Farmers' suicide in Vidarbha region of Maharashtra state: A myth or reality?

Incidence of farmers ending their lives in Vidarbha region had hit epidemic proportions recently. We adopted the psychological autopsy approach to offer some insight into the reason why these individuals resorted to such a drastic step. Suicide in farmers is public health problem and we suggested some immediate and serious interventions to prevent suicide.

Quality of life in patients with early and advanced carcinoma of the breast.

AIM: Emotional disturbances are known to occur in patients suffering from malignant diseases even after treatment. This is mainly because of a fear of death which modifies quality of life (QOL). QOL has gained an important place in the management of cancer in industrialized nations, with the increase in survival. However, in developing countries like India, very little attention has been paid to this issue. Developing countries have poor infrastructure and lack proper treatment facilities at most centres, this leads to poor survival rates and hence much emphasis is on attaining quantity of life rather than quality. This study was carried out to assess the quality of life determinant in patients with breast cancer and the impact of treatment on quality of life indices. METHODS: We carried out QOL assessment in 50 patients with breast cancer using the modified linear analogue scale for self assessment (LASA). RESULTS: Significant deterioration was seen in health-related parameters in terms of recreation (P=0.01), social life (P=0.002), mobility (P=0.03), physical activity (P=0.4) and sleep and appetite (P=0.05). Treatment related parameters deteriorated in both early and advanced carcinoma. Similarly, weight loss was seen in both the groups, however, this was not statistically significant. Self-care and recreation were found to be the most important parameters influencing the QOL in breast cancer patients. CONCLUSIONS: Breast cancer detection programs, health education and better awareness among women in industrialized nations has helped in downstaging of the disease, thus improving overall survival. It has not been so in developing countries, where the majority of patients present with advanced disease (T3 and T4). These are usually managed with surgery and adjuvant chemotherapy, which duly interferes with general health-related parameters and the social life of these patients, thereby adversely affecting the QOL.

Psychosocial characteristics of literate blinds: a study.

Blindness leaves a person in a state of physical, psychosocial and economic dependence. Aberrant mental attitudes and even frank mental illnesses can develop among the aged blinds. The present study shows that acceptance towards their disability was much higher (in 68.75% cases) among the aged blinds in group 'A' (mean age 42.2 years) than the younger student (in 47% cases) in group 'B' (mean age 17.6 years) All the younger blinds were found to be optimistic for their future but the level for this mental attitude among older subjects was relatively lower (in 68.75% cases). The aberrant mental attitude like rejection, guilt and aggressiveness which reflected negative attitude towards life were more prevalent among students. Older blinds were found to be relatively more shameful for their disability (in 43.75% cases). The negative attitude towards life was evaluated to be present among 12.5% cases in group 'A' and among 76.5% cases in group 'B'. Anxiety and depression were the mental illnesses evaluated among blind and were displayed by 6.25% and 0% cases in group 'A' i.e. the group of teachers and trained workers and in 35.3% and 43.7% cases among group 'B' i.e. the group of blind students respectively. Aberrant mental attitudes have shown no definite relation with the age at the onset of blindness or otherwise they appeared to change with age.

First-onset schizophrenia in the community: relationship of urbanization with onset, early manifestations and typology.

As part of a World Health Organization collaborative study in 12 centres in developing and developed countries within defined urban and rural catchment areas with populations of 348,786 and 103,865, respectively, a total of 155 and 54 cases of first-onset schizophrenia, respectively, were identified over a 24-month period by a comprehensive and active recruitment of all cases. Approximately 50% of the subjects in both cohorts were in the age range of 15-24 years. There was a preponderance of males in the younger age group and of females in the older age group. The majority of cases had no family history and had shown good adjustment in childhood and adolescence. The onset was much more frequently acute and much less often insidious in our samples and (more so in the rural cohort), compared to the figure for all developed countries' sites. With regard to early manifestations of the disorder, there was a much higher incidence of loss of interest in appearance and cleanliness, being irritable and angry without reason, and loss of appetite, sleep or interest in sex in both of our samples, and of being excited or overactive for days or weeks in our rural cohort than in the developed countries' centres as a whole. On the other hand, claiming impossible things, behaving as if hearing voices and feeling persecuted, harmed or bewitched were much less frequent in our rural cohort than in the urban cohort or the developed countries' centres as a whole. With regard to the clinical diagnosis of schizophrenia, paranoid, hebephrenic/disorganized and residual types were under-represented in our samples (more so in the rural sample), and catatonic type and acute schizophrenic episode were over-represented compared to the developed countries' centres. Moreover, the proportion of subjects of CATEGO class S+ was lower in our samples. With regard to onset, early manifestations and clinical subtypes of schizophrenia, our rural cohort deviated most from developed countries' centres as a whole, with our urban sample falling in between, thus indicating the role of socio-cultural factors in general, and urbanization in particular, in these variables in schizophrenia.

The right-ear advantage in schizophrenia.

Schizophrenics, patients with affective disorder and normal controls were tested on a verbal dichotic listening task at three time periods, 0-2, 4-6 and 14-16 weeks. Schizophrenics had non-significant ear difference during the acute state of illness (0-2 weeks) and the normal right-ear advantage emerged when acuteness subsided (14-16 weeks).

Effect of lithium therapy on thyroid function: a retrospective study on Indian patients.

