Journal of Psychiatrists' Association of Nepal <p>The official journal of the Psychiatrists' Association of Nepal. Full text articles available.</p> Psychiatrists' Association of Nepal en-US Journal of Psychiatrists' Association of Nepal 2091-2862 Atypical Presentation Of Paediatric Absence Seizure: EEG As A Diagnostic Tool <p>Absence seizures involve brief, sudden lapses of consciousness and are more common in children than in adults. We report a case of absence seizure in a girl with atypical presentation which was diagnosed by electroencephalogram. She responded well to sodium valproate. Detailed history, clinical examination and use of electroencephalogram for diagnosis is necessary especially when such atypical presentations are encountered.</p> R. KC R. Poudel Copyright (c) 2021 Journal of Psychiatrists' Association of Nepal 2021-10-14 2021-10-14 10 1 76 78 10.3126/jpan.v10i1.40366 Post Covid Neuropsychiatric Problems <p>No abstract available.</p> R. Thapa S. Subedi Copyright (c) 2021 Journal of Psychiatrists' Association of Nepal 2021-10-14 2021-10-14 10 1 1 5 10.3126/jpan.v10i1.40338 Buddhist Psychology, Mind And Consciousness <p>No abstract available.</p> KD Upadhyaya Copyright (c) 2021 Journal of Psychiatrists' Association of Nepal 2021-10-14 2021-10-14 10 1 79 81 10.3126/jpan.v10i1.40367 Assessment Of Occupational Burnout And Its Correlates Among Medical Doctors in Nepal during COVID-19 pandemic: A cross-sectional study <p><strong>Introduction: </strong>The current COVID-19 pandemic has increased emotional and physical toll on healthcare workers. The burnout among doctors could be another psychological outcome due to this. Considering the dearth of literature we planned this study with an aim to explore burnout and its correlates among medical doctors of Nepal.</p> <p><strong>Material And Method:</strong> An online survey using a cross-sectional design and purposive sampling was conducted during the lock-down due to COVID-19 pandemic in Nepal. The tools used were basic proforma, Copenhagen Burn out Inventory (CBI) and Perceived Stress Scale (PSS). Descriptive and inferential statistical analysis (bivariate analysis followed by multiple linear regression) was performed with an objective to study prevalence of burnout and its correlates among the medical doctors.</p> <p><strong>Results:</strong> The average age of participants was 30.44 years with the majority being male. All the study participants reported moderate to severe level of perceived stress. Around half of them reported moderate to high burnout. The multiple linear regression analyses showed that perceived stress, and working in surgical department were significant correlates for personal and work-related burnout among medical doctors. Additionally, being front-line worker was a significant correlate for client-related burnout.</p> <p><strong>Conclusion: </strong>The burden and severity of burnout and perceived stress reported by the medical doctors during COVID-19 pandemic in the present study, suggests it to be an important mental health issue in Nepal. Suitable interventions for targeting this urgent issue of effectively reducing the burnout are warranted.</p> Pawan Sharma Swarndeep Singh Umakanta Tiwari Rahul Ranjan Nabin Lekhak Sajan Acharya Copyright (c) 2021 Journal of Psychiatrists' Association of Nepal 2021-10-14 2021-10-14 10 1 6 13 10.3126/jpan.v10i1.40339 Psychological Distress Among General Adult Population Of Kathmandu Valley <p><strong>Introduction: </strong>A large proportion of the population in the community with psychological distress goes unnoticed. This study was done to assess the psychological distress among adult population of urban area of the Kathmandu Valley.</p> <p><strong>Material And Method: </strong>The study was conducted among 280 individuals of age 18 years and above. Samples were conveniently selected from passersby in front of Mental Hospital, Lagankhel on World Mental health day 2018. The Nepali translated version of the General Health Questionnaire-12 (GHQ-12) was used to assess the psychological distress among the study participants.</p> <p><strong>Results: </strong>Majority of the participants had low psychological distress (62.86%) followed by typical (12.86%), more than typical (9.29%), evidence of psychological distress (5.71%) &amp; severe distress (8.93%). 23.93% of the participants had psychological distress which needed attention.</p> <p><strong>Conclusion</strong>: The psychological distress is a major public health concern in our study population. Focused interventions to improve the mental health of population are required to decrease the level of psychological distress among the general population.