Browsing by Author "Rodrigo, A."

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Changes in attitudes toward psychiatry with introduction of a new curriculum: experiences of a Sri Lankan medical school
(Sri Lanka College of Psychiatrists, 2012) Rodrigo, A.; Wijesinghe, C.; Kuruppuarachchi, K.A.L.A.
BACKGROUND A Sri Lankan university recently changed its medical undergraduate curriculum by including a multifaceted psychiatry clerkship for final year students. Aims We investigated the effect of introducing an eightweek clinical rotation on career choice and attitudes of medical students towards psychiatry as a discipline. METHOD One hundred medical students completed the Attitudes Towards Psychiatry (ATP-30) questionnaire before and after the final year psychiatry clerkship. RESULTS This study showed favourable improvements in the ATP-30 score following exposure to the professorial clerkship. Significant increase was noted in the desire to pursue a career in psychiatry. CONCLUSION Exposure to a psychiatry clerkship in the final year could improve the attitudes of medical students towards psychiatry.
Child abuse: the role of psychiatrists
(Sri Lanka College of Psychiatrists, 2015) Rodrigo, A.; Liyanage, N.
Cognitive behavioral therapy management of a patient with atypical Anorexia Nervosa.
(Hindawi Pub. Corp., 2019) Liyanage, N.; Suraweera, C.; Rodrigo, A.
Eating disorders are becoming more common in nonwestern societies and some of these presentations are atypical variants such as atypical anorexia nervosa. There is very little data on how to treat these patients. This case study reports the treatment of a young adult female in Sri Lanka who presented with atypical anorexia nervosa and moderate depressive disorder. She was successfully treated with nine sessions of enhanced cognitive-behavioural therapy (CBT-E). According to our knowledge this is the first case report that describes the management of a patient with atypical anorexia nervosa using psychological therapy specifically adapted to nonwestern context.
Comparison of suicide rates in Sri Lanka during and after the civil war
(SAGE Publishing, 2013) Rodrigo, A.; Owada, K.; Wainer, J.; Baker, R.; Williams, S.
No Abstract Available
A Cross sectional survey of adherence, perceived efficacy and side effects of methylphenidate among children at a teaching hospital in Sri Lanka
(Sri Lanka College of Psychiatrists, 2018) Jayamaha, G.; Perera, W.M.T.M.; Herath, T.A.; Rodrigo, A.
INTRODUCTION:Attention deficit hyperactivity disorder (ADHD) is the most commonly diagnosed psychiatric condition in childhood, which if untreated may have a negative effect on education, peer relationships and family disharmony. Methylphenidate is an effective treatment for ADHD, although its use is limited by poor compliance and side effects. Studies on effects of side effects on efficacy, and adherence of methylphenidate in developing countries are scarce. METHODS: We assessed the adherence, efficacy, and side effects of methylphenidate in children and adolescents treated at a child and adolescent psychiatry clinic of North Colombo Teaching Hospital, Ragama. We gathered information from guardians of the children treated with methylphenidate for at least 2 months, using an interviewer administered questionnaire. RESULTS: Among the 149 participants, a majority were males and the mean age of the population was 10.4 years. More than 52% participants reported 100% compliance with methylphenidate, but only 12% complied with non-pharmacological therapies. While 75% believed the medication to be effective, only 17% perceived psychosocial strategies to be useful. Poor appetite (44%) was the most common side effect of methylphenidate and 43% did not report any side effect. There was a negative correlation between compliance with methylphenidate and the occurrence of poor appetite, as well as with not increasing the initial dose. DISCUSSION: The results of this study suggest that methylphenidate is an effective and well-tolerated treatment for children in Sri Lanka with ADHD
Disaster and mental health: the role of Sri Lankan psychiatrists
(Sri Lanka College of Psychiatrists, 2017) Rodrigo, A.; Liyanage, N.
Erectile dysfunction among male patients diagnosed with schizophrenia being treated with antipsychotic medication, and the impact on quality of life
(Sri Lanka College of Psychiatrists, 2018) Rowel, W. W. J. S. M .; Liyange, U. L. N. S.; Hewawitharana, U. H.; Dayabandara, M.; Rodrigo, A.
