, Armonk, NY, USA). Results: The results of Pillai's trace revealed the scores of depression and anxiety as severe and perceived stress as moderate. Linear logistic regression stepwise disclosed the order of included variables affecting depression, anxiety, and perceived stress based on their level of significance (P < 0.05). Conclusion: The findings in our study exemplify a strong correlation between psychiatric variables and OA.
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BRIEF REPORT Top

Psychological distress during early phase of COVID-19 pandemic among Indian adults p. 101
Aditya Somani, Suhas Chandran, Ashirbad Satapathy, Ajay Kumar, Azhar Mahmood Farooqui, Johnson Pradeep, Priya Sreedaran, Debasweta Purkayastha
DOI:10.4103/AMH.AMH_53_20  
Introduction: Novel coronavirus disease (COVID-19) pandemic and resultant lockdown are likely to cause a significant negative impact on mental health of people all over the world. Aim: To assess psychological distress due to COVID-19 pandemic among Indian adults and its possible correlates. Subjects and Methods: An online survey using nonprobability snowball sampling technique was carried out. The survey included willing adult residents of India with access to internet. Health-care professionals, people with COVID-19 or those with a relative having COVID-19, and those receiving treatment for any psychiatric disorder currently were excluded. Psychological distress was assessed using COVID-19 Peritraumatic Distress Index (CPDI). Results: Majority of participants were young (age group, 18–40 years) (71.8%), males (72%), married (69.9%), graduate (51.8%), and semiprofessionals and professionals (56.5%). Majority of the participants did not have family members of age up to 5 years or less (64.8%) or age 60 years and above (61.9%) in their families. There was no COVID-19-positive patient in town or district of majority of participants (53.9%). Based on CPDI score, 22% of the participants had mild psychological distress and 1.6% had severe distress. CPDI score showed a positive correlation with size of family of participants. Other demographic variables did not show any association/correlation with CPDI score. Conclusions: Nearly a quarter of participants were found to have psychological distress due to COVID-19 pandemic. Anxiety and psychological distress might worsen with further worsening of pandemic and downfall of global economy. It is imperative to implement preventive and early intervention measures to safeguard mental health of people.
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REVIEW ARTICLES Top

The role of trace elements in Alzheimer's disease p. 107
Sujeetha Purushothaman, Aashika Ragavi, Preethi Basavaraju, Puthamohan Vinayaga Moorthi, Arumugam Vijaya Anand
DOI:10.4103/AMH.AMH_18_20  
Alzheimer's disease is a degenerative brain disease and the most common cause of dementia. The characteristic symptoms of dementia are difficulties with memory, language, problem solving, and other cognitive skills which affects a person's ability to perform everyday activities. Trace elements have found to play a major role in the Alzheimer's disease. Nowadays, the association of trace elements in the pathogenesis of Alzheimer's disease is more considered, and trace elements such as aluminum (Al), iron (Fe), copper (Cu), and zinc (Zn) imbalances in the amyloid beta peptides have been seen in the Alzheimer's disease This review focuses on the accumulation of trace elements aluminum (Al), copper (Cu), iron (Fe), and zinc (Zn) in the pathogenesis of Alzheimer's disease.
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Let's fight against the ailment not the ailing p. 112
Janmejaya Samal
DOI:10.4103/AMH.AMH_23_20  
Coronavirus disease-19 (COVID-19) is a global crisis and has crippled the entire humankind throughout the globe. More than 200 countries in the globe are under the clutch of this pandemic. Apart from creating medical and public health problems, it has created a plethora of social problems in the globe. As a new disease, inadequate and inaccurate information has created havoc in the global community. This in turn has created social stigma and discrimination across the globe irrespective of social strata, geographical distribution, level of education, and economic status. The stigma and discrimination has vehemently affected the efforts to fight against COVID-19 such as containment measures, health-care provision, prevention, and control measures. This disease has peculiarly created stigma and discrimination among both the recipients and providers of health-care services. The stigma and discrimination continue to prevail in societies for both these categories. It is imperative that society should understand the significance of this disease and the role of stigma and discrimination mitigation to win the war against COVID-19.
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CASE REPORTS Top

Lobe-specific neuropsychiatric manifestation of neurocysticercosis p. 116
Arun Selvaraj, Vinoth Krishna Dass, Lakshmi Sanjay
DOI:10.4103/AMH.AMH_32_20  
Neurocysticercosis (NCC), an infectious disease has got polymorphic clinical features. Neuropsychiatric manifestation of NCC is a rare presentation, always misleads the diagnosis. A 43-year-old male, nonvegetarian presented with 1-month history of visual hallucination associated with wandering, muttering to self, irritability and suicidal ideas. Onset of symptoms was sudden and progressive in nature. Mental Status Examination revealed mild cognitive impairment (MCI). Magnetic resonance imaging showed calcified lesions of size 6–7 mm in left parietal and occipital lobe in gray-white matter junction. NCC often present with neurological features of the seizure (79%) and headaches (38%). In neuropsychiatric manifestation, depression was the most common presentation. This case report has highlighted a case presenting with psychotic features, a rare phenomenon of rare neuropsychiatric manifestation of NCC. The neuropsychiatric symptoms right-sided monocular visual hallucination and the MCI were found to be related to the prominent lesions in occipito-parietal lobe of the left hemisphere. Lobar-specific neuropsychiatric manifestation can be a presenting feature of NCC without any common neurological symptoms.
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Atypical presentation of bipolar disorder in adolescent p. 119
Pankaj Mahal, Pratibha Gehlawat, Tanu Gupta
DOI:10.4103/AMH.AMH_40_20  
Mood disorders in children account for a significant amount of disability. However due to varied presentation of symptoms and subsyndromal episodes among children and adolescents, it is often difficult to correctly diagnose mood disorders. We are presenting a case of an adolescent male with atypical mood symptoms and highlighting on the difficulties faced in the diagnosis and the challenges in his management.
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