Shaunak Ajinkya

Depression during pregnancy: Prevalence and obstetric risk factors among pregnant women attending a tertiary care hospital in Navi Mumbai.

Context: Depression affects about 20% of women during their lifetime, with pregnancy being a period of high vulnerability. Prevalence of depression during pregnancy ranges from 4% to 20%. Several risk factors predispose to depression during pregnancy including obstetric factors. Depression during pregnancy is not only the strongest risk factor for post-natal depression but also leads to adverse obstetric outcomes. Aims: To study the prevalence of depression during pregnancy and its associated obstetric risk factors among pregnant women attending routine antenatal checkup. Settings and Design: Cross-sectional observational survey done at the outpatient department (OPD) of the department of obstetrics of a tertiary care hospital in Navi Mumbai. Materials and Methods: One hundred and eighty-five pregnant women were randomly administered the Beck Depression Inventory (BDI) for detecting depression. Additional socio-demographic and obstetric history was recorded and analyzed. Results: Prevalence of depression during pregnancy was found to be 9.18% based upon BDI, and it was significantly associated with several obstetric risk factors like gravidity (P = 0.0092), unplanned pregnancy (P = 0.001), history of abortions (P = 0.0001), and a history of obstetric complications, both present (P = 0.0001) and past (P = 0.0001). Conclusions: Depression during pregnancy is prevalent among pregnant women in Navi-Mumbai, and several obstetric risk factors were associated to depression during pregnancy. Future research in this area is needed, which will clearly elucidate the potential long-term impact of depression during pregnancy and associated obstetric risk factors so as to help health professionals identify vulnerable groups for early detection, diagnosis, and providing effective interventions for depression during pregnancy.

Prevalence of Mobile Phone Dependence in Secondary School Adolescents.

INTRODUCTION Mobile phones have become an essential part of modern human life. They have many attributes which makes them very attractive to both young and old. There has been an increasing trend of use of mobile phones among students. Data has now started emerging with respect to the negative physical and psychological consequences of excessive use of mobile phones. New research has shown excessive use of mobile phones leading to development of symptoms suggestive of dependence syndrome. AIM To study the prevalence of Mobile Phone Dependence (MPD) in secondary school adolescents. SETTING AND DESIGN Cross-sectional, observational study conducted in secondary section of English-medium schools at Navi Mumbai (India). MATERIALS AND METHODS Four hundred and fifteen students studying in 8(th), 9(th) and 10(th) standards of schools at Navi Mumbai (India) having personal mobile phone were randomly included in the study. Participant information like age, gender, family type, phone type, duration of use per day and years of mobile phone usage was recorded. They were administered an MPD questionnaire based upon the dependence syndrome criteria as per ICD-10. According to their responses, participants who fulfilled three or more of the diagnostic criteria were rated as having MPD. RESULTS Mobile Phone Dependence was found in 31.33% of sample students. It was significantly associated with gender (p=0.003, OR=1.91, CI: 1.23-2.99), family type (p=0.0012), type of mobile phone used (p<0.001, OR=2.6, CI: 1.63-4.35), average time per day spent using mobile phone (p<0.001) and years of mobile phone usage (p =0.004, OR=2.4, CI: 1.31-4.55). CONCLUSION Mobile Phone Dependence has been found to be an emerging public health problem. There is need to recognize and identify early the growing trends and negative consequences of inappropriate mobile phone use in young users so as to generate awareness, and plan educational and treatment interventions, if need be, so as to prevent a major public health concern.

Bullying and Victimization Trends in Undergraduate Medical Students - A Self-Reported Cross-Sectional Observational Survey.

INTRODUCTION Bullying is a form of behaviour that can negatively impact a person. It can lead to several deleterious consequences like low self-confidence, drop in academic performance and depression. Studies have shown that bullying behaviour exists amongst medical students also. In the medical field, it is known to negatively impact dispensing of health care and attitudes of medical students towards becoming doctors. It is very difficult for medical students to cope with such a menace as they are already burdened with a vast curriculum and rigorous schedules. There exists paucity of studies regarding bullying amongst undergraduate medical students in Indian context. AIM To study prevalence of peer-based bullying and victimization along with their associated factors in undergraduate medical students. MATERIALS AND METHODS Four hundred randomly chosen undergraduate medical students were included in the study. Socio-demographic and personal details including history of substance use were recorded in a self-designed case record form. Illinois Bullying Scale was used to assess bullying behaviours. Out of total 400 students, 383 completed the survey and this data was analysed. RESULTS In this study, 98.69% participants self-reported to having indulged in bullying while 88.77% reported feeling victimized. Physical (p<0.001) as well as verbal (p=0.001) bullying was found to be of significantly greater severity in males as compared to females. Students of the third year of medical school indulged in significantly (p=0.034) greater severity of physical bullying than those of other years. Alcohol consumption (p=0.001) and cigarette smoking (p<0.001) were significantly associated with physical bullying. CONCLUSION Peer-based bullying and victimization was found to be highly prevalent amongst undergraduate medical students. There is an urgent need for more detailed studies on bullying in medical students so that remedial measures can be initiated and steps to limit such behaviours can be looked at seriously.

