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K S Jacob

Publications and source records attributed to K S Jacob.

At least 19 recordsLinked to original sources
PubMed2007

The effect of community based daycare on mental health and quality of life of elderly in rural south India: a community intervention study.

BACKGROUND: Sustainable cost-effective interventions to improve psychiatric morbidity and quality of life among the elderly have not been systematically evaluated in developing countries. METHOD: The most vulnerable elderly living in Pennathur, Vellore district, India, in terms of socioeconomic status and social supports, were invited to participate in a day-care program. Baseline assessments were done using the Mini Mental Status Examination, the Revised Clinical Interview Schedule and the World Health Organisation Quality of Life- Bref. Follow-up assessment was done at 3 months on subjects who took part and those who refused. RESULTS AND CONCLUSIONS: Forty-one (16.4%) were invited to take part. Twenty subjects took part in the program while 21 refused. There was a significant reduction in psychiatric morbidity and improvement in quality of life scores at 3 months for subjects who attended the program. The improvement in quality of life persisted after adjusting for gender, socioeconomic status and baseline scores. Costing of the program suggests sustainability.

Aged↗
PubMed2006

Psychological distress, personality, and adjustment among nursing students.

Psychological distress and poor adjustment among a significant number of nursing students is an important issue facing nursing education. The concerns need to be studied in detail and solutions need to be built into the nursing course in order to help students with such difficulty. This study used a cross-sectional survey design to study psychological distress, personality and adjustment among nursing students attending the College of Nursing, Christian Medical College, Vellore, India. One hundred and forty five nursing students were assessed using the General Health Questionnaire 12, the Eysenck Personality Questionnaire, and the Bell's Adjustment Inventory to investigate psychological distress, personality profile and adjustment, respectively. Thirty participants (20.7%) of the 145 students assessed reported high scores on the General Health Questionnaire. Psychological distress was significantly associated with having neurotic personality and adjustment difficulties in different areas of functioning.

Adaptation, Psychological↗
PubMed2006

Leisure satisfaction and psychiatric morbidity among informal carers of people with spinal cord injury.

STUDY DESIGN: Cross sectional survey. OBJECTIVE: To examine the nature and prevalence of common mental disorders among informal carers of people with Spinal Cord Injury (SCI) and the association with their leisure satisfaction. SETTING: Christian Medical College, Vellore, Tamilnadu, India. METHODS: A cross-sectional survey of informal carers of people SCI at the Department of Physical Medicine and Rehabilitation. Fifty-three informal carers of people with SCI were interviewed using the Revised Clinical Interview Schedule to assess psychiatric morbidity, and using the Leisure Satisfaction Scale to measure leisure and contentment. Data on carers with psychiatric morbidity were compared to those without common mental disorders using univariate and multivariate statistics. RESULTS: Study reported a high morbidity (53%), with most consistent diagnoses of depression and anxiety. Carers who were spouses, women, currently married and those with lower education had greater psychiatric morbidity and lesser leisure satisfaction, even after adjusting for age and education using logistic/linear regression. Age, occupation, residence, socioeconomic status, type and duration of SCI were not associated with either morbidity or leisure satisfaction. CONCLUSION: Many carers of people with SCI suffer from psychiatric morbidity and also have low scores on leisure satisfaction.

Adult↗
PubMed2006

A community health programme in rural Tamil Nadu, India: the need for gender justice for women.

This article highlights the efforts of the Community Health and Development (CHAD) Programme of Christian Medical College to address the issues of gender discrimination and improve the status of women in the Kaniyambadi Block, Vellore, Tamil Nadu, India. The many schemes that are specifically for women and general projects for the community from which women can also benefit represent a multi-pronged approach whose aim is the improvement of women's health, education and employment in the context of community development. However, despite five decades of work with a clear bias in favour of women, the improvement in health and the empowerment of women has lagged behind that achieved by men. We believe this is because the community, with its strong male bias, utilises the health facilities and education and employment programmes more for the benefit of men and boys than women and girls. The article argues for a change of approach, in which gender and women's issues are openly discussed and debated with the community. It would appear that nothing short of social change will bring about an improvement in the health of women and a semblance of gender equality in the region.

Community Health Services↗
PubMed2006

Perspectives of patients and relatives about electroconvulsive therapy: a qualitative study from Vellore, India.

