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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 A preliminary study of the psycho-social burden of bipolar disorder on siblings(Sri Lanka Medical Association, 2017) Fernando, P.S.; Ranaweera, H.P.A.L.; Karunarathna, K.A.S.T.; Kaushalya, N.I.; Samarasinghe, G.; Peiris, M.U.P.K.; Williams, S.S.INTRODUCTION & OBJECTIVES: Bipolar disorder (BD) is a recurrent mood disorder with a prevalence of 1-2% in the general population. Individuals with BD experience significant impacts on family and social relationships, suffer from occupational instability, and are at greater risk of self-harm and suicide. This research aims to examine experiences and concerns of siblings of individuals with BD. METHODS: Quantitative data was collected from siblings of persons with BD through the psychiatry clinics at North Colombo Teaching Hospital after informed consent. For data collection, the ‘Sibling Impact Questionnaire–Bipolar Disorder’ (SIQ-BD) was developed. The SIQ-BD measures the impact on a sibling of a person with BD, across three timeframes, the ‘past year’, ‘over the years’, and ’worst time’. RESULTS: Out of 48 siblings (14 males, 34 females; mean age 42.7 years), 44 (11 males, 33 females) act as care givers to their siblings. The highest burden was during the ‘worst time’; and during this ‘worst time’ 16.7% of siblings worried that their sibling may commit suicide ‘very much so’, followed by 12.5% and 6.2% during the ‘whole time’ and ‘past year’ respectively. On a positive note, stigma was reported as high by only one sibling during the ‘worst time’ and none during the ‘past year’ and ‘whole time’. The highest disruption to daily life was experienced during the ‘worst time’. Providing financial support during the past year was significantly associated with higher burden (p=0.002). CONCLUSION: Siblings of persons with BD experience a mixed burden with low perception of stigma in this preliminary study.Item Validity of the Sinhala version of the general health questionnaires item 12 and 30: Using different sampling strategies and scoring methods(Ibn Sina Academy of Medieval Medicine & Sciences, 2016) Abeysena, H.T.C.S.; Jayawardana, P.L.; Peiris, M.U.P.K.; Rodrigo, A.OBJECTIVE: To determine the criterion validity of the Sinhala version of the General Health Questionnaire-12 (GHQ-12) and GHQ-30 employing different sampling designs and scoring methods. METHODS: This was a descriptive cross-sectional study including 374 patients. The GHQ-30 was completed by the participants using likert scale and then converted into standard score. The ‘Clinical Examination’ was done blindly to the GHQ score as the reference standard. Total study sample was considered as a representative sample taken consecutively. Case-reference design included 126 cases and 126 randomly selected controls based on reference standard. Test result-based designs included two groups of positive and negative GHQ, based on the optimal cut-off level. Cut-off levels were determined by using three criteria. In addition stratum specific likelihood (SSLR) ratio also considered. RESULTS: Applying consecutive sampling design, for the GHQ-12, the optimal cut-off levels were 9/10 using likert score and 2/3 using standard score and for the GHQ-30, 25/26 using likert score and 6/7 using standard score. The optimal cut-off level depends on the different sampling designs employed in addition to criteria for determining cut-off levels. The SSLR of>1 was useful for determining optimal cut-off level. Irrespective of the scoring methods, application of case-reference design tends to be overestimation of the specificity with high threshold values and test result-based design tends to be overestimation of the sensitivity, compared to consecutive sampling. Using likert scoring method, the sensitivities were higher than standard scoring method. CONCLUSIONS: The optimal cut-off levels depend on the sampling design and the scoring method employed and criteria to determine cut-off levels.Item Validation of Kessler's psychological distress scale among the Sinhalese population in Sri Lanka(SAARC Psychiatric Federation, 2011) Wijeratne, L.T.; Williams, S.S.; Rodrigo, M.D.A.; Peiris, M.U.P.K.; Kawamura, N.; Wickremasinghe, A.R.OBJECTIVE: Kessler's psychological distress scales, KlO and K6 are short rating scales designed to screen psychiatric morbidity in the population. Despite being increasingly popular elsewhere, they have not been validated in Sri Lanka. We examined the validity of these scales among the Sinhala speaking population in the Gampaha district of Sri Lanka. DESIGN: The English language version of the KiD and K6 questionnaire were translated into Sinhala using standard methods. The KiD and K6 scores for 27 healthy and 37 psychiatrically ill individuals were compared with the Structured Clinical Interview for DSM disorders (SClD) outcome categories. RESULTS: The KiD and K6 were sensitive and specific in detecting mental illness, especially depression. Those with schizophrenia had scores similar to healthy individuals. We suggest cut offs of 12 for KiD and 7 for K6 having 9D% sensitivity and 81% specificity for both scales. INTERPRETATION: KiD and K6 are valid screening tools for non-psychotic psychiatric illness among the Sinhala speaking population in Sri Lanka. They can be used in psychiatric epidemiological studies.Item A Study of intimate partner violence among females attending a Teaching Hospital out-patient department(Sri Lanka College of Psychiatrists, 2010) Kuruppuarachchi, K.A.L.A.; Wijeratne, L.T.; Weerasinghe, G.D.S.S.K.; Peiris, M.U.P.K.; Williams, S.S.BACKGROUND: Intimate partner violence (IPV) is considered a public health problem with physical and psychological consequences. AIMS: To describe the prevalence of IPV among married females attending the out-patient department of North Colombo Teaching Hospital and their attitude towards abuse. METHODS: A pre-tested self-administered questionnaire on physical, verbal, sexual and emotional abuse was given to the first 50 consenting married females attending the out-patient department on each day for five consecutive days. Confidentiality of responses was assured and adequate privacy was provided for the questionnaires to be completed. RESULTS: Of the 242 participants 98(40.5%) reported some form of abuse by their male partner. Prevalence of abuse reported was physical abuse 19%, verbal abuse 23%, emotional abuse 23% and sexual abuse 7%. A quarter (26.9%) of those inflicted physical violence sought medical treatment for the injuries but only two of them divulged the reason for the injury to medical staff. More than three quarters (79%) of those abused were in the relationship for more than ten years. The majority of the females surveyed believed that violence by the male partner should be tolerated. CONCLUSIONS: IPV is a common problem that is poorly divulged to medical personnel. Attitudes regarding IPV have to be changed in order to reduce abuse significantly.Item Trichotillomania(Sri Lanka Medical Association, 2004) Williams, S.S.; Peiris, M.U.P.K.No Abstract AvailableItem A Two-year follow-up study of alcohol dependent men rehabilitated at a special unit in a developing country(Churchill Livingstone, 1992) de Silva, H.J.; Peiris, M.U.P.K.; Samarasinghe, D.S.; Ellawala, N.S.Two hundred and thirty-four alcohol dependent men who had all failed to improve after previous hospital-based interventions were admitted to an intensive 6-week residential rehabilitation programme conducted at a special unit in Sri Lanka. Outcome was assessed at 2 years post-treatment, and 36% of dependent persons remained totally abstinent. During an extended period of follow-up (mean 39.2 months) a significant association was found between abstinence and having a life partner, stable family support, a higher income and regular employment. However, there was no significant association between abstinence and age, duration of alcohol dependence, level of education or type of employment. Although the majority of alcohol dependent persons did not benefit from the programme, our results compare favourably with those of similar studies done in developed countries.