Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
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Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
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Dr. Mamta Gupta
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Aug 2018

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Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
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Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
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Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."

Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
On May 11,2011

Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
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Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."

Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
On April 2011

Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.

Dr. Anuradha
On Jan 2020

Important Notice

Original article / research
Year : 2022 | Month : December | Volume : 16 | Issue : 12 | Page : VC22 - VC25 Full Version

Correlation of Alcohol Dependence and Delusions of Infidelity: A Cross-sectional Study

Published: December 1, 2022 | DOI:
Mrinalini Reddy, Arun Narayan Pradeep, Vadivumbal, Sivabalan

1. Assistant Professor, Department of Psychiatry, SRM Medical College Hospital and Research Institute, Chennai, Tamil Nadu, India. 2. Assistant Professor, Department of Psychiatry, SRM Medical College Hospital and Research Institute, Chennai, Tamil Nadu, India. 3. Assistant Professor, Department of Psychiatry, SRM Medical College Hospital and Research Institute, Chennai, Tamil Nadu, India. 4. Professor, Department of Psychiatry, SRM Medical College Hospital and Research Institute, Chennai, Tamil Nadu, India.

Correspondence Address :
Dr. Arun Narayan Pradeep,
Old No. 24, New No. 61, EVK Sampath Road Vepery, Chennai, Tamil Nadu, India.


Introduction: Delusions of infidelity are harmful malfunctioning beliefs that can bear significant impact on an individual’s interpersonal, social and occupational functioning. The exact prevalence is not known, due to the lack of community surveys but is not uncommonly seen by practicing physicians. However, they are more common in male alcoholics, morbid jealousy is encountered mostly in old age psychiatry and clinicians should be familiar with its recognition and management.

Aim: To identify the correlation of delusion of infidelity in patients with alcohol dependence syndrome.

Materials and Methods: A cross-sectional study was conducted at Psychiatry Outpatient Department (OPD), SRM Medical College, Hospital and Research Centre, Chennai, Tamil Nadu, India, for duration of one month in March 2020. Male patients attending the Psychiatric OPD, diagnosed with alcohol dependence syndrome as per International Classification of Diseases-10 (ICD-10) guidelines were selected. A total of 30 patients who attended the OPD in one month were screened by Mini-International Neuropsychiatric Inventory (MINI). Alcohol Dependence Scale (ADS) for alcohol dependence as well as Browns Assessment of Beliefs Scale (BABS) to assess their delusion was applied. Statistical analysis using regression analysis and correlation coefficient was done.

Results: The mean of age of study group was 32.47 years with a standard deviation of 5.05 years. Out of the 30 male alcoholic patients, 13 patients had delusions of infidelity. The mean alcohol dependence score of study population was 27.6±11.51 and the mean BABS of study population was 9±10.77.

Conclusion: There was a weak positive correlation between alcohol dependence and the delusions of infidelity. Physicians must have sufficient knowledge in identifying alcohol dependence syndrome.


Browns assessment of beliefs scale, Males, Morbid jealousy

Jealousy is considered a normal human emotional experience. The past decade has undergone various developments via neurological and neuroscientific approaches with regard to the concept of jealousy. According to Silva AJ et al., global homicide statistics depict jealousy as the most frequent catalyst of spousal homicide worldwide (1).

A delusion is a fixed, false and firm belief that is unshakeable, despite contradictory evidence and is out of keeping with the patient’s social and cultural background (2). Delusions of infidelity (pure delusional jealously), is characterised by an unshakable false belief of infidelity, without any sort of hallucinations and mood disturbance, and not associated with alcohol or any other drug abuse or any co-morbid illness (3). Morbid jealousy is a rare entity. Though commonly encountered by clinicians, the prevalence is not known due to the lack of community surveys (4). Substance dependence is reportedly more common among males with delusion of infidelity. According to Jellinek, alcohol is harmful to the individual, society, and/or both (5).

In 2014, according to the Global Status report, about 38.3% of the world’s population is reported to consume alcohol regularly (6). On an average, an individual consumption amounts to 6.2 liters of alcohol each year. The Organisation for Economic Cooperation and Development (OECD) released a report in 2015 that documented a significant rise in alcoholism by approximately 55% between 1992 and 2012. This became a major concern amongst the youth. In the past, alcohol use, though not very common among the youth, was a common practice in middle aged adults. Today, it is estimated worldwide that drinking alcohol in excessive amounts among the youth has doubled compared to previous statistics (7). Apart from this, male alcoholics seem likely to develop these kinds of delusions depending on many factors like severity of alcohol consumption and relationship with partner. Once developed, it’s effects on any social or cultural setting should not be ignored, as it may disrupt the integrity of a marriage which could eventually lead to dire consequences (1). Authors feel emphasis must be placed upon the social as well cultural consequences, and awareness to be created among medical professionals to promote prompt referral and treatment.