Thirty patients with Bipolar affective disorder who were on Lithium therapy for 6 months to 24 months, were tested for any alteration in their thyroid function. Eight (26.67%) patients had elevated serum TSH level and four (13.33%) patients had decreased serum T(4) level than the normal range. Serum T(3), although showing a declining trend was found within the normal range in all the patients.

Effect of seizure control on improvement of cognitive functions in epileptic patients.

A group of fifty epileptic patients were tested with neuropsychological tools for cognitive functions like memory, intelligence, visuomotor coordination, spatial perception and body schema perception. Patients were on carbamazepine and were tested after three months. Seizure improvement was shown to have different effects on different cognitive functions. Memory and intellectual deficits improved, while no difference was observed in visuomotor coordination, spatial and personal perception.

An incidence study of schizophrenia in India.

Under a WHO collaborative study, the Chandigarh center monitored two geographically defined populations over a 2-year period. Using helping-agency-coverage and other methods along with a set of specified criteria, 268 first-onset potentially schizophrenic cases were actively identified. Of these, 232 cases could be assessed in detail which included 209 schizophrenics as per specified ICD-9 or Catego criteria. The annual incidence rates obtained were 4.4 and 3.8 per 10,000 for rural and urban areas, respectively. The rural cohort had a higher incidence for each of the three diagnostic definitions. In the urban cohort, sex and diagnostic definition did not affect the incidence. In the rural cohort, females had a lower incidence for Catego S+ and a higher incidence for other diagnostic definitions.

The concept of aging in ayurveda.

The present study reveals that the process of aging was elaborately described in Ayurveda. In order to prology the life span and to promote longevity a separate discipline called Rasayana Tantra was also developed. The sailent feature of this discipline are described in this article.

A study of cerebral dominance by laterality score and order of reporting in dichotic listening test.

The Dichotic listening test was performed on 8 schizophrenics and 8 normal healthy controls. A positive correlation between laterality score and shift of order of reporting from one hemisphere to other was found in light handed scliizophrenics during active stage of the disease. Order of reporting alone may be a factor responsible for this shift of laterality in these patients. Further, on follow-up the abnormalities returned back to normal as these patients recovered. This suggests that schizophrenia is a left hemisphere abnormality with tempcral lobe dysfunction.

Humoral concepts of mental illness in India.

Based on interviews with patients at three allopathic psychiatric clinics in Bombay, Bangalore and Varanasi, employing a preliminary version of the Explanatory Model Interview for Classification (EMIC) to elicit indigenous explanations of illness and patterns of prior help seeking, we discuss popular humoral theories of mental disorder. Even though most laypersons are unfamiliar with the content of the classical treatises of Ayurveda, the humoral traditions which they represent influence current perceptions. Case vignettes clarify the nature of the relationship between cultural, familial and personal factors that influence the experience of illness.

Changing diagnosis in psychiatry.

The present study was conducted to find out changes in the diagnosis of hospitalized patients. Out of 421 hospitalized psychiatric patients from 1974 to 1976, the diagnosis was changed in 54 (12.8%) patients. The change in diagnosis occured once in 51 and twice in 3 cases. Finally reasons for change and its implementations are discussed.

Dhat syndrome: the phenomenology of a culture bound sex neurosis of the orient.

Indian Dhat syndrome which is symptom complex most commonly seen in younger group of patients in between 16 to 23 years of age. These patients present with whitish discharge with urine (patients believe it to be semen). This is associated most commonly with impotency, marked anxiety, general weakness, premature ejaculations and hypochondriasis. All the patients were either from low or average socioeconomic status. Majority of the patients attributed masturbation as a causative factor for this problem.

A study of prophylactic value of antiparkinsonian drug.

The present prospective study is conducted to determine the prophylactic value of antiparkinsonian drug (A.P.) at the time of initiation of antipsychotic therapy. Seventy patients were selected who fulfilled the selection criteria. Thirty five patients received antipsychotic drugs alone (Group A), while another thirty five patients received A.P. drugs concurrently with antipsychotic drugs (Group B.) These patients were assessed weekly for 4 weeks for any extra pyramidal symptoms (E.P.S.). There was no statistically significant difference between E.P.S. scores of the two groups in different weeks. The difference in percentage of patients who developed E.P.S. in different weeks in both the groups was statistically non-significant (p<0.05). None of the female subjects developed E.P.S. in either group.

Psychological reactions to leprosy.

The study was conducted to find out the psychological reactions to leprosy, to correlate psychological symptomatology with duration of leprosy and to find out suicidal attempts among leprosy patients. 24 patients were randomly selected from "Kashi Kusth Swasth Shala and Punarvas Mandir". They were administered the Hindi adaptation of Middlesex Hospital Questionnaire. 14 patients verbalised suicidal ideas and 2 have had suicidal attempts. Psychological symptomatology was less reported by those whose duration of illness was longer and more symptoms were reported by those whose illness was of shorter duration. The various findings are discussed in length.

Psychological reactions to leprosy

The study was conducted to find out the psychological reactions to leprosy, to correlate psychological symptomatology with duration of leprosy and to find out suicidal attempts among leprosy patients. 24 patients were randomly selected from Kashi Kusth Swasth Shala and Punarvas Mandir. They were administered the Hindi adaptation of Middlesex Hospital Questionnaire. 14 patients verbalised suicidal ideas and 2 have had suicidal attempts. Psychological symptomatology was less reported by those whose duration of illness was longer and more symptoms were reported by those whose illness was of shorter duration. The various findings are discussed in length.