Effect of Alcohol Dependency on Spouse

Effect of Alcohol Dependency on Spouse Psychiatric illnesses are increasingly known to be common in the recent decades and affects over 25% of people at some point in a adults at any point in time, and at least one affected individual living in one every four families—(1). Alcohol dependence syndrome is the maladaptive patters of alcohol intake with tolerance craving, loss of control, and withdrawal symptoms (3). Bipolar affective disorder is episodic in nature with manic or hypomanic or depressive or mixed symptoms occur. Patients exhibit fluctuating severity of any of these symptoms interspersed with a symptom free (euthymics 2) or subsyndromal periods. Cwvently the prevalence of bipolar affective disorder (BPAD) is around 0.4-0.5% with an 1 year prevalence of 0.5to 1.4% and a life-time prevalence of about 2.6 to 7.8% (4). The life-time prevalence of bipolar disorder is about 20.8 per 1000 population in India (6  ±); and that of alcohol use ranges from 1.15% to upto 50% in general (8, 9). Burden Definition (10) – Platt Stigmatization, chronic emotional and economic burden from caring are endured by the families of individuals with psychiatric illness. The illness impact on the primary caregiver’s leisure time activities work and social relationships. These deficits evoke different reactions infifferent or expressed emotional reaction towards the patients, and a sense of insufficiency and helplessness in themselves, all of which impact on the progression and prognosis of the patient’s illness (1). AIM To compare the family burden, the quality of life and psychiatric morbidity between female spouses of patients with alcohol dependence syndrome, patients with schizophrenia, and patients with bipolar affective disorder OBJECTIVES To find the family burden and quality of life in female spouses of patients with alcohol dependence, schizophrenia and bipolar affective disorder To evaluate the prevalence of psychiatric morbidity in female spouses of patients of these three groups To study the association between symptom severity in patients, perceived apathy, significant life events and family burden, and the quality of life and psychiatric morbidity in female spouses in these groups To compare psychiatric morbidity, family burden of care and quality of life in female spouses between all patient groups. MATERIALS AND METHODS: The sample is drawn from male patients with female spouses attending the outpatient Psychiatry department at this hospital. Design: Crosssectional, comparative study, including 64 patients with alcohol dependence, 64 patients with schizophrenia, and 64 patients with bipolar affective disorder, and their female spouses. With consecutive sampling from Outpatient department, a total of 192 patients with their spouses are taken up for the study. Duration and period of Study- 4 months Inclusion criteria: male patients with equal to or more than 10 year duration of alcohol dependence or schizophrenia or bipolar affective disorder, satisfying the criteria for the corresponding DSM IV-TR diagnoses patients with onset of psychiatric symptoms/disorder after marriage female spouses who provide care for the patients participa nts should be not less than 60 years of age participants to be willing to provide informed consent for the interview and assessment patients willing to allow spouse to be assessed Exclusion criteria: those who did not give their consent refusal to allow spouse to be evaluated patients and/or their spouses with any chronic general medical illness spouses with a history of substance abuse, suicide or previous history of psychiatric symptoms and intervention spouses with a family history of psychiatric illness spouses related to the patients by consanguinity Instruments used A semistructured profoma to collect the sociodemographic details, family history details and a semistructured clinical profile International Classification of Diseases ICD-10 Shortform Alcohol Dependence Data Questionnaire SADDQ Clinical Global Impressions CGI-BP bipolar and CGI-SCH schizophrenia, severity scales Presumptive stressful life events scale PSLES Apathy inventory –caregiver version Burden Assessment Scale BAS; Caregiver Reaction Assessment -Selfesteem, High life-esteem -positive caregiving, Burnout -Negative Caregiving subscales –CRASH-BOUNCE score WHO Quality Of Life WHOQOL –BREF-1 General Health Questionnaire GHQ-12 MINI plus 5.0.0 v Mini International Neuropsychiatric Interview –plus Beck Depression Inventory BDI; Hospital Anxiety and Depression Scale –anxiety HADS-A CGI-BP Bipolar disorder is a cyclic and polymorphic disease. Patients may show manic, hipomanic, depressive or mixed symptoms, and they may be in partial or complete remission. For this reason, the assessment of the course, severity and outcome of the disorder is very complex. Most of the available psychometric instruments have been designed for the assessment of acute episodes of specific polarity. The CGI-BP-M, a user-friendly scale for the assessment of manic, hypomanic, depressive or mixed symptoms, and long-term outcome of bipolar disorder, is a useful tool for the assessment of the efficacy of several treatments. CGI-S: Amongst the most widely used of extant brief assessment  tools in psychiatry, the CGI is a 3-item observer-rated  scale that measures illness severity (CGIS), global  improvement or change (CGIC) and therapeutic response.   