Suchergebnisse

Background:Identifying patient perspectives about recovery may help the service providers to enhance active participation of patients in their recovery.Aim:This study aimed to explore patients' perspectives about factors affecting recovery from schizophrenia.Methods:A semi-structured interview schedule was used to explore the perceptions of 18 patients diagnosed with schizophrenia. The interviews were recorded, transcribed and analysed. Codes were identified and similar codes were grouped together and main themes were identified.Results:Nine main themes on facilitators and barriers of recovery from schizophrenia were derived.Conclusion:Deeper understanding of patients' perspectives of recovery from schizophrenia can help mental health professionals to plan appropriate recovery-oriented services.

Background: The prevalence — and type — of dissociative disorders is considered to vary across cultures and over time. Aims: The aim of the study was to examine patterns of dissociative disorders among subjects attending psychiatric services over a period of 10 years. Methods: The sample consisted of both inpatients and outpatients attending a psychiatric hospital between 1999 and 2008. Information of those subjects diagnosed to have dissociative disorders was reviewed. A semi-structured proforma was used to collect information about demographic details and diagnosis. Results: A total of 893 patients had been diagnosed with dissociative disorder over the past decade: 591 (66%) were outpatients and 302 (34%) were inpatients. The proportion of patients diagnosed with dissociative disorders ranged between 1.5 and 15.0 per 1,000 for outpatients and between 1.5 and 11.6 per 1,000 for inpatients. The majority of patients were diagnosed with dissociative motor disorder (43.3% outpatients, 37.7% inpatients), followed by dissociative convulsions (23% outpatients, 27.8% inpatients). Female preponderance was seen across all sub-types of dissociative disorder except dissociative fugue. Conclusions: Dissociative disorders are still commonly diagnosed in both inpatient and outpatient settings. Dissociative motor disorders and dissociative convulsions are the most common disorders. Unlike in the West, dissociative identity disorders were rarely diagnosed; instead, possession states were commonly seen in the Indian population, indicating cross-cultural disparity.

Background: Explanatory models (EMs) influence decision-making related to treatment and compliance. There is little knowledge about belief systems related to postpartum psychosis in different cultures. Aims: To study EMs of illness among women with postpartum psychosis and their family members in India. Method: A total of 123 women with postpartum psychosis and their caregivers were assessed to understand their beliefs regarding causes of postpartum psychosis using Short Explanatory Model Interview (SEMI). Local names were listed and emerging themes were analysed. Results: Respondents often held more than one EM and only one-third held a biomedical EM. Other common models included stressors unique to childbirth, marital stress and supernatural causes. Local names reflected the underlying models. Conclusion: Non-biomedical EMs are common in women with postpartum psychosis. Cultural and social factors unique to childbirth appear to influence these models. There is a need to enhance awareness and knowledge about this serious disorder in the community.

Background:The positive association between adverse life events and somatoform disorders is a consistent observation. But no systematic studies have evaluated the relationship between health-related life events (HLEs) in patients with somatic symptom disorder (SSD)/somatoform disorders.Aim:To examine the nature and relationship of HLE in patients with SSD and to assess the correlates of HLE.Methods:A total of 50 adult patients with SSD and 50 matched healthy controls from a Neuropsychiatric hospital were recruited. Sociodemographic interview, scale for assessment of somatic symptoms (SASS), Patient Health Questionnaire-15 (PHQ-15) and a semi-structured interview schedule to gather information on HLE were used.Results:Patients in the SSD group had a significantly higher number of total HLE in general (4.72 ± 2.63, 3.36 ± 1.92; p = .004), major HLE (1.48 ± 1.45, 0.68 ± 0.94; p = .006), during their lifetime in comparison to controls. Infections, trauma, non-communicable diseases and reproductive system–related diseases were the more common types of HLE in SSD group.Conclusion:Our findings may implicate a role of major HLE of patients and HLE of their family members in the pathophysiology of SSD.

Background: Decision-making around pregnancy is challenging for women with severe mental illness (SMI), and several clinical and socio-cultural factors might influence this process. Aim: The main objective of this study was to determine factors that influence decision-making regarding pregnancy for women with SMI. Methods: Using a qualitative design, 42 women with SMI who were pregnant or planning pregnancy were assessed using a semi-structured interview by an independent researcher not involved in their clinical care. Areas of inquiry included knowledge about their illness, treatment; family and societal beliefs on mental illness and motherhood; illness management; and attitude towards medical advice. Results: Among the 42 women, majority of the women (88%) reported reduced autonomy in decision-making related to pregnancy. Stigma was one of the major contributory factors in decision-making. Over 80% reported not using contraception despite medical advice due to lack of control over the decisions related to the use of contraception. Over 50% of the women in the study believed that taking psychotropic medications during pregnancy would definitely harm the baby. A similar number believed that their illness would not recur if medications were to be stopped during pregnancy. Conclusion: Women with SMI who plan to become pregnant, especially from low-income settings in India, are disadvantaged by stigma and societal expectations, affecting their ability to make optimum decisions during this crucial period. Decision-making around pregnancy in women with SMI is complex and appears to be influenced by several socio-cultural factors and needs to be dealt with sensitively.

Background: Recent life events may be significant risk factors for depression during pregnancy. However, its association with the individual's resilience and social support is not clear. Aims: To understand the association between life events and depression during pregnancy and whether the association is moderated by resilience and social support. Methods: This study is part of a prospective cohort study on perinatal mental health in an urban antenatal clinic, which included 589 women recruited in the first and early second trimester. Participants were administered the Life Events Checklist adapted from the Social Readjustment Rating Scale by the authors to assess life events; Edinburgh Postnatal Depression Scale (EPDS) and Connor–Davidson Resilience Scale-10 to assess depression and resilience, respectively. The relationship between life events (12 months prior to the time of assessment) and antenatal depression and the moderating role of resilience and social support was analysed. Results: Thirty-eight women (6.5%) who had depression (EPDS score ⩾ 11) had significantly higher number of life events (i.e. on average three; U = 3,826; p < .01), lower resilience scores ( U = 4,053; p < .01) and lower perceived social support ( U = 2,423; p < .01) as compared to those who were negative for depression on EPDS. Life events predicted depression during pregnancy; however, the relationship was moderated by social support but not by resilience. Conclusion: The pregnant women who experienced life events may experience depression during the first trimester of pregnancy, but the effect could possibly be reduced by enhancing the social support.