RFP Indian Journal of Medical Psychiatry

Background: Pathological laughter is a disorder of emotional expression characterized by bouts of uncontrollable laughter with no motivating factor. It is seen in various neurological disorders such as Post Traumatic Brain injury, Post stroke, Multiple sclerosis, Amyotrophic lateral sclerosis, etc. Case Summary: Here, we present a case of a 46 year old male who presented with pathological laughter to the psychiatry outpatient department following acute infarct in the left frontal and right pons area of the brain. Discussion: Our patient had developed pathological laughter subsequently after right pons and left frontal infarct as pseudobulbar affect. Our case report is unique as both the voluntary and involuntary pathways mediating laughter are involved. Conclusion: Hence, our case may be indicative of possible role of combination of antipsychotics and antidepressants, which warrants further research.
 

Human beings are good in ideas and abstractions. Developing Software is a process that expands the documentation with details that are close to the machine. Donald Knuth proposed “Literate Programming” in 1984 which changes the traditional approaches to the design and development of programs. Instead of having the main task as instructing a computer what needs to be done, the focus should be on explaining to human beings what the stakeholders want a computer to do. Instead of writing code containing documentation, the literate programmer writes documentation containing code. The “program” then becomes primarily a document written for humans. Writing a literate program is more intricate than writing a program in a chosen programming language. With the computers becoming ubiquitous, the inherent essence of computing is so contagious that every human tends to code and even revel in a sequence of codes that work like a program that runs on a computer. The interplay “Human X Computer” with computing as the basis does impact the mental ability as well as the agility of the human coder or programmer. This paper is an overview of certain such impacts.
 

Background: This research study is part of a larger study, which was intended to examine the manifest dream content and meaning representation in children and adults. This part of the study addressed the question, Are there any significant differences between children’s and adults dream reports obtained through the Dream Recording Booklet with respect to the content? And are there any gender differences between children and adult groups. Aim and Objectives: To study how does the dream experience (length, location, characters, social interactions, and emotions) change from childhood to adulthood.  Materials and Methods: To study the objective, the researcher adopted the methodology standardized by Margaret Bowman Howard of Iowa State University, Iowa, USA (1978), which in turn is based on the methodology developed by Hall and Van de Castle. The Dream Recording Booklet was circulated among the participants with clear instructions. Children were requested to recall and record their dreams just after the sunrise awakenings. Parents were asked to support reminding children about their daily recordings without interfering with the children’s dream experiences. In six to eight months, dream data was collected from all the children and adults in the sample. This home-based data collection method worked out very well in obtaining the data. Results: In our comparison of assertiveness between children and adults, we observed that children have a mean score of 3.31, accompanied by a standard deviation of 1.65. Adults, on the other hand, exhibit a higher mean score of 4.42, with a standard deviation of 1.15. The analysis yielded a t-value of 3.491 and a p-value of 0.0008. Since the p-value is below the threshold of 0.05, we can confidently conclude that there is a significant difference between the two groups. This leads us to reject the null hypothesis (H0), which posits that there is no substantial difference in the number of dreams experienced by children and adults. Instead, we accept the alternative hypothesis (H1), indicating that children and adults indeed differ in the number of dreams they experience. This insight can guide further research and discussions on the emotional and cognitive development of both age groups.  Conclusion: The findings of this study align with those of several other studies conducted by Avila-White, Schneider, & Domhoff, 1999; Oberst, Charles, & Chamarro, 2005; Saline, 1999; Strauch & Lederbogen, 1999. The scores obtained support the idea that cultural differences influence the dreams of both children and adults. As a result, dream content analysis plays a significant role in understanding the nature of dreams across different age groups.

