Trust and expectation on psychiatrist and its correlation with satisfaction and adherence in patients with mental illness

Background Trust and expectation are important aspect of doctor patient relationship and its role in patient’s satisfaction and medication adherence is unclear. Objective To study the levels of trust and expectation on psychiatrist and its relationship with patient’s satisfaction and treatment adherence. Methods One hundred and twenty three consecutive outpatients were recruited on follow-up if they satisfied the selection criteria. They were assessed with socio-demographic and clinical proforma designed for this study, Patient Trust Scale, Patient Satisfaction Survey, Patient Expectations Questionnaire and Medication Adherence Rating Scale. Results There was a high mean score on trust scale (Mean 38.9, SD 8.5) and expectation questionnaire (Mean 13.5, SD 3.3). On Kruskal-Wallis H test significant group differences were observed in nuclear vs joint family type (c2 = 18.496, h2 = .151, df = 1, Sig. = .000) and knowledge of treatment option (medication only vs medication + psychotherapy) treatment option (c2 = 18.100, h2 = .148, df = 2, Sig. = .000) and occupational status (employed vs unemployed) (c2 = 3.165, h2 =.029, df = 1, Sig. = .056) on the score of PTS. Similar differences were also observed in method of treatment sought before (no treatment vs allopathic) (c2 = .065, h2 = .065, df = 3, Sig. = .005), knowledge about treatment option (medication only vs medication + psychotherapy) (c2 = .026, h2 = .161, df = 2, Sig. = .000) and occupation (employed vs unemployed) (c2 = .061, h2 = .061, df = 1, Sig. = .006) on the score of PEQ. On regression analysis (R2 = .723, F = 156.46, p = .000) value of the score on patient satisfaction was statistically significant as predicted by score on measure of expectation (beta = -0.095, t = -1.966, p = 0.052) and trust (beta = .842, t = 17.504, p = .000). Discussion Levels of patients trust and expectation on physician varies with knowledge about treatment option & occupational status, and significantly associated with levels of satisfaction

Treatment burden, not health risk attitude associated with adherence in patients with mental illness in South India

Background: Attitude towards health risks and treatment burden may mediate treatment adherence in therapeutic care. There is a paucity of study examining the levels and relationships of these variables in patients with mental illness. Objective: This study was conducted to know the relationships of health risk attitude & treatment burden and medication adherence in patients with mental illness. Settings and design: Cross-sectional, Hospital-based study. Methods and material: One hundred seventy consecutive participants in remission of mental illness were recruited. The patient\u27s details were assessed with Sociodemographic proforma while attitude towards health risk was assessed with Health-Risk Attitude Scale (HRAS). To evaluate the burden of treatment, the Treatment Burden Questionnaire (TBQ) was used while medication adherence was rated with the Medication Adherence Rating Scale (MARS). Statistical analysis used: Descriptive statistics, KruskaleWallis H, Linear regression analysis. Results: Mean score on MARS was 4.9 (SD ± 1.7) while HRAS and TBQ were 62.2 (SD ± 8.6) and 44.2 (SD ± 23). On linear regression analysis scores of TBQ were statistically significant positively linked to HRAS score (R2 ¼ .35, df ¼ 1, F ¼ 94.2, p ¼ 0.001), While Scores on MARS were statistically significant negatively linked TBQ and HRAS score (R2 ¼ .53, df ¼ 2, F ¼ 97.1, p ¼ 001). Conclusions: Health risk aversion and treatment burden may upraise in mentally ill, and linked to poor medication adherence

Understanding suicide and its prevention in the Indian context: Mental Health Perspective

In India, suicide research has largely concentrated on the prevalence, method, psychological, and demographic risk factors. Suicide processes, paradigms, prevention strategies, and other features of suicide that are common in the West may not be applicable in India. It is vital to study potential underlying processes, various suicide prevention methods, and suicide prevention in general, as well as what more work has to be done in the Indian context. Suicide, on the other hand, is a cross-sectoral public health issue that demands collaboration across all key sectors, and its prevention should engage all stakeholders in India

