SSRI induced hypnic jerks: A case series.

A hypnic jerk is an abrupt, involuntary, nonrepetitive contraction of muscles of the body that occurs during the onset of sleep in stage 1 of nonrapid eye movement sleep. Various physiological and stressful stimuli can precipitate hypnic jerks with no further neurological sequelae. Although selective serotonin reuptake inhibitor (SSRI) medications are well known to disturb the normal sleep cycle and cause rapid eye movement sleep behavioral disorders, there were only a few case reports of them causing hypnic jerks and those were reported due to Escitalopram only. Here is a case series of four cases of hypnic jerks found to be associated with the use of various SSRIs, Escitalopram, Sertraline, and Fluoxetine. Clonazepam was found to be very effective in reducing the hypnic jerks associated with SSRIs. In all the cases, the sleep-induced Electroencephalogram was normal.

A Study to Evaluate Depression and Perceived Stress Among Frontline Indian Doctors Combating the COVID-19 Pandemic.

OBJECTIVE: Amid the ongoing coronavirus disease 2019 (COVID-19) pandemic, health care workers of multiple disciplines have been designated as frontline doctors. This unforeseen situation has led to psychological problems among these health care workers. The objective of this study was to evaluate the mental health status of pan-Indian frontline doctors combating the COVID-19 pandemic. METHODS: A cross-sectional, observational study was conducted among frontline doctors of tertiary care hospitals in India (East: Kolkata, West Bengal; North: New Delhi; West: Nagpur, Maharashtra; and South: Thiruvananthapuram, Kerala) from May 23, 2020, to June 6, 2020. Doctors involved in clinical services in outpatient departments, designated COVID-19 wards, screening blocks, fever clinics, and intensive care units completed an online questionnaire. The 9-item Patient Health Questionnaire and the Perceived Stress Scale were used to assess depression and perceived stress. RESULTS: The results of 422 responses revealed a 63.5% and 45% prevalence of symptoms of depression and stress, respectively, among frontline COVID-19 doctors. Postgraduate trainees constituted the majority (45.5%) of the respondents. Moderately severe and severe depression was noted in 14.2% and 3.8% of the doctors, respectively. Moderate and severe stress was noted in 37.4% and 7.6% of participants, respectively. Multivariate regression analysis showed working ≥ 6 hours/day (adjusted odds ratio: 3.5; 95% CI, 1.9-6.3; P < .0001) to be a significant risk factor for moderate or severe perceived stress, while single relationship status (adjusted odds ratio: 2.9; 95% CI, 1.5-5.9; P = .002) and working ≥ 6 hours/day (adjusted odds ratio: 10.3; 95% CI, 4.3-24.6; P < .0001) significantly contributed to the development of moderate, moderately severe, or severe depression. CONCLUSIONS: The pandemic has taken a serious toll on the physical and mental health of doctors, as evident from our study. Regular screening of medical personnel involved in the diagnosis and treatment of patients with COVID-19 should be conducted to evaluate for stress, anxiety, and depression.

Assessing perceived stress in medical personnel: in search of an appropriate scale for the bengali population.

BACKGROUND: The occurrence of stress and stress related anxiety and depression in medical personnel are being increasingly reported in literature. The perceived stress scale (PSS) is the most widely used psychological instrument for measuring the perception of stress. It is needed to assess perceived stress in our population using appropriately translated version of PSS. The objectives of study were to prepare a Bengali version of PSS-10 and to establish its psychometric properties in the study population. MATERIALS AND METHODS: The study was conducted in a teaching hospital among medical students and interns (N=37). The translated Bengali version and the original English version of PSS-10 were separately handed over to the individual subjects. The scores were compared across different subgroups and psychometric properties of the translated version were assessed using SPSS 16. RESULTS: Internal consistency of PSS English (α=0.79) and Bengali (α=0.80) was satisfactory. Intra-rater reliability was adequate (κ>0.5) for most of the items, but showed an inadequate value (κ<0.5) for four items on the scale. After deleting these four items from the Bengali version, a new six-item PSS in Bengali was derived that showed good internal consistency (α=0.699). CONCLUSION: This new version needs to be validated in a larger study population. Perceived stress score using PSS-10 was considerably high in our study population, although there was no significant difference between the subgroups (male/female, intern/student).