Perinatal factors among children with neurodevelopmental disorders attending tertiary care hospitals in Dhaka city

Neurodevelopmental disorders (NDD) are public health burden worldwide. NDD causes disabilities and reduces the quality of life. Perinatal factors like maternal age, stress, maternal physical illnesses, birth complications, preterm birth, low birth weight and neonatal infections are the important risk factors for NDD. The objectives of the study were to determine the proportion of perinatal factors among children with neurodevelopmental disorders attending tertiary care hospitals in Dhaka city. This was a cross-sectional study conducted in outpatient department of National Institute of Mental Health (NIMH), Dhaka and Institute of Paediatric Neurodisorder and Autism (IPNA), Bangabandhu Sheikh Mujib Medical University (BSMMU) from January 2017 to July 2018. Among 115 children with NDD aged 0-17 years satisfying inclusion and exclusion criteria who were conveniently selected as sample. After diagnosing NDD using DSM- 5 criteria by psychiatrists and paediatric neurologists, a semi structured questionnaire was applied by researcher herself that included socio-demographic and perinatal factors as well. Results showed that majority of the respondents (29.6%) were 5-8 years with male predominance (78.3%). The most common perinatal factors were maternal factors like maternal stress (68.7%), maternal physical illness (66.1 %), inadequate food/rest intake (53.9%) and inadequate weight gain during pregnancy (50.4%). Fetal and neonatal factors like birth complication (82.6%), preterm birth (80%), low birth weight (75.6%), neonatal illness (69.6%) and birth asphyxia (61.7%). Most common neonatal illness were pneumonia (30.0 %) followed by neonatal Jaundice (20%). Early identification of possible perinatal factors and providing safe perinatal period can give a positive impact in prevention of NDD in children. Bang J Psychiatry 2018;32(2): 26-31

An assessment of mental health status of physicians working in medical college hospitals of Dhaka city

Mental health status is often ignored in our country. Even many health care professionals commonly ignore the impact of mental illness on both daily and professional lives, which may lead to dire consequences. The purpose of this study was to find the mental health status of physicians working in medical college hospitals of Dhaka city. A cross sectional study was conducted from January to December 2015 for this purpose among 215 number of respondents selected conveniently. Data were collected from 210 physicians by face-to face interview using a semi structured questionnaire containing 4DSQ (Four-Dimensional Symptom Questionnaire), socio economic and other variables. The prevalence of mental illness was calculated according to the scoring system of the scale. Mental illness prevalence was as follows: distress 20%, Anxiety 15.7%, Depression 15.2% and Somatization 8.6%. Majority of the respondents were interns and below 30 years of age. However, in light of current pandemic situation, regular assessment of health personnel’s mental health is needed more than ever. Bang J Psychiatry 2018;32(2): 37-39

Psychiatric morbidity among patients with irritable bowel syndrome

Irritable Bowel Syndrome (IBS) is a functional disorder characterized by a set of gastrointestinal symptoms often associated with extra-digestive symptoms with unknown organic basis. It is a prototypic functional bowel disorder in terms of its heterogeneous nature with multifactor pathogenesis. Invariably it is co-morbid with psychiatric disorders. This study was done to determine the frequency and types of psychiatric disorders with irritable bowel syndrome and to find out association of socio-demographic and relevant variables. It was cross-sectional study carried out in the Department of Gastroenterology, Bangabandhu Sheikh Mujib Medical University (BSMMU) from January 2014 to December 2014. Total 250 sample were included by convenient sampling technique in this study diagnosed as IBS. Diagnosis was done according to Rome III criteria and SCID-CV was used for psychiatric assessment. Respondents were above 18 years of age of either sex. Data was analyzed using SPSS 20. Results showed 86.4% patients have psychiatric disorders. The most common disorder was generalized anxiety disorder (44.9%) followed by major depressive disorder (37.5%). Maximum (35.2%) were IBS-D type followed by 32.8% IBS-C type and 32% IBS-M type. So, it is seen that significant proportion of psychiatric disorders was found in patients with irritable bowel syndrome. Among them, generalized anxiety disorder was leading psychiatric disorder. Bang J Psychiatry 2018;32(2): 32-36

A case report of schizophrenia with an atypical presentation of body dysmorphic disorder

Although body dysmorphic disorder is a psychiatric disorder. Sometimes, it can be a variant of a variety of psychiatric syndromes like schizophrenia, mood disorders, OCD etc. Here is an atypical case report of a 28 years old male patient who presented with body dysmorphic disorder later on diagnosed as having schizophrenia. The difficult part in this diagnosis is to make the difference between the psychotic and the non-psychotic form of the disorder. Finally, its successful treatment with antipsychotic drugs, thus contributing to what has been documented on the subject. Bang J Psychiatry 2018;32(2): 40-43

