There is growing evidence to support the rapid, albeit short-lived antidepressant effect of subanesthetic dose of ketamine, a noncompetitive glutamate N-methyl-D-aspartate receptor antagonist in treatment-resistant unipolar and bipolar depression. Ketamine is known to cause transient mood elevation or euphoria, psychotomimetic effects, and dissociative symptoms, but its use in unipolar or bipolar depression has not been reported to induce an affective switch amounting to persistent or prolonged hypomania/mania or manic-like syndrome. We report the case of a 52-year-old male with first episode, continuous, nonpsychotic, treatment-resistant, unipolar major depression of 10 years duration, who manifested a switch from depression to mania while being treated with subanesthetic dose of ketamine, given intramuscularly. This case suggests that polarity switch should be considered as a potential side effect while using ketamine for treatment-resistant depression.
Background: Electroconvulsive therapy (ECT) is a technique used to treat mental illnesses by applying electric current through the brain to induce convulsions. Stigmatized views regarding ECT also present among health care professionals which influences their decision in patient's future treatment. Aim: to assess knowledge and attitude of medical students regarding ECT. Methods: A cross-sectional study was carried out among 180 medical students. Non-psychiatric clinician's knowledge about and attitudes towards ECT was used to assess the association among various factors. Results: Negative attitudes like ECT causes pain to the patients (n=116), is cruel (n=40), used for punishment of violent patients(n=45) and misused by psychiatrists (n=47) were more prevalent and also significantly co-related with Unwillingness to receive ECT if indicated.
Conclusion:Results of the study suggests that Most of the knowledge was obtained from mass media and rather than demonstration of ECT, hence negative attitudes were more prevalent.
Background: Hemodialysis (HD) is associated with organic difficulties and also causes changes in psychological status of patients. Depression is the most common and probably the most important psychopathological complication in in hemodialysis patients. Hopelessness was reported as the aggravating factor of depression. Suicide is established as prevalent mental health problems in patients undergoing hemodialysis. Aim: To assess depression, hopelessness and risk of suicide in patients undergoing hemodialysis. Methods: A cross-sectional study was carried out among 50 hemodialysis patients at tertiary care hospital in India. Scales like Patients health questionnaire-9(PHQ-9), Beck's hopelessness scale (BHS) and Columbiasuicide severity rating scale(C-SSRS) were used to assess depression, hopelessness and risk of suicide. Result: Out of 50 patients, 38(76%) showed depression, 40(80%) showed hopelessness and 4(8%) showed risk of suicide. There is a significant correlation between sessions of hemodialysis with depression (p value=<0.05 ** ) and hopelessness (p value=<0.05 ** ). There is significant correlation between Depression and hopelessness in hemodialysis patients. (p value=<0.05 ** ).
Conclusion:The results from this study suggest that patients who have less sessions of dialysis showed more depression and hopelessness than the patients having more sessions of dialysis. This is may be due to adaptation with hemodialysis procedure in patient's lifestyle as the number of sessions increases. And in this study depression is strongly associated with hopelessness and well explained by hopelessness
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