Indian Journal of Psychiatric Social Work
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Experiences of Stigma among Outpatients with Psychotic Illnesses in a Tertiary Hospital
Get PDFBackground: Studies in most parts of the world, which have included persons with a mental illness in general and those with psychotic illnesses in particular conclusively show that they experience being stigmatized. These responses are seen as a major obstacle to recovery limiting opportunities and undermining self-esteem of people with mental illnesses. There is a conspicuous absence of this in the Indian context. This study assessed the nature and degree of stigma experienced by the persons with a psychotic disorder and examined its relationship with various clinical and demographic characteristics. Methods: The sample comprised of 100 consecutive remitted adults with a psychotic disorder as per DCR, ICD-10 attending outpatient services. Stigma was assessed using Wahl’s self-administered stigma questionnaire. After computing a composite score, groups experiencing ‘high’ stigma were differentiated from those having ‘low’ stigma scores on the basis of the median. Results: Results showed that participants tend to conceal their disorders, worry of being treated unfavorably, were treated as less competent and experienced offensive media portrayals of mental illness. Lower educational levels and history of psychiatric illness in the family significantly related with higher degrees of stigma. Conclusions: The findings of this study may be seen as a serious call for sustained attention to issues related to stigma as a central and powerful experience among those with a psychotic illness in the Indian context. Those who have another family member suffering from a psychiatric illness, and having lower levels of education should be particularly assessed and managed for stigma during routine outpatient evaluations.
Keywords: Stigmatizing experiences, psychosis, outpatients, tertiary hospita
A Study of Academic Anxiety and School Adjustment among Adolescents
Get PDFBackground: Adolescence is a stage with tremendous pressure and stress. Adolescents are expected to perform at every front, the main one being academics. Academic anxiety is a feeling of being fearful or stressed due to school pressures. School adjustment is a procedure that brings a person's behaviour in compliance with the norms of the school; it comprises academic, social and emotional adjustment. Aims: The present study aims to examine the level of academic anxiety and school adjustment among the school going adolescent girls and boys residing in orphanages and ones with their families. The gender differences were also examined. Methodology: A total of 60 school going adolescent girls and boys aged 14-18 years residing in orphanages and a controlled group of adolescents living with families matched on the basis of age, gender and school were selected as sample for the study. A self-constructed interview schedule was used to examine the socio-demographic profile of the respondents, Academic Anxiety Scale for Children by Singh and Sengupta and Adjustment Inventory for school students by Sinha & Singh were used. Results & Conclusion: The results showed that the adolescents residing in orphanages had lower academic anxiety than the ones living with their families and scores of adolescent girls were higher than the boys. The scores on school adjustment showed that the adolescents living with families had significantly better school adjustment than the ones living in the orphanages and overall the girls had lower adjustment level than the boys.
Keywords: Adolescents, orphanages, academic anxiety, school adjustmen
Expressed Emotion and Social Support in Rehospitalized Psychiatric Patients
Get PDFBackground: The phenomenon of hospital readmission of the psychiatric patient has been a matter of concern ever since the concepts of deinstitutionalization and community care of these patients have been emphasized. There are pieces of evidence from the literature that the readmission rate has been increasing substantially. The role of psychiatric hospitals has shifted dramatically. Inpatient programs are now focused on acute stabilization, leaving most treatment to community based providers. Aim: Aim of the study is to assess the psychosocial aspects of re-hospitalization of psychiatric patients namely Bipolar Affective Disorder and Schizophrenia and difference between both the groups. Methods: On the basis of purposive sampling 100 re-hospitalized (50 Bipolar Affective Disorder and 50 Schizophrenia) patients were taken from inpatient IMH, Rohtak. The socio-demographic data sheet was filled-up for assessment of socio-cultural aspects, social support questionnaire was administered for the assessment of the level of social support and attitude questionnaire was applied on the caregivers for assessment of the level expressed emotion. Results: Most of the re-hospitalized Schizophrenia patients face a high level of expressed emotion and poor social support in comparison to Bipolar Affective Disorder patients. Conclusion: The findings of the study illustrate that high expressed emotion and poor social support are associated with rehospitalization.
