Kerala Journal of Psychiatry

Authorship to contributorship: Issues related to credit in research publications

2023-06-28T19:11:54+0530

‘Authorship’ in a research article is mostly determined on the basis of ‘substantial contribution,’ which has diverse definitions. The broader concept of contributorship is based on the multiple roles of the contributors, especially in interprofessional and collaborative research. Issues related to authorship include order of authorship, corresponding authorship, and co-contributorship. To prevent disputes, the authors should negotiate these early in the research.

"Em and the Big Hoom," a story of love and madness

2023-02-19T23:46:12+0530

Two guards – One here and the other, there

2023-07-18T16:25:59+0530

Relationship between sleep quality and psychological well-being among caregivers of patients with mental illness

2023-06-06T20:26:01+0530

Background: Caregivers of patients with serious mental illness suffer from poor sleep quality and quality of life due to strong dependency of patients on caregivers. Addressing the caregiver burden and its effect on their physiological and psychological aspect of well-being can improve patient outcomes. Objectives: The study aimed to assess the correlation between sleep quality and psychological well-being among caregivers of patients with mental illness. The study also examined the association between the sleep quality of caregivers and selected variables such as age, gender, education, and occupation. Methods: A cross-sectional survey was used. Data were collected from 112 caregivers, who attended the outpatient psychiatry clinics of Government Medical College Hospital, Kozhikode, Kerala. Socio-personal data of caregivers as well as socio-personal and clinical data of patients were collected using a semi-structured interview schedule and record review. Sleep quality was assessed using Pittsburgh Sleep Quality Index (PSQI) and psychological well-being was assessed using Ryff’s Psychological Wellbeing Scale (RPWBS). Data were subjected to descriptive and inferential analysis. Results: Findings revealed that 59 (52.6%) caregivers experienced poor sleep quality (global PSQI score >5). A significant negative correlation was observed between the sleep quality index (PSQI score) and the psychological well-being (RPWBS score) of the caregivers. Findings also showed that the male gender, higher educational level, Above Poverty Line socioeconomic status, absence of lifestyle diseases, and joint/extended family were associated with better sleep quality. Conclusion: It is important to understand various psychological and physiological effects of caregiver burden in mental illness. Interventions targeting families where relatives experience mental health problems are important to prevent relapse and promote recovery in the patients. The psychological health of caregivers is affected by insufficient sleep, which can negatively impact patient outcomes. These results suggest close monitoring of the caregivers’ mental health and the provision of family-focused interventions.

Psychopathology and coping behaviors among wives of patients with bipolar affective disorder

2022-08-19T11:40:32+0530

Background: Bipolar Affective Disorder (BPAD) is a challenging psychiatric illness which burdens both the patient as well as the caregiver. As a consequence, many psychiatric symptoms are reported in the spouses and caregivers of patients with BPAD. Caregivers adopt various coping behaviors to tackle their stress and overcome these situations. The objective is to study psychopathology and coping strategies among wives of inpatients with BPAD admitted under the psychiatry department of a tertiary care teaching institute. Methods: This cross-sectional observational study was done at the inpatient wards of the Department of Psychiatry of Jubilee Mission Medical College & Research Institute, Kerala. The sample size was 70 and the study duration was 18 months. After approval from the institutional ethics committee, the study was done. Psychopathology was assessed using Comprehensive Psychopathological Rating Scale (CPRS) and psychiatric morbidity using Mini International Neuropsychiatric Interview Plus (Mini-Plus). Coping behavior was assessed using Brief-COPE. Results: Most commonly reported psychopathology was reduced sleep (71.4%). Nearly three-fourth were having psychiatric morbidity, with a majority having adjustment disorder – brief depressive reaction. The most commonly used coping behaviors were approach coping/problem-focused coping rather than avoidant coping. Conclusion: From this study, it was found that the majority of the wives of patients with BPAD had depressive symptoms and most of them were diagnosed to have adjustment disorder. Therefore, while planning the management of patients with BPAD we have to ensure that adequate psychosocial support is being provided to their primary caregivers also.

Stressful life events and other associated factors in patients with bipolar disorder current episode depression – A cross-sectional study

2023-06-28T19:04:24+0530

Background: Bipolar disorder (BD) is a mental illness which leads to considerable difficulties and challenges. The neurobiology of BD has complex underpinnings of gene–environment interactions. One such environmental factor, stressful life events (SLEs) can have adverse impacts on the course and prognosis of BD, however, this is underexplored. Aims and objectives: 1) To estimate the frequency and severity of SLEs in patients with BD-current episode depression 2) To determine the association of severity of depression with SLE, sociodemographic and illness-related factors. Methods: This was a cross-sectional study done on 100 consecutive patients diagnosed to have BD-current episode of depression (ICD-10), attending Psychiatry department at Pushpagiri Medical College, Thiruvalla, Kerala. A semi-structured proforma, Hamilton Rating Scale for Depression, Presumptive Stressful Life Events Scale and Brief Psychiatric Rating Scale were used. Results: About 73% of patients reported SLEs – of which 65% had mild/moderate and 8% had severe stress. A statistically significant association was found between SLEs and ‘very severe’ depressive episode. Past suicide attempt, the first episode as depression and lesser duration of the last episode also showed a statistically significant association with severity of depression. Conclusion: As the stressful life experiences have been linked to 'very severe' depressive episodes in a major way, understanding the association of stressful life events and BD can help in predicting further relapses and complications like suicide. It can aid in both symptom reduction and improving quality of life as well.