Recent changes in MBBS curriculum in psychiatry in Bangladesh: a call for attention

not available Bang J Psychiatry 2018;32(2): 24-25

Prevalence of substance use in Bangladesh

The prevalence of substance use is on rising trend in the country. This two-stage nationwide multicentric community based cross sectional study was conducted by National Institute of Mental Health (NIMH), Dhaka during the period of September 2017 to July 2018 to determine the prevalence of substance use as well as to identify the proportion of users used different substances and to find out socio-demographic correlates of substance use in Bangladesh. The sample were collected by cluster sampling technique. In the first stage data were collected from 19692 respondents aged between 7 years and above in 140 clusters through face-to-face interview using semi-structured questionnaires to collect information by trained data collector. Diagnoses of substance use were made in the second stage of interview by research psychiatrists following DSM-5 diagnostic criteria of mental disorders. Descriptive and inferential statistics of the collected data was done using standard statistical parameters. SPSS programme (Version 23) was used to summarize and to analyze the data. The results showed that, the prevalence of substance use was found as 3.3% among the population 18 years and above. Prevalence of substance use was 4.8% in male and 0.6% in female. Most frequently used substances include cannabis in (42.7%), alcohol in 27.5%, amphetamine (yaba) in 15.2%, opioid in 5.3% and sleeping pills in 3.4% users. Among professions of substance users 6.7% were labors, 5.7% unemployed, 4.3% business men, 3.8% farmers and 3.5% service holders. Extremes of social classes were found as increased users of substances such as people with low income 3.2% and people with high income 3.8% using as against 2.6% in middle income group. The data of this community survey will be used for planning of mental health services in Bangladesh. Bang J Psychiatry June 2018; 32(1): 1-8

Socio-demographic factors and suicidal behavior among the patients with psychiatric disorder attending outpatient department of a tertiary level hospital

The majority of suicides worldwide are related to psychiatric disorders. Overall, suicide rates vary concerning the age, gender, and socioeconomic status of the individual and the method of suicide. The objectives of the study were to find the socio-demographic factors and suicidal behavior associated with suicidal attempts in patients with psychiatric disorders. A cross-sectional, hospital-based, descriptive study was conducted among the patients attending the psychiatry outpatient departments (OPD) of the National Institute of Mental Health, Dhaka, Bangladesh. A total of 98 consecutive cases were included those who were at and above18year, have a definite psychiatric disorder and history of suicidal attempt. The data were collected by face-to face interview using semi structured questionnaire. The study identified that most of the patients were in the age group 21-30 years (53.1%), mean age± SD was 27.02±8.42, more in female (66.2%), housewives (35.7%), 57.1% were from an urban background and 35.7% of them studied up to SSC. The vast majority (73.5%) came from a nuclear family. Suicidal behavior revealed that mean suicidal attempt was 2.63±2.84, Communication intent was 20.4%, Suicidal note was put by10.2%, at home (90.8%),59.2%, sample choose day time and common method were hanging (25.5%) and medicine (22.4%). Help nearby in 72.4%, precaution against rescue was 18.4%, intent to die was 65.3% and hospitalization needed for 34.7% cases. Suicides can be prevented by early identification, diagnosis and proper intervention of psychiatric disorder among risk groups. Restricting access to means of suicide, by training caregivers, provide adequate follow-up care may reduce impulsive suicidal attempts. Bang J Psychiatry June 2018; 32(1): 14-18

A case of factitious disorder presenting with hematohidrosis: a rare case report

Factitious disorder is described as the patient’s intention to produce fake symptoms to play a sick role and gain medical attention.1 The symptoms could be physical, psychological or mixed. The wide spectrum of symptoms makes the diagnosis and management challenging. This is a case report of a 17 year old girl who was referred to us with history of recurrent bleeding from left side of her forehead. Detailed hematological investigations revealed no abnormal causes of bleeding but on clinical examination, we found multiple scar marks on the affected site. The history was suggestive of hematohidrosis but the patient had scar marks on the affected area which indicated that the bleeding was self-inflicted. This was the most important diagnostic and differentiating point in this patient. Pharmacotherapy and psychotherapy were followed by complete remission. Bang J Psychiatry June 2018; 32(1): 19-21

Premature ejaculation among post-coronary artery stenting patients attending cardiology out patient department of tertiary care hospitals

Premature ejaculation (PE) is the most frequent sexual complaint of men. It may develop not only due to psychiatric disorders but also due to many chronic organic illnesses. Coronary artery stenting is an invasive procedure to manage coronary artery disease which is one of the leading chronic illnesses all over the world. Patients who survive from coronary artery diseases by getting invasive cardiac procedures, often develop reduced sexual function. The aim of the study was to identify the frequency of premature ejaculation among post coronary artery stenting patients. This was a descriptive, cross sectional study conducted in cardiology outpatient department (OPD) of Bangabandhu Sheikh Mujib Medical University (BSMMU) and cardiology OPD of National Institute of Cardiovascular Diseases (NICVD) from October 2017 to September 2018. 153 patients were selected purposively. After taking written consent a predetermined questionnaire containing 11 socio-demographic variables was filled for each patient through face to face interview. After that PEDT bangle version was applied.37.25% post coronary artery stenting male scored 11 or more and were identified as highly suggestive to have PE. Among the socio-demographic variables, Regular exercise, amount of sleep per day, smoking and history of chronic physical illness were found to be significantly associated with PE among post coronary artery stenting patients. The study showed that the patients who practiced a disciplined and healthy lifestyle were not in risk. The research findings may help us for the early diagnosis and better treatment plan to reduce patient sufferings. Bang J Psychiatry June 2018; 32(1): 9-13

Parenting style in a schizophrenic patient: a case report

Both genetic and environmental factors including parenting style are responsible for the causation of schizophrenia. A young adult developed delusion regarding alien as well as some characters of the computer games he used to play. Later he was diagnosed with schizophrenia. There was evidence of intrafamilial conflict with lack of good relationship with father. His introverted nature, lack of social interactions and some irrelevant behavior were found as being reinforced by her mother. There may be an association of schizophrenia with parenting style which may be modifiable. Bang J Psychiatry June 2018; 32(1): 22-23