Pellagra Encephalopathy is a recognised medical condition due to niacin deficiency. Patients with alcohol dependence invariably have vitamin deficiencies, including niacin. Pellagra Encephalopathy can be challenging to diagnose alongside withdrawal delirium. Diarrhoea, skin rashes, memory and attention deficits, paraesthesia and proximal muscle weakness were noted in four patients diagnosed with delirium tremens. Atypical features such as cognitive and neurological deficits were understood as the presentation of pellagra encephalopathy. The presence of neurocognitive symptoms in addition to typical dermatological presentation guided consideration of pellagra encephalopathy comorbid with delirium due to alcohol withdrawal. Subtle neurological symptoms indicative of pellagra encephalopathy may be overlooked in patients with delirium.

Background: Consultation -liaison psychiatry (CLP) provides expert advice and act as a liaison. There is a high prevalence of psychiatric comorbidities among patients of other specialities. Yet, the referral rates are low, probably due to inadequate psychiatric awareness which can be assessed from the diagnostic concordance. Objective: To assess diagnostic concordance between the psychiatrist and referring doctor. Materials and Methods: This is a cross-sectional record-based study of all inpatients referred to CLP. Data was collected from CLP registry. Results: Most of the referrals were from General Medicine. The most common reason for referral was alcohol use disorders and common diagnoses made by referring physicians were alcohol use disorders, delirium and mood disorders, similar to the psychiatrist's diagnoses; however, deliberate self harm (DSH), a common diagnosis made by the referring doctor, constituted only 4.2% of psychiatrist's diagnoses. There was complete diagnostic concordance for 40.9%; perfect agreement was found for DSH and alcohol use disorders, substantial agreement for delirium and moderate agreement for mood disorders. The agreement was low for DSH with comorbid depression, other substance use disorders and organic mental disorders. Conclusion: The diagnostic concordance for common mental health problems is low, according to the present study. CLP needs to extend its educational function towards other specialities, and it should be an active component of undergraduate psychiatric training.

Context: Alcohol use disorder (AUD) in men has a profound impact on the mental health of wives of persons with alcohol use disorder (WoPA). Quality of their marital life is an overlooked aspect which affects both the mental health of the partners and their children. Resilience in WoPA acts as a protective element in maintaining their marital quality and, in turn, their mental health. Aims: The aim of this study was to assess the resilience in the WoPA and to find its association with marital quality. Subjects and Methods: Data was collected through an interview using a sociodemographic questionnaire and standardized tools and from current case records. The resilience of WoPA was assessed using the Connor-Davidson Resilience Scale. The Marital Quality Scale was used to assess their marital quality. The severity of alcohol consumption of patients with AUD was evaluated using the Severity of Alcohol Dependence Questionnaire. The differences between the scores were analyzed using ANOVA or Student t-test, whichever was applicable. Results: The mean score of resilience was 50.98 (26–77), and 52% of the wives reported their marital quality as severely affected. Low resilience was found to be associated with poor marital quality. Resilience was found to be poor in wives who experienced physical abuse from their husbands. Conclusions: The resilience of WoPA has a significant association with their marital quality. Hence, improving the resilience of WoPA would improve their marital quality, which, in turn, would positively impact the treatment of their husbands' alcohol use and their children's mental health.

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