Rc Das

Munchausen syndrome: Playing sick or sick player

Munchausen syndrome is rare factitious disorder which entails frequent hospitalization, pathological lying and intentional production of symptoms for sick role. Management requires collateral history taking, sound clinical approach, exclusion of organicity and addressing psychological issues. A case which presented with unusual symptoms of similar dimension is discussed here. The case brings out finer nuances in evaluation and management of this entity .

Virtual reality applications in mental health: Challenges and perspectives.

Jul-Dec 2014 | Vol 23 | Issue 2 83 the virtual world in real time by tracking the user’s head movements so that the field of view would change appropriately as the user looked around. In addition, for the first time the user could manipulate virtual objects in a realistic way. The combined effect was the substitution of sensory data from the natural world with sensory data about an imaginary world. The sensorydata from the imaginary or virtual world changed in response to the user’s actions, resulting in a “sense of presence” in an interactive three‐dimensional virtual environment.[7]

Empathy: Process of adaptation and change, is it trainable?

1 of ayurvedic theory.[6] It is interesting to note that even in the past enough emphasis was placed on desirable qualities of medical student. Selection and training had incorporated certain attributes for selecting medical students. Sushruta Samhita gives lucid account of desirable internal characteristics of medical student. Among the most desirable attributes, i.e., humility, honesty, and hardworking generosity and empathy were also adequately emphasized.[7]

A cross-sectional assessment of stress, coping, and burnout in the final-year medical undergraduate students

Background: Medical students undergo significant stress during training which may lead to own suffering or problem in patient care. High level of burnouts and depression is also not uncommon. The transition from preclinical to clinical training has been regarded as crucial to student in relation to the stress. Methodology: An assessment of perceived stress and its relation to general psychopathology, the pattern of coping, and burnout in the final-year medical student was done to bring out clear nature, pattern, and extent of the problem. Results: Perceived stress had statistically significant association with general psychopathology and depressive-anxiety component of burnout. Acceptance, positive reframing, humor, planning, and active coping correlated with lower score on perceived stress. Conclusion: Higher score on perceived stress was associated with higher scores on general psychopathology and burnout. Age of joining MBBS course and doctor in the family did not affect the stress significantly. People who displayed positive coping strategies had lesser stress and general psychopathology.

Crosssectional study of quality of life after renal transplant in end stage renal disease.

Background : End stage renal disease (ERD) is a psychologically debilitating illness with considerable emotional morbidity. There is variation in quality of life and mental health status among recipients and donor at different stages of kidney transplantation. Materials and Methods: The study is an observational analytic study. Sample for the study comprised of forty (40) consecutive patients including 20 recipients and 20 donors of 20 kidney transplantations, male and female, and who themselves/whose relatives provided written informed consent were included in the study. Both recipients and donors were followed-up from 2 weeks prior to transplant surgery to 6 months post-operatively by phone and when they came for review in Nephrology Out-Patient Department (OPD). Quality of life and mental health status was compared between the two groups. Results: Study groups were homogeneous on age, education, gender and marital status. After transplantation recipient′s mean score in all parameters had increased and all changes were statistically significant (<0.05). Conclusion: In this study significant changes in quality of life (QOL), and mental health status in recipients and donors before and after transplantation were noted. It is recommended to evaluate mental health related aspects of both donors and recipients.

A Cross-Sectional Study of Adaptation, Coping and Quality of Life in the HIV Seropositive Cases

Background: The role of quality of life and coping strategy with the HIV/AIDS disease cannot be overemphasized. In view of the above present study was planned to assess the Quality of life and coping in sero-positive cases. Material and Method: 182 patients with HIV sero-positive status on HAART for at least 3mths formed a study group. Individuals with a past history of mental illness / head injury / dementia and co-morbid psychiatric disorder were excluded. The cases with co-existing opportunistic infections and malignancy were also excluded. CD4 count was done using the Flow Cytometry, Scales pertaining to Coping, Quality of Life and Personality factors were applied. Data was analyzed with the help of SPSS 17. ANOVA and Kruskal wallis test was done. Results: The CD4 count was 200-500 /micro L in 69%, 16.5% had below 200/micro L and the rest 14.3% had the count above 500/micro L. The treatment profile of patients found 85.2% of patients on ART. Coping Resources fall within normal range. Domains of Quality of Life Scale namely Physical health, feelings and emotions, Pain and Sleep had higher mean score revealing better quality of life, Quality of life compromised was in the domain of appetite and food intake daily activities, cognitive functions and social support. Conclusion: Findings revealed significant association between CD4count and quality of life. There was a positive relationship with quality of life scale domains of Physical health and CD 4 count. Enhancement of quality of life in HIV sero-positive cases can be done by promoting adherence to ART and adapting healthy coping strategies.

Human capital management: Economics of psychological perspective.

Human capital management (HCM) is an old discipline frequently specialized and referred to by the financial and investment analysts as well as the accountants and HR professionals. HCM is concerned with obtaining, analyzing, and reporting on data and the direction of value‐adding people management at the corporate level and at the level of front‐line management.[9] HCM is a system approach to people management and refers to the discipline of acquiring, retaining, measuring, managing, and leveraging the workforce. It can aptly be stated that HCM treats employees as an asset rather than overhead.

Central registry in psychiatry: A structured review

Background: Central registry in psychiatry is being practiced in few countries and has been found useful in research and clinical management. Role of central registry has also expanded over the years. Materials and Methods: All accessible internet database Medline, Scopus, Embase were accessed from 1990 till date. Available data were systematically reviewed in structured manner and analyzed. Results: Central registry was found useful in epidemiological analysis, association studies, outcome studies, comorbidity studies, forensic issue, effective of medication, qualitative analysis etc., Conclusion: Central registry proves to be effective tool in quantitative and qualitative understanding of psychiatry practice. Findings of studies from central registry can be useful in modifying best practice and evidence based treatment in psychiatry.

Psychiatric comorbidity in multiple sclerosis

AIM To study the prevalence of psychiatric comorbidities in patients of multiple sclerosis and their association to the degree of disability. METHOD Psychiatric symptoms were assessed in 90 patients of multiple sclerosis using GHQ-12, MMSE, HADS, Beck Depression Inventory and AUDIT. Neurological disability was assessed using Expanded Disability Status Scale. Correlations were determined between EDSS scores and psychiatric scale scores. RESULT 61% of patients had significant psychological distress. Depression was most common (38.8%) which was followed by anxiety symptoms (27.8%). Cognitive functioning was relatively intact in patients with mild to moderate neurological disability. Alcohol abuse was mostly restricted to male gender. CONCLUSION Psychiatric illness is highly prevalent in patients of multiple sclerosis leading to poor quality of life and significant distress. Psychiatric disability was higher in patients who had greater deterioration in neurological function. All cases of MS should be assessed for psychiatric morbidities as can be alleviated by appropriate intervention.

Personality and health: Road to well-being.

1 These four categories Galen named “sanguine,” “choleric,” “melancholic,” and “phlegmatic” after the bodily humors, respectively. Each was the result of an excess of one of the humors that produced, in turn, the imbalance in paired qualities.[8] Subjective well‐being (SWB) reported as satisfaction with life has been commented upon by psychologists as one of the factors determining the positive sense of self. The moot question to be answered is as to what determines this sense of satisfaction and happiness. A review by Dienner et al.[9] found that genetic factors, e.g., inherited tendency to have pleasant, easygoing temperament contributes to positive mental health. Some of the personality factors like low on neuroticism and high in affiliation, perceived control feel positive and optimistic.[10]