Saturday, December 29, 2012

INDEX



INDEX - POSTS ON THIS BLOG

  1. ADVANCED TREATMENT IN OCD.... 
  2. LAST MINUTE TIPS TO SCORE WELL IN EXAM
  3. HOW TO OVER COME NEGATIVE THINKING / PESSIMISM
  4. MAGNETIC STIMULATION CAN CHANGE LIFE OF MENTALLY ILL…
  5. DEPRESSION- ASSESSMENT AND TREATMENT…
  6. ROLE OF VITAMINS & MINERALS IN MENTAL ILLNESS…
  7. RECENT ADVANCES IN TREATMENT OF SCHIZOPHRENIA…
  8. OBSESSIVE COMPULSIVE DISORDER (OCD) – ADVANCED CARE IN PUNE
  9. NEW GUIDELINES IN TREATMENT OF ANXIETY, PHOBIA & PANIC PROBLEMS…
  10. PSYCHIATRIC AND PSYCHOLOGICAL CARE CENTER IN PUNE… @ DECCAN.

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    DR SWAPNIL DESHMUKH CREATING AWARENESS IN NEWS, HIS OPINION PUBLISHED IN RECENT NEWS ARTICLES IN LEADING NEWS PAPERES OF INDIA. 

    Times Of India.
    Mental health issues on the rise in city
    14% of the population deals with depression, anxiety and other disorders say psychiatrists

        Around 14 per cent of the population in Pune suffers from mental health issues at a given time, say psychiatrists in the city. And this number, they believe, is higher than the normally acceptable incidence of 10 percent. What is alarming though, is that the situation seems to be spreading like an epidemic.
        “Nowadays, cases of depression are rising significantly. Besides depression, suicidal thoughts, anxiety, schizophrenia and bi-polar mood disorders are some of the serious issues that require clinical attention. This 14 per cent does not include issues such as stress and other disorders which are not so serious, but affect the mental health of an individual,” said Dr Swapnil Deshmukh , Secretary, Pune branch of the Indian Psychiatric Society.
       Dr Deshmukh added that the numbers might be slightly higher in Pune than in other cities given that the population here is predominantly youngsters and older people, who are at a higher risk of falling prey to these illnesses. “Mental illnesses were common among aged. However over the past few years, it has risen significantly amongst youngsters. The main reasons for this are increasing competition, lack of family support, lack of financial and job security and various addictions. The World Health Organization had issued a notice in 2009-2010 stating that mental health problems are very prevalent in India. Moreover, at the rate with which it is increasing, it would make India the country with the maximum number of depression as well as suicide cases even though China has a larger population,” he said.
        On Monday, the Supreme Court (SC) issued a notice to the Central and State governments after a plea by the National Human Rights Commission (NHRC) to seek a country-wide epidemiological survey to identify the magnitude of mental health problems. The SC in 1997 had asked them to monitor three mental health institutions — Ranchi, Agra and Gwalior. The commission extended its scope to the country dividing it into five zones — Northern, Eastern, Southern, Western and Central.
        “We found that with changes in lifestyle, mental health issues are on the rise. However, not much attention is paid to them. We are not geared to meet these challenges as we have no infrastructure and not enough healthcare workers in the sector. We do not even have a proper data base though these challenges have increased substantially. From time to time we issued government guidelines as well as suggestions, but nothing much was done about it,” he said.
        
    ALARMING FIGURES
    • MENTAL HEALTH DISORDERS IN THE CITY
    7% Anxiety and depression 3% Bipolar mood disorder 1% Schizophrenia 89% Stress and other issues
    • LACKING HEALTHCARE
    1 in 5 people in India live with mental illness There are 5,000mental health professionals 3:10,000 is the ratio of professionals to patients in Pune. ( TIO)
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    Learn what your partner loves


    Biswadeep Ghosh Sep 23, 2011, 12.00am IST

    (Learn what your partner…)

    The wife loves cooking. What is more, she loves discussing recipes. But, living in a nuclear family has its' disadvantages.

    She aspires to talk about food with her hubby, the only presence in her flat. But her man cannot differentiate between cabbage and cauliflower as long as they are not ready for consumption. Shouldn't the husband learn the craft of making food at least to such an extent that he can have a meaningful chat with his wife?


    Logically speaking, yes. But the husband might counter the thought by saying that, if he doesn't know how to cook, his wife knows nothing about cricket. The guy, on the other hand, is so besotted with the game that he dreams of dying with a cricket bat in his hand! Whenever he tries to talk to his wife about the merits of watching the game, she reacts with a disinterested 'I don't know why you guys are so obsessed with this game with a bat and a ball.'
    Consultant psychiatrist Dr Swapnil Deshmukh says, "In a long-term relationship, partners need to adjust to their spouses' likes and dislikes. It is important to try the activity that the partner enjoys. For example, if the husband enjoys watching cricket, and the wife makes an effort to do the same, the couple can connect on a personal level. This makes a lot of difference."

    A relationship may not run into earth-shattering problems if the husband and wife pursue completely different interests. But if each of them end favors to experience the passion of the other, life can be a little more beautiful.



