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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 Psychopathology among war-affected children and lessons from Sri Lanka on culturally relevant management(Science Forecast Publications LLC, 2018) Chandradasa, M.; Champika, L.Due to armed conflicts, family networks are disrupted with displacement, morbidity, death and ongoing threat to human lives. Children are directly and indirectly affected by conflict-related turmoil physically and mentally. Sri Lanka, an island nation in the Indian Ocean suffered an armed conflict lasting three decades causing more than 60,000 deaths. Elbert et al found that 92% of the minority Tamil children they surveyed in Northern Sri Lanka had experienced traumatizing events such as shelling and bombing and 25% met criteria for PTSD. Children in the South were also impacted by a continuous threat to their own and their parents’ lives due to frequent militant attacks, which included suicide bombers. Sri Lankan experience shows that culturally adapted psychotherapeutic interventions are effective for treating children with psychological trauma related to war and natural disasters. Child mental health professionals from other countries may find the Sri Lankan experience useful for planning their interventions.Item Tardive Dyskinesia in an 8-year-old child(Sri Lanka College of Psychiatrists, 2014) Chandradasa, M.; Champika, L.; Kotalawala, S.; Seneviratne, S.; Siriwardene, G.; Perera, H.Tardive dyskinesia (TD) is an uncommon presentation in children, which can be disabling and irreversible when it does occur. An 8 year old boy, with a diagnosis of autism spectrum disorder and borderline intelligence, developed features suggestive of TD on withdrawal of long-term haloperidol medication. After recommencing haloperidol at a lower dose his symptoms improved clinically and the Abnormal Involuntary Movement Scale score also decreased. Haloperidol was tailed off gradually and vitamin E was initiatedItem Female offenders with Psychiatric disorders(Sri Lanka College of Psychiatrists, 2015) Chandradasa, M.; Champika, L.; Mendis, S.; Fernando, F.BACKGROUND: Female offenders are characterised by higher rates of psychiatric morbidity. Studies in developed countries show an increase in the number of female prisoners in recent years. The objectives of this study were first to describe socio-demographic factors and rates of psychiatric morbidity in female offenders, and second, among females with psychiatric illness, to compare those with and without a history of offending. METHODS : A retrospective case control study was carried out among 71 alleged female offenders who had been admitted to the National Institute of Mental Health (NIMH), Sri Lanka over an 18 months period. Females attending an outpatient psychiatry clinic with no prior history of offending were considered as controls. Data were collected from court reports and patient records. RESULTS: Among the alleged offences, 63% were reported as ‘‘behavioural disturbance due to mental illness’’, and 14% as physical assault. The most common diagnoses among female offenders with psychiatric illness were schizophrenia (43%) and bipolar affective disorder (22%). Childhood sexual abuse was reported by 22% of cases compared to 12% of controls (p=0.08). Rates of marriage and employment were significantly lower among the female offenders with psychiatric illness, compared to the controls. CONCLUSION: Patterns of psychiatric illness among female offenders in Sri Lanka may differ from that of the West. Among females with psychiatric illness in Sri Lanka, being single, unemployed and use of alcohol is significantly associated with offending compared to controls. Further research is required to explore these findings.Item Racism toward Mental Health Workers(Thorofare, N.J. : C.B. Slack, 2017) Chandradasa, M.; Champika, L.No Abstract AvailableItem Improving mental health access to multi-religious university students in diverse cultures(Zagreb, 2018) Chandradasa, M.; Champika, L.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]