ABSTRACT
Objective: The aim of the study isto compare the sexual functioning among men with and without severe mental illness. Materials and Methods: The study was conducted inPsychiatry Department, Sree Balaji Medical College and hospital, Chromepet, Chennai Tamilnadu, India from the period of August 2016 to February 2018 (18 months). Cross sectional analytical study: 1.Semi structured questionnaire to capture demographic variables, illness variable, type of sexual practice and their expectations from MHPs. 2. General health questionnaire(12) tamil and English, 3. CAGE screening tool for alcohol. 4. The Brief Male Sexual Function Inventory (BMSF) for males (70). Results: The study population covered 50% of men with severe mental illness and 50% of men without severe mental illness. Among the study population regarding the educational status it was inferred that 70% were literate and only 30% were illiterate.An attempt to identify the mental illness of the study population was made and it was found that among the total cases, the prevailing mental illness was Schizophrenia (27%). Bipolar affective disorder (17%) was ranked as second highest. Delusional disorder, major depressive disorder covered up to 4% and 1% respectively. The comparisons of quantitative variable between the groups were given in Table 7. The median (range) of the age in case was 40 (29, 58) and in controls was 39 (25, 55), which shows that the median value of age between the groups was not found to be statistically significant (P>0.05). The median value of general health questionnaire among the patients with severe mental illness was 26 (18, 34) and in controls it was 1 (0, 4) which shows that this median difference was highly significant (P<0.0001). The median value of CAGE among the cases was 1 (0, 4) and in normal males was 19 (15, 29) which shows that the median difference between the groups were found to be highly significant (P<0.0001). Similarly, the median difference of variables such as BSFI sexual drive, ejection score, ejaculation score, overall satisfaction score, problem assessment score and total score was found to highly significant (P<0.0001). This implies that the sexual function of men with severe mental illness differs significantly from the normal males. Conclusion: Sexual dysfunction is common among men with severe mental illness than persons without severe mental illness. The male patients with severe mental illness such as Schizophrenia, delusional disorders, BPAD, major depressive disorder have impaired sexual function compared with the persons without severe mental illness study group which is evident from the BFSI score(17 in persons with severe mental illness vs 34 in persons without severe mental illness) which is clinically significant. In our study, sexual dysfunction among the men with severe mental illness is not proportional to the duration of the illness & the age of the patients. Recommendations based on gender identity development, attachment, non-sexual and sexual abuse, puberty/adolescence.
ABSTRACT
Background & Objectives: Osteoarthritis is chronic degenerative disorder of joint having many etiological factors. It is estimated to be the fourth leading cause of disability with prevalence of 22% to 39% in India. There is availability of less evidence of physiotherapy treatment for OA. Hence the need of the study is to find the individual and comparative effect of Apos therapy and knee brace in aspect of pain, range of motion and functional disability in patients with O.A. knee. Method: 30 subjects with osteoarthritis of Tibiofemoral joint were selected for the study and randomly divided in to two groups (A&B) of 15 subjects. Group A received Apos therapy and Group B received knee brace. Both groups treated with active exercises plus IFT. Pain was measured by VAS, Range of motion was measured by Goniometer and functional disability was measured by WOMAC scale. Results :Intra-group comparison of VAS , ROM and WOMAC score showed significant improvement in both the group but Apos therapy group showed highly significant (p< 0.001) improvement. Conclusion: In this study both groups have shown significant difference in reducing pain, improving ROM, and improving functional disability but Apos therapy showed more improvement than application of knee brace.
ABSTRACT
BACKGROUND: Patients with unexplained somatic symptoms are commonly seen in primary care. We assessed the explanatory models and common mental disorders in patients with unexplained somatic symptoms attending a primary care facility in a rural area of south India. METHODS: One hundred consecutive patients diagnosed to have unexplained somatic symptoms attending a primary care facility were examined. The Tamil version of the Revised Clinical Interview Schedule was used to assess common mental disorders and the Tamil version of the Short Explanatory Model Interview was used to assess their explanatory models. RESULTS: Ninety-eight patients thought that their problem was serious. Sixty-nine, 41 and 40 claimed that it affected their work, family and social lives, respectively. Forty-two of the patients believed in black magic. Forty-four patients satisfied the ICD-10 PC criteria for common mental disorders. Depression was the commonest diagnosis (63.6%). Patients with psychiatric diagnoses admitted to emotional problems (chi2 = 46.9; p < 0.001), and felt that their problems affected their family (chi2 = 38.5; p < 0.001), social life (chi2 = 28.6; p < 0.001) and work (chi2 = 34.4; p < 0.001). More patients who satisfied criteria for psychiatric diagnosis felt that their problems were moderate or very serious (chi2 = 21.5; p < 0.001) and they feared they might become disabled or die (chi2 = 12.2; p < 0.001). Psychiatric syndromes were significantly associated with belief in black magic (chi2 = 7.01; p < 0.01). These associations remained statstically significant after adjusting for age, gender, literacy and socioeconomic indices using logistic regression. CONCLUSION: The majority of patients held strong beliefs regarding the physical nature of their complaints, believed In the serious nature of the problem and feared disability or death. There is a need to elicit specific explanatory models regarding the nature of illness in patients who present with somatic symptoms without organic causes. Understanding the patient's perspectives is a prerequisite for providing the necessary treatment and to dispel fears.