    Relationships in which the husband and wife have diverse interests are very common. Such relationships can work reasonably well also. But, as Sanjana, a working journalist who is a passionate cook, says, "I would have been so much happier if my husband showed some interest in cooking. He loves to eat. But that is it." Sanjana, on the other hand, has learned the game of football ever since she got married. Today, she knows the names of players from Real Madrid and Manchester United like the proverbial back of her hand. But her hubby continues to be indifferent to the goings on the within the kitchen. That, kind of, saddens her.
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    Youth more prone, also seek psychiatric help


    Monday, Oct 10, 2011, 12:30 IST | Place: Pune | Agency: DNA

    Alifiya Khan  
      
    Stigma of mental illness stops 90% of people from seeking professional help.
    Although more than two lakh people in the city suffer from some form of mental illness, a meagre 10% seek psychiatric treatment, say doctors. This means only one in every 10 patients with mental illness have sought help, a shocking figure that points to the resistance among people to seeking treatment as well as low awareness about mental illnesses.
    On the occasion of World Mental Health Day, DNA spoke to leading psychiatrists, who said that despite advances in medical science, people are afraid or have reservations to enter a psychiatrist’s clinic.

    Agreeing that the younger generation is more open to psychiatric treatment,
    Dr Swapnil Deshmukh, consultant at Joshi Hospital, said Pune has a large population of migrant students who are quite regular in seeking help. “Even today we get patients who have tried all means of treatment like going to a general practitioner, neurosurgeon and even witch doctors before they walk into or are referred by someone to our clinics. In this group too, it is the younger population that is more proactive in seeking help and a large percentage of practice involves younger patients suffering from stress, anxiety and depression,” he said.
    “These students stay out of home and that’s why their emotional support network — family and friends — might not be so strong. That’s why we see a lot of these students seeking help from psychiatrists for stress either due to work, studies or relationship issues,” he said.
    He said youngsters do research on the Internet and try to correlate their symptoms with what they read and decide on self-medication. “Unfortunately, it is not so difficult to get drugs, if you so wish, without a prescription. What happens is that in psychiatry there is no readymade formula for medication, unlike other streams where if you have malaria, one type of treatment is given. Our line of treatment depends on various socio-economic, mental and biological factors and this kind of experiment of using the Internet has backfired and I have seen such cases,” he added.



        

ADVANCED TREATMENT IN OCD...



