Journal/Magazine Articles
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This collection contains original research articles, review articles and case reports published in local and international peer reviewed journals by the staff members of the Faculty of Medicine
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Item Silver Russell syndrome: A suspected syndromic child in Sri Lanka presenting with recurrent head-banging associated with force-feeding(Sri Lanka College of Psychiatrists, 2024-10) Vidyatilake, P.; Kodikaraarachchi, D.; Chandradasa, M.; Wijetunge, S.No abstract availableItem Auditory and visual hallucinations in an adolescent following orthotopic liver transplantation(Sri Lanka College of Psychiatrists, 2024-10) Chandradasa, M.; Abeyrathne, M.; Sithara, P.; Kodithuwakku, K.; Fernando, M.No abstract availableItem Brain drain among Sri Lankan psychiatrists(Sri Lanka College of Psychiatrists, 2023) Chandradasa, M.; Kuruppuarachchi, K.A.L.ANo abstract availableItem Religion, spirituality, and coping among the psychiatric population: a narrative review(Academy Publisher, 2024) Shoib, S.; Das, S.; Gupta, A.K.; Ullah, I.; Javed, S.; Nocera, A.; Kar, S.K.; Chandradasa, M.; de Filippis, R.BACKGROUND AND AIMS: The impact of religiosity and spirituality on mental health is still far to be adequately explored. Evidence-based data gathering papers that bring together various perspectives and facets of religion in the mentally ill population is needed. Therefore, we conducted this review to summarise evidence on the subject and raise awareness. METHODS: We searched the literature using generic terms for ‘mental health and psychiatry’, ‘beliefs’, ‘religion’, ‘religious involvement’, ‘religiosity’, ‘spiritual aspects’, and ‘spirituality’, finally summarising all appropriate references. However, for this narrative revision, we collected papers addressing various perspectives, data, and facets of religion in the mentally ill population, a subject with theoretical and practical implications in mental health. RESULTS: The initial literature search found 21,723 total results: 1,723 from PubMed/Medline and Scopus, and up to 20,000 from Google Scholar, Science Direct, and Web of Science. After removing repetitions and applying inclusion and exclusion criteria, only six studies were included in this review on religion as an adaptive resource, and nine studies on religion, spirituality, and mental health. CONCLUSIONS: Evidence-based studies on the topic are still challenging to develop while maintaining a high scientific value. Notwithstanding this, religion and spirituality can have positive/negative clinical implications depending on how they are managed. Indeed, it can reduce suicidal risk, relieve depressive and anxious symptoms, and improve patients’ and caregivers’ coping and resilience. Nevertheless, it can enhance guilt, worsen/ generate obsessions, and compulsions in the obsessive-compulsive disorder and determine or associate with mystical-religious delusions in the maniacal phase of bipolar disorder.Item Factors behind suicides in Muslim countries: a global ecological study(Taylor and Francis Group, 2024) Shoib, S.; Tayyeb, M.; Armiya’u, A.Y.; Raaj, S.; Elmahi, O.K.O.; Swed, S.; Saeed, F.; Nahidi, M.; Bashir, A.; Chandradasa, M.This study examines the relationship between suicide rates and social, political, and economic factors in Muslim-majority countries, considering the influence of Islam and unique socio-cultural factors. Conducted from January to December 2022, it covered 46 countries, collecting data on suicide rates, income, Human Development Index (HDI), poverty rate, life expectancy, literacy rate, and political system. Suicide rates in Muslim-majority countries could be predicted based on HDI, poverty rates, life expectancy, and literacy rates. Frequency of suicide rates varied across continents, with the highest rates in Africa. Culturally sensitive suicide prevention programs are crucial for Muslim-majority countries.Item Parity of esteem: A global COVID‑19 vaccination approach for people with mental illnesses, based on facts from 34 countries; recommendations and solutions(Medknow Publications, 2024) Shoib, S.; Saeed, F.; Philip, S.; Chandradasa, M.; Das, S.; de