29 research outputs found
Quality of life of patients with schizophrenia and chronic obstructive pulmonary disease: An observational study
No full textBackground: Quality of life (QOL) is a novel and holistic parameter in measuring health outcome. Recently, the concept is gaining importance as an outcome measure in illnesses, with a chronic and progressive course. Schizophrenia and chronic obstructive pulmonary disease (COPD) are psychological and physical illnesses, respectively, which share this characteristic. Studies comparing the QOL of psychological and physical illnesses are few. The extant literature did not reveal any studies comparing the QOL of schizophrenia and COPD. Aim: The aim of this study was to compare the QOL of patients with schizophrenia, a chronic psychiatric disorder, and COPD, a chronic physical illness. Materials and Methods: The study was cross-sectional in design. The QOL of thirty patients each with schizophrenia and COPD, from a tertiary care teaching hospital, was assessed using the WHO Quality of Life Assessment-BREF scale. Comparison was done between the two groups. Results: The QOL of patients with schizophrenia was significantly better in the physical domain (Z = 2.75, P = 0.006) and overall perception of life (Z = 3.25, P = 0.001). Overall perception of health was also better in schizophrenia (Z = 1.94, P = 0.052). The social domain was the only one in which COPD patients had a better score than schizophrenic patients, though it was not statistically significant (Z = 0.17, P = 0.86). Conclusion: The QOL of schizophrenic patients is slightly better compared to that of COPD patients. Only in the social domain was the QOL of schizophrenic patients inferior to that of COPD patients. Therefore, in schizophrenic patients, priority interventions to improve the social deficits are important because these determine their QOL vis a vis, a chronic physical illness
Borderline intelligence, disability provisions and fuzzy borders
No full textThe diagnosis and boundaries of borderline intellectual functioning (BIF) lack clarity. The nosological status in DSM 5 and ICD 10 and 11 are also dubious. The provision of 'borderline disability' of 25 % for the category of Intellectual Disability, in the RPWD (Rights of persons with disability) act, falls below the benchmark disability criteria. The Kerala State commissioner for persons with disabilities categorises those with IQ between 70 and 84, as 'borderline intelligent' and provides the benefits of scribe/interpreter to them. Can the psychiatrist certify an entity which does not exist in the current classificatory systems? The author tries to highlight the fallacies in the implementation of disability provisions in Kerala for students with BIF and provides alternative solutions vis a vis the disability plea
A Study of an antipsychotic prescription pattern of patients with schizophrenia in a developing country
No full textBackground: Though there are several recommended guidelines for treating schizophrenia, in routine clinical practice, these are not followed. Aim: To conduct an audit of the prescription pattern of antipsychotic drugs in patients with schizophrenia, in a tertiary care centre in India, during a period of 1 year and compare it with Maudsley guidelines and Clinical practice guidelines for Psychiatrists in India (IPS guidelines). Materials and Methods: Data were collected from the case records, compiled, and analyzed. The concordance or discordance with Maudsley and IPS guidelines were studied. Results: The demographic variables of the patients and the prescription pattern of drugs were analyzed. The correlations between supramaximal and sub-threshold dosage of drugs to the gender, age, duration of illness, and combination of drugs were examined. Conclusions: Polypharmacy of antipsychotics is common. 31% of patients were on combination of typical and atypical antipsychotics. 4% of patients were receiving supramaximal dose of antipsychotics and all of them were on combination (P =<0.03, x2 ). 24% of patients were on sub-threshold doses. 83% were not on anticholinergic drugs
An attempt of lethal self-harm in a 7-year-old child
No full textSuicidal behavior in young children is inadequately studied due to methodological limitations, although there is an increasing trend of suicidal behavior among youngsters. Here, we report the case of a lethal act of self-harm by a 7-year-old child. On evaluation, the child was detected to have attention-deficit/hyperactivity disorder and oppositional defiant disorder. He attempted hanging after a trivial altercation with mother and was nearly strangulated. He had learned the method from visual media and did the act impulsively. There was history of suicides in the family. Pharmacological and psychosocial interventions were done and the child was followed up for almost 1 year. There was good resolution of the symptoms and the family interaction pattern improved. This case highlights that, suicide threats even in very young children need to be urgently and sensitively handled, from a biopsychosocial perspective. The media influence on suicide on young children needs to be addressed urgently
Interrater Reliability After a Brief Training in CGI for Psychologists
No full textBackground: There is a paucity of mental health research in India, mainly due to lack of trained manpower. There are instances in India where basic health care is delivered by trained lay persons when services of professionals are unavailable. Can the same approach be adopted in conducting mental health research too?
Aims: To measure the interrater reliability of Clinical Global Impression scale (CGI) between psychologists and psychiatrist after a brief, focused training was imparted to the psychologists.
Materials and methods: Three psychologists with sound theoretical knowledge but little clinical exposure were given brief focused training by psychiatrist in the use of CGI. The interrater reliability between the trainees and the trainer was measured.
Results: There was significant inter-rater reliability as regards the subscale ‘severity of illness’, but not in the other two subscales of CGI.
Conclusions: It is possible to conduct research in a resource poor country like India by utilizing the services of paraprofessionals by imparting brief, focused training, under guidance. The approach has certain limitations too
A Hyperbolic model for Degradation in Tension mode-I Fracture of Masonry: Implementation and Validation in Engineering masonry model
No full textThe growing need to understand the behaviour of un-reinforced masonry URM), subjected torepeated light man-made earthquakes caused by the extraction of gas in the north-eastern partof The Netherlands has resulted in intense research to determine the exact process of crackinitiation and propagation. The historical masonry buildings and Dutch terraced houses inGroningen are prone to light damages which become severe upon repeated lateral earthquakeloading. Although there are material models that describe the behavior of modern brickmasonry, they do not accurately represent the mechanical properties of 19th century clay brickmasonry. This led to a large-scale research into the mechanical behavior of un-reinforcedmasonry and an orthotropic continuum macro-model called the Engineering Masonry Model(EMM) was proposed. The existing tension constitutive model in EMM assumes a secantunloading-reloading branch which does not consider the strength degradation of URM underrepeated loading. Since tension mode-I fracture results in cracking of URM, it is importantto study the effects of repeated loading on the propagation of the crack and its effects on thecapacity of the structure.This thesis presents a degradation model to represent the strength deterioration of URMobserved during repeated loading. The constitutive model formulated in this thesis is based onhyperbolic functions along with a secant slope for the unloading-reloading branch. To justifythe model assumptions, a single linear 4-node element is analysed with the new model and theeffect of varying different components of the constitutive equations is established. The windowbank spandrel sample modeled as a 4-point bending test is analysed using the new model for 10,30 and 100 repetitions. It is shown that the hyperbolic model can predict accurately the stressreduction within each repetition displacement set and also represent the crack width wideningand crack propagation accurately when compared to the experimental results. The new modelis tested on a wall with a window opening sample and the results closely matched that of theexperiment. Finally, recommendations are provided for further development of the hyperbolicmodel and calibration of the material properties.Civil Engineerin
