scholarly journals Psychiatric Diagnosis Among Patients With Self-Harm Attempts In A Tertiary Care Centre

2021 ◽  
Vol 10 (1) ◽  
pp. 57-61
Author(s):  
M. Acharya

Introduction: Self harm or suicidal attempt is one of the most common primary psychiatric emergencies. It has been increasing daily but unfortunately people seeking attention and help from psychiatrist is still lagging. This study aims to observe psychiatric comorbidities among self-harm or suicidal attempt. Material And Method: Those patients who presented with suicidal attempts and related problems in Nobel Medical College Teaching hospital, Biratnagar were assessed for socio demographic and clinical variables. Convenience sampling method was used. MINI 6.0 was applied to all the patients to see for psychiatric disorders. Those who had positive psychiatric disorders in MINI 6.0 were then reassessed according to ICD-10 (International classification of diseases, clinical description and diagnostic guidelines) and final psychiatric disorder was considered. Becks’ suicide intent scale was used to assess the intensity of suicide. Data entry was done using Microsoft Excel and statistical analysis was done by using IBM SPSS Version 16.0. Results: The result showed that 56.17% of the participants had some form of psychiatric comorbidities. The commonest among them was depression (23.97%), adjustment disorder (21.9%), followed by alcohol use disorder (5.47%) and others. The most common method of suicidal attempt was by poisoning (86.3%), followed by hanging (7.5%) and self- inflicted cut injury (6.2%). Psychosocial stressors were present in 84.9% of patients and 15.1% did not have notable psychosocial stressors. Conclusion: Patients with self-harm or suicidal attempt have common psychiatric comorbidities depression and adjustment disorder being the most prevalent entities. Hence, every suicidal attempt becomes common psychiatric emergency condition in Nepal.

2014 ◽  
Vol 52 (193) ◽  
pp. 697-701 ◽  
Author(s):  
Subash Ghimire ◽  
Sagar Devota ◽  
Rasmita Budhathoki ◽  
Nidesh Sapkota ◽  
Akhilesh Thakur

Introduction: Deliberate self-harm is one of the common psychiatric emergencies in medical practice. It has become a global health problem with rates increasing over time. This hospital based study may help in understanding the cause, methods and psychiatric comorbidities present in such patients. The aim of this study was to (i) study the relationship between major socio-demographic variables and deliberate self-harm (ii) evaluate methods and precipitating cause (iii) determine the nature and prevalence of psychiatric and personality disorders in deliberate-self harm patients.Methods: This retrospective observational study was performed on 200 cases of deliberate self-harm in a tertiary referral centre in Eastern Nepal by the data collected from the medical records of these patients. Various sociodemographic data and psychiatric comorbidities prevalent in them were analysed.Results: Majority of the suicide attempters (77%) were less than 35 years of age. The female-to-male ratio was 1.35:1. 76% of the patients had received formal education. Majority (73.5%) were married. By occupation, 38% were housewives and 25.5% were students. 72.5% of cases had consumed organophosphates/-chlorides. Interpersonal conflict (72%) was the major cause of DSH. ICD-10 psychiatric disorders were diagnosed in 37% of cases and premorbid personality problems were present in 20% of cases. The most common diagnosis was adjustment disorder (13.5%) followed by mood disorder (11%).Conclusions: Majority of DSH cases were of younger generation. Psychiatric disorders and comorbid personality problems are common in DSH patients. This has important implications for proper assessment and management.Keywords: Deliberate self-harm; Organophosphorous; Para suicide; Psychiatric co-morbidities.


Author(s):  
Sudip Parajuli ◽  
Jyoti Vidhan ◽  
Dinesh Binod Pokhrel ◽  
Upama Paudel

Introduction: Rituximab is effective and safe treatment of immunobullous disorders. There are variations in doses of drugs used in different studies and uncertainties on when to use it along with use of adjuvant therapies. Efficacy and safety of this drug has not been described in Nepalese population till date. Dermatologists have hesitation in starting this drug in immunobullous diseases because of lack of data on efficacy and safety. Aim: To assess the efficacy and side effects of Rituximab therapy in treating immunobullous disorders in Nepalese patients. Materials and Methods: This was a retrospective study of patients with immunobullous diseases treated with Rituximab in Dermatological ward of Tribhuvan University Teaching Hospital, Kathmandu, Nepal from May 2018 to August 2019. Data were analysed for duration of disease and treatment received before Rituximab therapy, duration of steroid used before Rituximab, adverse effects due to prolonged steroid use, time to remission from 1st Rituximab pulse, duration of remission, relapse, duration of steroid and adjuvant drug used post 1st pulse and adverse effects associated with Rituximab. SPSS version 20 was used for data entry and descriptive statistics was used for analysis of the data. Results: Nine patients (Pemphigus Vulgaris-8 (PV-8), Bullous Pemphigoid-1 (BP-1) were treated with Rituximab. Seven were treated for refractory disease not controlled by conventional therapy and two received Rituximab as first-line therapy. The patients were under follow-up for 15-60 weeks (mean 31.89±15.62 weeks). Out of these nine patients, eight were free of lesions in one to eight weeks (mean 5.125±2 weeks) of first pulse. One patient with Oral Pemphigus had persistence of old lesions, however there were no new cutaneous lesions after first pulse. Adverse effects were seen in four patients that included infusion reaction in one and infection in three. There was relapse in one patient at last follow-up. Conclusion: Rituximab is efficacious and is safe in treating immunobullous disorders in Nepalese Population.