Filippis, R.; Yousaf, Z.; Ojeahere, M.; Gad, H.K.; Yadivel, R.; Legris, Z.; Jatchavala, C.; Paul, R.; Gupta, A.K.; Handuleh, J.I.M.; Gürcan, A.; Costa, M.P.D.; Dannatt, L.; Ahmad, A.R.; Jaguga, F.; Saleem, S.M.; Sawitri, B.; Ari, N.; Islam, M.S.; Haque, M.A.; Őri, D.; Chumakov, E.; Swed, S.; Roza, T.H.; Islam, S.M.S.BACKGROUND: The coronavirus disease (COVID 19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS CoV 2), has detrimental effects on physical and mental health. Patients with severe mental illness are at higher risk of contracting the virus due to social determinants of health. Vulnerable populations include the elderly, people with pre existing conditions, and those exposed to SARS CoV 2. Unfortunately, only a few countries have updated vaccination strategies to prioritize patients with mental illnesses. Therefore, we aimed to explore whether individuals with mental disorders are prioritized in vaccine allocation strategies in different world regions. They are often neglected in policymaking but are highly vulnerable to the threatening complications of COVID 19. METHODS: A questionnaire was developed to record details regarding COVID 19 vaccination and prioritizations for groups of persons with non communicable diseases (NCDs), mental disorders, and substance use disorders (SUDs). NCDs were defined according to the WHO as chronic diseases that are the result of a combination of genetic, physiological, environmental, and behavioral factors such as cardiovascular diseases, cancer, respiratory diseases, and diabetes. RESULTS: Most countries surveyed (80%) reported healthcare delivery via a nationalized health service. It was found that 82% of the countries had set up advisory groups, but only 26% included a mental health professional. Most frequently, malignancy (68%) was prioritized followed by diabetes type 2 (62%) and type 1 (59%). Only nine countries (26%) prioritized mental health conditions. CONCLUSION: The spread of the coronavirus has exposed both the strengths and flaws of our healthcare systems. The most vulnerable groups suffered the most and were hit first and faced most challenges. These findings raise awareness that patients with mental illnesses have been overlooked in immunization campaigns. The range of their mortality, morbidity, and quality of life could have widened due to this delay.Item Diagnostic overlap between adolescent affective instability in borderline personality and juvenile bipolar disorder in Sri Lanka(Sri Lanka College of Psychiatrists, 2019) Chandradasa, M.; Fernando, W.K.T.R.; Kuruppuarachchi, K.A.L.A.Borderline personality disorder (BPD) and bipolar disorder (BD) could present a diagnostic challenge in the adolescent due to the presence of overlapping symptoms such as impulsivity, affective instability, and sexual arousal. Of these symptoms, affective instability is a central feature of BPD, and there is a rapid shift from the neutral affect to an intense affect, and this is associated with a dysfunctional modulation of emotions. We describe three Sri Lankan adolescents presenting with affective instability, treated with psychopharmacological agents as for BD. While BPD is characterized by transient mood shifts induced by interpersonal stressors, in BD, there are sustained mood changes. A longitudinal assessment of the symptomatic profile and collateral information clarified the diagnosis as being BPD. An examination of the nature of affective instability is vital for a proper diagnosis and provision of evidence-based treatment.Item Dose-dependent clozapine-induced skin picking and self-injurious behaviour in treatment-resistant schizophrenia(The Kandy Society of Medicine, 2020) Rathnayake, L.C.; Chandradasa, M.; Mendis, J.Clozapine is a second-generation antipsychotic used for treatment-resistant schizophrenia. Obsessive-compulsive symptoms induced by clozapine is a known entity. Skin-picking is closely related to obsessions and excoriation disorder is now categorised under obsessive-compulsive and related disorders. Skin-picking associated with clozapine dose increments has been reported in a young male from India. Apart from this, skin-picking and self-injurious behaviour associated with clozapine use are not well described in the literature. Here we report a young Sri Lankan male with treatment-resistant schizophrenia presenting with self-injurious behaviour that is related to clozapine-induced