Background: Schizophrenia is a major mental disorder characterized by positive, negative, and cognitive symptoms. Cognitive impairment is a central and enduring feature of schizophrenia and is associated with disability. It has a devastating consequence on the individuals, families, and the society. Our aim was to assess cognitive functioning, disability, and their association with sociodemographic and illness-related variables. Methodology: In an outpatient department of psychiatry, 82 adult patients with a diagnosis of schizophrenia were recruited. Schizophrenia Cognition Rating Scale (SCoRS), Positive and Negative Syndrome Scale (PANSS), and Indian Disability Evaluation and Assessment Scale (IDEAS) were used to assess cognitive function, psychopathology, and disability respectively. Socio-demographic and illness-related details were collected using a semi-structured questionnaire. Data were analyzed using STATA version 16.0 using appropriate statistical tests. Results: Approximately 93.9% of patients had at least one cognitive symptom even though not severe. The status of being married was associated with better cognitive outcome. No other socio-demographic factor was associated with cognitive dysfunction. Negative symptoms and general psychopathology scores of PANSS were positively correlated with SCoRS scores and IDEAS score. Cognitive dysfunction and disability were significantly associated suggesting higher the cognitive deficit in schizophrenia greater is the likelihood of patient experiencing disability. Conclusion: Cognitive deficits are commonly seen in patients with schizophrenia and are associated with disability. Therefore, treatment programs of schizophrenia should have a component to address these deficits using evidence-based cognitive remediation therapies. Family Physicians caring for those with schizophrenia should factor the cognitive deficits and simplify dosage regime and engage caregivers for supervision.
Background: Absence of menstrual period in a woman of reproductive age group could be physiological or pathological. Ascertaining the cause for this is a common clinical scenario faced by physicians. It is also a common clinical problem in women who are on treatment with antipsychotic medication. This cross-sectional study aimed to assess the occurrence of antipsychotic induced amenorrhoea among women aged 18-45 years, attending outpatient services of a tertiary care setting, the factors associated and to assess the effective strategies of treatment.Methods: Retrospective chart review of clinical details of women in the reproductive age group who fulfilled the inclusion criteria was carried out. They were divided into two groups: Group A included 84 women with antipsychotic induced amenorrhea and Group B included 94 women on antipsychotics and had normal menstrual cycles. Various factors and strategies which worsened or alleviated the symptoms were noted.Results: Women who were less than 35 years of age, on antipsychotic treatment for more than two years duration (52;83.9%) and those who were on treatment with Risperidone (69;73.4%) were identified as having the risk of developing antipsychotic induced amenorrhoea. The strategy of switch of medication to prolactin sparing antipsychotic was more effective in regularising the menstrual cycles (43;87.8%).Conclusions: In women presenting with amenorrhoea, a possible medication induced aetiology need to be considered, especially use of antipsychotics. Further understanding of the complexities of this relationship may help to guide the assessment and proper treatment of women with antipsychotic related amenorrhoea.
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