Biomedical subjects
S Srinath
Publications and source records attributed to S Srinath.
True hallucinations in non-psychotic states.
While hallucinations are known to occur as conversion symptoms in non-psychotic psychiatric states such as hysteria and grief, there is a lack of distinction between true and pseudo-hallucinations in such cases. We discuss the rationale which has necessitated this distinction, affirm that true hallucinations can occur in non-psychotic states, discuss the characteristics of such hallucinations, and postulate certain factors which may lead to hallucinations in non-psychotic states being judged as "true."
Childhood obsessive-compulsive disorder. 1. Psychopathology.
The obsessions and compulsions noted in 16 cases of obsessive-compulsive disorder in children were compared to the phenomenology seen in 398 cases during a decade. Less obsessions, more compulsions, more frequent washing and repeating compulsions characterised the childhood group.
True hallucinations as a culturally sanctioned experience.
Earlier, we reported that true hallucinations may present as a conversion symptom. We here reiterate this and suggest that cultural sanction may be one factor that can lead to hallucinations being classified as true in non-psychotic psychiatric states.
True auditory hallucinations as a conversion symptom.
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Symptomatic mania after minor head injury.
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Child and adolescent psychiatry in-patient facility.
The short-term in-patent facility of the Child and Adolescent Psychiatry Unit in the National Institute of Mental Health and Neurosciences, Bangalore is described. Its clientele over one year is reviewed. Totally 152 admissions were made. Hysterical neurosis (30.8%), Psychoses (25.2%), Conduct disorder (10.5%) and Hyperkinetic syndrome (9.8%) were the most common diagnoses observed in this population who needed short-term intervention. Average duration of stay was 4-12 weeks. All children were admitted with a parent. In 95.8% of the cases the treatment expenses were borne partially/fully by the hospital. The policy and functioning of the facility is discussed.
A clinical study of infants presenting to a mental retardation clinic.
Early detection has a central role in the prevention and management of mental retardation. The purpose of this present study is to delinerate the characteristics of developmentally delayed infants and their families attending Mental Retardation Clinic. The sample consisted of 101 infants who were registered in Mental Retardation Clinic of NIMHANS, Bangalore in 1988 constituting 12.5% of total registrations. Data was collected from case records. Majority of subjects were males, first or second born, 7 months or older, from a consanguineous lower or middle class family. Along with developmental delay, 60% had other complaints. Medical problems were reported in about half of the subjects and most had abnormalities on physical examination. Aetiology was discernible in 77.1%. Majority had associated physical disorder such as cerebral palsy, seizures and hearing and/or visual impairment. Around 17% came for follow-up thrice or more, 43% dropped out after work-up. The main conclusions are that; (i) certain socio-demographic, personal and clinical variables influence treatment seeking, and (ii) developmental delay recognised in infancy tends to be associated with clear aetiologic factors and significant medical/neurologic problems.
Cerebrospinal fluid levels of homovanillic acid and 5-hydroxyindoleacetic acid in autism.
Cerebrospinal fluid (CSF) concentrations of the serotonin and dopamine metabolites, 5-hydroxyindoleacetic acid (5HIAA) and homovanillic acid (HVA), respectively, were measured in a group of 17 children with Autistic Disorder (DSM-III-R). The group means observed for 5HIAA (135 +/- 91 nmol/L) and HVA (502 +/- 324 nmol/L) in the autistic children were not significantly different from those seen in the control group of 15 nonneurologically impaired children (5HIAA, 122 +/- 120 nmol/L; HVA 401 +/- 378 nmol/L). These data suggest that consistent, marked alterations in central serotonin and dopamine turnover are not present in the autistic subjects studied. Although studies to date have found little or no alteration in CSF 5-HIAA in autism, the various reports of CSF HVA are not entirely congruent. Although this study is consistent with most previous studies in not finding a group difference in CSF HVA, the possibility of increased CSF HVA in autism cannot be ruled out.
The relationship of obsessive-compulsive disorder to putative spectrum disorders: results from an Indian study.
The relationship between obsessive-compulsive disorder (OCD) and putative obsessive-compulsive (OC) spectrum disorders is unclear. This study investigates the prevalence of putative OC spectrum disorders in OCD subjects in a controlled clinical design. The putative OC spectrum disorders studied included somatoform disorders (body dysmorphic disorder [BDD] and hypochondriasis), eating disorders, tic disorders (e.g., Tourette's syndrome [TS]), and impulse control disorders (e.g., trichotillomania). Only those disorders that are commonly noted to be possibly related to OCD are studied. Included in this study were 231 subjects with a diagnosis of OCD according to DSM-IV criteria and 200 controls who were not screened for psychiatric morbidity. The subjects and controls were assessed in detail by extensive clinical and semistructured interviews by expert clinical psychiatrists. The lifetime diagnoses were made by consensus of two psychiatrists. Prevalence of tic disorders, hypochondriasis, BDD, and trichotillomania was significantly greater in OCD subjects compared to controls. However, the prevalence of sexual compulsions, pathological gambling, eating disorders, and depersonalization disorder was not greater in the OCD subjects compared to controls. The findings of this comorbidity study suggest that tic disorders, hypochondriasis, BDD, and trichotillomania are perhaps part of the OC spectrum disorders. There is a need to evaluate evidence from other sources such as epidemiological, neurobiological, and family studies to further our understanding of the concept of OC spectrum disorders.