INTRODUCTION:Erectile dysfunction is a distressing side effect of antipsychotics, which leads to poor medication compliance and poor quality of life. There is a scarcity of studies on antipsychotic-induced sexual dysfunction in Sri Lanka. We assessed the prevalence of erectile dysfunction among patients with schizophrenia who have been prescribed antipsychotic medication. METHODS : A cross sectional, descriptive study was conducted among patients attending the outpatient clinics of Colombo North Teaching Hospital and National Hospital, Sri Lanka. The five item International Index for Erectile Dysfunction, Erection Hardness Score and World Health Organization Quality of Life Brief Scale were used to assess erectile dysfunction and quality of life. RESULTS: Of the 102 patients in the study, 80 (79%) were found to have erectile dysfunction. The largest proportion of erec tile dysfunction was seen in patients who were prescribed clozapine (87.9%), followed by risperidone (82.1%), olanzapine (73.9%) and fluphenazine (68.8%). There was no significant correlation between erectile dysfunction and quality of life. None of the patients had initiated a discussion about sexual side effects, while only 8.3% reported that their psychiatrist had inquired about the sexual dysfunction. CONCLUSIONS: The results of this study suggest that sexual dysfunction is a common but often overlooked phenomenon among patients with schizophrenia. This study highlights the need for Sri Lankan psychiatrists to explore sexual problems in this cohort of patients.
Have primary mental health teams lived up to their expectations?
(Sage Publishing, 2013) Rodrigo, A.; Foo, L.; Majoor, J.
OBJECTIVE: Primary Mental Health Teams (PMHTs) were established in Victoria in 2002 to integrate psychiatric services into primary care. This study aimed to evaluate the characteristics of patients referred to Eastern Health PMHT, the effectiveness of management plans and referrer satisfaction. METHOD: Retrospective case note review of referrals (116) made to the PMHT from January to August 2010 and analysis of returned satisfaction surveys (105) from referrers between January 2006 and August 2010. RESULTS: The mean age of patients was 40 years with 55% being female. The commonest primary diagnosis was depression (41%). The majority of patients (59%) had multiple psychiatric diagnoses. The response time for telephonic consultation was 1.4 days and 13.2 days for an initial patient consultation. Psychotherapy was the most frequently recommended treatment (85%). Average treatment period was 6.8 weeks and the majority of patients (93%) were discharged back to the primary referrer. Referrers were satisfied with PMHT services and average improvement of patients on the Health of the Nation Outcome Scales was 2.3. CONCLUSION: Our study suggests that PMHTs have embedded psychiatric services within primary care settings, with high levels of referrer satisfaction and patient improvement
Imposing restrictions on pornography: its potential impact and effectiveness in Sri Lanka
(Sri Lanka College of Psychiatrists, 2011) Waduge, R.; Rodrigo, A.; Peiris, U.
The government of Sri Lanka recently introduced many measures to limit the accessibility and availability of pornography in the country including censorship of websites containing sexually explicit material and active prosecution of Sri Lankans who appeared on such websites Available evidence suggests that pornographic consumption among Sri Lankan adolescents is considerable and such exposure may influence sexual attitudes and activity including sexual aggression in youth. However the current evidence on the beneficial effects of censorship of pornography is less than convincing. The authors believe that warm, communicative parent-child relationship and open discussion about sexual matters at home and at school could be more effective than restrictive measures such as censorship and punitive legislation
INTEGRATING MINDFULNESS PRACTICES IN EFL/ESL: ENHANCING TEACHER AND STUDENT OUTCOMES
(The Library, University of Kelaniya, Sri Lanka., 2024) Rodrigo, A.; Baminiwatta, A.
Mindfulness is becoming a popular practice around the world, due to the myriad benefits it offers. Although mindfulness has been applied in educational contexts, the emphasis on the role of mindfulness in language learning is still inadequate. For this literature synthesis, a search was conducted using Google Scholar to identify empirical and conceptual papers on mindfulness applied in EFL/ESL contexts. Studies identified in this review indicated that higher mindfulness among students was associated with favorable outcomes on general measures such as mental wellbeing, resilience, stress, and anxiety, and specific learning-related outcomes such as higher engagement, critical and reflective thinking, better cognitive abilities, as well as lower anxiety in reading, writing, speaking, and listening, leading to better scores on language tests. Better teacher outcomes fostered by mindfulness included psychological wellbeing, coping skills, emotional competence, and work engagement. Mindfulness also promotes better student-teacher interactions. Based on the findings of this review, it can be recommended that integrating mindfulness practices such as breathing exercises and guided meditations would benefit both students and teachers.
