Attitudes toward mental illness

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Attitudes toward mental illness and stigma

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  • DEPARTMENT OF PSYCHIATRY

    SRI RAMACHANDRA UNIVERSITY

    PORUR, CHENNAI -600116

    PROTOCOL FOR SUBMISSION OF PLAN OF THESIS

    FOR THE AWARD OF MD PSYCHIATRY

    SRI RAMACHANDRA UNIVERSITY

    SESSION 2013-2016

    PRINCIPAL INVESTIGATOR : Dr Vikas Prabhav M

    NAME OF GUIDE : Dr.R.Balakrishnan,MD,DPM

    Professor& Head

    Department of Psychiatry

    Sri Ramachandra Medical College &

    Research Institute

    Chennai- 600116

    NAME OF CO-GUIDE : Dr. M.S.Karthik, MD

    Assistant Professor

    Department of Psychiatry

    Sri Ramachandra Medical College &

    Research Institute

    Chennai- 600116

    TITLE OF THESIS:

    KNOWLEDGE, AND ATTITUDES TOWARD MENTAL ILLNESS AMONG

    MEDICAL PROFESSIONALS.

  • SRI RAMACHANDRA UNIVERSITY INSTITUTIONAL ETHICS

    COMMITTEE

    Initial Review Submission Form for Research Proposal

    1. Title of the Research Proposal

    Knowledge, and attitudes toward mental illness among medical

    professionals.

    2. Name of Principal Investigator with qualification and designation

    Dr. Vikas Prabhav, M.B.B.S,

    1st year Postgraduate (M.D) in Psychiatry, Dept. of Psychiatry

    S.R.M.C & R.I, Chennai 60016

    3. Name of Co-Investigator (s) with Qualifications and designation

    (A)Dr.Balakrishnan,MD,DPM,

    Professor and Head,

    Dept. of Psychiatry,

    S.R.M.C & R.I, Chennai 600 116

    (B)Dr. M.S.Karthik,MD,

    Assistant Professor,

    Dept. of Psychiatry,

    S.R.M.C & R.I , Chennai 600 116

    4. Name of Institute /Hospital/Field area where research will be conducted:

  • Sri Ramachandra Hospital, Sri Ramachandra University, Porur,

    Chennai 600 116

    5. Forwarding Letter from the Head of the Department / Institution/guide

    (Enclosed)

    6. Consent of the Head of the Department where the study will be conducted.

    (Enclosed)

    7. Protocol of the Proposed Research

    (Enclosed)

    8. Ethical issues in the study and plans to address these:

    Written informed consent of patients will be obtained prior to induction.

    No invasive procedure will be carried out as a part of the current study

    No additional benefits will be given to the subject.

    Confidentiality of the information obtained will be maintained.

    Subject will have the right to withdraw consent at any stage. This will not affect their

    treatment in any way.

    9. Case Report Forms, Questionnaires:

    (Enclosed)

    10. Informed Consent Form:

    In English

    (Enclosed)

  • 11. Relevant Pre clinical animal data, Clinical Trial data from other countries:

    Not Applicable.

    12. Usefulness of the Project:

    13. Expected benefits to volunteers/community

    Benefits include

    -Better planning of educational interventions to improve knowledge on mental illness

    among doctors of other specialities.

    14. Benefits to other categories:

    Not Applicable

    15. Anticipated Risks:

    There will be no risks associated with this

    study.

    16. Efforts taken to minimize risks:

    Not applicable.

    17. Research Proposal Approval by Scientific Advisory Committee, Drug Controller

    General of India, Health ministry Screening Committee

    Not applicable.

    18. Regulatory Clearance:

    Not applicable

    19. Source of Funding:

    Self-funded.

    20. Financial Issues related to Insurance:

    Not applicable

  • 21. Agreement to report all Serious Adverse Events to SRU- IEC:

    No serious adverse events to the patients or others are being expected in this study. If any

    adverse effects are being noticed, then we will comply with SRU-IEC

    22. Statement of Conflicts of Interest:

    There are no issues of conflict of interest.

    23. Agreement to comply with relevant National and International Guidelines:

    Yes

    24. Statement describing Compensation given to study participants:

    No Compensation will be given to the study participants.

    25. Description of the arrangements for Indemnity, if applicable in study related injuries

    and description of the arrangements for insurance coverage for research participants, if

    applicable:

    Not applicable

    26. Significant previous decisions by other ECs:

    Not applicable.

