Yerwada Mental Hospital

Background: Risk for Violent Behavior (RPK) refers to aggressive actions that may result in harm to oneself or others, often triggered by unmet needs, perceived failure, frustration, or ineffective stress management. Non-pharmacological interventions play a crucial role in managing such behaviors, and one effective approach is Progressive Muscle Relaxation (PMR) therapy. Objective: This study aims to evaluate the effectiveness of Progressive Muscle Relaxation therapy in reducing signs and symptoms of violent behavior among patients at risk of aggression at Dr. RM. Soedjarwadi Regional Mental Hospital, Central Java. Methods: A descriptive case study design was employed, incorporating a pre-test and post-test approach using the RUFA (Rating Unit for Aggressive Behavior) observation sheet to assess changes in violent behavior. Two respondents were observed before and after the intervention. Results: Prior to the intervention, both respondents exhibited moderate levels of violent behavior, classified as Intensive Stage II, with baseline scores of 11 and 14, respectively. Following three consecutive days of PMR therapy, both respondents showed improvement, transitioning to Intensive Stage I (mild), with post-intervention scores of 8 and 9. Conclusion: Progressive Muscle Relaxation therapy demonstrates a positive impact in reducing violent behavior among psychiatric patients. The findings indicate a noticeable reduction in aggression levels after the intervention, suggesting that PMR is an effective non-pharmacological strategy for managing patients at risk of violent behavior.

Navkhare, Praveen MBBS, DNB; Kalra, Gurvinder MD; Saddichha, Sahoo DPM, MD, FAP, FRANZCP, FCP Author Information

Trichotillomania represents the symptom of pulling out hair. This has been recognised in many psychiatric disorders but is a relatively uncommon presentation. We report a case of trichotillomania associated with dementia. Treatment with Selective Serotonin Reuptake Inhibitors was found to be effective. DOI: http://dx.doi.org/10.4038/sljpsyc.v5i1.6920 SL J Psychiatry 2014; 5 (1): 27-28

Streptococcal infections in children rarely lead to neuropsychiatric manifestations referred to as pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections. The common sequelae include tics, Tourette's syndrome or obsessive-compulsive disorder. Rare presentations may include separation anxiety disorder, body dysmorphic disorder and attention deficit hyperactivity disorder. We present a case of a 10-year-old child that presented primarily with abrupt onset of separation anxiety without any other neuropsychiatric manifestations such as tics or obsessive-compulsive symptoms. Streptococcal infections may present with varied neuropsychiatric manifestations in the pediatric age group and one needs to be more vigilant in cases that have an abrupt onset and unusual presentation. A high index of suspicion is important to diagnose such cases and provide them with a timely treatment.

Context:Disorders of unexplained fatigue are researched globally and debated prominently concerning their biomedical and psychiatric comorbidity. Such studies are needed in India.Aims:To identify biomedical markers and psychiatric morbidity of disorders of severe unexplained fatigue or weakness with disability, designated neurasthenia spectrum disorders (NSDs). To compare biomedical markers of patients with controls. To study correlation between biomedical markers and psychiatric morbidity.Settings:Four specialty outpatient clinics of Psychiatry, Medicine, Dermatology, and Ayurved of an urban general hospital.Design:Case-control study for biomedical markers. Diagnostic interviews for assessment of psychiatric morbidity.Materials and Methods:Patients (N = 352) were recruited using screening criteria and Structured Clinical Interview for DSM-IV screening module. They were compared with controls (N = 38) for relevant biomedical markers. Psychiatric morbidity was assessed with SCID-I interviews, Hamilton scales, and Symptom Check List-90 (SCL-90). Correlations between a nutritional index and axis I morbidity were studied.Statistical Analyses:Frequencies and means of biomedical markers and psychiatric diagnoses were compared and associations assessed with regression analysis.Results:Corrected arm muscle area (CAMA) was significantly lower among patients (P < 0.001), but not anemia. Anxiety (73.0%) and somatoform (61.4%) disorders, especially nonspecific diagnoses, were more frequent than depressive disorders (55.4%). Generally, Hamilton and SCL scores were lowest in Ayurved clinic, and highest in Psychiatry clinic. Presence of Generalized Anxiety Disorder (GAD) and adjustment disorders correlated with low nutritional index.Conclusions:Malnutrition or de-conditioning that may explain weakness need to be considered in the management of NSDs in India, particularly with comorbid GAD or adjustment disorders. Weakness and anxiety, rather than fatigue and depression, are distinct features of Indian patients. SCL may be more useful than categorical diagnoses in NSDs. NSDs are an independent entity with nonspecific psychiatric comorbidity. Cross clinic differences among patients with similar complaints highlight need for idiographic studies.