ABSTRACT
Psychiatric disorders are among the leading causes of disability the world over. With the World Health Organization, spearheading the crusade to incorporate the mental health component into primary health care, developing countries also have accepted the need for community care of patients with psychiatric disorders. Since independence various initiatives by the government has led to a significant change in the place of mental health care as part of the general health care. At the time of independence apart from mental hospitals, there was practically no organized mental health care. Since then General Hospital Psychiatry units and also Psychiatric Nursing homes have started. Currently, mental health issues are actively seen as part of the public agenda in the various forms. The overall effect has been the movement to recognize mental health as an important issue in the community and services to move beyond mental hospital care to care to the community. Majority of population in Jharkhand is residing in rural areas. Due to the lack of proper communications and infrastructure, Ranchi Institute of Neuropsychiatry and Allied Sciences (RINPAS) had started community outreach program way back in 1999. At present, these centers are running in four different areas of the state with great success. RINPAS experience shows that how even with resource constraints, quality services can be provided to unreached population.
ABSTRACT
OBJECTIVE: To assess intracranial structural changes in obsessive-compulsive disorder (OCD) with CT scan. MATERIALS AND METHODS: Thirty patients of OCD between 21 and 40 years of age and fulfilling various inclusion and exclusion criteria were compared with control group. CT scans of all the patients and controls were taken and compared with regard to ventricular size, Evan's ratio and ventricular brain ratio (VBR). RESULTS: Patients of OCD were found to have greater cortical atrophy and scored significantly higher in frontal and parietal area. Only 4 patients had enlarged ventricles, and there were none with a smaller ventricle. Mean Evan's ratio of patients was lower than that of the control group but the difference was statistically nonsignificant. The mean VBR of patients was lower than that of the control group and the difference was highly significant. CONCLUSIONS: The evidence of neuro-radiological abnormalities in patients with OCD suggests that these disorders should not be considered merely functional in the traditional sense.