    27. Specific Ethical Issues:

    Not applicable

    28. Curriculum Vitae of all the Investigators:

    (Enclosed)

    29. Plans for Publication of the study:

    The study will be published while maintaining the privacy and confidentiality of the study

    participants.

    30. Registration of proposal with CTRI:

    Not applicable

    31. Any other information relevant to the study:

  • Nil

    32. Signature of the principal Investigator:

    Place: Chennai

  • PROTOCOL

    TITLE

    Knowledge, and attitudes toward mental illness among medical professionals.

    INTRODUCTION

    World Health Organization (2001) reported that mental disorders will affect one in four

    people worldwide. Early treatment is important and necessary in order for individuals who

    have a mental disorder to return to pre-illness functioning, retain employment, and to

    preserve family relationship and quality of life.

    Mental illness is estimated to account for 14% of all disability adjusted life years (DALYs)

    lost to disease worldwide 1,2

    and contribute more to the global burden of disease than either

    cardiovascular disease or cancer 1

    . In India, approximately 6% of the population is diagnosed

    with a mental illness 3, and suicide is a major public health problem

    4. People suffering from

    mental illness frequently present to a range of health care providers due to a significant

    overlap between physical and mental health. 5,6

    The primary care physician may not always be able to accurately assess and diagnose mental

    illness secondary to the lack of training in mental health issues in undergraduate medical

    curriculum, time constraints, and the fact that patients often present with somatic complaints.

    Physician knowledge, beliefs, and attitude have an effect upon the recognition, management,

    and prevention of mental disorders, Patients often report vague symptoms or symptoms that

    overlap and mimic those of a diagnosed medical condition.

    Besides structural barriers, like a scarcity of human, and financial resources, attitudinal

    barriers are also important in determining peoples help-seeking behaviour. The main

    psychological barriers cited are stigma and negative beliefs about the effectiveness of

    treatment

    It is highly pertinent for general practitioners to receive the education necessary to be able to

    detect, diagnose, and treat mental disorders. It is equally imperative that the general refer

    patients to specialist treatment when warranted.

  • AIM AND OBJECTIVES

    1. Assess the knowledge about mental illness among medical professionals.

    2. Assess the attitudes toward mental illness among medical professionals.

    3. To correlate the knowledge and attitude towards mental illness among medical

    professionals.

    MATERIALS AND METHODS

    The study will be conducted in the Department of Psychiatry, Sri Ramachandra medical

    college & research Centre (SRMC&RC), Porur.

    STUDY DESIGN

    Cross-sectional study.

    SAMPLE

    For the purpose of this study the term medical professional would include doctors

    who have completed their MBBS, Postgraduate students pursuing MD/MS courses and

    Specialist doctors who have completed their post-graduation. The sample of medical

    professionals will be obtained from

    1) Medical officers employed at Sri Ramachandra medical college and Sri Ramachandra

    medical centre in Chennai.

    2) Postgraduates, junior and senior residents at Sri Ramachandra medical college and Sri

    Ramachandra medical centre in Chennai.

    3) Consultants from various specialities practising at Sri Ramachandra medical college and

    Sri Ramachandra medical centre in Chennai.

    The sample will comprise of 100 medical professionals .

    SAMPLING METHODS

    Simple random sampling will be used to select participants from the source population.

    SELECTION CRITERIA

  • INCLUSION CRITERIA

    Doctors who have completed their MBBS , and are practising currently.

    Post graduate students of MD/MS and DM/Mch

    Specialist and super specialist doctors in various medical/surgical departments.

    Males and females between 21 and 65 years of age.

    EXCLUSION CRITERIA

    Physicians who have had formal psychiatric training or have been a resident or have done house job in the department of psychiatry.

    Those who are having psychiatric morbidity.

    Those who are too ill to participate.

    Those who are not willing to give informed consent.

    TOOLS AND INSTRUMENTS:

    A) Demographics.

    Detailed data of socio-demographic profile of each subject will be collected including age,

    sex, marital status, religion, family type, highest educational qualification, speciality and

    designation, prior psychiatric training if any and current practicing hospital.

    B) Questionnaire to assess the knowledge about mental illness among the medical

    professionals.

    The questionnaire to assess the knowledge about mental illness was originally

    developed by NIMHANS, Bangalore as part of District Mental Health Program (DMHP).

