ABSTRACT
Background: Studies have established that Theory of Mind (ToM) is impaired in patients with depression, but few studies have investigated the status of ToM in breast cancer patients who often suffer from depression. Our objective was to compare the ToM deficits in women with breast cancer with and without depression with a control group. Methods: The study was conducted at the Oncology department of a multi-speciality hospital in Kolkata. It was a cross sectional matched control study. We compared the ToM performance of women with breast cancer and depression (N=39), breast cancer without depression (N=63) and a healthy control group (N=34) using the widely used ToM task, Reading the Mind in the Eyes test (Eyes Test). Depression was diagnosed using Mini - International Neuropsychiatric Interview following International Classification of Diseases - 10th edition guidelines. Chi-square and one-way analysis of variances was done. Results: Both groups of patients had greater impairment in ToM compared to healthy controls (p<0.05). Among breast cancer patients, presence of depression predicted even greater impairment of ToM (p<0.05). Lower income, less education and not being in any occupation other than homemaking were associated with greater ToM impairment across all groups (p<0.05). Conclusion: Breast cancer patients suffering from depression may have an additional burden of impaired social cognition, which may reduce their ability to shore up social support when it is most required. This needs to be addressed urgently to ensure better quality of life.
ABSTRACT
Background & objectives: The family caregivers of patients with chronic diseases are known to undergo psychiatric stress leading to oxidative damage to glomerular membrane of kidney resulting in proteinuria. This study was aimed to compare current anxiety, depression levels and urinary albumin:creatinine ratio between primary caregivers of chronic mental patients and matched controls, and also whether the urinary albumin : creatinine ratio is correlated with stress factors (state and trait anxiety level, depression and caregiver burden) amongst caregivers. Methods: The present cross-sectional study included 131 subjects (93 primary caregivers of patients with major mental illness as cases and 38 normal controls). They completed the Burden Assessment Schedule of SCARF, State Trait Anxiety Inventory and Beck’s Depression Inventory. A spot urine sample was tested for urinary albumin : creatinine ratio from all study subjects. Results: Mean values of current State and Trait anxiety, depression, urinary albumin:creatinine ratio were significantly higher in caregivers than controls (P<0.001). Urinary albumin : creatinine ratio was significantly correlated (P<0.001) with State and Trait anxiety level, depression as well as caregiver burden. Interpretation & conclusions: The study demonstrated depression , anxiety and albuminuria amongst primary caregivers of patients with mental illness. Increase in the caregivers’ burden, depression and anxiety resulted in an increase in the urinary albumin: creatinine ratio. This indicates that psychological stress is one of the determinants of albumin excretion rate in otherwise healthy subjects.
ABSTRACT
Background: Quantitative measurement of valproate and lithium induced tremor using hand steadiness tester and their comparison in bipolar disorder. Methods: 200 newly diagnosed patients of bipolar disorder were randomly allocated into two equal groups receiving lithium (300mg twice daily) and sodium valproate (500 mg twice daily) after they fulfilled the inclusion / exclusion criteria of the study. 87 patients from Lithium group and 93 from Valproate completed the study. Hand Tremor was assessed quantitatively at 0, 6, 12, 18 and 24 weeks using hand steadiness tester. Anxiety level of the study subjects was assessed to be insignificant using a standardized anxiety scale. Final data was assessed after 24 weeks by using Stat Calc and Z test. P value <0.05 was considered to be significant. Results: No significant difference was found in terms of the development and transition of tremor induced by valproate and lithium (p=0.22). However more men developed tremor with lithium when compared with females (p<0.05) and the mean age of patients who developed tremor appeared to be significantly higher in lithium group (54.7±3.9) than valproate (39.6±5.1). Conclusions: Tremor of hands is a common side effect of lithium and valproate treatment. Timely, objective assessment of onset and extent of tremor has always remained a challenge to the clinicians. Hand Steadiness tester is a simple, portable, inexpensive, non-invasive instrument that can be used to ascertain the development and transition of tremor in a quantitative manner. This would guide the clinicians as when to intervene for better management of such tremors.
ABSTRACT
The association of hyperglycaemia and weight gain with the use of atypical antipsychotics has been documented. However, there is still not enough data from India. The fact that Indian patients usually have a lower body weight compared to European and American counterparts makes it difficult to extrapolate available data to the Indian context. The purpose of this study is: (a) To compare the prevalence of hyperglycaemia in schizophrenic patients taking olanzapine with those taking typical antipsychotics, and (b) to follow-up non-diabetic, non-obese schizophrenics on a stable regimen of antipsychotic monotherapy and determine the proportion of patients who develop weight gain, diabetes or impaired glucose tolerance; comparing the effects of olanzapine versus typical antipsychotics. Fifty-five schizophrenic patients attending psychiatry outpatients' department and on stable antipsychotic monotherapy for at least 6 weeks were included in the study. Those with a family or personal history of diabetes were excluded. There were 28 cases on olanzapine and 27 on either haloperidol or trifluoperazine. Fasting blood glucose estimation and body-mass Index (BMI) were recorded at baseline, at 6 weeks, and at 12 weeks. The two groups were comparable with respect to age, genderwise composition, and duration of illness. There was no significant difference in baseline glycaemic status or BMI. At the end of 12 weeks, olanzapine was not associated with any significant change in body weight, BMI or plasma fasting glucose. Duration of use of antipsychotic emerged as the only statistically significant risk factor for developing hyperglycaemia across both groups.