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K S Jacob

Publications and source records attributed to K S Jacob.

61 records · Page 4Linked to original sources
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Mania associated with interferon alpha2b treatment.

Neuropsychiatric side effects are common with Interferon a 2b. Psychosis and depression have been reported. Several cases of mania have been reported but only few have been associated with treatment for hepatitis B. We report a case of mania with psychotic symptoms in a 21-year-old female diagnosed to have hepatitis-B infection, who was receiving interferon. The report supports the view that dose reductions or pauses during interferon treatment can cause mania. Family history of mood disorder could be a risk factor. Atypical presentations are common in interferon-induced mania. Mania induced by interferon responds well to antimanic drugs. Since the use of interferon is increasing in developing countries, the need for awareness of side effects and management issues are important and these are highlighted.

Adult↗
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The cultures of depression.

Diverse frameworks, models and 'cultures' of depression have been postulated and promoted by psychiatrists, the pharmaceutical industry, general practitioners, primary care psychiatrists and the general population. Psychiatrists and the pharmaceutical industry endorse the medical model while general practitioners and the public subscribe to social and psychological frameworks. These models are partial truths and should be viewed as complementary rather than competitive, some more valid in a specific context than others. The issues that need to be resolved include: (i) reexamination of the validity of the psychiatric diagnosis of depression in the primary care context; (ii) a review of the adequacy of a single label of depression to describe the diverse human context of distress; (iii) acknowledging the problems of using a symptom checklist in diagnosing depression; (iv) recognizing the need for psychosocial diagnostic formulations which clearly state the context, personality factors, acute and chronic stress and coping; (iv) highlighting the fact that antidepressant medication should be reserved for severe forms of distress; (v) re-emphasizing the need to manage stress and alter coping strategies in the treatment of people with such presentations; (vi) de-emphasizing medicalization of all forms of personal and social distress; (vii) focusing on other underlying causes of human misery including poverty, unmet needs and lack of rights. Clinically, there is a need to look beyond symptoms and explore personality, life events, situational difficulties and coping strategies in order to comprehensively evaluate the role of vulnerability, personality factors and stress in the causation of depression.

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