    This was used to assess the knowledge of medical officers in mental health prior to training in

    psychiatry. Since the questionnaire has been developed in 1980's few terminologies have

    been changed in accordance with Diagnostic and Stastical Manual of Mental Disorders- 4th

    edition text revision (DSM IV TR). It has seven case vignettes with answer sheet in

    prescribed format. Each vignette consists of brief descriptions of 5to7 features characteristic

    of a major psychiatric diagnoses, commonly encountered in clinical practice. Each case

    vignette will be scored according to participants response. The maximum score of each

    vignette will be 14 and the total score will be the sum of all 7 vignettes. Higher the score

  • better will be the knowledge about mental health. The questionnaire was well validated with

    good internal consistency. It has high degree of inter-rater reliability with correlation

    coefficient of 0.94 to 0.98.

    C)Attitudes to Mental Illness Questionnaire (AMIQ)

    The Attitudes to Mental Illness Questionnaire (AMIQ) is a brief, self-completion

    questionnaire with good psychometric properties that can be used in most situations. Content

    validity and reliability is high, as indicated by Cronbachs alpha score, factor analysis and

    test-retest correlation coefficients. Vignettes describing highly stigmatised individuals (such

    as a convicted criminal) produce consistently negative scores and those describing non-

    stigmatised individuals (a Christian and a diabetic) produce positive scores. Respondents will

    be asked to read a short vignette describing one of five imaginary individuals and then

    answer five questions. Three of the vignettes were chosen deliberately to produce a strongly

    negative or positive response. Vignettes were presented in random order on the

    questionnaire. The individual questions were scored on a 5-point Likert scale (maximum +2,

    minimum-2) with blank questions, neutral and dont know being scored 0. The score for

    the five questions was added giving a total score for each vignette between-10 and +10.

    Positive score will indicate positive attitude and negative score will indicate negative attitude

    PROCEDURE

    All the participants who are fulfilling the selection criteria will be randomly inducted into the

    study by simple random sampling method. Thereafter they will be informed about the

    purpose of the study and written informed consent will be obtained. Then socio-demographic

    data will be obtained and then they will be assessed for knowledge and attitude about mental

    illness using questionnaire to assess the knowledge about mental illness among the medical

    professionals and attitudes to mental illness questionnaire respectively.

    STATISTICAL ANALYSIS

    The data will be analysed by using descriptive and inferential statistics.

    Descriptive statistics - frequency counts will be obtained for all discrete variables such as

    gender, designation, specialization, practicing hospital etc. Mean and standard deviation will

    be computed for all continuous variables e.g. age, etc.

  • Inferential statistics - The Student t test will be used to compare the continuous variable in

    groups. The Chi square test will be used to compare the discrete variables in groups.

    Pearsons product moment correlation and spearman rank correlation will be used for

    correlation of variables

    ETHICAL CONSIDERATIONS

    1. Written informed consent of participants will be obtained prior to induction.

    2. No invasive procedure will be carried out as a part of the current study

    3. No additional benefits will be given to the participants.

    4 Confidentiality of the information obtained will be maintained.

    5 Participants have the right to withdraw consent at any stage of the study.

  • REFERENCES:

    1. Prince M, Patel V, Saxena S, Maj M, Maselko J, Phillips MR, Rahman A:No health without mental

    health.Lancet2007,370(9590):859877.

    2. Mathers CD, Loncar D:Projections of global mortality and burden of disease from 2002 to

    2030.PLoS Med2006,3(11):e442.

    3. World Health Organization, Wonca WOoFD:Integrating mental health into primary care: A global

    perspective. Geneva: WHO; 2008

    4.Patel V, Sumathipala A, Khan MM:South Asia Region.InCulture and Mental Health - a

    comprehensive textbook. Edited by Bhui K, Bhugra D. London: Hodder Arnold; 2007.

    5.Chaturvedi SK, Desai G:What's 'in the body' is actually 'in the mind'!Int Rev Psychiatr (Abingdon,

    England)2006,18(1):13.

    6.Patel V, Pednekar S, Weiss H, Rodrigues M, Barros P, Nayak B, Tanksale V,West B, Nevrekar P,

    Kirkwood BR,et al: Why do women complain of vaginal discharge? A population survey of infectious

    and pyschosocial risk factors in a South Asian community.Int J Epidemiol 2005,34(4):853862.

