ABSTRACT
report describes a patient suffering from somatoform disorder that developed suicidal ideation specifically due to the treatment with sertraline. After 6-7 months on the regimen, she presented slight suicidal ideations. However, with gradual progress of time and continuation of the therapy, the ideation became intense. She complained of intense restlessness and anxiety. She presented with fresh cuts and bruises on her left arm and neck. On reporting the problem, the drug was withdrawn. Patient experienced gradual improvement in her state. The case report underlines the importance of onset of suicide risk in panic disorders due to specific antidepressants, selective serotonin reuptake inhibitors (SSRIs). The exact neurobiological basis of depression though being uncertain, the role of serotonin has been mostly implicated. Hypothetically, biological alterations in the serotonergic system might have contributed to the suicidal ideation/attempt in the presence of an SSRI. The present case attempts to highlight an incidence of development of suicidal ideation in a patient who is on chronic SSRI therapy.
ABSTRACT
Objectives: Stress in medical students is well established. It may affect academic performance and lead to anxiety, depression, substance abuse, and burnouts. There is limited data on stress in Indian medical students. We conducted an analytical observational study to assess the magnitude of stress and identify possible "stressors" in medical students of a teaching hospital in Kolkata. Materials And Methods: This questionnaire-based study was conducted in the Institute of Post Graduate Medical Education and Research, Kolkata with consenting undergraduate students of 3 rd , 6 th , and 9 th (final) semesters, during lecture classes in individual semesters on a particular day. The students were not informed about the session beforehand and were assured of confidentiality. The first part of the questionnaire captured personal and interpersonal details which could be sources of stress. The rest comprised three rating scales - the 28-item General Health Questionnaire to identify the existence of stress, the Warwick-Edinburgh mental well-being scale to assess the mental well-being, and the revised version of the Lubben social network scale to assess the social networking. The responses and scores were compared between the three semesters as well as between various subgroups based on baseline characteristics. Results: Data from 215 respondents were analyzed - approximately 75% were male, 45% came from rural background, 25% from low-income families, and 60% from vernacular medium. Totally, 113 (52.56%; 95% confidence interval: 43.35-61.76%) students were found to be stressed, without significant difference in stress incidence between the semesters. About 60% of the female students were stressed in contrast to 50% of the males, but this observed difference was not statistically significant. The mental well-being and social networking of stressed respondents suffered in comparison to their non-stressed counterparts. Conclusions: The stress incidence in medical students in this institution in India is high and is negatively affecting their mental well-being. Further multicentric and longitudinal studies are needed to explore the incidence, causes, and consequences of stress in our setting.
ABSTRACT
With the advent of more safe and user-friendly drugs in the modern era of psychopharmacology and their use in general practice, a brief discussion regarding the pharmacological aspect of the new drugs has been attempted in the present article so that they may be used more effectively in practice.