Showing papers in "Industrial Psychiatry Journal in 2012"

Gender differences in stress response: Role of developmental and biological determinants.

Abstract: Stress response is associated with manifestations of various psychosomatic and psychiatric disorders. Hence, it is important to understand the underlying mechanisms that influence this association. Moreover, men and women tend to react differently with stress-both psychologically and biologically. These differences also need to be studied in order to have a better understanding in the gender difference observed for many disorders, which are likely to be contributed by the gender difference in stress reactivity and responses. Such an understanding would have a significant impact on our understanding about how adult health is set during early life and how adult disease could be prevented in men and women.

Job satisfaction in health-care organizations.

Abstract: Job satisfaction among health-care professionals acquires significance for the purpose of maximization of human resource potential. This article is aimed at emphasizing importance of studying various aspects of job satisfaction in health-care organizations.

Problematic use of social networking sites among urban school going teenagers.

Abstract: Background: Social networking sites like Facebook, Orkut and Twitter are virtual communities where users can create individual public profiles, interact with real-life friends and meet other people based on shared interests. An exponential rise in usage of Social Networking Sites have been seen within the last few years. Their ease of use and immediate gratification effect on users has changed the way people in general and students in particular spend their time. Young adults, particularly teenagers tended to be unaware of just how much time they really spent on social networking sites. Negative correlates of Social Networking Sites usage include the decrease in real life social community participation and academic achievement, as well as relationship problems, each of which may be indicative of potential addiction. Aims: the aim of the study was to find out whether teenagers, specially those living in cities spend too much time on social networking websites. Materials and Methods: 200 subjects, both boys and girls were included in the cross sectional study who were given a 20 item Young's internet addiction test modified for social networking sites. The responses were analyzed using chi square test and Fisher's exact test. Results: 24.74% of the students were having occasional or 'frequency' problems while 2.02% of them were experiencing severe problems due to excessive time spent using social networking sites. Conclusion: With the ever increasing popularity of social media, teenagers are devoting significant time to social networking on websites and are prone to get 'addicted' to such form of online social interaction.

Psychological issues in pediatric obesity.

Abstract: Pediatric obesity is a major health problem and has reached epidemiological proportions today. The present paper reviews major psychological issues in pediatric obesity from a developmental perspective. Research and literature has shown that a number of developmental, family, maternal and child factors are responsible in the genesis of pediatric obesity. Family food habits, early developmental lifestyle of the child, parenting, early family relationships and harmony all contribute towards the growth and development of a child. The present review focuses on the role of developmental psychological factors in the pathogenesis of pediatric obesity and highlights the developmental factors that must be kept in mind when evaluating a case of pediatric obesity.

Impact of psychiatric education and training on attitude of medical students towards mentally ill: A comparative analysis

Abstract: Background: A number of studies from the western world have explored the negative beliefs held by individuals towards people with mental illness. The knowledge of attitude and awareness of undergraduate medical students towards psychiatry, mental health and mental disorders is of utmost importance. Objective: The current study aims at assessment of attitudes of medical students towards mental illness and mentally ill. Materials and Methods: The study used a cross-sectional survey design. The instruments used included Beliefs toward Mental Illness (BMI) scale, Attitudes to Mental Illness Questionnaire (AMIQ). ANOVA was carried out to compare the in between group differences for the four study groups. Additionally Bonferroni correction was used to conduct the post hoc analysis. Results: The interns were significantly more likely to agree with the statement that the mental disorders are recurrent; less likely to be of thought that the behavior of people with mental disorders is unpredictable; more likely to disagree with the fact that diagnosis of depression as described in the case vignette was going to damage the career of the individual; more likely to agree with the option of inviting a depressed person to a party; more likely to believe in fact that mentally ill individuals are more likely to be criminals as compared to medical students in different professional years. Conclusions: Adequate modifications to existing medical curriculum would help improve attitude of medical students towards mentally ill.

Supernatural beliefs, aetiological models and help seeking behaviour in patients with schizophrenia.

