SYNOPSIS
OF
DISSERTATION
DR. V. PRADEEP
DEPT OF PSYCHIATRY
VYDEHI INSTITUTE OF MEDICAL SCIENCES & RESEARCH CENTRE
WHITEFIELD, BANGALORE
RAJIVGANDHIUNIVERSITY OF HEALTH SCIENCES,
BANGALORE, KARNATAKA.
PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION
1 / NAME AND ADDRESS OF THE CANDIDATE /Dr. V. PRADEEP
Rani Nursing Home,No.17/10,kovai road,
Karur-639002.Tamilnadu.
2 / NAME OF THE INSTITUTION / Vydehi Institute of Medical Sciences & Research Centre Whitefield, Bangalore, Karnataka.
3 / COURSE OF STUDY AND SUBJECT / MD Psychiatry
4 / DATE OF ADMISSION / 22.05.2010
5 / TITLE OF THE TOPIC / “A STUDY OF PSYCHIATRIC MORBIDITY AND PSYCHOSOCIAL FACTORS ASSOCIATED WITH ADOLESCENT SUICIDE ATTEMPTS”
6. BRIEF RESUME OF THE INTENDED WORK:
6.1 NEED FOR THE STUDY
Adolescents constitute 22.8 per cent of the population of India1and this is the generation which will shape India’s future. Premature death among adolescents is a tragedy. Where the death is self-inflicted, it is often bewildering. The number of adolescent suicides over the past several decades has tripled or quadrupled2. Suicidal behaviour amongst adolescents is a matter of great concern and according to the American Academy of Paediatrics, committee on adolescence, suicide is the third leading cause of death for adolescents 15 to 19 years old3.Suicidal behaviour increases markedly during adolescence and there is clearly a need for systematic investigation of adolescent suicide attempts in order to gain information that can assist those providing clinical services for these subjects.
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6.1 REVIEW OF LITERATURE
The World Health Organization has defined adolescents as persons in the 10 to 19 years age group4. Adolescence is characterised by rapid physical, biological and hormonal changes resulting in psychosocial, behavioural and sexual maturation and these biopsychosocial factors play an important role in determining theadolescent behaviour towards suicide.A suicidal attempt can be defined as “SELF DESTRUCTIVE BEHAVIOR WITH INFERRED OR EXPLICIT INTENT TO DIE”5.The rates of suicide depend on age and they increase significantly after puberty whereas less than 1 per 1,00,000 completed suicide occurs in persons younger than 11 years of age, about 10 per 1,00,000 completed suicides occur in adolescents between 15 and 19 years of age2. About 95 percent of all persons who commit or attempt suicide have a diagnosed mental disorder2. The potential risk factors forsuicide attempts in adolescents include: Psychiatric illness [depression,affective disorders and substance use],female gender, previous suicide attempts, recent stressful life events, suicide attempts by family members or friends,chronic physical illness, family violence and dysfunction and lower academic achievement6. Suicidal behaviour is highly recurrent, around 15-20 per cent of adolescents reattempt suicide withinone year of the initial attempt and the risk for a completed suicide is 0.5 to 1 per cent per year.Given the elevated risk of suicide clustering among adolescents, the identification of adolescents at risk for suicide attempts before their behaviour escalates and becomes more serious would be of obvious value.
6.2 OBJECTIVES
1, To study the Psychiatric morbidity associated with adolescent suicide attempts.
2, To study the Psychosocial factors contributing to adolescent suicide attempts.
7. MATERIAL AND METHODS
7.1 SOURCE OF DATA
Adolescent suicide attempters attending the teaching hospital facility of Vydehi Institute Of Medical Sciences and Research Centre, Bangalore.
SAMPLE SIZE:50
AGE GROUP: 10-19 years of either sex.
7.2 METHOD OF COLLECTION OF DATA
SAMPLE PROCEDURE:50 cases in the age group of 10-19 years of either sex presenting with attempted suicide in the teaching hospital facility of Vydehi Instituteof Medical Sciences and Research Centre, Bangalore, during the period of study, who have given informedconsentfor the study will be included. Once the medical condition is stable, a detailed history, physical examination and mental status examination will be recorded in a proforma designed for the study.
INSTRUMENTS:
1, Semi structured proforma for recording socio-demographic variables, details of suicide attempt, medical & psychiatric history.
2,Beck Suicide Intent Scale.
3,Adolescent Suicide Assessment Protocol-20.
4, MINI International Neuropsychiatric Interview For Children & Adolescents [MINI KID]
5, Semi structured proforma for assessing psychosocial factors.
6, Children’s global assessment scale [CGAS].
