Rajiv Gandhi University of Health Sciences, Karnataka, Bangalore s4

SYNOPSIS

Rajiv Gandhi University of Health Sciences, Karnataka Bangalore

‘‘PSYCHIATRIC DISORDERS IN WIVES OF PATIENTS WITH ALCOHOL DEPENDENCE SYNDROME”

Name of the candidate : Dr. CAROLINE DIAS

Guide : Dr. P. JOHN MATHAI

Course and Subject : M.D. (PSYCHIATRY)

Department of Psychiatry Father Muller Medical College Kankanady, Mangalore- 575002 AUGUST-2010 RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, KARNATAKA, BANGALORE.

ANNEXURE – II

PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION

Dr. CAROLINE DIAS 1 Name of the Candidate DEPARTMENT OF PSYCHIATRY And address FATHER MULLER MEDICAL COLLEGE , KANKANADY, (In Block letters) MANGALORE -575 002

2. Name of Institution FR. MULLER MEDICAL COLLEGE KANKANADY, MANGALORE – 575 002

3. Course of study and Subject M.D. PSYCHIATRY

4. Date of admission to Course 30th APRIL 2010

5. TITLE OF THE TOPIC “PSYCHIATRIC DISORDERS IN WIVES OF PATIENTS WITH ALCOHOL DEPENDENCE SYNDROME” 6 BRIEF RESUME OF THE INTENDED WORK :

6.1 NEED FOR STUDY: Alcohol Dependence Syndrome is one of the most common psychiatric disorders in the general population and has a significant impact on public health. Alcohol Dependence Syndrome could be considered as a disorder of the family. It has deleterious consequences not only on the patient with Alcohol Dependence Syndrome but also on the members of his family. The wives of patients with alcohol use disorders are on most occasions the core members of the dysfunctional family system. Their mental health is very crucial for their husbands and children. The wife of the patient who is the key member in such a family is most vulnerable to have significant psychiatric disorders. The psychopathology in wives of patients with Alcohol Dependence Syndrome is a largely neglected area in psychiatric research. The present investigator has come across only a few published papers about psychiatric disorders in wives of patients with Alcohol Dependence Syndrome.

REVIEW OF LITERATURE : The problem of excessive alcohol consumption is a major cause of public health concern in most of the countries of the world today. Heavy consumption which involves more than dependence results in untold misery to the individual who is by and large affected by other physical, psychological and social disabilities.1 According to World Health Organization (WHO), alcohol use disorders accounted for 1.4% of the global disease burden. Globally alcohol consumption causes 3.2% of deaths (1.8 million) and 4.0% of the disability adjusted life years lost (58.3 million). The spouse of the patient with Alcohol Dependence Syndrome is vulnerable to have higher prevalence of medical morbidity, psychiatric morbidity and psychosocial problems.2 There are many research reports on the coping behavior , personality characteristics , quality of marital life, psychological distress and codependence of wives of persons with alcohol use disorders.3,4 In a study done in Russia on the psychopathology of wives of patients with Alcohol Dependence Syndrome, out of the 215 wives examined, borderline psychopathological conditions were diagnosed in 174 women who had long been married to alcoholic husbands or lived with them in one apartment. Psychopathy , neurotic personality, neurosis, reactive depression were identified in 27% , 24.7% , 23% , 15% respectively5 Dawson etal investigated the impact of partner alcohol problems on women’s physical and mental health. It was found that women whose partners had alcohol problems were more likely to experience victimization, injury, mood disorders, anxiety disorders, and being in fair or poor health than women whose partners did not have alcohol problems.6 In a study done in North Goa, it was found that excessive partner alcohol use increased the risk for common mental disorders two to threefold. Alcohol related problems partially mediated the association between partner excessive alcohol use and these mental disorders.7

6.2 AIMS :

1. To evaluate the frequency and nature of psychiatric disorders in wives of

patients with Alcohol Dependence Syndrome.

2. To study the relationships between psychiatric disorders and socio

demographic and clinical variables of Alcohol Dependence Syndrome in

wives of patients with Alcohol Dependence Syndrome.

