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Biomedical subjects

Santosh K Chaturvedi

Publications and source records attributed to Santosh K Chaturvedi.

12 recordsLinked to original sources
PubMed2006

Atypical antipsychotic-induced akathisia with depression: therapeutic role of mirtazapine.

OBJECTIVE: To investigate the efficacy of mirtazapine in treating akathisia caused by risperidone and olanzapine, as well as its use in alleviating comorbid depressive disorder. CASE SUMMARIES: Five patients with diagnoses varying from schizophrenia, delusional disorder, and bipolar disorder developed akathisia while on treatment with olanzapine and risperidone. The likelihood that risperidone and olanzapine had induced akathisia in all patients was rated probable according to the Naranjo probability scale. Four of these patients were also found to be depressed. The akathisia was successfully treated with mirtazapine, and 3 of the 4 depressed patients improved with mirtazapine treatment. Use of mirtazapine did not result in any adverse effect. DISCUSSION: Mirtazapine is a potent antagonist of central alpha(2) auto- and hetero-adrenergic receptors, as well as an antagonist of 5-HT(2A/2C), 5-HT(3), and histaminergic H(1) postsynaptic receptors. The efficacy of mirtazapine in treatment of akathisia may result from its antagonist property at the H(1) receptors and its dopaminergic activity in frontal cortex. The use of mirtazapine offers advantages over other anti-akathisia drugs in its better adverse effect profile, as well as its ability to treat coexisting depression. CONCLUSIONS: Mirtazapine is efficacious in treating atypical antipsychotic-induced akathisia. It may be a good option, particularly in patients with coexisting depression.

Adult↗
PubMed2006

Somatization, somatosensory amplification, attribution styles and illness behaviour: a review.

Somatic symptoms have been conceptualized in many different ways in literature. Current classifications mainly focus on the numbers of symptoms, with relative neglect of the underlying psychopathology. Researchers have emphasized the importance of a number of experiential, perceptual and cognitive-behavioural aspects of somatization. This review focuses on existing literature on the role of somatosensory amplification, attribution styles, and illness behaviour in somatization. Evidence suggests that somatosensory amplification is neither sensitive nor specific to somatizing states, and that other factors like anxiety, depression, neuroticism, alexithymia may also have an influence. Attribution research supports the existence of multiple causal attributions, which are related to the numbers of somatic symptoms. While somatizing patients have more organic attributions, depressed patients have more psychological attributions. A global somatic attribution style is associated with the number of obscure somatic symptoms, while a psychological attribution style is associated with both--psychological and somatic-- symptoms of depression and anxiety. There are conflicting findings with respect to the role of normalizing attributions in reducing physician recognition of anxiety and depression. Specific symptom attributions appear to explain physician recognition of psychological distress, but global attribution styles do not appear to explain any further variance in physician recognition beyond that explained by specific causal attributions. Illness behaviour has been studied in two distinct ways in literature. Research focusing on attendance rates as a form of illness behaviour suggests that somatization is associated with high levels of health care utilization. There is also some evidence that health care utilization, amplification and attributions styles may be interrelated among somatizing patients. More structured ways to assess illness behaviour have found high levels of abnormal illness behaviour in this population. Overall, research appears to suggest a complex (and as yet unclear) relationship between somatic symptoms and underlying cognitions/illness behaviours. While it is clear that somatization is closely related to a number of perceptual and cognitive-behavioural factors, the precise nature of these relationships are yet to be elucidated.

Affective Symptoms↗
PubMed2006

Somatization in cancer.

Somatic symptoms can occur in disease-free cancer patients. The causes of such symptoms in cancer can be many and varied. These could be due to anxiety, depression, somatization or a manifestation of illness behaviour. Somatic symptoms can also arise out of treatments for the cancer like radiation treatment or chemotherapy. Cancer related somatic symptoms have cognitive, psychological, and physiological causes, each of which is amenable to treatment. The occurrence of somatoform disorders in cancer patients is likely to complicate the treatment and outcome of the cancer. Common somatic symptoms in cancer have been found to be pain, fatigue, anorexia, tiredness or exhaustion, weakness, reduced energy, lethargy, and tremors. Breathlessness, muscle pain, dizziness, and palpitation are common symptoms of anxiety and panic attack which have also been noted in cancer patients. Somatic concern and preoccupation are also common. These symptoms create difficulty in diagnosing depression and anxiety in cancer patients, and leads to the need for modification of the standard diagnostic criteria. Somatic symptoms in cancer respond to counselling and psychopharmacotherapy. More research are needed on this area to understand the process of somatization in a somatic disease.

Antidepressive Agents↗
PubMed2005

Stigma experience in skin disorders: an Indian perspective.