    7.Gierk, Benjamin; Murray, Alexandra M.; Kohlmann, Sebastian; Lwe, Bernd. "Measuring the

    perceived stigma of mental illness with Stig-9: A re-conceptualisation of the Perceived-Devaluation-

    Discrimination-Scale.".

    8. Training primary care medical officers in mental health care: an evaluation using a multiple-choice

    questionnaire.Sriram TG, Chandrashekar CR, Isaac MK, Srinivasa Murthy R, Shanmugham V.

    9.Development of case vignettes to assess the mental health training of primary care medical officers.

    Sriram TG, Chandrashekar CR, Isaac MK, Srinivasa Murthy R, Kishore Kumar KV, Moily S,

    Shanmugham V

  • Knowledge, and attitudes toward mental illness among medical

    professionals.

    Demographics Sheet

    1. Age Sex Male Female

    2. Marital status Single Married Others

    3. Religion Hindu Muslim Christian Others

    4. Family type Nuclear Extended/joint

    5. Highest Educational qualification held :

    6. Current Practicing specialty :

    7. Current designation :

    8. Prior training in psychiatry if any :

    9. Hospital currently practicing in:

  • Questionnaire to assess the knowledge about mental illness among

    medical professionals.

    VIGNETTE 1

    Diagnosis Normal

    Physical problem Specify:

    Neuropsychiatric

    Treatment and Drug of

    choice with dose and

    common side effects

    Non pharmalogical

    management

    Duration of treatment

    Advice to family in regard

    to illness, treatment and

    work

    Prognosis at 6 Months

    Reason for refferal

    VIGNETTE 2

    Diagnosis Normal

    Physical problem Specify:

    Neuropsychiatric

    Treatment and Drug of

    choice with dose and

    common side effects

    Non pharmalogical

    management

    Duration of treatment

    Advice to family in regard

    to illness, treatment and

    work

    Prognosis at 6 Months

    Reason for refferal

  • VIGNETTE 3

    Diagnosis Normal

    Physical problem Specify:

    Neuropsychiatric

    Treatment and Drug of

    choice with dose and

    common side effects

    Non pharmalogical

    management

    Duration of treatment

    Advice to family in regard

    to illness, treatment and

    work

    Prognosis at 6 Months

    Reason for refferal

    VIGNETTE 4

    Diagnosis Normal

    Physical problem Specify:

    Neuropsychiatric

    Treatment and Drug of

    choice with dose and

    common side effects

    Non pharmalogical

    management

    Duration of treatment

    Advice to family in regard

    to illness, treatment and

    work

    Prognosis at 6 Months

    Reason for refferal

  • VIGNETTE 5

    Diagnosis Normal

    Physical problem Specify:

    Neuropsychiatric

    Treatment and Drug of

    choice with dose and

    common side effects

    Non pharmalogical

    management

    Duration of treatment

    Advice to family in regard

    to illness, treatment and

    work

    Prognosis at 6 Months

    Reason for refferal

    VIGNETTE 6

    Diagnosis Normal

    Physical problem Specify:

    Neuropsychiatric

    Treatment and Drug of

    choice with dose and

    common side effects

    Non pharmalogical

    management

    Duration of treatment

    Advice to family in regard

    to illness, treatment and

    work

    Prognosis at 6 Months

    Reason for refferal

  • The vignettes are scored in a standard format based on the response to each of the questions

    in the vignette response sheet. The maximum possible score of 14 is broken up as follows:

    Diagnosis 1

    Drug of choice and dosage 1+1

    Side effects of drugs and management of

    side effects

    1+1

    Other available drugs, dosage, side effects

    & Management of side effects

    1+1+1

    Non pharmalogical management 1 1/2

    Duration of treatment 1

    Advice to be given about illness, treatment

    and work

    1 1/2

    Prognosis 1

    Indications for referral 1

    VIGNETTE 7

    Diagnosis Normal

    Physical problem Specify:

    Neuropsychiatric

    Treatment and Drug of

    choice with dose and

    common side effects

    Non pharmalogical

    management

    Duration of treatment

    Advice to family in regard

    to illness, treatment and

    work

    Prognosis at 6 Months

    Reason for refferal

  • The Attitudes to Mental Illness Questionnaire

    (AMIQ)

    Please mark your response via a mark next to your desired response.

