Self-stigma in patients with major depressive disorder: An exploratory study from India

2020 ◽  
pp. 002076402097581
Author(s):  
Bichitra Nanda Patra ◽  
Vaibhav Patil ◽  
Yatan Pal Singh Balhara ◽  
Sudhir K Khandelwal
Keyword(s):  
Mental Health ◽  
Depressive Disorder ◽  
Depressive Disorders ◽  
Rating Scale ◽  
Mental Health Problems ◽  
Small Sample Size ◽  
Tertiary Care ◽  
Small Sample ◽  
Care Hospital ◽  
Unfair Treatment

Background: One of the barriers to effective care in patients with depression is stigma associated with having a mental disorder, which also acts as a barrier to recovery and increases the disability. Aims: To study the stigma and disabilities experienced by the patients with depressive disorders seeking treatment in a tertiary care hospital Methodology: Fifty patients diagnosed to have depressive disorder as per ICD-10 were recruited by convenient sampling. To measure the stigma, the Discrimination and Stigma Scale -12 was applied. The severity of depression was determined by applying Hamilton Depression Rating Scale (HAMD). The disability was calculated by using WHO Disability Assessment Schedule 2.0 Results: Fifty percentages of the participants reported unfair treatment and they experienced discrimination in at least one life domain. There was significant positive correlation between unfair treatment subscale of stigma and disability. Around one fourth of the participants reported to be treated unfairly by their own families. Seventy percent reported to have concealed their mental health problems, 54% have stopped themselves from having a close personal relationship and 32% didn’t apply for work in anticipating discrimination. Experienced and anticipated discrimination were significantly associated with concealing the mental health problem. Conclusion: Stigma due to having depression acts as a barrier to vocational & social integration and functional recovery. Concealment of the diagnosis of depression is itself barrier for help seeking and to receiving appropriate treatment. Small sample size and adopting the purposive sampling method are the limitations of the study.

scholarly journals Predictors of Suicidal Ideation and Attempt among Patients with Major Depressive Disorder at a Tertiary Care Hospital, Puducherry

2021 ◽  
Vol 12 (01) ◽  
pp. 122-128
Author(s):  
Ralte Lalthankimi ◽  
Padmavathi Nagarajan ◽  
Vikas Menon ◽  
Jeby Jose Olickal
Keyword(s):  
Major Depressive Disorder ◽  
Suicidal Ideation ◽  
Depressive Disorder ◽  
Rating Scale ◽  
Tertiary Care ◽  
Severe Depression ◽  
Care Hospital ◽  
Suicidal Behaviors ◽  
Major Depressive ◽  
Severity Of Depression

Abstract Objectives Mental disorders have a large impact on death by suicide. Hence, this study aims to determine the prevalence of suicidal behaviors among major depressive disorder (MDD) patients and the associated factors. Materials and Methods This cross-sectional analytical study was conducted among individuals aged 18 to 65 years, diagnosed with MDD in the Psychiatry Outpatient Department of a Tertiary Care Center, Puducherry during March to October 2019. Severity of depression was assessed using Hamilton Depression Rating Scale and Columbia-Suicide Severity Rating Scale was used to find the suicidal behaviors. Results For 166 participants in the study, mean (standard deviation) age was 40 (11) years and majority were females (76%). More than one-third (37%) had severe or very severe depression, and the prevalence of suicidal ideation, plan, and attempts were 83, 24, and 35%, respectively. After adjusting the covariates, the severity of depression and unemployment were significantly associated with suicidal attempts (adjusted prevalence ratios [aPR] = 11.4 and 1.9), and very severe depression was associated with suicidal ideation (aPR = 1.6). Among 140 individuals with suicidal ideation, 45 (32%) had an ideation frequency of 2 to 3 times/week, 69 (50%) had ideation for 1 hour, 36 (26%) could control ideation with little difficulty, and 12% had suicidal ideation mostly to end or stop their pain. Conclusion Suicidal ideation and attempts were significantly high in MDD patients, and the severity of depression was significantly associated with it. Early identification of high-risk suicidal behavior and implementation of effective preventive interventions are necessary to reduce death by suicide in these groups.

