Introduction:
q Patient with
psychiatric disorder presented with symptom of medical illness. Psychiatric
disorder can be consequence or comorbid with medical illness. Many previous studies have shown that
psychiatric disorders such as depressive
disorder, anxiety disorder , drug abuse , organic mental disorders and
somatoform disorder could be encountered approximately in 20-80 percent of
in-patients in any of the general hospitals world wide (Molhotra ,1984; Popkin
et al, 1984; Anstee,1972).
q The current study comprised of all consecutive patients
referred from different department of CMS Teaching hospital, Bharatpur Chitwan
over a period of six months.
q Prevalence of psychiatric disorders among general hospital
population is higher than in community (Michilon, 1993; Huyse et al,1993).
q The risk of psychiatric disorders among those psychically
ill inpatients is three fold high compared to those without (Low, 1998; Mayou,
1998; Loyd, 1991; Meakin,1992 .
q In many circumstance misdiagnosis of psychiatry disorders , which modify the
clinical picture and complicate the management of underlying medical or surgical illness , causes not only a great
drain of currently available health services
but also improper utilization and prolonged hospitalization (Saravay et
al,1994; Arolt et all ,1995 Stundermine et al 2000 ; Gasquet et al ,1996 ; Alja et al 199).
There is stigma about mental illness due to which on many occasion patients go
to non psychiatrist initially..
Objective
q To identify psychiatric consultation on different
departments Of CMS Teaching hospital.
Methods
n The subjects for this study comprised of all consecutive
patients admitted indifferent wards of CMS Teaching Hospital Bharatpur, in whom
psychiatric consulation was performed over a period of six months (1st November 2003 to 31st
may 2004 ).
n A brief explanation
about the study was offered to the subjects and written or verbal consent was
obtained either from them or guardians and all the subjects referred were included in the study.
n A continuous sequential number was given to each subject
and available necessary information was kept confidential in a separate file.
n The socio demographic characteristics and the information
about the illness ( referring departments, the physical diagnosis, any other
comorbid conditions and psychiatric diagnosis) were recorded on a especially
designed socio- demographic proforma by
psychiatrist.
RESULTS
DISTRIBUTION ON THE BASIS OF AGE GROUP |
|
AGE
|
N
|
|
|
|
|
%
|
|
10-19
|
25
|
16.02
|
|
20-29
|
36
|
22.52
|
|
30-39
|
42
|
26.92
|
|
40-49
|
30
|
19.23
|
|
50-59
|
9
|
5.77
|
|
60-69
|
2
|
1.28
|
|
70-79
|
2
|
1.28
|
|
TOTAL
|
156
|
100
|
Table 1 Data shows highest numbers of
patient were age group 30-39(N-42, 26.92%) followed by age group20-29
(N-36, 22.52%).
Table 2
DISTRIBUTION ON THE BASIS OF SEX
|
SEX
|
CASE
|
|
|
|
NO
|
%
|
|
MALE
|
81
|
51.92
|
|
FEMALE
|
75
|
48.07
|
|
TOTAL
|
156
|
100
|
Table -1 shows, distribution of on the basis of sex.
Total numbers of male were 81(51.92%) and female were 75 (48.07%).
Table –3
DISTRIBUTION ON THE BASIS OF MARIETAL STATUS
|
||||||||||||||||||||||||||||
Data shows highest numbers of patient were married (N-104, 66.66%).
Table-4
DISTURIBUTION ON THE BASIS OF OCCUPATION
|
OCCUPATION
|
N
|
%
|
|
|
||
|
FARMER
|
106
|
69.75
|
|
HOUSEWIFE
|
24
|
15.38
|
|
SERVICE
|
11
|
7.05
|
|
UNEMPLOYED
|
8
|
5.13
|
|
STUDENT
|
7
|
5.13
|
|
TOTAL
|
156
|
100
|
Data shows distribution on the basis of occupation, most
of cases were farmer (N-106, 79.75 %).
