A study of clinical correlates and predictors of insight in obsessive compulsive disorder.

Background: Obsessive compulsive disorder (OCD) is a clinically heterogeneous psychiatric disorder in terms of symptom content and insight. Aim: To study the various factors associated with insight in OCD. Materials and Methods: A cross-sectional hospital-based study was conducted among 40 patients with OCD who were evaluated on Yale-Brown Obsessive-Compulsive Scale, Hamilton Anxiety Rating Scale, Hamilton Depression Rating Scale, Brown Assessment of Beliefs Scale, Meta-Cognitions Questionnaire, WHOQOL-BREF, and Sheehan Disability Scale. Statistical analysis was done using SPSS version 22. Results: Metacognition, severity of OCD, and associated disability were the significant predictors for insight in patients with OCD. Conclusion: Factors associated with insight in OCD can enhance our understanding in the management of OCD.

High-Frequency Hearing Loss Amongst Smart Mobile Phone Users: A Case-Control Study.

BACKGROUND: In past 20 years, there is increase in mobile phone users from 12.4 million to about 5.6 billion i.e 70 % of the world's population.[1] Electromagnetic radiations emitted from mobile phone damages inner ear, cochlea and outer hair cells of inner ear and auditory pathway (AP).[2]. MATERIALS AND METHODS: Case control study. Group 1, N=30 subjects, using mobile smart phones since past 1-5 years and exposure time more than 2 hours per day. Group II included 30 subjects, using mobile smart phones for more than 5 years and exposure time more than 2 hours per day. Headache, tinnitus, or sensations of burning around phone-using were excluded. Brainstem auditory evoked potential (BAEP) done. Student Unpaired t test was used for analysis and chisquare test. RESULTS: Mean ± SD of absolute latencies (AL) of Brainstem evoked response auditory. (BERA) waves III, V and all interpeak latencies at 80 dB and 4,6,8 KHz in group 2 were delayed and significant as compared to group 1. All parameters were highly significant at 8KHz as compared to 4KHz in group 2. CONCLUSION: Brain stem evoked response audiometry (BERA) detects hearing loss in smart mobile phone using subjects at higher frequencies i.e at 8 KHz early. Hence central neural axis involvement can be detected early by BERA.

Résumé Contexte:Au cours des 20 dernières années, le nombre d'utilisateurs de téléphones mobiles est passé de 12,4 millions à environ 5,6 milliards, soit 70 % de la population mondiale. [1] Les rayonnements électromagnétiques émis par les téléphones portables endommagent l'oreille interne, la cochlée et les cellules ciliées externes de l'oreille interne et des voies auditives (PA). [2]Matériels et méthodes:étude cas-témoins. Groupe 1, N = 30 sujets, utilisant des téléphones intelligents mobiles depuis 1 à 5 ans et temps d'exposition supérieur à 2 heures par jour. Le groupe II comprenait 30 sujets, utilisant des téléphones portables intelligents depuis plus de 5 ans et ayant une durée d'exposition supérieure à 2 heures par jour. Les maux de tête, les acouphènes ou les sensations de brûlure lors de l'utilisation du téléphone ont été exclus. Potentiel évoqué auditif du tronc cérébral (BAEP) réalisé. Le test t non apparié de Student a été utilisé pour l'analyse et le test du chi carré.Résultats:Moyenne ± écart-type des latences absolues (AL) de la réponse auditive évoquée du tronc cérébral. (BERA) les ondes III, V et toutes les latences inter-pics à 80 dB et 4,6,8 KHz dans le groupe 2 étaient retardées et significatives par rapport au groupe 1. Tous les paramètres étaient hautement significatifs à 8 KHz par rapport à 4 KHz dans le groupe 2.Conclusion:L'audiométrie à réponse évoquée du tronc cérébral (BERA) détecte la perte auditive dans un téléphone mobile intelligent en utilisant des sujets à des fréquences plus élevées, c'est-à-dire à 8 KHz plus tôt. Par conséquent, l'implication de l'axe neural central peut être détectée précocement par BERA.

HRV changes in young adults with depression.

Background and Aims: Depression is a common and debilitant mental health disorder that is very common among young adults of the age group of 18-25 years. There is evidence that autonomic nervous system dysfunction associated with depression may play an important role in cardiovascular disease among patients with depression. HRV that is used to assess ANS function is found to be altered in depression. Since the HRV findings associated with depression remain inconsistent, this study is aimed to find HRV changes associated with depression so that the use of HRV as a diagnostic tool for depression can be validated. Methods: A total of 42 newly diagnosed patients of depression of the age group (18-26) years and 89 non-depressed volunteers matched for age, BMI and sex proportions were included in the study. Heart rate variability was recorded using five-minute stationary RR interval of Lead II by 4-channel Power Lab System (AD Instrument Ltd). HRV findings are summarized into Time-Domain parameters, Frequency-Domain parameters and Non-Linear parameters. Result: All HRV parameters are significantly reduced and the LF/HF ratio is significantly raised (P < 0.05) in the group of depressive patients when compared to the group of healthy controls. The reduction of HRV parameters (SDRR, RMSSD, Total Power, SD1 and SD2) in the group of patients with depression is found to be highly significant (P < 0.0001). Conclusion: The findings of our study suggest that depression may be associated with alterations in ANS activities, which contribute to an increased risk of cardiovascular disease. Thus, HRV can serve as a potential bio-marker for depression.

Prevalence of internet addiction and its relationship with insomnia, depression, anxiety, and stress among medical students of a tertiary care medical institute of Eastern India.

