Psychiatry and Society

Alcohol and driving don’t mix . In a flashback to Alex’s drug influenced joyride in A Clockwork Orange , a Pune youth bumped into four people at different points on his late night drive through the city. When chased and caught he was found to be under the influence of alcohol. In this post we take a look at the effects of alcohol on driving . We have already discussed some of the long term effects that necessitate imposing legal age limits for alcohol consumption in order to mitigate its neurotoxic effects on the developing brain . 30mg% is the legal blood alcohol concentration (BAC) limit for driving. Limits are a safety requirement to counter the adverse effects of alcohol on driving ability. The 30mg% level is often panned as being too low. Most countries have settled at a 50mg% threshold, some at 20mg%, others (considered very liberal) at 80mg%. Lets take a look at the effects on driving at these various blood alcohol concentrations (CDC 2011). BAC Effect on dri...

Training for caregivers of persons with Alzheimer's disease  helps address the distressing behaviours that arise in the affected person. Caregiver training also promotes wellness in caregivers by giving them the skills to  handle the relentless stress. Unfortunately most caregivers are unaware of the need or the availability of resources. The Alzheimer’s and Related Disorders Society of India (ARDSI) held its 16th conference in Nov 2011 at Pune. This significant event marked Pune’s arrival on the national dementia caregiver stage. Pune is now the 16th Indian city with an ARDSI chapter of its own. How does this help people with dementia (PwD) and their caregivers? The ARDSI Pune chapter “develops, coordinates and renders services in the field of dementia care, support, and training”. The training aspect is particularly interesting . Conversations with caregivers at the clinic usually swing around to the day-to-day nitty-gritty of dealing with dementia, the impa...

Turn off the television and speak to your toddler . Talking is the best thing you could do today for your child’s psychological development. Talking is an interactive process in which your child exercises a core feature of being human - communicating through speech. Your child's vocabulary is directly proportional to the amount of time you spend talking. Talking primes your child for independence. Speech evolves through attempts to communicate needs and feelings. Infants and toddlers are driven by evolution to master this complex process. You, the parent, play a key role in this two-way interaction. Infancy and toddler-hood are stages for developing secure bonding and attachment. The child is primed to bond with the mother or caregiver. The initial bond is secured by direct contact with the caregiver - through warmth, touch and voice. A secure attachment bond enables the infant seeks to explore the environment by attempts to crawl and later walk. The exploring toddler returns ...

Mental health and diet quality are closely linked . The food choices you made as a teenager affect the development of conduct and emotional problems that continue into adulthood. Lifestyle diseases such as heart disease, diabetes and obesity are attributed to changes in diet and exercise habits. Recently there is increasing evidence that diet and exercise also have a major influence on mental health. Dieting peaks after the festival season. This post will help you avoid the 'isms' and fads and point you in the direction indicated by current research. A good quality diet predicts better mental health Evaluating the quality of the complete diet provides a better and more consistent picture of nutrition status than focusing on individual nutrients like magnesium or food groups like various fatty acids (omega, polyunsaturated). A traditional diet of vegetables, fruit, meat, fish, and whole grains is associated with lower risk for depression and for anxiety disorders as compared...

What is the motivation or psychology behind obtaining a tattoo? Tattooing as a form of decorative body art has moved out of the realm of cults and organisations into mainstream society. It is increasingly common to see patients sporting a new tattoo. " Just like that, doctor. My friends were getting one ". The Pune magazines reflect this new found art form through full page articles every other week. Driving through the some parts of Pune takes you past at least three studios specialising in the art of tattooing. Here we are concerned with the psychological aspects of tattooing. As compared to body-piercing, a tattoo is relatively permanent and more deliberate operation. For the moment set aside doubts over hygiene, HIV, and hepatitis. 10 reasons people get a tattoo Beauty, art, and fashion . Tattoos are a means of decorating the body with a permanent fashion accessory. Many tattooed individuals refer to their tattoos as a piece of art.  In...

Impaired spelling and arithmetic in Standard 3 boy with Learning Disorder Learning Disorder (LD) is characterised by impaired acquisition of academic skills. This impairment in scholastic skills is not due to intellectual disability, physical disorders, emotional disturbances, or environmental, cultural, or economic disadvantage. There is a gap between ability and application. The child may know what is asked, is able to explain it verbally, but is unable to put it down in writing. Learning Disorder could affect any of the three scholastic Rs – R eading, w R iting or a R ithmetic. Types of Learning Disability Dyslexia – is the commonest learning disability (80%). It is marked by impairment of the ability to recognize and understand written words. Dyscalculia  – problems with doing math, understanding time, using money. Dysgraphia – problems with handwriting, spelling. Dyspraxia – problems with hand-eye coordination and balance, difficulties with fine motor skill...

Festivals as a source of stress? Festivals are meant to be a time of happiness, enjoyment and family togetherness. However for some it can be time of great stress   and can adversely affect mental health. The extended festival season starts around Independence Day (15th Aug) and extends right up to New Year including Ganesh Chathurti, Dusshera, and Diwali. Vacations have a positive effect on well-being. However, these effects fade soon after resumption of work (de Bloom 2009). These four months of celebration are associated with psychological distress and mental health problems for many individuals and their families. Festival distress (Harion 2009) Expectations take their toll on the family . Festivals are a prime time for couples to come in for counselling with relationship problems, problems with in-laws, siblings and their children. 'Don't we get to celebrate at least once in our own home?". They end up celebrating each in their own parental homes at Pune a...