Abstract: Background: Few studies have evaluated the supernatural beliefs of patients with schizophrenia. This study aimed to study the personal beliefs, aetiological models and help seeking behaviour of patients with schizophrenia using a self-rated questionnaire. Materials and Methods: Seventy three patients returned the completed supernatural Attitude questionnaire. Results: 62% of patients admitted that people in their community believed in sorcery and other magico-religious phenomena. One fourth to half of patients believed in ghosts/evil spirit (26%), spirit intrusion (28.8%) and sorcery (46.6%). Two-third patients believed that mental illness can occur either due to sorcery, ghosts/evil spirit, spirit intrusion, divine wrath, planetary/astrological influences, dissatisfied or evil spirits and bad deeds of the past. 40% of the subjects attributed mental disorders to more than one of these beliefs. About half of the patients (46.6%) believed that only performance of prayers was sufficient to improve their mental status. Few patients (9.6%) believed that magico-religious rituals were sufficient to improve their mental illness but about one-fourth (24.7%) admitted that during recent episode either they or their caregivers performed magico-religious rituals. Conclusion: Supernatural beliefs are common in patients with schizophrenia and many of them attribute the symptoms of mental disorders to these beliefs.

Sociodemographic profile, clinical factors, and mode of attempt in suicide attempters in consultation liaison psychiatry in a tertiary care center.

Abstract: Background: The objective was to study the sociodemographic data, psychiatric disorder, precipitating events, and mode of attempt in suicide attempted patients referred to consultation liaison psychiatric services. Settings and Design: A prospective study of 6-month duration was done in a tertiary care center in India. Materials and Methods: During the 6-month period all referrals were screened for the presence of suicide attempters in consultation liaison services. Those who fulfilled the criteria for suicide attempters were evaluated by using semistructured pro forma containing sociodemographic data, precipitating events, mode of attempt, and psychiatric diagnosis by using ICD-10. Results: The male-to-female ratio was similar. Adult age, urban background, employed, matriculation educated were more represented in this study. More than 80% of all attempters had psychiatric disorder. Majority had a precipitating event prior to suicide attempt. The most common method of attempt was by use of corrosive. Conclusions: Majority of suicide attempter patients had mental illness. Early identification and treatment of these disorders would have prevented morbidity and mortality associated with this. There is a need of proper education of relatives about keeping corrosive and other poisonous material away from patients as it was being commonest mode of attempt.

Body image satisfaction among female college students

Abstract: Objective: To determine body image satisfaction among newly entrant women students in a professional institution. Materials and Methods: A cross-sectional study using body image satisfaction described in words was undertaken, which also explored relationship with body mass index (BMI) and other selected co-variables such as socio-demographic details, overall satisfaction in life, and particularly in academic/professional life, current health status using 5-item based Likert scale. Height, weight, hip and waist circumference measurement was carried out using standard protocol. Data collection was carried through personal interview using pre-designed, pre-tested semi-structured interview schedule by female investigators during August-September 2010 and analysis carried out by computing percentages and Chi-square test. Results: Out of 96 study samples, 16.66%, 51.04%, and 32.29% girl students perceived their body image as fair, good and excellent, respectively while overall 13.54% were dissatisfied with their body image. The body image satisfaction had significant relationship with image perception ( P P P P =0.004) but negative relationship with outcome variable. Students with low weight (BMI 2 ) had a significantly higher (85.71%) prevalence of body image satisfaction while overweight students (BMI≤23 kg/m 2 ) had a significantly higher (54.54%) prevalence of dissatisfaction ( P Discussion: High body image satisfaction is reported in this study and was found to be significantly related to anthropometric measurements. On an encouraging note, this level needs to be preserved for overall mental and healthy development of students. Proactive preventive measures could be initiated on personality development, acceptance of self and individual differences while maintaining optimum weight and active life style.

Internal predictors of burnout in psychiatric nurses: An Indian study.

