Essay Example on The psychiatric morbidity substance abuse pattern and Pathway

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To study the psychiatric morbidity substance abuse pattern and pathway of care among tribal population of Odisha attending psychiatric OPD of a tertiary care centre INTRODUCTION The state Odisha is known for its tribal culture Of all the Indian states Odisha has the largest no of tribes A total of 62 distinct tribes inhabit most of it s 30 districts and constitute 22 01 of the state s total population 1 Tribals are the indigenous people and have not been much affected by the development outside their setup Since independence much effort have been made by the government for improving their healthcare facilities Like other population groups psychiatric morbidity is also prevalent among tribes but due to several factors viz Lack of awareness socio cultural belief system not much has been done to address psychiatric morbidity pattern among the tribes Alcohol and substance abuse have been intimate part of tribal rituals and gatherings since time immemorial Tribals are prone to substance abuse due to exposure to alcohol and tobacco since childhood due to cultural tradition and lack of health awareness 2 



Substance abuse has been found to be one of the precipitating factors for mental illness This study will be a pioneer study in this area as not much of studies have been done in this area in this state Due to lack of awareness of available healthcare facilities and containment with their traditional practices they do not attend much medical assistance Treatment from unqualified medical practitioners and faith healers is a common practice 3 Thus assessment of their pathway of care becomes an important area for addressing the pitfalls in the system and assessing the cause of delay to proper mental healthcare among the special population OBJECTIVE This study aims to find out the followings from the tribal population attending the psychiatric OPD in a tertiary healthcare centre Pattern of psychiatric morbidity among the tribes attaining the out patient clinic and in patient care of the tertiary healthcare system Alcohol and substance abuse pattern among them Pathway of care So as to find out the cause of delay to seek proper mental healthcare services METHODOLOGY After obtaining ethical clearance from the institutional ethical committee the tribes reporting to the psychiatric OPD and in patient care of the tertiary healthcare centre will be included in the study after obtaining due consent from the patient caregivers Following inclusion and exclusion criteria will be followed while selecting the cases from among the tribal population Inclusion criteria

All the new cases in the age group of 18 60 years attending psychiatric OPD or admitted to psychiatric ward during the study period will be included in the study They should belong to any of the 64 distinct tribes of the state of Odisha Exclusion criteria The patient unwilling to give consent or not having a proper caregiver would be excluded from the study This hospital based cross sectional study is aimed to be conducted within a period of two months after obtaining approval from the ICMR for the conduct the research Sampling technique to be used would be Simple Random Sampling Technique A semi structured proforma will be used for obtaining the socio demographic profile of the cases Their clinical diagnosis of the psychiatric morbidity done as per ICD 10 diagnostic criteria 4 will be obtained from the department itself Following scales will be used to evaluate the substance abuse pattern DAST Drug Abuse Screening Test 5 AUDIT Alcohol Use Disorder Identification Test 6 Fagerstrom s test for nicotine dependence 7 The pathway of care will be studied by descriptive method 



IMPLICATIONS By this study we will be able to find out the pattern of psychiatric morbidity and substance abuse pattern among the tribal community of Odisha and by studying their pathway of care we intend to find the factors associated with delay to reach proper mental healthcare and try to suggest some means to minimise this delay because duration of untreated illness is an adverse prognostic factor for the outcome of psychiatric disorders 8 REFERENCES https en m wikipedia org Chaturvedi HK Bajpai RC Pandey A 2016 Predictors of Substance Use in the Tribal Population of Northeast India Retrospective Analysis of a Cross Sectional Survey J Addict Res Ther 7 295 doi 10 4172 2155 6105 1000295 Lahariya C Singhal S Gupta S Mishra A Pathway of care among psychiatric patients attending a mental health institution in central India Indian Journal of Psychiatry 2010 52 4 333 338 doi 10 4103 0019 5545 74308 The ICD 10 Classification of Mental and Behavioural Disorders Diagnostic criteria for research Available from www who int Skinner H A 1982 The Drug Abuse Screening Test Addictive Behavior 7 4 363 371 Available from www drugabuse gov Internet Alcohol Screen AUDIT NCETA Available from www nceta flinders edu au Internet Citation Heatherton TF Kozlowski LT Frecker RC Fagerstrom K The Fagerstrom Test for Nicotine Dependence a revision of the Fagerstrom Tolerance Questionnaire British Journal of Addiction 1991 86 1119 1127 Dell osso B Altamura AC Duration of untreated psychosis and duration of untreated illness new vistas CNS Spectr 2010 Apr 15 4 238 46 Available from https www ncbi nlm nih gov pubmed 20414173 Internet



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