Rachna Bhargava

Prevalence of alcohol and drug dependence in rural and slum population of Chandigarh: A community survey

The present epidemiological survey was conducted by the department of psychiatry, Govt. Medical College and Hospital, Chandigarh to estimate the pattern of alcohol and other substance dependence in rural and slum dwellers population of Chandigarh. In this survey 6.88% individuals of the total population surveyed (2992) fulfilled dependence criteria of ICD-10. Alcohol was the primary substance of dependence for majority of urban slum substance users and rural areas users. Age at first drug use was 20.89 ± 5.31 years (mean ± S.D) among rural population and 19.75 ± 5.4 years (mean ± SD) in urban slums. Majority of them reported having health related complications (85.71%) followed by family problems (77.31%) due to drug dependence. This survey reflects the need to intensify efforts at the community level to reach the unreached.

Psychological impact of the Antarctic winter on Indian expeditioners.

The authors studied the psychological variables of 25 men who participated in the winter-over team of an Indian expedition to Antarctica for possible associations with seasonality and isolation. It was found that increased cigarette smoking was associated with the stress of the beginning of isolation (March), sleep difficulty was associated with midwinter (June), rapport was at a minimum at the point of maximum isolation in temporal terms (September), and decreased satisfaction with work and life situations was associated with continued isolation (December, January). The study suggested that variables postulated to affect performance undergo changes during the course of wintering over in Antarctica.

Psychotherapy Improves Compliance with Tuberculosis Treatment

Background: Low treatment completion rate in tuberculosis (TB) patients is a major concern. Physicians have always been striving for better treatment adherence in such patients. The present study is one such attempt in this direction. Objectives: The study was aimed to evaluate the role of behavior modification by psychotherapy in improving compliance with short-course anti-TB chemotherapy in India. Methods: It was a prospective controlled trial involving patients with confirmed pulmonary and extrapulmonary TB enrolled in the National Tuberculosis Program. The intervention group underwent pretreatment psychological assessment followed by regular psychotherapy sessions. Results: The intervention group had a demographic profile comparable to that of the control group. The patients were mostly from low- and middle-income backgrounds from urban and semi-urban areas. They consistently showed poor knowledge about the nature of the disease, low motivation, and had considerable apprehensions. Following the sessions, the intervention group showed improved compliance compared with the control group, reflected in significantly higher treatment completion and cure rates. Conclusions: The study suggests that psychological intervention is effective in improving compliance with anti-TB treatment, and may reduce the incidence of treatment failure, relapse and drug resistance.

Indian Perspective on Psychotherapy: Cultural Issues

India is in a state of transition between massively transformed ‘modern’ lifestyles on one hand and the influence of traditional values and customs on the other. In view of the current realities of urbanization, migration, globalisation and societal transformation, the mental health treatment needs have become complex. The article highlights the existing mental health issues and traces the development of various psychotherapeutic techniques in India. An effort has been made to look into the basic tenets of the Indian culture which have a bearing on the conceptualisation and practical application of psychotherapy in the Indian setting. The cross-cultural relevance and adaptability of western psychotherapies in multi-ethnic and collectivistic Asian culture are discussed. In view of the differences between the eastern and western approaches to mental health, challenges in culturally-responsive adaptations are highlighted. It is seen that psychological interventions among masses are beneficial if indigenous approaches based on paradigms like themes from Gita, are cross-fertilized with western psychotherapy. However, there is a need to generate empirical evidence for indigenization of psychological treatments.

Role of 24 hour telephonic helpline in delivery of mental health services

BACKGROUND A large number of persons with psychiatric disorders are not seeking treatment due to various reasons, thus contributing to the huge treatment gap. One of the ways to bring these people into treatment is through telephonic helplines. MATERIALS AND METHODS Following a large number of suicides in the city of Chandigarh in 2003, The department of Psychiatry, GMCH, Chandigarh was designated as nodal center for the prevention of suicide. A 24-hour suicide prevention helpline was set up as an immediate measure to help persons in crisis. Apart from providing telephonic counseling to persons in crisis, the helpline coordinated with police, media, schools, radio stations etc., to reduce the number of suicides in the city. RESULTS Majority of the callers were males (65.93%), between 20 to 39 years old (56.34%), married (79.50%), had less than 12 years of formal education (60.68%), and were earning less than Rs. 5000/month (56.80%). 72.96% callers had contacted the mental health services for the first time. A significant number of persons (434, 13.26%) called the helpline for marital, academic, stress-related problems. Majority of the calls were received between 8 A.M. and 2 P.M. The number of suicides in the city of Chandigarh showed a decline in the following years since the helpline was set up. CONCLUSIONS The telephonic helpline seems to be a very effective way of getting persons into contact with health services. They are cost-effective, the person can maintain his confidentiality and devoid of stigma.

