Annals of Psychaitry

The Immunological interplay in Schizophrenia: Impact of Clozapine and Risperidone treatment- A randomized study

Shivangi Mehta — 2024-09-02

Background: Recent research highlights the neuroimmunological basis of Schizophrenia with an intrigue into biomarkers for Schizophrenia.

Methods: It was a prospective, randomized, interventional study. Patients with ICD- 11 diagnosis of Schizophrenia were randomized to receive either Clozapine or Risperidone after baseline assessment [socio-demographic and clinical parameters, blood investigations ,immunoglobulins (IgM, IgA, IgG and IgE). Levels of immunoglobulin were reassessed at 6 and 12 weeks along with application of PANSS and Glasgow antipsychotic side effect check list.

Results: 30 patients in Clozapine group and 24 in Risperidone group completed the study. As compared to Risperidone group ,in the Clozapine group, IgG and IgM were higher at baseline and had a rise over 6 and 12 weeks, IgA was lower at baseline and had a significant rise from week 6 to week 12 and Ig E showed a steady decline . For Clozapine group, at baseline , the correlation analysis showed Ig A to be significant for Positive , General and total scores of PANSS while Ig G was significantly correlated with Total scores of PANSS and Ig M and Ig E with General scores on PANSS

Conclusion: The change in immunoglobulin levels from baseline in both Clozapine and Risperidone groups validate the immunological basis of Schizophrenia . There were no known immunodeficiency found in either of the groups during the study period ratifying that the immunodeficiency with Clozapine , if any , takes more than 12 weeks .

Treatment seeking among patients with mental illnesses during COVID-19: A retrospective chart review

Pankaj Mahal — 2024-09-02

Background: With the onset of the COVID-19 pandemic, we have witnessed that patients with other health conditions were either ignored or unable to avail of specific health services. Mental health issues, especially common mental illnesses (CMI), rose sharply during this period worldwide. Hence, in the current study, we assessed the impact of COVID-19 on the profile of patients availing outpatient department services for psychiatric care as compared to pre-pandemic.

Method: In this retrospective study, we collected data from electronic health records of patients availing of in-person outpatient psychiatry department consultations at a tertiary care hospital. The Institutional Ethics Committee approved the study. Data was collected from August 2020 to January 2021 during COVID-19 and compared with the pre-COVID-19 period during the same month a year before.

Results: Most patients during COVID-19 were between 18 and 60. Patients living in urban settings and nearer (<10km) to the hospital presented more to OPD. There was an increase in the proportion of patients with psychotic or mood disorders, whereas those with CMI consulted less during COVID-19. Even though the elderly age group visited less during the COVID-19 period, those with psychotic symptoms consulted more.

Conclusion: Patients with CMI avoided going to the hospital or could not access healthcare services. COVID-19 had a significant impact on mental health, and it further widened the treatment gap for CMI. Modalities to address the relevant factors are the need of the hour.

Keywords: Common Mental Illnesses; COVID-19; mental health; OPD; Treatment Gap

Study of sociodemographic profile phenomenology, psychological stressor, and life event in dissociative and conversion disorder patients.

Krishan K Sharma — 2024-09-02

sociodemographic profile phenomenology, psychological stressor, and life event in dissociative and conversion disorder patients.

Psychological Dynamics Among Bankers in Bangladesh: Exploring the Interrelationship of Self-esteem, Cognitive Distortion, and Depression

ATF Yazdany — 2024-09-07

This study aimed to explore the relationship between self-esteem, cognitive distortion, and depression among bankers in Bangladesh. A sample of 200 respondents (120 male, 80 female) participated in the study, completing questionnaires including background characteristics, the Rosenberg self-esteem scale (RSES), the Dhaka University Cognitive Distortion Scale (DUCDS), and the depression scale (DS). This study explores the associations among self-esteem, depression, and cognitive distortion and examines the influence of monthly income and gender on these variables. Correlation analysis reveals that self-esteem is negatively correlated with both depression (r = -0.220, p < 0.01) and cognitive distortion (r = -0.280, p < 0.01), while depression is positively correlated with cognitive distortion (r = 0.633, p < 0.01). Gender differences reveal higher self-esteem among males and higher levels of depression and cognitive distortion among females. Income analysis shows no significant difference in self-esteem across income levels, while higher income is associated with lower depression (p < .001) and cognitive distortion (p < .05). These findings underscore the complex interactions among psychological variables in the banking sector, suggesting the need for targeted interventions to mitigate depression and cognitive distortions among bankers in Bangladesh and potentially in similar international contexts.

Editorial

Parth Singh Meena — 2024-09-04

no abstract

Bio-psycho-social Approach to a Case of Mania-like Symptoms Associated with COVID-19 Infection

Sonali Aggarwal — 2024-09-04

Introduction: The corona virus or SARS-CoV 2 is known to also cause neuropsychiatric complications. Not only the infection itself but steroid use, fear of death and disruption of routine can act as stressors for precipitation of psychiatric illness in predisposed individuals.

Case summary: A 65 years old male presented with hyperactivity, verbal aggression and increased sexual interests. The patient encountered COVID 19 infection a few weeks back, on oral Dexamethasone treatment along with conservative management at home. With tapering of steroids within a week, family members noticed that the manic symptoms increased. Past history was negative for significant medical, psychiatric or substance use. On examination there was remarkable psychomotor agitation, loud pressured speech, irritable mood, flight of ideas, grandiose ideas and impaired attention and concentration. A clinical diagnosis of F06.8 (other specified mental disorder due to known physiological condition) was made. He was started on Tab Risperidone 2mg, leading to rapid reduction in symptoms within a week (YMRS score was reduced from 31 to 2). Psychosocial interventions focusing on activity scheduling and psycho-education were also initiated.

Discussion: This case illustrates an association between neuropsychiatric symptoms in SARS-CoV 2 patient and the complex interplay of three major domains (biological, psychological and social) in genesis of psychiatric illness.

Conclusion: Thus, we aim to establish role of COVID 19 infection as well as associated biopsychosocial changes that predispose an individual towards development of major psychiatric illnesses. Multimodal interventions keeping into account these factors are likely to result in rapid recovery.