The illness severity and improvement sections of the  instrument are used more frequently than the therapeutic  response section in both clinical and research settings. Amongst the most widely used of extant brief assessment  tools in psychiatry, the CGI is a 3-item observer-rated scale that measures illness severity (CGIS), global  improvement or change (CGIC) and therapeutic response. The illness severity and improvement sections of the  instrument are used more frequently than the therapeutic  response section in both clinical and research settings. Burden Assessment Schedule (BAS) (104): [ANNEXURE IV] It is an instrument to assess burden on caregivers of chronic mentally ill. It was developed to assess subjective burden in Indian population, as many of the burden assessment instruments developed in the west were not culturally suited to Indian population. This schedule has 40 items and 9 domains. The different domains are Spouse related, Physical and mental health, External support, Caregivers routine, Support of patient, Taking responsibility, Other relations, Patients, Patients behaviour and Caregivers strategy. Each of these 40 items was rated on a 3-point scale marked 1-3. The responses were not at all, to some extent and very much. Depending on the questions were framed, the responses and the score for each of those responses would vary. In this study the schedule was modified by arranging 40- items into the above 9 domains. Total score of each domain was calculated separately and at the end the total burden was calculated. This was done to get the domain score apart from the total score. In the spouse was replaced with either son, daughter, brother, sister, mother or father, depending of the patient to the caregiver. In the items 2 and 4, the word ‘sexual and marital’ was replaced by ‘family’ as and when needed. The minimum total score of burden in BAS is 40 and the maximum score in 120. In this the severity of burden was categorized into 4 groups, in the following way, 40-60 –Minimum burden 61-80 –Moderate burden 81-100 –Severe burden 101-120 –Very severs burden Method Consecutive patients attending the Psychiatry OPDs of hospitals attached to J.J.M. Medical College, diagnosed as BPAD and Alcohol dependence according to DSM IV criteria who met the inclusion criteria and did not get excluded were included in the study. Written informed consent was taken from the patients or from the caregivers depending on their ability to give consent, following an explanation about the nature and the purpose of the study in the language in which the patient could understand. Sociodemographic details were recorded on the self designed proforma. The primary family care-giver was one who met at least three of the following criteria (108). Is a spouse, parent or spouse equivalent. Has the most frequent contact with the patient. Helps to support the patients financially. Has most frequently been collateral in the patient’s treatment. Is contacted by treatment staff in case of emergency. Burden Assessment Scale (BAS) was administered to assess the burden on caregivers of BPAD group and ADS group. Severity of alcohol dependence was assessed using Short Alcohol Dependence Data (SADD) Questionnaire. GHQ Validity Discriminative validity There was a non-significant trend in GHQ Total scores and Depression subscales  scores to be higher for carers using Admiral Nurse (AN) teams vs. carers who did not  (Woods et al., 2003). On follow-up, a significant difference was found on the Anxiety  and Insomnia subscale, where outcome was better for the AN group. Another study  showed that carers of dementia patients showed higher levels of distress as measured  by GHQ than carers for patients with depression (Rosenvinge et al., 1998). Furthermore, significant differences in GHQ scores have been found between carers  of people with anorexia and psychosis (Treasure et al., 2001). GHQ scores have also  been found to differ in carers of people with a head injury according to different time  intervals post-injury. The GHQ scores were higher for carers of people with a recent  head injury, which indicates greater burden in this group (Sander et al., 1997). Predictive validity Coping style has been found to contribute significantly to GHQ score variance, with  emotion-focused coping being related to GHQ scores in a study by Sander et al.,  (1997). Furthermore, coping accounted for more of the GHQ variance than disability  scores. Socio-demographic variables Gender has been found to have a significant effect on GHQ scores, but neither race  nor relationship to the injured person had a significant effect (Sander et al., 1997). Dimension-specific variables Strong positive correlations were found between the GHQ and the Relatives Stress  Scale (Draper et al., 1992). Responsiveness The GHQ-28 has been shown to be responsive to change in a study using cognitive  behavioural therapy in carers of Parkinson’s disease patients. Both the Total score and  the scores for 3 of the sub-scales decreased in response to the intervention (Secker and  Brown 2005). Both conventional and AN services led to lower GHQ scores overall  and 2 of the 4 subscales over an 8-month period (Woods et al., 2003).