</p> Devavrat Joshi Pawan Sharma Kenison Shrestha Copyright (c) 2021 Journal of Psychiatrists' Association of Nepal 2021-10-14 2021-10-14 10 1 14 18 10.3126/jpan.v10i1.40340 Burden And Coping Behaviour Among the Family Caregivers of the People With Mental Illness <p><strong>Introduction: </strong>Caring for a person with mental disorder is a challenge for the caregivers. Little is known about the ways in which families cope while caring for a relative with mental illness in developing countries. This study has tried investigating the family burden and coping behaviour among the family caregivers of the people with mental illness.</p> <p><strong>Material And Method: </strong>This is a descriptive cross-sectional study conducted at Devdaha Medical College during the period of July 2019-December 2019. The research was approved by the Ethical Committee of the Institutional Review Board of Devdaha Medical College. The protocol approval number is 028/2019. Convenient sampling method was used. Data analysis was done in SPSS (Version 23, SPSS Inc, Chicago, USA). Results were presented as frequencies and percentages where required.</p> <p><strong>Results: </strong>Moderate Burden was experienced by 72% of the caregivers while the rest 28% experienced severe burden. People whose spouses were mentally ill had severe burden. Males coped with higher degree of problem and emotional focused coping strategy than females. Males felt more burden in comparison to the females and burden was found to be significantly higher among the caregivers who were taking care of their mentally ill spouses.</p> <p><strong>Conclusion</strong>: Caregiving is physically and psychologically demanding as it requires an enormous physical and emotional commitment as well as some basic skills. Teaching skills in the form of problem solving and communication are needed to promote the coping abilities and lessen the burden of caregivers.</p> B. Kafle Y. Bagale Copyright (c) 2021 Journal of Psychiatrists' Association of Nepal 2021-10-14 2021-10-14 10 1 19 23 10.3126/jpan.v10i1.40341 Covid 19 Related Knowledge, Anxiety And Coping Strategies Among Players And Officials Of Men's National Football Team In Nepal <p><strong>Introduction: </strong>This study aims to assess the knowledge and anxiety about CoVID 19 and coping skills involved in dealing with the anxiety in National men’s football team .</p> <p><strong>Material And Method: </strong>Cross sectional analytic study with purposive sampling of members affiliated to Mens national football team who presented to Patan hospital for PCR testing. Tools used were knowledge about corona, fear of COVID 19 scale and Brief Cope Scale Total sample size of 44.</p> <p><strong>Results: </strong>Overall, more than 90% the respondents showed good knowledge about most of the facts about corona virus. The median scores of fear scale showed they were mostly neutral or in disagreement with anxiety statements related to COVID. They mostly adopted coping strategies of Active Coping, Planning, Acceptance, Positive Reframing and informational support while Substance use and Humor were the least used.</p> <p><strong>Conclusion</strong>: The respondents mostly showed good knowledge about corona virus disease, low to mild levels of anxiety and most importantly adopted adaptive coping skills in dealing with the stress.</p> G. Bhattarai A. Bhattarai P. Sharma R. Shakya Copyright (c) 2021 Journal of Psychiatrists' Association of Nepal 2021-10-14 2021-10-14 10 1 24 30 10.3126/jpan.v10i1.40343 Sociodemographic Profiles And Psychiatric Comorbidities Among Patients With Alcohol Dependence In Western Nepal <p><strong>Introduction: </strong>Alcohol is a potent drug that causes acute and chronic changes in almost all neurochemical systems and heavy drinking can produce serious temporary psychological symptoms including depression, anxiety and psychoses. Alcoholism is clinically heterogenous disorder with variable age of onset, drinking patterns, severity and comorbidity with other mental disorders. There is a gender difference in many aspect of alcohol use. The aim of the study was to study the sociodemographic profile, severity, gender difference and psychiatric comorbidities in patient with alcohol dependence syndrome in Nepalese population.</p> <p><strong>Material And Method: </strong>This is a hospital based study done in patients coming to Nepalgunj Medical College, Kohalpur over a period of one year from June 2019 to May 2020 on consecutive serial basis. Diagnosis of alcohol dependence was made based on International Classification of Disease-10 (ICD-10) criteria. Semi structured proforma and Severity of Alcohol Dependence Questionnaire (SADQ) was applied in those patients and recorded accordingly. The data was analyzed using SPSS.