Abstract: Background: Research has not adequately focused on the issue of burnout in Psychiatric nurses, despite the fact that they suffer considerable stress in their work. Till date no study has been conducted on burnout among psychiatric nurses in India. Further, there is a particular lack of research in internal variables predicting burnout in them. Aims: To determine whether there are any internal psychological factors relevant to burnout in psychiatric nurses in India. Materials and Methods: We recruited 101 psychiatric nurses scoring less than two in General Health Questionnaire, version 12 (GHQ-12) from two psychiatric hospitals after obtaining informed consent. All subjects filled up a sociodemographic data sheet along with global adjustment scale, emotional maturity scale, PGI general well-being scale, locus of control scale, and Copenhagen burnout inventory (CBI). Correlations between burnout and sociodemographic/clinical variables were done by Pearson's r or Spearman's rho. Signi ficant variables were entered in a stepwise multiple linear regression analysis with total burnout score as dependent variable. Results: Age, duration of total period of nursing, prior military training, locus of control, sense of general well-being, adjustment capabilities, and emotional maturity had significant relation with burnout. Of them, emotional maturity was the most significant protective factors against burnout along with adjustment capabilities, sense of physical well-being, and military training in decreasing significance. Together they explained 41% variation in total burnout score which is significant at <0.001 level. An internal locus of control was inversely correlated with burnout, but failed to predict it in regression analysis. Conclusion: Emotional maturity, adjustability, sense of general physical well-being as well as prior military training significantly predicted lower burnout. Of them, emotional maturity was the most important predictor. Internal locus of control was also correlated with lower burnout.

Understanding sexuality among Indian urban school adolescents.

Abstract: Context: Adolescence is a very exciting phase of life fraught with many challenges like sexuality. Understanding them is important in helping the adolescents grow up healthily. Aims: To ascertain the attitudes and knowledge about sexuality among school-going adolescents. Settings and Design: Students in two urban schools of an Indian city from class IX to XII were administered a self-reporting questionnaire on matters related to sexuality. Materials and Methods: Requisite ethical clearances were taken as also the consent of the parents and students before administration of the questionnaire. The authors clarified doubts to adolescents. Statistical analysis: Statistical package for social sciences. Results: The incidence of having sexual contact was 30.08% for boys and 17.18% for girls. 6.31% boys and 1.31% girls reported having had experienced sexual intercourse. Friends constituted the main sexual partners for both boys and girls. Sexual abuse had been reported by both girls and boys. These and other findings are discussed in the article. Conclusions: Adolescent school students are involved in sexual activity, but lack adequate knowledge in this regard. Students, teachers, and parents need to understand various aspects of sexuality to be able to help adolescents' healthy sexual development.

Clozapine responsive catatonia: A series of five cases.

Abstract: The main objective of presenting the case series is that despite dramatic symptomatic response by intra venous lorazepam or electro convulsive therapy irrespective of primary diagnosis in catatonia cases some cases remain difficult to treat by conventional treatment. Here, we present five catatonia cases who did not respond to conventional treatment even when treated for primary psychiatric diagnosis along with treatment for catatonia. They ultimately responded partially or completely to clozapine only, which explains the multi-factorial causation of catatonia syndrome as postulated by different scientific research.

Efficacy of yoga therapy on subjective well-being and basic living skills of patients having chronic schizophrenia

Abstract: Background: Scientific studies demonstrate efficacy of yogic treatment methods in stress and anxiety related disorders, psychosomatic disorders and physical illness. Very few studies have been conducted on schizophrenic patients. Aims: This study was conducted to determine the efficacy of yoga therapy on subjective well-being, basic living skills, self-care, interpersonal, communicational and routine functions of schizophrenic patients. Materials and Methods: Thirty chronic schizophrenic hospitalized patients were selected from Ranchi Institute of Neuro-Psychiatry and Allied Sciences, Ranchi and were randomly assigned to the experimental group (yoga therapy along with Pharmacotherapy, n =15), and to control group (Pharmacotherapy alone, n =15). Baseline assessment was done using Post Graduate Institute general well-being measure (GWBM), Checklist for basic living skills and Indian disability evaluation and assessment scale (IDEAS). The experimental group attended yoga therapy every day for about 1΍ h including motivational and feedback session. After 1 month post-assessment was done for both the groups. Statistical Analysis: Pearson Chi-square test was used for comparing the results. Results: At the end of 1 month experimental group showed better rating in comparison to control group in PGI GWBM, basic living skills and IDEAS. Conclusion: Yoga could improve patients' subjective well-being, their daily basic living functioning, personal hygiene, self-care, interpersonal activities and communication, and prompted more involvement in routine work.

