Case report: Sleep deprivation presenting as acute psychosis

Sleeping is a basic human need and plays a key role in good health and well-being. Sleep deficiency can lead to physical and mental health problems, injuries, loss of productivity, and even a greater risk of death. Sleep deprivation is seen in several psychiatric disorders, and there may be a cause or effect relationship. Sleep-deprived individuals may have trouble making decisions, solving problems, controlling their emotions and behavior, and coping with stress or change. We report a case who started having sleep deprivation over 15 days following a stressor, which resulted in an acute psychosis-like condition with associated disorientation and perplexity. However, the patient responded to benzodiazepine medication given for the restoration of her sleep cycle and did not require any antipsychotics. There was also complete amelioration of her behavioral and thought disturbances

A Study of Depression and Quality of Life in Patients of Lichen Planus

The precise cause of lichen planus is unknown, but the disease seems to be immunologically mediated. It is a psychocutaneous disorder. Due to scarcity of Indian studies in this field, we decided to study in patients of lichen planus the prevalence of depression and quality of life with comparison of the same in both the genders. Patients diagnosed as having lichen planus by consultant dermatologist were enrolled after informed consent and ethics approval. 45 patients were screened, of which 35 who satisfied the criteria were taken up for the study. A semistructured proforma was designed to collect the necessary information with administration of dermatology life quality index and Beck’s depression inventory. While 25% were depressed with females being more affected than males, quality of life was impaired in more than 90% patients. Impairment was maximum due to symptoms and illness feelings, disturbed daily activities, or work and time consumption in treatment. There was a strong association between depression and impairment in quality of life in both the genders. This study helps in early identification of psychological problems in lichen planus patients and in planning their future course of management, hence reducing the lack of productivity and improving the prognosis and quality of life

A study on interictal depressive symptoms and laterality in temporal lobe and generalized epilepsies

Background: Mood disorders like inter-ictal depressive symptoms and inter-ictal major depressive episodes are the most frequent psychiatric co-morbidity seen in temporal lobe epilepsies with left hippocampal sclerosis than generalized epilepsies. Despite the clinical significance of depression, it often goes unrecognized and hence untreated in this population. These patients may tend to minimize their complaints to avoid further stigmatization of their illness. This study was undertaken to the prevalence and severity of depressive symptoms in patients with complex partial and generalized seizures, association of depression with the duration of illness and correlation of depression with right or left sided focus in complex partial seizures. Methods: 30 patients each of complex partial and generalized seizure disorder were enrolled to study depressive symptoms with the help of the Beck's Depression inventory a 21 item measure of depressive symptoms. A proforma was prepared to study the various demographic variables, details of seizure disorder &MRI findings. Results: As per the Beck's Depression inventory 26% of complex partial seizure patients and 40% of generalized seizure disorder patients had depressive symptoms which was not statistically significant. 20% and 63% of complex partial seizure patients and 30% and 40% of generalized seizure patients had moderate and mild severity of depression respectively. No significant association between left sided temporal lobe scleroses for depressive symptoms was seen. No correlation was seen of duration of illness with depressive symptoms in both the groups. Conclusions: A high prevalence of depressive symptoms in the generalized seizure group as compared to complex partial seizure group patients emphasizes the fact that the psychiatric morbidity is multi-factorial involving neurobiological as well as psychosocial issues which need to be addressed

Isolated sleep paralysis

Sleep paralysis (SP) is a cardinal symptom of narcolepsy. However, little is available in the literature about isolated sleep paralysis. This report discusses the case of a patient with isolated sleep paralysis who progressed from mild to severe SP over 8 years. He also restarted drinking alcohol to be able to fall asleep and allay his anxiety symptoms. The patient was taught relaxation techniques and he showed complete remission of the symptoms of SP on follow up after 8 months

A study on postgraduate medical students academic motivation and attitudes to research

Background: Medical students do postgraduation in a specific branch for a particular motive and goal in life. Due to workload, they have less desire to do research or even pursue academics. This study was undertaken to study the differences among the clinical and nonclinical postgraduate students in the intrinsic and extrinsic motivation to learning and the attitudes to research. Methods: This study was conducted in 373 postgraduate students in a tertiary care hospital after written informed consent and ethics approval. A semi-structured questionnaire, academic motivation scale, and attitudes toward research scale collected the information about aims of the study. Results: Two groups were formed depending on the disciplines being pursued by the students, namely, clinical (n = 245) and nonclinical (n = 128). The nonclinical group showed significant differences on extrinsic motivation (t = 2.886, P = 0.0004), total motivation (t = 2.92, P = 0.0024), and attitudes to research students (t = 11.14, P = 0.0001) as compared to the clinical disciplines. However, on the intrinsic motivation subscale, no significant differences were seen. Discussion: The nonclinical postgraduate students were influenced by extrinsic factors to pursue learning and gain mastery as well as to do research. Students pursuing clinical disciplines had lower scores for academic motivation as well as attitudes to research. Time constraints, lack of infrastructure, and clinical workload add to the woes of clinical students. Conclusion: The results of this study will help us in determining the ways of improving motivation of postgraduate medical students toward academics and research

Assessing metacognitive abilities of postgraduate medical students

Background: Metacognition is essential to successful learning, especially in the field of medicine because it enables individuals to better manage their cognitive skills and determine weaknesses that can be corrected by constructing new cognitive skills. This study was undertaken to study the difference in the metacognitive abilities toward learning in the clinical and nonclinical disciplines of medicine. Methods: Four hundred and sixty-eight residents were contacted, 442 consented, 373 completely filled pro formas were received, and two groups, namely, clinical (n = 275) and nonclinical (n = 128) were formed. Data were collected with the help of a semi-structured questionnaire and the metacognitive assessment inventory. It has two broad domains-knowledge about cognition and regulation of cognition with each having 3 and 5 subdomains, respectively. Results: The two broad domains of MAI revealed a highly significant difference with the students of nonclinical disciplines having higher knowledge about cognition (t = 1.46, P < 0.014) and regulation of cognition (t = 3.13, P < 0.0019) as compared to their clinical peers. All subdomains of knowledge about cognition showed highly significant differences. Planning and evaluation subdomains of regulation of cognition were significant in the nonclinical group. The other subdomains of information management, debugging strategies, and comprehension monitoring were not significant. Discussion: The nonclinical disciplines showed better ability for factual knowledge, use of critical thinking, knowledge about how to implement and when, and why to use learning procedures as compared to their clinical counterparts. Planning, goal setting, with an analysis of performance was also much better in the students of nonclinical disciplines. Conclusion: This study highlights the need to inculcate in medical postgraduates self-learning using their metacognitive abilities so that learning would become more focused and improvement in skills would take place