Eating attitudes and body shape concerns among medical students in Chandigarh

Background/Objectives: Eating disorders are rarely encountered in the Indian subcontinent. Surprisingly, there is sparse literature related to eating attitude distortions and body dissatisfaction in the Indian population. The objective of this study was to explore the eating attitudes and body shape concerns in medical students, with the objectives of determining any gender differences on eating attitudes and body shape concerns, and any predictors of psychological morbidity using demographic and psychosocial parameters. Materials and Methods: Sample comprised medical undergraduate students from all years (I-V) pursuing MBBS course at Government Medical College and Hospital, Sector 32, Chandigarh. It was a prospective, cross-sectional study. Instruments used were socioclinical sheet, acculturation index (AI), eating attitudes test-26 (Hindi version), and body shape questionnaire (BSQ) (Hindi version). Following written informed consent, all the questionnaires were administered in a group setting to each MBBS batch. Statistical analysis was carried out with Statistical Package for the Social Sciences (SPSS) version 17.0 using descriptive analysis (frequency, percentage, mean), univariate analysis (Chi-square, t-test), Pearsons correlational analysis, and binary logistic regression (backward). Results: A total of 250 medical students from 5 batches with mean age of 20.15 +/- 1.32 (18-28) years. And 55% (n = 137) were males and 45% (n = 113) were females. On gender comparison, males were more likely to be Hindu and have higher body weight (actual and ideal); females had significantly higher scores on dieting subscale of eating attitudes test-26 and BSQ (total score). On AI, there were no gender differences on family domain variables, with significantly less females reporting pure Western preference for social/peer domain variables. Correlation and logistic regression analysis showed high score on BSQ (median divide) as the only statistically significant predictor of eating (disorder) morbidity, whereas high score on AI (median divide) approached significance (P = 0.062). Conclusion: High score on BSQ is the mediating (proximate) risk factor for eating (disorder) morbidity. Influence of other/distal risk factors (especially AI) may be mediated through it.

Attitudes towards alcoholism and drug taking: a survey of rural and slum areas of Chandigarh, India

Alcohol and drug dependence is widely prevalent in rural and slum areas of society. In order to take effective preventive measures it is essential to study the attitude of the population towards alcohol and drug dependence. Hence this study was planned with the aim to: (1) ascertain the attitudes of persons living in rural and urban slum areas towards alcohol and drug taking; (2) find out the differences in attitudes between non-drug users and alcohol and drug users in this population; and (3) study the socio-demographic correlates of attitudes towards alcoholism and drug taking. In a cross-sectional, community survey of Chandigarh, 2992 individuals over 15 years of age were selected randomly from five villages and five slum areas. All individuals were assessed on the Scale for Assessment of Attitude Towards Drinking and Alcoholism and the Scale for Assessment of Drug Taking behavior; χ2 and correlations were used for analysis. Substance users had significantly higher acceptance of drinking and drug taking behavior as compared to the general population. Married persons, those with higher education and those from a joint family had more favorable attitudes towards drinking and alcoholism. Males had more favorable attitudes than females towards drinking and more negative attitudes towards drug taking. The findings show that the general population has a poor acceptance of alcohol use in the society. However drugs were perceived to be more dangerous than alcohol.

Multinational comparative cross-sectional survey of views of medical students about acceptable terminology and subgroups in schizophrenia

Aim The aim of this study was to inform thinking around the terminology for ‘schizophrenia’ in different countries. Objectives The objective of this study was to investigate: (1) whether medical students view alternative terminology (psychosis subgroups), derived from vulnerability-stress models of schizophrenia, as acceptable and less stigmatising than the term schizophrenia; (2) if there are differences in attitudes to the different terminology across countries with different cultures and (3) whether clinical training has an impact in reducing stigma. Design This is a cross-sectional survey that examined the attitudes of medical students towards schizophrenia and the alternative subgroups. Setting The study was conducted across eight sites: (1) University of Southampton, UK; (2) All India Institute of Medical Science, India; (3) Rowan University, USA; (4) Peshawar Medical College, Pakistan; (5) Capital Medical University, China; (6) College of Medicine and Medical sciences, Bahrain; (7) Queens University, Kingston, Canada and (8) University of Cape Town, South Africa. Method This study extended an initial pilot conducted by the Royal College of Psychiatrists on the term schizophrenia and psychosis subgroups to assess whether the subgroup terminology might have an effect on the attitudes of a convenience sample of medical students from eight different countries and potentially play a role in reducing stigmatisation. Results 1873 medical students completed a questionnaire recording their attitudes to schizophrenia and the psychosis subgroups. A reduction in negative perceptions were found for the psychosis subgroups, especially for the stress sensitivity psychosis and anxiety psychosis subgroups. Negative perceptions were found for drug-related psychosis. Participants who had undergone clinical training had overall positive attitudes. Differences across different countries were found. Conclusion The attitudes towards psychosis subgroups used in this study have shown mixed results and variation across countries. Further research is warranted to investigate acceptability of terminology. Methods of reducing stigma are discussed in line with the findings. Ethics The study received ethical approval from ERGO (Ethics and Research Governance Online; ID: 15972) and subsequently from the ethics committee at each site.

Prevention for child and adolescent psychiatry in low-resource settings

Preventive measures for mental health issues among children have received meager attention. Although the prevalence rates of mental disorders are significant, systematic focused efforts toward management specifically in this special population in low-resources settings have been markedly inconsequential. Certainly, unlike other medical conditions, policies, and services related to mental health of children and adolescent are not adequate and efficient to deal with the burden of mental disorders in children and adolescents. This article reviews the available resources and highlights the possible strengths that can be utilized in prevention strategies.

Need to develop a home-based intervention for specific learning disorder in Indian setting

10.4103/0253-7176.211748 This is an open access article distributed under the terms of the Creative Commons Attribution‐NonCommercial‐ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non‐commercially, as long as the author is credited and the new creations are licensed under the identical terms. How to cite this article: Naguy A. Benzodiazepines in schizophrenia: Nemesis or Nirvana?. Indian J Psychol Med 2017;39:547‐8.