Tokophobia: A dread of pregnancy.

Abstract: Tokophobia is a pathological fear of pregnancy and can lead to avoidance of childbirth. It can be classified as primary or secondary. Primary is morbid fear of childbirth in a woman, who has no previous experience of pregnancy. Secondary is morbid fear of childbirth developing after a traumatic obstetric event in a previous pregnancy. A case of tokophobia with depression who responded to fluoxetine is being described.

HIV serostatus disclosure: Experiences and perceptions of people living with HIV/AIDS and their service providers in Gujarat, India.

Abstract: Background: Human immunodeficiency virus (HIV) disclosure offers important benefits to people living with HIV/AIDS. However, fear of discrimination, blame, and disruption of family relationships can make disclosure a difficult decision. Barriers to HIV disclosure are influenced by the particular culture within which the individuals live. Although many studies have assessed such barriers in the U.S., very few studies have explored the factors that facilitate or prevent HIV disclosure in India. Understanding these factors is critical to the refinement, development, and implementation of a counseling intervention to facilitate disclosure. Materials and Methods: To explore these factors, we conducted 30 in-depth interviews in the local language with HIV- positive individuals from the Integrated Counselling and Testing Centre in Gujarat, India, assessing the experiences, perceived barriers, and facilitators to disclosure. To triangulate the findings, we conducted two focus group discussions with HIV medical and non-medical service providers, respectively. Results: Perceived HIV-associated stigma, fear of discrimination, and fear of family breakdown acted as barriers to HIV disclosure. Most people living with HIV/AIDS came to know of their HIV status due to poor physical health, spousal HIV-positive status, or a positive HIV test during pregnancy. Some wives only learned of their husbands' HIV positive status after their husbands died. The focus group participants confirmed similar findings. Disclosure had serious implications for individuals living with HIV, such as divorce, maltreatment, ostracism, and decisions regarding child bearing. Interpretation and Conclusion: The identified barriers and facilitators in the present study can be used to augment training of HIV service providers working in voluntary counseling and testing centers in India.

Attitude toward mental illness amongst urban nonpsychiatric health professionals.

Abstract: Background: This study was designed to examine the attitude of nonpsychiatric health professionals about mental illness in urban multispeciality tertiary care setting. Aim: To assess attitude toward mental illness among urban nonpsychiatric health professionals. Materials and Methods: A cross-sectional study design was used. A pretested, semistructured questionnaire was administered to 222 medical and paramedical staff at two tertiary care hospitals at Chandigarh. Results: There is an increased awareness of mental illness especially in military subjects. Literacy was associated with a positive attitude toward mental illness. Health care givers commonly fail to ask about the emotional well being of their patients. Many saw referral to psychiatrist as a form of punishment. There is uniform desire for more knowledge about psychiatric disorders in medical and paramedical staff. Conclusions: This study demonstrates the need for educational programs aimed at demystifying mental illness. A better understanding of mental disorders among the nonpsychiatric medical professional would help to allay fear and mistrust about mentally ill persons in the community as well as lessen stigmatization toward such persons.

Diabetes mellitus: A risk factor for cognitive impairment amongst urban older adults.

