ABSTRACT
Primary adrenal insufficiency rarely occurs due to infections, which consequently involves destruction or dysfunction of both adrenal cortices. Tuberculous adrenalitis is still a frequent cause of adrenal insufficiency in developing countries. We present the case of origin of multiple delusions along with recurrent spells of vomiting and giddiness in a patient with pulmonary tuberculosis (TB). A thorough medical history combined with a panel of biochemical and endocrine investigations revealed disseminated TB with choroid tubercles and adrenal infiltration leading to primary adrenal insufficiency. A diagnosis of organic delusional disorder secondary to disseminated TB-associated adrenal insufficiency was considered. The patient was managed with risperidone and antitubercular drugs. The psychosis improved and the patient was stable during the follow-up. The present case report adds to the literature on diagnostic challenges associated with psychosis due to adrenal insufficiency secondary to disseminated TB.
ABSTRACT
BACKGROUND: Depression causes significant burden both to the individual and to society, and its treatment by antidepressants has various disadvantages. There is preliminary evidence that adds on yoga therapy improves depression by impacting the neurotransmitters involved in the regulation of mood, motivation, and pleasure. Our study aimed to find the effect of adjunctive yoga therapy on outcome of depression and comorbid anxiety. MATERIALS AND METHODS: A randomized controlled study involving patients with major depressive disorder (n = 80) were allocated to two groups, one received standard therapy (antidepressants and counseling) and the other received adjunct yoga therapy along with standard therapy. Ratings of depression and anxiety were done using Montgomery-Asberg Depression Rating Scale and Hospital Anxiety and Depression Scale at baseline, 10th and 30th day. Clinical Global Impression (CGI) Scale was applied at baseline and 30th day to view the severity of illness and clinical improvement. RESULTS: By the 30th day, individuals in the yoga group had significantly lower scores of depression, anxiety, and CGI scores, in comparison to the control group. The individuals in the yoga group had a significant fall in depression scores and significant clinical improvement, compared to the control group, from baseline to 30th day and 10th to 30th day. In addition, the individuals in the yoga group had a significant fall in anxiety scores from baseline to 10th day. CONCLUSION: Anxiety starts to improve with short-term yoga sessions, while long-term yoga therapy is likely to be beneficial in the treatment of depression.