High school versus college Essay

Going to College after so many years made me realize how different high school is from College. In fact, many students that attend College straight after high school quit after their first semester of College due to the changes and difficulties encountered. There are various reasons why College differs from high school. However, knowing the expectations and the culture of College in comparison to high school would help in a more successful transition. College differs from high school in many ways. However, students should begin their transition to College by first looking at not only what to expect from College; but also what College will expect from them. As a college education is very important step to reach personal aspirations in the workplace and life. First of all, College offers an opportunity to learn independently. Unlike high school, College students can function with little guidance from their professors. As a result, College students have to develop many self management skills such as getting to school on time, turning projects by deadlines, being able to use electronic materials for the syllabus, class outlines, online classes or assignments. Secondly, College has a faster pace than high school. Each college course is twice faster than high school courses. In addition, College course usually requires more reading, more homework, and more projects. The workload is totally higher and faster and requires more time to study. The College books have more words per page, thus more chapters than the high school books. The language used in the textbooks is more difficult and requires more time to study. Unlike high school which has specific school hours 5 days a week excluding weekends; College on the other hands offer more out of class time. Students can choose to go to school any time based on their chosen schedule whether is day, night or weekends. As a result of this freedom, College students have to learn to manage their time effectively. In addition, all high schools students must take the same basic classes in order to graduate such as English, Mathematics, Sciences, Physical education, world history, economics, foreign languages and other elective. College students on the other hand can take any classes based on their academic major. Most college freshmen start with beginning classes such as English, writing, speech, and Mathematics then they can choose any other required course based on their academic field of study. College students also have higher level of thinking than high school students. They are able to do research on a topic and ideas as well as analyzing others ideas and interpreting and evaluating data from any given source. High school students on the other hands can only summarize and take ideas from others. Some of College student’s classes unlike high school class require research papers, presentation, and discussion in front of the whole class and sometimes peer evaluation. Although College culture differs widely from high school culture, students can also succeed with improved effort and practice. Whether students attend College straight from high school or its equivalents; or attending College after many years of working, going to college offers an opportunity to grow and to achieve goals. No matter what the background or motivation, being a College student will provide an opportunity to improve life and reach personal aspirations.

Lies Youve Been Told About Argumentative Essay Topics for Elementary Students

Lies You've Been Told About Argumentative Essay Topics for Elementary Students Argumentative Essay Topics for Elementary Students Explained A favourite author, middle school students may stretch their. They should be allowed to pray in school. Plenty of students put on a uniform. They lead busy lives and often forget about an upcoming deadline. When it has to do with writing an argumentative essay, the main point to do is to select a topic and an argument you may really get behind. A great topic will allow it to be simpler to pursue the purpose of an argumentative essay, which is, clearly, the entire investigation of the problem you speak about. Last word of advice is to ask your teacher before the last decision about this issue selection for argumentative essays. Before you commence writing your essay, you should study the sources related to the prospective subject, and make certain you have enough evidence to strengthen your thesis statement. Anyway, below, you will find topic that are fantastic for both instances. Education scholars are continuously evolving the way that they think about how we learn and what's taught. It is vital to opt for a great topic to be able to compose a terrific paper. Opinion writing and the subsequent manual that students to pick a formal letter for children puts an excessive amount of homework. If you would like a paper on the subject you are not certain about, contact online writing service to acquire appropriate assistance. If your paper includes more than merely a simple discussion of security in schools, you may want to incorporate a small background information regarding gun control. Finding the Best Argumentative Essay Topics for Elementary Students Likewise, you must have a an essay template that manages analytical essays if you have to compose an analytical essay body. You've approached the last portion of your essay. You are able to buy argumentative essay from a specialist writer. Among the various sorts of essay, there's a definition essay that could appear to be among the most simple assignments. You might also compose a narrative essay to talk about your story about traditional or internet learning. Persuasive essay because there is a position on an assortment of an informative essay topics. There are several persuasive essay topics to pick from to finish your high school or college assignment. In years past essay templates are known to help amateurs considerably. Whatever They Told You About Argumentative Essay Topics for Elementary Students Is Dead Wrong...And Here's Why Moral argumentative essay topics are a few of the simplest to get carried away with. To come across argumentative essay topics easy on various platforms, you want to comprehend about the argumentative essay. An argumentative essay requires you to choose a topic and have a position on it. Recent argumentative essay topics that are related to society is going to do. Inspiration to make your own advertising or media argumentative essay topics isn't challenging to discover. By obeying the above-given ideas you will readily attain an impactful argumentative essay. At times you might require some expert help with argumentative essay topics. If you're not assigned a specific theme, you might go on trying to find the inspiring topics all on your own. Argumentative Essay Topics for Elementary Students - What Is It? It's possible to summarize your major arguments or the principal points in your descriptions. Understanding how to compose a strong argumentative paper will help you advance your very own argumentative thinking. Bear in mind you could make funny argumentative essays if you do a few things. Therefore, the ideas ought to be selected carefully. Details of Argumentative Essay Topics for Elementary Students The very first step is where a significant number of students become stuck. Therefore choosing other viable courses besides the conventional ones have turned into a trend that is altering the face of education. Students are accustomed to the simple fact which their professors give them with the assignment's topic. Many students think that it is a waste of time. The second word, description,'' indicates your job is to create your audience understand precisely what issue it is that you're speaking about. Persuade your sister or brother to assist you talk your parents into something you would like to do. You find the right topic, where to compose a formal letter. When you're picking your topic, bear in mind that it's much simpler to write about something which you presently have interest ineven in case you don't know a great deal about it.

