Browsing by Author "Wijesinghe, C.A."

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A Case report of child sexual abuse - important points to ponder
(Sri Lanka College of Psychiatrists, 2010) Kuruppuarachchi, K.A.L.A.; Wijesinghe, C.A.
No Abstract Available
Charles Bonnet syndrome
(SAARC Psychiatric Federation, 2015) Dissanayake, D.M.R.M.; Hewarathne, A.; Wijesinghe, C.A.; Amarasinghe, B.; Williams, S.S.
A 41 year old married labourer presented with complex visual hallucinations for six months. He had reduced visual acuity, a subluxated lens, and two retained sutures from a previous surgery of the right eye and complete blindness of the left eye. His mental, physical and neurological examinations were unremarkable. Surgical correction of his visual impairment resulted in resolution of symptoms.
Delayed psychological morbidity associated with snakebite envenoming
(Public Library of Science, 2011) Williams, S.S.; Wijesinghe, C.A.; Jayamanne, S.F.; Buckley, N.A.; Dawson, A.H.; Lalloo, D.G.; de Silva, H.J.
INTRODUCTION: The psychological impact of snakebite on its victims, especially possible late effects, has not been systematically studied. OBJECTIVES: To assess delayed somatic symptoms, depressive disorder, post-traumatic stress disorder (PTSD), and impairment in functioning, among snakebite victims. METHODS: The study had qualitative and quantitative arms. In the quantitative arm, 88 persons who had systemic envenoming following snakebite from the North Central Province of Sri Lanka were randomly identified from an established research database and interviewed 12 to 48 months (mean 30) after the incident. Persons with no history of snakebite, matched for age, sex, geograpical location and occupation, acted as controls. A modified version of the Beck Depression Inventory, Post-Traumatic Stress Symptom Scale, Hopkins Somatic Symptoms Checklist, Sheehan Disability Inventory and a structured questionnaire were administered. In the qualitative arm, focus group discussions among snakebite victims explored common somatic symptoms attributed to envenoming. RESULTS: Previous snakebite victims (cases) had more symptoms than controls as measured by the modified Beck Depression Scale (mean 19.1 Vs 14.4; p<0.001) and Hopkins Symptoms Checklist (38.9 vs. 28.2; p<0.001). 48 (54%) cases met criteria for depressive disorder compared to 13 (15%) controls. 19 (21.6%) cases also met criteria for PTSD. 24 (27%) claimed that the snakebite caused a negative change in their employment; nine (10.2%) had stopped working and 15 (17%) claimed residual physical disability. The themes identified in the qualitative arm included blindness, tooth decay, body aches, headaches, tiredness and weakness. CONCLUSIONS: Snakebite causes significant ongoing psychological morbidity, a complication not previously documented. The economic and social impacts of this problem need further investigation
Delayed psychological morbidity in victims of snakebite envenoming
(Sri Lanka Medical Association, 2010) Williams, S.S.; Wijesinghe, C.A.; Jayamanne, S.F.; Buckley, N.; Dawson, A.; Lalloo, D.G.; de Silva, H.J.
OBJECTIVES: We assessed delayed somatic symptoms, depressive disorder, post-traumatic stress disorder (PTSD) and impairment in functioning among snakebite victims. The psychological impact of snakebite on its victims has not been systematically studied. METHODS: The study had qualitative and quantitative arms. In the quantitative arm, 88 persons who had systemic envenoming following snakebite from the Polonnaruwa District were randomly identified from an established research database and interviewed 12 to 48 months (mean 30) after the incident. 88 persons with no history of snakebite, matched for age, sex, geograpical location and occupation acted as controls. A modified version of the Beck Depression Inventory, Post-Traumatic Stress Symptom Scale, Hopkins Somatic Symptoms Checklist and Sheehan Disability Inventory, together with a structured questionnaire were administered. In the qualitative arm, focus group discussions among snakebite victims explored common somatic symptoms attributed to envenoming. Results: Snakebite victims had more symptoms as measured by the modified Beck Depression Scale (mean 19.1 vs 14.4) and Hopkins Symptoms Checklist (38.9 vs. 28.2) compared to controls (p<0.001). 48(54%) victims met criteria for depressive disorder compared to 13(15%) controls. 11(12.5%) victims also met criteria for PTSD. 24(27%) claimed that the snakebite caused a negative change in their employment; 9(10.2%) had stopped working. 15(17%) victims claimed residual physical disability, and themes identified in the qualitative arm included blindness, tooth decay, body aches, tiredness and weakness. CONCLUSIONS: Snakebite causes delayed psychological morbidity, a complication not previously documented.
