Letters to Editor
7. 8.
9.
inpatient population with hysteria in India. J Am Acad Child Adolesc Psychiatry 1993;32:822‑5. Mendhekar DN, Gupta D, Girotra V. Sertraline‑induced hypomania: A genuine side‑effect. Acta Psychiatr Scand 2003;108:70‑4. Oedegaard KJ, Neckelmann D, Benazzi F, Syrstad VE, Akiskal HS, Fasmer OB. Dissociative experiences differentiate bipolar‑II from unipolar depressed patients: The mediating role of cyclothymia and the Type A behaviour speed and impatience subscale. J Affect Disord 2008;108:207‑16. Jans T, Schneck‑Seif S, Weigand T, Schneider W, Ellgring H, Wewetzer C, et al. Long‑term outcome and prognosis of dissociative disorder with onset in childhood or adolescence. Child Adolesc Psychiatry Ment Health 2008;2:19.
Access this article online Quick Response Code Website: www.indianjpsychiatry.org
DOI: 10.4103/0019-5545.148548
Accounting for confounding Sir, Went through an article entitled “impact of psychiatry training on attitude of medical students toward mental illness and psychiatry” published in Indian Journal of Psychiatry.[1] The authors deserve credit for touching on the important issue of “role of training” in medical sciences. However, I have a concern. The authors stated aims are: (1) To compare the attitude of medical students and interns in a medical college toward mental illness and psychiatry and (2) to assess the impact of psychiatric training on attitude toward the mentally ill person and mental illness. The authors have done full justice to the first aim of this study in presenting comparable data about the attitude of medical students and interns. However, the second aim of this study, that is, impact assessment has been handled inadequately. The fact that the difference between attitudes of interns and undergraduate medical students (not yet fully exposed to clinical subjects) can provide an idea on impact of training, does not seem logical. The comparison groups are diverse enough to be included for comparison. The fact that interns have undergone clinical training in other disciplines (other than psychiatry) during their under graduation as well as internship period may influence their attitude to psychiatry and mental illness as well and thus act as a confounder in this study. This has not been accounted for in the study. In statistics, a confounder is an extraneous variable that correlates (directly or inversely) with both the dependent variable and the independent variable. A perceived relationship between an independent
variable and a dependent variable that has been misestimated due to the failure to account for a confounding factor, gives rise to a spurious relationship. The methodology to estimate the impact of psychiatry training should have been modified and study could have been conducted on interns only before and after they had received their training in psychiatry.
Sunil Kumar Raina
Department of Community Medicine, Dr. RPGMC, Tanda, Kangra, Himachal Pradesh, India E‑mail: [email protected] REFERENCE 1.
Gulati P, Das S, Chavan BS. Impact of psychiatry training on attitude of medical students toward mental illness and psychiatry. Indian J Psychiatry 2014;56:271‑7.
Access this article online Quick Response Code Website: www.indianjpsychiatry.org
DOI: 10.4103/0019-5545.148549
Pregabalin dependence with pregabalin induced intentional self‑harm behavior: A case report Sir, Pregabalin is a novel gamma amino butyric acid (GABA) analogue which is used for neuropathic pain and partial onset seizures.[1,2] Drug enforcement agency has categorized pregabalin as a schedule V drug under the terms 110
of controlled substances act. In 2008, US Food and Drug Administration announced a class warning regarding increased risk of suicidality in patients on pregabalin with epilepsy and psychiatric disorders.[3] This case report describes a case of pregabalin dependence with pregabalin induced intentional self-harm behavior. Indian Journal of Psychiatry 57(1), Jan-Mar 2015
Copyright of Indian Journal of Psychiatry is the property of Medknow Publications & Media Pvt. Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
7. 8.
9.
inpatient population with hysteria in India. J Am Acad Child Adolesc Psychiatry 1993;32:822‑5. Mendhekar DN, Gupta D, Girotra V. Sertraline‑induced hypomania: A genuine side‑effect. Acta Psychiatr Scand 2003;108:70‑4. Oedegaard KJ, Neckelmann D, Benazzi F, Syrstad VE, Akiskal HS, Fasmer OB. Dissociative experiences differentiate bipolar‑II from unipolar depressed patients: The mediating role of cyclothymia and the Type A behaviour speed and impatience subscale. J Affect Disord 2008;108:207‑16. Jans T, Schneck‑Seif S, Weigand T, Schneider W, Ellgring H, Wewetzer C, et al. Long‑term outcome and prognosis of dissociative disorder with onset in childhood or adolescence. Child Adolesc Psychiatry Ment Health 2008;2:19.
Access this article online Quick Response Code Website: www.indianjpsychiatry.org
DOI: 10.4103/0019-5545.148548
Accounting for confounding Sir, Went through an article entitled “impact of psychiatry training on attitude of medical students toward mental illness and psychiatry” published in Indian Journal of Psychiatry.[1] The authors deserve credit for touching on the important issue of “role of training” in medical sciences. However, I have a concern. The authors stated aims are: (1) To compare the attitude of medical students and interns in a medical college toward mental illness and psychiatry and (2) to assess the impact of psychiatric training on attitude toward the mentally ill person and mental illness. The authors have done full justice to the first aim of this study in presenting comparable data about the attitude of medical students and interns. However, the second aim of this study, that is, impact assessment has been handled inadequately. The fact that the difference between attitudes of interns and undergraduate medical students (not yet fully exposed to clinical subjects) can provide an idea on impact of training, does not seem logical. The comparison groups are diverse enough to be included for comparison. The fact that interns have undergone clinical training in other disciplines (other than psychiatry) during their under graduation as well as internship period may influence their attitude to psychiatry and mental illness as well and thus act as a confounder in this study. This has not been accounted for in the study. In statistics, a confounder is an extraneous variable that correlates (directly or inversely) with both the dependent variable and the independent variable. A perceived relationship between an independent
variable and a dependent variable that has been misestimated due to the failure to account for a confounding factor, gives rise to a spurious relationship. The methodology to estimate the impact of psychiatry training should have been modified and study could have been conducted on interns only before and after they had received their training in psychiatry.
Sunil Kumar Raina
Department of Community Medicine, Dr. RPGMC, Tanda, Kangra, Himachal Pradesh, India E‑mail: [email protected] REFERENCE 1.
Gulati P, Das S, Chavan BS. Impact of psychiatry training on attitude of medical students toward mental illness and psychiatry. Indian J Psychiatry 2014;56:271‑7.
Access this article online Quick Response Code Website: www.indianjpsychiatry.org
DOI: 10.4103/0019-5545.148549
Pregabalin dependence with pregabalin induced intentional self‑harm behavior: A case report Sir, Pregabalin is a novel gamma amino butyric acid (GABA) analogue which is used for neuropathic pain and partial onset seizures.[1,2] Drug enforcement agency has categorized pregabalin as a schedule V drug under the terms 110
of controlled substances act. In 2008, US Food and Drug Administration announced a class warning regarding increased risk of suicidality in patients on pregabalin with epilepsy and psychiatric disorders.[3] This case report describes a case of pregabalin dependence with pregabalin induced intentional self-harm behavior. Indian Journal of Psychiatry 57(1), Jan-Mar 2015
Copyright of Indian Journal of Psychiatry is the property of Medknow Publications & Media Pvt. Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
