Search

Background: Responsible media reporting of suicide is a key population-level suicide prevention strategy. Thus far, there has been no systematic analysis of media reporting of suicide in Puducherry, a consistently high suicide burden state in India., Aim: To evaluate the adherence of media reports of suicide against the World Health Organization (WHO) guidelines in Puducherry., Method: We conducted a year-round content analysis of all suicide-related reports in the two most widely read vernacular dailies of Puducherry. We used a pre-defined data extraction form and coded each item based on the WHO reporting guidelines., Results: A total of 318 suicide reports were retrieved. Harmful reporting practices such as mentioning the method of suicide (99.1%), description of the steps involved (68.2%) and location of suicide (86.5%), monocausal explanations (91.8%), and inciting life events (52.5%) were common. Helpful practices such as mentioning warning signs (1.3%), recognizing links with mental health disorders (3.8%) and effects on bereaved persons (2.2%) were rare. Only one article (0.31%) included any content related to educational/preventive aspects of suicide., Conclusion: Media reporting of suicide in Puducherry, India, does not adhere to reporting guidelines and there is very little focus on educating the public about preventive aspects of suicide. Urgent efforts are warranted to improve the quality of media reporting which should include the development of national guidelines on suicide reporting and collaborative efforts that take into account barriers and perspectives of media professionals.

Background: Mental disability is a common condition but is considered as an invisible disability. The disability certificate in psychiatry remains underexplored. Some reasons are issues of confidentiality, stigma, lack of awareness in the public, and the hesitancy in the mental health professionals. We aim to provide a brief profile of patients with mental illness issued disability certificates from a psychiatric unit over a five-year period (2013-2017)., Methods: Our retrospective study is based on the data available from the copies of the issued disability certificates from a psychiatric unit that functions in a multispecialty tertiary care teaching government hospital in Southern India. Patients undergoing treatment in psychiatry apply for a disability certificate to the medical superintendent of the hospital. Each applicant undergoes a detailed workup to ascertain the diagnosis, and the mental disability is assessed using Indian Disability Evaluation and Assessment Scale (IDEAS). Those with intellectual developmental disorder (IDD) are assessed by a clinical psychologist for quantifying intelligence quotient, based on which the disability certificate is issued. Data were extracted and analyzed using SPSS. Descriptive statistics were used., Results: Over five years, 258 disability certificates were issued. A total of 218 were for mental illness and 40 were for IDD. Schizophrenia was the commonest primary diagnosis. There was no gender predominance, nor the influence of gender on different domains of IDEAS except on work domain dysfunction due to mental illness. The validity period was not mentioned in 81% of the issued certificates for mental illness., Conclusions: This descriptive study found a lower number of certificates issued from the psychiatric unit. Schizophrenia remains the main psychiatric diagnosis for which a disability certificate was issued. We did not assess the utilization pattern of the issued certificates., Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© 2020 Indian Psychiatric Society - South Zonal Branch.)

Competing Interests: There are no conflicts of interest.

Background: Alteration in cytokine levels are known to be involved in the pathogenesis of schizophrenia., Objectives: To estimate the serum levels of interleukin-17 (IL-17) and interleukin-10 (IL-10) and their association with disease progression in schizophrenia., Methods: A total of 67 schizophrenia cases were enrolled in the present study. IL-17 and IL-10 were estimated by enzyme-linked immunosorbent assay. Positive and Negative Syndrome Scale (PANSS) was used to evaluate disease severity., Results: IL-17 was positively correlated with positive symptom score ( r = 0.256, p = .036), general psychopathology score ( r = 0.255, p = .038) and total score ( r = 0.273, p = .025) in schizophrenia. IL-17 and IL-10 were significantly increased in schizophrenia cases with PANSS more than 85 compared to those with 71-85., Conclusion: IL-17 and IL-10 are associated with disease severity in schizophrenia but are not good markers for predicting the disease progression., (© 2020 Indian Academy of Neurosciences (IAN).)

Background: In-patient (IP) suicides contribute a small but significant proportion of overall suicides. Despite this, suicide prevention strategies focusing on the general hospital IP population remain relatively underresearched. This paper is intended to provide an overview of various proposed suicide prevention approaches in the general hospital, including psychiatric IP, settings, and their evidence base., Methodology: Electronic searches of MEDLINE through PubMed, ScienceDirect, and Google Scholar databases were performed to identify potentially relevant articles from inception till January 2019. The generated abstracts were systematically screened for their eligibility to be included in the review. Included articles were grouped under five broad themes: environmental modification, staff education, pharmacotherapy, psychotherapy, and brain stimulation. Data extraction was done using a structured proforma., Results: Environmental modifications and educating the health care professionals appear to be the most promising strategies to reduce suicide-related mortality among IPs. Among pharmacological methods, ketamine has shown initial promise in reducing suicidal ideations. Follow-up data are lacking for most of the described methods. Limited but positive evidence exists for cognitive therapies focusing on the immediate postadmission period and brain stimulation techniques, and it warrants further replication., Conclusion: There is a striking paucity of original research on IP suicide prevention. Given the ethical and methodological issues in carrying out studies with IP suicide as the primary outcome, there is a need to focus on intermediate suicide outcome measures, such as knowledge, attitude, and skills among staff handlers of suicidal patients., Competing Interests: There are no conflicts of interest.

