Iloperidone – A Newer Antipsychotic.

The optimal treatment of schizophrenia poses a challenge to develop more effective treatments and safer drugs, to overcome poor compliance, discontinuation and frequent switching with available antipsychotics. Iloperidone is a new antipsychotic developed to overcome some of the limitations in the drug treatment of schizophrenia. It has been approved by regulating agencies for use in treatment of adult schizophrenia.

A Study of Psychiatric Symptomatalogy in Dengue Patients.

Introducation : Dengue Fever is an acute febrile infectious caused by dengue virus which is transmitted through mosquito. A fraction of Dengue patients exhibit idengifiable psychiatric symptoms. Aims; The present studywas undertaken with an aim to identify the psychiatric symtoms associated with dengue fever. Material & Methods: The study was carried out in the department of psychiarty, University Collange of medical science (U.C.M.S ) And guru Tegh Bahadur Hospital, a designated tertiary care center for Dengue cases in Delhi. The study period ranged from May 2012 to October 2012. The Study assessed the psychiatric symptomatology in dengue fever and its progression overt the course of dengue. Results During the acute phase, nearly all (90.3%) the patients exhibited thanatophobia. Over 80% of the subjects (most females ) had panic attacks and only less than 15% of these subject needed shor course of anxiolytics. During the recovery phase ( at the end of 1st week ), all the observed psychiatric symptoms decreased both in terms of frequency as well as severity.

A Study of the Prevalence, Socio-Demographic and Clinical Correlates of Metabolic Syndrome (M S) in Drug-naive Patients of Anxiety and Depressive Disorders.

Backgroud: The prevalence of Metabolic Syndrome (MS) and its components is reported to be higher in population with mental illness as compared to general population across al diagnostic categories. There is a paucity of studies on the baseline prevalence of MS and its these studes have produced mixed results. The present study was therefore carried out in patients attending the out-patient (OPD) psychiatry department. Aims and Objective:To find out and compare the prevalence and socio-demographic and clinical correlates of MS in drug native patients of anxiety and depressive disorders. Materials and Methods: Socio-demographic details, were collected and analyzed using appropriate statistical tools. Results and Conclusions: The overall prevalence of metabolic syndrome was 23.5% while it was 46.2% in the depressive group and 9.5% in the anxiety group. 50% of the sample fulfilled at least one criterion for MS. While age, all MS components predicted MS overall; HDL, waist circumference and BMI predicted MS in depressive patient and HDL and triglyceride abnormalities predicted MS in the anxiety group.

Current Scenario of Psychiatric Diagnosis in a Tertiary Care Teaching Hospital.

Background: There is a need to evaluate the pattern of current psychiatric diagnosis in our country with the emergence of DSM-5 and ICD-11. Methods: All consecutive cases visiting a tertiary care teaching hospital in the age group of 10-80 years during November 2011 to February 2012 were recruited for the purpose of the study. Psychiatric diagnosis was made by qualified psychiatrists using semi-structured Performa as per ICD-10 Criteria. Analysis of data was done by using descriptive and inferential statistics. Results: Out of 1000 patients, 54.5 % patients are in the age group of 20-40 years with male to female ratio of 3:2 and married to unmarried ratio of 4:3. 18% patients suffered from psychosis, 6.8 % substance dependence, 3.6 % organic disorders, 12.6 % depression, 20.8 % anxiety disorders, 9.1 % bipolar disorder, 13.9 % psychosexual disorders, neurological disorders 4.6 %, and 9.2% having other psychiatric diagnosis. Conclusions: There is a need to evaluate patients visiting every psychiatric outpatient’s clinic so that changing trends in psychiatric problems, co-morbidities, prescribing patterns in view of the current diagnostic systems and treatment guidelines can be updated with special reference to Indian population.

A Comparative Study of Temperament in Children of Patients Suffering from Depression in Comparison to Normal Controls.

Temperament is a very important aspect of functioning that needs to be understood in children of patients suffering from depression. It may be an early sign of vulnerability to the later development of depression. Early detection and early intervention in children of patients with depression are in premature state in India. The present study aimed to study the temperament characteristics in children of patients suffering from depression as compared to age and sex matched control sample. A case control study was conducted on children aged 4-16 years of patients with depression who presented to indoor and outdoor services of department of psychiatry in Lady Hardinge Medical College evaluating them on Temperament Measurement Schedule and comparing the outcome with children of healthy parents matched for age, sex, education, and socioeconomic status with the children of patients suffering from depression were found to show significantly lower threshold of responsiveness, lower approach withdrawal; they were low on sociability, low on mood, low on emotionality and lower activity ,intensity, energy and distractibility as compared to control. These children had lower mean score on the variable- Adaptability, Persistence and Rhythmicity although the difference was not found to be statistically significant.

Medication errors in psychiatric practice — A Cross-sectional Study.

Objectives: To analyse current prescription writing practices among psychiatrists and to identify and quantify various types of medication errors in psychiatric prescriptions in general and specifically in the prescriptions of antipsychotics. Method: A cross-sectional study of medication errors was carried out in the extra-mural psychiatry prescriptions brought by the patients attending the psychiatry outpatient department of a tertiary care hospital in Delhi. The study period ranged from 1st March, 2009 to 1st November, 2011. Microsoft Excel was used for data analysis. The WHO guidelines for prescription writing were used as a standard while making an assessment of the results. Results: Most of the prescriptions analysed exhibited polypharmacy, illegible handwriting, lack of necessary details pertaining to the patients (address, weight) as well as those pertaining to the prescriber (signature, contact details, registration number) and necessary instructions for the patient regarding taking drugs and advice for follow up.In the 648 extramural prescriptions analysed, the most common error was prescription of drug without dose (30 %). The least common error was the prescription of a wrong drug (2 %). In comparison to the rates found in all the 648 prescriptions, the error of prescribing drugs with same indication was identified at a relatively higher frequency (15%) among antipsychotics (only) prescriptions. Among the various antipsychotic drugs, the errors related to wrong frequency and wrong route of administration were observed at relatively higher frequencies in the prescriptions of the newly introduced drug asenapine while the first generation antipsychotic drugs like haloperidol and trifluoperazine exhibited comparatively higher rates of wrong dose errors. Conclusions: Routine psychiatric prescriptions exhibit large number of easily identifiable errors which are preventable. The need of the hour is to promote rational drug prescribing practices among psychiatrists, encouraging them to detect and report medication errors encountered by them. This approach will enrich our existing research base about this hitherto neglected domain of psychiatric practice thereby helping us in developing and implementing effective strategies to combat this menace of medication errors.

Pattern of Psychosexual Disorders among males attending Psychiatry OPD of a Tertiary Care Hospital.

Sexual dysfunction is a major healthcare issue and therefore deserves timely recognition, proper investigation and appropriate treatment. 100 consecutive male patients attending the psychiatric outpatient clinic were selected for the study. The cases with past history suggestive of primary organic pathology, Schizophrenia, depression, chronic drug intake were excluded. Mean age of the cases was 23.6 years, 26 cases (26.0%) had a history of premarital heterosexual act, 5 cases (5.0%) had homosexual contact, 72 cases (72.0%) had history of nocturnal emission and 12 cases (12.0%) gave history of extramarital heterosexual contact. The mean duration of illness was 6.2 months. 62 cases (62.0%) presented with Dhat syndrome. This was followed by erectile impotence (19 cases, 19%), premature ejaculation (12 cases;12%), and 7 cases (7%) presented with sexual misconceptions. The presence of high prevalence of additional psychiatric disorder in all types of psychosexual dysfunctions deserves for careful diagnostic evaluation, appropriate investigations and timely treatment.