Internet gaming disorder among adolescents
(Dr. K. C. Chaudhuri Foundation, co-published by Springer India, 2017) Chandradasa, M.; Rodrigo, A.
Making psychotherapy culturally relevant to South Asia: Burden of mental illnesses in South Asia
(SAARC Psychiatric Federation, 2015) Rodrigo, A.
No abstract available
Maternal perception of adequacy of mother's milk among mothers giving birth at a teaching hospital in Sri Lanka
(Sage Publications, 2019) Rodrigo, R.; Rodrigo, A.; Liyanage, N.; Hathagoda, W.; Hewavitharana, U.
BACKGROUND: Sri Lanka boasts high rates of early and exclusive breastfeeding. Perceived inadequacy of milk, a global problem, is the main cause for early cessation of breastfeeding. Research Aims: The aims of this study are to (a) determine the prevalence, (b) identify the risk factors, and (c) ascertain the association that maternal psychological distress has with perceived inadequacy of milk (PIM), among mothers during the early postpartum period. Identifying and addressing modifiable risk factors for PIM may improve mothers' satisfaction with breastfeeding. METHODS: A cross-sectional descriptive study of mothers ( n = 249) during the first week after birth was conducted at Colombo North Teaching Hospital (Ragama, Sri Lanka) from May 1, 2016, to June 10, 2016. Participants were recruited when the infant was more than 24 hours but less than 7 days old. A self-administered questionnaire, including the six-item Kessler Psychological Distress Scale, was used. RESULTS: The majority of mothers (78%) perceived their milk quantity to be adequate. A family member telling mothers that their milk supply was low had the most significant associations with perceived inadequacy. Other associations were antenatal maternal complications and birth by cesarean section. Kessler scores indicating psychological distressoccurred in 26% of all participating mothers, with a higher mean score in those with PIM. CONCLUSIONS: Sri Lankan family members should be educated further about normal patterns of milk production during the postpartum period. The authors recommend that PIM be included in screening tools for postpartum depression in Sri Lanka.
Media portrayal of child abuse in Sri Lanka and the impact of two incidents of child abuse on media coverage
(Sri Lanka College of Psychiatrists, 2016) Liyanage, N.; Rodrigo, A.
BACKGROUND: Child maltreatment is increasingly being recognized as an important public health issue in` Sri Lanka. Most public knowledge in Sri Lanka on this issue, and direction for public policy, originate from mass media, which may sensationalise the issue. AIMS: This paper evaluates the themes and major discourses present in Sri Lankan print media on child abuse, and aims to determine if content, style and frequency of these news items have been affected by the tragic child abuse-murder incidents in 2015. METHODS: Articles on child abuse and their readers’ comments were manually selected from the websites of the two daily newspapers with highest readership in Sri Lanka during two 3-month periods, before and after the above mentioned incidents. A combination of qualitative and quantitative methods were used to analyze the findings. RESULTS: The number of articles relating to child abuse increased significantly from 0.6% to 5% of the total articles reviewed in the two periods. The focus of the articles changed from merely reporting facts and highlighting the evil nature of child abuse perpetrators, to inefficiency of law enforcement authorities in finding and punishing perpetrators. Readership and online comments on these articles increased significantly in the post-incident period. Capital punishment for perpetrators was suggested by many readers in the post-incident period. CONCLUSION: The Sri Lankan public is very sensitive to news on child abuse with formation of firm, at times extreme, viewpoints on how to manage this issue. Thus responsible and accurate depiction of child abuse by the media is important.
“Muddling by googling” – Cyberchondria among outpatient attendees of two hospitals in Sri Lanka
(Sri Lanka Journal of Psychiatry, 2019) Wijesinghe, C.A.; Liyanage, U.L.N.S.; Kapugama, K.G.C.L.; Warsapperuma, W.A.N.P.; Williams, S.S.; Kuruppuarachchi, K.A.L.A.; Rodrigo, A.