Elder abuse and carer abuse: two sides of the same coin
(Sri Lanka Medical Association, 2010) Kuruppuarachchi, K.A.L.A.; Wijesinghe, C.A.
Comment on: Paranitharan P, Edirisinghe PA, Williams S. (Ceylon Med J. 2009; 54(1):1-3). No Abstract Available
“Muddling by googling” – Cyberchondria among outpatient attendees of two hospitals in Sri Lanka
(Sri Lanka Journal of Psychiatry, 2019) Wijesinghe, C.A.; Liyanage, U.L.N.S.; Kapugama, K.G.C.L.; Warsapperuma, W.A.N.P.; Williams, S.S.; Kuruppuarachchi, K.A.L.A.; Rodrigo, A.
BACKGROUND: The internet is widely used as a source of health information, and the negative effects of this practice is well documented. Cyberchondria, the unfounded escalation of concerns about common symptoms based on review of online information has been identified as a major concern. This area has not been studied in Sri Lanka. AIMS: We studied the prevalence, nature and effects of cyberchondria among outpatients in Sri Lanka. METHODS: Data was gathered from 300 outpatients, 150 patients each attending a government and private hospital in Western province using a self-administered questionnaire. RESULTS: Out of 300 participants 178 were female and the average age was 42 years. Only 24% of the participants used the internet as an information source on health related issues. The prevalence of cyberchondria was 16.3% in our study population. Cyberchondria was significantly more common among outpatients of the private hospital. A majority of patients who made a self-diagnosis using online information had made an incorrect diagnosis. One third of internet users felt anxious after searching about their symptoms and 34% sought further medical advice following internet use. CONCLUSIONS: The possible negative effects of online health information is a concern in Sri Lanka. Further studies and public education regarding this area in Sri Lanka are required.
Randomized controlled trial of a brief intervention for delayed psychological effects in snake bite victims
(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2016) Wijesinghe, C.A.
Snake bite results in delayed psychological morbidity and negative psycho-social impact. However, psychological support is rarely provided to victims. The aim of this study was to assess the effectiveness of a brief intervention which can be provided by non-specialist doctors, and aimed at reducing psychological morbidity following snake bite envenoming. In a single blind, randomized controlled trial, 225 snake bite victims with systemic envenoming were randomized into three arms. One arm received no intervention (Group A, n=68); the second received psychological first aid and psychoeducation at discharge from hospital (Group B, n = 65); while the third received psychological first aid and psychoeducation at discharge and a second intervention one month later (Group C, n = 69). All patients were assessed six months after hospital discharge for the presence of psychological symptoms and level of functioning. A statistically significant decreasing trend in the proportion of patients positive for psychiatric symptoms of depression and anxiety was observed at six month follow up, from Group A through Group B to Group C, mainly due to a decreasing trend for symptoms of anxiety. There was also significant decreasing trend in the overall prevalence of disability from Group A through Group B to Group C, predominantly in relation to disability in family life and social life.
A Randomized Controlled Trial of a brief Intervention for delayed psychological effects in snakebite victims
(Public Library of Science, 2015) Wijesinghe, C.A.; Williams, S.S.; Kasturiratne, A.; Dolawaththa, N.; Wimalaratne, P.; Wijewickrema, B.; Jayamanne, S.F.; Isbister, G.K.; Dawson, A.H.; Lalloo, D.G.; de Silva, H.J.
