ABSTRACT
Mental well-being is now an increasingly researched and discussed topic that primarily involves taking care of mental health in a preventive manner and is more of a subjective concept. Mental well-being ensures mental health and measures taken toward it can protect the person's overall health. Discussing and researching this concept is of paramount importance as this will not just safeguard an individual life but the society at large. The lifetime of a woman is multidimensionally unique with a complex interplay of biological, sociocultural, and environmental aspects. This demands a diverse variety of factors required to ensure mental well-being in a woman. In addition to this, these determinants vary on the life stage the woman is in. Factors that influence this well-being are also specific when it comes to an Indian context. This chapter considers and discusses in detail the various aspects of the mental health and well-being of women in the pubertal, perinatal, and menopausal age groups. Determinants are unique to particular age groups of women, and measures to focus on and ensure it will be elaborated on. Finally, recommendations towards policy making are also suggested.
ABSTRACT
Background: Neurocognitive deficits are well-documented in patients of schizophrenia and their first-degree relatives (FDRs). Metacognitive awareness of these deficits, called neurocognitive insight (NI), has been found to be poor in schizophrenia patients but has not been assessed in their FDRs. This study evaluated NI and its relationship with objective cognitive performance, a history of psychotic experiences (PEs), and social functioning in unaffected FDRs. Methods: This cross-sectional study was conducted at the outpatient department of a tertiary care teaching hospital. A total of 100 FDRs were assessed for PEs and evaluated for subjective cognitive complaints (SCC), objective cognitive performance, and social functioning using the Subjective Scale to Investigate Cognition in Schizophrenia, neurocognitive tests from the National Institute of Mental Health and Neurosciences battery, and SCARF Social Functioning Index, respectively. Results: Compared to normative data, episodic memory was the most commonly impaired domain (up to 72% of participants), followed by working memory, attention, and executive function. There was no correlation between SCC and neuropsychological test scores in the corresponding cognitive domains, implying poor NI. 15% of participants had a lifetime history of PEs. This group had significantly higher SCC as compared to those without PEs (U = 0.366, P = 0.009, r = 0.26). A regression analysis showed that the FDRs' social functioning reduced by 0.178 units for each unit increase in SCC [F (1,98) = 5.198, P = 0.025]. Conclusion: Similar to schizophrenia patients, FDRs also have poor NI. The severity and progression of SCC could be explored as a possible marker for screening and monitoring FDRs at an ultrahigh risk for psychosis. Importantly, even in unaffected FDRs, SCC could affect socio-occupational functioning and need further research.
ABSTRACT
Psychiatric disorders co-occur very frequently with epilepsy. This guideline covers the etiopathogenesis, presentation, evaluation and management of various psychiatric disorders in epilepsy such as mood, anxiety, psychotic and substance use disorders. It also provides an approach to important special issues in this population.
ABSTRACT
CONTEXT: Neurocognitive deficits are well documented in schizophrenia. Neurocognitive insight (NI), described as awareness of neurocognitive deficits, has not been evaluated in the Indian context. Its relation to clinical profile and social functioning also remains unexplored. AIMS: The aim of this study was to evaluate the subjective cognitive complaints (SCCs) and their relation to objective cognitive performance, clinical profile, clinical insight, and social functioning in patients of schizophrenia. SETTINGS AND DESIGN: This was a cross-sectional study at the outpatient department of a tertiary care teaching hospital. MATERIALS AND METHODS: One hundred individuals with schizophrenia were evaluated using Positive and Negative Syndrome Scale, Subjective Scale To Investigate Cognition in Schizophrenia, abbreviated version of Scale to Assess Unawareness in Mental Disorders, and Schizophrenia Research Foundation-Social Functioning Index. Cognitive performance was assessed using (1) Digit Span Test (attention) from Wechsler Adult Intelligence Scale, 3rd edition and (2) Passages Test (explicit memory), (3) Verbal n-back Test (working memory), and (4) Stroop Test (executive functioning) from the National Institute of Mental Health and Neuro Sciences Battery. STATISTICAL ANALYSIS: Statistical analysis was done using descriptive statistics, nonparametric tests, and Pearson's coefficient of correlation. RESULTS: Participants showed impairment in all cognitive domains. Except for working memory, there was no correlation between SCC and objective performance for other cognitive domains correspondingly, implying poor NI. Severity of psychosis and clinical insight did not have any correlation with SCC. Higher SCC correlated with poorer social functioning, especially in "occupational" and "other social roles" domains. CONCLUSIONS: Individuals with schizophrenia have poor NI. This is independent of severity of psychosis or clinical insight into illness. Socio-occupational functioning and depression should be actively enquired into when patients present with SCC.
