Lithium therapy in comorbid temporal lobe epilepsy and cycloid psychosis.

The treatment of post-ictal psychosis has foundered on uncertainty in diagnosis of psychotic phenotypes, and equivocal efficacy of first and second generation antipsychotics. This article presents a case history of comorbid temporal lobe epilepsy and psychosis, suggests the applicability of the continental, cycloid psychosis diagnostic conceptualization to post-ictal psychoses, and demonstrates the efficacy of lithium in their treatment. Clinical studies of comorbidity of epilepsy and psychosis offer great potential as a basis for modelling brain-mind relationships, and neuropsychiatric nosology, pathophysiology and treatment.

The 3rd Schizophrenia International Research Society Conference, 14-18 April 2012, Florence, Italy: summaries of oral sessions.

The 3rd Schizophrenia International Research Society Conference was held in Florence, Italy, April 14-18, 2012 and this year had as its emphasis, "The Globalization of Research". Student travel awardees served as rapporteurs for each oral session and focused their summaries on the most significant findings that emerged and the discussions that followed. The following report is a composite of these summaries. We hope that it will provide an overview for those who were present, but could not participate in all sessions, and those who did not have the opportunity to attend, but who would be interested in an update on current investigations ongoing in the field of schizophrenia research.

Evaluation of Integrated Counselling and Testing Centres (ICTC) for HIV in a District of India

ICTCs provide a critical entry point for prevention, care and support for both people affected by HIV/AIDS and general population. The study was conducted with the objective of evaluating ICTCs in terms of infrastructure and staffing, services provided, level of utilization and quality of counselling. The structure and process evaluation of 13 ICTCs under National AIDS control programme III (NACP III) was carried out in a Coastal District of South India. The evaluation was carried out using UNAIDS Tools between July and September of 2010. Twelve out of 13 ICTCs (92%) had adequate infrastructure and staff. Most of the general clients (75%) attending ICTCs were provider initiated and 84.5% of antenatal women in the district attended pre-test counselling and also underwent HIV testing. Twenty six pre-test counselling sessions and 12 post test sero-positive counselling sessions were observed. Pre-test counselling content assessment revealed that only 57.4% of sessions address all the issues whereas, 79% of post-test sessions addressed most of the issues during counselling. Counsellors’ skills assessment information gathering and information giving were found to be poorly done. It was found that post test counselling sessions were not conducted for clients with HIV negative report. The aspects of ICTCs such as services provided at the centers, utilization of services by the clients, infrastructure and staffing pattern were found to be adequate. Counselling forms the vital component of the ICTC needed improvement and post test counselling should be mandatory to all the clients.

Prevalence of depression, anxiety, and stress among young male adults in India: a dimensional and categorical diagnoses-based study.

The lifetime prevalence of depression, anxiety, and stress among adolescents and young adults around the world is currently estimated to range from 5% to 70%, with an Indian study reporting no depression among college going adolescents. This cross-sectional study was conducted to determine prevalence of current depressive, anxiety, and stress-related symptoms on a Dimensional and Categorical basis among young adults in Ranchi city of India. A stratified sample of 500 students was selected to be representative of the city's college going population (n = 50,000) of which 405 were taken up for final analysis. Data were obtained using Depression, Anxiety, and Stress Scale to assess symptoms on dimensional basis and using Mini International Neuropsychiatric Interview to diagnose on categorical basis. Mean age of students was 19.3 years with an average education of 14.7 years. Ranging from mild to extremely severe, depressive symptoms were present in 18.5% of the population, anxiety in 24.4%, and stress in 20%. Clinical depression was present in 12.1% and generalized anxiety disorder in 19.0%. Comorbid anxiety and depression was high, with about 87% of those having depression also suffering from anxiety disorder. Detecting depressive, anxiety, and stress-related symptoms in the college population is a critical preventive strategy, which can help in preventing disruption to the learning process. Health policies must integrate young adults' depression, stress, and anxiety as a disorder of public health significance.

Atypicality in presentation of neuroleptic malignant syndrome caused by olanzapine.

Neuroleptic malignant syndrome (NMS) is the most serious of acute neurological side effects produced by antipsychotic medication, characterized by hyperthermia, rigidity, altered consciousness and autonomic dysfunction, the prevalence of which varies from 0.4-1.4%. NMS is usually seen in treatment with high potency typical antipsychotics and very rarely with atypical antipsychotics. However, NMS cases have been reported with risperidone, clozapine, olanzapine and quetiapine. The presentations of NMS have often varied and we report another atypicality in presentation of NMS due to olanzapine use.

Chloroquine-induced recurrent psychosis.

Chloroquine is a commonly prescribed antimalarial drug that is widely used for the presumptive treatment of malaria in India. It has rarely been reported to cause psychosis, and to the best of our knowledge, recurrent psychosis due to chloroquine use has been reported only once, in 1996. We are reporting the second case of chloroquine-induced recurrent psychosis. We also discuss some of the possible neurobiological mechanisms leading to this neurotoxic adverse effect and our recommendations for future use of this drug.

Clozapine-induced angioneurotic edema.

Many prescribed drugs can cause cutaneous rashes and eruptions, which may present in various forms and severity. Most of these reactions are mild; however, the severe cases can lead to life-threatening complications. The most severe of these reactions may include angioedema, acute generalized exanthematous reactions, Stevens-Johnson syndrome and toxic epidermal necrolysis. We report two cases wherein the patients developed classical angioneurotic edema on clozapine therapy and improved rapidly when clozapine was stopped.