Mona Srivastava

A Comparative Study of Attitude of Mental Health Versus Nonmental Professionals toward Suicide

Background: Suicide is a major public health problem. Suicide can be prevented by understanding the disorder. Attitude plays a significant role in doing so. Aim: To assess the attitudes of mental health professionals and non-mental health professionals towards an act of suicide and to compare the two groups regarding their attitudes. Materials and Methods: A semistructured questionnaire having yes/no type questions was administered to 30 mental health and 30 nonmental health professionals. A blind analysis of the data was done. Statistical Analysis: Comparative analysis using mean and standard deviation and analysis of variance was performed to rate significance in differences of responses to questions that rate attitudes. Results: The results show a significant positive attitude of mental health professionals toward dealing with the patients who attempted suicide. Discussion: Considering the magnitude of the problem, simple training and education of nonmental health professionals can change their attitude toward patients who attempt suicide, which in turn leads to an optimal management. Conclusion: The study shows that the mental health professionals are much more positive in their approach towards a patient of parasuicide.

Predictors and prevalence of nicotine use in females: A village-based community study.

Background: Nicotine use and abuse is gaining increasing attention due to its negative and serious medical consequences. Multiple morbidities occur due to the intake of nicotine in various forms. Aims: To find the prevalence and type of nicotine use/abuse in females. Settings and Design: House to house survey in a village in Purvanchal, i.e. eastern part of Uttar Pradesh and bordering Bihar. Materials and Methods: Semi-structured performa was used to collect data; a house to house visit was made to collect data. Statistical Analysis: Simple percentages were calculated. Results: Tooth powder form of nicotine use is common and the need to address this problem is urgent. Conclusions: Widespread dissemination of knowledge and legislative measures have to be undertaken to stop the problem.

Prevalence of depression and anxiety among children in rural and suburban areas of Eastern Uttar Pradesh: A cross-sectional study

Background: Psychiatric morbidity in children and adolescents is a major concern as they become more complex and intense with childrens transition into adolescence. Aim: The aim of this study is to assess and compare the prevalence of depression and anxiety among children residing in rural and suburban area of eastern Uttar Pradesh and understand the burden of these problems in our society. Materials and Methods: Children, in the age group 11–18 years, were divided into 2 groups: Group I – 100 children from rural area Tikri; Group II – 100 children from suburban area Sunderpur. Their sociodemographic details were recorded. Childrens Depression Inventory and Revised Childrens Manifest Anxiety Scale were used to screen for depression and anxiety in children, respectively. The final diagnosis was done using present state examination in accordance with International Classification of Mental and Behavioral Disorders 10. Data were statistically analyzed using Chi-square test. Results: The prevalence of depression was found to be 14.5% while that of anxiety disorder was found to be 15%. There was no significant difference in the prevalence of depression or anxiety in rural and suburban areas (P > 0.05). Depression and anxiety were more prevalent in middle adolescence, in females, and in lower-middle socioeconomic group. Depression was more prevalent in the students of class 9th –12th, whereas anxiety was more in students of lower classes. Depression was more prevalent in joint families. These differences show some important trends regarding factors affecting these problems. Conclusion: This study yields useful information which could be of use in early management of psychiatric disorders present in the community and prevent their development into chronic disorders.

Plight of street children: An explorative study from Varanasi, India

Rapid pace of unplanned urbanization in the developing countries has resulted in a large proportion of children becoming homeless, leading to multiple children living on the streets. These children are highly vulnerable to exploitation and abuse. Against this background, studies on the situational analysis of street children across India are needed; therefore, a study to assess the condition of street children in the city of Varanasi was planned. Street children registered with a nongovernmental organization were contacted. Four hundred and fifteen children were selected by random sampling, and this group was administered a semi-structured interview containing 35 items. It was found that all forms of abuse were common, but physical abuse (74%) was highest and the police (25.5%) was an important perpetrator. Younger children were much more vulnerable. The sample commonly had boys and between the ages of 10 and 15 years. It was concluded that these children need policies to be incorporated into the mainstream.

The many faces of trichotillomania.