Context: The transition to motherhood brings about significant psychological and biological changes, making both pregnancy and the postpartum period are particularly susceptible to health challenges. Mental health issues during this time have often been neglected within the realm of reproductive health, despite their substantial contribution to the global burden of illness and disability. These conditions are associated with a range of symptoms including abnormally high or low mood, irritability, disturbed sleep, hallucinations/delusions, and occasionally suicidal or infanticidal ideation, if not treated promptly, they can substantially impact upon the mother’s health, mother-infant bonding, and family dynamics.  Aim: To study psychiatric morbidity in women during postpartum period.  Settings and Design: Hospital based cross sectional study.  Methods and Material: This is an observational, hospital-based cross-sectional study conducted on postpartum women visiting immunization clinic for first immunization of their babies within 6 weeks of delivery, who fulfil the inclusion and exclusion criteria. The sample size estimated is 100. Assessment tools used are Predesigned questionnaire, Edinburgh postnatal depression scale, BPRS and HAM A.  Statistical analysis used: The data were analysed using IBM SPSS version 29. Continuous and categorical variables have been presented as mean ± standard deviation and percentages respectively.  Results: The population studied tends to be younger (mean age of 27.4+5), predominantly from rural areas (65%), and with limited educational attainment (71% either illiterate or with only primary education) and majority come from lower socio-economic backgrounds. Psychiatric morbidity is mainly in the form of depression (31%) followed by anxiety (17%) with very low prevalence of psychosis (3%). This population appears to face socio-economic and educational disadvantages, but in our study no statistical significance was found between variants like socio economic status, religion and psychiatric morbidity.   Conclusions: The study found that postpartum psychiatric morbidity, particularly depression (31%) and anxiety (17%), is common, while psychosis is rare (3%). No significant   association was observed between psychiatric morbidity and socio-demographic factors like socio-economic status or religion. These findings highlight the need for broader mental health support for postpartum women, regardless of socio-demographic backgrounds. A larger sample size with prospective assessment is recommended to validate these results.
 

Objective: This study investigates the correlation between Obstructive Sleep Apnea (OSA) and depression, examining how OSA impacts psychiatric well-being and quality of life. Introduction: Obstructive Sleep Apnea (OSA) is characterized by episodes of partial or complete airway obstruction during sleep, leading to fragmented and non-restorative sleep. OSA has significant implications for mental health, including a strong association with depression and other psychiatric conditions. Despite considerable evidence linking OSA with psychiatric symptoms, the precise nature of this relationship remains ambiguous. Methods: A cross-sectional study was conducted with 182 participants at a tertiary care center in Telangana from July 2022 to June 2023. Tools employed included the Epworth Sleepiness Scale (ESS), Polysomnography (PSG), and the Hamilton Depression Rating Scale (HAM-D). Participants included those referred for PSG who consented to the study. Exclusions were made for patients with nocturnal oxygen supplementation, recent upper airway surgery, or unstable cardiopulmonary, neurological, or psychiatric conditions. Results: Out of 90 patients who underwent PSG, 23 were diagnosed with depression. These patients were significantly older (mean age 57.30 years) compared to non-depressed individuals (mean age 52.40 years, P < 0.001). Depression was associated with higher HAM-D scores (mean 17.25) and poorer sleep efficiency (68.55%) compared to non-depressed patients (HAM-D mean 8.64, sleep efficiency 72.50%). Additionally, depressed patients exhibited longer sleep latency and REM latency. The Apnoea-Hypopnoea Index (AHI) was significantly higher in depressed patients (mean 26.04) compared to non-depressed patients (mean 20.30, P = 0.005). The majority of depressed patients had abnormal PSG results, with 91.3% showing aberrant findings. Discussion: The study confirms a significant association between OSA and depression. Depression exacerbates OSA symptoms and impairs sleep quality, with substantial implications for patient management and treatment outcomes. The link between OSA and psychiatric conditions such as depression highlights the need for integrated treatment approaches that address both sleep and mental health issues.  Conclusion: OSA is prevalent among individuals with depression, and its impact on psychiatric well-being is considerable. Clinicians should be vigilant in screening for OSA  in depressed patients to improve overall treatment outcomes. Further research is needed to explore the mechanisms underlying the OSA-depression connection and to develop comprehensive management strategies.