A study of drug attitude and medication adherence and its relationship with the impact of illness among the mentally ill

Background: Impact of illness may vary with the medication adherence which in turn may vary with the attitude towards drugs. There is a paucity of research examining relationships between these variables. Objective: To study the levels of drug attitude, adherence and its relationship with the impact of illness. Methods: A total of 279 participants with mental illness in remission were assessed with socio-demographic and clinical proforma, scales like Hogan Drug Attitude Inventory (DAI), Impact of Illness Scale (IIS), and Morisky Medication Adherence Scale (MMAS) were used. Results: Mean score on DAI, IIS, and MMAS were 2.38 (SD = 4.6), 25.88 (SD = 6.6), and 5.04 (SD = 2.2) respectively. On linear regression analysis (R2 = .122, DF = 2, F = 17.598, p < .001) IIS Score was statistically significant but negatively associated with the score of MMAS (p < .05) and DAI (p < .05). Discussion: Impact of illness has an inverse relationship with the level of drug attitude and medication adherence. Improving drug attitude and adherence may buffer the impact of illness

The relationship of serum leptin, serum TNF-α, plasma lipids and obesity parameters in patients treated with weight neutral antidepressants

Background: Leptin and tumor necrosis factor (TNF­α) are involved in weight regulation1. Elevated lipids are frequently encountered in obese people which are helpful in the formation of atherosclerotic plaques in the coronary arteries. This study helps us to know whether weight neutral antidepressant therapy can be therapeutic option in those with obesity associated with depression.Methods: It is a Longitudinal study of sample size 72 where Patients with obesity attending to JSS hospital who are found to be depressive in both inpatients and out patients fulfilling the inclusion and exclusion criteria.Results: Our study showed mean difference value of weight, BMI and waist circumference, S. leptin, S.TNF-α, S. total cholesterol, S. LDL-C, S. VLDL-C, triglycerides of obese patients treated with lifestyle modifications, psychotherapy and weight neutral antidepressants at baseline and 3rd month was significantly decreased when compared to obese patients treated with lifestyle modifications, psychotherapy alone at baseline and 3rd month is 3.5kgs, 1.2kg/m2, 0.89cm, 9.53pg/ml, 10.86pg/ml, 22.34mg/dl, 17.94mg/dl, 4.42mg/dl, 21.78mg/dl and 1.2kgs, 0.32kg/m2, 0.02cm, 5.22pg/ml, 7.86pg/ml, 11.72mg/dl, 15.37mg/dl, 1.98mg/dl, 9.54mg/dl respectively (p=0.0001).Conclusions: Our study demonstrated a significant weight loss, and significant decrease in S. Leptin, S. TNF- α, TC, LDL-C, VLDL-C, triglycerides, when obese patients treated with lifestyle modifications, psychotherapy and weight neutral antidepressant (Desvenlafaxine)

Relationships of academic expectation stress & self-efficacy, efficacy for self-regulated learning with academic performance during Covid pandemic

Background: Academic expectation stress & self-efficacy and efficacy for self-regulated learning may affect academic performance. The Covid pandemic has affected the physical and psychological well-being of all, including students. However, there is a paucity of studies examining these variables in college students in Saudi Arabia. Objectives: This study was conducted to explore the levels and relationships of academic expectation stress & self-efficacy, self-regulated learning, and its relationships with academic performance in college students of ---- University during the Covid pandemic. Material and Methods: A total of 302 students were recruited in this cross-sectional study. They were assessed with sociodemographic and academic proforma designed for this study, the Academic expectation stress inventory (ASE), the Academic self-efficacy scale (AES), and the efficacy of the self-regulated learning scale (SRL). Results: Results revealed that the mean score of AES, SRL, and ASE was 29.18, 35.38, and 41.11, respectively. On linear regression analysis exam score was statistically significant positively predicted by the score on SRL, and the Score of AES was statistically significantly predicted by the score of SRL (+ve) and the score of ASE (-ve). Conclusions: It may be concluded that efficacy for self-regulated learning may mediate academic performance and academic self-efficacy during the Covid pandemic. Enhancing self-regulated learning may improve academic performance during the pandemic