Background: Internet has become an integral part of our daily lives but as the use of internet is increasing, it is important to be aware of the prevalence, context, and impact of its addiction on sleep and the presence of anxiety, depression, and stress in our lives. Aim: To assess the prevalence of internet addiction and its association with insomnia, depression, anxiety, and stress among medical students in a tertiary care medical institute in Eastern India. Materials and Methods: A descriptive cross-sectional questionnaire-based study with a purposive sampling method was conducted among 420 undergraduate medical students of different professional years. Out of 420 medical students, 413 students who gave consent and returned complete performa were taken in the study using a semi-structured performa for sociodemographic details, Young's Internet Addiction Test, Insomnia Severity Index, and Depression Anxiety Stress Scale. Results: We found 31.2% of students had internet addiction, 24.2% had clinical insomnia, 58.1% had stress, 68.8% had anxiety, and 64.6% had depression. Potential internet addiction was significantly related to average screen time, insomnia, stress, anxiety, and depression. Conclusions: Internet addiction is prevalent among medical students affecting sleep, anxiety, depression, and stress, which needs urgent preventive strategies.

Correlation of behavioral and psychological symptoms of dementia with patients' sociodemographic & clinical details and caregivers' distress.

Background: Behavioral and psychological symptoms of dementia (BPSD) influence dementia care significantly. BPSD can be affected by factors related to the patient's illness and socio-cultural background. Aim: This study aimed to find a relationship between BPSD with patients' socio-demographic and clinical profiles and their caregivers' distress in a tertiary care center. Materials and Methods: In this hospital-based cross-sectional study, the purposive sampling technique was used to select 100 dementia patients. A comprehensive record of socio-demographic and clinical details was made on a self-prepared semi-structured data sheet. The Neuropsychiatric Inventory Questionnaire was the principal tool to find the BPSD and related caregivers' distress. Results: The sample comprised predominantly Hindu (91%) male patients (66%) with Alzheimer's dementia (76%) coming from rural backgrounds (74%) and joint familial systems (96%), with a mean age of 71.77 ± 7.41 years. Patients' main caregivers were their children/children-in-law (65%). The severity of an overall BPSD and its variable individual domains were directly related to the duration of dementia, patients' age, their cognitive decline, and related decline in activities of living, as well as their caregivers' distress. In comparison to Alzheimer's disease patients, those with other dementia types had more impairment in cognitive functions and activities of daily living and they had a higher number and severity of BPSD. Conclusion: The advancing age, increased duration of dementia, and decline in cognition and related activities of daily living of the patients, as well as their caregivers' distress, are important correlates of BPSD. The findings are essential for the better management of dementia patients.

Study of Auditory Brainstem Evoked Response at Varying Frequencies in Subclinical Hypothyroid Subjects.

Background: Hearing deterioration in hypothyroid subject was documented by Kemp. Cristiane et al. reported delayed waves latency in subclinical hypothyroid subjects. Recording of auditory brain stem evoked response in subclinical hypothyroid subjects at 80 dB and varying frequencies has been done. Materials and Methods: Case control study. Group 1, N = 30 control subjects, free T3, free T4, thyroid stimulating hormone (TSH) within normal range. Group 2, N = 30 subclinical hypothyroid subjects, TSH was between 4.6-8 microIU/L. Student Unpaired t test was done. Those on epileptic, neuroleptics, depression, psychosis drugs, inflammatory, proliferative, traumatic ear disorder, smokers, on tobacco, COVID-19 positive subjects, altered sensorium, drug abuse, diabetes mellitus, neuropathy, hypertension, cardiac arrhythmia, family history of hearing disorder, and furosemide drug were excluded. Auditory brainstem evoked response (ABER) done. Results: Mean ± SD of Brainstem evoked response auditory (BERA) waves III, V, interpeak latencies at 80 dB, 2, 4,6 KHz reported delay and significant in subclinical hypothyroid group as compared to control. Conclusion: BERA study at 6 KHz and 80 dB detects central neuropathy earlier in subclinical hypothyroid patients.

A study of stressors, family environment, coping patterns, and family burden in persons with dissociative disorder.

Background: Dissociative disorder is a stress-related disorder usually present in adolescents and younger age groups. It is also accompanied by significant impairment in activity of daily living and family relations. Family environment and use of dysfunctional coping strategies play important roles in the initiation and maintenance of symptoms and this puts a considerable burden on the family. Objectives: This study aims to study the presence of stressors, the role of family environment, the role of family burden, and the use of coping mechanisms in persons with dissociative disorder. Materials and Method: This was a descriptive cross-sectional study in which 100 persons with a dissociative disorder were included after fulfilling inclusion and exclusion criteria from the outpatient department (OPD) of psychiatry. Results: In this study, the major part of the sample were women (87%), most were educated up to 12th standard or less than 12 years of formal education. According to stressors, 44% had family stress/problems. 77% (mostly women) had dissociative stupor. The dissociative disorder caused a considerable degree of burden on the other family members. There was a significant difference in financial burden among caregivers of persons who were married, belonging to rural areas, joint families, and from lower socio-economic classes. There was a significant difference in disruption of routine family activities, and burden in persons having a longer duration of illness. There was a significant difference found in conflict, achievement orientation, and dimensions of family environment between males and females. A significant difference in the venting of emotions, behavioral disengagement, and restraint as a coping strategy between males and females was found. Conclusion: Present study showed dissociative disorder patients cause a considerable degree of burden on family members in terms of leisure, physical, mental, financial, and routine family interrelationship domains. In personal growth and relationship dimensions, the use of dysfunctional coping strategies in the family environment has a causal effect on the symptoms of dissociative disorder patients.