Dermatologic disorders generally have a major impact on patients' daily activities, psychologic and emotional state, and social relationships. The intensity of impact of skin disease on an individual person is extremely variable, however, and depends on natural history of the disorder; the patient's demographic characteristics, personality, character, and value; the patient's life situation; and the attitudes of society. Social stigma toward dermatologic disorders in the Indian society is quite widespread, especially toward leprosy. Dermatologists are expected to consider quality of life issues along with social aspects, nature of disorder, efficacy, and tolerability of various therapeutic options to optimize relief and comfort to their patient.

Cultural Characteristics↗
PubMed2004

Delusion of test-tube pregnancy in a sexually abused girl.

We report the case of a patient who presented with catatonic features and delusion of test-tube pregnancy in the background of previous sexual abuse. The reported case illustrates the importance of contemporary themes in the evolution of psychopathology.

Adolescent↗
PubMed2002

GS-02 for dysthymic disorder: results of a preliminary, open study.

In an open clinical trial, 15 patients diagnosed with DSM-IV dysthymic disorder were treated with GS-02, a herbal formulation containing extracts of four Indian herbs: Ashvatha, Kapikachu, Dhanvayasa, and Bhuriphali. Twelve patients completed the study. The medication was very well-tolerated. Among treatment completers, three (25%) patients showed no response, two (16.7%) showed partial response, and seven (58.3%) showed good response; these response rates are similar to what can be expected from an allopathic antidepressant trial. In an intent- to-treat analysis, significant improvement was observed on Hamilton depression ratings as well as on global measures. The results of this preliminary study encourage further clinical investigation of the GS-02 formulation.

Journal Article↗
PubMed1987

Depressed and non-depressed chronic pain patients.

A comparison between 102 depressed and 101 non-depressed pain patients, identified with the use of DSM-III criteria, showed that depressed patients were more often elderly and employed as compared to non-depressed patients who were significantly more often found to be younger (P less than 0.001) and were students (P less than 0.02). No other demographic differences were observed. Family psychiatric morbidity as well as family history of depressive spectrum disorders were noted in both the groups, without much difference. The relevance of classifying pain patients on the basis of their predominant psychopathology is discussed.

Adolescent↗
PubMed1987

Prevalence of chronic pain in psychiatric patients.

Five hundred consecutive patients attending a psychiatric clinic were examined in order to ascertain the prevalence of chronic pain in various psychiatric illnesses and demographic categories. Chronic pain was found to be a frequent symptom in anxiety neurosis (60%), neurotic depression (45%) and hysteria (24.3%). Less than 3% of psychotic patients reported chronic pain. Females and those patients who had entered further education beyond secondary level were found to have significantly higher (P less than 0.001) representation as compared to the psychiatric population without pain. The results are in accordance with certain earlier studies carried out almost two decades ago. Chronic pain was found to be a common symptom of psychiatric illness, reported by 18.6% patients, especially those diagnosed as having neurosis. It was also reported more often by females and by those with a higher education. The reasons for these observations require investigation.

Adolescent↗
PubMed1987

Family morbidity in chronic pain patients.

Family morbidity in chronic pain patients could indicate genetic vulnerability to depressive spectrum disorders or presence of pain behaviour models. Assessment of family morbidity is an area of chronic pain research which has been neglected. In the present study, the frequency and nature of the family psychiatric morbidity of 203 consecutive chronic pain patients has been assessed and compared with that of 140 non-pain psychiatric patients. 30% of chronic pain patients and 33.6% of non-pain psychiatric patients had family psychiatric morbidity. The commonest illness in families of pain patients were found to be alcoholism, psychosomatic disorders and chronic pain. Schizophrenia and affective disorders were reported significantly more often in families of non-pain patients. 53% of psychogenic pain disorder patients had a positive family morbidity. Alcoholism among male relatives, and chronic pain and hypertension more often among female relatives, was another significant observation. No significant difference was found between chronic pain patients with and without family morbidity with regard to socio-demographic variables and clinical diagnosis.

Adolescent↗
PubMed1984

Non-organic chronic intractable pain: a comparative study.

This report compares patients with non-organic chronic intractable (NOCI) pain with those having chronic pain associated with diagnosed physical illness though it was insufficient to explain the severity and nature of pain. Samples were selected after strict screening procedures. The results reveal that NOCI pain is more often seen in those who are younger, unmarried, with higher education and belonging to a professional group of occupation. Chronic pain associated with physical illness is reported more by elderly, married, those with lesser education and housewives. However, only slight differences were noticeable in the clinical characteristics of pain. Thus there are two distinct groups of chronic pain patients. These differences, along with less predominance of low back pain and high number of whole body pain in the samples suggest cultural differences in localisation and presentation of chronic pain.

Adolescent↗