Knowledge and attitude of patients and their relatives towards electro-convulsive therapy: a study from a tertiary care centre in Northern India

Background: Electro-convulsive therapy (ECT) has been effective in various psychiatric disorders and is life-saving in some conditions. Despite its effectiveness and lack of serious side-effects, its use is restricted due to negative attitude of patients and their relatives towards ECT. The objective of the study was to study the attitude of patients and their attendants towards ECT. Also, we studied their knowledge regarding ECT prior to the administration of ECT.Methods: A 16 item questionnaire was formulated to be used for assessing the attitude and knowledge about ECT and was administered after translating it into Urdu language for better understanding. Patients planned for ECT were administered the questionnaire after taking consent. A total of 60 patients and 60 attendants were taken up for the study.Results: About 60-70% of patients gave correct (right) responses to questions like ECT being life-saving procedure, need of investigations before ECT and other questions like question numbers 1,5,6,7,11,14,15. There was little knowledge regarding other areas like use of ECT in pregnant females and elderly (question numbers 2, 4, 10, 12). The patients as well as their attendants did not differ significantly in the responses given to the queries. Maximum number of patients received knowledge regarding ECT from doctors; few had attained it from other sources like internet.Conclusions: The study is a preliminary one and emphasizes the need for better standardized questionnaire for proper assessment. It also gives us an insight into lack of knowledge among patients and their attendants regarding ECT

Stigma in coronavirus disease-19 survivors in Kashmir, India: A cross-sectional exploratory study.

BackgroundCoronavirus disease-19 (COVID-19) has not only spawned a lot of stigma and discrimination towards its survivors but also to their corpses. We aimed to assess the magnitude and correlates of stigma in these survivors, on return to their communities.MethodsThis was a cross-sectional, hospital-based, exploratory study conducted by the postgraduate department of psychiatry, in collaboration with the postgraduate department of chest medicine, Govt. medical college, Srinagar. The study was performed among COVID-19 survivors, who attended the outpatient department after their discharge from the hospital. Socio-demographic characteristics were recorded through semi-structured proforma. Stigma was measured by the stigma questionnaire. Data was analyzed using descriptive statistics and regression analysis.ResultsA total of 91 survivors consented to participate in the study. Almost half (46.2%) of them were in the age group of 30-49 years and close to two-thirds (68.1%) were males. About three-fourths (74.7%) were from the urban background. The mean time from hospital discharge to study entry was 11.7±5.1 [Range(R) = 7-21] days. 98% of survivors provided at least one stigma endorsing response and the total mean stigma score was 28.5±7.1[R = 6-39]. The mean stigma sub-scores were highest for enacted stigma (7.6±1.8) [R = 2-9] and externalized stigma (15.0±4.1) [R = 1-20]. Enacted stigma was significantly high in males as compared to females. Enacted stigma and internalized stigma were both associated with education. Enacted stigma, externalized stigma, disclosure concerns, and total stigma was significantly associated with the occupation. Being unemployed and time since discharge were identified as independent predictors of total stigma.ConclusionOur study results showed high levels of enacted and externalized stigma among COVID-19 survivors. Enacted stigma was more among males and in those who were highly educated. Survivor centered and community-driven anti-stigma programs are the need of the hour to promote the recovery and community re-integration of these survivors

Correction: Stigma in coronavirus disease-19 survivors in Kashmir, India: A cross-sectional exploratory study.

[This corrects the article DOI: 10.1371/journal.pone.0240152.]

Prevalence of psychiatric disorders in patients with a diagnosis of polycystic ovary syndrome in Kashmir

Background: Polycystic ovary syndrome (PCOS) is one of the common endocrine disorders and is associated with reproductive, metabolic, and psychological disturbances affecting one in five women of reproductive age group. Objective: To investigate the prevalence of psychiatric disorders among women in ambulatory treatment with a diagnosis of PCOS. Materials and Methods: One hundred and ten patients of PCOS were evaluated using Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition criteria by means of Mini International Neuropsychiatric Interview, English version 5.0.0. Diagnosis of PCOS was confirmed according to the National Institute of Health/National Institute of Child Health and Human Development, 1990 consensus conference criteria. Forty subjects without PCOS who were matched for age and body mass index were taken as a comparison group. Results: About 23% of cases had major depressive disorder as compared to 7.5% of controls, 1.8% had dysthymia, 15.45% had panic disorder compared to 5% of controls, 6.36% had obsessive compulsive disorder compared to 2.5% of controls, 8% cases had suicidality, 2.72% of cases were bipolar affective disorder, and 15.45% had generalized anxiety disorder (GAD). Conclusion: A high prevalence of mental disorders was observed, especially major depression, panic disorder, and GAD in patients with PCOS in our study. The results suggest that screening and appropriate management for psychiatric disorders should be part of the routine evaluation of these patients

Are health care systems insensitive to needs of suicidal patients in times of conflict? The Kashmir experience

Suicide and attempted suicide is an important health issue and the number of people who die of suicide exceeds that of conflicts. Kashmir has been suffering from a low intensity war since last 20 years in which thousands have been killed or injured. There has been phenomenal increase in cases of psychological disorders along with suicide and and suicide attempters. Suicide in a conflict zone is viewed with indifference due to focus on the physical part of trauma. Difficulties faced by the suicidal patient and his attendants are seldom highlighted. 1408 patients who reported to emergency room for suicide attempt from 2000 to 2008 were taken for the study. All the patients underwent the hospital protocol for poisoning management. Patients were subjected to detailed psychiatric evaluation and questions were specifically asked about the difficulties encountered during management. Most of the cases were females with 92.11% belonging to the Muslim religion. 76.20% cases were from a rural background. 32.5% had been referred because of the lack of specific antidotes. Forty-three percent required arrangement of transportation by their own family members. Fifty-seven percent had been stopped for security checks along the way. Seventy-three percent felt that the attitude of the staff hostile. Twenty-three percent of patients had to share a bed. Almost all patients were questioned by security agencies within the hospital. More than 68% patient reported hostility amongst their neighbors. Suicidal poisoning is a significant health problem in Kashmir and management of these cases is fraught with difficulties across the spectrum of health care. Educating the doctors at primary care about first aid, improvement in community services followed by long term resolution of the conflict would go some way in alleviating the difficulties faced by a suicidal patient and his family in a conflict zone