Vitamin B12 Deficiency Presenting as Acute Psychosis.

Psychiatric symptoms attributable to vitamin B12 deficiency have been described for decades. Vitamin B12 deficiency is common in developing countries and its prevalence ranges up to 67% among Indian population.1 The earlier reports are for the most part in accordance with more recent ones, despite being diagnostically less specific in psychiatric and haematological terms. These symptoms seem to fall into several clinically separate categories like slow cerebration, confusion, memory changes, delirium, with or without hallucinations and/or delusions, depression, acute psychotic states, and (more rarely) reversible manic and schizophreniform states.2 Apart from these conditions, some cases of dementia, violent behaviour and fatigue have also been documented to be caused by vitamin B12 deficiency.3 Reports of patients initially presenting to psychiatric facilities without associated haematological manifestations are rare. There are a few case reports of acute psychosis attributed to vitamin B12 deficiency, but more evidence is required to substantiate and establish this association.4 We describe three patients who developed acute psychosis accompanied by features suggestive of organic aetiology. They were found to have cobalamin deficiency in the absence of typical neurological or haematological abnormalities.

Risk Factors of Suicide among Patients Admitted with Suicide Attempt in Tata Main Hospital, Jamshedpur.

Background: More than one lakh lives are lost every year due to suicide in India. In the last three decades (from 1975 to 2005), the suicide rate has increased by 43%. Jamshedpur is an Industrial town, which is rapidly growing and having population with mixed cultural background. Recently, there has been increasing trend in a number of suicide attempt across various age groups; there are around 300 cases of suicide attempt admitted to Tata Main Hospital each year. Objective: To study the risk factors associated with suicide attempts. Methods: The study was carried out in the Tata Main Hospital, Jamshedpur. Over a period of 6 months, we gathered data of 101 suicide attempters referred from medical, surgical departments and casualties and taken up for the study. Data were collected on specific pro forma was prepared to collect various others risk factors. Results: More number of female patients compared to male, younger age, lower‑middle income group, urban background, school educated, and unemployed were more represented in this study. In 70% of patients, psychiatric disorder was found, but few among them had prior treatment. Increased family conflicts, marital problems, financial difficulties, and perceived humiliations are some of the risk factors. Conclusion: The early identification and treatment of vulnerable populations with risk factors for suicide across the lifespan will help in planning and implementing strategies for prevention.