Medicine
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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
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Item Reincarnation Type Presentations of Children with High-Functioning Autism in Sri Lanka(Elsevier, 2018) Chandradasa, M.; Champika, L.Autism is characterised by impaired social communication and restricted repetitive behaviours. However, language and intelligence are spared in high-functioning individuals. The symptomatology is complex and culturally diverse. Buddhists and Hindus believe in rebirth and reincarnation type presentations in children are frequently seen among these populations. Here we describe three children from Sri Lanka claiming memories of their past lives and later diagnosed to have high-functioning autism. The first, a seven-year-old Buddhist believes he was killed by terrorists as a soldier in his previous life and attributed his birthmark to be an injury which caused death. The second, a five-year-old Catholic girl suffering from asthma claiming she died of breathing difficulties in her previous life where she was a Buddhist grandmother. The third, an eight-year-old academically superior child claims he was a monk in his previous life and demands parents to allow him to enter the priesthood.Item Subspecialisation in Postgraduate Psychiatry and Implications for a Resource-Limited Specialised Child and Adolescent Mental Health Service(Springer, 2019) Chandradasa, M.; Champika, L.Item Commentary: Measuring depression in a non-western war-affected displaced population: measurement equivalence of the Beck Depression Inventory(Frontiers Research Foundation, 2018) Chandradasa, M.; Champika, L.Comment on : Measuring depression in a non-western war-affected displaced population: measurement equivalence of the Beck Depression Inventory.[Front Psychol. 2017; 8:1670]Item Delayed anxiety and depressive morbidity among dengue patients in a multi-ethnic urban setting: first report from Sri Lanka(BioMed Central, 2018) Gunathilaka, N.; Chandradasa, M.; Champika, L.; Siriwardana, S.; Wijesooriya, L.I.BACKGROUND: Although the physical consequences of dengue are well documented, delayed psychological co-morbidities are not well studied to date. Therefore, the objective of the present study was to determine the prevalence of depressive, anxiety and stress symptoms among past dengue patients. METHODS: A community-based, case-control study in a multi-ethnic urban setting was conducted in Sri Lanka involving adults who were diagnosed to have dengue fever by a positive dengue IgM antibody response between 6 and 24 months ago. Self-administered Depression, Anxiety and Stress Scale (DASS-21), Centre for Epidemiological Studies Depression Scale (CESD-20) and a structured clinical interview by a psychiatrist were done in the patients and in an age and gender-matched control group. RESULTS: Fifty-three participants each in the patient (mean age 42.9 years, SD 15.5) and control (mean age 41.6 years, SD 15.3) groups were surveyed. The ages ranged from 18 to 70 years and 64.2% were females. The majority (90.6%; n = 48) of the individuals had been diagnosed with dengue fever followed by dengue haemorrhagic fever (9.4% n = 5). Denguepatients had higher DASS-21 mean depressive scores (means 11.7/9.4, SD 6.4/4.0, t = 2.2, p = .028), anxiety scores (means 10.7/7.2, SD 6.8/1.8, t = 3.6, p = .0005), stress scores (means 12.0/8.8, SD 5.3/3.5, t = 3.6, p = .0004) and CESD-20 scores (means 16.1/11.7, SD 9.4/7.3, t = 2.6, p = .008) than controls. The DSM-5 depressive disorder was clinically detected by the psychiatrist among 15.1 and 7.5% in patient and control groups (OR 2.1; CI .5-7.7; p = .22). Limitations: a limitation is the small sample size. CONCLUSION: Patients with past dengue had significantly higher depressive, anxiety and stress symptoms than the control group according to the DASS-21 and CESD-20 tools. To our knowledge, this is the first report on delayed psychological morbidity related to dengue. This may warrant healthcare professionals to incorporate mental counselling for dengue patients.Item Transcultural factors related to depressive psychopathology in Sri Lankan migrants living in Australia(Sage Publications, 2018) Chandradasa, M.; Champika, L.Comment on :Becoming a patient-illness representations of depression of Anglo-Australian and Sri Lankan patients through the lens of Leventhal's illness representational model. [Int J Soc Psychiatry. 2017;63(7):569-579]Item The use of aripiprazole for tic disorders in children and adolescents and implications for resource limited settings in the developing world(Elsevier, 2018) Chandradasa, M.; Champika, L.Comment On: The efficacy and safety of aripiprazole for tic disorders in children and adolescents: a systematic review and meta-analysis. [Psychiatry Res. 2017 ;254:24-32.]Item Zoophilia in an adolescent with high-functioning autism from Sri Lanka(Blackwell Science, 2017) Chandradasa, M.; Champika, L.OBJECTIVE: Zoophilia is a rare paraphilic disorder with intense sexual urges involving animals. Autism is characterised by impairments in social communication and repetitive, restricted behaviours (RRB). Reported cases of zoophilia are limited worldwide, and zoophilia in autism is rarer. METHOD: This is a case report describing this unique and relatively unrecognised association in a male adolescent from Sri Lanka. RESULTS: A 17-year-old boy diagnosed with autism has average intelligence and academic capabilities. He had spent increasing time at his grandparents' cattle house. First, he was found masturbating near the cows and later having penetrative intercourse with a heifer. The shocked parents first sought traditional healing in the form of 'thovil', a demonic ritual of exorcist nature. Later, clinical evaluation found intense sexual urges towards cattle, which had led to marked distress and academic impairment. Sex hormone profile was normal. The adolescent was treated with a combination of cognitive-behaviour therapy and a selective serotonin reuptake inhibitor. CONCLUSION: We postulate that his persistent social difficulties contributed to the development of a paraphilic disorder. Unlike with his RRBs, he was markedly distressed about this sexual behaviour. Further research is required to explore this rarely reported, potential association.Item Fluoxetine-induced severe oral ulceration in a 13-year-old girl(Mary Ann Liebert, 2017) Chandradasa, M.; Champika, L.Item Serious bodily harm related to Obsessions from Sri Lanka(Zagreb, 2017) Chandradasa, M.; Champika, L.; Hettiarachchi, D.; Wijetunge, S.; Mendis, J.