BACKGROUND: The internet is widely used as a source of health information, and the negative effects of this practice is well documented. Cyberchondria, the unfounded escalation of concerns about common symptoms based on review of online information has been identified as a major concern. This area has not been studied in Sri Lanka. AIMS: We studied the prevalence, nature and effects of cyberchondria among outpatients in Sri Lanka. METHODS: Data was gathered from 300 outpatients, 150 patients each attending a government and private hospital in Western province using a self-administered questionnaire. RESULTS: Out of 300 participants 178 were female and the average age was 42 years. Only 24% of the participants used the internet as an information source on health related issues. The prevalence of cyberchondria was 16.3% in our study population. Cyberchondria was significantly more common among outpatients of the private hospital. A majority of patients who made a self-diagnosis using online information had made an incorrect diagnosis. One third of internet users felt anxious after searching about their symptoms and 34% sought further medical advice following internet use. CONCLUSIONS: The possible negative effects of online health information is a concern in Sri Lanka. Further studies and public education regarding this area in Sri Lanka are required.
Prevalence and correlates of depression in patients with epilepsy in Sri Lanka
(The Sri Lanka Medical Association, 2021) de Silva, S.; Isuru, A.; Rodrigo, A.; Kuruppuarachchi, L.
Background: Depression is one of the most common psychiatric disorder in patients with epilepsy and it is often associated with poor quality of life, increased risk of suicide and poor seizure control, yet remains underdiagnosed and undertreated. The prevalence and associations for depression in patients with epilepsy vary between studies reflecting regional and cultural influences. Therefore, it is important to identify unique attributes within a community on this phenomenon This is the first study from Sri Lanka on the prevalence and correlates of depression in patients with epilepsy. Method: We conducted this cross-sectional study at the Epilepsy clinic, Colombo North Teaching Hospital, Ragama. All consenting patients with a diagnosis of epilepsy followed up at the clinic, during study period, were enrolled. Symptoms of depression were screened with Beck Depression Inventory II and diagnosis was confirmed with a clinical assessment by psychiatrist. Results: Of 150 participants, majority were female 63.3%. (95) and 36.7% (55) of the sample were between 26-45 years. The prevalence of depressive disorder was 22% (33). The prevalence of depression was significantly associated with the recent diagnosis of epilepsy, use of multiple antiepileptic medications and duration of seizure free period (p<0.05). There is a statistically significant association between prevalence of depression with the use of carbamazepine, topiramate, clobazam and phenobarbitone. Regression analysis revealed higher the duration individuals suffering from epilepsy were at lower odds of having depression compared with that of individuals suffering from lower duration of epilepsy. For each year in increase of duration of epilepsy, the odds of depression decreased by 2% (95% CI 0.3% to 5.1%) Conclusion: The prevalence of depression is high in patients with epilepsy. Risk of having depression is higher during the early phase of the illness. Therefore, it is important to screen patients with epilepsy for depressive disorder during the early course of the illness.
Psychological morbidity and resilience associated with tinnitus in a Sri Lankan population
(Sri Lanka Medical Association, 2017) Herath, T.C.K.A.; Chandrasekara, A.; Illeperuma, L.D.; Rodrigo, A.
INTRODUCTION & OBJECTIVES: Tinnitus, the perception of noise or ringing in the ears, is a common and disabling condition. It often results in anxiety and depression. While it is believed to be common in Sri Lanka, no study has investigated this phenomena. This study aimed to describe the nature of tinnitus among patients attending the otorhinolaryngology (ENT) clinics in selected hospitals in Sri Lanka to determine the psychological morbidity associated with tinnitus and to investigate the factors influencing resilience among them. METHODS: This was a descriptive cross-sectional study. All the consenting adult patients with complaint of tinnitus who attended ENT clinics in Kandy, Kalubowila and Mathale hospitals were assessed using a self-administered questionnaire. Psychological morbidity was assessed using the validated GHQ-12 and Beck Depression Inventory (BDI). RESULTS: Of 93 patients included in the study, majority (56%) were females. Their average age was 55.1years and they have had tinnitus for 2.1years on average. While 63.5% reported tinnitus to be subjectively distressing, 63.4% noted it to be significantly interfering with daily activities. None of them had psychiatric illness prior to the onset of tinnitus. Yet, 62.4% reported psychiatric caseness and 47.3% had depression. Loudness of tinnitus, subjective distress, disturbance to sleep and daily activities due to tinnitus, had significant association with psychiatric caseness/depression. Constant pursuit of happiness was associated with resilience but religiosity and mindfulness were not. CONCLUSION: Tinnitus is a distressing illness associated with a significant functional impairment and psychiatric morbidity. Harnessing resilient factors would improve the quality of life for patients with tinnitus in Sri Lanka
A randomized, double blind, placebo controlled trial on effectiveness of preemptive analgesia with paracetamol on reduction of occurrence of headache after electro convulsive therapy
(Sri Lanka Medical Association, 2016) Isuru, L.L.A.; Rodrigo, A.; Wijesekera, C.; Premasinghe, S.; Wijesinghe, C.A.; Ediriweera, D.S.; Kuruppuarachchi, K.A.L.A.
