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Garg R, Chavan BS, Das S, Puri S, Banavaram AA, Benegal V, Rao GN, Varghese M, Gururaj G. Treatment gap for mental and behavioral disorders in Punjab. Indian J Psychiatry 2023; 65:1269-1274. [PMID: 38298876 PMCID: PMC10826874 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_839_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 05/03/2022] [Accepted: 11/07/2023] [Indexed: 02/02/2024] Open
Abstract
Background and Aims There is no data on the treatment gap and health care utilization for mental disorders from Punjab. The present study reports on the same by using the data collected during the National Mental Health Survey. Settings and Design Multisite, multistage, stratified, random cluster sampling study conducted in four districts, namely Faridkot, Moga, Patiala, and Ludhiana (for urban metro areas). Data were collected from October 2015 to March 2016. Materials and Methods Mini International Neuropsychiatric Interview 6.0.0 and Adapted Fagerstrom Nicotine Dependence Scale were used to diagnose mental and behavioral disorders and tobacco use disorder, respectively. Pathways Interview Schedule of the World Health Organization was applied to persons having any disorder to assess treatment gap and health care utilization. Exploratory focused group discussions (FGDs) were conducted to understand the community perceptions regarding mental and behavioral disorders. Results The treatment gap for mental and behavioral disorders was 79.59%, and it was higher for common mental disorders than severe mental disorders and higher for alcohol and tobacco use disorders as compared to opioid use disorders. The median treatment lag was 6 months. Only seven patients out of 79 were taking treatment from a psychiatrist, and the average distance traveled by the patient for treatment was 37.61 ± 45.5 km. Many attitudinal, structural, and other barriers leading to high treatment gaps were identified during FGDs in the community, such as stigma, poor knowledge about mental health, deficiency of psychiatrists, and distance from the hospital. Conclusions Vertical as well as horizontal multisectoral integration is required to reduce the treatment gap and improve healthcare utilization. Increasing mental health literacy, providing high-quality mental health services at the primary-healthcare level and human resources development are the need of the hour.
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Affiliation(s)
- Rohit Garg
- Department of Psychiatry, Government Medical College and Rajindra Hospital, Patiala, Punjab, India
| | - Bir Singh Chavan
- Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India
| | - Subhash Das
- Department of Psychiatry, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India
| | - Sonia Puri
- Department of Community Medicine, Government Medical College and Hospital, Chandigarh, India
| | - Arvind A. Banavaram
- Department of Epidemiology, Centre for Public Health, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Vivek Benegal
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Girish N. Rao
- Department of Epidemiology, Centre for Public Health, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Mathew Varghese
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Gopalkrishna Gururaj
- Department of Epidemiology, Centre for Public Health, WHO Collaborative Centre for Injury Prevention and Safety Promotion, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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Singh J, Singh S, Gupta S, Chavan BS. Cognitive Remediation and Schizophrenia: Effects on Brain Complexity. Neurosci Lett 2023; 808:137268. [PMID: 37100222 DOI: 10.1016/j.neulet.2023.137268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 04/10/2023] [Accepted: 04/20/2023] [Indexed: 04/28/2023]
Abstract
The objective of this study is to investigate nonlinear neural dynamics of chronic patients with schizophrenia following 3 months of cognitive remediation and to find correlations with neuropsychological measures of cognition. Twenty nine patients were randomized to Cognitive Training (CT) and Treatment as Usual (TAU) group. The system complexity is estimated by Correlation Dimension (D2) and Largest Lyapunov Exponent (LLE) from the reconstructed attractor of the underlying system. Significant increase in dimensional complexity (D2) over time is observed in prefrontal and medial frontal-central regions in eyes open and arithmetic condition; and posterior parietal-occipital region under eyes closed after 3 months. Dynamical complexity (LLE) significantly decreased over time in medial left central region under eyes closed and eyes open condition; prefrontal region in eyes open and lateral right temporal region in arithmetic condition. Interaction is significant for medial left central region with TAU group exhibiting greater decrease in LLE compared to CT group. The CT group showed significant correlation of increased D2 with focused attention. In this study it is found that patients with schizophrenia exhibit higher dimensional and lower dynamical complexity over time indicating improvement in neurodynamics of underlying physiological system.
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Affiliation(s)
- Jaskirat Singh
- Computational Neuroscience Lab, UIET, Panjab University, Chandigarh Pincode: 160014, India
| | - Sukhwinder Singh
- Computational Neuroscience Lab, UIET, Panjab University, Chandigarh Pincode: 160014, India.
| | - Savita Gupta
- Computational Neuroscience Lab, UIET, Panjab University, Chandigarh Pincode: 160014, India.
| | - B S Chavan
- Department of Psychiatry, Government Medical College and Hospital, Sector 32, Chandigarh, Pincode:160032, India.
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Chavan BS, Sidana A, Arun P, Rohilla R, Singh GP, Solanki RK, Aneja J, Murara MK, Verma M, Chakraborty S, Singh C, Sharrma H, Sharma R, Bahri S, Dushant. Psychiatric morbidity and substance use in migrant workers: A population based study. Int J Soc Psychiatry 2022; 68:210-215. [PMID: 33446003 DOI: 10.1177/0020764020988881] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The prevalence of mental health problems and substance abuse in the migrant population is higher than the general population. AIMS AND OBJECTIVES To assess the prevalence and pattern of mental health issues and substance use in the migrant population and highlight the association with the reverse migration of migrant workers. METHODOLOGY The field staff visited the shelter homes for migrant population in four cities of Northern India (Chandigarh (UT), Bhatinda (Punjab), Panchkula (Haryana) and Jaipur (Rajasthan). After maintaining the social distance and wearing masks by the staff and migrants, written informed consent was taken for participation in the study. The socio-demographic details of reverse migrants were noted down and Hindi version of Patient Health Questionnaire (PHQ-9) for mental health problems and screening tool for pattern of substance abuse was administered. Geographically matched undisplaced were also administered these tools. RESULTS A total of 275 reverse migrants and 276 undisplaced were included in the study. The prevalence of ever use for all the substances among reverse migrants was 44.4% (122/275) and among undisplaced, it was 45.3%. The prevalence of alcohol, tobacco and cannabis was higher than the general population. The prevalence of at least one diagnosis on PHQ-9 is 13.45% (reverse migrants 19.3% and undisplaced 7.6) and the prevalence of other depressive disorder is significantly higher in reverse migrants (17.1%) than undisplaced (4.0%). CONCLUSION The study concludes that prevalence of mental health issues and substance abuse in migrant population is significantly higher than the general population and the prevalence of at least one diagnosis and other depressive disorder is significantly higher in reverse migrants than undisplaced.
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Affiliation(s)
- B S Chavan
- Department of Psychiatry, Government Medical College & Hospital (GMCH), Chandigarh, India
| | - Ajeet Sidana
- Department of Psychiatry, Government Medical College & Hospital (GMCH), Chandigarh, India
| | - Priti Arun
- Department of Psychiatry, Government Medical College & Hospital (GMCH), Chandigarh, India
| | - Ravi Rohilla
- Department of Community Medicine, Government Medical College & Hospital, Chandigarh, India
| | - Gurvinder Pal Singh
- Department of Psychiatry, Government Medical College & Hospital (GMCH), Chandigarh, India
| | - R K Solanki
- Department of Psychiatry, SMS Medical College, Jaipur, RJ, India
| | | | | | - Madhur Verma
- Department of Community/Family Medicine, AIIMS Bhatinda, Bhatinda, PB, India
| | | | - Chitra Singh
- Department of Psychiatry, SMS Medical College, Jaipur, RJ, India
| | - Himanshu Sharrma
- Department of Psychiatry, SMS Medical College, Jaipur, RJ, India
| | | | | | - Dushant
- Volunteer member Corona Sena, Panchkula, HR, India
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Chavan BS, Ahmad W, Arun P, Mehta S, Nazli, Ratnam V, Raina D. Sexuality Among Adolescents and Young Adults With Intellectual Disability: Knowledge, Attitude, and Practices. Journal of Psychosexual Health 2021. [DOI: 10.1177/26318318211021544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Context: It is generally believed that persons with intellectual disability (PWID) do not have sufficient knowledge about sex and sexuality. As there is not much published work from India, such an attitude of clinicians and caregivers appears more to be an assumption. The scant information from other countries on sex and sexuality of the PWID cannot be generalized to India because of cultural differences. Aims and Objectives: The study was conducted to find out knowledge, attitude, and sexual practices among persons with mild intellectual disability (ID). Settings and Design: Thirteen participants with DSM-5 diagnosis of mild ID (intellect quotient [IQ] between 50 and 69) in the age ranging from 16 to 27 years (mean IQ and age was 56.69 and 21.0, respectively) were selected from the Government Rehabilitation Institute for Intellectual Disabilities, Chandigarh. For this study, exploratory method using focus group discussion (FGD) was used. Data was collected using qualitative method of FGD. Results: The results showed that persons with mild ID have knowledge about sex and sexual practices and they are sexually active and are indulging in sexual acts. Conclusion: Based on the findings derived from this research, it is concluded that PWID have knowledge and skills to experience sexual activities. However, findings of this study are limited to only persons with mild ID (IQ: 50-69). Need to sensitize and provide appropriate sexual health care for persons with ID are discussed.