7. MATERIALS AND METHODS : 7.1 Place and Period : The clinical study will be carried out in the Alcohol Deaddiction and Treatment Center (Vailankanni Ward), Department of Psychiatry, Fr. Muller Medical College, Mangalore. The clinical investigation will commence from September 2010 and data collection will be completed by August 2012.

7.2 Methods of Collection of data : SAMPLE: The wives of adult inpatients of the Alcohol Deaddiction and Treatment center Fr. Muller Medical College with a diagnosis of Alcohol Dependence Syndrome according to the ICD 10- Classification of Mental Health and Behavioural Disorders- Diagnostic Criteria for Research (DCR-10) will constitute the population for the investigation. One hundred such wives selected at random will form the sample.

INCLUSION CRITERIA : 1) The wives of male adult inpatients with a diagnosis of Alcohol Dependence Syndrome according to the ICD 10- Classification of Mental Health and Behavioural Disorders- Diagnostic Criteria for Research (DCR-10). 2) Age group between 18 and 64 years.

EXCLUSION CRITERIA: 1) Age below 18 and above 64 years 2) Physical and psychiatric disorders in the patient which are not related to alcohol use. 3) Wives of patients not consenting for the study 4) Co-morbid substance use other than tobacco in the patients

The control group will consist of 50 wives of patients with Bipolar Affective Disorder- current episode mania, as their presentation of symptoms is similar to those patients with Alcohol Dependence Syndrome. The selection of the control group will be random with similar inclusion and exclusion criteria as those of the study group.

TOOLS FOR ASSESSMENT: 1) Socioeconomic status schedule (Sodhi and Sharma 1986) 2) ICD-10 AM Symptom Checklist for Mental Disorders (WHO) 3) Comprehensive Psychopathology Rating scale ( Asberg M.et al 1978) 4) Marital Quality Scale (Shah A. 1991)

TYPE OF THE STUDY : CASE CONTROL STUDY 8. LIST OF REFERENCES:. 1) Marshall J.: Alcohol Dependence and Alcohol Problems .In. New Oxford Textbook of Psychiatry. Edited by Gelder MG, Andreasen NC, Lopez-Ibor JL, Geddes JR .second edition .Oxford University Press. Oxford. 2009; 437 2) Okazaki etal: Comparative study of health problems between wives of alcoholics and control wives. Arukoru Kenyuto Yakubutsu Ison .1994;29(1), 29-30. 3) Tempier R, Boyer R, Lambert J, Mosier K, Duncan CR: Psychological distress among female spouses of male at-risk drinkers; Alcohol .2006 ;40(1):41-49 4) Strain EC and Anthony JC; Substance-Related Disorders- Introduction and Overview. In .Kaplan and Sadock’s Comprehensive Textbook of Psychiatry. ninth edition. Edited by Sadock BJ, Sadock VA, Ruiz P Lipincott Williams and Wilkins. Philadelphia. 2009; 1264. 5) Moskalenko VD, Gun'ko AA: The wives of alcoholics: experience in the study of psychopathology; Zh Nevrol Psikhiatr Im S S Korsakova. 1994;94(1):51-54 6) Dawson DA, Grant BF, Chou SP, Stinson FS: The impact of partner alcohol problems on women’s physical and mental health; Journal of Studies on Alcohol and Drugs. 2007;68(1):66-75 7) Nayak Madhabika B., Patel Vikram, Bond Jason C. and Greenfield Thomas K.: Partner alcohol use, violence and women’s mental health: population-based survey in India; The British Journal of Psychiatry. 2010;196.192-199

9. Signature of Candidate

10. Remarks of Guide

11. Name and Designation of DR. P. JOHN MATHAI. (in Block letters) PROFESSOR DEPARTMENT OF PSYCHIATRY 11.1 Guide FATHER MULLER MEDICAL COLLEGE , MANGALORE - 575002

11.2 Signature

11.3 Co-Guide (if any )

11.4 Signature

11.5 Head of Department DR. KRISHNA MURTHY PROFESSOR & HOD DEPARTMENT OF PSYCHIATRY FATHER MULLER MEDICAL COLLEGE MANGALORE – 575002. 11.6 Signature