Background: The role of craving in alcohol dependence and its relationship with relapse has been studied widely in the past decade. The present study was undertaken to assess the role of craving in short-term relapse of patients seeking treatment for alcohol dependence and changes in craving score at the end of detoxification and at follow-up. Materials and Methods: A total of 34 male individuals with alcohol dependence (excluding comorbid drug dependence, organic or psychiatric disorder), after detoxification and discharge, consented. No anticraving medicine, aversive or psychotherapy, was advised. They were diagnosed on the International Statistical Classification of Diseases-10 using Diagnostic Interview for Genetic Studies. Severity of Alcohol Dependence Questionnaire (SADQ) and Clinical Institute Withdrawal Assessment Scale–Alcohol-Revised (CIWA-AR) were administered at the time of admission. Penn Alcohol Craving Scale (PACS) was applied at the time of discharge and follow-up to measure craving for alcohol. Results: Out of a total of thirty patients analyzed after dropout, 21 relapsed at the end of 1 month. On comparing PACS scores between relapsed and nonrelapsed patients, the difference was significant at both time points, i.e., at discharge and follow-up ( t = 4.15, P < 0.0001 and t = 4.01, P < 0.001, respectively). In the total sample, SADQ and CIWA-AR scores were positively correlated (r = 0.47, P = 0.009). PACS at discharge was compared with PACS at follow-up, of which the correlation was high (r = 0.832, P < 0.0001). Conclusion: Craving seems to be a main factor related to relapse. Its measurement with PACS can be a useful tool to predict subsequent drinking and to identify individual risk for relapse during treatment.
Objectives. Suicide is a major public health concern. Sensible media reporting of suicide is one of the important prevention strategies. There has been no report assessing the quality of media reporting of suicide in Nepal. We aimed to assess the quality of newspaper reporting of suicide in Nepal against the World Health Organization (WHO) reporting guidelines. Methods. We undertook a content analysis study of articles from the online archives on reporting of suicide deaths in six English language (daily or weekly) newspapers published in Nepal over the two-year duration from a period between January 1, 2019, and December 31, 2020. Also, we compared them with the World Health Organization (WHO) guidelines. Results. A total of 165 English newspaper articles reporting on suicide were analyzed. 163 (98.8%) of news were published in the main section of the newspaper, and the mean length was 17.6 sentences. The name and age of the person who died of suicide were mentioned in about 69.1% ( n = 114 ) and 53.3% ( n = 88 ) articles, respectively. The most common method of suicide reported in the news articles was hanging (45.5%, n = 75 ), followed by poisoning (11.5%, n = 19 ). About 97.6% ( n = 161 ) of news articles violated the recommendation provided in the WHO guidelines. Conclusions. The adherence to the WHO guidelines for media reporting of suicide in Nepal was found to be poor, with a large majority of news reports having at least one potentially harmful media characteristic. Only a small minority of news reports included potentially helpful information to prevent suicide.
that ORS involved a "contrite" reaction, such as repeated hand-washing, excessive use of perfumes and deodorants, frequently changing clothes, and restricting social contact. 7 The International Classification of Diseases (ICD-10) characterizes anthropophobia as a subcategory of social phobias. 10 As per DSM-5, ORS is classified under "Other Specified Obsessive Compulsive Disorders" a variant of TK. 11,12 Similarly ICD-11 has considered ORS under obsessive compulsive and related disorders (OCRDs). 13,14 Majority of these cases might have been diagnosed as phobias; hence, there is a lack of literature on this condition. The absence of sufficient reports on the distinct psychopathological profile of anthropophobia, 2 limited data on its prevalence, 1 and the ongoing debate over its classification in the diagnostic systems 15 make this disorder inimitable and worthy of research. To the authors' knowledge, no case has been reported so far in the Indian context. This case series illustrates two cases, highlighting the challenges in assessment and the treatment outcomes.
Objective: Research has demonstrated that dysfunctional cognitive schemas among mental health professionals (MHPs) may influence the ability to process clients’ information in an unbiased manner, may be a substantial source of error in psychotherapeutic ratings, hinder accurate reporting of clients’ cognitive schemas, and have a detrimental effect on therapeutic alliance. The present study compared cognitive schemas among MHPs and other health professionals (OHPs). Materials and Method: A sample of 128 professionals (64 MHPs and 64 OHPs) was chosen using a purposive sampling technique. The study used a cross-sectional observational research design. The Young Schema Questionnaire Short Form 3 rd version was administered on the consenting participants. Results: OHPs had higher maladaptive schemas on the domains of abandonment and defectiveness. Overall, males had more maladaptive schemas in the domains of abandonment, mistrust, entitlement/superiority, admiration/recognition seeking, and emotional inhibition. Among MHPs, a weak positive correlation of years of experience with vulnerability to harm or illness was seen. Among other health professionals, a significant but weak positive correlation of age with admiration/recognition seeking was seen. Conclusion: This study highlights the presence of maladaptive schemas in health professionals and the need for incorporation of training modules to address these.
Moyamoya disease (MMD) is a rare arteriopathy associated with cerebral ischemia, due to stenosis or occlusion of the internal carotid artery and its branches and primarily presenting with stroke. However, neuropsychiatric symptoms such as acute psychosis, manic symptoms, attention deficits, and behavioral problems are reported in relation to MMD. We describe here a case of an adult female, who presented with headache, easy irritability, and suspiciousness against family members, inability to identify familiar objects and faces, and inability to perform activities easily done earlier. This case appears informative as the presence and excessive importance given to behavioral symptoms lead to substantial delay in her diagnosis.
Neurocysticercosis is the most common neuro-parasitosis caused by the larval stage of Taenia solium. The most common manifestations include seizures and hydrocephalus. Psychiatric abnormalities are relatively rare but depressive symptoms are frequent in patients with neurocysticercosis. However, mania as a presentation is relatively rare. Pregnancy and the postpartum period are relatively vulnerable times and they can lead to reactivation of existing neurocysterci lesions. We are discussing the case of a 23-year-old female patient with neurocysticercosis leading to the reactivation of lesions in the peripartum and postpartum period leading to bipolar affective disorder. Improvement in the patient was seen with a combination of antipsychotics, antihelmintics, antiepileptics and steroids, along with improved radiological signs of neurocysterci lesions. Although neurocysticercosis is a common illness, its prevalence presenting as a manic episode is merely 2.6% and, hence, missed easily. Therefore, it is important to rule out organic aetiology in patients even with a classic presentation of bipolar affective disorder and those having any other neurological symptoms and signs.
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