INTRODUCTION: Hysterectomy is the commonest gynecological operation. It can be associated with ps... more INTRODUCTION: Hysterectomy is the commonest gynecological operation. It can be associated with psychological morbidity due to multiple factors.Though few studied showed on the contrary. MATERIALS AND METHODS: An observational study was conducted in a tertiary care center in West Bengal where 100 post hysterectomy patients who consented to be recruited, had undergone Bengali version of SRQ-20, and a semi structured questionnaire one month after hysterectomy. RESULT AND ANALYSIS: 64% had screener positive psychiatric morbidity.Occupation of the patient,type of operation and nature of histopathology can predict the occurrence of psychiatric morbidity. CONCLUSION: Post hysterectomy associated with significant psychiatric morbidity. Pre-post or case-control study with longer follow up would render stronger results.
Attention deficit hyperactivity disorder (ADHD) is an etiologically complex childhood onset neuro... more Attention deficit hyperactivity disorder (ADHD) is an etiologically complex childhood onset neurobehavioral disorder characterized by age-inappropriate inattention, hyperactivity, and impulsivity. Symptom severity varies widely and boys are diagnosed more frequently than girls. ADHD probands were reported to have abnormal transmissions of dopamine, serotonin, and/or noradrenaline. Monoamine oxidase A (MAOA) and B (MAOB), mitochondrial outer membrane bound two isoenzymes, mediate degradation of these neurotransmitters and thus regulating their circulating levels. Case-control analyses in different populations, including Indians, suggested involvement of MAOA and MAOB genes in the etiology of ADHD. Due to high heritability rate of ADHD, we tested familial transmission of MAOA and MAOB variants to ADHD probands in 190 nuclear families having ADHD probands from Indo-Caucasoid ethnicity. Subjects were recruited following the Diagnostic and Statistical Manual of Mental Disorders-4th editi...
A patient, diagnosed with schizophrenia, non-responsive to two atypical antipsychotics and partia... more A patient, diagnosed with schizophrenia, non-responsive to two atypical antipsychotics and partially responsive to the third (risperidone) in therapeutic dose, ultimately showed complete response without any unacceptable side-effect in a dose (20 mg) that was untried previously. This case makes an important observation that high dose of risperidone can be tried in a patient with good results if his clinical condition permits.
Leukodystrophy is a group of demyelinating neurodegenerative diseases of brain with varied presen... more Leukodystrophy is a group of demyelinating neurodegenerative diseases of brain with varied presentation and multiple etiologies. Prognosis is predominantly dismal. Misdiagnosis and wrong treatment are common in this group of rare neurological disorders, especially when it presents with psychiatric symptoms. In this case, importance of neurological and radiological evaluation and need for high diagnostic suspicion in treatment-resistant psychiatric disorders is highlighted.
A small proportion of bipolar disorder of adolescent onset can be secondary to underlying neurolo... more A small proportion of bipolar disorder of adolescent onset can be secondary to underlying neurological disorder (secondary mania). We report a case of treatment-resistant mania secondary to cerebral form of adrenoleukodystrophy of adolescent onset. This case demonstrates the need for clinicians to be alert to the possibility of rare neurological diseases that can present with psychiatric manifestations.
Contribution of genes in attention deficit hyperactivity disorder (ADHD) has been explored in var... more Contribution of genes in attention deficit hyperactivity disorder (ADHD) has been explored in various populations, and several genes were speculated to contribute small but additive effects. We have assessed variants in four genes, DDC (rs3837091 and rs3735273), DRD2 (rs1800496, rs1801028, and rs1799732), DRD4 (rs4646984 and rs4646983), and COMT (rs165599 and rs740603) in Indian ADHD subjects with comorbid attributes. Cases were recruited following the Diagnostic and Statistical Manual for Mental Disorders-IV-TR after obtaining informed written consent. DNA isolated from peripheral blood leukocytes of ADHD probands (N=170), their parents (N=310), and ethnically matched controls (n=180) was used for genotyping followed by population- and family-based analyses by the UNPHASED program. DRD4 sites showed significant difference in allelic frequencies by case-control analysis, while DDC and COMT exhibited bias in familial transmission (P<0.05). rs3837091 “AGAG,” rs3735273 “A,” rs179973...
Oppositional defiant disorder (ODD) is diagnosed broadly on the basis of frequent and persistent ... more Oppositional defiant disorder (ODD) is diagnosed broadly on the basis of frequent and persistent angry or irritable mood, argumentativeness/defiance, and vindictiveness. Since its inception in the third Diagnostic and Statistical Manual of Mental Disorders, epidemiological and longitudinal studies have strongly suggested a distinct existence of ODD that is different from other closely related externalizing disorders, with different course and outcome and possibly discrete subtypes. However, several issues, such as symptom threshold, dimensional versus categorical conceptualization, and sex-specific symptoms, are yet to be addressed. Although ODD was found to be highly heritable, no genetic polymorphism has been identified with confidence. There has been a definite genetic overlap with other externalizing disorders. Studies have begun to explore its epigenetics and gene-environment interaction. Neuroimaging findings converge to implicate various parts of the prefrontal cortex, amygda...
