A Study to Assess the Psycho-Social Implications of the COVID-19 Pandemic in India

Background: In response to the COVID-19 pandemic, the Indian Government called for a nation-wide quarantine or ‘Lockdown’ from 21st March 2020. While initially planned for 21days, satisfactory disease control was not achieved and cases continued to rise till November 2020. It is well established, that a Pandemic is associated with a decline in mental health of the population. This study was conducted in order to assess the prevalence, as well as to understand the causative factors for Depression, Anxiety and Stress in the population. Methodology: An online questionnaire including a consent form, semi-structured proforma, and the DASS- 21 was administered via various platforms. All subjects above 18 years of age, willing to give informed consent were included, while those with pre-existing psychiatric illness were excluded from the study. A total of 504 responses were thus analysed. Results: According to this study, 48.4% of the participants showed signs of psychiatric morbidity; younger age groups and females were more severely affected. Isolation and loneliness, fear of infection and death were reported as major causative factors. Conclusions: Thus, during a disease pandemic, another pandemic of mental illness may also be present. It is important to recognize and take measures to prevent such ill-effects of otherwise protective measures like quarantine.

Prevalence of Anxiety and Depressive disorders and the Role of Coping Strategies in females with Infertility

Background: Adjustment, anxiety and depressive disorders are amongst the most common psychiatricmorbidities in infertile women in previous studies. Different women cope with the unpredictable, chronicstress of infertility in different ways. Coping strategies may have an impact on the development of psychiatricmorbidity. Hence this study was undertaken.Methods: A cross sectional study was conducted by interviewing 68 consecutive patients with primary orsecondary infertility. Socio-demographic details were taken using the study proforma. Psychiatric morbiditywas diagnosed as per ICD-10 criteria. Severity was assessed using HAM-A and MADRS. Coping wasevaluated on the COMPI Coping Strategy Scale. Statistical Packages of Social Sciences version 20 was usedto compile, tabulate and analyze the data.Results: A majority (67.7 %) of infertile females had psychiatric morbidity, the most common beingAdjustment disorder (37 %), followed by Mixed anxiety and depressive disorder (32.6 %) and Mood(depressive) disorder (30.4 %).Conclusion: A high use of active confronting and meaning based coping was seen in majority of the femaleswho did not have psychiatric morbidity. The use of active confronting coping in majority (64.7 %) of thosewith Adjustment disorder was found to be statistically significant

Delusional disorder: prevalence, clinical correlates and co morbidity

Background: Delusional disorder is on a spectrum between more severe psychosis and overvalued ideas. Rates of psychiatric co morbidity in patients with delusional disorder have been found to be high, with affective disorders being the most common co morbid entity. Growing literature has revitalized the efforts to understand, define, characterize and treat this disorder. However, despite these, more studies are needed to clarify the role of mood disturbances in delusional disorder to provide for a better therapeutic approach. Aims: To study the prevalence, socio demographic profile and co morbid depression in delusional disorder patients. Methods: All patients diagnosed as delusional disorder in the last 3 years and attending the psychiatry outpatient department of a general teaching hospital were included. Semi-structured proforma specifically designed for the study was administered to collect socio-demographic data and illness related information. Results: In our study, 53 (1.88%) met the criteria of delusional disorder. Co morbid depression was seen in 17 (32.08%) of these patients. Conclusion: Delusional disorder is a unique entity with considerable psychiatric co morbidity especially depression.

A study of recovery and its variables in patients with schizophrenia

Background: Recovery orientation to psychiatric illness views that the patient is more than a sum of his symptoms. There is a great paucity of studies on recovery in schizophrenia in India. Aim: With this goal in mind this study was undertaken to study (1) the socio demographic profile of the sample and their relation with stages of recovery of schizophrenia, (2) the relationship between socio-occupational functioning and stages of recovery and to assess the relationship between stages of recovery and symptomatology. Methods: Study was conducted in Psychiatric outpatient department in general teaching hospital, on patients diagnosed as chronic schizophrenia. Semi-structured proforma, Positive and Negative Syndrome Scale (PANSS), Stages of Recovery Instrument (STORI) and Social and Occupational Functioning Scale (SOFAS) were used.In our study, 37 patients with a diagnosis of schizophrenia were included. Results: This study did not find any significant correlation between demographical variables and the stages of recovery. Stage of moratorium of STORI had significant positive correlation with all subscales of PANSS while stages of awareness, preparation and rebuilding and growth of STORI had significant negative correlation with all subscales of PANSS. Stage of preparation and growth had significant positive correlation with SOFAS while stage of moratorium had significant negative correlation with SOFAS. Thus each stage of recovery in schizophrenia had significant correlation with the level of functioning in our study. Conclusion: This clearly indicates that there is a significant relationship between psychopathological symptoms and the person’s ability to pursue the path of recovery.

Perception of burden by caregivers of patients with schizophrenia

Background: Schizophrenia being a debilitating illness leads to deterioration in occupational, interpersonal and self supporting abilities. This can pose numerous psychosocial difficulties for patients as well as family members who care for their loved ones resulting in burden of care. Due to the chronic stress of caring for these patients many caregivers develop psychiatric symptoms. Aims: This study was undertaken to assess the burden perceived by caregivers of schizophrenia patients, impact of socio-demographic and patient variables on perceived burden as well as the presence of psychological distress in the caregivers. Methods: 54 patients diagnosed as having schizophrenia as per the DSM IV TR with a duration of illness of two years or more and their caregivers were evaluated using the appropriate psychometric instruments to measure burden, anxiety and depression in caregivers. Results: Our study showed that overall burden perceived was 22.2% with no significant difference between the caregivers of either sex and burden perceived by the caregivers of the sample studied also had a significant impact on their anxiety and depression. Conclusion: Care-givers of schizophrenia patients experience burden as well as psychological distress secondary to caring for a relative with a chronic mental illness. Key message: Care-giver burden must be anticipated in schizophrenia patients and appropriate support must be provided.