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Background: Executive function (EF) impairment has been demonstrated in patients with schizophrenia. This study attempted to examine the clinical and demographic correlates associated with the different components of EF in these patients using a comprehensive battery of neuropsychological tests. Materials and Methods: Consecutive inpatients with schizophrenia in remission were recruited. The following instruments were administered: (a) Positive and Negative Syndrome Scale (PANSS), (b)World Health Organization Disability Assessment Schedule 2.0, (c) Tower of London, (d) Stroop Test, (e) Controlled Oral Word Association Test, (f) Animal Names Test, and (g) Verbal N-Back Test. Sociodemographic and clinical details were also recorded. Data was analyzed using standard bivariate and multivariate statistics. Results: A total of 50 patients were recruited. The mean age of the population was 30 years (standard deviation [SD]: 7.74). The majority were male, literate, single, from a rural background, from a middle socioeconomic background, and unemployed. The mean dose of antipsychotic medication was 618.57 mg (SD: 282.08) of chlorpromazine equivalents per day. Impairment was found in the different sub-components of EF. On multivariate analysis, factors significantly associated with executive dysfunction were lower education, unemployment, lower income, positive PANSS score, higher antipsychotic dose, and history of treatment with electroconvulsive therapy. Conclusion: EFs encompass a wide range of cognitive processes that influence an individual's ability to adapt and function in the society. These are often impaired in patients with schizophrenia. Clinicians need to be aware of these deficits and factors associated with them, to plan appropriate and effective remedial measures. [ABSTRACT FROM AUTHOR]

Introduction: The predictive factors of parent mediated, Early Intervention (EI) for children with Autism Spectrum Disorders (ASD) have not been studied in India; we document the structural therapeutic factors, which predict the EI outcome. Methods: Data of 77 children with an ICD 10 diagnosis of Pervasive Developmental Disorder (ASD in DSM 5), and completed a 12-week EI with proven effectiveness was collected from the database of a teaching hospital. We studied the structural therapeutic factors associated with EI outcome, as measured by Psycho-Educational Profile-Revised (PEP-R), while controlling the confounders with multiple linear regression analyses. Results: The Fine-motor skills improved in residential patients (t = 2.54, P = 0.02; 15 units). As the duration of intervention decreased at home per day, there was a significant decrease in Gross-motor skills (t = -2.67, P = 0.02; -15 units). With increase in duration of intervention in hospital per day, there was a significant increase (t = 2.86, P = 0.01; 30 units) in the Eye-hand integration. Cognitive-verbal skills acquisition decreased (t = -2.90, P = 0.01; 33 units) as the duration of intervention decreased at hospital. The use of medication did not predict any of the outcome factors. Conclusion: The above mentioned predictive factors should be monitored and titrated in the family context when children with ASD undergo parent mediated, EI programme. It is important to that the multidisciplinary family medicine teams reinforce these parents, who are the main column of support in primary-care settings for children with neuro-developmental disabilities in India. [ABSTRACT FROM AUTHOR]

Introduction: Adolescent Depression (AD) although is widely prevalent and is a prioritized disorder, it is under-diagnosed and under reported in primary-care. We document the post-test probability of three measures and select the best measure for identifying AD in primary-care settings in India based on the clinical utility. Materials and Methods: Three measures have been validated in India for AD and thus can be further evaluated for primary-care use; we calculated the positive (+PTP) and negative (-PTP) post-test probability from the prevalence of AD in India for Beck Depression Inventory-21 item version (BDI-21), Patient Health Questionnaire-9 item version (PHQ-9), and Children's Depression Rating Scale-Revised version (CDRS-R) using the Bayes theorem. The usefulness of the measure was defined a priori based on the odds ratio (OR) of +PTP (OR > 3) and −PTP (OR < 0.1). Results: The +PTP and −PTP for BDI-21 was 43% (95%CI = 40, 45%; OR = 0.7) and 25% (95%CI = 13, 43%; OR = 0.3) respectively. Similarly, the +PTP and − PTP for PHQ-9 was 74% (95%CI = 66, 81%; OR = 2.9) and 10% (95%CI = 6, 17%; OR = 0.1). Finally, +PTP and − PTP for CDRS-R was 78% (95%CI = 69, 84%; OR = 3.5) and 12% (95%CI = 7, 18%; OR = 0.1). Only CDRS-R achieved the useful decided a priori as can be seen in the Fagan's Nomograms. Conclusion: This research provides the evidence base for selecting CDRS-R as the screening measure, for Adolescent Depression, for clinical use in Primary-care settings in India. [ABSTRACT FROM AUTHOR]

Background: We examined the nature, prevalence and explanatory models of sexual concerns and dysfunction among women in rural Tamil Nadu., Methods: Married women between 18 and 65 years of age, from randomly selected villages in Kaniyambadi block, Vellore district, Tamil Nadu, were chosen by stratified sampling technique. Sexual functioning was assessed using the Female Sexual Function Index (FSFI). The modified Short Explanatory Model Interview (SEMI) was used to assess beliefs about sexual concerns and the General Health Questionnaire-12 (GHQ-12) was used to screen for common mental disorders. Sociodemographic variables and other risk factors were also assessed., Results: Most of the women (277; 98.2%) contacted agreed to participate in the study. The prevalence of sexual dysfunction, based on the cut-off score on the FSFI, was 64.3%. However, only a minority of women considered it a problem (4.7%), expressed dissatisfaction (5.8%) or sought medical help (2.5%). The most common explanatory models offered for sexual problems included an unhappy marriage,stress and physical problems. Factors associated with lower FSFI included older age, illiteracy, as well as medical illness and sexual and marital factors such as menopause, poor quality of marital relationship, history of physical abuse and lack of privacy., Conclusion: The diagnosis of female sexual dysfunction needs to be nuanced and based on the broader personal and social context. Our findings argue that there is a need to use models that employ personal, local and contextual standards in assessing complex behaviours such as sexual function., (Copyright 2014, NMJI.)