Browsing by Author "Sharma, PP"
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Publication Publication Psychiatric Illness in the Paediatric Population Presenting to a Psychiatry Clinic in a Tertiary Care Centre(Kathmandu University, 2010) Risal, A; Sharma, PPABSTRACT Background A variety of psychiatric manifestations can be seen in children below the age of 18 years. Such cases rarely present directly to psychiatric care. Methods Retrospective study in Tertiary care hospital . The study population included all the patients of paediatric age group presenting to Psychiatry Outpatient Department of Dhulikhel Hospital directly or referred by a paediatrician or other specialists from October 2008 to October 2010. Results Among the paediatric population evaluated in the psychiatry clinic for two years from October 2008 to October 2010 (N=168), 66.7% were in the age group 15-18 years {mean = 14.77 (±2.99)}, 71.4% were female and 42.3% belonged to Brahmin cast. The highest number of (15%) patients was seen during the month of August 2010. Six months analysis of the psychiatric illnesses of the patients from April 2010 up to October 2010 (n=80) showed dissociative disorder (15%), and seizure disorder (15%) to be the most common diagnoses, followed by depressive disorder and intentional self harm (ISH) (13.8% each). 15% of patients were found to be treated by magico-religious means, with the majority of patients (66.7%) diagnosed as having dissociative disorder. Conclusion The majority of the paediatric population presenting to a psychiatry clinic were in the age group 15-18 years and of female sex. Dissociative disorder was the most common diagnosis followed by depressive disorders. The majority of patients with dissociative disorder had previously been treated by magico-religious means. Key Words dissociative disorder, paediatric population, psychiatric profilePublication Psychiatric manifestations of patients admitted for intentional self harm(Institute of Medicine, 2011) Risal, A; Sharma, PPAbstract Introduction: Psychiatric illnesses are the most common risk factors for suicide. Most cases attempting suicide (Intentional self harm, ISH) present to the hospital emergency for medical complications arising as a result of self-harm forming an important group to understand the psychosocial profile. This study was undertaken to document the various psychiatric manifestations in the patients admitted for intentional self harm (ISH) in a tertiary care hospital. Methods: A cross-sectional study was conducted in a tertiary hospital setting. The study population included all those patients who were admitted and being managed for ISH and brought for psychiatric evaluation during the period of six months (16thApril- 15th October 2010) at Dhulikhel Hospital. Each patient underwent a detailed psychiatric evaluation by a consultant psychiatrist once they were medically stable. Psychiatric diagnoses were considered as per ICD-10 criteria. Results: Among the total subjects (N=73) evaluated during the six months period of the study, 43.8% were in the age group of 21-40 years {mean=30.26(±14.7)}, 69.9% were females (Female to Male ratio=2.31), 80.8% were married and 28.8% belonged to the Mongolian race. There were a steadily increasing number of the patients from April to August, peaking in the month of August. Poisoning was the commonest mode of ISH (93.2 %), Organophosphorus was the most common (72%) poison used. Maximum subjects (41.1%) were found to have Depression Spectrum Disorder (Depression, Dysthymia, Adjustment Disorder) followed by Personality Disorder (26%). Conclusions: Patients attempting ISH are brought to tertiary care hospital for associated medical complications. Organophosphorus poisoning was the commonest mode of suicide while Depression spectrum disorder was the most common psychiatric diagnosis related to suicide. Most suicide cases were seen in the summer months. Keywords: Depression Spectrum Disorder, intentional self harm, organophosphorusPublication Study of Depression among the Nursing Students in a University Medical College of Nepal(Kathmandu University, 2016) Risal, A; Sanjel, S; Sharma, PPABSTRACT Background Nursing students pass through many stressful situations during their academic course. Depression is frequently observed in this student group. Objective To quantify and compare the level of depression among the students undertaking undergraduate and graduate level nursing education in Kathmandu University School of Medical Sciences, Nepal. Method A questionnaire based cross-sectional study was carried out among all the students of Proficiency Certificate Level, Bachelor in Nursing Sciences and B.Sc. Nursing in Kathmandu University School of Medical Sciences, studying in different years during the academic year (2013-14) using Beck Depression Inventory. Descriptive statistics was used for computing scores of Beck Depression Inventory while Pearson correlation was used for analysis of association. Result Among the total 227 students consenting for the study, 212 were amenable for analysis. All of the participants were females, with mean age 20.10 (± 2.2). Almost 40% were found to be having depressive symptoms in variable degrees of severity (Mild-27.4%, Moderate-9%, Severe-1.4%). Frequency of depression was higher among the senior grade students. Agitation, fatigability and sadness were the items having highest mean score; (0.82 ± 0.72), (0.76 ± 0.63), and (0.74 ± 0.52) respectively, while weight loss and loss of libido had the least score, (0.10 ±0.33) and (0.19 ±0.55) respectively. Item on suicidal ideation was significantly correlated with age (p=0.038) and BDI score (<0.001). Conclusion Depression is common among the nursing students in Nepal; which may also be related to the multitude of stressors they experience during their studentship. KEY WORDS Academic, depression, nursing students, occupation, stress, suicidal ideation