BACKGROUND: Snakebite results in delayed psychological morbidity and negative psycho-social impact. However, psychological support is rarely provided to victims. AIM: To assess the effectiveness of a brief intervention which can be provided by non-specialist doctors aimed at reducing psychological morbidity following snakebite envenoming. METHOD: In a single blind, randomized controlled trial, snakebite victims with systemic envenoming [n = 225, 168 males, mean age 42.1 (SD 12.4) years] were randomized into three arms. One arm received no intervention (n = 68, Group A), the second received psychological first aid and psychoeducation (dispelling prevalent cultural beliefs related to snakebite which promote development of a sick role) at discharge from hospital (n = 65, Group B), while the third received psychological first aid and psychoeducation at discharge and a second intervention one month later based on cognitive behavioural principles (n = 69, Group C). All patients were assessed six months after hospital discharge for the presence of psychological symptoms and level of functioning using standardized tools. RESULTS: At six months, there was a decreasing trend in the proportion of patients who were positive for psychiatric symptoms of depression and anxiety from Group A through Group B to Group C (Chi square test for trend = 7.901, p = 0.005). This was mainly due to a decreasing trend for symptoms of anxiety (chi-square for trend = 11.256, p = 0.001). There was also decreasing trend in the overall prevalence of disability from Group A through Group B to Group C (chi square for trend = 7.551, p = 0.006), predominantly in relation to disability in family life (p = 0.006) and social life (p = 0.005). However, there was no difference in the proportion of patients diagnosed with depression between the three groups (chi square for trend = 0.391, p = 0.532), and the intervention also had no effect on post-traumatic stress disorder. CONCLUSIONS: A brief psychological intervention, which included psychological first aid and psychoeducation plus cognitive behavioural therapy that can be provided by non-specialist doctors appeared to reduce psychiatric symptoms and disability after snakebite envenoming, but not depression or post-traumatic stress disorder. TRIAL REGISTRATION: Sri Lanka Clinical Trials Registry: SLCTR/2011/003.
A randomized, double blind, placebo controlled trial on effectiveness of preemptive analgesia with paracetamol on reduction of occurrence of headache after electro convulsive therapy
(Sri Lanka Medical Association, 2016) Isuru, L.L.A.; Rodrigo, A.; Wijesekera, C.; Premasinghe, S.; Wijesinghe, C.A.; Ediriweera, D.S.; Kuruppuarachchi, K.A.L.A.
INTRODUCTION: Electro convulsive therapy (ECT) is a safe and effective treatment for a wide range of psychiatric disorders. However, its utility is mainly limited by side effects and stigma. Post ECT headache is one of the commonest side effects of ECT. There is little evidence to suggest Pre-ECT analgesia would prevent the occurrence of post ECT headache. OBJECTIVES: Objective was to compare the incidence and severity of the post ECT headache of the patients who had paracetamol 1g, 2hrs before the induction of anaesthesia with those who had a placebo. METHOD: This was a double-blind, placebo controlled trial. Sixty two patients were given placebo and 73 received paracetamol tablets. Ethical approval was granted by an Ethics Review Committee, University of Kelaniya, and the trial was registered in the clinical trial registry (SLCTR/2015/27). Post ECT headache was measured 2 hours after the administration of ECT by a visual analogue test and verbal descriptive scale. Variables were tested for normality and Mann-Whitney U test was used to compare groups. Subsequent analysis was non-parametric, with Mann-Whitney U test. RESULTS: Both intervention and controlled groups had comparable baseline demographic and clinical variables. One third (34%) of the paracetamol group experienced post ECT headache, while 62% of the placebo group experienced same. There was a statistically significant reduction in the incidence and severity of post-ECT headache in the test group (p <0.05). This remained significant after confounding factors were adjusted for in the regression analysis for the duration of illness and headache during this episode. CONCLUSIONS: Preemptive analgesia with paracetamol, 2hours beforeECT, reduces post ECT headache and this could be routinely practiced to ameliorate ECT induced headache.
Suicidal risk assessment and depression
(Sri Lanka Medical Association, 2009) Kuruppuarachchi, K.A.L.A.; Wijesinghe, C.A.
