Psychosocial quality-of-life correlates in functional gastrointestinal disorders

INTRODUCTION AND AIM

Functional gastrointestinal disorders (FGIDs) are complex illnesses characterized by gastrointestinal symptoms, with no underlying organic pathology. They are common, chronic, recurrent, and disabling disorders that significantly impair quality of life (QoL). The aim of the present cross-sectional analytical study was to assess QoL and its correlates in adult patients with FGIDs.

MATERIALS AND METHODS

A cross-sectional, observational, hospital-based study was conducted at the gastroenterology outpatient department of a tertiary care teaching hospital. The ROME IV diagnostic criteria were used to identify the FGIDs. Anxiety, depression, coping strategies, social support, and QoL were assessed by the hospital anxiety and depression scale, the coping strategies inventory, the multidimensional scale of perceived social support, and the functional digestive disorders quality-of-life questionnaire, respectively.

RESULTS

Of the 52 consecutive patients diagnosed with FGIDs, functional dyspepsia (51.92%) and irritable bowel syndrome (40.38%) were the most common. There were no significant associations between sociodemographic variables (age, sex, marital status, socioeconomic status, educational level, employment, occupation, dietary pattern) and QoL scores (all p values >0.05). Duration and social support were not significantly associated with QoL (all p values >0.05). In contrast, psychological variables, such as disengagement coping (r=-0.344, p=0.012), depression (r=-0.600, p=0.000), and anxiety (r=-0.590, p=0.000), were significantly correlated with QoL.

CONCLUSIONS

Despite advances in neurogastroenterology, patients continue to be disabled by FGIDs. Psychological factors, especially depression, significantly contribute to poor QoL in those patients and should be addressed in a holistic, multidisciplinary way. The biopsychosocial framework, as it applies to FGIDs, should lead to the inclusion of psychosocial assessments in the clinical management and research of those disorders.

Cyberbullying: A study of its extent, coping resources, and psychological impact among college students

Introduction

Bullying is an aggressive act with a hostile intent to dominate, abuse, or intimidate an individual(s) with a lesser social or physical power, repeatedly over a period of time. Though bullying can manifest in any social situation, its pernicious presence in the educational institutions has become a source of concern to all stakeholders. With their self-esteem and world view entwined in cyberspace, the present generation of young adults derive their social status and self-worth through affirmations through the internet via social networking sites. Cyberspace is an ideal environment for bullies as it is relatively anonymous, allows the participation of a large audience, and is almost impossible to supervise.

Aim

To estimate the extent, coping resources, and psychological impact of cyberbullying among Indian college students.

Methodology

This cross-sectional study was carried out among undergraduate medical students of Sikkim. Cyberbullying, cybervictimization, coping strategies used by students, self-esteem, and levels of depression, anxiety, and stress were estimated using standardized self-report scales.

Results

Out of 213 medical students, more than half of the college students (60.6%) were victims of cyberbullying. Coping strategies commonly used by cybervictims were technical coping, support from friends, and assertively confronting the bully online. Victims of cyberbullying had significantly more depression, anxiety, stress, and lower self-esteem (p values <0.05) compared to students who did not experience cyberbullying.

Conclusion

This study illuminates the extent and nature of cyberbullying among Indian medical students. The negative mental health consequences of cyberbullying are worrying. Mental health professionals and stakeholders need to create an awareness and formulate strategies to combat cyberbullying in colleges.

Internalized and Perceived Stigma and Depression in Pulmonary Tuberculosis: Do They Explain the Relationship Between Drug Sensitivity Status and Adherence?

Background

Adherence to medication for tuberculosis (TB) has been found to be deleteriously affected by psychosocial issues, including internalized and perceived stigma (IPS) and depression, usually resulting in the emergence of multidrug-resistant TB (MDR-TB). The objective of the study was to find the prevalence of depression among patients receiving treatment for pulmonary TB, and how stigma and depression affect the relationship between drug sensitivity status (DSS) and treatment adherence.

Method

It was a cross-sectional observational study conducted between January 2019 and July 2020 in two centers in Sikkim, India. The Patient Health Questionnaire-9 (PHQ-9), Internalized Social Stigma Scale (ISSS), and Tuberculosis Medication Adherence Scale were used to assess depression, IPS, and medication adherence, respectively. A path analysis was performed with DSS, treatment adherence, IPS, and depression. Education in years was included in the model as it was significantly correlated with IPS.

Results

A total of 71 patients who were on drug-sensitive TB (DS-TB) regimen (n = 26) and MDR-TB regimen (n = 45) participated in the study. Notably, 56.3% (n = 40) of the participants were found to have depression. Among the depressed participants, 32.5% were on the DS-TB regimen and 67.5% were on the MDR-TB regimen. The path analysis indicated that IPS and depression were serially mediating the relationship between DSS and treatment adherence (β = -0.06, p < 0.05, 95% CI = -3.20, -0.02). Finally, years of education had an exogenous predictor role, not only directly affecting IPS (β = -0.38, p < 0.001, 95% CI = -0.99, -0.31) but also affecting treatment adherence through IPS and depression (β = 0.08, p = 0.02, 95% CI = 0.03, 0.47). This indicated that with more years of education, the IPS decreases, which decreases depression and ultimately leads to better adherence.