</p> <p><strong>Results: </strong>Out of 40 patients studied (N-40), 37 (92.5 %) were male and 3 (7.5 %) were female. Alcohol dependence is most common in the age bracket of 30-39 (43.1%) followed by 40-49 (33.4 %) with mean age of 40.3 years and the mean age of duration of alcohol use being 13.45 years. The mean amount of alcohol consumed per day is 92.25 grams. The SADQ scores, age of first alcohol use, duration of alcohol use in years and daily amount of alcohol use in grams is significantly different between male and female. Similarly there is severe alcohol dependence in 75 % while moderate level in 25 % of study population. Regarding psychiatric comorbidities, 90 % have comorbid other substance use disorder followed by anxiety disorders in 37.5 %, personality disorders in 35 %, mood disorders in 32.5 %, deliberate self harm in 30 % and psychotic disorders in 12.5 %.</p> <p><strong>Conclusion</strong>: Alcohol dependence is most commonly found in young and adults of various age group. Age of first alcohol use, duration of alcohol use in years and daily amount of alcohol use in grams is significantly different between male and female. Alcohol dependence is comorbid with multiple psychiatric entities.</p> <p>&nbsp;</p> M. Belbase R.K. Jalan J. Adhikari Copyright (c) 2021 Journal of Psychiatrists' Association of Nepal 2021-10-14 2021-10-14 10 1 31 37 10.3126/jpan.v10i1.40345 Stressful Life Events In First Episode Psychosis <p><strong>Introduction: </strong>First episode psychosis refers to the first time someone experiences psychotic symptoms or a psychotic episode. There are evidences related to the role of major life events and childhood trauma in the development of first episode psychosis. There are few studies regarding the environmental exposure to stressful life events and how these events might influence the onset of a psychotic disorder, and role of perceived stress. This study aimed to identify the relationship between stressful life events and first episode psychosis in Nepalese context.</p> <p><strong>Material And Method: </strong>It was a hospital based cross-sectional, descriptive study. A total of 50 cases of first episode psychosis were included and the diagnosis was made according to ICD 10- Diagnostic Criteria for Research and verified by two consultant psychiatrists. Semi Structured Performa was designed to collect the information about the socio demographic data and perceived stress was assessed with Presumptive Stressful Life Events Scale (PSLES).</p> <p><strong>Results: </strong>There were 62% female and 38% male patients with first episode psychosis with mean age 26.32 years. Majority of the participants were from rural areas (94%), married (58%), educated up to primary level (38%) and housewife (40%). 60.7% of ATPD had stressful life events (P =0. 000)which was higher than the stressful life events in patient with Schizophrenia (P =0. 005). There was a positive correlation between stressful life events and gender, setting, socioeconomic status and Diagnosis (P &lt;0.05).</p> <p><strong>Conclusion</strong>: Results show the relevance of presence of stressful life events as a potent source of perceived stress in first episode psychosis sample. Therefore this study highlights the importance of psychosocial intervention in this vulnerable group for management of illness and might be an important strategy for prevention.</p> B.D. Karki D. Joshi A.P. Adhikari Copyright (c) 2021 Journal of Psychiatrists' Association of Nepal 2021-10-14 2021-10-14 10 1 38 42 10.3126/jpan.v10i1.40346 Knowledge And Attitude On Mental Illness Among People Of A Selected Community Of Biratnagar <p><strong>Introduction: </strong>Mental disorders are widely recognized as a major contributor to the global burden of disease. Mental illness often generates misunderstanding, prejudice, confusion and fear; therefore it should be a concern for all of us, rather than only for those who suffer from a mental disorder. Aim of this study is to assess the knowledge and attitude on mental illness among people of a selected community.</p> <p><strong>Material And Method: </strong>Descriptive cross-sectional research design was used to assess knowledge and attitude in selected community of Biratnagar. Sample size was 92. Non-probability purposive sampling technique was used to collect data through face to face interview using Semi-structured questionnaire. Data entry and analysis was done on SPSS version 16. Descriptive statistics was calculated.