ABSTRACT
Introduction: Most patients with bipolar disorder also exhibit suicidal behaviour. Early onset of illness and male preponderance have been noted in Indian population. There was no recent literature with regard to socio-demographic and clinical variables among suicidal behaviour in Indian population except a few earlier ones. This study was undertaken to find out the relationship of socio-demographic and clinical variables with suicidal behaviour in patients with bipolar disorder. Method: 60 bipolar disorder patients in remission coming to the Central Institute of Psychiatry diagnosed as per DSM IV-TR (American Psychiatric Association, 2000) criteria, 30 with suicidal ideation and 30 without suicidal ideation were taken in the study. Their sociodemographic and clinical data were collected. Results: The mean age of onset of the illness in the suicidal group (19.10±5.27 years) was significantly less than the mean age of onset of the illness in the non-suicidal group (23.33±7.56 years). Females were found to have higher BSI scores (mean = 8.20±8.88) than males (mean = 3.40±2.01). Most of the patients had a history of prior hospitalization and most of them had a manic episode as the most recent episode. Females were found to have higher BSI scores (mean = 8.20±8.88) than males (mean = 3.40±2.01). Positive history of prior hospitalization (mean=4.29±4.30) was associated with lower BSI scores as compared to higher scores of that without a positive history (mean=11.33±12.74). Conclusions: Suicidal patients had earlier age of onset of illness than non suicidal patients. Females were found to have higher suicidal ideation than males. Hospitalization can reduce the suicidal ideation in patients.
ABSTRACT
Introduction: Suicidal behaviour is common in bipolar disorder. This is especially true in anxious patients or comorbid anxiety disorder. The effect of subsyndromal anxiety in this group of patients in India needs to be assessed. This study was undertaken to assess comorbid anxiety in patients of bipolar disorder with and without suicidal behavior and to study the relationship of co-morbid anxiety with suicidal behavior in patients with bipolar disorder. Material & Method: 60 bipolar disorder patients in remission coming to the Central Institute of Psychiatry diagnosed as per DSM IV-TR (American Psychiatric Association, 2000) criteria, 30 with suicidal ideation and 30 without suicidal ideation were taken in the study. Co-morbid conditions other than anxiety were ruled out. They were further assessed on Hamilton Rating Scale for Anxiety. Results: The suicidal group was significantly more depressed than the Non-suicidal group with p < 0.001. Statistically significant positive correlation was found between General Somatic Symptoms (Muscular) item and duration of illness (r=0.481, p<0.01). Statistically significant positive correlation were found between the item anxious (r=0.380, p<0.05) and BSI scores. Statistically significant positive correlation were found between the item tension (r=0.435, p<0.05) and BSI scores. Statistically significant positive correlation was found between depressed mood (r=0.368, p< 0.05) and age of onset. Statistically significant positive correlation was found between General Somatic Symptoms (Muscular) (r=0.434, p< 0.05) and age of onset. Conclusions: Suicidal patients were significantly more depressed than the non suicidal patients. Within the suicidal group it was noted that patients who were more anxious and had more tension had higher scores on the suicidal ideation scale. These two items may be taken as indicators of higher suicidal tendencies in patients of bipolar disorders. Also, somatic symptoms were related to duration of illness. Within the Non-suicidal group, age of onset was related to depressed mood and somatic symptoms.
ABSTRACT
Background: Schizophrenia is a chronic and debilitating psychiatric illness affecting around 0.3-0.7% of people at some point in their life. The rate of schizophrenia and related disorders is affected by some environmental factors and social variables. Therefore, pharmacoepidemiological survey of patients suffering from schizophrenia was carried out to analyze the sociodemographic profile and drug prescribing pattern. Methods: A prospective observational study was conducted in psychiatry OPD of a tertiary care hospital for nine months. Diagnosis of schizophrenia was made according to DSM IV-TR criteria. Prescriptions were analyzed for socio demographic details, distribution of subsets of disease and psychotropic drugs prescribed. Results: Amongst 196 cases analyzed, 55.61% were males, 69.9% were below 40 years, 52.04% unmarried, 61.22% belonged to low income group, 82.14% unemployed and 58.16% came from urban locality. Paranoid schizophrenia (79.59%) was the most common diagnosis and a total of 402 psychotropic drugs were prescribed. Average number of psychotropic drugs per prescription was 2.05. Atypical antipsychotics (80.09%) were prescribed more commonly than typical antipsychotics; olanzapine (42.48%) was the commonest antipsychotic drug followed by risperidone (21.68%), haloperidol (19.91%), quetiapine (7.96%), aripiprazole (4.42%) and clozapine (3.54%). As an adjunctive treatment escitalopram, clonazepam and carbamazepine were the commonly prescribed antidepressant, anxiolytic and antimanic agent respectively. Conclusion: Low socioeconomic status, unemployment, urban locality and living alone are the sociodemographic factors associated with schizophrenia. The treatment pattern observed correlates with the changing trends in the treatment of schizophrenia world over.