RESUMEN
Objectives of this study are to determine the comparative prevalence of personality disorder in prisoners suffering with substance dependence and to find the relationship of personality disorder (PD) with pattern and severity of substance dependence (SD). Methods: This is a single-blind case controlled design prison hospital based study. A period sample of nineteen months was taken. Convenience samples of first 250 prisoners admitted in de-addiction ward fulfilling study criteria were taken as study participants and equal numbers of inmates were taken as control participants. Main outcome measure of the study was the presence of PD, whether it is related to the psychoactive substance dependence. Results: There was severe substance dependence among PD cases with the severity of dependence scale, SDS score of 10.7 ± 1.7 vs. 9.6 ± 1.3 in those without PD. Difference in duration of substance use of those with and without PD was statistically significant. However, the difference in age of onset of substance use and duration of substance dependence was not statistically significant. Prevalence of personality disorder in study was found to be 40.8% and was significantly higher than in control participants, i.e. 18.4%. Dissocial PD was noted as the most common type of PD in both study and control participants, i.e. 20.8% and 8%, respectively. In study participants, other most common types of PD were borderline, impulsive and anankastic PD at 7.2%, 5.6% 3.2%, respectively. More than 80% study participants were dependent on various types of substance-related use, i.e. alcohol, opioid and cannabis. Frequency of participants with use of greater than two substances at a time was much more common in participants with PD, than in those without a PD. Conclusions: In those prisoners, suffering from SD is usually of severe intensity. Prevalence of PD in prisoners suffering from SD is much higher than in non-SD population. In both groups, dissocial PD is the majority type of PD. Alcohol, cannabis and opioid are most commonly used substance. Prevalence on more than one substance was higher in those participants suffering from PD than those without PD. ASEAN Journal of Psychiatry, Vol. 18 (1): January – June 2017: XX XX
RESUMEN
Objectives: The aims of the study were to investigate whether Sudarshan Kriya (SK), a form of Yoga and related practices can lead to increased Global Assessment of Functioning (GAF) and increased feeling of wellness in patients with substance dependence. Method: This was a 3-month single blind parallel randomized controlled study with sample size of 111 patients which were allocated by simple randomization to two groups. Study subjects were involved in an intensive program of Sudarshan Kriya and practices (SK&P) which they practised daily for 6 weeks. The control subjects were instructed to sit in an armchair with their eyes closed and pay gentle attention to their breath. A period sample of three months consisting of all patients admitted in De-addiction (DAC) ward fulfilling study criteria was taken. Only male patients diagnosed to be suffering from Substance Dependence by ICD-10 (DCR) criteria, aged between 18-65 years were included in this study. The assessment tools were the Basic Socio-demographic Performa, Mini Mental State Examination (MMSE), Severity of Dependence Scale (SDS), Schedule for Clinical Assessment in Neuropsychiatry (SCAN) based clinical interview, Global Assessment of Functioning (GAF) and Psychological General Well Being (PGWB). These assessments were conducted before starting the intervention and six weeks thereafter. Results: In the final analysis, number of participants analyzed in the study group was 55 and in the control group was 56. Majority of subjects were unemployed, married individuals who did not have occupational skills of more than skilled labour level. After six weeks of SK&P, statistically significant improvement in study subject dimensional scores of GAF (48.43+/- 0.08 to 66.77+/-0.14), Anxiety (ANX) (9.64+/-0.52 to 15.66+/-0.38), Depressed Mood (DEP)(7.19+/-0.2 to 9.18+/-0.37), Positive Well Being (PWB)(10.28+/-0.61 to 12.92+/-0.73), General Health (GH)(7.74+/-0.18 to 9.75+/-0.22) and Total PGWB(41.46+/-0.35 to 59.28+/-0.63) were noticed. However, when compared with control subjects, improvement was statistically significant in the case of GAF (p=0.000158), Anxiety (ANX)(p=0.011), Positive Well Being (PWB)(p=0.02), General Health (GH)(p=0.02) and Total PGWB(p=0.05); but not in the case of Depressed Mood (DEP), Self Control (SC) and Vitality. Conclusion: Practicing SK&P helps in improving Global Assessment of Functioning, Psychological General Well Being, General Health (GH) and positive well being of an individual. SK&P also causes significant reduction in anxiety levels of an individual.
RESUMEN
Objective: This study aimed to determine the prevalence of epilepsy in prisoners suffering from substance dependence and the relationship between onset of epilepsy and substance dependence in a prison population. Methods: The present cross-sectional study in a prison population was conducted in Central Jail (CJ), New Delhi, India over a period of 3 months. The convenience sample consisted of 900 subjects. The study group consisted of 450 prisoners taken from the deaddiction ward and the rest were placed in the control group. Physical examination and Mini Mental State Examination (MMSE) of subjects were done to make necessary exclusion. Assessment tools were applied in the order starting from MMSE, Basic Socio-demographic Performa, Present State Examination (PSE), and Addiction Severity Index (ASI). Results: The average ages of study and control subjects were 34.5 + 2.3 years (mean + standard deviation) and 35.6 + 3.6 years respectively. Prevalence of epilepsy among substance using prisoners was 1.4 times higher than in non-substance using prisoners. Alcohol, opioid, and cannabis, either alone or in various combinations, were the most commonly used substances. Subjects suffering from epilepsy were likely to have higher chances of consuming three or more substances than those without problem of epilepsy. Study subjects suffering from epilepsy compared with those without epilepsy performed worse in all parameters. This is indicative of higher severity of psychoactive substance dependence. Conclusion: Findings of high prevalence rate of epilepsy and co-morbid substance dependence highlight the need for better screening among epileptic subjects for substance abuse at entry into prison for effective treatment while in custody, and at follow-up on release. Specialist addiction services for prisoners have a considerable impact in a wellplanned intervention programme for prisoners with substance use and comorbid epilepsy. ASEAN Journal of Psychiatry, Vol. 15 (2): July – December 2014: 153-163.