Substance use and its associated factors among school students

Background. There is lack of comprehensive data on substance use and associated factors among school students in Delhi, India. Methods. We used a cluster sampling method based on sections of classes in schools to conduct this study in two government-run schools in Delhi. All enrolled students from 8th, 9th and 11th grades participated (n = 405). The WHO Student Drug Use questionnaire was administered in a single session for a class section for assessing substance use. Results. The participation rate was 90.6%. The rates of past 12 months’ use of tobacco, alcohol, cannabis and inhalants were 22%, 12.1%, 12.1% and 8.6%, respectively, while rates for ‘sedatives and tranquillizers’ were 4.9%, opium 2.7% and other opioids 1.2%. Lifetime use of heroin was reported by two students and use in the past 12 months by one student. Multiple substance use was high. Higher age was associated with the use of alcohol and cannabis. According to logistic regression model results, use by a family member significantly increased the probability of using tobacco (adjusted odds ratio [AOR] 11.3; 95% confidence interval (CI) 3.4–37.8) and alcohol (AOR 3.75; 95% CI 5.1–1059.3). Similarly, use by peers significantly increased the probability of tobacco (AOR 7.7; 95% CI 2.0–29.8) and cannabis use (AOR 5.7; 95% CI 1.5–21.5). Having poor harm perception significantly increased the chances of inhalant use by students (AOR 5.5; 95% CI 1.5–20.1). Conclusion. The study results bring to attention the prevalent and important problem of substance use among schoolchildren. We recommend that (i) intervention strategies for school settings are important and need to factor in the use of illicit substances (cannabis); (ii) psychosocial intervention by trained school counsellors in school settings is the mainstay for intervention for cannabis and inhalants; and (iii) heroin users should be referred to healthcare facilities for detoxification.

Age and gender might influence big five factors of personality : a preliminary report in Indian population.

Age and gender are two important physiological variables which might influence the personality of an individual. The influence of age and gender on big five personality domains in Indian population was assessed in this cross-sectional study that included 155 subjects (female=76, male=79) aged from 16-75 years. Big five personality factors were evaluated using 60-item NEO-Five Factor Inventory (NEO-FFI) at a single point in time. Among the big five factors of personality, Conscientiousness was positively correlated (r=0.195; P<0.05) with age in total study population, and retained the significance (P<0.05)in men only when analyzed by gender subgroups. Further, age and gender sub-group analysis also showed that Neuroticism was inversely correlated with age in women aged 26-35 years (P<0.05). Neuroticism and Extraversion showed a positive correlation with age in men aged 36-45 years (P<0.001 and P<0.05, respectively). Neuroticism was inversely correlated with age in men aged 46-55 years (P<0.05). This preliminary report suggested that personality traits might change with age, and is gender-dependent.

The psychosocial impact of vitiligo in Indian patients.

Background: Vitiligo has a special significance in Indian patients both because depigmentation is obvious on darker skin and the enormous stigma associated with the disease in the culture. Aims: This study was carried out to determine the beliefs about causation, aspects of the disease that cause concern, medical, and psychosocial needs of the patients, expectation from treatment and from the treating physician, and effects of disease on the patient's life. Methods: Semi-structured interviews were conducted in 50 patients with vitiligo. Purposive sampling was used to select subjects for the study. Each interview was recorded on an audio-cassette and transcripts were analyzed to identify significant issues and concerns. Results: Patients had a range of concerns regarding their disease such as physical appearance, progression of white patches onto exposed skin and the whole body, ostracism, social restriction, dietary restrictions, difficulty in getting jobs, and they considered it to be a significant barrier to getting married. The condition was perceived to be a serious illness. Stigma and suicidal ideation was reported. While there were several misconceptions about the cause of vitiligo, most patients did not think their disease was contagious, heritable or related to leprosy. Multiple medical consultations were frequent. Complete repigmentation was strongly desired, but a lesser degree of repigmentation was acceptable if progression of disease could be arrested. The problems were perceived to be more severe in women. The disease imposed a significant financial burden. Conclusion: Addressing psychosocial factors is an important aspect of the management of vitiligo, particularly in patients from communities where the disease is greatly stigmatizing.

Vitiligo impact scale: An instrument to assess the psychosocial burden of vitiligo.

Background : Vitiligo is a disease that significantly impairs quality of life. Previous studies have shown that vitiligo has an impact that may not correlate with the size and extent of depigmentation, indicating a need for an independent measure of the psychosocial burden. Aims : To develop a rating scale to assess the psychosocial impact of vitiligo. Methods : The study was undertaken in three broad phases: item generation, pre- and pilot testing, and test administration. Items were generated largely from a qualitative study using semi-structured interviews of patients. Face and content validity were assessed through pre- and pilot testing in 80 patients and the final version was administered to 100 patients who also received the Dermatology Life Quality Index (DLQI) and the Skindex-16. Each patient also underwent a physician global assessment (PGA) of the impact of vitiligo. Test-retest reliability was assessed in 20 patients. Results: Of 72 items initially generated for the scale, 27 were retained in the final version. Subjects were able to comprehend the items and took about 5-7 min to complete the instrument. The scale was internally consistent (Cronbach's α = 0.85). Scores on the scale correlated moderately well with the DLQI and the Skindex (Spearman rank correlation: 0.51 and 0.65, respectively). The scale was able to discriminate between patients having mild and those having moderate and severe impact as assessed by PGA. The test-retest reliability coefficient (Spearman rank correlation) was 0.80. Conclusion: The Vitiligo Impact Scale appears to be a valid measure of the psychosocial impact of vitiligo and this instrument may be useful both in the clinic and in clinical trials.

