Adaptation, linguistic and clinimetric validation of the Bangla version of Zarit Burden Interview

The aim of this study was to develop a culturally adapted and validated Bangla version of Zarit Burden Interview  (ZBI-B) questionnaire for use in Bangla speaking caregiver of patient with dementia. This study was conducted on 100 caregivers related to consecutively attending outpatients with a previously established primary diagnosis of dementia, according to DSM-IV criteria. Validity and reliability were evaluated by comparing with the caregiver burden inventory (CBI). An exploratory factor analysis with the principle component with varimax rotation was used to detect the factorial structure in observed measurements. To attain the best-fitting structure and the correct number of factors, the following criteria were used: Eigen values >1.0, factor loadings >0.30. The Cronbachs alpha value was 0.847 for test and 0.839 retest. The intra-class correlation for the test-retest reliability was 0.89. The ZBI score was highly correlated with the CBI score (Pearsons correlation coefficient, r=0.909, P=.001). From the exploratory factor analysis six factors comprising 20 items were extracted with Eigen values higher than 1.00 accounting for 69% of the total item variance. In conclusion, ZBI-B is valid, reliable and useful for use in clinical contexts and in future studies that could lead to a better understanding of caregiver burden in dementia

Psychiatric Morbidity, Stressors, Impact, and Burden in Juvenile Idiopathic Arthritis

Juvenile idiopathic arthritis (JIA) is a chronic painful disorder conceivably with adverse psychological sequelae that might influence the outcome of the disease and its treatment. This study was designed to detect the presence of psychiatric disorders and associated abnormal psychosocial situations among children and adolescents with JIA and to evaluate their impact on and burden for their caregivers. Forty subjects with JIA suffering for at least one year were included in the study. Forty age- and sex-matched healthy subjects were included as controls. Clinical psychiatric assessment was carried out blindly, and psychiatric disorders and stressors on abnormal psychosocial situation were assigned on the basis of ICD-10 clinical diagnoses of multiaxial classification of child and adolescent psychiatric disorders. Chronicity, distress, social impairment, and burden for others were rated with the impact supplement of the strengths and difficulties questionnaire (SDQ). Of the 40 cases of JIA, 24 were boys and 16 were girls aged 10-18 years, with a mean age of 13.25 years. The frequency of psychiatric disorders was 35% in the JIA and 12.5% in the controlgroup (p <0.001). The long duration of illness was associated with a higher proportion of cases with psychiatric disorders. In the JIA group, the diagnoses in decreasing order were depressive disorder (15%), somatoform disorder (12.5%), adjustment disorder (5%), and mixed anxiety and depressive disorder (2.5%). Significantly higher stressors, perceived difficulties, distress, social impairment, and burden for caregivers were reported in the JIA group with psychiatric morbidity. The presence of psychiatric disorders was associated with substantial impairment of learning, peer relationship, and leisure activities. Early psychiatric intervention might increase the likelihood of satisfactory outcome of treatment in JIA

Adaptation, linguistic and clinimetric validation of the Bangla version of Zarit Burden Interview

The aim of this study was to develop a culturally adapted and validated Bangla version of Zarit Burden Interview  (ZBI-B) questionnaire for use in Bangla speaking caregiver of patient with dementia. This study was conducted on 100 caregivers related to consecutively attending outpatients with a previously established primary diagnosis of dementia, according to DSM-IV criteria. Validity and reliability were evaluated by comparing with the caregiver burden inventory (CBI). An exploratory factor analysis with the principle component with varimax rotation was used to detect the factorial structure in observed measurements. To attain the best-fitting structure and the correct number of factors, the following criteria were used: Eigen values >1.0, factor loadings >0.30. The Cronbachs alpha value was 0.847 for test and 0.839 retest. The intra-class correlation for the test-retest reliability was 0.89. The ZBI score was highly correlated with the CBI score (Pearsons correlation coefficient, r=0.909, P=.001). From the exploratory factor analysis six factors comprising 20 items were extracted with Eigen values higher than 1.00 accounting for 69% of the total item variance. In conclusion, ZBI-B is valid, reliable and useful for use in clinical contexts and in future studies that could lead to a better understanding of caregiver burden in dementia

Psychiatric disorders among the children of 5 to 18 years old of 'SIDR' affected areas

Background: Natural disasters give raise a significant amount of physical and mental impairment in human beings. Any sort of disaster acts as a causative and maintaining factor for any psychiatric morbidity. In November 15, 2007, the cyclone "SIDR" intensified to reach peak winds of 215 km/h (135 mph) according to the IMD, a peak of 250 km/h (155 mph) according to the JTWC. "SIDR" officially made landfall around 1700 UTC later that day, with sustained winds of 215 km/h (135 mph). As it intensified to a Category 4-equivalent cyclone and thus coastal districts of Bangladesh faced heavy rainfall as an early impact of the cyclone. The damage in Bangladesh was extensive, including tin shacks flattened, houses and schools blown away and enormous tree damage. The entire cities of Patuakhali, Barguna and Jhalokati District were hit hard by the storm surge of over 5 meters ( 16 ft). The head of the Red Crescent in Bangladesh expects the death toll to reach as high as 10,000. Over 3,000 other fishermen were reported missing on over 500 fishing boats. The "SIDR" left its strong impact on those who survived. Objectives: The Study was aimed to estimate the prevalence of psychiatric disorder among children and adolescents in the "SIDR" affected areas. Method: This was cross sectional, qualitative study done among the children and adolescent groups of 5 to 18 years old to see the effect of natural disaster on the people of southern part of Bangladesh. The whole of the children population who attended in the health camp were included in the study during the study period. Three teams have worked among the four "SIDR" affected districts. Each team consists of Psychiatrists, General Physicians, and Clinical Psychologist.Results: A total of 158 children in four defined areas revealed that the prevalence rate of psychiatric disorder was 48%.Conclusion: This type of study should be done in multi-centers in SIDR affected disti.icts of Bangladesh to find out the actual prevalence rate of child and adolescent psychiatric disorder