No Abstract Available
Tobacco smoking in persons with schizophrenia followed up at a teaching hospital in Sri Lanka
(Sri Lanka College of Psychiatrists, 2014) Edrisinghe, N.; Wijesinghe, C.A.; Williams, S.S.; Kuruppuarachchi, K.A.L.A.
Background Studies in Western populations indicate that the prevalence of smoking in patients with schizophrenia ranges from 70-90%. Data from low and middle income countries is sparse. Aims To determine the prevalence of smoking in patients with schizophrenia, and to identify probable ssociations. Methodology The study was conducted at the psychiatry outpatient clinics of Colombo North Teaching Hospital, Ragama. Consecutive outpatients who met ICD-10 diagnostic criteria for schizophrenia were invited to answer an interviewer administered, pre-tested questionnaire on socio-demographic status, smoking habits, disease and treatment related characteristics. The Fagerstrom’s Test for Nicotine Dependence was used to grade the level of nicotine addiction. Results Of the 400 patients with schizophrenia, 171 (42.8%) were smokers. Of them 150 (87.7%) were dependent on nicotine. In terms of Fagerstrom’s Test, high dependence was seen in 3.3% (n=5) while 39.2% (n=59) and 57.3% (n=86) reported moderate and low dependence respectively. All the smokers were male. For a majority of the patients the age of initiation of smoking was between 16-25 years, correlating with the onset of schizophrenia. Interestingly, most of the smokers (63.2%) were keen to quit smoking. Participants who smoked were significantly more likely to misuse other substances (p=0.001) and to suffer from physical illnesses (p=0.0001), compared to non-smokers. Smokers were also significantly more likely to be on intramuscular depot antipsychotics (p=0.032), whereas non-smokers in contrast, were more likely to be on atypical antipsychotics (p=0.0001). Conclusion A dual diagnosis of schizophrenia and nicotine dependence could be made in nearly half of our study population with schizophrenia. Although these rates are lower than in western populations, it is an issue that needs to be addressed in the treatment. DOI: http://dx.doi.org/10.4038/sljpsyc.v5i2.7816Sri Lanka Journal of Psychiatry Vol 5(2):19-23 Keywords: Smoking, Schizophrenia, Nicotine dependence, Substance misuse
Unusual presentations of reflex epilepsy in psychiatric practice: A case series
(SAARC Psychiatric Federation, 2015) Kuruppuarachchi, K.A.L.A.; Kapugama, K.G.C.L.; Wijesinghe, C.A.
No abstract available
Validation of the Internet Addiction Test (IAT) translated to Sinhala and assessing internet addiction among school children in the Western province of Sri Lanka
(Sri Lanka Medical Association, 2021) Wijesinghe, C.A.; Gunasekera, T.N.P.; Premathilake, W.D.B.M.; Rodrigo, M.D.A.; Pathmeshwaran, A.; Kuruppuarachi, K.A.L.A.
Introduction and objectives Addiction to the internet is a recognized problem worldwide but has not been scientifically studied in Sri Lanka according to our knowledge. The objectives of the study were to translate Young’s Internet Addiction Test (IAT) to Sinhala and validate for use in a Sri Lankan population and to assess the prevalence of internet addiction in school children. Methods A school based cross sectional analytical study conducted in two stages among students aged 15 to 19 years. In stage 1 of the study, 200 students were administered the Sinhala translation of the IAT and internal consistency and test retest validity assessed. Once validation of the scale was established the translated scale was used on a sample of 2800 students to assess presence of internet addiction. Results The Sinhala translation of the Internet addiction test showed good reliability with a Chrohnbach’s alpha value of 0.78 and good validity with a Pearson correlation coefficient of 0.85. 8% of the entire study sample and 12.6% among those using the internet showed features of internet addiction. The majority of cases of internet addiction identified were mild 8.2% followed by moderate internet addiction in 3.6% and only 0.9 % having severe internet addiction. Conclusions This study demonstrated that the Sinhala translation of Young’s IAT is suitable to assess internet addiction in Sri Lanka. It also identified that there are students in Sri Lanka who are addicted to the internet. More studies are required to identify characteristics of those who are addicted to the internet and to plan interventions.