Abstract

Background: Though opioid abuse is a common clinical entity, only few published articles are available in Nepal.

Aim and Objectives: To study the socio-demographic and clinical profile of patients with chronic migraine headache, and to study the frequency and pattern of co-morbid psychiatric illnesses amongst these patients. Methodology: The study was done at the headache clinic in the Department of Psychiatry at Universal College of Medical Sciences, Bhairahawa, Nepal. All out-patients attending our clinic over a period of three months and aged between 15 to 55 years with a diagnosis of chronic migraine headache were included in the present study. Demographic and clinical profiles of these patients were noted in a specially designed socio-demographic and clinical data sheets prepared for the present study. Schedules for Clinical Assessment in Neuropsychiatry (SCAN) was used as diagnostic instrument; Hamilton Rating Scales for Anxiety & Depression (HAM-A, HAM-D) were used to rate the severity of Anxiety and Depressive symptoms. Simple statistical procedures like frequency, percentages, ‘t’-tests and chi-square tests were used for analysis of data thus obtained. Results: A total no of 48 cases of chronic migraine were included in the present study. Forty one cases (85.4%) were female and rest 7 patients were male. Comorbid psychiatric illness was present in thirty one (64.6%) cases among which Anxiety was the most common diagnosis (35.4%) followed by depressive disorders (29.2%). Conclusion: chronic migraine headache has high rate of co-morbid mood and anxiety disorder. Effective treatment of chronic migraine headache requires screening and accurately diagnosing specific psychiatric disorders when present. DOI: http://dx.doi.org/10.3126/jpan.v3i1.11345 J Psychiatrists’ Association of Nepal Vol .3, No.1, 2014: 3-9

INTRODUCTION: Mental Health has been hidden behind the curtain of stigma and discrimination for a long time. Not only the mentally ill, even the mental health professionals are stigmatized. The medical professional's attitude to psychiatry appear to be negative, although the data are dated. Attitude of non-psychiatry consultants towards psychiatry may affect their ability to promote psychiatry as a discipline. The main aim of this study is to study the non-psychiatry consultants' attitude towards psychiatry. METHODS: It is a hospital based cross-sectional descriptive study of 30 non-psychiatry consultants working in Universal College of Medical Sciences Teaching Hospital, Bhairahawa, Nepal. ATP-30 self report questionnaire was used to collect the data. RESULTS: Majority of the subjects were male. About 69% of the consultants didn't have any exposure in the psychiatry. However, majority of the consultants had positive attitude towards psychiatry. The mean score for ATP-30 was 110.03. CONCLUSION: Majority of the consultants had positive attitude towards psychiatry. However some erroneous beliefs are still prevalent among the consultants. The attitude of non-psychiatry consultants directly/indirectly affects the development of psychiatry as a discipline. Further studies of such kind can help to determine whether changes in attitudes towards psychiatry are needed among the non-psychiatry consultants. DOI: http://dx.doi.org/10.3126/jucms.v1i4.9563 Journal of Universal College of Medical Sciences (2013) Vol.1 No.04: 2-6

Introduction: First Methadone Maintenance Programme (MMTP) in Nepal was started in the year 1994. This study was done to study and explore/compare findings of the present study with that of studies published in Nepal in the new millennium. Material and Method: Study was conducted at the Mental Hospital, Lalitpur, Kathmandu, Nepal from 1994 to 2002. Data was collected for the initial 5 years from 1994 to 1998. These patients were followed up for the next five years till 2002. Data thus obtained are presented in a tabulated form, in terms of frequencies and percentages. Results: A total of 204 patients were put on Methadone Maintenance Treatment Programme (MMTP) during the scheduled period. One-hundred-and-twenty-two (60%) of them were abusing buprenorphine. Severity of buprenorphine abuse was between 1-6 ampoules (2 ml per ampoule) per day. Approximately 40% (81) of them were sharing the injecting equipment. Seventy-seven (38%) of them had been in police custody in the past, for various reasons like theft, cheating, possessing, trafficking, violence and other antisocial behaviours. Forty-five percent (92) clients were retained at the end of 5 years. Sixty-nine family members (spouses, mothers, brothers) from these 92 regular methadone clients were interviewed. Eighty-six percent (79) of the interviewed family members reported significant improvement in clients’ health. Eighty-one percent (75) of the family members reported significant improvement among the methadone users’ family in financial responsibilities and interest in work. Overall, MMTP was found to have reduced the amount of illicit drug abuse significantly in these patients. These results are compared with the data of the subsequent published data on MMTP from Nepal in the new millennium. Conclusion: Though the present study data may appear to be of historical value, we are presenting these data, in the light of the findings of the newer studies published of late from Nepal. Till date, our study remained the largest MMT Programme in Nepal, in terms of number of patients studied, number of years of study and number of years of follow up of these patients.

Epilepsy and schizophrenia are both due to altered cerebral functioning and their history is often connected. Here we present a case of epilepsy of generalized tonic clonic type presenting with schizophrenia like symptoms.DOI: http://dx.doi.org/10.3126/jucms.v1i2.8408 Journal of Universal College of Medical Sciences Vol.1(2) 2013: 35-36

No abstract

Studying medicine is a physically and emotionally demanding course. Several studies have documented that medical students are at high risk for developing psychiatric disorders. Also the risk increases because these students who are the future health care providers may misunderstand and stigmatize psychiatric disorders. This can be potentially tragic. This article reviews the data on prevalence of psychiatric disorders among medical students. PubMed and Medline were searched to identify latest peer-reviewed English-language studies reporting on depression, anxiety, suicide and other psychiatric disorders among medical students from different parts of the world. Searches were done using the key words medical students, psychiatric disorders, depression, burnout and suicide. References of the retrieved articles were inspected to identify relevant additional articles. The studies suggest a high prevalence of burnout, depression, suicide and other psychiatric disorders among medical students, higher than in the general population. Medical students are reluctant to seek psychiatric treatment more than the general population. The environment where they study may make them behave in the unprofessional way rather than the mental illness itself. Medical school is a time of significant psychological distress. Large, prospective, multicenter studies are needed to identify personal and training-related features that influence depression, anxiety, and burnout among students and explore relationships between distress and competency. DOI: http://dx.doi.org/10.3126/jucms.v1i4.9578 Journal of Universal College of Medical Sciences (2013) Vol.1 No.04: 56-60