Background: Use of complementary and alternative medicine (CAM) is more common in elderly patients due to the prevalence of various age-related chronic medical conditions. The pharmacokinetics and pharmacodynamics change with age and are different in the elderly as compared to a young adult. Non-disclosure of CAM usage voluntarily by the patients, along with the practice of poly-pharmacy for various comorbidities and concurrent use of modern medicine with CAM, makes this age group particularly prone to adverse effects of drugs and the drug-drug interactions. Use of CAM assumes further importance in the context of Indian elderly, due to the widespread belief in traditional medicines and easy over-the-counter availability of many prescription drugs in India. Aims and Objective: The study was conducted to understand and analyze the knowledge, attitude, and perception of CAM usage specifically in elderly Indian patients, which to the best of our knowledge has yet not been assessed previously. Materials and Methods: It was a descriptive cross-sectional study assessing a representative sample of 325 elderly patients over the age of 60 years. Data collection was done after face-to-face interview-based survey administered on a semi-structured questionnaire. Results: The number of CAM users (65.5%) was significantly more than the non-users (P ≤ 0.05). In the age group between 60 and 69 years, 59% had used CAM, as compared to a significantly more number of 76% patients (P ≤ 0.05), in the age group above 70 years. The CAM practice in the elderly was not influenced significantly by gender, education, rural or urban background, and distance from the health-care facility of modern medicine system. CAM was the initial choice of therapy for 65.7% of the users. Ayurveda was the most popular practice (64.8%), followed by homeopathy (62.4%) with many patients using both the practices together. Use of CAM practices concomitantly with modern medicine was not considered unsafe by 56.8% of patients. The physicians of modern medicine did not ask 91.5% of elderly patients about CAM usage and 85.5% of patients did not volunteer any information on CAM usage unless asked for. Conclusions: The study suggests the need to acknowledge and explore the high prevalence of CAM usage with increasing age in the Indian elderly, both to identify the irrational usage of CAM alone or in combination with the modern medicine system and to facilitate the integration of rational CAM practices in the mainstream medicine.

Background: Schizophrenia and obsessive-compulsive disorder (OCD) are two common and chronic psychiatric illnesses known to be associated with a considerable burden of caregiving. Various sociodemographic and clinical variables can influence the caregiving experience of the caregivers of these patients. Aim and Objectives: The present study aims to assess the burden of care, with the help of a well-standardized tool, and its relationship with different factors related to the caregivers. Materials and Methods: After obtaining the ethical approval from the Institutional Ethical Committee, a total of 50 adult caregivers with their patients with OCD as well as 50 caregivers with their patients with schizophrenia were enrolled on the study. The burden assessment schedule (BAS) was the principal tool to assess the burden of care in the caregivers of both patient groups. Results: The majority of the caregivers were male in both study groups. Both the study groups were comparable in terms of all sociodemographic variables except education and occupation. An education level of high school and above was found in a significantly higher number of the caregivers of patients with the OCD than those with schizophrenia (76% vs. 34%; χ2= 25.76; P<0.001). A significantly higher number (70% vs. 42%, χ2=8.227, P<0.05) of caregivers of patients with schizophrenia were unemployed. Both groups were comparable in terms of the overall burden of care (i.e., total BAS score), but the caregivers of patients with schizophrenia had a significantly higher mean score of the burden in the domain “caregiver’s routine” (8.92±1.82 vs. 8.08±1.85; t=2.291; P<0.05) and in the domain “taking responsibility” (11.0±0.50 vs. 10.08±0.94; t=6.103; P<0.001) than the caregivers of patients with OCD. Conclusion: The burden of care in the caregivers of patients with the OCD was not less than that in patients with schizophrenia in almost all of its domains except the burden of caregiver’s routines and taking responsibilities which were higher than the caregivers of patients with schizophrenia. There is a need for the development of educational inputs and support programs for these caregivers based on their local needs.

Background: Headache is a health disorder that affects a large proportion of the world population, resulting in a huge economic burden. Nearly half the world’s population has a history of current headache disorder. Its prevalence is reported to vary over a wide range from 1.3% to 65% in men and 2.7% to 86% in women. It is responsible for 7.2 million years of life lived with disability. The present study was planned to study the prevalence and clinical impact of psychiatric comorbidity and quality of life among patients with tension-type headache (TTH) in a North Indian population. Aims and Objectives: To assess the psychiatric comorbidity and quality of life among the patients of Tension type Headache and compare them with healthy controls. Materials and Methods: Patients presenting with complaints of headache and healthy individuals without complaints of headache were included in the study. A total of 100 patients were studied that were presenting in tertiary care hospital. Patients were subjected to a semi-structured interview, diagnosis made by ICHD-3 for TTH, and psychiatric comorbidity was detected by Mini-International Neuropsychiatric Interview applied to both patients and controls. Results: Psychiatric morbidity was diagnosed in 90% of cases and only 9% of controls. Among cases with psychiatric morbidity, generalized anxiety disorder (28%) was the most common, followed by major depressive disorder (MDD) (27%), panic disorder (12%), social phobia (11%), agoraphobia (6%), alcohol dependence (4%), and substance dependence (2%), respectively. On the other hand, among controls, 7% had MDD and 2% had alcohol dependence. Statistically, a significant difference was found between the two groups (P<0.001). The quality of life of TTH patients with psychiatric comorbidity was significantly lower as compared to that of TTH patients without psychiatric morbidity. Conclusion: The findings of the study showed a much higher prevalence of psychiatric comorbidity among TTH patients as compared to matched healthy controls. The quality of life of TTH patients was highly impaired, presence of psychiatric comorbidity made the quality of life of affected patients even worse.