BACKGROUND: There has been little systematic study from developing countries on the perspectives of patients and their relatives about electroconvulsive therapy (ECT). This study attempted to ascertain the views of patients and their relatives on the possible benefits and adverse effects of ECT. METHOD: Qualitative methodology using semistructured interviews, with the Short Explanatory Model Interview as the basis, was used to interview 52 patients who received ECT and their relatives before and after a course of the treatment. The most eloquent 10 among them were chosen for further in-depth interviews. Professional perception of efficacy and cognitive adverse effects were obtained from the patients' medical records. RESULTS: More than half of the recipients were not aware of the details of ECT even at the end of the course but were not unhappy about receiving ECT. Most relatives believed in the disease model, considered the illness serious, felt that enough information about the treatment was provided, knew about its benefits and memory problems, and felt that they were offered an alternative choice of treatment, but also admitted to perceiving coercion. All relatives had signed the consent for treatment, and most were not unhappy with ECT. There were significant differences in perception between patients and relatives and between the perceptions of patients admitted to the hospital involuntarily and of those who agreed for admission. The difference between the clinicians' and the relatives' perceptions of benefits and cognitive adverse effects was not statistically significant. CONCLUSIONS: The results of the study highlight the complex issues and contradictions in the process of providing information and obtaining consent for ECT.

Adult↗
PubMed2006

Sildenafil in the treatment of antipsychotic-induced erectile dysfunction: a randomized, double-blind, placebo-controlled, flexible-dose, two-way crossover trial.

OBJECTIVE: Antipsychotic-induced erectile dysfunction is a significant clinical problem and is a common reason for poor medication compliance. This report studied the efficacy and tolerability of sildenafil citrate in patients with antipsychotic-induced erectile dysfunction. METHOD: The study design was a randomized, double-blind, placebo-controlled, flexible-dose, two-way crossover trial carried out at a tertiary referral center. Thirty-two married male outpatients with schizophrenia or delusional disorder and antipsychotic-induced erectile dysfunction were recruited for the trial. Sexual function was assessed from patient logs of sexual activity. RESULTS: Thirty-two subjects and their spouses, who agreed to take part in the study, were included in the crossover trial. Thirty-one (96.9%) completed the trial. There was no significant period effect or treatment-period interaction. Patients reported significant improvement while taking sildenafil in the number of adequate erections, satisfaction with sexual intercourse, and the duration of erections over 2 weeks. The odds ratios for adequate erections and for satisfactory sexual intercourse with sildenafil were 4.07 and 3.77, respectively. The effect of sildenafil remained significant even after adjustment for period and week effects and treatment-period interaction with Poisson regression analysis. There were no major side effects or adverse drug interactions. CONCLUSIONS: Sildenafil citrate is safe and effective in the treatment of antipsychotic-induced erectile dysfunction. It is also well tolerated.

3',5'-Cyclic-GMP Phosphodiesterases↗
PubMed2006

Rates and factors associated with suicide in Kaniyambadi Block, Tamil Nadu, South India, 2000-2002.

BACKGROUND: Inefficient civil registration systems, non-report of deaths, variable standards in certifying death and the legal and social consequences of suicide are major obstacles to investigating suicide in the developing world. OBJECTIVE: The aim of this study was to prospectively determine the suicide rate in Kaniyambadi Block, Tamil Nadu, South India, for the years 2000-2002 using verbal autopsies. METHOD: The setting for the study was a comprehensive community health programme in a development block in rural South India. The main outcome measure was death by suicide, diagnosed by a detailed verbal autopsy and census, and birth and death data to identify the population base. RESULTS: The average suicide rate was 92.1 per 100,000. The ratio of male to female suicides was 1:0.66. The age-specific suicide rate for men increased with age while that for women showed two peaks: 15-24 years and over 65 years of age. Hanging (49%) and poisoning with organo-phosphorus compounds (40.5%) were the commonest methods of committing suicide. Acute and/or chronic stress was elicited for nearly all subjects. More men suffered from chronic stress while more women had acute precipitating events (chi2 = 4.58; p < 0.04). People less than 44 years of age had more acute precipitating events before death while older subjects reported more chronic stress (chi2 = 17.38; p < 0.001). CONCLUSION: The study replicates findings of an earlier study from the area. The suicide rate documented in this study is very high and is a major public health concern. There is a need for sentinel centres in India and in developing countries to monitor trends and to develop innovative strategies to reduce deaths by suicide.

Adolescent↗
PubMed2006

Explanatory models of common mental disorders among traditional healers and their patients in rural south India.

OBJECTIVE: To delineate concepts, categories, causes of common mental disorders (CMD) and their treatment as understood by traditional healers practicing in rural South India. METHODS: Key informant interviews, focus group discussions and in-depth interviews with traditional and faith healers were conducted to identify concepts, causes, presentations and treatments for CMD. Patients attending clinics conducted by these healers were interviewed using the Tamil versions of the Revised Clinical Interview Schedule (CIS-R) and the Short Explanatory Model Interview (SEMI) in order to identify CMD and understand their explanatory models of illness respectively. RESULTS: Different terms, concepts and treatments were used by traditional and faith healers. A total of 72 patients were interviewed using the CIS-R and the SEMI. Thirty (42.3%) satisfied the International Classification of Diseases-10 Primary Care Version criteria for CMD. Mixed anxiety depression was the most common diagnosis (40%). CONCLUSIONS: An understanding of local patient perspectives of common mental disorders will allow modern medicine to provide culturally sensitive and locally acceptable health care.