Microscopic picture of the brain showing amyloid plaques and  neurofibrillary tangles first seen by Alois Alzheimer in 1907 The diagnosis of Alzheimer's disease became headline news when the defence counsel of a prominent citizen of  Pune stated they were awaiting results of his brain MRI to finalise the diagnosis of dementia. Recently a patient's medication was stopped when his neuro-physician declared there were 'no plaques on MRI so it is not a case of Alzheimers'. The caregivers returned to me when his behaviour problems recurred. Dementia including that of the Alzheimer's type is a clinical diagnosis (Grand 2011). Dementia is characterised by a triad of Progressive deterioration of mental processes ( cognitive abilities ) Behavioural and psychological symptoms of dementia ( BPSD ) Difficulties carrying out day-to-day activities ( activities of daily living or ADL).   Alzheimer's Disease is commonest dementia after 65 years of age Alzheime...

Parental supervision protects boisterous children from injury: More time unsupervised corresponds to more injury  “To my parents we were just two girls in the bedroom” . What exactly was going on? Without adequate supervision the parents of this teenager never found out; the memories returned to haunt her in adulthood. Studies comparing children with and without parental supervision show that lax parental supervision is associated with injury in toddlers and preschoolers; conduct problems in school going children; and road accidents, addictions, gambling and sexual risk taking in teenagers. Parental supervision has three dimensions (Gitanjali 2004) Attention - watching or listening  Proximity - within or beyond reach  Continuity - constant, intermittent, or not at all  Two factors determine the degree to which a child would be left unsupervised (Morrongiello 2008) Parent’s conscientiousness  - the more conscientious the parent more the sup...

Depressed mood or sadness lasting two weeks or more requires treatment. We all feel depressed, sad, or ‘blue’ occasionally. Moods and feelings change in response to events in our external environment. Usually depressive feelings or sadness last for a day or two; longer in case of loss or bereavement. However, if these feelings of sadness and hopelessness persist for more than 2 weeks and interfere with daily life, it indicates a clinical depression. Depression is the fourth highest contributor to the global burden of disease.  Clinical depression is a treatable illness. Many people never seek treatment due to lack of awareness, lack of access to mental health care, ignorance, or shame. Signs and Symptoms The hallmark of Clinical Depression is a pervasive depressed mood . This depressed mood is not responsive to positive events. There is associated slowness of thinking and movement; and there are thoughts related to guilt, self-blame, hopelessness and suicide . These f...

Rejection experienced in an intimate relationship can trigger unexpected aggression with sometimes fatal consequences. A working woman in Pune was stabbed to death in her home when she spurned the marriage proposal of a good friend. Another 17 year-old girl from Hadapsar was stabbed in the stomach for rebuffing the overtures of a relative. Why would a man assault a woman after professing his love to her? Many instances of aggression arise from events where an individual perceives he is not sufficiently loved or valued in the context of an intimate relationship. People differ in their readiness to perceive and react to rejection . The desire to belong is a basic human need. Some maintain equanimity while others over-react in ways that harm their relationships and their well-being. Hostility and aggression are among the most destructive reactions to rejection. Low self-esteem, depression, jealousy, self-neglect and a breakdown of daily routine are other painful outcomes of being reje...

Mobile phone induced EEG changes Cellular phones affect the brain to cause injury and death through inattention and reaction time delays. Cellular phone radiations also induce abnormal changes in brainwaves. Here we are not concerned with the potential for death due to the cancer generating properties of GSM radiation. We are concerned with the direct and immediate adverse effects of cellular phone conversations. Cellphones continue to kill their users in Pune . At least two people died crossing the Hadapsar railway tracks while engrossed in conversation. One of them was oblivious to shouting onlookers warning him of the oncoming train. Another cell-bewitched user fell off his eighth-floor balcony while conversing. And of course cellphone use while driving continues to kill despite the ban. All this is besides the cancer risk that the WHO (2011) is unable to disregard. How distracting is a cellphone conversation? Any extraneous demand on attention will distract from performance...

Discrimination of mentally ill persons by hospitals A young woman with psychiatric illness was refused admission at a leading tertiary care hospital in Pune. The reason - “mentally unstable patients are known to cause harm not only to themselves but to others as well. The hospital lacks facilities and infrastructure for catering to psychiatric patients.” A similar unwritten policy of denying inpatient care on grounds of psychiatric illness exists in at least one other large corporate hospital in Pune. We have already stressed the importance of access to healthcare for persons with mental illness . We will now further explore the stereotype of harm in mental illness. The stigma associated with this stereotype has an adverse impact on timely delivery of healthcare to persons with psychiatric illness. Are mentally ill persons likely to harm other hospital inpatients? Hospital and healthcare settings have the highest levels workplace related violence across all industry sect...

Inclusive Education Inclusive education for children with autism and other developmental disabilities is now approaching reality in Pune. Nine children with autism appeared for the Maharashtra 10th standard (SSC) board exam. The accommodations and waivers granted to these students reflect an infusion of the fresh breath of inclusion into the corridors of the board of education . Sarva Shiksha Abhiyan (SSA) in Maharashtra The Education for All Movement , the central government’s flagship SSA, seeks to ensure that every child, including those with special needs, is provided an elementary education. As far as disability is concerned the SSA has adopted a zero rejection policy. It provides for universal access to infrastructure and curricula in schools. Maharashtra is at the forefront of this scheme. In all 380000 teachers from Maharashtra attended workshops on inclusive education through the SSA. 414277 children with special needs were identified and 380723 enrolled under the SSA in...