</p> <p><strong>Results: </strong>Finding of the study shows 88% views mental illness as a medical condition. All respondents identified that mentally ill people cannot held his/her responsibility and are prone to violent. Mental illness perceived as treatable by 66.7% with regular treatment and follow-up and 20.7% preferred treatment with traditional healer. Findings of the study showed adequate level of knowledge among 97.8% respondents.</p> <p><strong>Conclusion: </strong>The finding of the study suggests level of knowledge was adequate among respondents whereas most of them had negative attitude towards mental illness. The level of negative attitude suggests the strong emphasis on public education towards mental illness.</p> P. Jha P.K. Mandal Copyright (c) 2021 Journal of Psychiatrists' Association of Nepal 2021-10-14 2021-10-14 10 1 43 49 10.3126/jpan.v10i1.40347 A Study Of Personality Traits And Attachment In Romantic Relationships Among Normal Weight, Overweight And Obese Adults <p><strong>Introduction: </strong>Obesity has significant physical and psychological implications along with severe impacts on social and interpersonal relationships of individuals. The present work is a comparative study between normal weight, overweight and obese individuals with respect to their personality traits and attachment in romantic relationships, it also aims to explore the relationship of body mass index with the variables chosen.</p> <p><strong>Material And Method: </strong>The total sample size was 90. The study was conducted upon three groups-the three groups consisted of 30 normal weight participants, 30 overweight participants and 30 obese participants each. Participants were grouped on the basis of their Body Mass Index (BMI)- which was calculated from self-reported measures of height and weight. All participants were administered the NEO-Five Factor Inventory and the Experiences in Close Relationships- Revised Questionnaire. On the basis of the obtained data, an Independent Samples t-test was done to see if there existed any significant difference between the groups. A Pearson’s coefficient correlation was performed for the total sample and a Stepwise multiple regression analysis was performed to see if any of the variables were significant predictors of BMI for the present sample.</p> <p><strong>Results: </strong>Significant differences existed between the groups in case of neuroticism, extraversion, openness and conscientiousness. The BMI of adults in the present sample has a significant positive correlation with openness and anxious attachment in romantic relationships and a significant negative correlation with extraversion and conscientiousness. Openness and conscientiousness were also significant predictors of BMI for the present sample.</p> <p><strong>Conclusion</strong>: The study adds significant findings to the interaction of obesity with the big five personality traits and sheds light on how attachment in romantic relationships is often affected by the weight stigma.</p> S. Chowdhury T. Mukherjee Copyright (c) 2021 Journal of Psychiatrists' Association of Nepal 2021-10-14 2021-10-14 10 1 50 56 10.3126/jpan.v10i1.40348 Psychiatric Diagnosis Among Patients With Self-Harm Attempts In A Tertiary Care Centre <p><strong>Introduction: </strong>Self harm or suicidal attempt is one of the most common primary psychiatric emergencies. It has been increasing daily but unfortunately people seeking attention and help from psychiatrist is still lagging. This study aims to observe psychiatric comorbidities among self-harm or suicidal attempt.</p> <p><strong>Material And Method: </strong>Those patients who presented with suicidal attempts and related problems in Nobel Medical College Teaching hospital, Biratnagar were assessed for socio demographic and clinical variables. Convenience sampling method was used. MINI 6.0 was applied to all the patients to see for psychiatric disorders. Those who had positive psychiatric disorders in MINI 6.0 were then reassessed according to ICD-10 (International classification of diseases, clinical description and diagnostic guidelines) and final psychiatric disorder was considered. Becks’ suicide intent scale was used to assess the intensity of suicide. Data entry was done using Microsoft Excel and statistical analysis was done by using IBM SPSS Version 16.0.