Bengal Journal of Psychiatry

Caregiver burden in patients with schizophrenia

Late Dutt — 2023-09-06

Background: Schizophrenia is a chronic psychiatric disorder. It imposes high level of burden on the caregivers who look after those patients. Previous studies tried to point out various factors which effected caregiver’s burden. Burden Assessment Schedule (BAS) is an Indian tool to assess severity of burden in chronic mentally ill patients. Aims & objectives: to measure caregiver burden of patients with schizophrenia and to find out its various determinants in Bengali culture. Methodology: Consecutive 30 OPD patients fulfilling ICD-10 DCR criteria for schizophrenia and their caregivers, fulfilling inclusion and exclusion criterion were interviewed for socio-demographic data. Caregiver burden was measured on Burden Assessment Schedule. Collected data was assessed for statistically significant relation between socio-demographic variables and severity of burden. Results: Adjusted total score of burden was 64.26(±7.68). Statistically significant (p<0.05) relation was found between caregivers’ burden and their distribution of sex (p=0.013), educational status (p=0.006), family type (p=0.002) and residence (p=0.002). There was no significant relationship found between severity of burden and caregiver's socio-economic status, marital status, religion, occupation and with their relationship with patient (p>0.05) Conclusion: Caregivers of patients with schizophrenia suffer from high level of burden. Sex, education, family type, residence and duration of illness are statistically related to severity of burden.

Key word: schizophrenia, caregiver, burden assessment schedule, burden

The journey ends….

Sujit Sarkhel — 2023-09-06

My journey as the Editor of the Bengal Journal of Psychiatry began a decade ago when I took charge from one of the most respected and revered scholars of West Bengal psychiatry- Professor Gautam Bandopadhyay. Stepping into the shoe of such a giant was definitely a difficult task because the standards set were quite high. The online system of submissions was gradually gaining ground during that period. Getting an ISSN number was an uphill task because one had to visit the New Delhi office in person and convince the clerical staff. We got our Print ISSN number within 2 years. Thereafter followed indexing by several bodies including Google Scholar, ResearchBib, Indian Science Abstract, International Institute of Organized Research (I2OR), PKP-INDEX, Publons, Cosmos Impact Factor, Eduindex Impact Factor (EIF). Indexing in Index Copernicus and Directory of Open Access Journals is yet to be done. Another important milestone was launching the journal as a part of free online journal submission platform. After logging into the website www.bjponline.org, authors can submit their manuscripts online and keep track of the review process. However, for ease of use, article submission by mailing the editor directly is also allowed. Attempt has been made to keep the expenses minimum by using the free online platform although there is a recent trend to hand over journals to reputed systems like Medknow, Jaypee and others. It is for the next editorial team to take a call in this matter. I am really thankful to the contributors, reviewers and members of the editorial team for their constant support and guidance throughout.

I wish the very best to the next Editor of Bengal Journal of Psychiatry for taking it to newer heights!

A Model “Gatekeeper training” for Physicians and Nurses

Avik Chakraborty — 2023-09-06

Suicide is a global pandemic now-a-days and takes a toll of around seven lakh lives per year, the majority of them being young and from low and middle income countries. In 2008, the World Health Organisation launched Mental Health Gap Action Program and set Suicide prevention as a primary goal and recommended "Gatekeeper training" for every nation. Gatekeepers are those who are trained to identify persons at risk of suicide and intervene appropriately.

Opinion on how the concept of Saussure’s ‘sign’ from ‘semiotics’ may aid in metacognitive therapy of OCD

Shaswata Sengupta — 2023-09-06

One of the most singular kinds of mental disorders, Obsessive Compulsive Disorder (OCD) is a mental illness that causes repetition of unwanted thoughts or sensations (obsessions) or the urge to do something over and over again (compulsions). Obsessions and compulsions, though different when taken at face value, have formed a kind of unhealthy symbiotic relationship in OCD. In case of OCD, a trigger often stimulates an intrusive thought stirring up fears of probability of transgression in the minds of those suffering from the disorder. This leads to individuals procrastinating obsessively over these perceived probable transgressions for extended periods of time and trying to reason out with them in order to come to a sense of security that they won’t take fruition by compulsively indulging in some sort of ritualistic behaviour or thought process which, they feel, mitigates the perceived probability. This exercise however proves to be futile. However, when taken rationally, the relationships between the trigger and the intrusive thought as well as the intrusive thought and the perceived transgression are arbitrary by nature. Ferdinand de Saussure’s Semiotic theory depicted a ‘Sign’ as being composed of two parts viz the ‘Signifier’ and the ‘Signified’. However, there is no inherent relationship between these two parts just as an intrusive thought has no intrinsic relationship with a perceived transgression which an individual suffering from OCD associates with it. This article tries to rationally suggest the possibility of utilizing Saussure’s theory in aiding the Meta Cognitive Therapy of individuals suffering from OCD.

Keywords: Obsessive Compulsive Disorder, Semiotics, Signifier, Signified, Freud, Saussure, Id, Ego, Superego, Metacognition

E therapies are going to replace out patient based psychiatric consultation-is it the way forward?

Anamika Das — 2023-09-06

E-therapy has been defined in various ways. One of the more comprehensive definition is ‘‘a licensed mental health care professional providing mental health services via email, video conferencing, virtual reality technology, chat technology or any combination of these’’. It may be synchronous-taking place at the same time (like live chats) or can be asynchronous- taking place back and forth over a period of time (like over emails) or a combination of both.

Role of Ketamine in Obsessive-Compulsive Disorder: A review of Literature

Lalchhandama Haumar — 2023-09-06

OCD is a chronic neuropsychiatric disorder characterised by obsessions and/or compulsions that are ego-dystonic. It is associated with significant disability, poor quality of life and high family burden, often comparable to schizophrenia and other severe mental illnesses (Gururaj et al., 2008). The National Mental Health Survey of India (2015-2016) reported the prevalence of anxiety disorders (including PTSD and OCD) to be 2·94% in the country. With its varied aetiology, autoimmunity was initially implicated in the OCD pathophysiology in the early 1990s, with the paediatric autoimmune neuropsychiatric disorder associated with group A beta-hemolytic streptococcus (GABHS), initially named PANDAS, then renamed paediatric acute neuropsychiatric syndrome (PANS) (Swedo et al., 2012). There is a fivefold higher rate of anti-basal ganglia antibodies in both paediatric and adult OCD patients compared to controls (Pearlman et al., 2014). Studies confirmed the presence of inflammatory markers in the adult OCD brain, specifically within the cortico-striatal-thalamo-cortical regions implicated in OCD pathophysiology (Attwells et al., 2017; Cosco et al., 2019). Raised levels of Interleukins (IL-2,4,6,10), and TNF-alpha were found in comorbidity-free OCD (Rao et al., 2015). Raposo-Lima and colleagues in 2021 found raised serum levels of Neutrophil Gelatinase Associated Lipocalin (NGAL) in OCD patients compared to healthy controls (Raposo-Lima at al., 2021).