Demographic and clinical characteristics of patients presenting with conversion disorder in a tertiary care hospital in north India

 Background: Conversion (functional neurological symptom) disorder refers to patients who have neurological symptoms in the absence of neurological disease, encompassing one or more symptoms of altered voluntary motor or sensory function. Aim of the study was to study the demographic and clinical characteristics of patients with conversion disorder.Methods: The study population comprised all the patients (both inpatients and outpatients) of conversion disorder attending department of psychiatry, government medical college Srinagar over a period of 6 months who fulfilled the inclusion criteria of the study were evaluated on a semi-structured proforma for demographic variables and clinical characteristics.Results: A total of 76 patients of conversion disorder were included in our study. Conversion disorder is more common in age group of 20-29 years (52.6%), females (93.4%) and among students (71.1%) belonging to rural background. Motor symptoms were the predominant presentation with pseudo seizure (69.7%) being the commonest. A majority of the patients had an obvious psychosocial stressor, of which family-related (36.8%) and relationship- related (15.8%) problems accounted for the major types.Conclusions: Conversion disorders are commonly seen in young adult females, students and in those from rural background. They are mostly preceded by psychosocial stressors

Stigmatisation in chronic hepatitis B and C infections-time to debunk the myth!

Background: Hepatitis B and C are chronic diseases with mental and social impacts which can result in poor quality of life. The routes of transmission and lack of education among the masses may cause stigmatisation of the affected patients.  The aim of the study was to document the stigmatisation among chronic hepatitis B and C positive patients. Methods: The 242 patients suffering from hepatitis B and C were included in the study. Stigma experienced from relatives, friends, spouse and health care providers was assessed using a semi structured questionnaire. Results: Majority of the patients were males 174 (72%). The 162 (67%) were hepatitis B infected and 76 (32%) were Hepatitis C infected and 4 were dual infected. Male patients were significantly more affected than females in term of changes in lifestyle (86% versus 61%) and changes in relationship with the spouse (89% versus 16%). Significantly more females than males reported feelings of loneliness and isolation (64% versus 30%). Stigma was marked in terms of disease transmission, with 170 (70%) of patients fearing that they could transmit the infection to others. Marital relationships were affected for 52% of married patients. Around 80% unmarried patients were experiencing delay in getting married. Conclusions: Patients comments showed a sense of family and societal discrimination resulting in feelings of disappointment which could be changed by educational interventions, effective patient and family centric awareness and scientific models of approach

Psychosocial differences in children living in orphanages of Kashmir with and without psychiatric morbidity

Background/Objectives: Orphanages are emerging as an important source of care and child-raising for the ever-increasing number of orphans in the conflict-ridden Kashmir. These children are generally prone to develop psychiatric disorders even reared in well run institution. Objective is to highlight the psychosocial differences in children living in orphanages of Kashmir with and without psychiatric morbidity. Materials and Methods: Cross-sectional descriptive study was carried out where 348 children were recruited from eight registered orphanages of Srinagar, Jammu and Kashmir. Semistructured questionnaire was used to collect data related to sociodemographic profile of the children. Development and Well-Being Assessment (DAWBA) was used for one stage structured assessment of psychopathology. Data analysis was done by Statistical Package for Social Sciences for windows 20.0 version. Results: A total of 97.87% among those having psychiatric morbidity were males as against those without psychiatric morbidity where 28.99% were females. While 8.51% among those having psychiatric morbidity were double orphans, it formed only 1.45% of those without psychiatric morbidity. Likewise 25% among those having psychiatric morbidity had parental deaths due to fire-arm injury, while only 11.67% of them fall in the group without psychiatric morbidity. Among the group with psychiatric morbidity 31.91% had spent less than a year in an orphanage and 10.64% had spent ≥ 9 years as against those without morbidity where percentages were 14.49% and 4.35%, respectively. While 21.28% among those with psychiatric morbidity were enrolled in high education, it formed only 13.04% of those without psychiatric morbidity. Gender, type of orphan, length of stay, cause of parental death, and grade (education level) were significantly associated with the psychiatric morbidity (40.52%). Conclusion: The psychosocial differences in children with and without psychiatric morbidity may help in understanding the factors associated with the emerging psychopathology. Early timely intervention to the children especially “at risk” can be provided to alleviate their mental health problems