Clinical profile of child and adolescent patients attending a mental hospital OPD

Background: Psychiatric morbidity profile of children and adolescents is very different from that of adults. These problems are rising but largely remain unreported. Very few studies have been carried out in this specialty of psychiatry.Methods: In this retrospective file review study, all child and adolescent patients attending the general psychiatry out-patient between January-August 2014 in a city of central India. Semi-structured socio-demographic and clinical profile collection performa and international classification of diseases-10 (ICD-10) were used as tool and statistical analysis was done by using SPSS 16.Results: The results showed that among total 2544 children presented during study period, 175 children (6.8%) had psychiatric morbidity. Most of them were in the age group of 11-16 years, from middle income group, illiterate, Hindu by religion and residing in urban locality. No significant sexual preference was found regarding distribution of the disorders. Mental retardation was commonest (n=112; 64%), without (n=42; 24%) and with co-morbidities (epilepsy n=42; 24%, behavioural disturbance n= 28; 16%) found to be the most prevalent disorder followed by epilepsy (7%), ADHD (5.7%), schizophrenia and other psychosis (5.7%), depression (4%) and autism 1.1% and then others.Conclusions: Mental and psychiatric services for children lag behind those for adults in developing countries. Also, a community based study can be a better study design in future

Pattern of antidepressant prescription at tertiary (mental hospital vs medical college) care centre of central India

Background: Western literature full of extensively study the antidepressant prescription pattern at different settings. Recently in Indian context multicentre study and individual centers reported pattern of antidepressant uses for management of depression. With the time newer antidepressant approved, with better understanding of evidence based pathogenesis of illness influence the treatment patterns. Mental hospital setting is different that medical college setting at least for stigma related issue. The aim of the research work was to study the pattern of antidepressant prescription at mental hospital and medical college settings.Methods: Cross-sectional assessments were done at mental hospital and medical college centers. Subjects diagnosed as depressive episode as per ICD 10, age >18 year included in study. Total 105 treatment seeking subject included in study from both centers Data was collected on socio-demographic characteristics, Clinical profile and prescribed medication.Results: 49 subjects from mental hospital, 56 subjects from medical college included in study. Mean age of study sample 39.27±12.96 vs 37.49±14.90 years respectively at mental hospital and medical college centers. Escitalopram prescribed 83.7% subjects, 53.3 % subjects receive monotherapy. L methyl folate and atypical antipsychotics was most commonly adjunctive medication with antidepressants.Conclusions: In sociodemographic differences subjects attending mental hospital belong to lower socioeconomic status compare to subject attending mental hospitals. There were no significant differences in prescription pattern of antidepressant medication for treatment of depressive episode. Escitalopram most commonly prescribed antidepressant and L methyl folate and atypical antipsychotics was most commonly used adjuvant with antidepressant medications.

A comparative study of inflammatory marker highly sensitive C- Reactive Protein in depression patients exhibiting suicidal behaviour and depression patients without suicidal behaviour

Background: Recent research have found a link between inflammatory pathway and suicidal behaviour. hs-CRP, IL, TNF have been shown to have significant alterations in suicidality, however multiple covariates influence this relationship. One of the main limitations of most of the studies is that they have evaluated the CRP in patients demonstrating suicidal behaviour but not in depression. No study has been conducted in Indian subpopulation with parameters of our study. Aims of the study was to compare hsCRP levels between depression patients with suicidal behaviour and without suicidal behaviour.Methods: Authors compared 50 depression patients with suicidal behaviour and 50 depression patients without suicidal behaviour, diagnosed using ICD10. Hamilton Depression Rating Scale (HDRS‑17), Suicide behaviour Questionnaire- Revised (SBQ-R), Beck Scale for Suicidal Ideation (BSSI) were applied for assessment of depression and suicidality. Highly sensitive CRP was measured using autoanalyzer.Results: hsCRP levels were significantly high in depression patients with suicidal behaviour (4.12 mg/dl) than depression without suicidal behaviour (2.42 mg/dl). Duration of illness, HAM-D, BSSI and SBQ-R scores correlated positively with hsCRP levels.Conclusions: Depression with suicidal behaviour patients have a significantly higher hs-CRP levels than depression without suicidal behaviour. Patients of depression with suicidal behaviour group have a strong positive correlation between hs-CRP levels and HAM-D, BSSI and SBQ-R scores

Effects of Escitalopram on C reactive protein in patients of depression

Objective: To study the anti-inflammatory activity of Escitalopram in newly diagnosed patients of depression. Materials and Methods: 100 Newly diagnosed patients of Depression as per ICD 10 (International classification of diseases) DCR (Diagnostic criteria for research) were selected for study after applying strict inclusion and exclusion criteria. Baseline Hamilton depression rating scale (HAMD) and baseline C reactive protein (CRP) was assessed and antidepressant treatment was started. After 8 weeks, again HAMD and CRP were assessed. Results: Mean of Baseline CRP was higher in patients in those who have no response after antidepressant treatment and it was significant. The relationship between baseline HAMD and baseline CRP was found to be significantly positively correlated. Mean HAMD was significantly reduced after 8 weeks of antidepressant treatment. Mean CRP was significantly reduced after 8 weeks of antidepressant treatment. The relationship between baseline CRP and reduction in HAM D (in baseline and after 8 weeks of treatment) found to be negatively correlated and it was significant. Conclusion: Escitalopram reduced C reactive protein in depressed patient and result was significant

Cross-Sectional study of differences in phenomenology of acute psychosis with or without cannabis

Background: Therehas been plethora of research regarding cannabis use disorder but very few studiesreporteddemographicand phenomenological differences of acute psychosis with cannabis use to those of acute psychosis without cannabis use. This study attempted to evaluate the demographic and phenomenology differences between two groups of patients presenting with acute psychosis with cannabis use and acute psychosis without cannabis use. Material & Method: Two group of patients recruited for study were ‘Cases with Cannabis’ and ‘control without Cannabis’ presenting with acute psychosis with preceding cannabis use and second one presenting with acute psychosis without preceding cannabis use in out-patient department of psychiatry, M. Yhospital, Indore Assessment done using rating scales. Results: Acute psychosis with cannabis wascharacterizedby primarily polymorphic clinical picture with predominance of positive and mood symptoms both in clear and disturbed sensorium.Acute psychosis without cannabis was characterized by mixed positive and negative symptoms in clear sensorium. In ‘Cases with cannabis’ group 96.7% were males and 3.3% were females, mean age was higher (33.7%) than control (27.7%) group. Conclusion: Acute psychosis with cannabis is characterized by primarily polymorphic clinical picture with predominance of positive and mood symptoms both in clear and disturbed sensorium. Acute psychosis without cannabis is characterized by mixed positive and negative symptoms. General symptoms of psychosis were also more in acute psychosis without cannabis

An expanded and flexible form of the vacuolar ATPase membrane sector

SummaryThe vacuolar ATPase integral membrane c-ring from Nephrops norvegicus occurs in paired complexes in a double membrane. Using cryo-electron microscopy and single particle image processing of 2D crystals, we have obtained a projection structure of the c-ring of N. norvegicus. The c-ring was found to be very flexible, most likely as a result of an expanded conformation of the c subunits. This structure may support a role for the vacuolar ATPase c-rings in membrane fusion