    EXAMPLE

    -Do you think that this would damage Johns career?

    Strongly agree / Agree/Neutral/Disagree/Strongly disagree/Dont know

    a)John has been injecting heroin daily for 1 year.

    -Do you think that this would damage Johns career?

    Strongly agree /Agree/Neutral/Disagree/Strongly disagree/Dont know

    -I would be comfortable if John was my colleague at work?

    Strongly agree /Agree/Neutral/Disagree/Strongly disagree/Dont know

    -I would be comfortable about inviting John to a dinner party?

    Strongly agree /Agree/Neutral/Disagree/Strongly disagree/Dont know

    - How likely do you think it would be for Johns wife to leave him?

    Strongly agree /Agree/Neutral/Disagree/Strongly disagree/Dont know

    - How likely do you think it would be for John to get in trouble with the law?

    Strongly agree /Agree/Neutral/Disagree/Strongly disagree/Dont know

    b)Tim is depressed and took a paracetamol overdose last month to try and

    hurt himself.

    -Do you think that this would damage Tims career?

    Strongly agree /Agree/Neutral/Disagree/Strongly disagree/Dont know

    - I would be comfortable if Tim was my colleague at work?

    Strongly agree /Agree/Neutral/Disagree/Strongly disagree/Dont know

    - I would be comfortable about inviting Tim to a dinner party?

    Strongly agree /Agree/Neutral/Disagree/Strongly disagree/Dont know

  • - How likely do you think it would be for Tims wife to leave him?

    Strongly agree /Agree/Neutral/Disagree/Strongly disagree/Dont know

    - How likely do you think it would be for Tim to get in trouble with the law?

    Strongly agree /Agree/Neutral/Disagree/Strongly disagree/Dont know

    c) Steve has been drinking heavily for 5 years. He is now going for

    treatment and has started attending Alcoholics Anonymous meetings.

    -Do you think that this would damage Steves career?

    Strongly agree /Agree/Neutral/Disagree/Strongly disagree/Dont know

    - I would be comfortable if Steve was my colleague at work?

    Strongly agree /Agree/Neutral/Disagree/Strongly disagree/Dont know

    -I would be comfortable about inviting Steve to a dinner party?

    Strongly agree /Agree/Neutral/Disagree/Strongly disagree/Dont know

    -How likely do you think it would be for Steves wife to leave him?

    Strongly agree /Agree/Neutral/Disagree/Strongly disagree/Dont know

    - How likely do you think it would be for Steve to get in trouble with the law?

    Strongly agree /Agree/Neutral/Disagree/Strongly disagree/Dont know

    d) Robert is a convicted criminal. He has spent time in prison for several

    convictions for theft and shoplifting and is currently on bail for fraud and

    burglary.

    - How likely do you think it would be for Robert to get in trouble with the law?

    Strongly agree /Agree/Neutral/Disagree/Strongly disagree/Dont know

    -Do you think that this would damage Roberts career?

    Strongly agree /Agree/Neutral/Disagree/Strongly disagree/Dont know

    - I would be comfortable if Robert was my colleague at work?

    Strongly agree /Agree/Neutral/Disagree/Strongly disagree/Dont know

  • - I would be comfortable about inviting Robert to a dinner party?

    Strongly agree /Agree/Neutral/Disagree/Strongly disagree/Dont know

    -How likely do you think it would be for Roberts wife to leave him?

    Strongly agree /Agree/Neutral/Disagree/Strongly disagree/Dont know

    -How likely do you think it would be for Robert to get in trouble with the law?

    Strongly agree /Agree/Neutral/Disagree/Strongly disagree/Dont know

    e) Peter has diabetes. He needs to inject insulin every day and has a special

    diet.

    -Do you think that this would damage Peters career?

    Strongly agree /Agree/Neutral/Disagree/Strongly disagree/Dont know

    -I would be comfortable if Peter was my colleague at work?

    Strongly agree /Agree/Neutral/Disagree/Strongly disagree/Dont know

    - I would be comfortable about inviting Peter to a dinner party?

    Strongly agree /Agree/Neutral/Disagree/Strongly disagree/Dont know

    -How likely do you think it would be for Peters wife to leave him?

    Strongly agree /Agree/Neutral/Disagree/Strongly disagree/Dont know

    f) Michael has schizophrenia. He needs an injection of medication every 2

    weeks. He was detained in hospital for several weeks 2 years ago because he

    was hearing voices from the Devil and thought that he had the power to

    cause earthquakes. He has been detained under the Mental Health Act 1983

    in the past.

