Adverse Drug Reaction Monitoring of Antidepressant Drugs in a Mental Health Institute in Odisha

Introduction: Antidepressants are used primarily in the management of depressive and anxiety disorders. The occurrence of adverse drug reactions (ADRs) to antidepressants is a major challenge as it influences patient compliance. Aim: The aim of this study was to find out the ADR profile of antidepressant drugs in a mental health institute in Odisha. Materials and Methods: This is a cross sectional observational study conducted in Department of Pharmacology in collaboration with Mental Health Institute (Centre of Excellence) S.C.B Medical College and Hospital, Cuttack from September 2017 to September 2019. Patients who received at least one antidepressant drug were included in the study irrespective of age and sex. Data were collected by interviewing the patients or attendants and on detection of ADR, it was recorded on suspected ADR reporting form designed by PvPI. Causality, severity and preventability of ADRs were assessed by, WHO-UMC causality assessment, modified Hartwig-Siegel Scale and modified Schumock-Thornton criteria respectively. Results: Out of 180 patients taking antidepressants, ADRs were reported in 24% of patients, with either possible or probable causality. None were labelled as certain. ADRs were observed in 50% of patients who received TCAs and among 34.5% who received polytherapy. Insomnia (27%), fatigue (17%) and agitation (13%) were most common ADRs. Most of the ADRs were of mild severity (91%) and not preventable (84%). Conclusion: Insomnia, fatigue and agitation were among most common ADRs. There was increased chance of ADRs with polytherapy and use of TCAs. Most ADRs were mild and not preventable.

Practice of Standard Safety Measures among Nursing Personnel at Tertiary Mental Health Institute, North-East, India

Background: Health care-associated infection (HAI) is a serious problem that deeply impacts patient safety and is a major cause of patient morbidity and mortality. Adherence to standard safety measures while performing procedures and related infection control measures is a part of nurses responsibility as it protects patients and health care workers from transmission of health-care associated infections. Assessing practice of standard safety measures while performing nursing procedures is immensely important so that necessary changes can be brought to enhanced quality nursing care. Methodology: The study adopted an observational descriptive research design. The setting of the study was the Tertiary Mental Health Institute, North-East, India. The sample of the study consisted of the thirty eight (38) nursing personnel who performed the total 150 procedures i.e. 30 times of each five domains (waste disposal, intramuscular injection, intravenous injection, hand-washing, aseptic wound dressing). Convenience sampling technique was used. Result: Finding showed that all the nursing personnel followed proper waste disposal practice but partially adhere to standard safety measures while administering intramuscular and intravenous injections. Whereas practice on standard safety measures while performing hand washing and aseptic wound dressing were less than average. Conclusion: The present study highlights the importance of in-service education on standard safety measures by incorporating new guidelines of nursing procedures based on evidence based practices. In-service education brought changes in the performance level as it is showed that the nursing personnel who had earlier received in-service education on Bio-medical waste management from the institute followed satisfactory waste disposal practice. Keywords: Standard safety measures, nursing personnel.

University–Public Behavioral Health Collaboration

This chapter describes a partnership between faculty at the Florida Mental Health Institute, University of South Florida, and various public agencies. It is a broad and wide-ranging collaboration, including areas such as civil commitment (providing a reporting center), Medicaid drug therapy management for behavioral health, and problem-solving courts. Advantages to these multiple partnerships have included the more extensive provision of research and evaluation services and the partnership with public agencies as part of application for extramural funding in the form of grants and contracts. These partnerships illustrate the scope of the projects that can be developed through successful collaboration.

T233. CULTURAL CONSENSUS AND HIGH EXPRESSED EMOTION IN RELATIVES OF PEOPLE WITH SCHIZOPHRENIA AT THE MENTAL HEALTH INSTITUTE OF JALISCO, MEXICO

Background Schizophrenia is a chronic mental disorder that affects almost 21 million people (WHO, 2017), in areas like: cognition, perception, language, behavior, and in its general functionality. Also generates complications in primary caregivers, whom in different studies have shown levels of emotional, physical and financial overload (De la higuera, 2005). This variables creates environments with High Expressed Emotionality (EE) in these families. EE is characterized by a series of relationships and communications in the family environment, loaded with negative assessments, criticism, control and over-involvement; such dynamics causes poor self-concept in individuals with psychosis, difficulty in adhering to treatment, negative emotional behaviors, symptomatic exacerbations and continuous relapses according to Rosenfarb, et al. (2000), Barrowclough, et al. (2003), and Sellwood, et al (2003). Methods This research had a Mixed method design, with an exploratory sequential strategy. The main objective of this study was to Identify the association between cultural consensus and expressed emotion in relatives of people with schizophrenia from the Mental Health Institute of Jalisco, México (SALME). The universe involved 40 relatives from 18 families of people diagnosed with schizophrenia, users of SALME. The sample was calculated based on Weller and Romney (1998) proporsal to obtain a level of proficiency higher than 50% for cognitive anthropology samples, with a confidence level of 95% and error of 5%. The EE was evaluated with the Seclén & Guanilo (1993) Familiar Expressed Emotionality Scale. The Cultural consensus was analized with Anthropac program for cultural domain analysis. Results 66% of the families had high expressed emotion (EE) and 45% of the sample were cataloged with a high EE. A significant difference was found among relatives who had high EE and lower knowledge about schizophrenia vs relatives who had greater scientific knowledge and lower EE (t= -9.15, p=.00 /U. Mann-Witney= 1.00, p=.00). There was no evidence of a significant association between high EE and sociodemographic variables such as: sex, education, type of family member, occupation or religion. There was only a significant association between high EE and relatives living with the patient (x2 = 4.82, p≤.05) versus those relatives who only participated in day care. Discussion The sample of relatives contemplated for this study was similar to the number of families that have been included in other studies, for example: Jeff & Kuipers, et al (1982) or Guidorizzi, et al (2012). However, this design and research purposes were innovative in this area since there wasn′t found any reference from another study that addresses the issue of cultural consensus in schizophrenia, nor its relationship with high EE in relatives of people with this disorder. Conclusion: The less scientific knowledge about schizophrenia, the more expressed emotionality is shown.The importance of psychoeducation is highlighted to promote scientific knowledge of mental illnesses in order to reduce high EE.