PICA WITH AN UNUSUAL FORM OF PRESENTATION: A CASE REPORT

ABSTRACTGeophagia is a condition involving the consumption of mud and is a form of eating disorder known as pica. Pica is an unusual craving for ingestion ofeither edible or inedible substances. Although, pica is not linked to solvent abuse, here we report a middle aged lady with mud eating that respondedto selective serotonin-reuptake inhibitors and cognitive behavior therapy.Keywords: Pica, Geophagia, Mud eating

Various Facets of Anxiety during the Pandemic in India - Critical Issues

The COVID-19 pandemic has brought on a lot of challenges. Among these challenges, the most pressing causes for concern are mental health issues. Anxiety is one such mental health concern that statistics has shown as increasing since the beginning of the pandemic. Numerous causes have contributed to these rising levels of anxiety. Health related concerns, loss of income, are just some of the many reasons that individuals have attributed their anxiety to. The Indian population has especially seen a massive number of jobs that have been lost, and the first lockdown in April 2020 saw a major domestic migrant crisis. In addition, a number of groups, such as the elderly, women, and the youth have faced anxiety provoking situations of their own. While India is currently facing a second wave exactly a year later, the facets of anxiety to take into consideration are numerous. The chapter looks at various facets of anxiety that have been encountered during the pandemic from an Indian context

Sexuality in older adults: Clinical and psychosocial dilemmas

The present review aims to throw some light on the various aspects of sexuality in older adults and the challenges faced by medical professionals working in this area. Keyword searches using the terms "sexuality," "sexual dysfunction," "geriatric," "old age," and others in combination were carried out on PubMed, Google Scholar, and the Cochrane Database of Systematic Reviews. Relevant clinical trials, case studies, and review papers were selected. This was further supplemented with the clinical experience of the authors, who work with older patients in a psychiatric outpatient setting with a dedicated sexual disorders clinic. Sexuality is a lifelong phenomenon and its expression a basic human right across all ages. However, the construct of normalcy for sex in aging is blurred, with agism playing a distinct role. Older adults face much stigma when expressing sexual desires or concerns, both from their own families and the health-care system. Sexual dysfunctions due to comorbid medical illnesses and medications are often treatable. Evidence-based treatments for sexual dysfunction in the elderly, lesbian, gay, bisexual, transgender, and queer, and other orientations are especially underrepresented in research; available research has several limitations. Sexuality in people with dementia and sexual rights in nursing homes are gray areas. Medical training, treatment guidelines, and health-care facilities all need to be stepped up in terms of awareness and quality of care provided to the elderly with concerns related to sexuality

Psychological issues in pediatric obesity

Pediatric obesity is a major health problem and has reached epidemiological proportions today. The present paper reviews major psychological issues in pediatric obesity from a developmental perspective. Research and literature has shown that a number of developmental, family, maternal and child factors are responsible in the genesis of pediatric obesity. Family food habits, early developmental lifestyle of the child, parenting, early family relationships and harmony all contribute towards the growth and development of a child. The present review focuses on the role of developmental psychological factors in the pathogenesis of pediatric obesity and highlights the developmental factors that must be kept in mind when evaluating a case of pediatric obesity

Compulsive masturbation in a patient with delusional disorder

Compulsive masturbation is a type of paraphilia related disorder in which a person engages in masturbatory behavior to such an extent that it causes socio-occupational dysfunction. The psychiatric co-morbidities associated with it include mood and anxiety disorders, substance use disorders, etc. Here, we report a case of a patient with the delusional disorder having compulsive masturbation

The use of cerebroprotein hydrolysate in dementia: A case series of 25 cases seen in a tertiary general hospital

Background: Cerebroprotein hydrolysate (Cerebrolysin) is a pharmacological and neurotrophic agent that has been used widely in the management of various forms of dementia. Purpose: The present paper presents a retrospective chart review of 25 patients with dementia visiting a tertiary general hospital psychiatry unit who received cerebroprotein hydrolysate as an add on treatment for dementia. Materials and Methods: Twenty-five patients were administered 20 doses of cerebroprotein hydrolysate intravenously at a dose of 60 mg in 250 ml normal saline over 1-2 h after a test dose on 20 consecutive days. The cognitive assessment was done before the first injection and after the last dose using the Adenbrook′s Cognitive Examination-Revised (ACER) and the Mini Mental Status Examination (MMSE). Results: There was significant improvement in scores on the ACER and MMSE, although the final scores remained in the dementia range. None of the patients experienced any major side effects. Conclusions: Cerebroprotein thus is a useful pharmacological option in the management of dementia and warrants further study and exploration

Electroconvulsive in a 75-year-old patient with severe agitated behavior and dementia

Various drugs have been used in the management of behavioral and psychotic symptoms including aggression and agitation in dementia. However, the risk of side effects and sedation limits the use of higher doses of many agents. Electroconvulsive therapy (ECT) has been used in the management of behavioral symptoms related to dementia although sparingly and rare. We report the case of a 75.year.old male patient with moderate Alzheimer's dementia and severe agitated behavior and aggression which failed to respond to pharmacological treatment and whom we treated using seven ECT sessions with success. Significant clinical improvement was noted and no cognitive decline or worsening of the dementia in any form was reported. The patient was followed up 6 months post the ECT sessions. This case report demonstrates the safety and efficacy ECT use patients with Alzheimer's dementia when behavioral problems and aggression or agitation fail to respond to medications

Genital self-mutilation in a case of first episode psychosis

Genital self-mutilation (GSM) is a much rare finding and more commonly associated with psychosis when it comes to comparison with self-mutilation as a whole. There have been anecdotal case reports of GSM in psychotic disorders with most of them being in long standing psychoses. We describe herein a case of GSM during the first episode of psychosis where multiple phenomenological variables were seen responsible for the act