Editorial: Public health, suicide, and substance addiction

Suicide remains a critical public health concern, intricately entwined with factors ranging from mental health vulnerabilities to societal pressures. Research on “Public health, suicide, and substance addiction” offers a wealth of information about the complex interplay between these three problems. Suicide is a hidden epidemic that is quiet and has many underlying factors. Scholars have traditionally placed a high value on investigating and evaluating various causative factors. In this editorial, we navigate through the key themes and notable findings across a diverse array of studies, each shedding light on distinct facets of this complex landscape

Socio demographic, clinical and side effect profile of electroconvulsive therapy use among psychiatric inpatients: a cross sectional study from South East Asia - Kashmir

Background:Electroconvulsive Therapy (ECT) is a neuromodulative technique, which is effective but underutilized for treatment of psychiatric disorders. The aim of the study was to investigate socio demographic, clinical and side effect profile of electroconvulsive therapy use among psychiatric inpatients.  Methods:A cross sectional study was performed for a period of 1 year in postgraduate department of psychiatry (Institute of mental health and neurosciences Kashmir - center of excellence). Patients of pharmacotherapy resistant psychiatric disorders attending the hospital during this period were taken in study. The data was recorded in a specially designed proforma which documented the socio-demographic variables including age, sex, residence, occupation, socioeconomic status was recorded. Chi-square, Fisher exact, and t tests were used to note the statistically significant association.Results:The mean age of the study sample was 39.6 (±11.76) years. Maximum number of patients were in the age group 41-50 years i.e. 16 (28.6%), followed by 31-40 years i.e. 15 (26.8%). The mean number of ECT’s received was 8.22 (±2.073). About 29 (51.8%) patients reported body aches, 24 (42.9%) patients reported forgetfulness, 9 (16%) patients reported headache and only 1 (2%) patient reported agitation.Conclusion:The results indicate that electroconvulsive therapy is used in all psychiatric disorder with fewer side effects in pharmacotherapy resistant psychiatric disorders.

First Reported Case of Lorazepam-Assisted Interview in a Young Indian Female Presenting with Dissociative Identity Disorder and Improvement in Symptoms after the Interview

Dissociative identity disorder (DID) is one of the most fascinating disorders in psychiatry. The arduous search to reveal the obscurity of this disorder has led to colossal research in this area over the years. Although drug-assisted interviews are not widely used, they may be beneficial for some patients that do not respond to conventional treatments such as supportive psychotherapy or psychopharmacotherapy. Drug-assisted interviews facilitate recall of memories in promoting integration of dissociative information. We report a case of a 16-year-old female with dissociative identity disorder (DID) that was treated with lorazepam-assisted interview and there was rapid improvement in symptoms after the interview

THE RISING SCOURGE OF MENTAL ILLNESS AND INFODEMIC: AN OUTCOME OF SOCIAL MEDIA AND COVID-19

COVID-19 was accompanied with the increasing broadcast of fake news, misinformation and excessive information via social media platforms. This phenomenon has been termed “infodemic”, to describe an overwhelming amount of mostly fake, false or inaccurate information which spreads rapidly and impacts negatively on achieving a solution. It would therefore be desirable to use a cautious approach which utilizes culturally sensitive and country specific measures to deal with this occurrence. We aim to raise awareness, likewise draw the attention of global scientific community on this topic of public and mental health concern and it calls for further comments on this issue

Quality of life and wellbeing in patients receiving electroconvulsive therapy: a study from Kashmir

Background: Electroconvulsive therapy (ECT) is an effective neurostimulative treatment in psychiatric disorders and is widely used throughout the world except few countries. Studies regarding quality of life and well-being in patients receiving electroconvulsive therapy have not been undertaken in our country. Objective of current study was to study the quality of life and well-being in patients receiving Electroconvulsive therapy. Methods: 50 patients who have been prescribed pharmacological drugs form the control group and 50 patients already on psychotropic medication who were prescribed electroconvulsive therapy form the case group were taken up for study. Detailed evaluations were carried out clinically and by measurement of Well-being index. Pre-treatment evaluation was carried out one day before Electroconvulsive therapy, and post treatment was carried out at 3 and 7 week. Data were evaluated by means of chi square and Repeat ANOVA, Post hoc Bonferroni correction for within group comparisons applicable. Results: Mean wellbeing index for study group is 14 which is slightly higher than control (11) (p>0.001.) Well-being index of study group is much higher than that of control group at 3 and 7 week post treatment (p>0.001). Conclusions: Sustained effect on quality of life remains in depression up to 7 weeks and in mania it responds rapidly wanes off within 7 weeks. Electroconvulsive therapy improves the quality of life in psychiatric patients.

