Barrier to Treatment in Patients with Neurotic, Stress Related and Somatoform Disorders: Study from A Tertiary Centre of North India

Background: Psychiatric disorders are highly prevalent and also the leading causes of disability worldwide. Because of multiple factors playing as barriers in help seeking many people who might benefit from the treatment do not obtain it. Data regarding common mental disorders is even more lacking. Methods: Present study was undertaken to assess various treatment barriers affecting help seeking behavior in 156 patients of “neurotic, stress related and somatoform disorders” who were assessed on various tools. The study sample was divided in Aware and Unaware group on the basis of their awareness about psychiatric disorder at the time of onset/initial stages of illness. Results: Inability to recognize patient’s behavioral problem by family members and lack of treatment facility/ resource were important barrier to care. Prevalent nonscientific etiological belief (e.g. supernatural phenomenon, a form of worry or tension) in society also delayed treatment seeking. The observations of present study have helped in revealing the barriers in treatment seeking for patients of neurotic and stress related disorders. Raising awareness about these disorders in community and making psychiatric easily accessible to general population will be helpful in overcoming these barriers.

A Comparative Study of Body Image and Coping Style in Breast Cancer Patients.

Background: Breast cancer is one of the most common malignancies and leading cause of death in women. It not only encompasses physical but also social and psychological implications because of the importance of the breast in feminity, sexuality and motherhood. It leads to the fear of disfigurement, disability, dependence and disruption of relationships. Very few studies assessed the psychological aspect of cancer causing altered feminity and fear of death. Aims and Objectives: To assess the coping skills, death anxiety and body image in breast cancer patients, who have undergone mastectomy and who have been treated nonsurgically. Methods: 45 female in the age group of 25 years to 55 years who were aware of their diagnosis and had undergone mastectomy or treated nonsurgically between three months to twelve months at the time of inclusion were assessed on body image index, coping strategy checklist and death anxiety scale. Results and Conclusion: There were no significant differences in total coping scores between two groups but denial was used significantly higher by the patient of mastectomy group. Body image was found to be significantly better in joint family patients while patients with nuclear family had higher psychological distress. Thus types of treatment, socioeconomic and family status have important psychological implication in breast cancer patients.

A Comparative Study of Social, Adaptive, Relational and Global Functioning of Adolescents with OCD and ADHD.

Aim – Attention Deficit Hyperactivity Disorder (ADHD) and Obsessive Compulsive Disorder (OCD) are one of the most common childhood and adolescent neuropsychiatric disorders. Adolescents with these disorders experience difficulties and impairments in various domains of life. However studies on functional impairments in adolescents with these disorders are lacking in India. This study was conducted with the aim to study and compare the functional impairments of Indian adolescents suffering with these disorders. Methods – 57 adolescents (36 having ADHD and 21 having OCD) between the age group 13 years to less than 18 years were recruited during the study period. HONOSCA, VABSII and C-GAS were applied to study the social, relational, emotional, adaptive and global functioning of these adolescents. The two groups were compared with each other using appropriate statistical methods. Result – Adolescents with ADHD had significantly greater impairments in the areas of ‘disruptive, antisocial and aggressive behavior’, ‘peer relationships’ and ‘self care and independence’ whereas adolescents with OCD had significantly greater impairments in the areas of ‘emotional and related problems’ and ‘poor school attendance’. Significantly greater number of adolescents with ADHD were below average in their functioning in the ‘receptive’ (77.8%) and ‘written’ (75%) subdomain and overall in the ‘communication’ domain (63.9%) as compared to the adolescents having OCD. Adolescents with ADHD were more impaired in their global functioning as compared to adolescents with OCD. Conclusion - There are important differences in the various correlates of functioning between the two groups of adolescents. The present findings have implications in the planning for treatment intervention in these adolescents to make them more cost effective and efficient.