Prevalence of depression in persons with schizophrenia – A cross-sectional study from a tertiary psychiatric hospital

2023-04-06T22:12:42+0530

Background: It is important to be aware of depressive symptoms in schizophrenia because of the impact it has on its course and outcome. There are only a few studies that have evaluated depression in schizophrenia in Indian settings and no data is available from Kerala. The objective of this study was to find the prevalence and associated factors of depression in persons with schizophrenia. Methods: This was a cross-sectional study in which 225 patients with a diagnosis of schizophrenia according to DSM-5 who availed outpatient or inpatient services from a tertiary psychiatric hospital were included. Socio-demographic data were collected using a structured proforma. The symptom domains of schizophrenia were assessed using the Positive and Negative Syndrome Scale (PANSS). Depression was measured using the Calgary Depression Scale for Schizophrenia (CDSS). A cut-off score of ?6 on the CDSS was used to identify clinically significant depressive symptoms. Results: This study found the prevalence of depression in schizophrenia to be 30% (95 % CI - 29.94, 30.06). Higher education, being married, greater insight, a past history of suicide attempt, positive symptoms and general psychopathology symptoms were found to be associated with depression in schizophrenia. A positive correlation between PANSS positive subscale and CDSS scores was identified. Conclusions: Depression was seen in almost one-third of the patients with schizophrenia. Screening and management of depressive symptoms can help in improving the quality of care provided to patients with schizophrenia.

Resilience and experiences of nursing students during COVID-19 pandemic: A mixed method study

2023-06-06T20:43:48+0530

Background: COVID-19 resulted in uncertainties and new normal, which had an impact on nursing education too. Therefore, the study aimed to assess the resilience and to explore the experiences of nursing students during the pandemic. Methods: The study adopted a mixed method design. In the quantitative phase, resilience was assessed using Connor-Davidson Resilience scale among 477 nursing students. The data was collected through google forms. This was followed by qualitative phase in which experiences and resilience was explored by conducting eleven In-depth Interviews and five Focus Group Discussions. The resilience was dichotomised into good and poor resilience based on the median score. Latent content analysis was adopted for qualitative analysis. Results: The mean age was 22.15 (SD 4.42). Majority of the study participants were studying were studying for BSc Nursing 297 (62.3%) and 95(19.9%) were studying for three-year diploma nursing course and 37 (7.8%) of students studying for post-graduation in nursing. The mean resilience score was 71.20 (SD 13.74), 95% CI (69.97- 72.44). Domicile and year of study showed significant association with resilience. Four major themes emerged were psychological torment, Experience related to Covid 19, Experience related to teaching learning activity and Resilience. Conclusion: The present study revealed that the mean resilience score of nursing students was high. Educational strategies have to be developed focusing on promotion of resilience among nursing students so that they can render quality nursing care even during pandemic.

Attitude towards mental illness among doctors working in a tertiary care centre: A cross-sectional study

2023-03-03T23:43:53+0530

Background: Stigma towards mental illness, can limit patients from seeking help at the right time. Considering the disproportionate workforce of psychiatrists among the Indian population, a person needing psychiatric care may be first seen by a physician. This study assesses the attitude of doctors because they play a vital role in the pathway to the care of a psychiatric patient. Methods: It is a cross-sectional analytical study conducted in MOSC Medical College, Kolenchery, including all doctors, except those specialized in psychiatry. A semi-structured questionnaire and a 34-item Attitude Scale for Mental Illness (ASMI) were employed for assessing the attitude. Attitudes were studied using the independent sample t-test and Mann-Whitney U test. Results: Out of 188 doctors consisting of 152 (80.8%) clinicians and 36 (19.2%) non-clinicians, the majority had more than ten years of experience. The mean attitude score was 73.55 [Standard Deviation (SD) = 13.78] with 119 (63%) having negative attitude. The average attitude of clinicians was 72.48 (SD = 12.36) and non-clinicians was 78.02 (SD = 18.17), which did not show statistically significant difference (p = 0.086). Non-clinicians were found to show more separatism (p = 0.05). There was no statistically significant difference in attitude when gender and experience were considered. Conclusion: The study shows negative attitude of doctors, clinicians and non-clinicians alike, towards mental illness. This may be, in part, due to limited exposure to individuals with mental illness during undergraduate training. This study highlights the need to broaden undergraduate curriculum to include more exposure to mental illness.

Medical education and medical profession: Are we headed the right way?

2023-08-30T15:28:32+0530