Avinash De Sousa

Dementia as a diagnosis at any age is a clinical challenge in psychiatric practice. In recent research reports there have been many case series and anecdotal case reports of dementia with an onset below the age of 45 years. In this case report, we present the case of a 23 years old female that presented with psychotic features initially and on clinical examination and imaging was diagnosed as young onset frontotemporal dementia. Keywords: Dementia, Young onset dementia, Fronto-temporal dementia.

Background: Rheumatoid arthritis (RA) is a chronic autoimmune disorder characterized by pain stiffness and swelling in the joints with long standing effects on quality of life and is complicated by the presence of medical and psychiatric comorbidity. The current study was aimed at comparing the psychopathology, quality of life and life satisfaction between patients with RA and healthy controls. Methodology: There were two groups in the study – a study group with RA patients (n=97) and control group with their first-degree relatives (n=93). A semi-structured proforma collected data related to socio-demographic variables and RA. The groups were assessed using the Mini International Neuropsychiatric Interview, WHO Quality of Life scale brief version and Satisfaction with Life Scale. The scores were statistically analyzed and presented. Results: The mean age of the sample was 44.94 ± 13.02 years (range 18-82 years) and that of the control group was 23.02 ± 8.41 years (range 18-55 years). The mean duration of illness of the group was 7.2 ± 16.9 years (range 1-40 years). Major depression was the commonest disorder seen in 73.1% (n=73) patients with RA. Generalized anxiety disorder, panic disorder and suicidal feelings were also detected. The RA group had significantly lower QOL scores in the psychological and environmental domains of QOL Life satisfaction scores were also significantly lower in the RA group (p=0.0001) when compared to controls. Conclusion: Patients with RA have significant psychopathology that warrants attention and this affects their quality of life and life satisfaction. Further longitudinal studies in this area to gain clinical and epidemiological Indian data are warranted. Keywords: Rheumatoid arthritis, Depression, Psychopathology, Quality of life, Life satisfaction.

Skin rashes have been reported after the start of various antipsychotic drugs in the scientific literature. It is important that psychiatrists be aware of antipsychotic-induced skin reactions in patients on antipsychotic medication which can be an uncommon yet possible occurrence. Patients with psychiatric problems may be prone to skin reactions and may not report the same as they may not be aware of the same. We herewith report a case of skin reaction with Olanzapine in a patient with schizophrenia. Keywords: Schizophrenia, Skin rash, Skin reaction, Antipsychotics, Olanzapine.

Ofloxacin is a commonly used fluoroquinolone antibiotic in adults as well as children. It is generally safe and well tolerated though rare neurological and psychiatric adverse reactions have been reported with Ofloxacin. We report a case of a 6 years old child who developed hallucinations after being started on Ofloxacin and which resolved on discontinuation of the drug. Keywords: Ofloxacin, Hallucination, Fluoroquinolones.

Dementias are the most common type of neurodegenerative disorders. Behavioral disturbances are seen in 50-80% of patients suffering from these disorders. Sexually inappropriate behaviors are not as common as other behaviors seen in dementia but may be seen in 7-30% subjects. These behaviors cause a lot of distress to all those who are affected along with shame and embarrassment. Sexual behaviors in dementia lie on a spectrum that may range from mild or benign to severe. There are no rigorous clinical studies for the treatment of these behaviors and there is no fixed classification for the types of behavior either. There is sparse data that suggest efficacy for some commonly used treatment modalities in dementia. In this chapter, we review the various aspects of these behaviors, their types and the available treatment for the same. Keywords: Sexual issues, Dementia, Sexuality, Sexually inappropriate behavior.

This brief clinical review summarizes the literature on sleep paralysis most relevant to clinicians. Sleep paralysis is a condition where the sufferer awakens to rapid eye movement sleep based atonia, combined with conscious awareness. This is a frightening event accompanied by vivid, waking dreams and hallucinations. Sleep paralysis occurring independent of narcolepsy and other medical conditions is termed isolated sleep paralysis. Though rare in clinical practice, the unusual nature of the condition and a lack of training during medical residency and graduate education leads to fewer cases being detected. This paper looks at the prevalence, risk factors, diagnosis and management of sleep paralysis. The management consists of both pharmacological and psychotherapeutic interventions that need clear guidelines, empirical support and larger randomized controlled trials. Keywords: Sleep, Sleep paralysis, Isolated sleep paralysis.