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BACKGROUND: Spinal cord injury (SCI) patients usually experience multiple and ongoing, neurological, and other medical problems with significant damage to the social and psychological well-being of themselves and their families. MATERIALS AND METHODS: Soldiers with SCI transferred to the regional centre after suitable stabilization of their fractures and general physical condition were included in the study. The baseline assessment included a diagnostic interview and review of case notes for a comprehensive, multi-axial diagnosis. The participants were assessed using the Barthel's Index, the Hospital Anxiety and Depression Scale, the General Health Questionnaire, Quality of life (QOL) Index, AFMC stressful life event Scale, and the Social Support Survey with the current defense or coping style also being recorded. Similar assessments were repeated at 1 month, 6 months, and at 1 year after intake. RESULTS: It was noticed that the mean scores on the Hospital Anxiety and Depression Scale were below the cut-off point for diagnosable disorder, or in the mild end of the spectrum. However, the measures of psychological distress and QOL showed significantly high mean scores. Anxiety Scores showed little variation over time initially, and none of the mean differences (t values) reached statistical significance. However, when the scores of intake and those at 6 months are compared, there was a statistically significant improvement. Depression scores, on the other hand, showed a steady improvement with each assessment. General lack of well-being and psychological distress along with poor QOL remained high throughout the period of assessment with little variation over time .These morbidity measures could not be accounted for by variations in stressful life-event scores or by variations in degree of disability. Although the negative correlation between anxiety and depression scores and those on the QOL index approached conventional levels of significance, there was little correlation overall between morbidity measures and the putative modifying variables at any stage of assessment. CONCLUSIONS: Although psychological symptoms of depressive and anxious spectrum was virtually universal, psychiatric illness at syndromal intensity warranting a formal psychiatric referral and management was rare in patients with SCI in the 1st year. The general well-being and QOL were expectedly dismal throughout. Expected correlations between the measures of social support and degree of disability with the measures of anxiety, depression, subjective distress, and QOL were not demonstrated .There is a need to look beyond these and explore factors such as lack of information, physical morbidity, quality of social support, and dependence for the activities of daily living to evolve a nuanced approach toward the challenge that these clientele represent.
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Transient global amnesia is characterized by abrupt and short lasting loss of ability to recall recent events or to remember new information. A case of transient global amnesia is presented and the importance of awareness of this condition for the psychiatrist is discussed.
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Venlafaxine is a newly introduced antidepressant that is clinically different from other antidepressants, possesses a slightly different mechanism of action and may have unique efficacy properties and a faster onset of action. A case of venlafaxine induced severe hypertension is reported to highlight the need for caution while using this drug.
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Fifty coronary heart disease cases along with an equal number of controls, matched in age and educational levels were studied using Middlesex Hospital Questionnaire, Somatic Inkblot Series I and Command Hospital Questionnaire. They were between 20 and 55 years of age. Obsession and somatic personality traits measured on SIS variables were found to be statistically significant in coronary cases compared to controls. However the subject belief in the philosophy of "Karma" when measured on command hospital questionnaire did not show any difference between the two groups.