    Do you think that this would damage Michaels career?

    Strongly agree /Agree/Neutral/Disagree/Strongly disagree/Dont know

    - I would be comfortable if Michael was my colleague at work?

    Strongly agree /Agree/Neutral/Disagree/Strongly disagree/Dont know

    - I would be comfortable about inviting Michael to a dinner party?

  • Strongly agree /Agree/Neutral/Disagree/Strongly disagree/Dont know

    - How likely do you think it would be for Michaels wife to leave him?

    Strongly agree /Agree/Neutral/Disagree/Strongly disagree/Dont know

    g) Steve is a practicing Christian. He attends church every Sunday and

    attempts to lead a Christian life.

    -Do you think that this would damage Michaels career?

    Strongly agree /Agree/Neutral/Disagree/Strongly disagree/Dont know

    - I would be comfortable if Michael was my colleague at work?

    Strongly agree /Agree/Neutral/Disagree/Strongly disagree/Dont know

    - I would be comfortable about inviting Michael to a dinner party?

    Strongly agree /Agree/Neutral/Disagree/Strongly disagree/Dont know

    -How likely do you think it would be for Michaels wife to leave him?

    Strongly agree /Agree/Neutral/Disagree/Strongly disagree/Dont know

    Thank you for your valuable time and effort in taking part in

    this study.

  • CASE VIGNETTES FOR THE ASSESSMENT OF KNOWLEDGE

    IN REGARD TO MENTAL ILLNESS AMONG THE MEDICAL

    PROFESSIONALS.

    Dear doctor, Given below are certain commonly encountered clinical situations.

    Read the clinical descriptions carefully. The descriptions may suggest a neuropsychiatry

    problem, physical problem or even may be normal. For to each clinical description, answer

    the set of questions in the answer Sheet that is provided. Please be specific in your answers. If

    you find certain questions are not applicable to the case, kindly mention not applicable.

    Thank you for your co-operation.

    VIGNETTE 1 15 year old girl is accompanied by her mother.

    Duration of symptoms - 4 months.

    Since 4 months, patient has had 7 attacks of sudden loss of consciousness lasting about 10-15 minutes.

    During these attacks, there is rhythmic jerking of all four limbs, associated with frothing in the mouth.

    On two such attacks, there was bleeding from the tongue.

    Between the attacks, patient is normal.

    Physical examinations normal.

    VIGNETTE 2 35 years old factory worker comes alone

    Duration of symptoms - 2 months.

    Two months back patient developed chest pain, palpitations and tremors while working. These symptoms are continuing.

    His electrocardiogram taken by a physician earlier is normal.

    On enquiry, patient reports worries about loans he has made to bring up his children.

    On and off he has disturbed sleep He has not found improvement with Iron and B-complex vitamins that were prescribed.

    VIGNETTE 3

    32 year old factory worker is brought by his wife and relatives.

    Duration of symptoms - 2 months.

    Since 2 months patient is noticed to be restless, sleepless and quarrelsome.

    In the factory he claims he is the manager, assures everybody that he would givethem double salary.

    His food habits have become irregular, he smokes excessively and keeps playing the tape recorder all through the night.

    This is the third episode. Earlier episodes occurred ten years back and six years back.

    He recovered fully from these episodes within 4-5 months.

  • Physical examination reveals abrasions in his hands and legs.

    VIGNETTE 4 30-year-old agricultural labourer comes alone.

    Duration of symptoms 1 year

    Patient's main complaint is tiredness. He also gets palpitations and breathlessness on exertion.

    At times he feels sad because he is unable to work.

    His sleep is disturbed on and off. His appetite has decreased.

    His family members are worried.

    Physical examination reveals pallor of the tongue and conjunctiva. Cardiac examination reveals a systolic murmur.

    VIGNETTE 5 30-year-old lady is brought by husband.

    Duration of symptoms - one year.

    Since one year patient has gradually become withdrawn.

    Sometimes says she hears some voices even though no one is around. Is very suspicious of her neighbors. People say that evil spirits haunts her.

    At times she is noticed to talk and smile to self

    She was taken to faith healers, but there was no improvement.

    Physical examination is normal.

    VIGNETTE 6

    Child aged 10 years is brought by the parents.

