A rating scale for drug-induced akathisia has been derived that incorporates diagnostic criteria for pseudoakathisia, and mild, moderate, and severe akathisia. It comprises items for rating the observable, restless movements which characterise the condition, the subjective awareness of restlessness, and any distress associated with the akathisia. In addition, there is an item for rating global severity. A standard examination procedure is recommended. The inter-rater reliability for the scale items (Cohen's kappa) ranged from 0.738 to 0.955. Akathisia was found in eight of 42 schizophrenic in-patients, and nine had pseudoakathisia, where the typical sense of inner restlessness was not reported.

A rating scale for drug-induced akathisia

Data from two studies were utilized to examine whether the co-occurrence of maladaptive behaviors thought to serve an emotion regulating function would be associated with greater emotion regulation difficulties compared to one or none of these behaviors. Study 1 included an undergraduate sample (N = 119; 76 % female) and Study 2 included a sample of patients receiving treatment at a residential substance abuse treatment facility (N = 82; 48 % female). Subgroups were created based on the presence or absence of the following maladaptive behaviors: (a) deliberate self-harm (DSH) and disordered eating (Study 1); and (b) DSH, disordered eating, and substance misuse (Study 2). Subgroup differences in mean levels of emotion regulation difficulties (overall and six dimensions) were evaluated for each study. In Study 1, individuals who reported clinically-relevant levels of both DSH and disordered eating had more difficulties with emotion regulation (overall and three dimensions) compared to those who reported neither behavior. In Study 2, individuals who reported clinically-relevant levels of both DSH and substance misuse had more difficulties with emotion regulation (Study 2; overall and five dimensions) compared to those with only substance misuse. Overall, the results of these studies support the hypothesis that the co-occurrence of clinically-relevant maladaptive behaviors is associated with greater difficulties regulating emotions than the presence of only one maladaptive behavior (or no maladaptive behaviors). These findings suggest that clinical interventions targeting emotion regulation skills may be particularly useful for individuals who display a pattern of co-occurring maladaptive behaviors.

Emotion Regulation Difficulties and Maladaptive Behaviors: Examination of Deliberate Self-harm, Disordered Eating, and Substance Misuse in Two Samples

Understanding relationships between substance use and suicidal ideation and behaviour (SIB) has important public health implications for suicide prevention in low- and middle-income countries (LMICs), where 75% of suicides occur. This systematic review explored the associations between substance use and SIB in LMICs. We searched five databases using a combination of keywords for substance use, SIB and LMICs to identify English-written quantitative studies published between January 2006 and February 2016. Data were extracted to provide an overview of what is known about the topic, highlight gaps in the literature, and explore the implications of current knowledge for suicide prevention. Studies included in the review were assessed for methodological quality using the Scottish Intercollegiate Guidelines Network checklist. Analysis of included studies (N = 108) demonstrated a consistent positive association between substance use and SIB across all substances (i.e. alcohol, tobacco, cannabis, illicit drugs, non-medical use of prescription drugs), all substance use dimensions (i.e. intoxication, use, and pathological use) and all SIB dimensions (i.e. suicidal ideation, non-fatal suicidal behaviour, and suicide). Most of the available research evidence comes from upper-middle-income countries, only 22% comes from lower-middle-income and low-income countries. Most studies focused on alcohol and tobacco, while neglecting substances such as cannabis, opioids, sedatives, stimulants, misuse of prescription medication, inhalants, and hallucinogens. Most of the studies employed a cross-sectional design, were conducted within a risk-factor paradigm, and provided little information about the potential interaction between variables. Public health suicide prevention policy and research in LMICs should take account of the fact that: substance use is a potentially modifiable risk factor; assessment and management of substance use is integral to the care of at-risk patients; reducing consumption and hazardous use of substances in LMICs is important for suicide prevention; and research needs to be expanded to include more theory driven research that focuses on all substance use dimensions and SIB dimensions, while employing more sophisticated statistical methods.

/pdf/substance-use-and-suicidal-ideation-and-behaviour-in-low-and-1de7swdaz5.pdf

Substance use and suicidal ideation and behaviour in low- and middle-income countries: a systematic review

The aim of this study was to develop levosulpiride-loaded solid lipid nanoparticles (SLNs) with enhanced solubilisation and bioavailability. The levosulpiride loaded-SLNs were composed of levosulpi...