Trichotillomania is a poorly understood complex disorder of multifaceted pathology which often requires an interdisciplinary approach for management. While sharing similarities with obsessive-compulsive disorder, compelling differences between these have also been noted. We present three cases of trichotillomania highlighting the remarkable variability seen in the presentation of this disorder. In doing so, we discuss on resolving the classificatory issues and call for a consensus on the understanding of the disorder.

Substance use among outdoor treatment-seeking patients with mental illness: A case–control study from a tertiary care hospital of northern India

BACKGROUND: Substance abuse and mental disorder often coexist and may cause several consequences in sociooccupational functioning and health care and management. Indian data are sparse in this area. OBJECTIVES: The aim of the study was to examine the sociodemographic profile, pattern, and prevalence of alcohol and substance use among person suffering with mental illness and to compare with those without mental illness. METHODS: A total of 80 treatment-seeking patients with mental illness and 80 nontreatment seeking healthy accompanying persons were assessed for current substance use. Mental illness was screened using Structured Clinical Interview for DSM-IV Axis I Disorders and the diagnosis was made as per DSM IV, semi-structured sociodemographic pro forma was also applied. The data collected were analyzed using the Chi-square and Students t-test. RESULTS: Substance use was found 2.5 times higher among cases (56.2%) than controls (22.5%). Substance-using participants comprised mainly males belonging to rural residence. The substance using cases were more unmarried, less educated, poorer economically, and more nuclear family structures that substance-using controls. When compared with non-substance using cases, cases with substance use had more males than females and lower education. Although both groups were almost similar in term of marital status, family structure, residence, and socioeconomic status. Among both groups, most common substance use was tobacco, followed by alcohol and cannabis. Although all the substances were more prevalent among cases than controls. The prevalence of any substance use was highest among cases with psychotic disorder (77.3%), followed by unipolar depression (62.5%), bipolar affective disorder (41.7%), and anxiety disorders (21.4%). Tobacco and cannabis use was most prevalent among cases suffering with psychotic disorders, whereas alcohol use was most prevalent among cases suffering with unipolar depression. CONCLUSIONS: Mentally ill individuals are vulnerable to develop substance use, thus they are doubly jeopardized. The susceptibility of these individuals stem from lesser insight, need for stimulation, to decrease the anhedonia induced by psychoactive medicines and poor awareness hence this group of individuals has several health and social consequences; therefore, they require due attention. A better care, support, and education are needed for substance using patients with mental illness to improve their prognosis and also help in their appropriate rehabilitation.

Insulin resistance factor in subjects suffering from depressive disorder

Objective: The purpose of this study was to find out the occurrence of depressive disorders in patients with freshly detected diabetes mellitus (DM) and its relationship with the sociodemographic status of the subjects, severity of the disease, and insulin resistance (IR) factor in the subjects suffering from depression and DM. Materials and Methods: In this cross-sectional study, 100 patients aged between 30 and 60 years who fulfilled the criteria for diagnosis as per the World Health Organization criteria of DM were selected randomly from endocrinology outpatient department (OPD) of Sir Sunderlal Hospital, Institute of Medical Sciences, Banaras Hindu University, Varanasi. All patients who attended the OPD services from November 2014 to July 2015 were screened for participation in the study. The patients were assessed for depressive disorder as per the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision criteria and IR by blood chemistry measure of fasting insulin (by enzyme-linked immunosorbent assay KIT) and fasting glucose (GOD-POD method) using homeostasis model assessment method (HOMA-IR scale). Results: In the study group of 100 patients, 34% of the patients were found to be suffering from depressive illness and they were not on any treatment. Out of the 34% patients who had insulin resistance; most common psychiatric disorder was major depressive disorder found in 21%,mild to moderate depressive disorder in 7% and 4% were found to have depression mixed anxiety symptoms. The estimated IR by HOMA-IR scale was found higher in 25 patients (74%) with psychiatric illness. Conclusions: This study highlights the high comorbidity of depressions in newly detected diabetes and also emphasizes the need of psychiatric evaluation in subjects who are vulnerable at the time of being diagnosed as a case of DM.