Socio-demographic Profile and Psychiatric Comorbidity in Patients with a Diagnosis of Post Traumatic Stress Disorder – A study from Kashmir Valley.

Objective: Kashmir valley has witnessed an armed conflict from last three decades, with one of the studies suggesting the prevalence of trauma exposure of 58.69% in the general population and 15.9% prevalence of Post-traumatic stress disorder (PTSD). The current study was undertaken to explore the socio demographic profile and psychiatric comorbidity in treatment seeking PTSD patients. Methods: This cross-sectional study was conducted at Government Psychiatric Diseases Hospital Srinagar, Kashmir from January 2006 to January 2007. A total of 100 PTSD patients were interviewed and screened for psychiatric comorbidity using DSM-IV diagnostic criteria and their socio demographic details were recorded using a proforma. Results: Most of the patients in our study had multiple comorbidities. Apart from depression and anxiety disorders, somatisation and peri-traumatic dissociation was highly comorbid. Conclusion: Post-Traumatic Stress Disorder is a complex diagnosis with commonly associated psychiatric comorbidity. The high comorbidity in our study sample could be due to repeated exposure to trauma, cultural expression of distress and the ongoing conflict situation which makes the recovery difficult. Recognizing the comorbidities early on may help to achieve an optimal treatment outcome. Finally, the lack of appropriate service provision results in increased morbidity and probable chronicity of the symptoms.

An epidemiological study on substance abuse among college students of north India (Kashmir valley).

Background: Substance abuse disorder is among the leading public health problems in modern day world as they cause enormous human suffering in terms of morbidity, mortality and economic loss; and threatens the very social fabric of almost all communities around the world and as such is a great threat to the global health, economy and peace. Like most social behaviours the etiology of substance abuse is complex, varying through time, geographical regions and by demographic characteristics. Among young people, students are the most vulnerable group as the initiation into substance abuse first starts during this period. Aims & Objective: To find out the prevalence and pattern of substance abuse and its association with various sociocultural and demographic variables. Material and Methods: Multi-stage random sampling method was adopted to select the study subjects. The study subjects were asked about the substance abuse and related socio-demographic variables by means of WHO model core questionnaire format and results were subjected to statistical analysis. Results: The overall life-time prevalence of for substance abuse among college students was found to be 31.3%. Male students had significantly higher prevalence of substance abuse as compared to female counterparts(37.5% versus 19.6% respectively).The most common substance being abused was Tobacco products(22.5%) followed by solvents (10.0%), alcohol (6.2%), sedatives (5.9%), cannabis (4.4%), amphetamine products (2.1%), hallucinogens (0.5%) and cocaine (0.3%). Age, gender and family type were found to be strongly associated with substance abuse (p<0.001). Conclusion: Prevalence of substance abuse among college students is high and causes significant problems in this population; therefore there is necessity of targeted interventions to reduce this huge burden.

Alexithymia and Type “A” Behavior Pattern (TABP) in Coronary Heart Diseases: A preliminary study.

Background: The number of patients with CHD is increasing and psychosocial factors are now recognized as playing a significant and independent role in the development of CHD and its complications. Aims: The present study aimed at examining the association between alexithymia and Type A Behavior Pattern (TABP) in Coronary Heart Disease (CHD) patients. Methodology: The sample consisted of 150 participants, comprising 50 in the study group (drawn from the outpatient clinical services) and 50 in the control group (from the general population) from Kashmir. Further 50 controls from the general population of Haryana were included to study alexithymia in broader context. The tools used included Jenkins Activity Survey (JAS-C) and Toronto Alexithymia Scale (TAS-20). Statistical analysis was done using SPSS-12.0 and various descriptive and inferential statistics were applied. Results: The results revealed a high prevalence (40%) of alexithymia in our study group. However the association of alexithymia with CHD was not clearly indicated as the comparison of alexithymia between our study group and control group did not reveal any significant difference and paradoxically the prevalence in the control group was even higher. Further a comparison of the control group from Kashmir with that of Haryana revealed a highly significant difference. Thus, our study suggests that perpetual trauma and unending stress due to present prevailing condition in Kashmir together with the presence of some kind of mental disorders in a significant segment of Kashmiri population has rendered the whole population more vulnerable to developing alexithymia. Further, our findings did not reveal any association between Type A Behavior Pattern and CHD. Conclusion: This indicates a need for further clarification of the precise role of personality types in producing and preventing CHD.

Comparative Study of Prevalence of Psychological Distress Factors in Coronary Heart Disease Patients Living Under Disturbed Conditions and a normal place of North India.

Background: The experience of heart disease seems to contribute to risk for numerous psychiatric problems, especially depression, anxiety, and stress. Although, these psychosocial factors appear to be outside the immediate realm of medicine, they have a profound impact on morbidity and mortality in cardiac patients. Aims: Purpose of the present study was to assess psychological distress (depression, anxiety, perceived stress) in Coronary Heart Disease (CHD) patients and compare the levels of these constructs among CHD patients living in disturbed condition (Kashmir) and a normal place (Haryana). Methods: Hospital Anxiety Depression Scale (HADS) and Perceived Stress Scale (PSS-4) were administered to a total of 200 male participants, 100 (50 CHD Patients and 50 healthy controls) from Kashmir and 100 (50 CHD Patients and 50 healthy controls) from Haryana. Statistical analysis was done using SPSS- 12.0. Results: The results revealed a high prevalence of depression, anxiety and stress in our study groups from both the places. Unlike Haryana, the stress levels between the CHD patients and healthy controls in the Kashmiri population did not show any significant difference. Comparison of depression between the study groups of the two states also did not reveal any significant difference. Further comparison of anxiety and stress between the study groups of the two states revealed a highly significant difference. The levels of depression, anxiety and stress in the control groups of the 2 states also differed significantly with alarmingly higher levels of psychological distress in the Kashmiri population. Conclusions: Thus, our study suggests that increased exposure of the Kashmiri population to traumatic events and stressful conditions has increased their levels of emotional distress, adversely affecting the mental connotation of their chronic physical condition (CHD) as well as putting the whole population at a greater risk of developing psychological problems due to extremely high levels of psychological distress.