Dealing with resistant OCD. Other modalities
1        1. St. John's Wort and OCD
Alternative medicine such as herbal remedies have been growing in popularity in both Europe and North America. Many people with anxiety disorders such as OCD have tried alternative therapies at one time or another. One of the most popular herbal remedies for anxiety is St. John's Wort. Because antidepressant medications that target the serotonin system, such as Paroxetine and Clomipramine, are effective in treating OCD, it has been suggested that St. John's Wort -- which is said to also have antidepressant qualities -- could be an alternative therapy for reducing OCD symptoms.
2.   Repetitive Transcranial Magnetic Stimulation
r-TMS has got maximum popularity in both Europe and North America as its is safest treatment modality. rTMS, is a relatively non-invasive procedure that has received considerable attention as a possible alternative treatment to reduce OCD symptoms. Repetitive TMS is a relatively non-invasive procedure that involves placing a small device directly on the skull. This sealed device contains a coil of wire that carries electricity. The flow of electricity through the device causes cells in the brain called neurons to become either more or less active. The activity level of neurons has been linked to symptoms of mental illness like OCD. Recent research has shown very good results of this treatment in Depression and OCD. Also is approved by US-FDA.
3.   D-cycloserine and Behavior Therapy
Psychotherapeutic techniques such as exposure and response prevention therapy are highly effective in treating symptoms of OCD. However, these treatments do not always work for everyone, and the challenging nature of behavior therapy and the associated cost cause many people to decline or drop out of treatment. Given this, there has been a lot of interest in identifying ways that behavior therapy can be made both more effective and accessible for more people. One possibility may be to supplement behavior therapy with medication. A medication that has generated a lot of interest with respect to this is the drug D-cycloserine.
4.   Exercise and OCD
Most of us are familiar with the many physical benefits of aerobic exercise, including reduced cholesterol levels and lowered risk of heart disease and diabetes. However, there is growing evidence that physical activity may also help to reduce symptoms of mental illness. Indeed, it is now known that aerobic exercise can be used therapeutically to improve mild to moderate symptoms of depression, as well as reduce overall stress and anxiety levels. Recently, preliminary studies have also examined whether aerobic exercise is helpful in reducing the severity of OCD symptoms. Also Yoga and Pranayam helps in reducing anxiety symptoms.
5.   Deep Brain Stimulation for OCD
Although a number of medications and psychological therapies are available to treat OCD, it has been estimated that between 25 and 40% of people will not respond adequately to these first-line strategies. In the past 20 years, the development of sophisticated brain imaging technologies, such as functional magnetic resonance imaging (FMRI) have led to an explosive growth in our knowledge of the inner workings of the brain. Results of these investigations have begun to explain the biological and anatomical basis of OCD. In particular, these studies have suggested that treatments targeting specific circuits in the brain could be helpful in reducing OCD symptoms in those people who have severe symptoms and do not respond to traditional treatment. Deep brain stimulation may offer such a treatment.
Although there are many effective treatments for OCD, some people have what is called treatment resistant OCD. Up to a third of people with OCD have treatment resistant OCD and do not respond to standard treatment protocols. Here are some options to consider when coping with treatment resistant OCD.
1. Explore Reasons Why Your Medication May Not Be Working
Although there are many FDA approved medications available for the treatment of OCD, medications do not seem to work for one-third of people’s OCD symptoms. There are many reasons why this can happen and there are things you can do about it.
2. Consider Augmentation Treatment Strategies
Augmentation therapy treats OCD symptoms with medication. This strategy improves the odds of relieving symptoms by using combinations of drugs, rather than a single drug. Augmentation antidepressant treatment may be helpful for people who do not achieve remission with mono-therapy.
3. Explore Reasons Why Psychotherapy May Not Be Working
Although psychological treatments have come to the forefront in the treatment of OCD, they are not always effective. There are many reasons why psychotherapy for OCD may not be working for you and there are things can do about it.
4. Investigate Intensive Treatment Programs
While there are many effective medical and psychological treatments available for OCD, not all treatments work for everybody. Unfortunately, for some people nothing seems to be effective. To combat this, a number of intensive residential OCD treatment programs have been developed.
5. Consider Taking Part in a Clinical Trial
There are a number of reasons why people with OCD consider taking part in a clinical research trial. For starters, clinical trials often offer cutting edge treatments that are not yet widely available to the public.
6. Explore r-TMS, Psychosurgery and Deep Brain Stimulation for Treatment-Resistant OCD
Although a number of medications and psychological therapies are available for OCD, it has been estimated that between 25 and 40% of people will not respond to treatment. A very small minority of individuals with OCD have symptoms severe enough to consider brain surgery. Surgical procedures for OCD involve inactivating certain brain regions that are responsible for the symptoms associated with OCD. In most cases, approximately 50% to 70% of people who have these procedures see a significant improvement in symptoms. One of these neurosurgical procedures is deep brain stimulation, which appears promising although it is still in the experimental stage and often considered a last resort.
In the last 20 years, the development of sophisticated brain imaging technologies such a functional magnetic resonance imaging (FMRI) have led to an explosive growth in our knowledge of the inner workings of the brain. Results of these investigations have begun to explain the biological and anatomical basis of OCD. In particular, these studies have suggested that treatments targeting specific circuits in the brain could be helpful in reducing OCD symptoms in those people who have severe symptoms and do not respond to traditional treatment.
Repetitive Transcranial Magnetic Stimulation & Deep brain stimulation may offer such a treatment.
Deep Brain Stimulation - A Primer
Deep brain stimulation is a technique that involves precise stimulation of particular parts of the brain through the implantation of removable electrodes. rTMS is non-invasive way of modulation. The way in which deep brain stimulation works is still unknown, but it has been suggested that it restores normal activity to areas of the brain that have become dysregulated.
Deep brain stimulation and rTMS has shown considerable promise in the treatment of movement disorders such as Parkinson’s disease, and there is a growing body of evidence that it may be helpful for the treatment of OCD.
Deep brain stimulation and rTMS has a number of advantages over traditional brain surgery for OCD.
·         Deep brain stimulation can be used to treat symptoms with little risk of permanent changes in the brain.
·         The level of stimulation can be adjusted up or down, and the stimulation can be used continuously or intermittently depending on the treatment plan. This allows for greater precision and tailoring of treatment.
·         The surgery is minimally invasive, meaning there is a reduced potential for side effects. It is important to keep in mind, however, that -- like any surgery -- there is risk of complications or side effects, such as bleeding, infection or unanticipated changes in symptoms or personality. For this reason, deep brain stimulation is usually reserved for those people who have not responded to other forms of treatment.
Deep Brain Stimulation and OCD
Deep brain stimulation for the treatment of OCD has been evaluated in a handful of studies. However, because different techniques have been used and diverse brain areas targeted, it has been difficult to compare the results. These preliminary trials hold promise, but it's important to note that this is still an unapproved and experimental treatment for OCD.
Among the most exciting of these studies is an investigation that appeared in the New England Journal of Medicine. Over 10 months, half of the 18 treatment-resistant patients enrolled in the study first received a period of active stimulation of an area of the brain called the subthalamic nucleus, followed by a period of placebo stimulation. The other half of the patients received the placebo stimulation, and then the real stimulation.
Following active stimulation, the majority of patients showed a reduction in OCD symptoms as well as an improvement in their overall ability to return to normal family life, engage in new relationships or go back to work. Only a very small number of patients achieved this while receiving the placebo stimulation.
Although this treatment did not work for everyone, the results of this study are a very positive development in the treatment of OCD. Future studies will have to further examine which brain areas to target as well as determine the pattern of stimulation that works best.