Depressive disorder among the breast cancer patients in outpatient department of a tertiary care hospital in Pakistan

2011 ◽  
Vol 26 (S2) ◽  
pp. 677-677 ◽  
Author(s):  
R.U. Rahman ◽  
A. Nisar ◽  
N. Hussain ◽  
I. Chaudhary
Keyword(s):  
Breast Cancer ◽  
Depressive Disorder ◽  
Rating Scale ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Psychiatric Morbidity ◽  
Depression Scale ◽  
Outpatient Department ◽  
Care Hospital ◽  
Had Scale

ObjectivesTo determine the frequency of Depressive Disorder among patients with breast cancer in an outpatient department of a tertiary care hospital in Pakistan.BackgroundCancer not only affects body physically but can also affect the mind in the form of psychiatric disorder. Proper identification and treatment of these conditions can be beneficial and cost-effective.MethodologyThis cross-sectional descriptive study was conducted on patients of breast cancer attending OPD of oncology department of Civil Hospital Karachi. The sample consisted of ninety three diagnosed patients of breast cancer who were screened for psychiatric morbidity through Hospital Anxiety and Depression Scale (HAD Scale). Screened patients were interviewed and diagnosed as depressive disorder according to ICD criteria. The level of depression in these diagnosed patients was quantified through ZUNG'S Depression Rating Scale.ResultsEighty two percent (n = 76) of the sample (n = 93) were found to have psychiatric morbidity on HAD scale. Out of these screened sample sixty percent (n = 46) were found to be depressed on Zung self rating depression scale. Majority of these patients were suffering from mild to moderate depression. Half of the female in this sample were undergone mastectomy that was not found to have any statistically significant impact on psychiatric morbidity of the patient.ConclusionThis study shows high prevalence of depression in patients with breast cancer. The health professional involve in care of breast cancer should screen routinely their patients for symptoms of depression.

scholarly journals An epidemiological study to assess the mental health status of pregnant women in a tertiary care hospital, Srinagar, Jammu and Kashmir, India

2017 ◽  
Vol 6 (6) ◽  
pp. 2580
Author(s):  
Bilal Ur Rehman ◽  
Javid Ahmad ◽  
Rauf Ur Rashid Kaul ◽  
Mohammad Kaleem ul Haque
Keyword(s):  
Mental Health ◽  
Developing Countries ◽  
Health Status ◽  
Depressive Disorder ◽  
Pregnant Women ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Antenatal Clinic ◽  
Mental Health Status ◽  
Care Hospital

Background: Pregnancy is a major psychological, as well as physiological event; women may find themselves unable to cope with additional demands of pregnancy. Mental illness during pregnancy-whether anxiety, depression or more severe psychiatric disorders-can have a significant negative impact on a mother and her baby. Poor psychological health has been associated with low birth weight, premature birth, perinatal and infant death, postnatal depression, as well as long term behavioural and psychological impacts on the child. Depressive disorders are a common source of disability among women. Mental health problems during pregnancy and postpartum periods are one of the alarming health issue among women. Community-based epidemiological data on antenatal depression from developing countries is scarce. This study was conducted to assess the mental health status of pregnant women attending antenatal clinic of tertiary care hospital, SKIMS, Srinagar (J and K).Methods: A cross sectional study was conducted over a period of six months from 1stSeptember 2016 to 28th February 2017 among randomly selected pregnant women attending antenatal clinic of tertiary care hospital, SKIMS, Srinagar. A total of 200 pregnant women formed the study subjects. Data was collected by interviewing the pregnant women using pre-designed, pre-tested, semi-structured questionnaire. Data was analysed using Statistical Programme for the social science (SPSS) version 19.0.Results: Amongst the study population, prevalence of depressive disorder was 26%. The depression was significantly increasing with advancing pregnancy and advancing age. Socio-economic status and depression was associated statistically significant (p=0.024). Women with bad relationship with in laws had significantly more depression compared to those who had good relationship with in laws (P=0.0037). The association between parity and depressive disorder was statistically insignificant(P=0,7144).Conclusions: When we care for mother we care for two live and live without psychological consideration is completely materialistic. A depressive symptom occurs commonly during 2nd and 3rd trimester of pregnancy, drawing attention to a need to screen for depression during antenatal care. Maternal health policies, a priority in developing countries, must integrate maternal depression as a disorder of public health importance. Intervention should target women in the early antenatal period.

