Prevalence of psychiatric morbidity amongst the community dwelling rural older adults in northern India.

Background & objectives: The population of elderly is growing globally and so are the physical illnesses and psychiatric morbidity. This study was planned to assess the prevalence and patterns of psychiatric morbidity amongst rural older adults in Lucknow, north India. Methods: A survey was conducted in subjects aged 60 yr and above to identify the cases of psychiatric morbidity in rural population from randomly selected two revenue blocks of Lucknow district, Uttar Pradesh, India. All subjects were screened through Hindi Mental Status Examination (HMSE) and Survey Psychiatric Assessment Schedule (SPAS) to identify for the suspected cases of cognitive and the psychiatric disorders, respectively. The subjects screened positive on HMSE and SPAS were assessed in detail on Cambridge Mental Disorder of the Elderly Examination-Revised (CAMDEX-R) and Schedule for Clinical Assessment in Neuropsychiatry (SCAN), to diagnose cognitive disorders and psychiatric disorders (other than the cognitive), respectively on the basis of International Classification of Diseases-10 (ICD-10) diagnostic guidelines. Results: The overall prevalence of psychiatric morbidity in rural older adults was found to be 23.7 per cent (95% CI=21.89-25.53). Mood (affective) disorders were the commonest (7.6%, 95% CI=6.51-8.80), followed by mild cognitive impairment (4.6%, 95% CI=3.72-5.53), mental and behavioural disorders due to substance use (4.0%, 95% CI=3.17-4.87) and dementia (2.8%) [Alzheimer’s disease (2.4%, 95% CI=1.81-3.16) and vascular (0.4%, 95% CI=0.16-0.73)]. Interpretation & conclusions: Overall prevalence of psychiatric morbidity amongst rural elderly in this study was found to be less in comparison to those reported in earlier studies from India. However, prevalence pattern of different disorders was found to be similar. Therefore, it appears that a stringent methodology, refined case criteria for diagnosis and assessment by trained professionals restrict false diagnosis.

Health Conducive Behavioural Intervention Needs of Rural and Urban Communities.

The study reports the prevalence of non-conducive behavioural practices in the area of “health care” prevalent in 1134 families of Northern India. Sample consisted of 563 families from rural and 571 families from urban area of Barabanki (Centre), Muzaffarnagar (North) & Gorakhpur (East) district of Uttar Pradesh, India. Behaviour correlates in the area of health care were mapped on a pre-prepared schedule, “Proforma for mapping of Behaviour correlates”. Percentage, hypothesis testing for difference between proportions and rank-order correlation was used for statistical analysis of data. Findings suggest that significantly more families from rural areas were involved in non-health conducive behavioral practices in all the studied constituent elements of self care except ‘carefulness about oral hygiene’. Urban families were more frequently involved in regular daily routine, carefulness about personal hygiene, appropriate use of personal & leisure time activities, elderly & child care than rural area. The study highlights the need for behavioural intervention both in urban as well as rural families in day to day living.

Bilateral adrenal abscess in a neonate.

A 23-day-old male baby with a history of perinatal hypoxia presented with refusal of feeds and abdominal distension. The child had a right-sided cystic upper abdominal mass and features of neonatal septicemia. Abdominal ultrasound (US) and contrast-enhanced CT scan showed bilateral adrenal abscesses. Laparotomy with drainage of the abscesses successfully treated the condition. The literature on the subject is reviewed.