Abstract: Background: Studies reported in relation to diabetes mellitus and cognitive impairment are inconclusive. Diabetes mellitus is a wide spread physical illness amongst older adults. The study explores whether, it leads to cognitive impairment amongst older adults in comparison to those without diabetes mellitus. Materials and Methods: Study sample consisted of 900 subjects fulfilling the inclusion/exclusion criteria out of 1067 elderlies aged 55 years and above residing in a randomly selected ward of urban Lucknow. Pathological investigation was done on all elderlies to rule out diabetes mellitus. Out of 900 subjects 145 were found to have Diabetes Mellitus and rests 755 were without diabetes mellitus. These subjects were further divided into two groups: (i) with and (ii) without cognitive impairment based on detailed assessment of Mini Mental State Examination positive subjects by Cambridge Examination for Mental Disorders of the Elderly- Revised (CAMDEX-R). International Classification of Diseases-10 th revision criteria were used to make diagnosis. Data analysis was done calculating odds ratio, Chi square, and percentages. Results: Diabetes mellitus was found to be prevalent is 13.7% and 16.9% amongst older adults aged 55-59 years and 60 years and above respectively. Odds ratio 1.3 with CI 95% indicates that subjects with diabetes mellitus is 1.3 times at more risk to develop cognitive impairment amongst urban older adults than non-cognitively impaired subjects. But differences on Chi square test were found to be insignificant. Conclusion: There is a weak association between diabetes mellitus and cognitive impairment amongst urban older adults.

Migraine: Clinical pattern and psychiatric comorbidity.

Abstract: Background: Migraine is a common disorder which has psychiatric sequelae. Objective: The objective of this study was to determine the clinical pattern and psychiatric comorbidity of migraine. Materials and Methods: 100 cases of migraine seen over a period of one year were analysed to know the sociodemographic characteristics, clinical pattern and psychiatric morbidity. Results: Maximum patients were between 31-40 years of age group (40%), females (78.0%), married (76%) and housewives (56.0%). Family history of migraine was present in 12% cases. Average age of onset was 22 years. Unilateral and throbbing type of headache was most common. The commonest frequency was one to two per week. Migraine without aura was commonest sub-type (80%). Generalized anxiety disorder (F41.1) was the most common psychiatric disorder (34%), followed by mixed anxiety and depressive disorder (F41.2) (18%) and depressive episode (F32) (14%). In 22% cases, no psychiatric disorder could be elicited. Conclusion: The present study confirms that majority patients with migraine had psychiatric disorders. This needs timely detection and appropriate intervention to treat and control the migraine effectively.

Tobacco-alcohol amblyopia: A rare complication of prolonged alcohol abuse.

Abstract: Tobacco-alcohol amblyopia is rare, however, extremely disabling complication seen in patient with alcohol dependence syndrome, which if not addressed properly and at the right time may lead to persisting deficits. We here report a patient of alcohol-dependence syndrome who presented with significant diminution of vision bilaterally in the background of excess alcohol consumption.

Delusional parasitosis: Worms of the mind.

Abstract: Delusional parasitosis is an uncommon psychotic illness Patients often report to dermatologists and physicians for treatment and are brought to psychiatric attention only for associated psychological distress One such case is discussed in this report

Does psychiatry rotation in undergraduate curriculum bring about a change in the attitude of medical student toward concept and practice of psychiatry: A comparative analysis.

Abstract: Objective: To assess the attitude of MBBS student toward concept and practice of psychiatry between groups of students exposed to psychiatry rotation versus those not yet exposed to. Materials and Methods: A cross-sectional analytical study was carried out. Anonymity and confidentiality of the respondent was emphasized. Attitude was measured with 30-item attitude toward psychiatry scale. Results: Attitude toward psychiatry was found to be better in groups of medical students exposed to 2 weeks clinical rotation in psychiatry . However, the same reached statistical significance in only 36.7% of the questions. Conclusion: Clinical rotation in Psychiatry in undergraduate has a favorable effect on the attitude of medical students toward concept and practice of psychiatry. Better curriculum and more hours in psychiatry may yield better gain.

Emotional intelligence scale for medical students.