2020 ◽  
Vol 8 (1) ◽  
pp. 50-55
Author(s):  
Sanjay Chaudhary

Background and Objectives: Gallstone disease (GSD) is a chronic disease that consumes a lot of economic and medical resources. It not only affects patients’ life quality, but also is associated with the potential risks of the development of consequences of gallstone diseases. Therefore, the study is aimed to investigate the epidemiology and risk factors of gall stone diseases among patients attending tertiary care centre in Nepal. Material and Methods: A cross sectional study was conducted among patients attending surgical department of Janaki Medical College Teaching Hospital (JMCTH) over a period of one year from January 2019 to December 2019. Chi-square test was applied to show the association between the two groups. P-value < 0.05 was considered statistically significant. Results: In a total of 148 patients, 69.59% had mixed gallstone, 17.57% had cholesterol stone and 12.84% had pigment gallstone. Types of gallstone was found significant for age group (p=0.006), gender (p=0.027) and presence of diabetes (p=0.003) but insignificant with presence of hypertension (p=0.992). Conclusion: Age of the patients, gender and presence of diabetes were found significant for the all types of gall stone. Further large scale research need to be conducted.


2018 ◽  
Vol 6 (2) ◽  
pp. 42-44
Author(s):  
B Sharma ◽  
A Devkota ◽  
SC Pant

Introduction: Study on prevalence of psychiatric disorders in Palpa and nearby districts which lie in western Nepal, is not much studied till date. We therefore conducted this study aiming to see the pattern of psychiatric illness in an Outpatient Department of Lumbini Medical College which is a tertiary care centre located in Palpa district.Material And Method: : This is a retrospective study where outpatient record of all new cases attending the Psychiatry OPD from 29th Oct 2014 to 29th Dec 2014 were studied and statistical analysis were done. The number of new patients were 107.Results: Out of 107 patients, 60.74 % (65)) were females and 39.26 %( 42) were males. Patients of age group 31-40yrs showed the largest proportion (27.49%) followed by age group 41-50yrs (24.29%). Majority cases were illiterate (69.15%) followed by primary level of education (14.95%). The occupation of most of the cases were household work (35.51%) followed by farming (31.77%). Anxiety disorder (27.10%) was the most frequent diagnosis ahead of “Others” (18.69%) followed by depressive disorder (15.88%).Conclusion: Most of the new patients attending the psychiatry OPD of Lumbini Medical College were females, of 31-40 age group and most of the patients suffered from anxiety disorders. J Psychiatrists’ Association of Nepal Vol. 6, No. 2, 2017, Page: 42-44


2016 ◽  
Vol 3 (4) ◽  
Author(s):  
Dr Vaddadi. Venkata kiran ◽  
Dr. Neeli Uma Jyothi ◽  
Mounica. Bollu

Suicide attempt is a deliberate act of self harm with at least some intent of die that does not result in death. Such act has a wide range of medical seriousness. Individuals with psychiatric disorders are far more likely to commit suicide than the others. People who are psychologically disabled are often commit suicide from years of pain, frustration and depression. Spiritually they may perceive themselves as hopelessly damaged and lose all sense of purpose and meaning of life. Suicide is not a diagnosis or a disorder. it is a behaviour. Suicide is a worldwide, national, local and familial problem. 90% of people who kill themselves suffer from a diagnosable and preventable problem such as depression co-occurring mental and substance use disorders are common and potent combination among those who die by suicide.


Author(s):  
Dharmendra K. Sharma ◽  
Prathvi R. Meena ◽  
Rakesh K. Punia ◽  
Deepali Pathak

Background: The trends of deaths due to unnatural incidents are on the rise each year throughout the world, including India. Incremental trends have been observed in all mortalities throughout the country. Although all these mortalities seem preventable, yet not much has been achieved over the years. Intentional mortalities are yet more preventable as compared to non intentional ones. The trends of unnatural deaths were observed at a tertiary care centre of the capital city of Rajasthan to determine the comparative magnitude of such fatalities to predict possible reasons for them.Methods: An observational study was carried out for a one year period (2013-14) at the Department of Forensic Medicine of an apex institution of the capital metropolitan city to determine the comparative trends of accidental to suicidal and homicidal deaths amongst the medico-legal autopsies carried out over the study period. The results were analysed to look into the probable reasons for these preventable deaths.Results: Accidental fatalities contributed maximally followed by suicides and homicides. All types of unnatural deaths were more commonly observed in young adult male population. Road accidents were the major offenders followed by thermal injuries and falls. Intentional fatalities due to self harm or other human beings shared a considerable burden among unexpected mortalities over the study region.Conclusions: Majority of the reported fatalities were preventable deaths occurring amongst the active and productive population and hence, it is of utmost importance to analyse such deaths to suggest remedial measures bring down the toll of such causalities.