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Affiliation(s)
- Bir Singh Chavan
- Department of Psychiatry, Government Medical College and Hospital (GMCH), Chandigarh, India
| | - Wasim Ahmad
- Government Rehabilitation Institute for Intellectual Disabilities (GRIID), Chandigarh, India
| | - Priti Arun
- Department of Psychiatry, Government Medical College and Hospital (GMCH), Chandigarh, India
| | - Shivangi Mehta
- Department of Psychiatry, Government Medical College and Hospital (GMCH), Chandigarh, India
| | - Nazli
- Government Rehabilitation Institute for Intellectual Disabilities (GRIID), Chandigarh, India
| | - Vani Ratnam
- Government Rehabilitation Institute for Intellectual Disabilities (GRIID), Chandigarh, India
| | - Deepti Raina
- Government Rehabilitation Institute for Intellectual Disabilities (GRIID), Chandigarh, India
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Chavan BS, Sidana A, Arun P, Rohilla R, Singh GP, Solanki RK, Aneja J, Murara MK, Verma M, Chakraborty S, Singh C, Sharma H, Sharma R, Bahri S, Bhanwra D. Factors Leading to Reverse Migration Among Migrant Workers During the COVID-19 Pandemic: A Multicenter Study From Northwest India. Prim Care Companion CNS Disord 2021; 23. [PMID: 34000151 DOI: 10.4088/pcc.20m02810] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Accepted: 12/30/2020] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVE To examine the various psychosocial factors associated with reverse migration among migrant workers during the coronavirus disease 2019 (COVID-19) lockdown in India. METHODS A cross-sectional multicenter study was conducted at 4 sites in Northwest India. The migrant workers were recruited from various shelter homes, and information was gathered from reverse migrant workers and controls using various tools including a sociodemographic profile; knowledge, attitudes, and practices questionnaire; and reasons for migration and reverse migration questionnaires. A total of 275 reverse migrant workers and 276 controls participated in the study. RESULTS There was a considerable difference between reverse migrant workers and controls regarding the question of whether it was safe to travel during lockdown (76.0% vs 26.4%, respectively). The most common route of spread of COVID-19 infection was through touching and sneezing, and symptoms were fever, dry cough, and sore throat in both groups. Reverse migrant workers had low self-esteem and were reluctant to participate in customs of their migration city. A large number of reverse migrant workers reported that they had no money to survive, worried about family back home at their village, felt pressured by family members to come back to the village, and had been terminated from their job. CONCLUSIONS Reverse migrant workers had the attitude that it was safe to travel during the lockdown. About one-fifth of the reverse migrant workers reported no place to live and fear of getting an infection. The reverse migrant workers also reported feeling low and gloomy, restless, and uncertain about the future and fear of death. Lack of jobs was a major factor driving migrant workers from their native homes.
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Affiliation(s)
- B S Chavan
- Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India
| | - Ajeet Sidana
- Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India
| | - Priti Arun
- Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India
| | - Ravi Rohilla
- Department of Community Medicine, Government Medical College and Hospital, Chandigarh, India
| | - Gurvinder Pal Singh
- Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India.,Corresponding author: Gurvinder Pal Singh, MD, Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India 160030
| | - R K Solanki
- Department of Psychiatry, SMS Medical College, Jaipur, Rajasthan, India
| | - Jitender Aneja
- Department of Psychiatry, AIIMS, Bathinda, Punjab, India
| | | | - Madhur Verma
- Department of Community Medicine, AIIMS, Bathinda, Punjab, India
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Chavan BS, Arun P, Singh GP. Psychosocial intervention model for migrant workers during extended lockdown: The Chandigarh model. Indian J Psychiatry 2021; 63:175-178. [PMID: 34194062 PMCID: PMC8214120 DOI: 10.4103/psychiatry.indianjpsychiatry_542_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 06/11/2020] [Accepted: 02/27/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Human suffering and future uncertainty due to extended lockdown is enormous and this is much more among migrant workers. AIM The aim of this study was to design and utilize a model for psychosocial intervention for migrant workers during the extended lockdown. MATERIALS AND METHODS In Chandigarh, due to lockdown, 61 migrant workers from various states were lodged in a shelter home at village Maloya, located in the outskirt of Chandigarh. Since no specific model was available to handle the psychosocial issues of this specific population, hence, an attempt was made to prepare a model for psychosocial intervention using Maslow's hierarchy of needs. RESULTS Changes in infrastructure and facilities provided to migrant workers due to implementation of this model for psychosocial intervention helped the participants seeing beyond their problems. CONCLUSION Psychosocial intervention model based on Maslow's theory was found suitable for migrant workers in shelter home in Chandigarh.
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Affiliation(s)
- B S Chavan
- Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India
| | - Priti Arun
- Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India
| | - Gurvinder Pal Singh
- Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India
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Miglani M, Chavan BS, Gupta N. Pain threshold and pain tolerance as a predictor of deliberate self-harm among adolescents and young adults. Indian J Psychiatry 2021; 63:142-145. [PMID: 34194057 PMCID: PMC8214128 DOI: 10.4103/psychiatry.indianjpsychiatry_348_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 11/04/2019] [Accepted: 02/17/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Recently, the assessment of pain has been used as a parameter to differentiate adolescents who indulge in deliberate self-harm from healthy individuals. AIMS AND OBJECTIVES The present study was conducted to compare pain sensitivity between three groups, i.e., nonsuicidal self-injury/nonsuicidal self-harm (NSSI), suicide attempters (SA), and matched healthy control (NSSI, SA, and healthy controls). MATERIALS AND METHODS Ninety participants (30-NSSI, 30-SA, and 30 matched control) between the age of 10 and 25 years were inducted from the individuals who came for help at the outdoor and emergency services for recent self-harm. Pain sensitivity was assessed by cold pain stimulation test through a cold pressor task. RESULTS Pain threshold, pain tolerance, total pain index as well as pain experience intensity were significantly different in the three groups. CONCLUSION Participants who indulge in NSSI and SA have significantly higher pain threshold, pain tolerance, total pain index, and pain experience intensity as compared to healthy control. Although all the pain parameters were higher in the NSSI group as compared to SA group, the difference did not reach to significant level.
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Affiliation(s)
- Mitthat Miglani
- Department of Psychiatry, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Bir Singh Chavan
- Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India
| | - Nitin Gupta
- Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India
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Sidana A, Chavan BS, Rohilla R, Singh J. Coping With Craving and Withdrawal Due to Substance Use Disorders During the COVID-19 Lockdown. Prim Care Companion CNS Disord 2021; 23. [PMID: 34000123 DOI: 10.4088/pcc.20m02802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVE Substance use disorder (SUD) is a chronic remitting and relapsing disorder, and abrupt discontinuation of the substance due to nonavailability in the absence of treatment precipitates withdrawals and craving. The objective of this study was to assess the craving and withdrawal coping mechanisms used by patients with SUDs as a result of disruption in availability of substances and medications due to sudden lockdown in response to coronavirus disease 2019. METHODS A survey was administered via telephone from June 25, 2020, to July 15, 2020, to patients who had previously attended the substance use clinic of a tertiary care teaching hospital in North India from January 1, 2020, to March 21, 2020 (up to the time of lockdown). Sociodemographic and clinical details were obtained from case record files. A 16-item questionnaire was developed to collect information on coping with craving and withdrawal symptoms. A total of 215 patients were registered in the substance use clinic during this period for the treatment of SUDs, and of those, 43 could not be contacted due to various reasons such as wrong contact numbers, patient expired (not related to substance withdrawal), or not willing to talk. The mean age of the subjects was 37.05 (SD = 13.22) years, and men outnumbered women. The remaining 172 patients were contacted via telephone, and responses were gathered regarding withdrawal symptoms and coping with craving. RESULTS More than two-thirds of the patients were still maintaining abstinence from their primary substance of abuse during lockdown. A large number of patients (n = 41, 43.2%) reported difficulty in obtaining prescribed medication for detoxification without renewal of their prescription. More than 66% of patients reported that they were able to control their craving, and many kept themselves busy with household activities. CONCLUSIONS The majority of patients who had completed the acute phase of withdrawals were able to maintain abstinence in the absence of renewal of prescribed medication and substance of abuse due to sudden disruption in supply. The patients were able to use certain strategies to control their craving.