scholarly journals Radiological Analysis of Frontal Cells and its Association with Frontal Sinus Mucosal Disease: A Tertiary Care Hospital Based Study

2019 ◽  
Vol 27 (1) ◽  
pp. 1-7
Author(s):  
Bikash Lal Shrestha ◽  
Sameer Karmacharya
Keyword(s):  
Frontal Sinus ◽  
Small Sample Size ◽  
Statistical Significance ◽  
Tertiary Care ◽  
Small Sample ◽  
Care Hospital ◽  
Prospective Longitudinal Study ◽  
Mucosal Disease ◽  
Complex Anatomy ◽  
Prospective Longitudinal

Introduction The frontal sinus and frontal recess both have complex anatomy causing difficulty during endoscopic sinus surgeries. The term frontal cells is currently used to describe a group of anterior ethmoidal cells classified by Kuhn et al into 4 types. Though there are precise descriptions, the frequency of frontal sinus cells (FSCs) varies widely in the literature. The presence of FSCs is responsible for a narrowing of the frontal sinus outflow tract which subsequently causes a partial obstruction of drainage and aeration of the frontal sinus. Our main aim is to the see the distribution of different frontal cells in Nepali population and relation with frontal sinus mucosal disease.   Materials and Methods This prospective, longitudinal study performed in 110 consecutive patients who underwent CT scan of nose and paranasal sinuses. The frontal cells and agger nasi cells were identified and association between the frontal cells and agger nasi cells with frontal sinus mucosal disease was analyzed with chi square test.   Results The agger nasi was present in 83.63% CT scans whereas frontal cells were distributed in 61.82% CT (computed tomogram) scans. There was not statistical significance and any association between the frontal cells and agger nasi cells with frontal sinus mucosal disease.   Conclusion The frontal cells and agger nasi cells distribution in Nepalese population, even though in small sample size, is similar with other studies in the literature. There is also non association of either frontal cells or agger nasi cells with frontal sinus mucosal disease.

scholarly journals The effectiveness of interventions for reducing subjective and objective social isolation among people with mental health problems: a systematic review

2019 ◽  
Vol 55 (7) ◽  
pp. 839-876 ◽  
Author(s):  
Ruimin Ma ◽  
Farhana Mann ◽  
Jingyi Wang ◽  
Brynmor Lloyd-Evans ◽  
James Terhune ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Social Isolation ◽  
Mental Health Problems ◽  
Small Sample Size ◽  
Intervention Development ◽  
Health Problems ◽  
Small Sample ◽  
Current Evidence ◽  
Physical And Mental Health

Abstract Purpose Subjective and objective social isolation are important factors contributing to both physical and mental health problems, including premature mortality and depression. This systematic review evaluated the current evidence for the effectiveness of interventions to improve subjective and/or objective social isolation for people with mental health problems. Primary outcomes of interest included loneliness, perceived social support, and objective social isolation. Methods Three databases were searched for relevant randomised controlled trials (RCTs). Studies were included if they evaluated interventions for people with mental health problems and had objective and/or subjective social isolation (including loneliness) as their primary outcome, or as one of a number of outcomes with none identified as primary. Results In total, 30 RCTs met the review’s inclusion criteria: 15 included subjective social isolation as an outcome and 11 included objective social isolation. The remaining four evaluated both outcomes. There was considerable variability between trials in types of intervention and participants’ characteristics. Significant results were reported in a minority of trials, but methodological limitations, such as small sample size, restricted conclusions from many studies. Conclusion The evidence is not yet strong enough to make specific recommendations for practice. Preliminary evidence suggests that promising interventions may include cognitive modification for subjective social isolation, and interventions with mixed strategies and supported socialisation for objective social isolation. We highlight the need for more thorough, theory-driven intervention development and for well-designed and adequately powered RCTs.

