Marital quality in alcohol dependance syndrome: a comparative study between first time and repeatedly hospitalised patients

Background: Marital quality is considered as a significant part of social well-being. Poor marital quality adversely affects physical and mental health as well as the overall quality of life. Moreover, it can significantly affect the course of alcohol dependance syndrome. The aim this study was to compare the marital quality among patients with alcohol dependance syndrome who are admit-ted for the first time and patients with alcohol dependance syndrome (ADS) who are admitted for multiple times.Methods: The sample consisted of each 30 patients with alcohol dependance syndrome who are admitted for the first time and patients with alcohol dependance syndrome who are admitted for multiple times, diagnosed as per international classification of diseases-10 diagnostic criteria for research. The sample population was evaluated using Severity of Alcohol Dependence Questionnaire and The Marital Quality Scale. The data was analysed using SPSS-16.0.Results: The severity of alcohol dependance was found to be significantly higher in the repeatedly hospitalised group when compared to first time admitted patients with ADS (p<0.01). The repeatedly hospitalised patients are found to be having significantly poor Marital Quality in the domains of Understanding, Rejection, Satisfaction, Affection, Despair, Decision Making, Dominance, Self-Disclosure, Trust and Role Functioning, when compared to first time admitted patients (p<.001).Conclusions: How problem use of alcohol affect marital quality is not settled in research till date, though most of the studies suggest a negative correlation. There are contradictory hypotheses regarding the effects of alcohol use on marital quality. Our study showed that patients with severe degrees alcoholism and who are admitted repeatedly have poor marital quality when compared to patients with lesser severity of alcoholism and admitted for the first time in Indian context

Parental bonding among individuals with recurrent depressive disorder, anxiety disorder and healthy controls

  Background: The relationship between parents and children in early life has a significant determining role in the development of various aspects of mental health in human beings. This study aimed to have a comparative assessment of the quality of parental bonding among individuals with Recurrent Depressive Disorder (RDD), anxiety disorder and healthy controls while controlling the factors such as age, sex, and education. Materials and Method: This study was conducted at the Out-patient Department of a referral mental health care facility in India. The samples consisted of 30 individuals with the diagnosis of RDD, 30 individuals with Anxiety Disorder as per ICD-10-DCR and 30 matched healthy controls. Age ranged between 18-50 years. Parental bonding instrument was used to assess the parental bonding in all three groups. Results: The two groups RDD and anxiety disorder differed significantly from the healthy control group on maternal protection (χ2=42.643, p&lt;0.001), paternal care (χ2=8.063, p=0.018) and protection (χ2=43.468, p&lt;0.001) but did not differ significantly in terms of maternal care (χ2=0.449, p=0.799). Conclusion: Findings highlight the role of parental bonding in the etiology of RDD and anxiety disorders, which reflects the need for strengthening the healthy bonding between parents and children in order to prevent such psychiatric conditions. Keywords:  Parental bonding, recurrent depressive disorder, anxiety disorde

Perceived Reasons for and Consequences of Substance Abuse Among Patients With Psychosis

Background: Substance use is a common comorbidity with psychotic illnesses. Although several theories exist to explain this link, individual reasons for use may differ. The aim of this study was to evaluate patient perceptions of the reasons for and consequences of their substance use in patients with psychosis and compare them with those of an age-, sex-, and tobacco use-matched control sample without psychosis. Method: Consecutively admitted patients were divided into 2 groups, those who had substance dependence without psychosis (n = 32), admitted in our addiction unit, and those who had psychotic illness with substance dependence, admitted in our inpatient psychosis unit and referred to as the dual-diagnosis group (n = 62). Patients were administered the Schedules for Clinical Assessment in Neuropsychiatry for ICD-10 Diagnostic Criteria for Research to confirm schizophrenia, bipolar affective disorder, and substance dependence diagnoses and were asked open-ended questions to evaluate the perceived reasons for and consequences of their substance use. The study was conducted from July to September 2006. Results: There were significant differences between the 2 groups in reasons for maintenance and relapse of both cannabis use and alcohol use, the 2 most common substances. While the substance dependence without psychosis group attributed both maintenance and relapse to external factors such as nature of work, social milieu, or peer pressure, the dual-diagnosis group attributed them to internal factors such as enhancement of positive mood and alleviation of withdrawal effects. Conclusions: Individuals with psychosis have greater vulnerability to internal factors, which may maintain substance use. Targeting perceived internal factors may play a useful role in management and possibly identification and prevention of psychosis in vulnerable individuals in the future

Delayed-onset delirium tremens - a diagnostic and management challenge

Background: Delirium tremens (DT) is one of the most serious complications of alcohol withdrawal, affecting 5-10% of in-patients with a mortality rate up to 15%. DT, characterised by delirium and tremors, appears within 48-72 h of abstinence and persists for about 5-10 days. Case presentation: We report a case of DT in a young man with delayed onset on the 15th day after the cessation of alcohol use, despite an uncomplicated detoxification with benzodiazepine treatment. Conclusion: We hypothesise that the intake of country liquor in our patient, which contains higher percentages of alcohol, causes a prolonged imbalance of N-methyl-d-aspartic acid and glutamate receptor activity, leading to the picture of delayed-onset DT and that an atypical presentation at the time of admission and atypicality in early course are clinical pointers to the subsequent development of delayed-onset DT