Objective:The objective of this study was to compare the psychiatric morbidity between the displaced and non-displaced populations of the Andaman and Nicobar Islands during the first three months following the 2004 earthquake and tsunami.Methods:The study was conducted at the 74 relief camps in the Andaman and Nicobar Islands. Port Blair had 12 camps, which provided shelter to 4,684 displaced survivors. There were 62 camps on Car-Nicobar Island, which provided shelter to approximately 8,100 survivors who continued to stay in their habitat (non-displaced population). The study sample included all of the survivors who sought mental health assistance inside the camp. A psychiatrist diagnosed the patients using the ICD-10 criteria.Results:Psychiatric morbidity was 5.2% in the displaced population and 2.8% in the non-displaced population. The overall psychiatric morbidity was 3.7%. The displaced survivors had significantly higher psychiatric morbidity than did the non-displaced population.The disorders included panic disorder, anxiety disorders not otherwise specified, and somatic complaints. The existence of an adjustment disorder was significantly higher in the non-displaced survivors. Depression and post-traumatic stress disorder (PTSD) were distributed equally in both groups.Conclusions:Psychiatric morbidity was found to be highest in the displaced population. However, the incidence of depression and PTSD were distributed equally in both groups. Involvement of community leaders and survivors in shared decision-making processes and culturally acceptable interventions improved the community participation. Cohesive community, family systems, social support, altruistic behavior of the community leaders, and religious faith and spirituality were factors that helped survivors cope during the early phase of the disaster.
Background:Mental retardation (MR) has a varied phenomenology in different parts of the world. While studying MR, psychological issues of caretakers are equally relevant. A study to investigate the phenomenology of MR in Indian children and the prevalence of depression in their mothers was planned in a teaching institute in Madhya Pradesh with an attached tertiary care hospital.Objectives:The objective of the following study is to study the clinical profile of mentally retarded children in the study sample, prevalence of depression in the mothers and investigate various factors affecting it.Study Design:A cross-sectional study.Materials and Methods:A total of 60 patients diagnosed as MR were included in the study. Objective data was collected in a special proforma and mothers of these individuals were subjected to evaluation with Beck's Anxiety Inventory and the 17 item Hamilton Rating Scale for Depression.Results:The mean age of patients in the sample was 11.6 years, had received an average of 2.42 years of schooling, mean age at diagnosis of MR was 6.5 years and their mean IQ was 53. Out of the total 60 patients, 88% of the patients had significant co-morbidities. The prevalence of depression in mothers was 85% and it was more in mothers of, the ones with significant co-morbidities (OR = 2.67), severer forms of retardation and with higher levels of anxiety in the mother.Conclusions:Prevalence of depression in mothers of mentally retarded children in India seems to be much greater than those reported from studies around the world. Medical services offered to the mentally retarded should move from an individual level to the family level, especially toward the mothers, who are the main caretakers. Counseling services, treatment if required and regular screening of mothers of the mentally retarded should be included in the protocol for management of mental retardation.
Only a few of the primary and secondary survivors required intensive individual psychiatric interventions; however, a majority of the primary, secondary, and tertiary survivors required community-based group interventions. Community-based group interventions and group discussions are simple, easy to implement using local resources, and effective in all groups, and provide important components of psychosocial rehabilitation. This kind of approach should be started as early as possible, targeting all children and adolescents affected by any disaster in developing countries.
Introduction: Cough is the most common presenting symptom in pediatric primary care settings. Cough can impact a child's activity level and ability to sleep, play or attend school and is often a source of parental anxiety. However, an etiology of cough is not always easily identified even after a thorough systematic investigation and psychological and neurological conditions are in the differential diagnosis. Psychogenic cough is diagnosed in cases without a clear pulmonary or extrapulmonary etiology in the presence of some suggestive clinical characteristics and/or an association with psychological issue. Psychogenic cough has been reported to be the second most common cause of chronic cough in children of age 6-16 years. Methodology: The present paper highlights four case reports of children who presented with symptoms of psychogenic cough in the OPD of CNBC hospital, Delhi.The presenting nature of the symptoms along with the underlying psychological factors have been discussed. Cognitive Behavioural techniques like distraction and cognitive restructuring interventions with the children along with family interventions were used. Conclusions: All the children showed significant improvement at the end of therapy. Three month follow up showed that the results were maintained. Cognitive Behavioural approaches are found to be effective in managing psychogenic cough and the present paper highlights the process of cognitive behavioural management of psychogenic cough in children.
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