Specialty choices of postgraduate medical students: Are they related to the kind of animal identified with oneself.

Background: Research has pointed to a possible role of certain personality attributes in the choice of medical specialties, but not much is known about the Indian setting. Furthermore, most personality assessments are quite lengthy and time-consuming. Objective: The study aimed to explore if the specialty choices of Indian postgraduate students are related to their personality attributes, using a brief projective animal question. Methods: The study was carried out as a retrospective survey (n=450) of responses to a projective question, in which students were asked to name the animal they identified themselves with the most and their reasons. Results: Mean age was 25.46±1.94 years (Males: 71.8% males; females: 28.2%). Reasons for identification with the stated animal were categorized as aggressive 11.8%, autonomous 40%, nurturing 30.4% and aesthetic 17.8%. Technology-oriented specialties were associated with aggressive/ autonomous responses (p<0.01), while pre/paraclinical specialties were associated with nurturing/aesthetic responses (p<0.01). Females had twice the odds (OR: 1.86) of choosing a personoriented clinical specialty over a technology-oriented specialty. Conclusion: Research in this direction is needed to assist the career counseling of medical students.

Clinical Profile of Mood Disorders in Children.

Objective: To described the clinical profile of pediatric mood disorders. Design: Retrospective record review; Ages 16 y. Setting: Tertiary case hospital. Participants: Children 16 year with a DSM-IV diagnosis of Mood disorders. Methods: Records were screened for the period between June 1, 2008 and May 31, 2010. Results: The prevalence of mood disorders was 4.1% (38/930). Mood was depressed in 51.9% and irritable in 33.3% of depressive disorders. Other common symptoms were anhedonia, sleep/appetite disturbances, concentration difficulty and anxiety. Nearly 13.2% had suicidal ideation and 28.5% had comorbid psychiatric disorder. Family history was positive in 39.5%, while an identifiable stressor was present in 50%. Conclusions: The pediatric mood disorders have a unique clinical presentation and requires more research, especially from Indian setting.

Pattern & correlates of neurocognitive dysfunction in Asian Indian adults with severe obstructive sleep apnoea.

Background & objectives: No published data are available on neurocognitive dysfunction in Asian Indians with obstructive sleep apnoea (OSA). We therefore, studied the pattern and correlates of neurocognitive dysfunction in Indian adults with severe OSA. Methods: Fifty patients aged 25-65 yr with severe OSA (apnoea-hypopnoea index > 30) and 25 age, sex, and education level-matched normal controls were studied. Both groups were administered a standardized battery of neurocognitive tests. Results: Patients with severe OSA had significantly impaired performance on tests of alertness, working memory, response inhibition, problem solving, and executive function. However, the difference in executive function between the groups disappeared after adjusting for delayed information processing. The test scores did not correlate with apnoea-hypopnoea index, arousal index, or Epworth sleepiness score. However, the percentage of time spent at < 90 per cent oxygen saturation had a weak correlation with the number of stroop errors (Spearman’s rho = 0.64; P = 0.033), number of trials required (rho = 0.05; P = 0.02), and perseverative errors on Wisconsin card sorting test (rho = 0.36; P = 0.02). Interpretation & conclusions: Our results suggested that delayed information processing rather than impaired abstract thinking was probably the cause of impaired performance on composite tests of neurocognitive function in patients with severe OSA.

Pattern of tobacco use among school children in National Capital Territory (NCT).

OBJECTIVE: To study the prevalence, consumption patterns and correlates of tobacco use among adolescent SZI children in Government schools in the National Capital territory of Delhi. METHODS: Thirty schools in National Capital Territory (NCT) of Delhi, India, were selected by two stage cluster random design and population proportionate to size sampling (PPS) methodology. A sample of 3,422 children in the age group of 10-18 years studying in the 30 middle and senior secondary Government schools in NCT of Delhi were studied. Each student was administered a pre-tested, semi-structured questionnaire. RESULTS: Overall 9.8% of the study children had at least once experimented with any form of tobacco in their lifetime. The proportion of children who were current users of tobacco products was 5.4% (boys: 4.6%, Girls: 0.8%). Current users differed from abstainers in location of their schools, category of school, class, gender, hobbies, not having friends, having tobacco users in family and school etc. CONCLUSION: Consumption of tobacco amongst adolescents is an emerging health problem in Delhi. A number of variables seem to differentiate between the current users and abstainers. Tobacco use in family and school environment is a mutable factor that should be focused in tobacco reduction campaigns. Encouraging friendship has a protective influence. There is a need for similar studies in other metropolitan cities of the country.

Tobacco consumption and awareness of their health hazards amongst lower income group school children in National Capital Territory of Delhi.

Consumption of tobacco is a complex and multidimensional problem faced by the country. It is the main culprit behind oral cancer. The present study was undertaken to assess the prevalence of consumption of tobacco amongst adolescent school children of low-income group in National Capital Territory (NCT) of Delhi and to study the perception of the children regarding the health hazards of tobacco. A cross-sectional study was conducted amongst 3,422 children in the age group of 10-18 years studying in government schools in NCT of Delhi. About 9.8% of the study children had at least once experimented with any form of tobacco in their lifetime. The proportion of children who were "current users" of tobacco products was 5.4% (boys: 4.6%, Girls: 0.8%). Nearly eighty percent of the study subjects knew that, tobacco consumption is injurious to health. The parents of 59% of the children discussed the harmful effects of tobacco consumption with their children.