Conclusion

We found an important relationship between different psychosocial factors which may affect treatment adherence. Patients who have higher IPS are more likely to develop depression which negatively affect adherence. Patients on the MDR-TB regimen have higher stigma. There is an urgent need to integrate mental health services with TB Control Programs.

Social networking sites and its relation to social comparison and psychological well-being among medical university students

BACKGROUND

Social networking sites (SNSs) have become an indispensable part of young adults in India. The content on one's profile and that of others on social media makes social comparison easier among young adults leading to poor mental health and life dissatisfaction.

AIMS

To assess the relationship between the pattern of SNS use among young adults and depression, anxiety, and social comparison.

MATERIALS AND METHODS

This was a cross-sectional study among medical students done using a questionnaire consisting of pattern of SNS use and scales for social comparison, depression, and anxiety.

RESULTS

We collected data from 220 students (mean age 20.44 years). Impression management was associated with higher social comparison, depression, and anxiety scores. Social comparison had a significant correlation between depression and anxiety scores.

CONCLUSION

A complex association exists between duration or time spent on SNS use and psychopathology.

A variable presentation of Joubert syndrome: Case report and a brief review

Joubert syndrome is a rare neurological manifestation usually present in late infancy or early childhood with characteristic episodes of abnormal breathing pattern along with the neurological and other systemic involvement.We report a case of confirmed Joubert syndrome present in the immediate neonatal period with isolated spells of oxygen desaturations not accompanied by the classically described breathing pattern and absent neurological symptoms causing delay in the diagnosis. Isolated oxygen desaturation episodes could be a presenting manifestation of Joubert syndrome in a neonatal period.

Delirium in medical intensive care units: Incidence, subtypes, risk factors, and outcome

BACKGROUND

Delirium is a frequent yet underdiagnosed neuropsychiatric condition encountered in intensive care units (ICUs). Being both a preventable and potentially reversible process associated with significant morbidity and mortality, understanding risk factors that predispose and precipitate delirium in any given patient are critical in ICUs.

AIMS AND OBJECTIVES

The aim of this study is to evaluate the incidence, motor subtypes, risk factors, and clinical outcome of delirium in the medical ICU.

MATERIALS AND METHODS

We used a prospective study design on a cohort of consecutive medical ICU admissions of a tertiary care teaching hospital. The Confusion Assessment Method-ICU and Richmond Agitation Sedation Scale were used to diagnose and motor subtype delirium, respectively, along with a checklist to assess risk factors.

RESULTS

Of the 280 ICU admissions, 88 (31.4%) developed delirium. Hypoactive delirium was the most common motor subtype (55.7%). The detection rate of delirium was 12.5% (lowest for hypoactive delirium at 2.04%). Age, gender, and years of education did not significantly predict delirium (all P > 0.05). Tobacco use, chronic liver disease, and past episodes of delirium significantly predisposed, while mechanical ventilation, hypoxia, fever, raised levels of bilirubin and creatinine, and benzodiazepine administration significantly precipitated ICU delirium. Delirium was significantly associated with longer ICU stay (t = 4.23, P = 0.000) and 1-month postdischarge mortality (χ ² = 6.867, P = 0.009).

CONCLUSION

Detection of delirium is challenging, especially in ICU patients on mechanical ventilation and hypoactive delirium. Screening and monitoring for predisposing and precipitating risk factors can greatly improve the odds of detection and intervention as ICU delirium is associated with significant morbidity and mortality.

Body dissatisfaction and its relation to Big Five personality factors and self-esteem in young adult college women in India

INTRODUCTION

Eating disorders are increasingly becoming common among men and women across the world. Body dissatisfaction is found to be one of the prominent risk factors for the development and maintenance of eating disorders. Research suggests that the internalization of culturally unattainable ideals is in fact mediated by self-esteem and personality factors such as high neuroticism, perfectionism, and impulsiveness. Studies on body image concerns in the cultural context of the Indian population are limited. We aimed to study the prevalence of body image dissatisfaction and its association with self-esteem and personality traits among young Indian women.

MATERIALS AND METHODS

Using a cross-sectional design we studied on 555 female college students of North India. Data was collected using self-reported questionnaires: Sociodemographic pro forma, Body Shape Questionnaire (-8C), Rosenberg's Self-Esteem Scale, and Mini-International Personality Item Pool.

RESULTS

The mean age of the participants in the study was 22.24 years (±2.75). Twenty-seven percent of the participants had moderate-to-severe body concern. Body shape dissatisfaction significantly correlated with higher body mass index (BMI) (rs = 0.12, P = 0.003) and lower self-esteem (rs = -0.22, P < 0.001). Among the personality traits, only neuroticism (beta = 0.35, P = 0.01) and conscientiousness (beta = 0.29, P = 0.031) significantly predicted body shape dissatisfaction.

CONCLUSION

A significant percentage of young women in this study had a negative body image associated with higher BMI, lower self-esteem, high neuroticism, and high conscientiousness. Thus, consideration of individual variations in personality traits and self-esteem is important understanding body image concerns. This can help in selection of better interventions in the treatment of body image dissatisfaction.