2021 ◽  
Vol 59 (238) ◽  
Author(s):  
Neelam Joshi ◽  
Asim Shrestha ◽  
Deepika Karki ◽  
Pradip Man Singh

Introduction: Adolescence is the time when most mental illness begins most of the time these problems are overlooked leading to increased morbidity and mortality. The study is undertaken to find out the prevalence of psychiatric disorders in adolescents attending psychiatry outpatient department in a tertiary hospital. Methods: A descriptive cross-sectional study was done from 1st December 2019 to 29th November 2020 at a tertiary care centre of Kathmandu. Ethical approval (Ref No.: 012-076/077) was taken from the Institution Review Committee. A semi-structured proforma was used for the socio-demographic profile of patients and International Classification of Diseases-10 was used to make the diagnosis. Data were analyzed using Statistical Package for the Social Sciences version 16. Results: A total of 174 adolescents were included in the study. Out of the total cases 141 (81.03%) (75.1-86.8 at 95% Confidence Interval) were diagnosed with psychiatric disorders, among them 73 (51.77%) were males and 68 (48.23%) were females. The common diagnoses were anxiety disorders 63 (36.20%), mood disorders 34 (19.54%), psychotic disorders 26 (14.94%), substance use disorders 8 (4.59%), non-organic sleep disorders 5 (2.87%), behavioral and emotional disorders 3 (1.72%) and mental retardation 2 (1.149%). Conclusions: Prevalence of psychiatric illnesses is high in the adolescent population compared to the similar studies.


BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S288-S288
Author(s):  
Saumya Madhri Senanayake ◽  
Iresha Perera ◽  
Janith Galhenage ◽  
Raveen Hanwella

AimsOur objective was to study the psychological morbidity and associated risk factors among antenatal and postnatal patients referred for the psychiatric assessment at University Psychiatry Unit of National Hospital of Sri Lanka.MethodAll the Clinic records of perinatal referrals from 1st January 2019 to 31st December 2019 were assessed. Sociodemographic details, delivery details, health of the newborn, past and present psychiatry illness related details were obtained using a questionnaire. Data were analysed using SPSS.ResultTotal of 161 perinatal referrals were studied. Mean age of the mothers were 28.7 years (SD = 6.60). About 18 (11.8%) were not legally married, partner passed away or estranged. Above Ordinary level education was having 34.5% of participants. Majority were postnatal mothers (61.5%). Some mothers (32.3%) have reported the pregnancy was unexpected whilst 20(32.3%) and 49(30.8%) have experienced delivery complications and neonatal illnesses respectively. Past mental illnesses were found among 31(20.7%) of mothers. Out of whole perinatal referrals maternity blues (28.9%) was the commonest current psychiatry diagnosis. Among antenatal mothers, adjustment disorder (28.8%) and depressive disorder (17.3%) were the commonest. Schizophrenia, Schizophreniform disorder and bipolar illness were found among 8(5%), 6(3.7%) and 3(1.9%) mothers respectively. Major psychoactive substance use disorder was found among 4 (2.5%) mothers. Presence of pregnancy related complications were significantly associated with postpartum metal illnesses(p = 0.008).ConclusionCommonest perinatal mental illness was the maternity blues. Depressive disorder was the commonest major mental illness and neonatal complications were associated with psychological morbidity in postnatal mothers.


Author(s):  
Neha Singhal ◽  
Alka S. Gupta ◽  
Madhva Prasad

Background: Autoimmune disorders have a significant impact over the health of an individual. This heterogenous group of disorders affects pregnancy in a multitude of ways. Pregnancies with autoimmune disorders are usually cared for by a multidisciplinary team of doctors.Methods: Pregnancies with autoimmune disorders were studied over a one-year period in one unit of a medical college teaching hospital set up. Obstetric and neonatal outcomes were studied.Results: Ten patients were studied. Average age was 29.9 years. Majority presented in early second trimester. Eight patients were ANA positive. Two patients had antiphospholipid antibody syndrome, for whom low molecular weight heparin was helpful. Hypothyroidism was seen in two patients. Bad obstetric history was seen in most patients. Successful neonatal outcome was seen in six patients. One patient had Evans syndrome. There were no maternal mortalities. There was one perinatal mortality.Conclusions: Autoimmune disorders in pregnancy when managed in a tertiary care centre with multidisciplinary approach can result in good obstetric and neonatal outcomes.


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