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Affiliation(s)
- Ajeet Sidana
- Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India.,Corresponding author: Ajeet Sidana, MD, Department of Psychiatry, Government Medical College and Hospital, Level-5, Block-D, Sector-32, Chandigarh 160030, India
| | - Bir Singh Chavan
- Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India
| | - Ravi Rohilla
- Department of Community Medicine, Government Medical College and Hospital, Chandigarh, India
| | - Jasvir Singh
- Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India
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Arun P, Chavan BS. Understanding of Lockdown Among Adolescents and Youth With Intellectual Disabilities. Prim Care Companion CNS Disord 2020; 22. [DOI: 10.4088/pcc.20br02777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Singh GP, Arun P, Chavan BS. Migrant Workers' Needs and Perceptions While Lodged in a Shelter Home in India During the COVID-19 Pandemic. Prim Care Companion CNS Disord 2020; 22. [PMID: 33185989 DOI: 10.4088/pcc.20m02753] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Accepted: 08/11/2020] [Indexed: 10/23/2022] Open
Abstract
Objective India is combating a large-scale migrant crisis in many states during the coronavirus disease 2019 (COVID-19) pandemic. The objective of this study was to identify migrant workers needs and perceptions regarding lockdown while staying in a shelter home during the COVID-19 crisis. Methods This exploratory study was conducted with 54 migrants staying in a makeshift shelter home in Chandigarh, India. Three discussions were conducted with groups consisting of 15-20 participants to maintain social distancing. Five discussion questions were designed to facilitate group discussions. Results One important theme among migrants was their eagerness to return to their native homes. Participants were also concerned about pending agriculture-related work, their families back home, and job insecurity. Most of the migrants supported the government-mandated lockdown and agreed that they would follow all instructions. Conclusions Physiologic requirements, safety, and security were the predominant needs of the migrant workers while staying in the shelter home during lockdown. The participants feared contracting COVID-19 and were uncertain about when and how they would return to their native homes.
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Affiliation(s)
- Gurvinder Pal Singh
- Department of Psychiatry, Govt. Medical College and Hospital, Sector 32, Chandigarh India 160030. .,Department of Psychiatry, Govt. Medical College and Hospital, Chandigarh, India
| | - Priti Arun
- Department of Psychiatry, Govt. Medical College and Hospital, Chandigarh, India
| | - B S Chavan
- Department of Psychiatry, Govt. Medical College and Hospital, Chandigarh, India
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Singh GP, Arun P, Chavan BS. Efforts to Minimize the Impact of Lockdown on Migrant Workers in India During the COVID-19 Pandemic. Prim Care Companion CNS Disord 2020; 22. [PMID: 32530581 DOI: 10.4088/pcc.20com02648] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Affiliation(s)
- Gurvinder Pal Singh
- Department of Psychiatry, Govt Medical College and Hospital, Chandigarh, Sector 32, Chandigarh 160030, India. .,Department of Psychiatry, Govt Medical College and Hospital, Chandigarh, Chandigarh, India
| | - Priti Arun
- Department of Psychiatry, Govt Medical College and Hospital, Chandigarh, Chandigarh, India
| | - B S Chavan
- Department of Psychiatry, Govt Medical College and Hospital, Chandigarh, Chandigarh, India
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Gautham MS, Gururaj G, Varghese M, Benegal V, Rao GN, Kokane A, Chavan BS, Dalal PK, Ram D, Pathak K, Lenin Singh RK, Singh LK, Sharma P, Saha PK, Ramasubramanian C, Mehta RY, Shibukumar TM, Krishnatreya M, Gogoi V, Sobhana H, Sengupta S, Banerjee I, Sharma S, Giri AK, Kavishvar AB, Dave KR, Chauhan NT, Sinha VK, Goyal N, Thavody J, Anish PK, Bina T, Pakhare AP, Mittal P, Ray S, Chatterji R, Akoijam BS, Singh H, Gojendro, Kayina P, Singh LR, Das S, Puri S, Garg R, Kashyap A, Satija Y, Gaur K, Sharma D, Sathish RV, Selvi M, Krishnaraj, Singh SK, Agarwal V, Sharma E, Kar SK, Misra R, Neogi R, Sinha D, Saha S, Halder A, Aravind BA, Amudhan RS, Banandur SP, Subbakrishna DK, Marimuthu TP, Kumar BB, Jain S, Reddy YCJ, Jagadisha T, Sivakumar PT, Chand PK, Muralidharan K, Reddi S, Kumar CN, Prasad MK, Jaisoorya TS, Janardhanan CN, Sharma MP, Suman LN, Paulomi S, Kumar K, Sharma MK, Manjula M, Bhola P, Roopesh BN, Kishore MT, Veena S, Mary KAR, Anand N, Srinath S, Girimaji SC, Vijayasagar KJ, Kasi S, Muralidhar D, Pandian RD, Hamza A, Janardhana N, Raj EA, Majhi G. The National Mental Health Survey of India (2016): Prevalence, socio-demographic correlates and treatment gap of mental morbidity. Int J Soc Psychiatry 2020; 66:361-372. [PMID: 32126902 DOI: 10.1177/0020764020907941] [Citation(s) in RCA: 95] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Recognizing the need for good quality, scientific and reliable information for strengthening mental health policies and programmes, the National Mental Health Survey (NMHS) of India was implemented by National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, in the year 2015-2016. AIM To estimate the prevalence, socio-demographic correlates and treatment gap of mental morbidity in a representative population of India. METHODS NMHS was conducted across 12 Indian states where trained field investigators completed 34,802 interviews using tablet-assisted personal interviews. Eligible study subjects (18+ years) in households were selected by a multi-stage, stratified, random cluster sampling technique. Mental morbidity was assessed using MINI 6. Three-tier data monitoring system was adopted for quality assurance. Weighted and specific prevalence estimates were derived (current and lifetime) for different mental disorders. Mental morbidity was defined as those disorders as per the International Statistical Classification of Diseases, Tenth Revision Diagnostic Criteria for Research (ICD-10 DCR). Multivariate logistic regression was conducted to examine risk for mental morbidity by different socio-demographic factors. Survey was approved by central and state-level institutional ethical committees. RESULTS The weighted lifetime prevalence of 'any mental morbidity' was estimated at 13.67% (95% confidence interval (CI) = 13.61, 13.73) and current prevalence was 10.56% (95% CI = 10.51, 10.61). Mental and behavioural problems due to psychoactive substance use (F10-F19; 22.44%), mood disorders (F30-F39; 5.61%) and neurotic and stress-related disorders (F40-F48; 3.70%) were the most commonly prevalent mental morbidity in India. The overall prevalence was estimated to be higher among males, middle-aged individuals, in urban-metros, among less educated and in households with lower income. Treatment gap for overall mental morbidity was 84.5%. CONCLUSION NMHS is the largest reported survey of mental morbidity in India. Survey estimated that nearly 150 million individuals suffer from one or the other mental morbidity in India. This information is to be used for planning, delivery and evaluating mental health programming in the country.
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Affiliation(s)
- Melur Sukumar Gautham
- Department of Epidemiology, National Institute of Mental Health and Neurosciences Bangalore, India
| | - Gopalkrishna Gururaj
- Department of Epidemiology, National Institute of Mental Health and Neurosciences Bangalore, India
| | - Mathew Varghese
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Vivek Benegal
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Girish N Rao
- Department of Epidemiology, National Institute of Mental Health and Neurosciences Bangalore, India
| | - Arun Kokane
- Department of Community Medicine, All India Institute of Medical Sciences, Bhopal, India
| | - Bir Singh Chavan
- Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India
| | - Pronob Kumar Dalal
- Department of Psychiatry, King George's Medical University, Lucknow, India
| | - Daya Ram
- Department of Psychiatry, Central Institute of Psychiatry, Ranchi, India
| | - Kangkan Pathak
- Department of Psychiatry, Lokopriya Gopinath Bordoloi (LGB) Regional Institute of Mental Health, Tezpur, India
| | | | - Lokesh Kumar Singh
- Department of Psychiatry, All India Institute of Medical Sciences, Raipur, India
| | - Pradeep Sharma
- Department of Psychiatry, Sawai Man Singh Medical College, Jaipur, India
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Abstract
Background & objectives: Substance use disorders are a major public health concern in Punjab. However, reliable estimates of prevalence of substance use disorders are not available for the State. The present study reports estimates of prevalence of substance use disorders in Punjab, conducted as part of National Mental Health Survey, India. Methods: Using multistage stratified random cluster sampling, 2895 individuals from 719 households of 60 clusters (from 4 districts of Punjab) were interviewed. Mini International Neuropsychiatric Interview and Fagerstrom nicotine dependence scale were used to assess substance use disorders. Results: The sample comprised almost equal numbers of males and females. Nearly 80 per cent had less than or equal to high school education, and 70 per cent were married. The weighted prevalence of alcohol and other substance use disorders was 7.9 and 2.48 per cent, respectively. The prevalence of tobacco dependence was 5.5 per cent; 35 per cent households had one person with substance use disorder. The prevalence was highest in the productive age group (30-39 yr), urban metro and less educated persons. The prevalence of alcohol and other substance use disorders was much higher in Punjab as compared to other States where survey was done. Tobacco dependence was lowest in Punjab. Majority (87%) of the persons with substance use disorders did not suffer from any other mental disorder. Treatment gap was 80 per cent. Interpretation & conclusions: Punjab has a high burden of substance use disorders. The estimates will help clinicians and policymakers to plan the strategies against the menace of substance use disorders effectively.
