Retinal Nerve Fiber Layer Thickness in Patients with Schizophrenia and Its Relation with Cognitive Impairment.

Background: Schizophrenia is a chronic severe mental illness with heterogeneous clinical presentation, course, and outcome. Cognitive impairment is one of its core features. Retinal nerve fiber layer (RNFL) imaging using OCT (optical coherence tomography) could provide easy access for in vivo imaging of the retina, rendering it as a "window to the brain." Studies done on schizophrenia have shown RNFL thinning. This study attempts to look into the association between cognitive impairment, disease duration, and RNFL abnormality in patients with schizophrenia using OCT. Methods: Patients diagnosed with schizophrenia meeting DSM 5 (Diagnostic and Statistical Manual of Mental Disorders) criteria and who were confirmed to be in remission for at least six months clinically and scoring less than three on PANSS-8 (positive and negative symptom scale-8) remission scale were included. They were administered the Montreal Cognitive Assessment Scale (MoCA) for cognitive assessment. RNFL measures were taken using spectral domain-OCT. Variables were compared using Pearson's correlation test, one-way ANOVA test, and independent t-test as appropriate. Results: A total of 36 patients were studied. MoCA scores and RNFL thickness showed a positive correlation. Patients with schizophrenia had reduced average RNFL thickness and reduced RNFL thickness in superior, inferior, and temporal quadrants. Average RNFL thickness, Superior and inferior quadrant RNFL thickness showed a positive correlation with MoCA scores. No correlation was obtained between macular volume, macular thickness, duration of illness, and MoCA scores. Conclusion: Patients with schizophrenia have reduced average RNFL thickness. Patients with low MoCA scores have RNFL thinning.

Domestic violence and psychological problems in married women during COVID-19 pandemic and lockdown: A community-based survey.

BACKGROUND: Following the declaration of Coronavirus disease-2019 as a pandemic, a nation-wide lockdown was announced in India. This led to increase in psychological problems, especially in women. OBJECTIVES: To assess the prevalence of psychological problems and domestic violence (DV) in married women during the pandemic and lockdown in a panchayat in Southern India and to study the association of socio-demographic and clinical variables with psychological problems. MATERIALS AND METHODS: A cross-sectional study was undertaken in 209 married women of 18-55 years residing in a village panchayat of northern Kerala, India. Socio-demographic variables and clinical variables, like depressive symptoms, anxiety symptoms, perceived stress and DV, among others, were evaluated. The participants were interviewed by trained community health workers in the post-lockdown period. RESULTS: The prevalence of depressive symptoms was found to be 10.0 %, anxiety symptoms 7.2 % and perceived stress 66.0 %. Severe DV was reported by 6.2 %; but at least one form of DV was experienced by 25.8 % of the women. Significant positive correlation was observed for DV with depression and anxiety. DV was also found to be a significant predictor of depression (adjusted OR [aOR] = 4.26, P = 0.006) and anxiety (aOR=4.34, P=0.02). Being a homemaker (aOR=4.51, P = 0.03) and having past history of mental illness (aOR=5.39, P = 0.03) were also found to increase the risk for depression significantly. CONCLUSION: There is a high prevalence of psychological problems in married women during the pandemic and lockdown. DV was found to be a significant predictor of depression and anxiety in this population.

Validation of a Screening Tool for Learning Disorder in Children.

BACKGROUND: Learning disorder (LD) is a common cause for poor academic performance among school students. Poor detection of this may be due to lack of proper validated diagnostic and screening tools, leading to considerable difficulty for affected children and their families. This study aims to validate a screening tool developed by us among students with poor scholastic performance. It is an easy-to-use tool that can be used by parents or teachers. Preliminary validation was done earlier using case-control design among 100 students, and the results were encouraging. MATERIALS AND METHODS: A tool with 26 items was applied in 365 schoolchildren with poor scholastic performance in Calicut district. Receiver operating characteristic curve analysis was done to find area under curve (AUC) and to obtain the sensitivity and specificity at the predefined cutoff score ≥10. RESULTS: ROC analysis showed AUC of 0.93 for differentiating LD cases against the normal children. The optimum cutoff was taken as score ≥10 which has a sensitivity and specificity of 84.7% and 100%, respectively. CONCLUSIONS: The new tool showed promising validity.