Dissociative disorders :A study of Clinico-demographic Profile and Associated Stressors.

Objectives: To study relevant clinico-demographic profile and stressors of dissociative disorders. Methods: This is a case-control study of 39 cases of dissociative disorders (and) compared (them) with 39 controls using a self designed questionnaire and G. Singh’s Presumptive Stressful Life Events Scale (PSLE). Results: The mean age of the cases was 21.23 years. Cases of Dissociative motor disorders had significantly higher age (26.4 yrs) as compared to dissociative convulsion (18.8 yrs) and dissociative stupor of 20.6 yrs(38.5%).Two thirds of the cases had comorbid neuro-psychiatric illness; the commonest one being depression (35.9%). The cases had more stressful life events in the past one year as well as whole life when compared to controls. Family conflict was seen to be the commonest precipitating stress. Conclusions: Dissociative disorder mainly affects young people. Dissociative motor disorder is a distinct subtype with a higher age of onset. Presence of neuro-psychiatric co-morbidity is the rule rather than exception. Psychosocial stressors play an important role in disease production.

Psychiatric Comorbidity in Cases Admitted for Alcohol Dependence.

Background – Alcohol dependence syndrome (ADS) is a medical disorder with some particular features resulting from a prolonged and heavy use of alcohol. When people with ADS present to a psychiatric service, they usually have developed other health problems. Objective – Since eastern Nepal has a heavy load of alcohol related problems, this hospital based descriptive study was carried out to observe psychiatric co-morbidity among inpatient-ADS cases. Method – In this cross sectional study of 60 consecutive inpatients, psychiatric co-morbidities were diagnosed according to the diagnostic criteria of ICD-10. Results – Mean age of the cases was 39.19 years, 75% were male and 90% were married. Three fourths used other substances besides alcohol; main being nicotine, opioid and cannabis. Eighty percent cases had one or other or more than one diagnosable psychiatric illness, including ICD-10 mental and behavioral disorders in 63% and personality problems severe enough to affect the course of substance use disorder in 48% of the total cases. The most common psychiatric disorder in ADS cases was anxiety disorders, followed by mood affective disorders, and psychotic illness. Among the personality problems, dissocial plus narcissistic, and anxious group were common. Conclusion – Psychiatric co-morbidity is common in people with alcohol dependence.