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Affiliation(s)
- B S Chavan
- Department of Psychiatry, Government Medical College & Hospital, Chandigarh, India
| | - Rohit Garg
- Department of Psychiatry, Government Medical College & Rajindra Hospital, Patiala, India
| | - Subhash Das
- Department of Psychiatry, Government Medical College & Hospital, Chandigarh, India
| | - Sonia Puri
- Department of Community Medicine, Government Medical College & Hospital, Chandigarh, India
| | - Arvind Anniappan Banavaram
- Department of Epidemiology, Centre for Public Health, National Institute of Mental Health & Neuro Sciences, Bengaluru, India
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Amudhan S, Gururaj G, Varghese M, Benegal V, Rao GN, Sheehan DV, Kokane AM, Chavan BS, Dalal PK, Ram D, Pathak K, Lenin Singh RK, Singh LK, Sharma P, Saha PK, Ramasubramanian C, Mehta RY, Shibukumar TM. A population-based analysis of suicidality and its correlates: findings from the National Mental Health Survey of India, 2015-16. Lancet Psychiatry 2020; 7:41-51. [PMID: 31826821 DOI: 10.1016/s2215-0366(19)30404-3] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 09/17/2019] [Accepted: 10/01/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND India accounts for 18% of the global population and 26·6% of global suicide deaths. However, robust population-based, nationally representative data on suicidality are not readily available to plan and implement suicide prevention programmes in India. We aimed to investigate the prevalence and sociodemographic differentials of suicidality using data from the National Mental Health Survey (NMHS) of India, 2015-16. METHODS Trained field data collectors from the NMHS obtained information on suicidality (during the past month) from a community sample of adults aged 18 years and older using the suicidality module of the Mini-International Neuropsychiatric Interview (version 6.0). Suicidality was categorised as low, moderate, high, and overall (representing any suicidality), and examined for sociodemographic differentials using normalised sampling weights. For each of the 12 surveyed states, we calculated the age-standardised suicidality prevalence for men and women, men-to-women ratio of weighted suicidality prevalence, ratio of suicidality to suicide deaths, and ratio of suicide attempts to suicide deaths. We used logistic regression analysis to examine the association between sociodemographic factors and overall suicidality and severity. FINDINGS Among 34 748 participants with complete interviews, 5·1% (95% CI 4·7-5·6) had some level of suicidality, and 0·3% (0·2-0·4) had at least one suicide attempt in the past month. The prevalence of overall suicidality was higher in women (6·0% [5·4-6·6]) than in men (4·1% [3·7-4·6]). The prevalence of overall suicidality was highest in those aged 40-49 years among women and in those aged 60 years or older among men. Compared with their counterparts, individuals with lower educational attainment, individuals residing in urban metropolitan cities, individuals who were widowed, separated, or divorced, and unemployed individuals had a higher prevalence of overall suicidality. The men-to-women ratio of overall suicidality prevalence for India was 0·68 (range 0·55-0·85). For every death by suicide in India, there were more than 200 people with suicidality and more than 15 suicide attempts. We found variations for various severities of suicidality. We found an increased risk for overall suicidality in women versus men (odds ratio [OR] 1·54 [95% CI 1·31-1·81]; p<0·0001) and in individuals residing in urban metropolitan cities versus those residing in rural areas (1·75 [1·30-2·35]; p=0·0002). Individuals belonging to the lowest income quintile (reference group with OR <1·00 and p<0·05 for other income quintiles), those with depressive disorders (28·78 [20·04-41·33]; p<0.0001) and those with alcohol use disorders (6·52 [3·83-11·10]; p<0.0001) had an increased risk for high suicidality, compared with their corresponding counterparts. INTERPRETATION A national suicide prevention strategy that is comprehensive, using multisectoral approaches, is required to address the prevailing sociodemographic and other risk factors for reducing suicidality and suicide deaths in India. This study also has implications for other low-income and middle-income countries in south Asia, where sociodemographic factors play a crucial role for suicide prevention. FUNDING Ministry of Health and Family Welfare, Government of India.
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Affiliation(s)
- Senthil Amudhan
- Department of Epidemiology, National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | - Gopalkrishna Gururaj
- Department of Epidemiology, National Institute of Mental Health and Neuro Sciences, Bangalore, India.
| | - Mathew Varghese
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | - Vivek Benegal
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | - Girish Nagaraja Rao
- Department of Epidemiology, National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | | | - Arun Mahadeo Kokane
- Department of Community Medicine, All India Institute of Medical Sciences, Bhopal, India
| | - Bir Singh Chavan
- Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India
| | - Pronob Kumar Dalal
- Department of Psychiatry, King George's Medical University, Lucknow, India
| | - Daya Ram
- Department of Psychiatry, Central Institute of Psychiatry, Ranchi, India
| | - Kangkan Pathak
- Department of Psychiatry, LGB Regional Institute of Mental Health, Tezpur, India
| | | | - Lokesh Kumar Singh
- Department of Psychiatry, All India Institute of Medical Sciences, Raipur, India
| | - Pradeep Sharma
- Department of Psychiatry, Sawai Man Singh Medical College, Jaipur, India
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Sidana A, Singh A, Sawal N, Chavan BS, Gupta R. Neuropsychiatric manifestations of methyl iodide toxicity. Indian J Psychiatry 2020; 62:97-99. [PMID: 32001939 PMCID: PMC6964443 DOI: 10.4103/psychiatry.indianjpsychiatry_638_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 12/05/2019] [Indexed: 11/10/2022] Open
Abstract
Methyl iodide is an industrial chemical used in methylation for pharmaceutical intermediates. Its toxicity is a rare industrial hazard. Its toxicity is reported with both acute sudden exposure and gradual exposure. The authors report a case of methyl iodide toxicity occurring in a 47 year-old male with sudden exposure to this chemical. He presented with neuropsychiatric symptoms primarily slurring of speech, ataxia followed by delusion and hallucinations which resolved within 2 weeks with parenteral thiamine and an antipsychotic. Symptoms reappeared after a re-exposure, this time with more prominent psychiatric symptoms which were late to resolve (4 weeks) with similar treatment. Neuroimaging revealed hyperintensities in posterior regions of the brain which resolved after 4 weeks. The patient had prominent neurocognitive deficits which were persistent. The case highlights the rare chemical toxicity with neuropsychiatric manifestations with persistent neurocognitive symptoms.
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Affiliation(s)
- Ajeet Sidana
- Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India
| | - Akashdeep Singh
- Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India
| | - Nishit Sawal
- Department of Medicine, Government Medical College and Hospital, Chandigarh, India
| | - B S Chavan
- Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India
| | - Rekha Gupta
- Department of Radiology, Government Medical College and Hospital, Chandigarh, India
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Chavan BS. Epidemiological mapping and public mental health skills in preventing community spread of COVID-19 infection: A psychiatrist's perspective. Indian J Soc Psychiatry 2020. [DOI: 10.4103/ijsp.ijsp_253_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Chavan BS. Understanding of emotional health of migrants, with special focus on social factors. Indian J Soc Psychiatry 2020. [DOI: 10.4103/ijsp.ijsp_244_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Gulati P, Chavan BS, Sidana A. Authors' reply to commentary on "Gulati P, Chavan BS, Sidana A. Comparative efficacy of baclofen and lorazepam in the treatment of alcohol withdrawal syndrome". Indian J Psychiatry 2019; 61:652-653. [PMID: 31896877 PMCID: PMC6862991 DOI: 10.4103/psychiatry.indianjpsychiatry_325_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Affiliation(s)
- Prannay Gulati
- Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India. E-mail:
| | - Bir Singh Chavan
- Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India. E-mail:
| | - Ajeet Sidana
- Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India. E-mail:
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Abstract
Background: Sexual health is the most important aspect of person's well being, self-esteem and quality of life. Sexual pleasure leads to enhanced conjugal relationships and an overall healthy psychological state. There is paucity of data on sexual health of postmenopausal women. Aims and Objectives: To assess the prevalence and determinants of sexual health in postmenopausal women of North India. Materials and Methods: The study was conducted over a period of 18 months, from January 2016 to June 2017. Standard FSFI-6 questionnaire and various socio-demographic factors were used to analyse the sexual health of 110 menopausal women. Results: 80.9% postmenopausal women reported sexual dysfunction (SD). We found more sexual dysfunction in postmenopausal women with increasing age and increasing duration of menopause. Satisfied past sexual experience, joint family structure, low socioeconomic and education status were found to be important determinants of sexual health of postmenopausal females. Parity, substance use and past medical and gynaecological history of participants and various partner's factors like medical disorders, substance use and sexual disorders showed no association with sexual health in postmenopausal females. Conclusion: Sexuality varies with cultural and social differences across the globe. The prevalence of female sexual dysfunction in our study is much higher because Indian women are suppressed, self conscious, inhibited and hesistant to talk about their sexual problems with health care professionals. Also revalidation of the FSFI tool for Indian population is required. Further studies are needed to evaluate the sexual health in postmenopausal women.
