ABSTRACT
Background: Schizophrenia is one of the most devastating mental disorders that impair language, thinking, perception and sense of self. Recent estimates suggest that around 1% of the adult population that is around 21 million people is suffering from this disabling disease. In India, caregiving is mainly by family members because there are limited alternatives in institutional facilities and welfare supports for those with chronic illnesses such as mental disorders. Most Indian families prefer to care for ill persons at all stages of illness. But, the changing society places significant demands on the caregivers. Aim of the study: To study the prevalence of anxiety and depression among caregivers of schizophrenia patients. To find the association between anxiety and depression of caregivers with the duration of illness, severity of illness (schizophrenia) and the years of association with the patients. Materials and methods: The study was conducted among patients of schizophrenia and their K. Arun Kumar, R. Gandhi Babu, M. Asok Kumar. Prevalence of anxiety and depression among the primary caregivers of patients with schizophrenia who attended Psychiatry Outpatient Department at Rajah Muthiah Medical College and Hospital, Chidambaram. IAIM, 2019; 6(11): 63-75. Page 64 caregivers attending Psychiatry Outpatient Department Rajah Muthiah Medical College and Hospital, Annamalai University, A hundred patients with a diagnosis of schizophrenia and their primary caregivers had been consecutively selected from Psychiatry Outpatient department, Rajah Muthiah medical college, Annamalai university in the year 2018-2019. Then the Self innovated proforma was filled and details about the patients and their caregivers were obtained. HAM-D and HAM-A scales were administered for caregivers and scored for the level of psychiatry morbidity among them. BPRS scale was administered for patient and the severity of illness was assessed. The prevalence was then compared with different variables and associations if any was found. Results: In 100 peoples, Ham- A anxiety score level was analyzed. Severe anxiety was seen in 8 persons, mild to moderate anxiety was in 9 caretakers. Mild severity was observed in 83 patients. Pearson Chi-Square=27.936**, p<0.001. Depression score was absent and less significant among 61 caretakers, mild depression was observed in 24 peoples, moderate depression in 7 caretakers, severe depression was observed in only 8 cases. Paranoid type is more which was around 64%, hebephrenic was 11 %, residual -7%, simple -7%, undifferentiated -7%, catatonia-4%. BPRS score was < 31 in 74 patients, 31-42 were 12 cases, > 43 in 14 patients. More than 10-20 years in people who were taking care of ill patients had severe anxiety when compared to 1-3 years, up to 1 year, 3-10 years. Pearson Chi-Square = 9.784, P = 0.134 which was statistically significant. Severe depression was seen in the illness of 10-20 years in (8) cases. Up to 1 Year, 1-3 Years, 3-10 Years, 10-20 Years had less incidence of severe depression. Few peoples had less depression, mild, and moderate depression. Pearson Chi-Square = 15.405, P = 0.080 which was statistically less significant. Conclusion: Psychiatric disorders were prevalent amongst caregivers who are first- degree relatives of schizophrenic probands. BPRS Score of the patient gave the best diagnostic accuracy for screening psychiatric morbidity and increased the probability of finding a psychiatric disorder in caregivers. Therefore, routine screening of caregivers will aid early diagnosis of psychiatric disorders and enable timely psychological intervention.
ABSTRACT
Bacille Calmette-Guérin (BCG) vaccination administered at birth can lead to certain complications which may present immediate or late. We report a rare case of BCG osteomyelitis in a nine months old immunocompetent female child with extensive destruction of middle and distal third of humerus sparing the proximal bone. Surgical debridement revealed casseous material and dead bone. Biopsy showed inflammatory tissue containing Langhan’s giant cells and granulomatous inflammatory infiltrate. Culture was suggestive of BCG osteomyelitis. Anti-tubercular chemotherapy favoured betterment of her condition and the child has no signs of infection after one year.