The socio-demographic variables of the patient will be recorded in the semi structured proforma. The assessment of suicide will be done by clinical interview by faculty supported by Beck Suicide Intent Scale and Adolescent Suicide Assessment Protocol-20.The Psychiatric morbidity will be assessed independently by a faculty and validated by MINI KID and coded as per International Classification of Disorders (ICD-10). Psychosocial factors contributing to the attempt will be documented with the help of a semi structured proforma for assessing psychosocial factors and the over all functioning of the adolescent in the past one month will be recorded using the Children’s Global Assessment Scale [CGAS].
7.3 STUDY DESIGN
Descriptive type of observational study.
7.4 STATISTICAL METHOD USED
Outcome of the study will be analysed using Proportions & Z – test.
7.5 INCLUSION CRITERIA
All patients in the age group of 10-19 years, of either sex who had attempted suicide and who have givenInformed consent for the study, attendingVydehi Instituteof Medical Sciences and Research Centre, Bangalore.
7.6 EXCLUSION CRITERIA
There are no specific exclusion criteriafor the study.
8.Does the study require any investigations or interventions to be conducted on patients or other humans or animals?
YES
8.1 Has ethical clearance been obtained from your institution in case of 8?
YES
9. LIST OF REFERENCES
- United Nations Population Fund-Adolescents in India: A profile. UN system in India; 2003.
- Sadock BJ, SadockVA. Kaplan & Sadock’s Synopsis of Psychiatry, 10th ed.USA: Lippincott H. Williams and Wilkins, 2009, 1264pp.
- Shain B.N and the Committee on Adolescence.2007 “Suicide and Suicide Attempts in Adolescents”.AmericanAcademy of Paediatrics,120(3);669.
- World Health Organization. Adolescent friendly health services: An agenda for change. WHO: Geneva; 2002.
- Wagner K.D,Brent D.A “Mood disorders in children and adolescence- Depressive disorders and suicide-chapter 48.1 in Kaplan & Sadock’s Comprehensive Textbook of Psychiatry.9th ed.Sadock BJ,Sadock VA and Ruiz P, USA. Wolters Kluwer/Lippincott Williams & Wilkins, 2009,3652-3663pp.
- Sudhir Kumar C.T, Chandrasekaran R .2000 “A study of Psychosocial and Clinical factors associated with Adolescent suicide attempts”. Indian J Psychiatry, 42(3):237-242.
10. / Signature of Candidate
11. / Remarks of the guide / The topic selected is relevant keeping in view the proportion of adolescents in Indian population and increasing incidence of attempted suicide.
12. / Name and Designation of
12.1 Guide /
Dr. FIAZ AHMED SATTAR
PROFESSOR AND HODVydehi Institute of Medical Sciences & Research Centre Whitefield, Bangalore, Karnataka.
12.2 Signature
12.3 Co-guide(if any)
12.4 Signature
12.5 Head of Department /
Dr. FIAZ AHMED SATTAR
PROFESSOR AND HODVydehi Institute of Medical Sciences & Research Centre Whitefield, Bangalore, Karnataka.
12.6 Signature
13. / 13.1 Remarks of the Chairman and Principal
13.2 Signature
VYDEHI INSTITUTE OF MEDICAL SCIENCES & RESEARCH CENTRE
WHITEFIELD, BANGALORE
(Recognised by Medical Council of India & Affiliated to Bangalore University/R.G.U.H.S)
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Ref No VIMS/PRI/ /2010-2011
TO,
The Registrar.
R.G.U.H.S. Jayanagar, 4th block,
Bangalore-560011. KARNATAKA.
Respected Sir,
SUB: Departmental Ethical Clearance
With regard to subject mentioned above the dissertation subject titled “A STUDY OF PSYCHIATRIC MORBIDITY AND PSYCHOSOCIAL FACTORS ASSOCIATED WITH ADOLESCENT SUICIDE ATTEMPTS”is justifiable & has taken ethical clearance from the department.
Thanking you,
Yours Faithfully.
Prof. & H. O. D.
Department of PSYCHIATRY
VYDEHI INSTITUTE OF MEDICAL
SCIENCES, WHITEFIELD, BANGALORE
VYDEHI INSTITUTE OF MEDICAL SCIENCES & RESEARCH CENTRE
WHITEFIELD, BANGALORE
(Recognised by Medical Council of India & Affiliated to Bangalore University/R.G.U.H.S)
______
Ref No VIMS/PRI/ /2010-2011
TO,
The Registrar.
R.G.U.H.S. Jayanagar, 4th block,
Bangalore-560011. KARNATAKA.
Respected Sir,
SUB: Departmental Ethical Clearance
With regard to subject mentioned above the dissertation subject titled“A STUDY OF PSYCHIATRIC MORBIDITY AND PSYCHOSOCIAL FACTORS ASSOCIATED WITH ADOLESCENT SUICIDE ATTEMPTS”is justifiable & has taken ethical clearance from the department.
Thanking you,
Yours Faithfully.
Principal
VYDEHI INSTITUTE OF MEDICAL SCIENCES, WHITEFIELD, BANGALORE
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