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Affiliation(s)
- Neelam Jain
- Department of Obstetrics and Gynaecology, Government Medical College and Hospital, Chandigarh, India
| | - Reeti Mehra
- Department of Obstetrics and Gynaecology, Government Medical College and Hospital, Chandigarh, India
| | - Poonam Goel
- Department of Obstetrics and Gynaecology, Government Medical College and Hospital, Chandigarh, India
| | - B S Chavan
- Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India
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Chavan BS, Sharma N, Singh K. Prevalence of disability in Chandigarh: Findings of large household screening. Ind Psychiatry J 2019; 28:218-224. [PMID: 33223714 PMCID: PMC7659999 DOI: 10.4103/ipj.ipj_59_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 04/21/2020] [Accepted: 06/06/2020] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND The robust and sound national statistics on disability is the cornerstone for empowering the disabled population to have a barrier-free and right-based society for this population. The disability rates in India have marked discrepancies across various surveys. Taking into account the lack of data on disability in Chandigarh in terms of the proportion of disabled not included or counted owing to nonavailability of disability certificate or just lack of awareness as well as lack of data on the degree of utilization of various disability benefits, the present survey was planned. METHODOLOGY The present study aimed at screening all the households of Chandigarh for different forms of disability using a 12-item screening tool. The survey included 254, 436 households with 925,380 population. A total of 8577 persons were screened positive for disability. The prevalence rates for the whole population were extrapolated by further confirming disability in a random sample chosen from screen-positive cases. RESULTS The estimated prevalence for disability in Chandigarh ranged between 0.83 and 0.86 after generating the confidence intervals. CONCLUSION The prevalence rate of disability in Chandigarh is less than the national census data.
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Affiliation(s)
- Bir Singh Chavan
- Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India
| | - Nitasha Sharma
- Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India
| | - Karuna Singh
- Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India
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Kaur G, Singh Chavan B, Gupta D, Sinhmar V, Prasad R, Tripathi A, Garg PD, Gupta R, Khurana H, Gautam S, Margoob MA, Aneja J. An association study of dopaminergic (DRD2) and serotoninergic (5-HT2) gene polymorphism and schizophrenia in a North Indian population. Asian J Psychiatr 2019; 39:178-184. [PMID: 30389402 DOI: 10.1016/j.ajp.2018.10.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2018] [Revised: 09/24/2018] [Accepted: 10/23/2018] [Indexed: 01/04/2023]
Abstract
The aim of this study was to investigate whether single nucleotide polymorphisms (SNPs) in DRD2 and 5-HT2 receptor genes are associated with schizophrenia in North Indian population. Four hundred forty-three patients who met ICD10-DCR criteria for schizophrenia were enrolled from six participating centers along with 443 genetically related healthy subjects and 150 genetically unrelated healthy participants. A total of 7 gene polymorphisms from DRD2 (rs1800497, rs1079597, rs1800498, rs1801028) and 5-HT2 A (rs6313, rs6311, rs6305) were genotyped for their association with schizophrenia. No significant difference was found in frequency of various genotypes and alleles of the studied markers for DRD2 and 5-HT2 A genes between the cases and their genetic controls. However, significant differences were noted for rs1079597 genotype (Taq1B; p = 0.039) and its allele frequencies (p = 0.029) in persons with schizophrenia and the unrelated healthy controls. The DRD2 (Taq1 A-B-D) and 5-HT2 A (rs6311-rs6313-rs6305) haplotype frequencies differed significantly for A2B1D2 [p = 0.038; OR = 0.685 (95%CI = 0.479-0.981)] and ACC [p = 0.001; OR = 0.621 (95%CI = 0.461-0.838)] for the cases vs genetically related healthy controls. Similarly, significant difference was observed for the frequencies of GCC [p = 0.006; OR = 0.692 (95%CI = 0.532-0.900)] and ACC [p < 0.001; OR = 3.622 (95%CI = 1.73-7.585)] in the cases and unrelated healthy controls. Unlike previous research from India as well as abroad, the predominance of B1 allele of rs1079597 in patients with schizophrenia and absence of Cys311 in all study participants is a salient difference. Concluding, the B2 allele of rs1079597 may increase the risk of schizophrenia while the A2B1D2 haplotype may be protective in North Indian population.
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Affiliation(s)
- Gurjit Kaur
- Department of Physiology, Government Medical College & Hospital, Sector 32, Chandigarh, India
| | - Bir Singh Chavan
- Department of Psychiatry, Government Medical College & Hospital, Sector 32, Chandigarh, India
| | - Deepti Gupta
- Genetic Centre, Government Medical College & Hospital, Sector 32, Chandigarh, India
| | - Vikas Sinhmar
- Genetic Centre, Government Medical College & Hospital, Sector 32, Chandigarh, India
| | - Rajendra Prasad
- Department of Biochemistry, Postgraduate Institute of Medical Education & Research, Sector 12, Chandigarh, India
| | - Adarsh Tripathi
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - P D Garg
- Department of Psychiatry, Government Medical College, Amritsar, Punjab, India
| | - Rajiv Gupta
- Department of Psychiatry, Postgraduate Institute of Medical Sciences, Rohtak, Haryana, India
| | - Hitesh Khurana
- Department of Psychiatry, Postgraduate Institute of Medical Sciences, Rohtak, Haryana, India
| | - Shiv Gautam
- Department of Psychiatry, SMS Medical College, Jaipur, Rajasthan, India
| | - Mushtaq Ahmed Margoob
- Department of Psychiatry, Government Medical College, Srinagar, Jammu & Kashmir, India
| | - Jitender Aneja
- Department of Psychiatry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.
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Affiliation(s)
- Priti Arun
- Department of Psychiatry, Government Medical College & Hospital, Chandigarh 160 030, India
| | - Bir Singh Chavan
- Department of Psychiatry, Government Medical College & Hospital, Chandigarh 160 030, India
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Kaur T, Chavan BS, Kaur N. Treatment of phobia using modified form of exposure and response prevention. Indian J Soc Psychiatry 2019. [DOI: 10.4103/ijsp.ijsp_56_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Abstract
BACKGROUND Benzodiazepines (BDZs) have been the treatment of choice for alcohol withdrawal syndrome (AWS); however, they are associated with several side effects and also have abuse potential. In some studies, the use of baclofen has been effective in reducing symptoms of alcohol withdrawal symptoms. AIM The objective of this study was to compare the efficacy of baclofen and benzodiazepine (lorazepam) in reducing symptoms of AWS. MATERIALS AND METHODS It was a single-center, randomized, open-label study. Patients with alcohol dependence syndrome were enrolled in the study and randomized into two groups using computer-generated random table number. Baclofen (experimental group, 10 mg three times a day) and BZDs (control group, lorazepam, 8-12 mg/day in divided doses) were orally administered for reducing symptoms of alcohol withdrawal. Both groups received Vitamin B1 (100 mg/day through intramuscular route) and psychotherapeutic interventions. The severity of alcohol dependence was assessed by using the Severity of Alcohol Dependence Questionnaire, and alcohol withdrawal was assessed with the Clinical Institute Withdrawal Assessment for Alcohol, revised (CIWA-Ar). RESULTS Sixty-six patients were randomized (baclofen n = 34, benzodiazepine (BZD) group n = 32). Two patients (one patient in each group) had complicated withdrawal symptoms and were dropped from the final analysis. There was a significant reduction in alcohol withdrawal symptoms in both groups. There were no significant differences in CIWA-Ar scores between the two groups. Both the drugs were well-tolerated. CONCLUSION Baclofen and lorazepam are comparable in efficacy and tolerability in reducing symptoms of AWS.
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Affiliation(s)
- Prannay Gulati
- Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India
| | - Bir Singh Chavan
- Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India
| | - Ajeet Sidana
- Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India
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Abstract
Background & objectives: There is a paucity of trained professionals for the diagnosis of autism spectrum disorder (ASD), and a large number of cases go undetected and are diagnosed only during adolescence. There is no screening instrument specifically developed for screening of Indian population for ASD. This study was undertaken to develop a screening instrument to screen ASD in north Indian Hindi speaking population by multipurpose health workers. Methods: A 37-item instrument in Hindi with dichotomous yes/no responses [Chandigarh Autism Screening Instrument (CASI)] was developed to be applied on children aged 1.5-10 yr. The instrument was pilot tested and then reliability and validity of this instrument were tested. The sample included children with intellectual disability (n=75), ASD (n=83), other developmental disorders (n=87) and typically developing children (n=160). Results: Reliability, construct and content validity testing of the instrument were performed, and a score of 10 as cut-off had sensitivity of 89.16 per cent, specificity of 89.13 per cent, positive predictive value of 67.89 per cent and negative predictive value of 96.96 per cent. A shorter four-item version (CASI Bref) has also been developed with good sensitivity (73.49%) and specificity (90.68%) at a cut-off score of 2. Interpretation & conclusions: CASI was found to be a valid instrument for screening general Hindi speaking population of north India with adequate sensitivity and specificity.
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Affiliation(s)
- Priti Arun
- Department of Psychiatry, Government Medical College & Hospital, Chandigarh, India
| | - Bir Singh Chavan
- Department of Psychiatry, Government Medical College & Hospital, Chandigarh, India
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Chavan BS, Das S, Garg R, Puri S, Banavaram AB. Disability and socio-economic impact of mental disorders in the state of Punjab, India: Findings from national mental health survey, 2015-2016. Int J Soc Psychiatry 2018; 64:589-596. [PMID: 30067103 DOI: 10.1177/0020764018792590] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Mental illness results in a plethora of distressing issues, has tremendous socio-economic impact and causes socio-occupational dysfunction in the individual as well as the caregivers. There is a felt need to explore the disability caused by mental illness and the associated socio-economic impact at the population level in a developing nation like India. AIMS To elucidate the disability and socio-economic impact associated with mental illness at the individual and household levels for the state of Punjab in India. METHOD This was a multisite cross-sectional study carried out during 2015-2016 (as a part of the National Mental Health Survey of India) in three districts and one urban metro area of Punjab. The sample was selected using multi-stage, stratified, random cluster sampling technique, with random selection based on Probability Proportionate to Size (PPS) at different stages. A validated set of questions was used to assess the socio-economic impact of mental illness and the Sheehan Disability Scale was used to document self-perceived disability among individuals with mental morbidity. Median (IQR) and proportions were used to summarize quantitative and qualitative data, respectively Results: Subjects with any mental morbidity reported disability of varying severities across different domains of life; family life was affected the most (70.1%). One in every six persons reported that their mental illness interfered with their daily activities to a large extent. Economic burden was high and a typical family would spend about INR 1500/month (US$23) towards the treatment of its member with mental morbidity. Family members had to forego their work for at least 7 days in 3 months to take care of their relative with mental illness. CONCLUSION Mental illness causes disability in the individual and has tremendous socio-economic impact on the family, incapacitating a family's productivity to a large extent and thus affecting the society.