A long wait: barriers to discharge for long length of stay patients

2018 ◽  
Vol 94 (1116) ◽  
pp. 546-550 ◽  
Author(s):  
Emma Jane Zhao ◽  
Apurva Yeluru ◽  
Lakshman Manjunath ◽  
Lei Ray Zhong ◽  
Hsiao-Tieh Hsu ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Chart Review ◽  
Small Sample Size ◽  
Tertiary Care ◽  
Small Sample ◽  
Care Hospital ◽  
Healthcare Staff ◽  
Care Capacity ◽  
Improve Cost

IntroductionReducing long length of stay (LLOS, or inpatient stays lasting over 30 days) is an important way for hospitals to improve cost efficiency, bed availability and health outcomes. Discharge delays can cost hundreds to thousands of dollars per patient, and LLOS represents a burden on bed availability for other potential patients. However, most research studies investigating discharge barriers are not LLOS-specific. Of those that do, nearly all are limited by further patient subpopulation focus or small sample size. To our knowledge, our study is the first to describe LLOS discharge barriers in an entire Department of Medicine.MethodsWe conducted a chart review of 172 LLOS patients in the Department of Medicine at an academic tertiary care hospital and quantified the most frequent causes of delay as well as factors causing the greatest amount of delay time. We also interviewed healthcare staff for their perceptions on barriers to discharge.ResultsDischarge site coordination was the most frequent cause of delay, affecting 56% of patients and accounting for 80% of total non-medical postponement days. Goals of care issues and establishment of follow-up care were the next most frequent contributors to delay.ConclusionTogether with perspectives from interviewed staff, these results highlight multiple different areas of opportunity for reducing LLOS and maximising the care capacity of inpatient hospitals.

scholarly journals Emotional & Behavioural Problems among Siblings of Children with Chronic Neuromuscular Illnesses

2020 ◽  
pp. 29-37
Author(s):  
Nidhi Garg ◽  
Krishna Moorthi Adhikari
Keyword(s):  
Behavioral Problems ◽  
Assessment Tool ◽  
Small Sample Size ◽  
Tertiary Care ◽  
Small Sample ◽  
Emotional And Behavioral Problems ◽  
Behavioural Problems ◽  
P Value ◽  
Care Hospital ◽  
Significant Difference

Introduction and Objective: To determine the prevalence of emotional and behavioral problems among siblings of children with chronic neuromuscular illnesses by using validated parent completed assessment tool. Method: It is a cross-sectional study conducted in a tertiary care hospital from over a period of 34 months. Siblings of children with chronic neuromuscular illnesses were serially recruited while attending pediatric OPD and IPD. Parents were interviewed and requested to fill the Strength and Difficulty Questionnaire (SDQ) to assess and analyze emotional and behavioral problems among siblings. Results: Study included 171 siblings of children with chronic neuromuscular illnesses. Of 171 siblings, 124 (72.51%) had normal scores, 25 siblings (14.62%) were in borderline range and remaining 22 (12.87%) had abnormal values. The mean ± SD of SDQ score was 12.41 ± 3.6 with median score of 11. There was no significant difference between total SDQ scores of male vs female siblings (p value= 0.229) or between birth order of the sibling or GMFCS class of the affected child to emotional and behavioural problems. Subgroup analysis was not possible because of small sample size.

scholarly journals Suicide: can we identify and manage those at risk more effectively?

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S345-S346
Author(s):  
Emily Roberts ◽  
Anne-Marie Grew ◽  
T Everett Julyan
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Mental Health Problems ◽  
Small Sample Size ◽  
Primary Diagnosis ◽  
Small Sample ◽  
Public Health Issue ◽  
Service Users ◽  
Emotional Instability