Development of levosulpiride-loaded solid lipid nanoparticles and their in vitro and in vivo comparison with commercial product

Campbell's Psychiatric Dictionary

OBJECTIVE:: The lifetime diagnosis of substance dependence syndrome is a major risk factor for attempting suicide. The systematic study of various risk factors of suicide in substance-dependent patients in Indian population will have far-reaching implications about the understanding of disorder. The objective was to study the sociodemographic and clinical factors associated with deliberate self-harm (DSH) in nondepressed substance-dependent patients. METHODS:: Participants included 60 male inpatients (30 patients with DSH and 30 without DSH) fulfilling International Classification of Diseases, Tenth Revision Diagnostic Criteria for Research for substance dependence syndrome, aged between 18 and 60 years, with Hamilton Depression Rating Scale score fewer than 7. They were assessed using Addiction Severity Index, Presumptive Stressful Life Event Scale, State-Trait Anger Expression Inventory, Lubben Social Network Scale, International Personality Disorder Examination, Risk Rescue Rating Scale, and Global Assessment of Functioning. RESULT:: Patients with DSH had significantly higher rates of opioid dependence (P Language: en

Deliberate self-harm in nondepressed substance-dependent patients

Background: Injectable antipsychotics are frequently required for controlling agitation and aggression in acute psychosis. No study has examined the use of injectable levosulpiride for this indication.
Objective: To compare the efficacy and safety of injectable levosulpiride and haloperidol in patients with acute psychosis.
Methods: This was a randomized, double-blind, parallel-group study in which 60 drug-naive patients having acute psychosis were randomly assigned to receive either intramuscular haloperidol (10–20 mg/d) or levosulpiride (25–50 mg/d) for 5 days. All patientswere rated on Brief Psychiatric Rating Scale (BPRS), Overt Agitation Severity Scale (OASS), Overt Aggression Scale–Modified (OAS-M) scores, Simpson Angus Scale (SAS), and Barnes Akathisia Rating Scale (BARS).
Results: Repeated-measures ANOVA for BPRS scores showed significant effect of time (P < 0.001) and a trend toward greater reduction in scores in haloperidol group as shown by group � time interaction (P = 0.076). Repeated-measures ANOVA for OASS showed significant effect of time (P < 0.001) but no group � time interaction. Repeatedmeasures ANOVA for OAS-M scores showed significant effect of time (P < 0.001) and greater reduction in scores in haloperidol group as shown by group � time interaction (P = 0.032). Lorazepam requirement was much lower in haloperidol group as compared with those receiving levosulpiride (P = 0.022). Higher rates of akathisia and extrapyramidal symptoms were noted in the haloperidol group.
Conclusions: Haloperidol was more effective than levosulpiride injection for psychotic symptoms, aggression, and severity of agitation in acute psychosis, but extrapyramidal adverse effects were less frequent with levosulpiride as compared with those receiving haloperidol.

Efficacy and safety of levosulpiride versus haloperidol injection in patients with acute psychosis: A randomized double-blind study

Background: Psychiatric morbidity represents most important problem among all children including school going children worldwide, prevalence of psychiatric disorders among children has been reported to be 14-20% across various studies Child and adolescent population are susceptible for psychiatric morbidity; we plan to evaluate the prevalence of psychiatric morbidity among school going students of class 8 and 9.Methods: It was a cross sectional observational study. Study was conducted in two steps, firstly screening was done with GHQ-12 along with socio-demographic data sheets, on second step students scoring above GHQ cutoff score were interviewed by consultant psychiatrist and diagnosis was made as per ICD 10 DCR.Results: A total of 128 students, consisting of 73 male and 55 females (57% and 43% respectively) with mean age of 13.02±0.58 years participated. With GHQ screening 38 students scored above the cut-off marks and finally 6 children were diagnosed as generalized anxiety disorder, 6 as Depression, 1 as elimination disorder (nocturnal enuresis), 3 as separation anxiety, 4 cases of OCD, and 2 cases of Panic disorder totaling to 21 (16.41%) students.Conclusions: This study finds a prevalence of 16.41% of the psychiatric morbidity among school students.

/pdf/psychiatric-morbidity-among-school-students-1eqj0g7vb2.pdf

Psychiatric morbidity among school students

Tardive dysmentia has been described as the behavioral equivalent of tardive dyskinesia in patients with schizophrenia. Its association with tardive dyskinesia and psychopathology has been controversial. The authors assessed 123 inpatients with chronic schizophrenia for presence of tardive dysmentia symptoms/signs. Psychopathology and tardive dyskinesia were also assessed. Of the group, 24 patients (19.5%) had at least one tardive dysmentia symptom/sign, whereas only 1 patient (0.8%) fulfilled the syndromal criteria for tardive dysmentia. Those with tardive dysmentia had higher psychopathology scores, higher Abnormal Involuntary Movement Scale total scores, higher number of women and family psychiatric illness, and higher rates of persistent tardive dyskinesia. Tardive dysmentia symptoms/signs are frequently seen in chronic schizophrenia, but the complete syndrome may be rare.

https://neuro.psychiatryonline.org/doi/pdf/10.1176/appi.neuropsych.12020024

Sagar Lavania

Papers

Deliberate self-harm in nondepressed substance-dependent patients

Efficacy and safety of levosulpiride versus haloperidol injection in patients with acute psychosis: A randomized double-blind study

Psychiatric morbidity among school students

Does Tardive Dysmentia Really Exist

Modulation of physical activity, adiposity, diet composition and cardiovascular risk factors in type 2 diabetic patients