Depressive and anxiety disorders among single mothers in Dhaka.

BACKGROUND: Recent reports revealed that the number of single mothers has been increasing day by day in Dhaka city; however, their psychological problems have not been studied yet. AIM: We aimed to see the proportion of single mothers having depressive and anxiety disorders. METHODS: This descriptive cross-sectional study was conducted under the supervision of the Department of Psychiatry, Bangabandhu Sheikh Mujib Medical University, Dhaka from August 2016 to July 2017. A total of 156 single mothers from three social strata, namely, lower-, middle- and upper-class group were included purposively. Data were collected through face-to-face interviews using a semi-structured questionnaire consisting of demography and structured clinical interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth edition, axis-I disorders, clinician version (SCID-I-CV) which were analyzed by Statistical Package for the Social Sciences (SPSS) version 17. RESULTS: This study showed that the mean age of the single mothers was 34.8 ± 8.9 years. The overall 48.8% of single mothers had either depressive and/or anxiety disorders where 17.3% depressive disorder, 21.2% anxiety disorders and 10.3% had a dual diagnosis. Major depressive disorder and generalized anxiety disorder were the most common specific diagnosis. CONCLUSION: This study provided us a sound background knowledge regarding psychiatric disorders among single mothers. This study shows the need for larger research on this issue and early detection would help them to improve the quality of life.

Validation of the Bangla version of the Dimensional Obsessive-Compulsive Scale.

BACKGROUND: Obsessive-compulsive disorder (OCD) is a common and severe psychiatric illness which affects about 1-3% of the population across the globe. The Dimensional Obsessive-Compulsive Scale (DOCS) is a 20-item self-report instrument that assesses the severity of OCD in four dimensions. OBJECTIVES: We aimed to adapt and validate the DOCS in Bangla. METHODS: This validation study was conducted from January 2016 to July 2017 using purposive sampling technique. A total of 100 OCD patients were recruited from OCD clinic of Bangabandhu Sheikh Mujib Medical University after considering the inclusion and exclusion criteria. We applied Bangla version of DOCS to collect data and assessed different forms of validity and reliability. RESULTS: Cronbach's alpha of DOCS Bangla was 0.93 which signifies a good internal consistency. Cronbach's alpha of contamination domain was 0.92; responsibility domain 0.94, thought domain 0.91 and symmetry domain was found 0.93. Four factors were extracted from exploratory factor analysis with varimax rotation. Pearson correlation was 0.73 between the DOCS Bangla total global score and the Y-BOCS total score which signifies good criterion validity. CONCLUSION: DOCS Bangla is a psychometrically reliable and valid tool for use in clinical settings, research and primary care setting to diagnose and manage OCD for Bangla speaking population.

Clozapine Can Be the Good Option in Resistant Mania.

Bipolar mood disorder is a mental disorder with a lifetime prevalence rate of about 1% in the general population and there are still a proportion of individuals who suffer from bipolar mood disorders that are resistant to standard treatment. Reporting clozapine responsive mania that was not responding to two previous consecutive atypical antipsychotics and one typical antipsychotic was aimed at. A 17-year-old male manic patient was admitted into the psychiatry inpatient department and was nonresponsive to Risperidone 12 mg daily for 4 weeks, Olanzapine 30 mg daily for 3 weeks, and Haloperidol 30 mg daily for 3 weeks, along with valproate preparation 1500 mg daily. He was started on clozapine as he was nonresponsive to Lithium in previous episodes and did not consent to starting Electroconvulsive Therapy (ECT). He responded adequately to 100 mg clozapine and 1500 mg valproate preparation and remission happened within 2 weeks of starting clozapine. Clozapine can be a good option for resistant mania and further RCT based evidences will strengthen the options in treating resistant mania.

Efficacy of combination of fluoxetine and cognitive behavioral therapy and fluoxetine alone for the treatment of obsessive compulsive disorder.

A number of pharmacological approaches as well as psychological interventions are effective in the treatment of obsessive-compulsive disorder (OCD). The present study was conducted to see the relative efficacy of treatment approaches. 30 diagnosed cases of OCD were taken and divided into two groups. Each group consisted of 15 patients. Group A (N=15) received capsule fluoxetine and Group B (N=15) received capsule fluoxetine and CBT (13 weekly sessions). Twenty six participants completed the study (13 in each group). Dhaka University Obsessive-compulsive Scale (DUOCS) was used to measure the symptom severity. Symptom scores were measured at weeks 1, 5, 9 and 13. After 13 weeks, analysis of the data was done and the means of initial DUOCS score and 13th week score were compared. In both the groups the mean score changes were highly significant (p=0.000). Intra group analysis revealed that both the treatment approaches were highly efficacious. Inter-group analysis revealed that the response in combination group was significantly higher starting from 9th week, continuing up to 13th week. Mean symptom reduction and mean percentage reduction of symptoms were also higher in the case of combination group.