compulsive skin-picking. Due to the partial response, clozapine dose of the described patient was increased above 550 mg/day. Skin-picking was seen only above this dose and the addition of risperidone helped to resolve the psychotic symptoms and keep the clozapine dose at the previous level. The current report is unique in the sense that the self-injurious behaviour was associated with clozapine dose increments.Item Prevention of suicides associated with global warming: perspectives from early career psychiatrists(Frontiers Research Foundation, 2023) Shoib, S.; Hussaini, S.S.; Armiya'u, A.Y.; Saeed, F.; Őri, D.; Roza, T.H.; Gürcan, A.; Agrawal, A.; Solerdelcoll, M.; Lucero-Prisno Iii, D.E.; Nahidi, M.; Swed, S.; Ahmed, S.; Chandradasa, M.Climate change poses significant challenges to global mental health, with potential consequences including increased rates of suicide and mental health disorders. Early Career Psychiatrists (ECPs) play a crucial role in addressing these challenges. The Climate Psychiatry Alliance, a group of psychiatrists dedicated to improving mental health amidst climate change, recognizes the importance of cultivating climate-aware ECPs. Training ECPs to become confident climate-aware clinicians enables them to effectively treat patients experiencing anxiety, depression, and PTSD in the context of climate-related distress. Together with other mental health professionals, ECPs can contribute to efforts by implementing strategies for monitoring and treating mental health problems arising from climate events. Additionally, they can raise awareness about the psychological consequences and risks of suicide associated with climate change. Collaboration among ECPs from various regions is essential in developing community-based approaches and reducing vulnerabilities. ECPs must prioritize supporting vulnerable populations by advocating for increased funding for mental health support and research in affected areas. Long-term solutions to address the mental health impacts of climate change and global warming should be pursued to mitigate future suicidality. Integrating climate considerations into local mental health programs and expanding psychological support services is crucial. By promoting emotional resilience and self-awareness, ECPs can contribute to building a more climate-resilient and mentally healthy society.Item Prevalence and associated factors of depression in Sri Lanka: a systematic review and meta-analysis(Springer International, 2024) Alwis, I.; Baminiwatta, A.; Chandradasa, M.PURPOSE: Epidemiological data on depression are required to inform policies and service planning in mental health in Sri Lanka. This review aimed to synthesise data from existing studies to calculate the pooled prevalence of depression in Sri Lanka, assess its variability across subgroups, and identify associated factors within each subgroup. METHODS: PubMed, Embase, PsycINFO, Science Direct, Google Scholar and local journals were searched to identify peer-reviewed studies reporting the prevalence of depression among non-clinical adult, young, older, and maternal populations in Sri Lanka. A meta-analysis was performed using a random-effects model to calculate pooled prevalence estimates. Subgroup, sensitivity and moderator analyses were performed. A qualitative synthesis of factors associated with depression was conducted. RESULTS: A total of 33 studies representing a total of 52,778 participants were included. Overall, the pooled prevalence of depression was 19.4% [14.44-25.54%]. Among subpopulations, the highest prevalence was reported among young persons (39%); the rates in adults, older persons and maternal populations were 8.7%, 18.4% and 16.9%, respectively. Prevalence estimates were higher when based on screening instruments (21.2%) compared to diagnostic interviews (4.3%). A high degree of heterogeneity (I2 = 99.2) was observed. A qualitative synthesis of factors associated with depression, including individual attributes and behaviours, socio-economic circumstances and broader environmental factors, is reported for each age group. CONCLUSION: Approximately one-fifth of the population was detected to have depression. Notable variations in prevalence were observed across age groups. The heterogeneity of studies limits the inferences drawn from this review.