Psychiatric Morbidity, Stressors, Impact, and Burden in Juvenile Idiopathic Arthritis

Juvenile idiopathic arthritis (JIA) is a chronic painful disorder conceivably with adverse psychological sequelae that might influence the outcome of the disease and its treatment. This study was designed to detect the presence of psychiatric disorders and associated abnormal psychosocial situations among children and adolescents with JIA and to evaluate their impact on and burden for their caregivers. Forty subjects with JIA suffering for at least one year were included in the study. Forty age- and sex-matched healthy subjects were included as controls. Clinical psychiatric assessment was carried out blindly, and psychiatric disorders and stressors on abnormal psychosocial situation were assigned on the basis of ICD-10 clinical diagnoses of multiaxial classification of child and adolescent psychiatric disorders. Chronicity, distress, social impairment, and burden for others were rated with the impact supplement of the strengths and difficulties questionnaire (SDQ). Of the 40 cases of JIA, 24 were boys and 16 were girls aged 10-18 years, with a mean age of 13.25 years. The frequency of psychiatric disorders was 35% in the JIA and 12.5% in the controlgroup (p <0.001). The long duration of illness was associated with a higher proportion of cases with psychiatric disorders. In the JIA group, the diagnoses in decreasing order were depressive disorder (15%), somatoform disorder (12.5%), adjustment disorder (5%), and mixed anxiety and depressive disorder (2.5%). Significantly higher stressors, perceived difficulties, distress, social impairment, and burden for caregivers were reported in the JIA group with psychiatric morbidity. The presence of psychiatric disorders was associated with substantial impairment of learning, peer relationship, and leisure activities. Early psychiatric intervention might increase the likelihood of satisfactory outcome of treatment in JIA

Beliefs about Jinn, black magic and evil eye in Bangladesh: the effects of gender and level of education

The study was aimed to examine beliefs among 320 attendees of a large University Hospital in Dhaka about Jinn, black magic and evil eye among Muslims in Bangladesh, using a self-completed questionnaire. The majority believed in the existence of Jinn (72%) and in Jinn possession (61%). In contrast, a relatively smaller proportion believed in the existence of black magic and evil eye (50% and 44%, respectively). Women were more likely than men to believe in the existence of Jinn and to cite religious figures as the treating authority for diseases attributed to affliction by black magic. Participants with a higher educational attainment were less likely than those with lower attainment to believe in jinn possession; or to believe that Jinn, black magic, or evil eye could cause mental health problems. Mental health care practitioners need to be mindful of these beliefs to achieve the best outcome for their patients

Clozapine Can Be the Good Option in Resistant Mania

Bipolar mood disorder is a mental disorder with a lifetime prevalence rate of about 1% in the general population and there are still a proportion of individuals who suffer from bipolar mood disorders that are resistant to standard treatment. Reporting clozapine responsive mania that was not responding to two previous consecutive atypical antipsychotics and one typical antipsychotic was aimed at. A 17-year-old male manic patient was admitted into the psychiatry inpatient department and was nonresponsive to Risperidone 12 mg daily for 4 weeks, Olanzapine 30 mg daily for 3 weeks, and Haloperidol 30 mg daily for 3 weeks, along with valproate preparation 1500 mg daily. He was started on clozapine as he was nonresponsive to Lithium in previous episodes and did not consent to starting Electroconvulsive Therapy (ECT). He responded adequately to 100 mg clozapine and 1500 mg valproate preparation and remission happened within 2 weeks of starting clozapine. Clozapine can be a good option for resistant mania and further RCT based evidences will strengthen the options in treating resistant mania

Dhaka Stress Scale-Adult: A scale for assessing psychosocial stressors among adults

Stress is an integral part of daily life and inevitable. This study was aimed to produce a culturally validated scale for measuring stressful life events of adults in Bangladesh and formulate the relative life change units of each event. The study used qualitative research, including a focus group and questionnaire, as well as quantitative statistical analysis in the validation process. Researchers first developed a provisional scale with 62 items that were translated in Bangla through a translation exercise. Using an open-ended question along with this provisional scale on 518 (260 rated on imagination and 258 on experience) subjects, researchers developed Dhaka Stress Scale-Adult with 58 items and the predictive interpretation of the overall score was made. Content validity was found excellent as I-CVI was 1 except 3 items and S-CVI was 0.91. In factor analysis on the two-factor model, no item had salient loading on more than one factor and there were 3 items failed to load on either factor. The correlation coefficient was 0.84 between this scale and the Presumptive Stressful Life Events Scale. In term of reliability, Cronbach’s alpha values were ranging from 0.53-0.88. The scale is simple to administer to assess stress and usable for both clinical and research purpose