A cross-sectional study to assess the prevalence of somatisation and associated socio demographic factors in depression

Background: Somatisation, the tendency to seek treatment for medically unexplained physical complaints is frequently associated with depression and is more frequently seen in Indian context. Aim: This study is aimed to assess the prevalence of somatisation symptoms among various subgroups of Indian patients with depression and the sociodemographic factors associated with depression. Methods: This is a cross sectional study of 262 patients, who were categorized into three sub groups of as per ICD 10.All the subjects were administrated MADRS and BSI to study severity of depression and nature of somatisation. Results: Female subjects exhibited a higher prevalence of somatisation than male subjects. Similarly married, illiterate, low socio-economic and rural background subjects showed high prevalence of somatisation. Subjects with diagnosis of dysthymia exhibited high prevalence of somatisation (56.42%) followed by mixed anxiety depression (51.08%) and depression with somatic symptoms (48.55%). Conclusion: Somatisation is common in depression. The tendency to perceive and report physical complaints are influenced by various socio demographic factors including gender difference.

Pellagra in patient with schizophrenia: a case report and review of literature

Background: Pellagra, called the disease of 4D’S- dermatitis, diarrhoea, dementia and death, is seen in patients of chronic alcohol dependence, mal absorption syndrome, and psychiatric illnesses like schizophrenia. Mostly a clinical diagnosis, its treatment includes balanced diet and niacin supplementation. There are hardly any case reports about pellagra in schizophrenia patients. Case description: A young Asian woman with complaints of abusing and assaulting, talking to self since three years and loose motions since fifteen days presented to psychiatric outpatient department with signs of dehydration, sharply defined symmetrical, desquamating rash in the neck area and in the sun exposed parts of forearms and legs with mental status examination findings of muttering to self, impaired recent and immediate memory and inability to do simple calculations. Patient showed significant improvement with supportive therapy, antipsychotics, niacin supplementation and balanced diet. Discussion: Pellagra can be seen in psychiatric illnesses like alcohol dependence syndrome, eating disorders and schizophrenia. It occurs along with other vitamin deficiencies which improve with medication and balanced diet. Conclusions: Early identification of vitamin deficiency along with proper education to patients and family regarding the need of balanced diet and adequate vitamin supplementation will prevent further complications. Thus, pellagra seen in schizophrenia patients requires medication and balanced diet.