Psychological impact of adult alcoholism on spouses and children

Chronic alcoholism can have an adverse psychological impact on the family involved in caregiving and coping with the alcoholic. This article attempts to review and discuss relevant literature pertaining to the overall psychological impact of adult alcoholism on spouses and children. A literature search on various search engines like Pubmed, Psychinfo, OmniMedicalSearch, and WebMD was done using search words such as psychological impact, alcoholism, family spouse, parents, and children. The articles perceived to be relevant have been reviewed and discussed. The literature search revealed significant problems in coping among family members. It was found that there exists a huge burden on the immediate family members of the chronic alcoholic. Recent studies have found high levels of psychological stress and depressive symptoms in spouses of alcoholics. Alcohol use has also been significantly linked to aggressive behaviors and intimate partner violence. Parentification and emotional caretaking were found in the children of chronic alcoholics. This can have a major impact on the psychological development of these children. Recent studies have shown that the offsprings of alcoholics are at a high risk for Conduct Disorders, Attention Deficit Hyperactivity Disorder, Major Depressive Disorder, and Substance Dependence. Marital and Family therapy may have a role in therapeutic as well as preventive care approaches in alcoholism.

Mindfulness-based hypnotherapy for common psychological disorders

′Mindfulness′ is an essential element of Buddhist meditative practices. It is paying attention to the present moment and to what we experience. Hypnosis is a state of a state of increased suggestibility with constriction of peripheral awareness and increased focal concentration on task at hand. Thus there are many similarities between hypnosis and mindfulness and they are, many a times, complementary. This review article focuses on the applications and evidences for using mindfulness- based hypnotherapy in the management of psychological disorders.

Factors associated with organ donation

Dear Editor, Organ donation has evolved significantly from an experimental procedure to acceptable medical treatment for terminal illnesses. Despite these contemporary advances, there has been a relatively slow progress in the supply of organs for transplantation. This has resulted in global shortage of organs available for transplantation. There is a paucity of literature about the relationship between knowledge and attitudes toward organ donation. If barriers to the willingness for organ donation can be identified, these items can be targeted for change.[1] We conducted a literature search and identified numerous studies on factors associated with organ donation. We found many studies which assessed knowledge, attitudes, perceptions, and beliefs of health care professionals toward organ donation. We have attempted to summarize a few studies which we believe to have relevance regarding the same. Matten et al. interviewed nurses regarding organ donation and found that they were knowledgeable about organ donation and their attitudes were moderately positive. Factors that were significant were knowledge, attitudes, and beliefs about donation.[2] Wakefield et al. assessed the role of religious and ethnic views regarding organ donation amongst university students. They administered the Organ Donation Attitude Scale with measures assessing knowledge and attitude. They found that females, younger students, and those with higher knowledge levels were more likely to have attitudes that favored organ donation. They also found that students who described themselves as having stronger religious beliefs and those with poor knowledge had less favorable attitudes toward organ donation. They suggested that further in-depth research examining the impact of religion and culture was essential to explore strategies for improving organ donation.[3] Jelinek et al. administered an online questionnaire regarding organ donation to Australasian healthcare professionals. They found that most members supported organ donation and around a quarter of their staff had received no education about it.[4] Zampieron et al. conducted a survey on attitudes toward organ donation amongst undergraduate nursing students. They administered a self-rated quantitative questionnaire and the Organ Donation Attitude scale. They found no significant correlations between attitude toward organ-donation and the age and sex of the students. They concluded that awareness and attitude levels of nursing students toward organ donation was inadequate.[5] Siminoff et al. collected data regarding organ donation from health care professionals and family members of patients. Their study revealed that family and patient socio-demographics and prior knowledge of the patients’ wishes were significantly associated with willingness to donate. They suggested that public education is needed to modify attitudes about organ donation prior to a donation opportunity.[6] Ballala et al. assessed the knowledge, attitude, and practices regarding organ donation among Indian medical professionals. They administered a semi-structured questionnaire and found that 8% were unaware of the term “body donation” and 85% believed that donated bodies were misused. They also found that 22% physicians were willing to donate their bodies and 68% expected the public to do the same.[7] Eide et al. investigated the need for learning and communication of intensive care doctors and neurosurgeons toward organ donation. They found that more than half had little experience of organ donation or how to relate to the patients’ relatives. They also found that many doctors reported a need to learn more about the medical issues and communication skills associated with organ donation. They concluded that training programs should focus on communication regarding organ donation with the caregivers of patients.[8] Tam et al. administered a questionnaire regarding knowledge, attitudes and commitment toward organ donation to nursing students. They found that attitude and educational year of the students were strongly correlated with commitment toward organ donation. They concluded that educational materials may be provided to students to facilitate their attitudes toward organ donation.[9] Jeon et al. assessed the knowledge and attitudes of health care professionals regarding organ donation. They found that the knowledge and attitudes of health care professionals regarding brain death and organ retrieval was poor. They found that gender, age, marital status, education level, and job position were significant in the attitude scores while marital status and education level emerged significant in the scores on knowledge.[10] The reviewed literature suggests that health care professionals have poor knowledge and variable attitudes toward organ donation. We found differences in the methodology and measures in the studies that we reviewed. Certain studies used validated and reliable scales for assessment. However, few studies developed their own questionnaires for assessing knowledge and attitudes toward organ donation. Methods of data collection varied from telephone conversations, online surveys, face-to-face interviews to self-rated questionnaires. Background literature suggests the need for improving existing knowledge and communication skills of health care professionals regarding organ donation. We believe that cultural factors may also contribute toward attitudinal differences regarding organ donation. There is a need to explore the complex interplay of culture, religion, and spirituality in this arena.