Issues in acute psychosis of an illiterate hearing impaired with minimal speech output: A psychiatrist perspective

<p>Assessment and management of mental disorder among sensory impaired is challenging as there is no clear guideline. Most physicians and psychiatrists are not trained to provide competent care in such patients. This report highlights the issues and challenges that a clinician may encounter in patient with profound hearing loss and speech impairment</p

Subsyndromal states in bipolar disorder

<p>Background: Despite adequate treatment, patients with bipolar disorder suffer from subsyndromal symptoms. This study has been done to see the association of subsyndromal symptoms with age of onset, duration of illness, duration of episodes, and number of episodes.<br>Aims: To know the prevalence of subsyndromal symptoms and their relationship with age of onset, total duration of illness, number of episodes, and duration of episodes in patients with bipolar disorder in remission.<br>Materials and Methods: The study was cross sectional and hospital based. One hundred patients, aged between 18 and 65 years, diagnosed as bipolar disorder according to Research Diagnostic Criteria of ICD-10, and with good compliance with the prophylactic medications, score of ≤5 on Beck's Mania Rating Scale (BMRS) and score ≤8 on Hamilton Depression Rating Scale (HDRS) were recruited by the purposive sampling method. Descriptive statistics were used to describe various sample characteristics. Group differences for categorical variables were examined with the chi-square test, whereas an independent 't' test was used for continuous variables.<br>Results: The most common manic symptom was a decrease in sleep (49%), followed by an increase in verbal activity (39%), hostility (37%), and increase in motor activity (33.33%). The subsyndromal manic group had a lower age of onset (58.8%), males (82.4%), unemployed (23.5%), educated (80.4%). There was no significant difference between with and without subsyndromal mania groups with respect to age, age of onset, duration of illness, number of episode, and average duration of episode.<br>Conclusion: Subsyndromal manic symptoms are prevalent and have no relationship with current age, age of onset of illness, duration of illness, number of episode, and average duration of illness in patient with bipolar disorder in remission.</p

Relationship between consanguinity and depression in a south Indian population

<p>A Pilot study was Carried out to study the association of consanguinity marriage with depression. It was observed that the consanguinity of marriage was associated with depression. The odds ratio was 5.66 (CI: 2.42-13.54). The age and sex had an association with depression. The age and sex adjusted odds ratio of consanguinity marriage was 7.66 (CI: 3.93-19.45) indicating that it is independently associated with depression.</p

2009 Conceptualisation of term moof and affect

<p>Background: The management of psychiatric disorders should ideally be carried out by a multidisciplinary team that consists of mental health professionals from different disciplines. All mental health professionals are expected to learn similar basic clinical skills during their training, despite the difference in their graduation.<br>Objective: To compare the conceptualization of the terms 'mood' and 'affect' in all academic trainees of mental health in the Central Institute of Psychiatry (CIP), Ranchi, India.<br>Materials and Methods: The 'modified mood and affect questionnaire' administered to all mental health trainees of CIP, Ranchi, India, in this study. The participants were requested to mark one response (either 'true', 'false' or 'not sure') for each item. The completed questionnaire was collected on the spot.<br>Results: The statistical analysis was done for the data from psychiatric residents and trainees of clinical psychology. The statistical differences were observed between these two groups in response to the items-'Mood is the moment to moment emotional tone' and items of 'sign/symptom dimension'.<br>Conclusions: The observed statistical difference in items could be the reflection of the differences in the description of 'mood' and 'affect' in textbooks of psychopathology, as well as, the difference in their graduation. The trainees of clinical psychology may be benefitted with more exposure in medical knowledge during their training.</p