Table-5
|
DIAGNODIS
|
MALE
|
FEMALE
|
TOTAL
|
%
|
|
DEPRESSIVE DISORDER
|
6
|
11
|
17
|
10.90
|
|
DEPRESSION AND HEART
DISEASE
|
3
|
1
|
4
|
2.56
|
|
DEPRESSION AND ANAEMIA
|
3
|
1
|
4
|
2.56
|
|
DEPRESSION AND CVA
|
3
|
1
|
4
|
2.56
|
|
DEPRESSION AND HTN
|
3
|
0
|
3
|
1.92
|
|
DEPRESSION AND POISONING
|
1
|
1
|
2
|
1.28
|
|
GAD
|
6
|
13
|
19
|
12.18
|
|
PANIC ATTACK
|
1
|
3
|
4
|
2.56
|
|
ALCOHOL USE DISORDER
|
8
|
1
|
9
|
5.77
|
|
SCHIZOPHRENIA
|
1
|
0
|
1
|
0.64
|
|
SOMATOFORM DISORDER
|
6
|
8
|
14
|
8.97
|
|
POST PARTUM PSYCHOSIS
|
0
|
1
|
1
|
0.64
|
|
EPILEPSY
|
4
|
5
|
9
|
5.77
|
|
SEQUELAE POST VIRAL
INFECTION
|
1
|
0
|
1
|
0.64
|
|
PSYCHOSEXUAL DISORDER
|
3
|
0
|
3
|
1.92
|
|
TENSION HEADACHE
|
5
|
5
|
10
|
6.41
|
|
MIGRAINE HEADACHE
|
3
|
3
|
6
|
3.85
|
|
DELIRIUM
|
3
|
2
|
5
|
3.21
|
|
CONVERSION DISORDER
|
1
|
18
|
19
|
12.18
|
|
ADS AND PANCREATIS
|
4
|
0
|
4
|
2.56
|
|
ADS AND FRACTURE LIMB
|
10
|
0
|
10
|
12.80
|
|
ADS AND CIROSIS OF LIVER
|
5
|
0
|
5
|
3.21
|
|
PTSD AND BULLET INJURY
|
1
|
0
|
1
|
0.64
|
|
GAD AND DM
|
0
|
1
|
1
|
0.64
|
|
TOTAL
|
81
|
75
|
156
|
100
|
Legend:
GAD=generalized anxiety
disorder
CVA=cerebrovascular accident
HTN= hypertensions
ADS=alcohol dependent
syndrome
PTSD=posttraumatic stress
disorder
DM=diabetes mellitus
Data shows distribution on the basis of diagnosis, highest
number of cases were depressive disorder including other co morbid condition (N-34,
21.79 %) followed by alcohol and co morbid
condition (N-28, 17.94 %) and anxiety disorder including panic attack(N-23, 14.74 %). Schizophrenia and post partum
psychosis(N-2,
1.28 %).,somatoform disorder (N-14, 8.97 %).,
tension and migraine headache(N-16, 10.26%),
delirium(N-5, 3.21 %), sequelae post viral infection (N-1, 0.64 %), psychosexual
disorder(N-3, 1.92 %).
Table-6
DISTURIBUTION
ON THE BASIS OF CONSULTATION FROM DIFFERENT DEPARTMENT
|
DEPARTMENT
|
M
|
F
|
T
|
%
|
|
MEDICINE
|
39
|
27
|
66
|
42.31
|
|
ENT
|
7
|
8
|
15
|
9.62
|
|
DERMATOLOGY
|
7
|
5
|
12
|
7.69
|
|
SURGERY
|
9
|
8
|
17
|
10.89
|
|
GY/OBS
|
0
|
9
|
9
|
5.77
|
|
OPTHALMOLOGY
|
6
|
4
|
10
|
6.41
|
|
PEDIATRICS
|
5
|
7
|
12
|
7.69
|
|
ORTHOPEDICS
|
8
|
7
|
15
|
9.62
|
|
TOTAL
|
81
|
75
|
156
|
100
|
Data shows distribution on the basis of consultation
from different department most of cases were from Department of Medicine (N-66,
42.31%) followed by Department of Surgery (N-17, 10.89%).
Table 7
DISTRIBUTION ON THE BASIS OF OPENION ABOUT MENTAL
ILLNESS
|
OPENION ABOUT MENTAL ILLNESS
|
M
|
F
|
TOTAL
|
%
|
|
|
||||
|
LIKE TO SPEAK
|
27
|
39
|
66
|
55.93
|
|
NOT
LIKE TO SPEAK
|
21
|
31
|
52
|
44.06
|
|
TOTAL
|
48
|
70
|
118
|
100
|
Data shows distribution on the basis of opinion about
mental illness data shows (N-52, 44.06%) patients don’t like to speak them as
mental illness.