</p> <p><strong>Results: </strong>The result showed that 56.17% of the participants had some form of psychiatric comorbidities. The commonest among them was depression (23.97%), adjustment disorder (21.9%), followed by alcohol use disorder (5.47%) and others. The most common method of suicidal attempt was by poisoning (86.3%), followed by hanging (7.5%) and self- inflicted cut injury (6.2%). Psychosocial stressors were present in 84.9% of patients and 15.1% did not have notable psychosocial stressors.</p> <p><strong>Conclusion</strong>: Patients with self-harm or suicidal attempt have common psychiatric comorbidities depression and adjustment disorder being the most prevalent entities. Hence, every suicidal attempt becomes common psychiatric emergency condition in Nepal.</p> M. Acharya Copyright (c) 2021 Journal of Psychiatrists' Association of Nepal 2021-10-14 2021-10-14 10 1 57 61 10.3126/jpan.v10i1.40363 Outlook Regarding Mental Illness In Patients And Caregivers In Eastern Nepal <p><strong>Introduction: </strong>Mental health is an integral component of overall health. Various factors along with stigma affect knowledge, perspectives and behavior of the people ultimately affecting help seeking and treatment. The patient and their caregivers are directly involved in overall management and outcome. Hence ascertaining those aspects among them is important and so are aims of this study.</p> <p><strong>Material And Method: </strong>A cross sectional comparative study was carried out among 160 participants (80 patients and 80 caregivers) visiting neuropsychiatry outpatient department of a tertiary care hospital. Data was collected through semi-structured proforma and Attitude towards mental illness questionnaire (modified). Data were analysed by using SPSS version 25 and Microsoft excel.</p> <p><strong>Results: </strong>The socio-demographic profiles between both groups were similar. About 75% from both the groups had good knowledge about mental illness. Almost 60% from both groups had positive perception/attitude regarding mentally ill and mental illness with an only significant difference in relation to rights to mentally ill. More than 70% from both groups had positive attitude regarding help-seeking with only significant difference in view about people with mental illness seeking help from psychiatrist. About 50% from both groups had positive attitude regarding care and treatment.</p> <p><strong>Conclusion</strong>: With good knowledge and positive attitude/perception regarding mental illness, self-stigma persisted regarding some domains. Despite positive attitudes for help-seeking, ambivalent views regarding care and treatment into both groups necessitate easy accessibility and upgrading of mental health services.</p> S. Adhikari A. Jha Copyright (c) 2021 Journal of Psychiatrists' Association of Nepal 2021-10-14 2021-10-14 10 1 62 71 10.3126/jpan.v10i1.40364 Psychosocial Profile Of Subjects Presenting With Sexual Dysfunctions In Psychiatry Outpatient Department Of A Teaching Hospital In Nepal <p><strong>Introduction: </strong>Sexuality is way people experience and express themselves sexually. It influences psychological, physical and social well-being of both men and women. Sexual dysfunctions are believed to be among the commonly prevalent psychological disorders in the general population but there is a lack of published research papers and literature related to sexuality and sexual medicine from Nepal. The aim of the present study was to descriptively analyze the nature of sexual dysfunctions in a teaching hospital.</p> <p><strong>Material And Method: </strong>Retrospective analysis of data from subjects attending the psychiatry outpatient department in Nepalgunj Medical College Teaching Hospital, Kohalpur over the calendar year 2019 was done. Sociodemographic and clinical parameters of the subjects were obtained from the OPD register. Diagnosis was made using the DSM-5.</p> <p><strong>Results: </strong>Out of total 54 subjects, 92.6% were male while 7.4% were female. Married subjects constituted 79.6% while single/unmarried 20.4%. Premature ejaculation was the most common sexual dysfunction encountered (55.5%) followed by erectile disorder (33.3%) and female sexual interest/arousal disorder (5.5%). Male hypoactive sexual desire disorder was seen in 3.7% and genito-pelvic pain/penetration disorder was seen in 2%.</p> <p><strong>Conclusion</strong>: Males more commonly seek medical help for sexual dysfunction than females. People especially females, hesitate to discuss and seek medical help for sexual dysfunctions. There is lack of research on sexual medicine and sexuality from Nepal and prevalence of various sexual dysfunctions is not known.</p> R. Poudel Copyright (c) 2021 Journal of Psychiatrists' Association of Nepal 2021-10-14 2021-10-14 10 1 72 75 10.3126/jpan.v10i1.40365