Open Access Case Report

Effectiveness of Psychosocial Intervention in the Management of Alcohol Dependence Syndrome with Poor Marital Adjustment: A Case Report

Mayank Kumar, Riyal Das, Aniket Mukherjee, Atindra Paul, Banasri Chakraborty

International Neuropsychiatric Disease Journal, Page 28-36
DOI: 10.9734/indj/2022/v18i2348

Aim: Globally, it has been found that the mean lifetime prevalence of alcohol use is 80% and for alcohol use disorder (AUD) is 8.6%, and AUD has an adverse impact on an individual as well as on the person’s family. In view of the same, we choose a case of alcohol dependence syndrome (ADS) to investigate the effect of long-term alcohol use on family dynamics, marital adjustment, interpersonal relationship, and motivational level of the individual with ADS, as well as the effectiveness of pre- and post- brief psychosocial intervention in the treatment outcome of the individual with ADS by involving his family and strengthening his interpersonal relationships.

Presentation of the Case: The client had a history of alcohol use for 22 years. Gradually, his alcohol intake was increased from 100 ml/day to 2-5 litres/day in the last few years. Due to his worsening condition, he was admitted to hospital in 2016 and diagnosed with ADS. He remained abstinent for the next 5–6 months after discharge, but had poor treatment compliance. For the past 2.5 years (2016– 2019), the client again started drinking and the symptoms recurred. He was admitted there again on May 30, 2019. It was found that the prolonged alcohol use of the client had an adverse impact on his spouse’s wellbeing and also on his interpersonal relationships with his parents and siblings. Further, it was found that the client had a lower level of motivation, poor adaptive patterns, inadequate social support, and poor marital adjustment.

Discussion: This study discovered a significant difference between pre- and post-psychosocial intervention in the management of ADS. After our intervention, the client has been doing well. His marital adjustment has increased with his improvement in quality of life, family dynamics, and adaptive patterns.

Conclusion: It was found that psychosocial intervention with the person with alcohol dependence as well as his family is effective and plays a very crucial role in treatment and wellbeing.

Open Access Original Research Article

Comparison of Depressive Symptoms among Women with Gynecological Cancer and other Cancer Types Before and during the COVID-19 Pandemic

Godwin Okoye, Kenechukwu Ben-Umeh, Victor Okoye, Shedrack Osuji, Rachel Vincent

International Neuropsychiatric Disease Journal, Page 15-27
DOI: 10.9734/indj/2022/v18i2347

Objective: Cancer patients are at a high risk of exhibiting depressive symptoms. However, what remains unknown is whether gynecological cancer (GC) worsens this risk. This study seeks to compare depressive symptoms amongst women diagnosed with GC and women diagnosed with other cancer types before COVID-19 pandemic and during the COVID-19  pandemic. It also seeks to compare both study periods to confirm if COVID-19 influenced depressive symptoms of women with GC.

Methods: A retrospective cross-sectional study was conducted to find an association between depressive symptoms and gynecological cancers using other cancer type diagnosis in females as a reference. We utilized the sample adult file of NHIS (National Health Interview Survey) data from 2019 (Pre-Pandemic data) and data from 2020 (Pandemic data). We also utilized the PHQ-8 scale to quantify major depressive disorder. Each of the 8 items were scored from 0-3. All statistical analysis were performed using SAS v9.4 ((SAS Institute Inc, Cary, NC), and statistical significance  was set at α = 0.05.

Results: A weighted population of women with GC vs other cancer types was obtained. Women with GC tend to have lesser Age, Educational status, Health status, Income. They also tend to be more obese and smokers. Women with GC tend to have had hysterectomy (68.03% vs 35.43%) and access to care during COVID-19 (71.63% vs 68.01%). Severe depressive symptoms were higher before pandemic and among women with GC OR 2.89 (95%CI 1.64 - 5.12). Moderate depressive symptoms were higher during the pandemic and among women with GC OR 2.19 (95%CI 1.35 – 3.57). Among women with GC, depressive symptoms were less likely in 2020 than 2019 with an OR 0.57 (95%CI 0.36 – 0.91)

Conclusion: Based on the data available, women with gynecologic cancer are more prone to having depressive symptoms than women with other cancer types. Therefore, policies should be implemented to improve wellness of women with gynecologic cancer. Although, depressive symptoms wasn’t worsened by the COVID-19 pandemic.