Abstract: Background: Emotional Intelligence has been associated with positive outcome process in varied professions. There is paucity of Indian literature on the subject; especially involving medical undergraduates; and presently there is no scale available to measure the same in the Indian scenario. Objective: To develop a scale to measure Emotional Intelligence among medical undergraduates. Materials and Methods: Four domains of Emotional intelligence were selected, viz. Self-Awareness, Self-Management, Social-Awareness & Social-Skills and these were included for the purpose of domains of the scale. On the basis of focused group discussions and in-depth deliberations with experts, undergraduate and postgraduate medical students a pool of 50 items was generated. The items were reduced to 27 based on expert consensus and on the basis of frequency of endorsement by expert reviews. It was followed by a pilot study of 50 undergraduates. This completed the preparation of the preliminary draft based on content analysis. The questionnaire was then administered in 480 students and the data was analyzed by appropriate statistical methods. For the purpose of concurrent validity, emotional intelligence scale developed by Dr. Ekta was used. Results: The Cronbach's Alpha for Internal Consistency Reliability was 0.68. The EIS had a significant correlation with social awareness domain of Emotional Intelligence Test (EIT) establishing Concurrent Validity. Conclusion: Emotional Intelligence Scale for medical undergraduates was constructed. Reliability and concurrent validity were also established for the same.

Perception and prevalence of domestic violence in the study population.

Abstract: Background: Domestic violence is a major contributor to physical and mental ill health of the victim, and it is evident to some degree, in every society of the world. Objectives: 1) To study perception about domestic violence in the study population. 2) To compare prevalence of domestic violence within the three subgroups of the study population (i.e. spouses of psychotic patients, spouses of non-psychiatric patients and hospital staff). Materials and Methods: A cross-sectional study was conducted among married men and women coming to Dhiraj General Hospital. Interviews were conducted using a semi-structured questionnaire. Inquiry was done about their perception regarding domestic violence, own experience any time in their life, and about the form of violence. Data was entered and analyzed using SPSS. Results: 42.7% of study participants had never heard the words domestic violence. The overall prevalence of any form of violence in the study population as a whole was 32.3%. There was no significant difference found in the proportion of domestic violence among the three groups. The prevalence of physical, emotional, sexual and economic domestic violence was 16.3%, 25.3%, 2% and 11.3% respectively. Younger age group and female sex were significantly associated with the occurrence of domestic violence. Conclusion: Apart from the high prevalence of domestic violence in the present era, it is evident from the study that the participants' perception about domestic violence was low. Efforts should be made to raise public consciousness and reporting of domestic violence and its attendant consequences.

Psychological benefits of yoga in industrial workers

Abstract: Background: The industrial workers are exposed to stress and strain due to the tough nature of their duties. There is a need to incorporate simple, cost effective, and easily implementable measures in the industries to tackle this menace of stress. Yoga has been considered a suitable candidate for this job. Hence this study was undertaken to evaluate the psychological benefits of yoga in workers. Materials and Methods: Four hundred healthy young general duty workers were enrolled for this study and made into four matched groups of 100 each. One group was given regular Yoga practice in the morning, another group was given regular physical training in the morning, third group was exposed to regular physical training in the morning and Yoga in the evening, and the last group was exposed to neither of them. All were assessed for their psychological state at base line, 4 weeks and at 12 weeks using specified scales. The findings were statistically analysed. Results: Yoga was found to have more beneficial psychological effect comparable to physical training. However maximum benefit was obtained when Yoga was combined with PT. Conclusion: Yoga has got positive psychological benefits in general duty workers when practiced regularly. The benefits are enhanced when Yoga is combined with PT.