INTRODUCTION: Hysterectomy is the commonest gynecological operation. It can be associated with ps... more INTRODUCTION: Hysterectomy is the commonest gynecological operation. It can be associated with psychological morbidity due to multiple factors.Though few studied showed on the contrary. MATERIALS AND METHODS: An observational study was conducted in a tertiary care center in West Bengal where 100 post hysterectomy patients who consented to be recruited, had undergone Bengali version of SRQ-20, and a semi structured questionnaire one month after hysterectomy. RESULT AND ANALYSIS: 64% had screener positive psychiatric morbidity.Occupation of the patient,type of operation and nature of histopathology can predict the occurrence of psychiatric morbidity. CONCLUSION: Post hysterectomy associated with significant psychiatric morbidity. Pre-post or case-control study with longer follow up would render stronger results.
Attention deficit hyperactivity disorder (ADHD) is an etiologically complex childhood onset neuro... more Attention deficit hyperactivity disorder (ADHD) is an etiologically complex childhood onset neurobehavioral disorder characterized by age-inappropriate inattention, hyperactivity, and impulsivity. Symptom severity varies widely and boys are diagnosed more frequently than girls. ADHD probands were reported to have abnormal transmissions of dopamine, serotonin, and/or noradrenaline. Monoamine oxidase A (MAOA) and B (MAOB), mitochondrial outer membrane bound two isoenzymes, mediate degradation of these neurotransmitters and thus regulating their circulating levels. Case-control analyses in different populations, including Indians, suggested involvement of MAOA and MAOB genes in the etiology of ADHD. Due to high heritability rate of ADHD, we tested familial transmission of MAOA and MAOB variants to ADHD probands in 190 nuclear families having ADHD probands from Indo-Caucasoid ethnicity. Subjects were recruited following the Diagnostic and Statistical Manual of Mental Disorders-4th editi...
A patient, diagnosed with schizophrenia, non-responsive to two atypical antipsychotics and partia... more A patient, diagnosed with schizophrenia, non-responsive to two atypical antipsychotics and partially responsive to the third (risperidone) in therapeutic dose, ultimately showed complete response without any unacceptable side-effect in a dose (20 mg) that was untried previously. This case makes an important observation that high dose of risperidone can be tried in a patient with good results if his clinical condition permits.
Leukodystrophy is a group of demyelinating neurodegenerative diseases of brain with varied presen... more Leukodystrophy is a group of demyelinating neurodegenerative diseases of brain with varied presentation and multiple etiologies. Prognosis is predominantly dismal. Misdiagnosis and wrong treatment are common in this group of rare neurological disorders, especially when it presents with psychiatric symptoms. In this case, importance of neurological and radiological evaluation and need for high diagnostic suspicion in treatment-resistant psychiatric disorders is highlighted.
A small proportion of bipolar disorder of adolescent onset can be secondary to underlying neurolo... more A small proportion of bipolar disorder of adolescent onset can be secondary to underlying neurological disorder (secondary mania). We report a case of treatment-resistant mania secondary to cerebral form of adrenoleukodystrophy of adolescent onset. This case demonstrates the need for clinicians to be alert to the possibility of rare neurological diseases that can present with psychiatric manifestations.
Contribution of genes in attention deficit hyperactivity disorder (ADHD) has been explored in var... more Contribution of genes in attention deficit hyperactivity disorder (ADHD) has been explored in various populations, and several genes were speculated to contribute small but additive effects. We have assessed variants in four genes, DDC (rs3837091 and rs3735273), DRD2 (rs1800496, rs1801028, and rs1799732), DRD4 (rs4646984 and rs4646983), and COMT (rs165599 and rs740603) in Indian ADHD subjects with comorbid attributes. Cases were recruited following the Diagnostic and Statistical Manual for Mental Disorders-IV-TR after obtaining informed written consent. DNA isolated from peripheral blood leukocytes of ADHD probands (N=170), their parents (N=310), and ethnically matched controls (n=180) was used for genotyping followed by population- and family-based analyses by the UNPHASED program. DRD4 sites showed significant difference in allelic frequencies by case-control analysis, while DDC and COMT exhibited bias in familial transmission (P<0.05). rs3837091 “AGAG,” rs3735273 “A,” rs179973...
Oppositional defiant disorder (ODD) is diagnosed broadly on the basis of frequent and persistent ... more Oppositional defiant disorder (ODD) is diagnosed broadly on the basis of frequent and persistent angry or irritable mood, argumentativeness/defiance, and vindictiveness. Since its inception in the third Diagnostic and Statistical Manual of Mental Disorders, epidemiological and longitudinal studies have strongly suggested a distinct existence of ODD that is different from other closely related externalizing disorders, with different course and outcome and possibly discrete subtypes. However, several issues, such as symptom threshold, dimensional versus categorical conceptualization, and sex-specific symptoms, are yet to be addressed. Although ODD was found to be highly heritable, no genetic polymorphism has been identified with confidence. There has been a definite genetic overlap with other externalizing disorders. Studies have begun to explore its epigenetics and gene-environment interaction. Neuroimaging findings converge to implicate various parts of the prefrontal cortex, amygda...
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