BACKGROUND Psychiatric disorders in pemphigus vulgaris may occur due to long term course, impact of body image, unlikelihood of complete recovery and frequent recurrences. These are the major predisposing factors towards depression and anxiety. Although, investigators have evaluated psychiatric aspects of the patients suffering from skin diseases, there are rare studies in India concerning mental health in pemphigus patients. Aim-The aim and objectives of the study is to estimate the prevalence of depression and anxiety in patients with pemphigus vulgaris, to assess the socio demographic profile and quality of life. MATERIALS AND METHODS Between august 2017 and September 2017, a cross sectional study of 105 patients diagnosed as pemphigus vulgaris attending pemphigus clinic of dermatology department, Rajiv Gandhi Government General Hospital, Chennai were assessed using semi structured proforma and following questionnaires GHQ-12, HAMA, HAMD, DLQI. RESULTS 105 patients were evaluated; 55% presented depression (58/120; 46 women and 12 men); 45 patients (43%) with mild depression, 13 patients (12%) with moderate depression. Duration of illness and social support presented statistical significance (P = 0.039) and (P <0.001) respectively. 32% presented anxiety (34/105; 25 women and 9 men); 32 patients (30%) with mild anxiety, 2 patients (2%) with moderate anxiety. Social support showed statistical significance (P<0.001). In DLQI, 32 patients had no effect, 24 patients (23%) had small effect, 33 patients (31%) had moderate effect, 16 patients (15%) had very large effect. QOL was significantly impaired, particularly with poor social support (P<0.001), low education (P=0.010), duration of illness (P = 0.003) and number of episodes (P = 0.017). CONCLUSIONS Prevalence of depression and anxiety were higher in patients with pemphigus vulgaris and depression was found to be higher among females and anxiety was higher among male patients. Also increased duration of illness, increased number of episodes, site of lesion especially at genitals and whole body showed increased prevalence of depression and anxiety and affected their quality of life. They are at need of mental health professionals help and should be screened for depression and anxiety.
BACKGROUND Lithium is a novel mood stabilizer in the treatment of bipolar disorders. Toxic effects are frequently encountered in clinical practice due to its narrow therapeutic index. Thyrostatic effects especially clinical hypothyroidism, is a well-known side effect of long term lithium treatment and has been reported in medical literature. However, Indian studies on this major issue is sparse. The aim of the study was to evaluate the prevalence and risk factors for the onset of hypothyroidism (overt and subclinical) in bipolar disorder patients treated with lithium. MATERIALS AND METHODS 110 patients who fulfilled the study criteria were taken from inpatient and outpatient departments of Institute of Mental Health and assessed for prevalence of hypothyroidism (clinical and subclinical) based on thyroid function test taken from case records (T3, T4, TSH). Retrospective analysis of risk factors like age, sex, weight gain during lithium intake, family history of thyroid disease, dose and duration of lithium intake and onset of hypothyroidism was done.
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