DISCUSSION:
Out of 156 subjects male were 81(51.92%) and female were
75 (48.07%). Data shows highest numbers of patient were age group 30-39(N-42,
26.92%) followed by age group20-29 (N-36, 22.52%). Highest numbers of patient
were married (N-104, 66.66%). most of cases were farmer (N-106, 79.75 %).
Data shows
distribution on the basis of diagnosis, highest number of cases were depressive
disorder including other co morbid condition (N-34, 21.79 %) followed by
alcohol and co morbid condition (N-28, 17.94 %) and anxiety disorder including
panic attack(N-23, 14.74 %). Schizophrenia and post partum psychosis(N-2, 1.28 %),somatoform disorder
epilepsy(N-14, 8.97 %)., tension and
migraine headache(N-16, 10.26%),
delirium(N-5, 3.21 %), sequele
post viral infection (N-1, 0.64 %). Psychosexual disorder (N-3, 1.92 %).
Distribution on
the basis of consultation from different department most of cases were from department of medicine (N-66, 42.31%)
followed by department of surgery (N-17, 10.89%) and shows that (N-52, 44.06%)
patients don’t like to speak them as mental illness.
Conclusion
There is increasing trend for
psychiatric consultation for better management in general hospital which
reduces misdiagnosis and offer good quality treatment. As WHO giving emphasis on establishing
psychiatric department on general hospital rather than established many mental
hospitals.
Data shows most of cases were
from department of medicine (N-66, 42.31%) followed by department of surgery
(N-17, 10.89%).
Highest number of cases were
depressive disorder including other co morbid condition (N-34, 21.79 %). Data
shows that (N-52, 44.06%) patients don’t like to speak them as mental illness,
might be stigma about mental illness, which is challenging for psychiatrists
Hi, there. I am Tom Neil and I want to describe how life had been for my younger brother living with schizophrenia and how he had been forever able to overcome this debilitating disease via a naturopathic, herbal method.
ReplyDeleteMaicon - my kid brother was twenty years old when he was brought to the emergency room by the campus police of the college from which he had been suspended several months ago. A professor had called and reported that he had walked into his classroom, accused him of taking his tuition money, and refused to leave.
Although he had much academic success as a teenager, his behavior had become increasingly odd during the past year. He quit seeing his friends and no longer seemed to care about his appearance or social pursuits. He began wearing the same clothes each day and seldom bathed. He lived with several family members but rarely spoke to any of them. When he did talk to them, he said he had found clues that his college was just a front for an organized crime operation. He had been suspended from college because of missing many classes. My sister said that she had often seen him mumbling quietly to himself and at times he seemed to be talking to people who were not there. He would emerge from my room and ask my family to be quiet even when they were not making any noise.
My father and sister told the staff that Maicon's great-grandmother had had a serious illness and had lived for 30 years in a state hospital, which they believed was a mental hospital. Our mother left the family when Maicon was very young. She has been out of touch with us, and they thought she might have been treated for mental health problems.
Maicon agreed to sign himself into the psychiatric unit for treatment. The whole family except I had agreed to have Maicon transferred to a mental asylum. I knew inwardly there was still some plausible means by which my kid brother could overcome this condition. I knew botanical means of treatment will be more favorable than any other type of treatment, and as such, I had taken a keen interest in the research of naturopathic alternative measures suitable for the treatment of schizophrenia. I had pleaded for some little patience from the family in the delay of the transfer, I was looking forward to proving a point to the entire family, of a positive botanical remedy for this condition.
It was during my ceaseless search on the internet I had been fortunate enough to come across Dr. Utu Herbal Cure: an African herbalist and witch doctor whose professional works had majored on the eradication of certain viral conditions, especially schizophrenia, ( improving the memory capacity positively), via a traditional, naturopathic process and distinguished diet plan. It was by the administration of this herbal specialist that my brother had been able to improve his condition for better.
Before the naturopathic remedy - Maicon's story had reflected a common case, in which a high-functioning young adult goes through a major decline in day-to-day skills. Although family and friends may feel this is a loss of the person they knew, the illness can be treated and a good outcome is possible.
My brother Maicon is just like many other patients out there suffering from this disease. Although he was able to overcome this condition via a naturopathic herbal remedy administered by this African herbal physician and saved completely thus, rekindling the lost joy which had been experienced by the family members.
I wish to use this opportunity to reach across to anyone who may happen to be diagnosed with this disastrous condition to spread the hope of an everlasting herbal remedy that is capable of imposing a permanent end to this disease.
For more information concerning this naturopathic herbal remedy, feel free to contact this African herbal practitioner via email:
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