My Personal Philosophy Of Education - 966 Words

Personal Philosophy of Education Allyson C. Taylor EDUC 542 Dr. M. Derrick Regent University The definition of curriculum can be as mysterious as the curriculum itself. Oliva (2013) described the hunt for the curriculum as being similar to â€Å"efforts to track down Bigfoot, the Bear Lake Monster, [and] the Florida Everglades Skunk Ape †¦Ã¢â‚¬  (pg. 2). All of these elusive beings have left tracks, yet there isn’t a single photograph to prove their existence—just like there isn’t one tangible definition for curriculum. Sure, there’s a binder labeled â€Å"curriculum,† but that doesn’t mean it’s merely a set of plans. Initially, I believed the curriculum to be something elusive; I loosely interpreted it as the information that should be taught in a given subject and the corresponding objectives or learning intentions. I believed that the â€Å"curriculum [could] be conceived in a narrow way as subjects taught (Oliva, 2013, pg. 3). What I was unaware of was the interdependency of curriculum and instruction. I learned th at the curriculum is just as reliant on instruction as instruction is on the curriculum. One is â€Å"the what† while the other is â€Å"the how.† Now, I view the curriculum as more than just a framework of content and standards. It includes â€Å"all the experiences that the learner encounters under the direction of the school† (Oliva, 2013, pg. 7). The curriculum is transient. It can be molded, shaped, and restructured to meet the needs of the childrenShow MoreRelatedMy Personal Philosophy : My Philosophy Of Education1046 Words   |  5 Pagesmanipulate the information for their own use in the future. Choosing between the four, I would say my philosophical views line up more as an essentialist. 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This essay focuses on my personal philosophy of education. It unfolds the function of philosophy in a teacher’s life, my view on the purpose of education, the student teacher- relationship and the philosophy which influences myRead MoreMy Personal Philosophy : My Philosophy Of Education1844 Words   |  8 PagesMy philosophy of education is romanticism. According to Ryan, Cooper, and Bolick, romanticism can be defined as â€Å"a child-centered philosophy of education that condemns the influences of society and suggests that a child’s natural curiosity and the natural world should be used to teach.† I am a believer in â€Å"gaining knowledge through sensory experiences and interactions with your peers† (Ryan, Cooper, a nd Bolick, 2016). I agree with this philosophy because it says that the needs of the student areRead MoreMy Personal Philosophy Of Education1443 Words   |  6 PagesThese beliefs of education are known as the philosophy of education. 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So, in order to be best prepared for my future endeavors as an educator, I believe it is in my best interest to lay out a personal philosophy of education—a lay out that will aid me in times of need and a way to gauge change, progress, and growth through my Simps on College career. In doing so I will be prepared to be the best educator as I will