    Symptoms noticed at 6 months of age.

    Parents say that child is not developing like other children.

    Child also had 3 attacks of fits at the age of one year. Later there were no attacks.

    This is the first child. Child was born after prolonged labour.

    Parents are healthy. There is no similar problem in other relatives.

    On examination, child is unable to talk properly and is unable to do simple

    calculations. No physical deficits.

    VIGNETTE 7

    35 year old factory worker is brought by wife and friends.

    Duration of symptoms one week.

    Noticed to be restless and very fearful.

    Says that a gang is following him to murder him.

    Says he can clearly hear their movements.

    Since one week he has not been sleeping at all. Has been refusing to take food.

    He has been consuming daily alcohol for 10 years. He stopped taking alcohol 10 days back because of lack of money.

    On examination, patient appears very frightened. He has anemia and glositis.

  • INFORMED CONSENT

    STUDY TITLE: Knowledge, and attitudes toward mental illness among

    medical professionals.

    Name of Principal Investigator with qualification and designation

    Dr. Vikas Prabhav M, M.B.B.S,

    1st year Postgraduate (M.D) in Psychiatry,

    Department of Psychiatry,

    SRMC&RI.

    In accordance with your preliminary verbal consent, this form is given to you for your

    participation in the above mentioned research study being conducted at Sri Ramachandra

    Medical Centre. Before you participate in this study it is important for you to understand why

    the research study is being done, what is your role in the study and its effects on you.

    Please take time to read the following information carefully and discuss it with

    friends, relatives and your own doctor if needed. You can ask your physician/ surgeon/ study

    doctor to explain any words that you might not understand or furnish any information

    regarding the same.

    Your participation in this study is completely voluntary and non-participation does not

    interfere with the treatment of your illness at this institute.

    DESCRIPTION OF THE STUDY:

    The primary care physician may not always be able to accurately assess and diagnose mental

    illness secondary to the lack of training in mental health issues in undergraduate medical

    curriculum, time constraints, and the fact that patients often present with somatic complaints.

    Physician knowledge, beliefs, and attitude have an effect upon the recognition, management,

    and prevention of mental disorders, Patients often report vague symptoms or symptoms that

    overlap and mimic those of diagnosed medical conditions.

    Thus, It is highly pertinent for general practitioners and specialists to receive the education

  • necessary to be able to detect, diagnose, and treat mental disorders. It is equally imperative

    that the general refer patients to specialist treatment when warranted.

    This study will focus on the assessment of knowledge and attitudes about mental illness

    among medical professionals.

    POSSIBLE RISKS TO THE PARTICIPANTS:

    There are no anticipated risks to the participants.

    COSTS AND PAYMENTS TO THE PARTICIPANTS:

    There is no cost for participation in this study. Participation is completely voluntary

    and no payment will be provided.

    CONFIDENTIALITY:

    Information obtained in this study is strictly confidential. Your name or identifiers will

    not be used in reporting of information in publications or conference.

    PARTICIPANTS RIGHT TO WITHDRAW FROM THE STUDY:

    You have the right to refuse to participate in this study, the right to withdraw from this

    study and the right to have your data destroyed at any point during the study, without penalty.

    VOLUNTARY CONSENT BY THE PARTICIPANT:

    Participation in this study is completely voluntary, and your consent is required before

    you can participate in this study.

    I have read this consent form (or it has been read to me) and I fully understand the

    contents of this document and voluntarily participate in this study. All of my questions

    concerning this study have been answered. If I have any questions in the future about this

    study they will be answered by the investigators listed below. I understand that this consent

    ends at the conclusion of this study.

    Contact address with phone number:

    Dr.Vikas Prabhav, Mobile no. 9840780211

    Postgraduate,

    Department of Psychiatry,

  • SRMC & RI.

    Porur, Chennai 600 116.

    By signing this form, I agree to participate in this study.

    Name:

    Date:

    Participant signature/ thumb impression

    Certification of INFORMED CONSENT:

    I certify that I had explained the nature and purpose of this study to the above named

    individuals and I have discussed the potential benefits of this study participation. The

    questions the individuals had about this study have been answered and I will always be

    available to address future questions as they arise.