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Affiliation(s)
- B S Chavan
- 1 Department of Psychiatry, Government Medical College & Hospital, Chandigarh, India
| | - Subhash Das
- 1 Department of Psychiatry, Government Medical College & Hospital, Chandigarh, India
| | - Rohit Garg
- 2 Department of Psychiatry, Government Medical College and Rajindra Hospital, Patiala, India
| | - Sonia Puri
- 3 Department of Community Medicine, Government Medical College & Hospital, Chandigarh, India
| | - Aravind Ba Banavaram
- 4 Department of Epidemiology, Centre for Public Health, National Institute of Mental Health and Neurosciences, Bengaluru, India
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Abstract
BACKGROUND The need for effective and accepted method for opioid detoxification is ever increasing. Sublingual buprenorphine and oral clonidine have been effective in opioid detoxification. As often, there is a great variation in the dosage of buprenorphine and clonidine prescribed by the clinicians; hence, there is a felt need to find an effective dosage for a favorable outcome of opioid detoxification. OBJECTIVE The objective of this study was to compare the effectiveness of different doses of sublingual buprenorphine and clonidine in opioid detoxification. MATERIALS AND METHODS A total of 100 patients with the diagnosis of opioid dependence as per the international classification of diseases-10 criteria were recruited for this study. Participants were assigned randomly into four groups - low-dose clonidine, high-dose clonidine, low-dose sublingual buprenorphine, and high sublingual dose buprenorphine using a computer-generated random number table, resulting in 25, 26, 23, and 26 patients in each group, respectively. RESULTS The four groups had comparable scores on all the items of "stages of change readiness and treatment eagerness scale" for the assessment of motivation at baseline. Progressive decrease in withdrawal score was seen in all the groups on "clinical opiate withdrawal scale" and "subjective opiate withdrawal scale." CONCLUSION From the current study, we can infer that both low and high doses of buprenorphine and clonidine are comparable regarding controlling withdrawal.
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Affiliation(s)
- Neeraj Jain
- Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India
| | - B S Chavan
- Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India
| | - Ajeet Sidana
- Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India
| | - Subhash Das
- Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India
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Abstract
BACKGROUND Knowledge of the prevalence of mental disorders is essential for setting up services and allocation of resources. Existing studies suffer from methodological problems which limit their utility and generalizability. There was a long felt need to conduct a scientifically robust study in different regions of India to have national prevalence rates. AIMS This study aims to estimate the prevalence of mental disorders in a representative population of Punjab as a part of the National Mental Health Survey. SETTINGS AND DESIGN Community-based survey carried out in rural and urban areas of Punjab using multistage, stratified, random cluster sampling technique and random selection was based on Probability Proportion to Size. MATERIALS AND METHODS The survey was conducted in 60 clusters of 4 districts (Faridkot, Ludhiana, Moga, and Patiala) of Punjab. Mini-International Neuropsychiatric Interview adult version 6.0 for mental morbidity, case definition for generalized tonic-clonic seizure, an expansion of the Fagerström Nicotine Dependence Scale for tobacco use and screener for intellectual disability were used. Appropriate statistical methods were applied. RESULTS A total of 2895 respondents aged >18 years from 719 households were interviewed. The prevalence of lifetime and current mental morbidity was 17.94% and 13.42%, respectively. Higher prevalence of mental morbidity was found among persons aged >60 years and those belonging to lower income group and rural population. CONCLUSIONS The prevalence of mental morbidity is high in the population. The findings give a clear picture of magnitude of the problem and will help policy planners to tackle the situation which looks grave and warrants immediate intervention.
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Affiliation(s)
- B S Chavan
- Department of Psychiatry, Government Medical College and Hospital, Chandigarh, Punjab, India
| | - Subhash Das
- Department of Psychiatry, Government Medical College and Hospital, Chandigarh, Punjab, India
| | - Rohit Garg
- Department of Psychiatry, Government Medical College and Rajindra Hospital, Patiala, Punjab, India
| | - Sonia Puri
- Department of Community Medicine, Government Medical College and Hospital, Chandigarh, Punjab, India
| | - Aravind A Banavaram
- Department of Epidemiology, Centre for Public Health, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
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Abstract
OBJECTIVES To compare the efficacy and tolerability of clozapine and quetiapine in patients with treatment-resistant schizophrenia (TRS). PATIENTS AND METHODS In this prospective, randomized, open label study of 14 weeks, 53 patients with schizophrenia diagnosed as per ICD-10 and fulfilling the modified version of Conley and Kelly's criteria of TRS were randomly assigned to receive clozapine or quetiapine as per a computer-generated random table. After 2-weeks of dose-titration phase, doses were fixed at minimum therapeutic dose and subsequently adjusted according to the clinical improvement. All patients received dosage of respective drug in therapeutic range. 13 patients were lost to follow up. Treatment efficacy and side effects were evaluated with standardized rating scales. RESULTS Clozapine group (reduction in total score: mean=14.45, SD=10.39) had significantly greater reductions (P=0.004; CI=3.541-17.059) in the Positive and Negative Syndrome Scale (PANSS) total score, PANSS positive subscale and PANSS general psychopathology subscale at 14 weeks in comparison to the quetiapine group (reduction in total score: mean=4.15, SD=10.71). Significant reduction in PANSS negative subscale was seen with both drugs but no significant difference was present between the two drugs. At 14 weeks, 30% patients in clozapine group and 15% patients in quetiapine group showed response. Clozapine led to significantly greater side effects (P< 0.001, CI=2.241-6.059) on Glassgow Antipsychotic Side-effect Scale (GASS) than quetiapine. CONCLUSIONS Clozapine was found to be more efficacious than quetiapine in patients with TRS but was associated with greater side effects. Both the drugs were found to be equally effective in reducing the negative symptoms.
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Affiliation(s)
- Mitesh Kumar
- Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India
| | - B S Chavan
- Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India
| | - Ajeet Sidana
- Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India
| | - Subhash Das
- Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India
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Kaur G, Gupta D, Chavan BS, Sinhmar V, Prasad R, Tripathi A, Garg PD, Gupta R, Khurana H, Gautam S, Margoob MA, Aneja J. Identification of genetic correlates of response to Risperidone: Findings of a multicentric schizophrenia study from India. Asian J Psychiatr 2017; 29:174-182. [PMID: 28692863 DOI: 10.1016/j.ajp.2017.07.026] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Revised: 05/30/2017] [Accepted: 07/04/2017] [Indexed: 01/18/2023]
Abstract
Risperidone is most commonly used as an antipsychotic in India for treatment of schizophrenia. However, the response to treatment with risperidone is affected by many factors, genetic factors being one of them. So, we attempted to evaluate the association between dopamine D2 (DRD2) receptor, serotonergic (5HT2A) receptor and CYP2D6 gene polymorphisms and response to treatment with risperidone in persons with schizophrenia from North India. It was a multicentric 12-weeks prospective study, undertaken in patients diagnosed with schizophrenia according to International Classification of Diseases 10th revision, Diagnostic Criteria for Research module (ICD-10 DCR). Patients were treated with incremental dosages of risperidone. Nine gene polymorphisms from three genes viz. DRD2, 5-HT2A and CYP2D6 along with socio-demographical and clinical variables were analyzed to ascertain the association in response to risperidone treatment. The change in the Positive and Negative Syndrome Scale (PANSS) was used to measure the outcome. Significant differences in the frequencies of single nucleotide proteins (SNPs) rs180498 (Taq1D) and rs 6305 (C516T) polymorphisms were found amongst the groups defined according to percent decline in PANSS. The CYP2D6*4 polymorphism differed significantly when drop outs were excluded from analysis. Presence of DRD2 Taq 1 D2D2 and 5-HT2A C516T CT genotypes in patients were more likely to be associated with non-response to risperidone. Ser311Cys (rs1801028) mutation was absent in the North Indian patients suffering from schizophrenia.
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Affiliation(s)
- Gurjit Kaur
- Department of Physiology, Government Medical College & Hospital, Sector 32, Chandigarh, India
| | - Deepti Gupta
- Genetic Centre, Government Medical College & Hospital, Sector 32, Chandigarh, India
| | - Bir Singh Chavan
- Department of Psychiatry, Government Medical College & Hospital, Sector 32, Chandigarh, India
| | - Vikas Sinhmar
- Genetic Centre, Government Medical College & Hospital, Sector 32, Chandigarh, India
| | - Rajendra Prasad
- Department of Biochemistry, Postgraduate Institute of Medical Education & Research, Sector 12, Chandigarh, India
| | - Adarsh Tripathi
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - P D Garg
- Department of Psychiatry, Government Medical College, Amritsar, Punjab, India
| | - Rajiv Gupta
- Department of Psychiatry, Postgraduate Institute of Medical Sciences, Rohtak, Haryana, India
| | - Hitesh Khurana
- Department of Psychiatry, Postgraduate Institute of Medical Sciences, Rohtak, Haryana, India
| | - Shiv Gautam
- Department of Psychiatry, SMS Medical College, Jaipur, Rajasthan, India
| | - Mushtaq Ahmed Margoob
- Department of Psychiatry, Government Medical College, Srinagar, Jammu & Kashmir, India
| | - Jitender Aneja
- Department of Psychiatry, Government Medical College & Hospital, Sector 32, Chandigarh, India.
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Garg J, Sidana A, Chavan BS, Goel S. Sociodemographic and Clinical Predictors of Response in Manic Episodes: A Naturalistic, Prospective, Cohort Study. Indian J Psychol Med 2017; 39:584-589. [PMID: 29200553 PMCID: PMC5688884 DOI: 10.4103/ijpsym.ijpsym_418_16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Response to treatment of a manic episode is dependent on several sociodemographic and clinical factors as reported by researchers from other countries. The prescription of mood stabilizers and/or antipsychotics for manic episode depends on these factors. There is a lack of availability of data from India on this topic. Hence, this study was planned to identify the predictors of pharmacological response. MATERIALS AND METHODS Forty-two patients with a diagnosis of bipolar affective disorder current episode manic were enrolled and assessed for sociodemographic variables and clinical variables such as age of onset, family history, comorbidities, index episode, and number of past episodes. They were divided into four groups depending on the treatment they were receiving, namely, lithium with an antipsychotic (n = 25), lithium with divalproex and an antipsychotic (n = 8), divalproex with an antipsychotic (n = 5), and the miscellaneous group (n = 4). The primary outcome measure was improvement in the Young Mania Rating Scale score and secondary outcome measure was duration of ward stay. RESULTS There was a significant improvement in all the treatment modalities and it was comparable. There was no significant impact of any sociodemographic or clinical variable on treatment outcome except that females had significantly better response than males. There was nearly significant shorter duration of hospitalization in the lithium and antipsychotics groups compared to divalproex group. CONCLUSION All treatment modalities are equally efficacious in the management of manic episode in short term. However, lithium and antipsychotics tend to produce early response than divalproex. Other sociodemographic and clinical predictors were not significantly associated with response.
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Affiliation(s)
- Jasmin Garg
- Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India
| | - Ajeet Sidana
- Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India
| | - B S Chavan
- Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India
| | - Shikha Goel
- Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India
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Aneja J, Chavan BS, Huria A, Goel P, Kohli N, Chhabra P. Perceived stress and its psychological correlates in pregnant women: an Indian study. ACTA ACUST UNITED AC 2017. [DOI: 10.1080/17542863.2017.1364284] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Jitender Aneja
- Department of Psychiatry, Government Medical College & Hospital, Chandigarh, India
| | - Bir Singh Chavan
- Department of Psychiatry, Government Medical College & Hospital, Chandigarh, India
| | - Anju Huria
- Department of Obstetrics & Gynaecology, Government Medical College & Hospital, Chandigarh, India
| | - Poonam Goel
- Department of Obstetrics & Gynaecology, Government Medical College & Hospital, Chandigarh, India
| | - Navneet Kohli
- Department of Psychiatry, Government Medical College & Hospital, Chandigarh, India
| | - Preeti Chhabra
- Department of Psychiatry, Government Medical College & Hospital, Chandigarh, India
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Das S, Chavan BS, Sahni S, Sidana A. Concept of depression in rural community of Chandigarh. Indian J Soc Psychiatry 2017. [DOI: 10.4103/0971-9962.214589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Abstract
BACKGROUND AND OBJECTIVES Academically typically achieving adolescents were compared with students having academic difficulty on stress and suicidal ideas. MATERIALS AND METHODS In a cross-sectional study, 75 academically typically achieving adolescents were compared with 105 students with academic difficulty and 52 students with specific learning disability (SLD). Academic functioning was assessed using teacher's screening instrument, intelligence quotient, and National Institute of Mental Health and Neurosciences index for SLD. Stress and suicidal ideas were assessed using general health questionnaire, suicide risk-11, and Mooney Problem Checklist (MPC). Appropriate statistical methods were applied. RESULTS Three groups were comparable on age, gender, mother's working status, being only child, nuclear family, self-reported academic decline, and type of school. About half of adolescents reported psychological problems on General Health Questionnaire (mean score >3 in all the groups). Academically typically achieving adolescents showed higher stressors in peer relationships, planning for future and suicidal ideation compared to adolescents with academic difficulty. Adolescents face stress regarding worry about examinations, family not understanding what child has to do in school, unfair tests, too much work in some subjects, afraid of failure in school work, not spending enough time in studies, parental expectations, wanting to be more popular, worried about a family member, planning for the future, and fear of the future. Significant positive correlation was seen between General Health Questionnaire scores and all four subscales of MPC. Suicidal ideas showed a negative correlation with MPC. INTERPRETATIONS AND CONCLUSIONS Adolescents experience considerable stress in multiple areas irrespective of their academic ability and performance. Hence, assessment and management of stress among adolescents must extend beyond academic difficulties.
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Affiliation(s)
- Priti Arun
- Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India
| | - Rohit Garg
- Department of Psychiatry, Government Medical College and Rajindra Hospital, Patiala, Punjab, India
| | - Bir Singh Chavan
- Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India
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Kaushal T, Gupta N, Rushi, Singhal S, Chander J, Chavan BS. Quality of life in patients with fungal infection of nose and paranasal sinuses: A study from North India. Indian J Soc Psychiatry 2017. [DOI: 10.4103/0971-9962.218607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Garg J, Chavan BS, Sidana A, Arun P. Lurasidone: Watch out for dystonia. J Mental Health Hum Behav 2017. [DOI: 10.4103/jmhhb.jmhhb_7_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Patra S, Chavan BS, Gupta N, Sidana A. Clinical profile of patients seeking services at urban community psychiatric services in Chandigarh. Indian J Psychiatry 2016; 58:410-416. [PMID: 28196998 PMCID: PMC5270266 DOI: 10.4103/0019-5545.196729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
CONTEXT About two-third of patients with mental, neurological, and substance use disorder in India do not get adequate treatment due to insufficient clinical facilities. In a country with diverse population such as India, no single model can be effective and each region needs to develop local system of service delivery unique to population needs. Community outreach clinics (COCs) being run by the department of psychiatry provide mental health services in the primary health-care setting. The study reports on the pattern of service utilization across different COCs in Chandigarh. AIMS The aim of this study was to describe the sociodemographic and clinical profile of patients seeking mental health-care services from COCs and to compare this with patients seeking care at tertiary care center. SETTINGS AND DESIGN This was a cross-sectional case record review. SUBJECTS AND METHODS Community services are provided in the areas adjoining Chandigarh, through four COCs: Civil Dispensary, Dhanas; Khuda Ali Sher; Rural Health Training Center, Palsaura; and Police Dispensary Sector 26 by Department of Psychiatry, Government Medical College and Hospital, Chandigarh. The current study reports on sociodemographic and clinical profile of 728 patients seen in these clinics from July 2010 to June 2011. STATISTICAL ANALYSIS USED Descriptive statistics were performed using SPSS version 16.0. Chi-square test was used to compare two groups, ANOVA for comparing more than two groups. RESULTS Out of the 728 patients, majority were males in productive age group with diagnosis of substance use disorder. Majority were reaching the clinics on their own and only a few were referred by various community referral agencies. Only twelve patients needed referral to the Department of Psychiatry in the above mentioned period. CONCLUSIONS Patients of substance use disorder prefer to be seen in the outreach clinics and it is possible to manage them in these clinics with very little need to refer them to tertiary care hospitals.
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Affiliation(s)
- Suravi Patra
- Department of Psychiatry, AIIMS, Bhubaneswar, Odisha, India
| | - Bir Singh Chavan
- Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India
| | - Nitin Gupta
- Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India
| | - Ajeet Sidana
- Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India
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Patra S, Arun P, Chavan BS. Impact of psychoeducation intervention module on parents of children with autism spectrum disorders: A preliminary study. J Neurosci Rural Pract 2016; 6:529-35. [PMID: 26752898 PMCID: PMC4692011 DOI: 10.4103/0976-3147.165422] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Context: Parents of children with autism spectrum disorders (ASD) in India face a host of challenges, while seeking care which ranges from unavailability of information to difficulty in availing services. Aims: To develop a psycho-education intervention module for parents of children with ASD and to study its impact on parent stress and knowledge. Settings and Design: Child Guidance Clinic Department of Psychiatry, Government Medical College and Hospital, Chandigarh. Interventional study. Methodology: Parents of children diagnosed with ASD as per Diagnostic and Statistical Manual of Mental Disorders, 4th Edition criteria, recruited through consecutive sampling. Total number of 18 participants participated in the two phase study. Phase I included preparation of a parent training module through a four stage process and Phase II was evaluation of impact of the final version of the module on parental stress and knowledge. Statistical Analysis: Wilcoxon Signed-Rank test using SPSS version 17.0. Results: There was an improvement in all the domains of parenting stress and knowledge. Social stress score and total stress score showed significant improvement. Conclusions: Parent psycho-education intervention module on ASD decreases parenting stress, and improves knowledge about ASD. Psycho-education intervention module is a feasible and acceptable way of parent empowerment.