Adult↗
PubMed2006

Suicide in India.

Explore the source record for details and available documents.

Adolescent↗
PubMed2006

Effect of a structured educational intervention on explanatory models of relatives of patients with schizophrenia: randomised controlled trial.

We examined the effect of a structured educational programme on explanatory models of illness among the relatives of people with schizophrenia, in a randomised controlled trial. Participants were assessed at baseline (n=100) and after 2 weeks (n=75) using a vignette from the Short Explanatory Model Interview. There was a reduction in non-biomedical causal explanatory models at follow-up among those who had completed the structured educational programme compared with the control group. There was no significant difference in non-biomedical treatment explanatory models between the two groups.

Adult↗
PubMed2006

Validation and usefulness of the Tamil version of the GHQ-12 in the community.

The 12-item General Health Questionnaire (GHQ-12), increasingly used to screen for common mental disorders (CMD) in primary care, has been validated in different languages and cultures. However, the validity and usefulness of the Tamil version has not been established for use in the community. This article reports a study to validate the Tamil version of the GHQ-12 in a rural setting in southern India. The research found that 16.5% of people interviewed satisfied international criteria for CMD. However, the predictive value of the tool as a tool for screening was found to differ from that found in studies undertaken in a hospital setting. While screening instruments need to be validated in specific types of populations before being employed, such tests may be less useful in community surveys where the prevalence of common mental disorders is low. Strategies which artificially increase the prevalence of common mental disorders in the sample screened will improve the performance of the instrument.

Adult↗
PubMed2005

Suicide in the elderly in Kaniyambadi block, Tamil Nadu, South India.

BACKGROUND: Inefficient civil registration systems, non-report of deaths, variable standards in certifying death and the legal and social consequences of suicide are major obstacles in investigating suicide in the developing world. Very high rates of suicide have been recorded in the region in the general population and among younger people. OBJECTIVE: This paper describes the suicide rate among the elderly in Kaniyambadi block, Tamil Nadu, South India for the years 1994-2002 using verbal autopsies. METHOD: The setting for the study was a comprehensive community health program in a development block in rural South India. The main outcome measure was death by suicide diagnosed by a detailed verbal autopsy and census, birth and death data to identify the population base. RESULTS: The average annual suicide rate was 189 per 100,000 for people over 55 years of age. The ratio of male to female suicides was 1: 0.66. The age-specific suicide rate for men and women increased with age. Hanging (52%) and poisoning with organo-phosphorus compounds (39%) were the commonest methods employed for committing suicide. Significantly more women chose drowning or burning than men who preferred poisoning or hanging (chi2 19.75; df 1; p < 0.001). CONCLUSIONS: The suicide rate documented in this study among the elderly is very high. The reasons for the high suicide rate observed in older people are not known. There is a need to develop innovative strategies to reduce deaths by suicide.

Age Distribution↗
PubMed2005

Insight in people with psychosis: the influence of culture.

The assessment of insight is a part of the routine clinical examination for people with mental illness. Such assessment, by psychiatrists, is based on the current definitions of insight, which rely on western notions of health and illness. This paper discusses the recent findings of explanatory models of people with a variety of physical diseases in Vellore, India. It also summaries the results of studies on insight in schizophrenia, which examined explanatory models of illness among patients, relatives, and the general population, in Vellore. The findings argue for the fact that the assessment of insight should be against the local cultural standards rather than universal yardsticks.

Culture↗
PubMed2005

Tuberculous meningitis masked by delirium in an alcohol-dependent patient: a case report.

OBJECTIVE: Patients with alcohol dependence syndrome can present with delirium which will mask underlying organic causes for the delirium. However, other medical diseases can also present with similar symptoms and should not be missed. The issues related to differentiating the different causes of delirium are briefly discussed. We describe a case of tuberculous meningitis in a patient with history of alcohol dependence who presented with delirium. METHOD: A case report. RESULTS: A 38-year-old male was admitted with history of irrelevant talk and abnormal behaviour of 2-month duration. He was also disoriented and his short-term memory was impaired. He reported visual hallucinations. He had history of alcohol dependence of 5 years. A detailed mental status examination and neurological workup revealed an organic psychosis. CT scan showed a hypodense lesion suggestive of a tuberculoma. The cerebrospinal fluid findings were corroborative. He responded to antituberculous drugs which he took for one and a half years and recovered completely. He also underwent group therapy for his alcohol dependence and has since then refrained from alcohol intake. Currently he has gone back to his work as a car mechanic. CONCLUSION: We have highlighted the need for diagnosing and investigating carefully the cause of delirium in a patient with alcohol dependence syndrome. This shows that other curable causes of delirium must also be investigated in patients with alcohol dependence.

Adult↗