Keywords: Expressed emotion, social support, rehospitalizatio
Half-Widows in Kashmir: A Psychosocial Study
Get PDFIntroduction: Disappearance or enforced disappearance happens when a person comes in contact with an armed group (state and non-state), he is taken into custody against his/her will and his whereabouts become unknown. This phenomenon is very common in conflict situations. It has been experienced in all countries facing the conflict between security forces of the state and anti-state militants. Likewise, in Kashmir, the Armed Conflict situation from the year 1989 has resulted in many enforced disappearances. Methodology: Mixed methodology was adopted wherein both qualitative and quantitative methods of data collection was used. The data for the study was collected from half-widows (N=109) hailing from District Baramulla of Kashmir valley using a purposive sampling method. The psychological issues were studied using Trauma Symptom Check-List-40 and in-depth interviews were carried out with half-widows to understand their issues in depth. Results: The study revealed that all the respondents developed psychological distress. The majority of the half-widows report anxiety, palpitations, sleep disorders, and lack of interest in everyday activities along with various psychosocial problems. Conclusion: The majority of the respondents have moderate to severe symptoms of dissociation, anxiety, depression and sleep disturbances along with other psychosocial issues or problems. They face the double burden of living with the uncertainty about the fate of their husbands and the challenges which are posed to them to ensure not only the survival of their dependents but also a life of dignity for themselves.
Keywords: Half-widows, enforced disappearance, conflic
Effects of Strength Based Supportive Therapy on Family Functioning and Coping among Persons with Alcohol Dependence Syndrome
Get PDFBackground: Alcohol dependence is a complex behaviour with far-reaching harmful effects on the family, work, society, as well as on the physical and mental health of the individual. Epidemiological studies conducted in India showed that 20-30% of our population is using alcohol at a harmful level. Mental health professionals provide support and understanding of the illness for the affected individual and family members. They work together on planning treatment; provide mutual support and understanding of the disorder. Aim: To study the effects of strength based supportive therapy on family functioning and coping of persons with alcohol dependence syndrome. Methodology: This was a hospital based intervention study. It had adopted the quasi-experimental before and after with control group research design. Participants were randomly allocated to the experimental and control groups. 10 persons with alcohol dependence syndrome were selected for the study five each person with alcohol dependence syndrome and their family members were assigned in the control group (treatment as usual group; TAU) and five persons with alcohol dependence syndrome and their family members were assigned in the experimental group (treatment as usual positive family intervention group). Family functioning was assessed through McMaster family assessment device Patients were assessed through brief cope. Result: The study results indicated a significant improvement in various domains of family functioning in experimental group participants compared to the treatment as usual group. It has also noted improvement in coping among patients. Conclusion: strength based supportive intervention useful for the caregivers as well as it also helps in improving coping among person with alcohol dependence syndrome.
Keywords: Strength based supportive therapy, alcohol dependence, caregiver
Effectiveness of Psychoeducation on Psychological Wellbeing and Self-Determination in Key Caregivers of Children with Intellectual Disability
Get PDFIntroduction: For the parents to have a child with intellectual disability becomes the most traumatic experience of life which makes them unenthusiastic to accept the fact. Studies have mostly tended to focus on parental adjustment to their child’s disability and its correlates. There is little research examining interventions that aim to improve parents’ and children’s relationship or quality of life. This study aimed to see the effectiveness of psychoeducation in increasing the level of psychological well-being and self-determination of the caregivers of children with intellectual disability (ID). Methodology: A total of 20 caregivers of children with intellectual disability were purposively selected from the Central Institute of Psychiatry and Deepshika Institute of Child Development and Mental Health, Ranchi. They were assessed with General Health Questionnaire (GHQ-28), Ryff’s Psychological wellbeing scale, Family Interview for Stress and Coping in Mental Retardation (FISC-MR), Social Problem Solving Inventory (SPSI-R) and Self-determination scales before giving the psychoeducation. The psychoeducational module was developed especially for the caregivers based on the National Institute of Mental Health manual for Psychologists and Teachers, Counsellors manual for family intervention in mental retardation & Problem Solving therapy manual. This module was applied to them individually for the period of four weeks. The measures mentioned earlier were used again to assess the post treatment levels on the selected key caregivers. Results: Study identified a significant increase in the caregiver’s psychological well-being and self-determination levels after eight sessions of psychoeducational. Conclusions: Results suggested that psycho‐educational intervention is effective in increasing knowledge regarding the condition and in meeting the needs of the care givers.
There are very few culturally sensitive parent intervention practices directed to the key caregivers of children with intellectual disability and these practices should be enhanced.
Keywords: Intellectual disability, psychological wellbeing, self-determination, psychoeducatio
Suicide an Alarming Need to Go Beyond Medication - An Exploration of Primary Care Scenario
Get PDFBackground: In the current globalized, technologically advanced society, suicide is one of the serious public health issues. The health system has an important role in assessing and preventing the suicidal act. General practitioners are the first contact for the community to seek health care. The aim of the study is to explore knowledge of general practitioners’ regarding suicide prevention and the extent of risk assessment and management in the primary health care setting. Methods: Twelve in-depth interviews were conducted among general practitioners working in the primary health care setup both the public and private sectors in Urban Bangalore, Karnataka. A qualitative research design was adopted. Data was analyzed using thematic analysis approach. Results: This study reveals the general practitioners who are working in the primary health care set up, had inadequate knowledge about the causation of suicide, warning signs, risk and protective factors of suicide and also lacked skills in risk assessment and prevention strategies in the primary health care set up. Conclusion: Viewing suicide as a public health issue, it is very important to relate to the primary health care set up –where; people directly coming, approaching and being in contact with the health care system. The study indicates to focus psycho-social aspect with the medical management of the suicidal behaviour and also highlights the importance of risk assessment of suicidal behaviour in the primary health care setup by enhancing the knowledge of general practitioners regarding suicide prevention in a bio-psycho-social framework.
Keywords: General practitioner, knowledge, suicide preventio
Needs of Persons with Neurological Disorders
Get PDFBackground: In India Many persons with neurological disorder (PwND) get discharged from several hospitals with significant unmet needs. Aim: To assess the needs of persons with neurological disorders in a tertiary care hospital, Bangalore, India. Method and Materials: It was a cross-sectional deceptive study where thirty PwND availing the in-patient services at NIMHANS, Bangalore were selected through purposive sampling. Camberwell Assessment of Need – Research version was used. Results: Large majority (90%) of the respondents have unmet needs in daytime activities, psychological distress, information about illness, sex. Majority (70%) have unmet needs in job, self-care, medicines, mobility, child care. Half (50%) of the respondents have unmet need in accommodation, intimate and social relationships, finance. Three-fourth revealed that their need for food, safety and social welfare needs have been met. Conclusion: Patients from lower economic, educational status and urban domicile have more service needs. Present study attempts a systematic need assessment which has implication in addressing the unmet needs of PwND to improve their quality of life.
Keywords: Need assessment, neurology, discharge plannin
Anxiety Depression and Burden among the Caregivers of Persons with Neurological Illness
Get PDFBackground: Studies have shown that caregivers of the persons with neurological illness have high levels of psychological distress, depression and caregiver’s burden. The aim of the study was to find out anxiety, depression and caregiver’s burden among the caregivers of persons with neurological illness (PWNI). Method: Thirty caregivers of PWNI attending the Centre of Rehabilitation Sciences, LGB Regional Institute of Mental Health, Tezpur, Assam were selected using purposive sampling technique for the present study. Socio-demographic and clinical data sheet, Zarit Burden Interview Scale and The Hospital Anxiety and Depression Scale were used. Results: The results shown that in Hospital Anxiety and Depression Scale, 26.6% of the caregivers’ scores were in the abnormal range in the domain of depression. While in the domain of anxiety, 16.6% scored in the abnormal range. In Zarit Burden of Scale, 13.3% of the caregivers were having little or no burden, 26.6% of the caregivers were having mild to moderate level of burden, 20% were having moderate to severe burden and 30% were having a severe burden of care. Care burden has significant positive correlation with depression (r= .124, p≤ 0.01 and anxiety (r= .124, p≤ 0.05). Conclusion: Caregivers of PWNI have been found to be at higher risk of mental health problems and care burden. The importance of addressing the burden of caregivers involved in the care of PWNI needs to be taken into consideration while providing treatment and rehabilitation of PWNI.
Keywords: Anxiety, depression, burden, neurological illnes
A Comparative Study of Perceived Social Support among Persons with Schizophrenia and Mania
Get PDFBackground: In recent years social support has emerged as an important influencing variable and perhaps determining outcome in various disorders. It is proposed and generally accepted that social support buttresses against the deleterious of stress. In the context of better outcome of schizophrenia and mania in India and other developing countries, consideration of social support as an influential variable assumes importance. So the present study was conducted with the objective of to study and comparing of perceived social support of the persons diagnosed with Schizophrenia and Mania and to find out its relationship with the socio-demographic variables. Method: The research work was done at the outpatient department of Gwalior Mansik Arogyashala, Gwalior, India. It was a cross-sectional hospital based study using a purposive sampling technique. The sample consisting of 150 samples, 75 from each group diagnosed with Schizophrenia and Mania which were consented and met the inclusion criteria. Socio-demographic and clinical data sheet and Social Support Questionnaire (SSQ) were used to collect the data. The persons with Schizophrenia and Mania have taken in study. Result: It indicates that persons with schizophrenia (PWS) group has less perceived social support in comparison to persons with mania (PWM) group. Conclusion: Perceived social support was correlated to symptoms because when individuals are provided good support they cope with stressful events more effectively and thus are likely to experience less psychological distress.
Keywords: Schizophrenia, bipolar affective disorder, mania, perceived social suppor