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AimsThe present study aimed to study maternal bonding impairment among postpartum women at 6–8 weeks postpartum. We compared the severity of bonding impairment among women with high and low risk pregnancies. We also explored gestational factors related to maternal bonding impairment in these women.MethodsHundred women at six – eight weeks postpartum, without any significant physical or mental illness, were assessed for bonding failure using the Postpartum Bonding questionnaire. Their antenatal and postnatal records were reviewed to determine various gestational factors and subsequently classify them as high risk or low risk pregnancies. Unpaired t test and multiple regression analysis were used as appropriate for statistical analysis.Results7% of the mothers had significant impairment in bonding with their infants. The most prevalent type of bonding impairment was infant focused anxiety (1%) and incipient abuse (1%). Maternal bonding failure (d = 0.74) and rejection of infant (d = 0.45) were significantly higher in women with high risk pregnancies (P < 0.01). Not having a term delivery was the most significant factor associated with impaired maternal bonding (β = - 0.26, P = 0.02). Other factors in the model were maternal BMI, mode of delivery, having an emergency caesarean section, presence of congenital malformations in the baby and history of NICU admission. Overall adjusted R-squared for the model was low (0.07), indicating only 7% of variation can be accounted by the gestational factors in the model.ConclusionWomen with high risk pregnancies have higher chances of an impaired bond with their infants. Preterm / post term delivery is the most important risk factor.

Background: Empathy plays a role not only in pathophysiology but also in planning management strategies for alcohol dependence; however, few studies have looked into it. No data are available regarding the variation of empathy with abstinence and motivation. Assessment based on cognitive and affective dimensions of empathy is needed. Aim: This study aimed to assess cognitive and affective empathy in men with alcohol dependence and compared it with normal controls. Association of empathy with disease-specific variables, motivation, and abstinence was also done. Methods: This was a cross-sectional observational study conducted in the outpatient department of a tertiary care center. Sixty men with alcohol dependence and 60 healthy controls were recruited and assessed using the Basic Empathy Scale for cognitive and affective empathy. The University of Rhode Island Change Assessment Scale was used to assess motivation. Other variables were assessed using a semi-structured pro forma. Comparative analysis was done using unpaired t-test and one-way ANOVA. Correlation was done using Pearson's correlation test. Results: Cases with alcohol dependence showed lower levels of cognitive, affective, and total empathy as compared to controls. Affective and total empathy were higher in abstinent men. Empathy varied across various stages of motivation, with a significant difference seen between precontemplation and action stages. Empathy correlated negatively with number of relapses and positively with family history of addiction. Conclusions: Empathy (both cognitive and affective) is significantly reduced in alcohol dependence. Higher empathy correlates with lesser relapses. Abstinence and progression in motivation cycle is associated with remission in empathic deficits.

Background: Nonadherence in attention deficit hyperactivity disorder (ADHD) can be as high as 80%, yet studies on adherence to medications in preadolescent children are few. Recent Indian trends in prescription patterns are lacking. Aim: The present study assesses prescription patterns and adherence to medications in preadolescent children with ADHD. Materials and Methods: Fifty children aged 5-12 years with ADHD, who were on medications for at least 6 months, were enrolled. Their sociodemographic factors and prescription details were noted. Vanderbilt ADHD Diagnostic Parents Rating Scale and Compliance Rating Scale were administered. Results: Sixty-two percent of the children had good compliance, whereas 38% showed reluctance. Adherence was better in children with shorter duration of illness, lesser severity, absence of side effects, and stimulant prescription. Non-stimulant-based combination (40%) was more common compared to stimulants (28%), with atomoxetine and risperidone being the most commonly prescribed medications. Conclusions: Adherence to medications in preadolescent children with ADHD is good. Associated factors and implications are discussed.

Tardive dyskinesia (TD) is a chronic, stigmatizing side effect of typical and atypical antipsychotics that is often debilitating for the patient and resistant to treatment. Obsessive-compulsive symptoms (OCS) may arise at any stage of schizophrenia ranging from prodrome to posttreatment and carry a poor prognosis. Management of both the conditions is a challenging and often fatiguing task for the treating physician. We report a case of schizo-obsessive disorder in an Indian quadragenarian who had developed TD with olanzapine and had failed to show improvement with clozapine and quetiapine. The patient improved dramatically with risperidone. Our findings corroborate with previous literature which has shown risperidone to be effective in treatment of TD and obsessive symptoms, possibly due to its action on the serotonergic system. The authors conclude that risperidone is an effective choice to treat TD and comorbid OCS in patients with schizophrenia.

Background: Children with attention-deficit hyperactivity disorder (ADHD) have severe impairment in their social functioning, and such literature from their sibling relations is limited. Sibling relations have several dimensions to them and a more detailed assessment into their impairment in ADHD is needed. We compared quality of sibling relations among ADHD sibling dyads and healthy controls. We also correlated the quality of sibling relations with severity of inattention and hyperactivity in ADHD. Materials and Methods: The present case-control study enrolled 30 cases of ADHD and 30 healthy controls from a child guidance clinic. The quality of their sibling relations was assessed by parent-rated version of the sibling relationship questionnaire (SRQ) on four domains of warmth, power struggle, conflict, and rivalry as well as their respective sub-domains. Their severity of inattention and hyperactivity was assessed using the Vanderbilt ADHD Diagnostic Parents Rating Scale (VADPRS). Results: ADHD sibling pairs had significantly lower warmth, prosocial behavior, affection, companionship, and competition as compared to their healthy counterparts. ADHD child was admired less by the sibling, and they were also seen to nurture each other less. The most significant difference was seen in affection (r = 0.59), followed by nurturance (r = 0.56). Intersibling conflict correlated positively with hyperactivity scores on VADPRS (ρ = 0.410, P = 0.04). Conclusions: Sibling relations are significantly affected in ADHD, with lower warmth and nurturance. Most significant impairment is noted in affection followed by nurturance. Intersibling conflict correlates significantly with severity of hyperactivity.

Background: Smoking has been shown to have a positive effect on DNA damage in almost all the cells of the body. Quantitative analysis of this damage will help in assessing the etiopathogenesis of various nicotine induced damage to the body. Comet assay has been an emerging tool in this regard and hence was applied by us to estimate the severity of DNA damage in smokers. Aims & Objectives: To evaluate the DNA genotoxicity in peripheral blood lymphocytes in smokers and their comparison with non smokers & assess the quantitative damage. Materials and methods: 30 smokers & 20 non smokers were recruited & their peripheral blood was taken for the comet assay to lookfor Olive moment & Tail moment to quantitatively assess the DNA damage due to cigarette smoking. Results: In our study there was no significant difference in the analysis of DNA damage (with regard to tail moment & olive moment) in smokers versus non smokers (P value: more than 0.05). Conclusions: Though smoking is known to cause DNA damage, we did not find significant differences between the two groups probably due to other multifactorial etiologies for genotoxicity.