INTRODUCTION: Electro convulsive therapy (ECT) is a safe and effective treatment for a wide range of psychiatric disorders. However, its utility is mainly limited by side effects and stigma. Post ECT headache is one of the commonest side effects of ECT. There is little evidence to suggest Pre-ECT analgesia would prevent the occurrence of post ECT headache. OBJECTIVES: Objective was to compare the incidence and severity of the post ECT headache of the patients who had paracetamol 1g, 2hrs before the induction of anaesthesia with those who had a placebo. METHOD: This was a double-blind, placebo controlled trial. Sixty two patients were given placebo and 73 received paracetamol tablets. Ethical approval was granted by an Ethics Review Committee, University of Kelaniya, and the trial was registered in the clinical trial registry (SLCTR/2015/27). Post ECT headache was measured 2 hours after the administration of ECT by a visual analogue test and verbal descriptive scale. Variables were tested for normality and Mann-Whitney U test was used to compare groups. Subsequent analysis was non-parametric, with Mann-Whitney U test. RESULTS: Both intervention and controlled groups had comparable baseline demographic and clinical variables. One third (34%) of the paracetamol group experienced post ECT headache, while 62% of the placebo group experienced same. There was a statistically significant reduction in the incidence and severity of post-ECT headache in the test group (p <0.05). This remained significant after confounding factors were adjusted for in the regression analysis for the duration of illness and headache during this episode. CONCLUSIONS: Preemptive analgesia with paracetamol, 2hours beforeECT, reduces post ECT headache and this could be routinely practiced to ameliorate ECT induced headache.
A Randomized, double-blind, placebo-controlled trial on the role of preemptive analgesia with acetaminophen [paracetamol] in reducing headache following electroconvulsive therapy [ECT]
(BioMed Central, 2017) Isuru, A.; Rodrigo, A.; Wijesinghe, C.; Ediriweera, D.; Premadasa, S.; Wijesekera, C.; Kuruppuarachchi, L.
BACKGROUND: Electroconvulsive therapy (ECT) is a safe and efficient treatment for several severe psychiatric disorders, but its use is limited by side effects. Post-ECT headache is one of the commonest side effects. Preemptive analgesia is effective in post-surgical pain management. The most commonly used analgesic is acetaminophen (paracetamol). However, acetaminophen as a preemptive analgesic for post-ECT headache has not been studied adequately. This study was conducted to compare the incidence and severity of post-ECT headache in patients who were administered acetaminophen pre-ECT with a placebo group. METHODS: This study was a randomised, double-blind, placebo-controlled trial. Sixty-three patients received 1 g acetaminophen and 63 patients received a placebo identical to acetaminophen. The incidence and severity of headache 2 h before and after ECT were compared between placebo and acetaminophen groups. The severity was measured using a visual analog scale. Generalised linear models were used to evaluate variables associated with post ECT headache. RESULTS: Demographic and clinical variables of placebo and acetaminophen groups were comparable except for the energy level used to induce a seizure. Higher proportion of the placebo group (71.4%) experienced post-ECT headache when compared to the acetaminophen group (p < 0.001). The median pain score for headache was 0 (Inter quartile range: 0-2) in acetaminophen group whereas the score was 2 (IQR: 0-4) in placebo group (P < 0.001). Model fitting showed that the administration of acetaminophen is associated with less post-ECT headache (odds ratio = 0.23, 95% CI: 0.11-0.48, P < 0.001). CONCLUSION: A significant reduction was seen in both the incidence and severity of post-ECT headache with preemptive analgesia with acetaminophen.
Recent trends in psychotherapy training among psychiatrists in the UK, Australia and New Zealand
(Sage Publishing, 2013) Rodrigo, A.; Majoor, J.; Minson, F.; Jayakody, K.
No Abstract Available