Life-threatening thrombocytosis following GCSF treatment in a case of clozapine-induced agranulocytosis.

Clozapine was introduced in European market in 1972 as an effective treatment for schizophrenia without extrapyramidal side effects. Within a short while, the clozapine story virtually came to a halt following detection of life-threatening neutropenia and agranulocytosis. Judicial use of granulocyte colony stimulating factor (GCSF) can be life saving with infrequent side effects in these cases. Here we are presenting a case of clozapine induced agranulocytosis managed with GCSF but had transient but life-threatening thrombocytosis, a very uncommon complication of GCSF therapy. Expression of GCSF receptors on the surface of megakaryocytic lineage is thought to be the cause of this unusual phenomenon.

A study of clinical correlates and socio-demographic profile in conversion disorder.

AIM: To study the clinical presentations and relationship of socio-demographic variables with conversion disorder. METHODS: Forty patients admitted to the department of psychiatry, Assam Medical College and Hospital, Dibrugarh, during November 2004 to August 2005 who fulfilled the inclusion criteria of the study were evaluated for socio-demographic variables and clinical presentations on a semi-structured pro forma. RESULTS: Conversion disorder is more common in young adults (57.5%), females (92.5%) and among students belonging to nuclear family of lower socioeconomic status. A majority of the patients had an obvious precipitating factor, of which family-related (40%) and school-related (30%) problems accounted for the major types. Motor symptoms were the predominant presentation (87.5%) with pseudo seizure being the commonest.

Conduct disorder-A sequelae of viral encephalitis.

An 11-year-old girl presented with a behavioural problem of 2 years' duration, which developed following an attack of viral encephalitis. Her behavioural changes had manifested as conduct disorder and were treated with pharmacotherapy as well as behavioural therapy.

Disability associated with mental disorders.

BACKGROUND: Disability associated with mental illness is a major contributor to the global burden of disease. The present study looks at some aspects of disability associated with 7 psychiatric disorders: schizophrenia, bipolar affective disorder, anxiety disorders, depression, obsessive-compulsive disorder, dementia, and mental and behavioural disorders due to the use of alcohol. AIMS: (i) To evaluate the nature and quantity of disabilities in the study groups; (ii) to compare the degree of disability with the severity of the disorder; (iii) to compare disability among various disorders; and (iv) to study the longitudinal stability of disability in the disease groups. METHODS: A total of 228 patients attending the OPD, Department of Psychiatry, Assam Medical College, Dibrugarh, between July 2003 and June 2004, who were diagnosed as per ICD-10 guidelines and SCAN, were included in the study. Severity was assessed by the application of some commonly used rating scales for each specific disorder. The level of disability was assessed by using the Indian Disability Evaluation and Assessment Scale (IDEAS). Patients were followed up at 6 and 12 months. Statistical analysis was done on SPSS version 10. RESULTS: All the 7 disorders under study are associated with significant disability; schizophrenia being maximally disabling. Disability associated with alcohol use disorder and anxiety is comparable to disability on account of OCD. Over a period of 12 months, disability due to depression, alcohol use disorder and anxiety tend to remain significant.