    Date: Signature of person obtaining consent:

    Name:

    ` Signature of Principal investigator

  • BIOGRAPHICAL SKETCH

    NAME

    TITLE

    BIRTHDATE(Month/ Day/

    Year)

    Vikas Prabhav M Post Graduate 18/05/1987

    EDUCATION

    INSTITUTION AND

    LOCATION

    DEGREE(UG/ PG)

    YEAR CONFERRED

    FIELD OF STUDY

    Sri Ramachandra

    Medical College &

    Research Institute,

    Chennai

    M.D Pursuing Psychiatry

    Shree Balaji medical

    college and hospitals

    MBBS 2010 M.B.B.S

  • BIOGRAPHICAL SKETCH

    NAME

    TITLE

    BIRTHDATE(Month/ Day/

    Year)

    Prof.Dr.Balakrishnan Doctor 25/03/1952

    EDUCATION

    INSTITUTION AND

    LOCATION

    DEGREE(UG/ PG)

    YEAR CONFERRED

    FIELD OF STUDY

    Thanjavur Medical

    college Thanjavur

    UG 1976 M.B.B.S

    Madras Medical

    College Chennai PG 1983 PSYCHIATRY

    Madras Medical

    College Chennai

    PG 1986 PSYCHIATRY

    TEACHING AND RESEARCH EXPERIENCE

    Institute From To Designation

    Madras

    Medical

    College

    25/09/1991 24/09/1994 Assistant professor

    Madras

    Medical

    College

    25/09/1994 11/08/1995 Sr.Assistant professor

    Kilpauk

    medical

    College

    12/08/1995 24/09/1996 Sr.Assistant professor

    Kilpauk

    medical

    College

    25/09/1996 24/09/2000 Associate professor

  • SRMC and RI 26/04/2010 22/08/2010 Associate

    professor

    Kilpauk

    medical

    College

    25/09/2000 13/02/2007 Professor

    Tirunelveli

    Medical

    college

    14/02/2007 28/05/2008 Professor

    Chengalpettu

    Medical

    college

    29/05/2008 03/04/2009 Professor

    Madras

    Medical

    College

    04/04/2009 31/03/2010 Professor

    SRMC and RI 23/08/2010 31/01/2012 Professor

    SRMC and RI 01/02/2012 To Date Professor & Head

  • BIOGRAPHICAL SKETCH

    NAME

    TITLE

    BIRTHDATE(Month/ Day/

    Year)

    Dr.Karthik.M.S. Doctor 11/11/1979

    EDUCATION

    INSTITUTION AND

    LOCATION

    DEGREE(UG/ PG)

    YEAR CONFERRED

    FIELD OF STUDY

    IRT-Perundurai

    Medical college &

    Research Centre

    UG 2003 MBBS

    PGIMER-Chandigarh PG 2009 MD(Psychiatry)

    TEACHING AND RESEARCH EXPERIENCE

    INSTITUTE

    FROM

    TO

    DESIGNATION

    SRM, Medical

    College,Kancheepuram 1/1/2010 17/12/11 Assistant professor

    SRMC&RI,Porur,Chennai 10/12/11 Till Date Assistant Professor

    RESPONSIBILITIES

    CLINICAL- Managing Patients ,OPD & Ward

  • UG TEACHING- Clinical &Lecture

    PG TEACHING- Clinical &Lecture, Academic supervisor

    PUBLICATIONS, CONFERENCE, SEMINAR, CME ATTENDED(last five years and

    the relevant ones for the present study)

    Attitude towards second generation antipsychotics among patients with schizophrenia

    and their relatives

    Attended ANCIPS-2011,2012,2013

    Attended TANPSYCON-2011,2012

    Attended IPS south zone conference-2011,2012

    PROFESSIONAL MEMBERSHIP

    Life ordinary Member of Indian Psychiatric Society.

  • From

    Vikas Prabhav M,

    1st year, M.D PG,

    Department of Psychiatry,

    Sri Ramachandra Medical College & Research Institute,

    Porur, Chennai 116.

    To

    The Chairperson,

    Ethics Committee for Students Proposals,

    Institutional Ethics Committee,

    Sri Ramachandra University,

    Porur, Chennai - 116.

    Respected Sir/ Madam,

    Herewith I am submitting the Initial Review Submission Form for Research proposal

    of my dissertation entitled Knowledge, and attitudes toward mental illness among medical

    professionals. for the committee meeting to be held on 18.02.2014.

    Thanking You,

    Yours sincerely,

    Station: Chennai

    Date: