Disseminated tuberculosis masquerading as depression.

We report the case of a 23-year-old man without any significant premorbid conditions initially presenting to a psychiatrist with suspected depression but later referred to our hospital owing to the possibility of systemic disease and subsequently diagnosed as having disseminated tuberculosis.

Psychological well-being and coping strategies among secondary school teachers: A cross-sectional study.

INTRODUCTION: Educators, academicians, and teachers are responsible for the development of the nation's human capital. Teacher coping methods are becoming more widely recognized as a key factor in determining teacher effectiveness. The aim of this study was to identify the various coping strategies adopted by high school teachers in Southern India. MATERIALS AND METHODS: A cross-sectional study was conducted in government, aided, and unaided schools of Udupi, a coastal district in Southern India. A self-administered questionnaire was used to collect the data from 460 high school teachers chosen based on convenience sampling. The coping strategies were identified using a modified version of Brief COPE(Coping Orientation to Problems Experienced) Inventory (Carver, 1997). Data were entered using SPSS version 15 and descriptive statistics was performed. RESULTS: The study found that teachers had moderate level of coping skills in all domains. The most popular coping techniques used by secondary school teachers were positive reframing, active coping, and planning; nevertheless, substance use was recognized as the least popular coping strategy. CONCLUSION: Positive reframing, active coping, and preparation were the most commonly used coping strategies by the teachers in the survey. Teachers are a vital resource who have received less attention than they deserve for their psychological well-being. A customized intervention program based on their perceived needs could be a good place to start.

Parenting attitudes and dimensions as predictors of adolescent behavioural problems in the Indian context: A community-based study.

INTRODUCTION: Adolescent behavioural problems are a growing public health concern. The authors in this study investigated paternal and maternal reports of parenting attitudes and dimensions as predictors of adolescent behavioural problems in the Indian context. MATERIALS AND METHODS: Using stratified sampling at the community level, 640 parents including 419 mothers and 221 fathers participated in the study. Tools included a socio-demographic pro-forma; Parental attitude inventory (PAI) to assess parenting attitudes, Parent Global Report of the Alabama Parenting Questionnaire (APQ) to assess current parenting dimensions, and the parent version of the Strengths and Difficulties Questionnaire (SDQ) to assess behavioural problems among adolescents. We examined the prevalence and predictors of total difficulties, externalizing and internalizing behavioural problems among adolescents from paternal and maternal reports. RESULTS: Paternal and maternal reports of total difficulties (11.3 %, 13.6 %), externalizing (2.3 %, 1.9 %) and internalizing behaviours (8.6 %, 7.4 %) among adolescents are reported. Predictors of abnormal behaviours per paternal reports included lower social class and poor paternal control. Being a male adolescent increased the odds of total difficulties and externalizing problems. Favourable maternal attitude, good maternal warmth and control predicted the reduced likelihood of total difficulties and externalizing behaviours per maternal reports. Paternal control and maternal warmth and control were found to reduce the likelihood of internalizing behaviours among adolescents. CONCLUSION: Maternal attitude, paternal control and maternal warmth and control dimensions emerged as significant predictors of total difficulties, externalizing and internalizing behavioural problems among adolescents.

Parental Involvement - Perceptions of Parents and their Adolescent Children.

OBJECTIVE: To explore the experiences of parents and their adolescent children, specifically the dimension of parental involvement in the lives of their adolescent children and how adolescents perceived it. METHODS: Following informed consent, a total of nine families with 22 participants took part in the study including nine adolescents, aged between 14 and 16 y, and 13 parents. One-on-one in-depth interviews were conducted at their homes following informed consent. Following transcription, the data was coded and themes were identified using Atlas.ti software. A grounded theory approach was undertaken in analysing the data. RESULTS: Two main themes were identified including perceptions of parental involvement in the lives of their adolescent children and family strategies to improve bonding. Adolescents' concerns centered on reduced interaction time with their family members. Concerns were also raised over the adolescents' increasing academic burden and parents particularly emphasized the increasing use of media and mobile technology by adolescents as deterrents to interaction. Though mothers functioned as primary caregivers, fathers also took on more active roles in the rearing of their children, stepping away from the traditionally viewed role of being a distant patriarchal provider. To improve interaction, parents devised creative strategies to increase time spent interacting with family members such as having dinner, performing household chores, playing games, or visiting places together. CONCLUSIONS: The increasing academic burden and access to digital media were perceived as factors leading to reduced interaction between the parent-adolescent dyad. Creative parenting strategies to increase interaction were sought as a solution.

Increased Levels of Acetylcholinesterase, Paraoxonase 1, and Copper in Patients with Moderate Depression- a Preliminary Study.

BACKGROUND: Depression is a common and widespread mood disorder, which affects an emotional level that varies widely in its intensity. Biochemical parameter alterations have been observed in different depression types. In the present study, we examined acetylcholinesterase (AChE), paraoxonase 1 (PON1), and copper levels in moderately-depressed patients and healthy controls to ascertain whether the measurement of red blood cell (RBC) AChE, and plasma PON1 and copper could be used to evaluate moderate depression. METHODS: This case control study was performed in the Department of Biochemistry, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India. Patients who met ICD 10 diagnostic criteria were considered as cases. Goldberg's General Health Questionnaire 28 (GHQ-28) was used to select controls. Four ml of blood was collected from 24 cases and 20 controls aged 35-70 years and used to determine RBC AChE, and plasma PON1 and copper levels. RESULTS: Red blood cell AChE, and plasma PON1 and copper levels were significantly greater in patients with moderate depression than in controls. Further, a receiver operating characteristic curve for validity of the biochemical parameters in plasma from patients with moderate depression indicated sensitivity and specificity above 85% for copper and PON1. CONCLUSION: Red blood cell AChE, plasma PON1, and copper levels may have roles in the pathogenesis of depressive disorders.

The effect of a brief family intervention on primary carer's functioning and their schizophrenic relatives levels of psychopathology in India.

This study examined the short term effects of a brief familial intervention on schizophrenic the patient's levels of psychopathology and their primary caregiver's functioning in India. Caregiver functioning was measured by the caregiver's levels of burden and coping along with the patient's perceived level of expressed emotion (EE). The participants were 18 schizophrenic patients and their related primary carer from a medical facility in India. The patients' levels of psychopathology and EE were assessed at baseline and at completion of the study with the Positive and Negative Syndrome Scale (PANSS; Kay et al., 1987) and the Family Emotional Involvement And Criticism Scale (FEICS; Shields et al., 1992), respectively. The primary caregiver's levels of burden and coping were also measured at baseline and upon completion of the study by the Burden Assessment Scale (BAS; Thara et al., 1998) and the Family Crisis Oriented Personal Evaluation Scale (F-COPES; McCubbin et al., 1981), respectively. The brief intervention was comprised of 3 one hour sessions aimed at educating the primary caregiver and patient about schizophrenia; along with improving their communication, problem solving skills and expression of emotions. A significant improvement was found between baseline and the final 3-month follow-up on measures of psychopathology for the patients, as well as family functioning for both the caregivers and patients. The implications of the findings are discussed, along with future research directions.

Pedal edema with olanzepine.

Olanzapine, an atypical antipsychotic is considered superior to its conventional congeners. Here we report two cases of pedal edema secondary to olanzapine. In both cases the systemic causes of pedal edema were ruled out. On reducing the dose of olanzapine, pedal edema regressed and completely resolved after stopping the drug. So we attribute the edema to olanzapine therapy. As the definitive cause and further consequences of pedal edema are not known, hence stringent monitoring of adverse effects of this drug is required.