Unusual foreign body insertion in rectum and vagina in schizophrenic patient

Insertion of foreign body in to the body is rare in medical literature. Here we report a case of 21 year old female who presented to emergency with acute abdomen and on detailed evaluation turned out to be schizophrenia. Our patient had history of insertion of ball pen in rectum following command hallucination. The foreign body was later removed through laparotomy. The cause of insertion of foreign body are multiple from command hallucination, suicidal attempt, erotism to somatic delusions. Thus the clinician should always be vigilant while dealing with psychiatric patients as sometimes impacted foreign body can present as acute emergency

A Cross-Sectional of Syrians' Knowledge of Diabetes Mellitus and Hypertension Management

Background: Diabetes and hypertension are the two most common types of non-communicable diseases (NCDs) impacting people globally. There is no prior research on the Syrian population's knowledge and treatment of hypertension and diabetes, so it is crucial to assess how the Syrian population acknowledges and perceives these illnesses. This research intends to assess the level of hypertension and diabetes-related awareness, knowledge, attitude, and practices among Syrian individuals.    Methods: A cross-sectional study was conducted between 1 August and 25 August 2022 to assess adult awareness, knowledge, attitude, and behavior about hypertension and diabetes. The questionnaire for the study was developed based on previous research, and the inclusion criteria for the sample were Syrian residents older than 18 who presently live in Syria. On the questionnaire, there were four sections: sociodemographics information, WHO STEPS survey instrument on knowledge of and lifestyle determinants for hypertension and diabetes, respondents' knowledge of and comprehension of hypertension and diabetes, and respondents' awareness of these disorders.   Results: Among 976 participants, (65.8%) were females. Participants reported hypertension caused by (90.1%) stress, (78.2%) old age, (69%) anxiety, and (38.6%) drug usage. High salt consumption (87%), genetics (82.1%), and obesity (78%) are all risk factors for hypertension. In addition, minimizing salt consumption (92.4%), regular exercise (87.2%), and avoiding anxiety (85%) are preventative measures for hypertension. Participant answers to hypertension consequences were (75.8%) foot ulcer and (74%) eyesight loss. Primary and middle school educational status participants had greater hypertension knowledge (92.3%) than other educational levels. Alcohol use was linked to hypertension knowledge (P < 0.05). Participants whose lifestyles did not include alcohol use had a higher hypertension knowledge level (90.3%). Participants with a family history of diabetes have a greater knowledge of hypertension (92%) than those without (66.9%). Almost age groups have shown good knowledge of diabetes, especially participants aged above 55 (93.8%). However, most individuals have examined blood pressure (82.3%), whereas fewer than half had screened for blood sugar (64.4%). 82.2% of individuals check their blood pressure frequently, whereas 6.2% monitor their blood sugar. Men have a higher hypertension knowledge than females (mean=8.39, SD=2.02), P-value< 0.05, and knowledge of hypertension among participants was shown to be higher among those in good income status than other economic levels (mean=8.34, SD=1.98), P-value< 0.05. Participants between the ages of 40 and 55 showed better knowledge of diabetes compared to other age groups (mean=11.32, SD=2.54), P-value< 0.05; as well, men demonstrated greater knowledge of diabetes than females (mean=10.76, SD=2.79), P-value< 0.05.   Conclusion: Our results demonstrated that the Syrian population has a good to moderate understanding of hypertension and diabetes. However, there is still a shortage of standardized, regular screening practices. Since individuals remain involved in unhealthy lifestyle habits, it is vital to provide accurate information about hypertension and diabetes

Is institutionalization a risk factor for poor oral health; a comparison of the oral status of schizophrenia and bipolar affective disorders

Background:Oral health is an integral part of general health and psychiatric disorders lead them to change their life style and lose concern for general and oral health. In view of this, the study was planned to compare the oral health status in different types of in-patient psychiatric patients. Objective of current study was to study the oral health status in schizophrenia and bipolar affective disorders institutionalized in psychiatric hospital.Methods:50 Psychiatric patient (43 patients suffering from schizophrenia, 7 patients of bipolar affective disorder,) and 50 unrelated healthy volunteers were taken in the study. Dental examinations were done in both groups to measure the following indices of oral health: decayed, missing, and filled teeth index (DMFT)  for caries; simplified oral hygiene index (OHI-S) for oral hygiene status; and tooth wear index for the wear of teeth. For comparison analyses t test was used.Results: Mean age of the study group was 37.74 years. Mean decayed missing filled teeth index (DMFT) score for study group and control population was 8.52 ± 4.36 vs. 4.72 ± 2.74 vs. 1.81 ± 1.00 (P ≤0.0001). The mean simplified oral hygiene index (OHI-S) for study group was 3.87±1.21, while that of control was (p≤0.0001).The mean Tooth wear index (TWI) score for study group was found to be 1.62 ± 0.75 and for control group was 1.08±0.48 (P ≤0.0001).Conclusion: Oral health status is affected in psychiatric patients and improving the oral health in psychiatric patients can go long way in improving the quality and management of these patients.