Gender differences in perception of workplace sexual harassment among future professionals

Abstract: Background: Indian society is in a stage of rapid social transition. As more women enter the workforce, stresses vis-a-vis the genders are to be expected in patriarchal society to which most of our population belongs. Earlier studies in Western societies have revealed gender differences in perception of what constitutes sexual harassment. Aim: Elicit gender differences, if any, in the workplace sexual harassment among future professionals. Settings and Design: A cross-sectional study among the students of professional colleges. Materials and Methods: A total of 200 students of both sexes were randomly selected from four professional colleges. Data collection was done on a structured questionnaire by interview. Statistical Analysis: Internal consistency of the questionnaire was tested by Crohnbach's α coefficient. Associations between gender and perceptions were explored with Chi-square, Odds Ratio with 95% confidence interval, where applicable. Results: The differences in perception on what constitutes sexual harassment among the genders were statistically significant on many measures (P<0.01). Conclusions: Men and women differ in their awareness as to what constitute sexual harassment. Men were more lacking in awareness regarding sexual harassment.

Integrated yoga therapy for improving mental health in managers.

Abstract: Background: Managers' lives have become a never-ending race against time, technology, and targets. This race creates tension, which leads to dissatisfaction and frustration and eventually manifests itself as psychological and physiological stress with mental and emotional drain. This modern lifestyle intensifies the stress leading to Excessive Tension and consequent deterioration in Executive Efficiency. Objective: To assess mental health in managers undergoing yoga-based Self-Management of Excessive Tension (SMET) program. Materials and Methods: 72 managers with 48.75±3.86 years of mean age were participated in this study of single group pre-post design. The General Health Questionnaire data were taken on the first and sixth day of 5 days SMET program. Results: The data analysis showed 68.25% decrease (P<0.001) in somatic symptoms, 66.29% decrease (P<0.001) in anxiety and insomnia, 65.00% decrease (P<0.001) in social dysfunction, 87.08% decrease (P<0.001) in severe depression, and 71.47% decrease (P<0.001) in all medical complaints. Conclusion: These results suggest that participation in a SMET program was associated with improvement in mental health and may have implications for Executive Efficiency.

Tolerability and efficacy of paliperidone ER compared to olanzapine in the treatment of schizophrenia: A randomized, double-blind, multicentric trial.

Abstract: Background: Paliperidone is an active metabolite of risperidone and actss through a combination of central dopamine Type 2 (D2) and serotonin Type 2 (5HT2A) receptor antagonism. Aim: The present randomized, double-blind, multicentric trial was designed to determine the safety and efficacy of paliperidone extended release (ER) compared to olanzapine in the treatment of acute schizophrenia. Materials and Methods: A total of 214 patients with diagnosis of schizophrenia were randomized to paliperidone ER (n=109) and olanzapine (n=106) treatment groups. Totally 206 patients were evaluated for efficacy parameters using Positive and negative syndrome scale (PANSS) score and Clinical Global Impression-severity of illness (CGI-S) and Clinical Global Impression-improvement of illness (CGI-I) scales. Safety was assessed by treatment-emergent adverse events and movement disorders. Results: All patients showed significant reduction in PANSS scores at the end of treatment. However, the results were comparable and there was no significant difference at the end of the trial between paliperidone ER group and olanzapine group. Both the treatment groups showed decrease in the severity of illness and improvement in symptomatology. The most common adverse events reported in paliperidone ER versus olanzapine group were Extra Pyramidal Syndrome (EPS) (13.7% vs. 15.6%), headache (12.7% vs. 8.9%), increased appetite (8.8% vs. 10.0%) and drowsiness (4.9% vs. 303%). There was no clinically relevant difference in change from baseline to the end of the trial in abnormal involuntary movement scale (AIMS) and barnes akathisia rating scale (BARS) total scores between both the groups. Conclusion: Paliperidone ER is effective in controlling schizophrenic symptoms as well as exhibits comparable tolerability profile. Thus, paliperidone ER has the potential to be a useful new treatment option for patients with schizophrenia.

Mania in dengue fever

Abstract: Dengue fever, also known as break bone fever, is a mosquito-borne infection that causes a severe flu-like illness. During the last few years, there had been increasing reports of dengue fever with unusual manifestations, primarily with neurological symptoms. Psychiatric morbidity during acute dengue infection has rarely been reported. There has not been any systemic study mentioning the prevalence and pattern of psychiatric sequelae. We report a 28-year-old male who after an acute dengue infection developed an episode of mania which was successfully treated.