RESUMO
BACKGROUND: Cognitive impairment is usually associated with impairment in everyday activities. Scales to assess activities of daily living, like the Everyday Abilities Scale for India (EASI), have been employed as screening tools for dementia or major neurocognitive disorder. EASI had not been validated in Malayalam. This study's objective was to validate the Malayalam version of EASI (M-EASI) in those aged ≥60 years. METHODS: In a study undertaken in a tertiary care center, those aged ≥60 years attending psychiatry, neurology, or geriatric clinic of general medicine departments were evaluated using M-EASI and the Malayalam version of Addenbrooke's Cognitive Examination (M-ACE). A total of 304 participants were recruited for this questionnaire validation. Information for M-EASI was obtained from a reliable informant. RESULTS: The mean age of the sample was 70.04 years (standard deviation-7.33). The majority of them were males (58.6%) and educated up to primary school (42.4%), while the majority of the informants were sons/daughters/siblings (47.7%) and were females (73.7%). Taking M-ACE scores as the gold standard for diagnosing MNCD according to Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition criteria, there were 162 cases of MNCD and 142 normal controls. Cronbach's α was 0.91. At an optimal cut-off of 4.5, adequate sensitivity (77.8%), and specificity (75.4%) were observed. The positive predictive value was 78.6%, and the negative predictive value, 74.5%. CONCLUSION: M-EASI has adequate psychometric properties as a screening tool for MNCD.
RESUMO
BACKGROUND: Specific learning disorder (SLD) is a neurodevelopmental disorder characterized by impairment in reading, written expression, and mathematics. The government provides several educational and social benefits to students with SLD, hence, an accurate assessment of the prevalence of SLD is important. This study is an attempt to find the prevalence of SLD and its determinants among the school-going children in Ernakulam district, Kerala, India. METHODS: School-going children from the fourth standard to the seventh standard were included in the study. Multistage stratified cluster sampling was used. The screening for SLD was done using the LD screening tool, and confirmation of the diagnosis was made using the NIMHANS index for SLD and Malin's Intelligence Scale for Indian Children (MISIC). RESULTS: The prevalence of SLD was 16.49% (95% CI =14.59-18.37). The prevalence of impairment in reading, written expression, and mathematics was 12.57%, 15.6%, and 9.93%, respectively. Binary logistic regression analysis showed that male gender, low birth weight, presence of developmental delay, family history of poor scholastic performance, and syllabus were independently associated with SLD. CONCLUSIONS: The study found a higher prevalence of SLD (16.49%) and certain modifiable determinants of SLD were identified. It highlights the need for early detection and remedial measures for children with SLD.
RESUMO
High rates of suicide attempts and domestic violence (DV) in women of reproductive age group have been reported from South India, but the association between them was not studied. Hence, this study was undertaken to assess whether DV is a risk factor for attempted suicide in married women of reproductive age group. A hospital-based case-control study with 77 incident cases of attempted suicide in married women of the age group of 18 to 45 years and 153 controls belonging to the same age group, without history of suicide attempt, was undertaken over a period of 6 months. Univariate and multivariate analyses were done. The crude odds ratio (cOR) for DV was found to be 6.15 (95% confidence interval [95% CI] = [2.95, 12.82], p value = .0001). Other statistically significant risk factors included younger age group (below 30 years); gross family income > Rs. 5,000; higher occupational status of spouse; having poor social support; having a family history of psychiatric disorders, substance use disorders, and suicide/suicide attempt; higher impulsiveness scores; having higher scores of stressful life events over the past 12 months, and alcohol use disorder in husband. Islamic faith was found to be a significant protective factor. On logistic regression, DV was found to be an independent risk factor for attempted suicide in this study population (adjusted OR = 3.79, 95% CI = [1.35, 10.62], p value = .011). Age groups, stressful life events, impulsiveness, and alcohol use disorder in husband were the confounders adjusted for in logistic regression along with other significant risk and protective factors. Significant dose-response relationship was also observed between DV and attempted suicide. In accordance with the stress-diathesis model for suicidal behavior, DV is found to be a stressor which precipitates suicide attempt in those with diathesis like family history of psychiatric disorders. Clinical, research, and policy implications of the findings are discussed.
