POSTGRADUATE PSYCHIATRIC TEACHING CENTRES: FINDINGS OF A SURVEY

A survey by a questionnaire method was undertaken to enquire about the facilities, the level of medical and non-medical staffing, structure and functioning of psychiatric teaching centres offering teaching and training in psychiatry at postgraduate level. The results of the survey are presented and discussed. It is evident that postgraduate teaching centres are inadequately staffed and poorly equipped. The implications of these vis-a-vis teaching and training and effective participation in the implementation of National Mental Health Programme are commented upon

PATTERNS OF ANTIDEPRESSANT PRESCRIPTIONS : II CONTINUATION PHASE TREATMENTS

In an exercise carried out to ascertain adequacy of antidepressant treatment, seventy case notes of patients of depression on continuation treatment with antidepressants were scanned. Antidepressants had been used universally. TCAs were the most commonly used drugs, although Fluoxetine had also been used quite frequently. Continuation treatment was found to be deficient in over a third (n=24; 34 %) of the cases, on either of the two parameters i. e. dose of drugs or duration of treatment. The outcome was poorer in those treated inadequately. The reasons for this ‘treatment gap’ need to be explored. Similar studies need to be conducted in other settings. Education of all clinicians about these central issues of antidepressant treatment is essential

SYMPTOMATOLOGY, SYMPTOM RESOLUTION AND SHORT TERM COURSE IN MANIA

In a prospective study, 40 patients satisfying DSM-III criteria for the diagnosis of a manic episode were identified and followed up for a period of 90 days. The patients were assessed on the Present State Examination Schedule and the Bech Ralaelsen Mania Scale. The severity of manic illness in the patients was observed to be same as in patients from the West. Symptoms of mania followed a variable pattern of symptom resolution. Majority of patients had recovered by the end of 90 days and were functioning normally

LIFE EVENTS IN OBSESSIVE COMPULSIVE NEUROSIS

Twenty four patients diagnosed to be suffering from Obsessive Compulsive Neurosis for the first time and individually matched controls were rated on a Life Events Scale. Leyton Obsessional Inventory was also administered to the patients and controls. It was seen that patients had significantly higher scores on life events for a time span of one year prior to the onset of illness as compared to controls. The patient group also scored highly on obsessional trait scores. The study points to a strong association between excess of life events and the onset of obsessional illness

OBSESSIVE COMPULSIVE NEUROSIS IN NORTH-WEST INDIA: A phenomenological study*

Seventy two patients fulfilling Research Diagnostic Criteria for obsessional illness were studied in detail from a phenomenological point of view. Frequency of various forms and contents of obsessions and compulsions were delineated. The forms of obsessions seen were; doubts (65%); thinking (52.7 %); fear (47.2%); magical thinking (36.1%); impulse (4.1%); image (4.1 %) and others (5.5%). In compulsions, yielding compulsions were most common being present in 59.7% of the cases. Analysis of the content of the obsessions revealed that dirt and contamination was the commonest content (48.3%)

PROGNOSTIC VARIABLES IN SCHIZOPHRENIA*

This study examined the relationship between measures of outcome and socio-demographic arid diagnostic variables in schizophrenia. Product moment co-efficient of correlation and stepwise multiple regression were the main statistical techniques of analyses. The results of the study indicate that DSM-III diagnosis of schizophrenia, duration of illness, and Present State Examination-PSE Syndrome of non-specific psychosis are important predictors of outcome. CATEGO and Research Diagnostic Criteria-RDC diagnosis of Schizophrenia, and Schneiderian First Rank Symptoms were found to be poor predictors of outcome. Socio-demographic and clinical variables like gender of the patient, place of origin, impersistence at work, poor premorbid work record, hospitalization at the time of admittance into the study, loss of interest, affective flattening and incoherent speech were found to have prognostic implications

LINGUISTIC COMPENTENCE IN POSITIVE AND NEGATIVE SUBTYPES OF SCHIZOPHRENIA

Twenty patients of positive schizophrenia and 20 patients of negative schizophrenia, individually matched for age, sex, place of residence and education were studied to assess their linguistic competence and its relationship with psychopalhology and subsequent course of the disorder over a follow-up period of 6 months. It was observed that positive schizophrenics had significantly higher linguistic competence than negative schizophrenics. Linguistic competence was significantly related not only to the type of symptoms (positive or negative) but also to the severity of these symptoms. High linguistic competence was an indicator of poor prognosis in positive schizophrenia whereas in negative schizophrenia it was indicative of good prognosis

PSYCHOLOGICAL ASPECTS OF HAEMATOLOGICAL MALIGNANCIES

Sixty nine patients with various types of haematological malignancies were studied. Chronic myeloid leukaemia (n =32) was the commonest diagnosis. The patients were assessed on Hamilton Rating Scale for Depression, PGI-N2 Health Questionnaire and Presumptive Stressful Life Events Scale and those who had scores above the cut off points for Hamilton Rating Scale and/or PGI-N2 Health Questionnaire were assessed on Present State Examination. The patients were followed up at 3 and 6 months interval. At 3 months 51 patients were re-assessed whilst at 6 months only 26 could be re-evaluated. There were no significant changes in scores of Hamilton Rating scale and PGI-N2 Health Questionnaire at intake and subsequent follow-up assessments. No significant correlations between stressful life experience and severity of illness emerged. Twenty nine patients were interviewed on Present State Examination and of these 20 had diagnosable depressive neuroses- From consultation liaison psychiatric point of view, provision of psychiatric help to these patients is discussed

DEXAMENTHASONE SUPPRESSION TEST IN OBSESSIVE COMPULSIVE DISORDER

Dexamethasone Suppression Test (DST) was performed on twenty five patients satisfying Research Diagnostic Criteria for the diagnosis of Obsessive Compulsive Disorder. Abnormal DST responses were seen in twelve (48%) patients. It was observed that the non-suppressor group scored significantly more on depression and obsessionality. The implications of the results are discussed