ABSTRACT
Background: Children of Alcoholics (COAs) form a large but heterogeneous group. Along with genetic predisposition to develop dependence, COAs may inherit other comorbid mental disorders, that the alcohol dependence syndrome often presents with. Prevalence of psychiatric morbidity in children in general have been reported to be around 6.46 % in Indian studies. Studies done with COAs have shown mixed findings, reporting both internalizing, externalizing and other behaviour problems. With dearth of Indian studies assessing psychiatric morbidity in COAs, a study was conducted to assess same. Methodology: A cross sectional study was conducted in private de-addiction centre in South India. Sixty- five children in age group of 6 to 18 years, whose fathers were admitted for alcohol dependence syndrome, were assessed along with their primary care giver using a semi-structured socio-demographic proforma and Kiddie-Schedule for Affective Disorder and Schizophrenia-Present and Lifetime version. Chi square and independent samples t test were used as appropriate. Results: 55.4% of the children had some lifetime psychiatric diagnosis. Around 21.5% of children had more than one lifetime diagnoses. Most common disorders found were anxiety disorders followed by mood disorders. Comparison of socio-demographic variables with respect to presence or absence of any lifetime psychiatric diagnosis, anxiety disorders, mood disorders and multiple diagnoses did not reveal any significant differences. Conclusion: Psychiatric morbidity in COAs was higher than in children in general population as reported in other studies. Having alcohol dependent males in de-addiction centres provides an avenue for early detection and treatment of psychiatric morbidity in their children.
ABSTRACT
Objectives -It has been estimated that 20-50% patients with Schizophrenia can develop treatment resistance. Treatment resistance is associated with increased morbidity in these patients and it also increases the burden for the caretakers. Very few Indian studies have tried to establish the factors associated with resistance in Schizophrenia. Hence, this study was conducted to identify the socio-demographic profile, illness variables, co-morbidities and cognitive insight in patients with Treatment Resistant Schizophrenia. Methodology: The study was conducted after permission from Institutional Ethics Committee. 50 consecutive patients of Treatment Resistant Schizophrenia (treated with 2 antipsychotics from different classes with adequate doses for 6 weeks each and currently satisfying the DSM IV TR criteria for Schizophrenia) were included in the study. Patients were administered a semi-structured questionnaire to obtain details about sociodemographic status, age of onset, family history, number of episodes and treatment received. DSM-IV-TR was used to identify psychiatric comorbidities. Becks cognitive insight scale was used to assess cognitive insight. Results: The mean age of patients in the study with Treatment Resistant Schizophrenia (TRS) was found to be 33.5yrs with M: F ratio of 1.77:1. It was found that 34% of patients had an onset before 20 yrs of age. Positive family history of mental illness was present in 48% of the TRS patients. Multiple episodes (>5) were present in 36% of patients. TRS was characterized by absence of affective symptoms in 90% of patients. On applying Beck's cognitive insight scale, patients of TRS were found to have higher Self-Certainty score as compared to Self-Reflection, indicating poor awareness into their illness and treatment. Conclusions: It is important to identify Schizophrenia patients with early age of onset, positive family history, absence of affective features and poor cognitive insight to improve the long-term course of Schizophrenia