Background: Identifying those who are likely to make suicide attempts under alcohol intoxication has important implications for management and prevention of further suicidal behavior., Aims: To identify the frequency of suicide attempts made under the influence of alcohol and the percentage of impulsive suicide attempts among them. We also aimed to identify predictors of attempted suicide under intoxication with alcohol., Setting and Design: Record-based study carried out at a tertiary care hospital., Materials and Methods: The clinical charts of consecutive suicide attempters ( n = 147) who presented to the crisis intervention clinic from July 2013 to June 2014 were reviewed, and relevant data were extracted. The participants were divided into three groups - nonusers of alcohol ( n = 85), alcohol users who did not attempt under intoxication ( n = 31) and alcohol users who attempted under intoxication ( n = 31). These groups were compared on various sociodemographic and clinical variables. Logistic regression was done to identify predictors of suicide attempt under intoxication., Statistical Analysis Used: Chi-square (χ 2 ) test, one-way ANOVA (F) test and backward stepwise logistic regression., Results: About 21.08% of all suicide attempts occurred under alcohol intoxication. Such subjects were more likely to be older ( F = 12.428, P < 0.001), male (χ 2 = 87.367, P < 0.001), married (χ 2 = 6.787, P = 0.034), employed (χ 2 = 41.778, P < 0.001), and fewer years of formal schooling ( F = 3.312, P = 0.039). Physical methods (hanging) were used more often in this group (χ 2 = 19.510, P = 0.012). In regression analysis, only marital status and living condition emerged as predictors of attempt under intoxication (odds ratios 4.52 [confidence interval (CI) 1.34-15.24, P = 0.015] and 5.67 [CI 1.17-27.39, P = 0.031] respectively)., Conclusion: Certain demographic features may help us in identifying those who are more likely to make attempts under intoxication. The role of personality factors as potential mediators of such behavior needs further exploration., Competing Interests: There are no conflicts of interest.

Background: Little is known about the association of personality traits with intent in attempted suicide., Aims: Our objectives were to assess the levels of selected personality factors among suicide attempters and to examine their association with suicide intent., Materials and Methods: A chart review of 156 consecutive suicide attempters was carried out. All participants were administered the Beck Suicide Intent Scale, Barratt Impulsivity Scale-11, Buss-Perry Aggression Questionnaire, and Past Feelings and Acts of Violence Scale to assess suicide intent, trait impulsivity, hostility-aggression, and violence, respectively. Pearson's product moment correlation was the used as the test of association. Stepwise linear regression was used to identify predictors of suicide intent., Results: Suicide intent was significantly correlated with verbal aggression (Pearson r = 0.90, P = 0.030), hostility (Pearson r = 0.316, P < 0.001), and nonplanning impulsivity (r = -0.174, P = 0.049). High hostility and low motor impulsivity emerged as significant predictors of suicide intent., Conclusion: Personality traits such as hostility and to an extent, impulsivity are accurate predictors of intentionality in attempted suicide. Clinicians should focus on these personality attributes during a routine evaluation of suicide attempters. They can also be considered as potential targets for suicide prevention programs.

Background: Oxidative parameters are altered during alcohol withdrawal and are said to contribute towards withdrawal symptoms in alcoholic patients., Aims: To study levels of five selected oxidative parameters during alcohol withdrawal state and after treatment of the withdrawal state and to assess the association of the oxidative parameters with the severity of alcohol withdrawal., Materials and Methods: This was a case-control study done in a De-addiction clinic of a tertiary teaching centre, Southern India. 50 persons having alcohol withdrawal symptoms were included. The oxidative stress parameters malondialdehyde, protein carbonyl, glutathione peroxidase, superoxide dismutase and catalase were assessed in during the withdrawal phase and again after the withdrawal had subsided. The same oxidative stress parameters were measured in the control group., Statistical Analysis: Statistical analysis was done using SPSS version 17.0. One way ANOVA and Pearson correlation test were used for finding the association between the oxidative stress parameters levels and the severity of alcohol withdrawal. Multiple linear regression analysis done to predict variables associated with level of oxidative parameters., Results: During alcohol withdrawal the pro-oxidant malondialdehyde was elevated compared to that in the control group. Among the antioxidant enzymes the superoxide dismutase was higher and catalase was lower than the control group levels. After remission of the alcohol withdrawal both malondialdehyde remained higher and superoxide dismutase lower than in the control group. The levels of oxidative stress parameters not correlated with the severity of alcohol withdrawal., Conclusions: oxidative stress parameters show changes during alcohol withdrawal and during the remission of withdrawal. However, levels of oxidative stress parameters not correlated with the severity of withdrawal.

Context: Attention deficit hyperactivity disorder (ADHD) is one of the common neurodevelopmental disorders., Aims: Study objective is to report impact of comorbidities on short-term outcome in children with ADHD followed in a child guidance clinic., Settings and Design: This was done in a child guidance clinic run jointly by the pediatric and psychiatry department at a tertiary teaching hospital. This is a 3 month prospective follow-up study to assess the outcome in ADHD children., Materials and Methods: Children attending pediatric department with behavioral problems or poor scholastic performance were screened for ADHD and further confirmation of diagnosis was done by semistructured interview of the child and parent. Children functional assessment and ADHD symptom profile was compared at baseline and at follow-up. We screened for and excluded those showing autistic spectrum disorder and having worse than mild mental retardation. Baseline variables were compared between improved and not improved subgroups and impact of these variables on outcome at 3-month follow-up was analyzed., Statistical Analysis: Descriptive statistics., Results: Of the 25 children completing the study, at the end of 3 months, 15 improved (not fulfilling criteria for ADHD) and 10 did not improve. Applying Kiddie-Schedule for Affective Disorders and Schizophrenia (K-SADS) for diagnosis of psychiatric comorbidities, six had associated psychiatric comorbidities. This was significantly higher in those who did not improve., Conclusions: Presence of comorbidities at baseline was found to affect outcome at 3 month assessment in this preliminary study. Future studies with larger sample and longer follow-up are needed for finding the predictors of outcome in ADHD children in developing nations.