AimsThis study aimed to conduct longitudinal analysis of suicide reviews for mental health service users in Ayrshire to improve local practice and outcomes. Traditional risk factors – middle-age, male and alcohol misuse – were hypothesised to convey greater risk of completing suicide.BackgroundSuicide is an important public health issue in Scotland, with potentially devastating impacts. Practice and policy may lag behind emerging evidence. Mental health problems are associated with an increased suicide risk, and care provided to those who take their own lives is reviewed to identify recommendations and learning points to improve practice and outcomes. However, these reviews and their conclusions are often considered individually, when studying them collectively over time it is necessary to characterise common themes and highlight factors that could be addressed to reduce suicide. Moreover, national averages can obscure local patterns.MethodAccess to reviews of suicides for mental health service users in Ayrshire was granted by the Adverse Event Review Group. Relevant data were extracted for the 35 General Adult service users completing suicide between 2013 and 2015, including details of the act, demographics and clinical factors, and analysed for trends. Those with and without emotional instability as a primary diagnosis or significant problem were dichotomised to facilitate identification of statistically significant factors specific to these symptoms.ResultThere were 35 completed suicides including three inpatients. Suicide was most common in the 25-29 and 45-54 age ranges, and over 68.6% were male. Hanging accounted for 60.0% of deaths, and self-poisoning for 8.6%. Up to 62.9% of patients did not appear to have ongoing scheduled appointments on a regular basis. Diagnoses were difficult to identify – 48.6% had no clear primary diagnosis specified in the reviews, and features of depressive, anxiety, psychotic, substance misuse and personality disorders frequently overlapped and co-occurred. 22.9% had problems with emotional instability; their median age was 14 years younger, and 87.5% were female.ConclusionSmall sample size precluded detailed analysis. The traditional risk profile remains relevant. However, almost 25% of those completing suicide were younger females with emotional instability, despite frequent contact with services. Given the challenges in predicting suicide, we should continue to consider how best to prevent this tragic outcome in all service users, especially in younger females with emotional instability; middle-aged males who misuse alcohol, and those with ill-defined diffuse psychological difficulties who do not fit into discrete categories or are reviewed infrequently.

Epidemiology of in-hospital cardiac arrest in a Pakistani tertiary care hospital pre- and during COVID-19 pandemic

2021 ◽  
Vol 38 (ICON-2022) ◽  
Author(s):  
Faiza Ahmed ◽  
Lubna Abbasi ◽  
Nida Ghouri ◽  
Muhammad Junaid Patel
Keyword(s):  
Gender Differences ◽  
Cardiac Arrest ◽  
Tertiary Care Hospital ◽  
Small Sample Size ◽  
Tertiary Care ◽  
Small Sample ◽  
Care Hospital ◽  
Cross Sectional ◽  
Shockable Rhythm ◽  
Hospital Cardiac Arrest

Objectives: To determine epidemiology of in-hospital cardiac arrest (IHCA) in a tertiary care hospital, pre- and during pandemic. Methods: This is a cross-sectional study of inpatients who experienced an in-hospital-cardiac arrest at a tertiary care hospital in Karachi between August 2019 and August 2020. Outcome variables were return of spontaneous circulation (ROSC) and survival to discharge (StD) and analysis was also done comparing pre- and during pandemic period. Results: A total of 77 patients experienced at least one IHCA event during the 1-year study period. Comparing pre- and during pandemic, ROSC for women was higher during the pandemic albeit not significant (43% vs 50%) in comparison to men (54% vs 10%, p<0.001). During the pandemic, women with IHCA were significantly younger than men (μ ± sd; 36.8 ± 15.3 vs 55.9 ± 12.7, p=0.001,) whereas pre-pandemic, there was no gender differences in mean age. Non-shockable rhythm was more common (92.2%) than shockable rhythm (6.5%). Pre- and during pandemic, there were significant differences in the cause of IHCA for 4H4T (87% vs 100%) and cardiac (36% vs 9%). The proportion of hypoxic patients increased from 50% during pre-pandemic to 91% during the pandemic period, whereas hypo/hyperkalemia decreased from 53% to 34%. Conclusion: Despite the limitation of a small sample size, our study has provided important information regarding the epidemiology and outcomes of IHCA pre- and during pandemic in a busy Pakistani tertiary care hospital. Our finding that gender differences exist in survival pre- and during pandemic needs to be explored further with more hospitals doing comparative studies. doi: https://doi.org/10.12669/pjms.38.ICON-2022.5776 How to cite this:Ahmed F, Abbasi L, Ghouri N, Patel MJ. Epidemiology of in-hospital cardiac arrest in a Pakistani tertiary care hospital pre- and during COVID-19 pandemic. Pak J Med Sci. 2022;38(2):387-392. doi: https://doi.org/10.12669/pjms.38.ICON-2022.5776 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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