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Affiliation(s)
- Suravi Patra
- Department of Psychiatry, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Priti Arun
- Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India
| | - Bir Singh Chavan
- Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India
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Chavan BS, Aneja J. Global mental health movement has not helped in reducing global burden of psychiatric disorders. Indian J Soc Psychiatry 2016. [DOI: 10.4103/0971-9962.193203] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Abstract
BACKGROUND Newborn screening comprises a paramount public health program seeking timely detection, diagnosis, and intervention for genetic disorders that may otherwise produce serious clinical consequences. Today newborn screening is part of the health care system of developed countries, whereas in India, newborn screening is still in the toddler stage. METHOD We searched PubMed with the keywords newborn screening for metabolic disorders, newborn screening in India, and congenital disorder in neonates, and selected publications that seem appropriate. RESULTS In India, in spite of the high birth rate and high frequency of metabolic disorders, newborn screening programs are not part of the health care system. At Union Territory, Chandigarh in 2007, newborn screening was initiated and is currently ongoing for three disorders, that is, congenital hypothyroidism, congenital adrenal hyperplasia, and glucose-6-phosphate dehydrogenase (G6PD) deficiency. Prevalence of these disorders is found to be 1:1400 for congenital hypothyroidism, 1:6334 for congenital adrenal hyperplasia, and 1:80 for G6PD deficiency. CONCLUSION Mandatory newborn screening for congenital hypothyroidism should be implemented in India, and other disorders can be added in the screening panel on the basis of region-wise prevalence. The objective of this review is to provide insight toward present scenario of newborn screening in India along with recommendations to combat the hurdles in the pathway of mandatory newborn screening.
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Abstract
INTRODUCTION Craving is recognized as a formidable barrier in the management of patients with alcohol dependence. Among pharmacological agents that have been used in experimental studies for reduction in craving, baclofen appears to have a significant advantage over other agents. METHODOLOGY The study is retrospective chart review of patients (n = 113) who have been treated with baclofen for alcohol dependence in a tertiary hospital of North India. Baseline assessments included sociodemography, motivation, quantity-frequency of alcohol use, and other alcohol-related clinical parameters. Weekly assessments, for a period of 4 weeks, were extracted from records which included dose of baclofen, craving intensity, and alcohol consumption. RESULTS The study sample was predominantly male, mean age of 41.49 (±9.75) years, most having a family history of substance use (70.97%), and many reporting binge use pattern in last year (49.46%). Baseline assessment revealed 48.7% of the sample was in precontemplation phase for alcohol use and 70% reported severe and persistent craving. This persistent craving was reported by only 15% of the sample by the end of 4 weeks treatment with baclofen (20-40 mg/day). Thirty-four percent of patients reported continued problematic use of alcohol by the end of 4 weeks. CONCLUSION Our clinical experience suggests that baclofen reduces craving and alcohol consumption including in those with poor motivation. The drug causes few side effects and does not add to the intoxication effect of alcohol. Considering that baclofen is safe in those with liver cirrhosis and reduces withdrawal symptoms due to alcohol, a controlled trial comparing it with standard treatment is required.
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Affiliation(s)
- Abhijit R Rozatkar
- Department of Psychiatry, SHKM Government Medical College, Nalhar, Haryana, India
| | - Abhishek Kapoor
- Department of Psychiatry, SGT Hospital and Medical College, Gurgaon, Haryana, India
| | - Ajeet Sidana
- Department of Psychiatry, Government Medical College, Chandigarh, India
| | - Bir Singh Chavan
- Department of Psychiatry, Government Medical College, Chandigarh, India
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Chadda R, Khandelwal S, Chavan BS, WASP Congress. Social psychiatry: Looking at the horizon. Indian J Soc Psychiatry 2016. [DOI: 10.4103/0971-9962.193209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Affiliation(s)
- B S Chavan
- Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India
| | - Subhash Das
- Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India
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Garg J, Arun P, Chavan BS. Comparative efficacy of methylphenidate and atomoxetine in oppositional defiant disorder comorbid with attention deficit hyperactivity disorder. Int J Appl Basic Med Res 2015; 5:114-8. [PMID: 26097819 PMCID: PMC4456885 DOI: 10.4103/2229-516x.157162] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Accepted: 09/30/2014] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Oppositional defiant disorder (ODD) is frequently comorbid with attention deficit hyperactivity disorder (ADHD) and is associated with substantial functional impairments. Methylphenidate and atomoxetine are well-established drugs for the management of ADHD. Some studies from Western countries have reported these drugs to be effective in the management of ODD comorbid with ADHD. This study aimed to assess if methylphenidate and atomoxetine are efficacious in treating Indian children with ODD comorbid with ADHD. SUBJECTS AND METHODS In this prospective, open-label study, 37 patients of age 6-14 years with a diagnosis of ODD comorbid with ADHD randomly received either methylphenidate (dose 0.2-1 mg/kg/day) or atomoxetine (dose 0.5-1.2 mg/kg/day) for 8 weeks. Improvements in ADHD and ODD symptoms were assessed using Vanderbilt ADHD diagnostic parent rating scale (VADPRS). RESULTS At 8 weeks, there were statistically significant improvements in both ADHD and ODD symptoms in both methylphenidate and atomoxetine groups, as per VADPRS. The improvements produced and tolerability was comparable in the two groups. 80% of the patients from methylphenidate group and 64.3% patients from atomoxetine group ceased to fulfill the criteria for the presence of ODD at 8 weeks. CONCLUSIONS Methylphenidate and atomoxetine are effective in the treatment of ODD comorbid with ADHD in short duration.
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Affiliation(s)
- Jasmin Garg
- Department of Psychiatry, Government Medical College and Hospital, Sector 32, Chandigarh, India
| | - Priti Arun
- Department of Psychiatry, Government Medical College and Hospital, Sector 32, Chandigarh, India
| | - B S Chavan
- Department of Psychiatry, Government Medical College and Hospital, Sector 32, Chandigarh, India
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Chavan BS, Das S, Kaushal T, Arora S, Gupta N. An exploratory study assessing reasons behind initiation, continuation or stoppage of alcohol after first use. Indian J Soc Psychiatry 2015. [DOI: 10.4103/0971-9962.162030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Gupta N, Chavan BS, Chongtham V. Structuring and self-competence: How they can make a difference in assessing and managing risk. Indian J Soc Psychiatry 2015. [DOI: 10.4103/0971-9962.161999] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Abstract
Drug-induced galactorrhea has been reported with agents such as antidopaminergic antiemetics, antipsychotics, etc., with few case reports of galactorrhea with selective serotonin reuptake inhibitors, including paroxetine, being reported in last few decades. Prolactin levels have been found to be either raised or normal in these cases. We here report a case of paroxetine induced galactorrhea in a 48-year-old female patient of obsessive compulsive disorder, having hyperprolactinemic and euprolactinemic galactorrhea at different time with a pituitary incidentaloma.
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Affiliation(s)
- Prannay Gulati
- Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India
| | - B S Chavan
- Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India
| | - Subhash Das
- Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India
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Abstract
CONTEXT Attitude of fresh graduates toward psychiatric patients is important to bridge the treatment gap due to mental illness. Psychiatry as a subject has been neglected in the undergraduates of MBBS. AIMS (1) To compare the attitude of medical students and interns in a medical college toward mental illness and psychiatry. (2) To assess the impact of psychiatric training on attitude toward the mentally ill person and mental illness. SETTINGS AND DESIGN Cross-sectional, single assessment study conducted at a tertiary hospital. SUBJECTS AND METHODS Participants consisted of medical students of 1(st) and 2(nd) year who didn't have any exposure to psychiatry and interns, who had completed their compulsory 2 week clinical posting in psychiatry. Participants were individually administered sociodemographic proforma, General Health Questionnaire-12 (GHQ-12), opinion about mental illness (OMI) scale, and attitude to psychiatry-29 (ATP-29) scale. STATISTICAL ANALYSIS Standard descriptive statistics (mean, percentage), Chi-square test. RESULTS A total of 135 participants formed the study sample, with 48, 47, and 40 participants from 1(st) year, 2(nd) year and interns, respectively. Mean GHQ score was 14.03 for the entire sample. There was better outlook of interns toward psychiatry and patients with mental disorders in comparison to fresh graduate students in some areas. Overall, negative attitude toward mental illness and psychiatry was reflected. CONCLUSIONS Exposure to psychiatry as per the current curriculum seems to have a limited influence in bringing a positive change in OMI and psychiatry.
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Affiliation(s)
- Prannay Gulati
- Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India
| | - Subhash Das
- Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India
| | - B S Chavan
- Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India
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