Open Access Review Article

Impacts of Telehealth on Access-to-Care for Mental Health Patients

Jennings Hernandez

International Neuropsychiatric Disease Journal, Page 1-7
DOI: 10.9734/indj/2022/v18i2345

The age of technology and smart devices has paved the way for a current and encouraging method to address mental healthcare that benefits from global connectivity: telehealth. According to the American Telemedicine Association, telehealth or telemedicine is defined as the usage of medical information from one site to another through electronic communication with the goal of improving a client’s overall health through emails, cellular phones, two-way videos, and conference calls.  With the current Covid-19 pandemic, hospitals (especially those with mental health units or free-standing psychiatry facilities) are seldomly able to keep up with the influx of mental health patients without being turned away or having to wait for an extended period of time. Through telemedicine, those barriers have been lifted providing more efficient and enhanced access to care for everyone, especially those seeking mental health services. This review paper attempts to establish that despite the observations that telehealth has a positive impact on improved access to mental healthcare, it has not flourished to the extent it could have prior to the COVID-19 pandemic. We also try to provide long-term telehealth solutions, some of which are already being implemented in the current pandemic to improve the quality of mental healthcare access to a larger majority of Americans and those in other countries as well.  With people being advised to stay-at-home coupled with the fear of cross-contamination in public places, people are resorting to telehealth for psychiatric visits and follow-ups. Before this pandemic, however, certain laws and rules have been a barrier to more telehealth options becoming available or feasible to the public. Telehealth is changing the conventional standard of psychiatric medicine by enhancing access to care, reducing re-admission rates, and enhancing the quality of life. Those that have tested positive for the COVID-19 virus and are quarantined at home can still meet with their mental healthcare provider periodically to discuss progress and prognosis. Research has shown that telemedicine has neutralized the impacts of delayed care, hospital admissions, and complications from psychiatric conditions globally. Telehealth has proven to provide steady benefits to patients, psychiatrists, and mental health providers through round-the-clock access remotely.

Open Access Review Article

Transcranial Magnetic Stimulation: New Sapience into How Brain Stimulation Palliates Symptoms of PTSD

Supreet Khare

International Neuropsychiatric Disease Journal, Page 8-14
DOI: 10.9734/indj/2022/v18i2346

Posttraumatic stress disorder (PTSD) is a chronic, often debilitating psychological state disorder that may develop after a traumatic life event. Most patients get over the initial symptoms naturally, but those that experience persistent symptoms require standard treatment approaches such as 1: 1 psychotherapy, psychotropic medications, or both whichever have relevance. However, there are secondary hindrances such as drug safety and drug tolerability associated with these psychotropic medications, that interdict an appropriate course of treatment. The upshot of those events is that it creates a breach in our potential to properly manage PTSD in a significant number of patients, leaving them endangered to surfacing complications like employment-related incapacities, suicidal ideations, co-morbid medical disorders, and illicit drug abuse. Thus, there is a need for more worthwhile, tolerable, and long-standing approaches. Transcranial magnetic stimulation may be a safe and non-invasive treatment technique used to treat various psychiatric and neurological disorders. This neuromodulation technique involves stimulation of specific deep brain regions by the assembly of high and low-intensity magnetic fields thus filling the therapeutic void. This text mainly focuses on the results of controlled and pragmatic trials for efficacy, safety, and tolerability of patients affected by PTSD. The alternative treatment for PTSD currently is psychotherapy and antidepressant medications.Despite receiving these alternatives, there are about 50% of patients who continue to experience major symptoms..That is, the reason why TMS came out as another suitable option. Atleast 5 directories such as MEDLINE, CINAHL, Psych INFO, SCOPUS and EMBASE were probed to pinpoint pragmatic studies and randomized controlled trials that were designed for the treatment of PTSD with TMS. A total of 28 studies were found worthy for this review, out of which 5 are mentioned in this article. Although, so far it looks propitious in spite of the manifoldness as far as its outcomes and its clinical importance are concerned. Hence, still researches involving stimulation constraints are to be conducted in the near future.