Browsing by Author "Joshi, Sulochana"
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Publication Coping Strategies among Patients with Dissociative Disorder: A Descriptive Cross-sectional Study(Nepal Medical Association, 2025) Joshi, Sulochana; Bhandari, Anup Raj; Shakya, RabiAbstract Introduction: Various factors contribute to the development of dissociative disorders. The ability to cope with different stressful events is key to symptom manifestations in this disorder. This study aims to explore various stressors, and coping strategies in patients with dissociative disorder, and the relationship between coping strategies with stressors and clinicodemographic characteristics. Methods: This descriptive cross-sectional study evaluated patients with dissociative disorder presenting at the Department of Psychiatry in a tertiary care teaching hospital for 6 months (May to October 2017). We collected data on the demographic and clinical characteristics. We used the Presumptive Stressful Life Event Scale (PSLES) and Brief COPE scale to record the stressors and the coping responses, respectively. We summarized numerical variables with median and interquartile range (IQR) and categorical variables with proportions. Spearman rank correlation was run to determine the relationship between the PSLES and each coping strategy. Results: Of 108 patients, 86 (79.62%) patients were studied. 77 (89.53%) patients reported stressful life events, and failure in the examination was the most common stressor. Overall, coping strategies were used minimally. Problem-focused coping strategies were used slightly more frequently. There was no statistically significant correlation between stressors and coping strategies. Only religious coping was found to have a significant correlation with age. Conclusions: The majority had stressful events. The use of coping strategies was uncommon. Problem-focused coping strategies were used more frequently.Publication Development and Use of Suicide Registry for Recording Patient Profile with Self-harm Visiting Tertiary Hospital of Nepal: A Descriptive Cross-sectional Study(Nepal Medical Association, 2024) Sharma, Pawan; Bhandari, Anup Raj; Shakya, Rabi; Sapkota, Nidesh; Joshi, Sulochana; Bhattarai, Gaurav; Shah, Bigya; Marahatta, KedarAbstract Introduction: Suicide is a major public health concern globally as well as in Nepal. It is important to have baseline data regarding suicide attempts to develop a prevention strategy. This study aims to describe the methodology used to develop a suicide registry and use it to collect data from patient visiting emergency or psychiatric outpatient department with suicide attempts in a tertiary care hospital. Methods: This is a descriptive cross-sectional study conducted retrospectively after obtaining ethical approval (Reference number: drs2005211371) from institutional review committee. Total sampling was done from the database covering the period from October 1, 2017, to September 30, 2023. The database was in the form of suicide registry that was developed after reviewing the existing data of primary health care centres, private hospitals, and tertiary care centers and a series of discussions among mental health experts. Data was entered in Microsoft Excel and analysis was done. Results: Among the 248 patients, there were 109 (43.95%) male and 139 (56.05%) female. There were 209 (84.27%) patients who attempted suicide inside home, poisoning was seen in 90 (36.29%) and 183 (73.79%) had impulsive intention. Out of total patients, 59 (23.79%) had prior communication and 84 (33.87%) had previous attempts, 109 (43.95%) patients had impulsive attempts as diagnosis and 75 (30.24%) had depression. Conclusions: As per the suicide registry, most of the patients attempted suicide inside home and the most common method used was ingestion of poison.Publication Impulsivity and Childhood Trauma Experience in Borderline Personality Disorder and Healthy Controls: A Comparative Study(Nepal Medical Association, 2025) Ghimire, Pratistha; Joshi, Sulochana; Shakya, RabiAbstract Introduction: Borderline personality disorder is a chronic psychiatric disorder characterized by pervasive patterns of affective instability, self-image disturbances, interpersonal relationship instability, marked impulsivity and suicidal behaviour. Impulsive trait is a major component of BPD. Another major risk factor for the development of borderline personality disorder is childhood trauma. The objective of this study was to compare childhood trauma and impulsivity in borderline personality disorder and healthy controls. Methods: This is a hospital based cross sectional comparative study. Patients seeking treatment in inpatient and outpatient in Department of psychiatry, Patan Hospital, Lalitpur, Nepal who fulfilled the inclusion and exclusion criteria were taken. Patients were divided into two groups: Borderline Personality Disorder (n=21) and Healthy Control (n=42). Childhood Trauma Questionnaire-28 and Barratt Impulsivity score-11 were filled. Results: The mean Barratt Impulsivity Score-11 for borderline personality disorder was 76.95±11.06 and 66.42± 8.92 in health controls. The observed difference was statistically significant (p=<0.001). Childhood trauma questionnaire-28 score for borderline personality disorder was 69.05±21.37 and that for healthy control was 46.43±9.27. The observed difference was statistically significant (p-value<0.05). Conclusions: In this study higher impulsivity and childhood trauma experience was observed with BPD than HC and childhood trauma experience was correlated with impulsivity.