A person with morbid jealousy is commonly characterised by a range of irrational thoughts and behaviours in which the predominant theme is a preoccupation with their partner’s fidelity irrespective of the evidence provided to them (8). A point to be noted is that individuals who suffer from morbid jealousy even when their partner is being unfaithful, provided that the evidence that they cite for unfaithfulness is incorrect and the response to such evidence on the part of the accuser is excessive or irrational. Healthy people become jealous, only in response to concrete evidence, are prepared to alter their beliefs and reactions as new information becomes available (9). In contrast, those with morbid jealousy form their own interpretations even though sufficient evidence is provided and are fixed with their beliefs. This, in turn, leads to interpersonal problems in the dyadic relationship (10).

Many alcoholics have been encountered in clinical practice, who suspects the loyalty of their partners, especially when intoxicated (11). There is lack of literature on the association between these two entities. Thus, the aim of the present study was to find out the correlation between delusions of infidelity and alcohol dependence in male alcoholics.

Material and Methods

This cross-sectional study was conducted in the Psychiatry Outpatient Department (OPD), SRM Medical College, Hospital and Research Centre, Chennai, Tamil Nadu, India, for duration of one month in March 2020. It was a short-term study. Ethical clearance was obtained from Institutional Ethical Committee (2115/IEC/2020). A convenient sample of 30 male patients was considered.

Inclusion criteria: Males attending the Psychiatry Outpatient Department (OPD in the study month, diagnosed with alcohol dependence syndrome according to International Classification of Disease-10 (ICD-10) (12), patients between the ages of 20-50 years and those who gave consent to participate in the study were included in the study.

Exclusion criteria: Patients with co-morbid mental and behavioural disturbances and hose who did not give informed consent were excluded from the study.

Study Procedure

The questionnaires included general information of each participant. Mini-International Neuropsychiatric Inventory (MINI) was given to rule out any other psychopathology (13). MINI is a short structured diagnostic interview, developed jointly by Psychiatrists and clinicians in the United States and Europe, for Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) and ICD-10 psychiatric disorders; the administration of which takes approximately 15 minutes.

Alcohol Dependence Scale (ADS) was assessed for all the male alcoholics. The ADS assess the severity of alcohol dependence based on the DSM criteria for alcohol dependence syndrome. It consists of 25 items which covers broad areas of ADS. The instruction can be used in different ways for instance, initial assessment is asked for the period of 12 months, and outcome measures at three different levels for example 6 months, 12 months and 24 months for the treatment follow-up. The total ADS scores range from 0 to 47 and as taken following order: low 1-9, Intermediate 10-19, Substantial 20-29 and Severe 30 and above (14). The item scores as 0-1; three-point scale scores as 0-1-2; and four-point scale scored as 0-1-2-3. The Brown’s Assessment of Beliefs Scale (BABS) was given to assess their delusions of infidelity, developed by Eisen JL et al., (15). The BABS consists of seven items in which the first six are totaled to get the final score. A score from 0 to 4 (from least to most severe) is used to rate each item. The instrument is semi-structured. Rate each item according to the patient’s experience during the past week and including the time of the interview. The interviewer determines, what the patient actually believes, not what she has been told is true.

Method of collection of data: The present study has been performed in a tertiary care center in South India. Each participant was informed of the voluntary nature of their participation, the protection of participant’s confidentiality and the intended use of the information. After obtaining informed consent, the relevant data were collected and then, evaluated accordingly.

Statistical Analysis

The obtained data was organised in an Microsoft Excel sheet intially and then analysed using Machines IB. IBM Statistical Package for the Social Sciences (SPSS) Statistics for Windows, version 22.0. IBM Corp Armonk, NY; 2013. ADS and BABS were considered as the primary outcome variable. Demographic age, religion and delusions of infidelity were recorded. The association between categorical explanatory variables and quantitative outcome was assessed by comparing the mean values. The mean differences along with their 95% CI were presented. Pearson’s correlation coefficient was used to determine the correlation between quantitative explanatory and outcome variables. Linear regression analysis was done. Regression coefficient, along with its 95% CI and p-values are presented. The p-value <0.05 was considered statistically significant.


The mean±Standard Deviation (SD) age of the study population was 32.47±5.05 years. The youngest person was 23-year-old, and the oldest person was 42-year-old (Table/Fig 1).

Among the study population, 6 (20%) people were unemployed. The number of shopkeepers, teachers, auto drivers, bus drivers, car drivers, milkmen, students, attenders, meat sellers and mechanics were 7 (23.33%), 3 (10%), 2 (6.67%) and 1 (3.33%), respectively (Table/Fig 2). Among the study population, 17 (56.67%) people were Hindus (Table/Fig 2).

Among the study population, 13 (43.33%) people had positive of delusions of infidelity and 17 (56.67%) people had negative of delusions of infidelity (Table/Fig 3).

The mean ADS score of study population was 27.6±11.51 with minimum 10 and maximum of 44 ADS (Table/Fig 4).

The mean BABS of study population was 9±10.77 with minimum 0 and maximum of 26 BABS (Table/Fig 5).

Among the study population, 56.67% strongly displayed conviction, perception of others’ views of belief, explanation of differing views, fixity of ideas and attempt to disapprove ideas individually (Table/Fig 6).

Among the study population, 5 (16.67%) people had low level of ADS. The number of ADS of intermediate, substantial level and severe level was 5 (16.67%), 7 (23.33%) and 13 (43.33%), respectively (Table/Fig 7).

There was a weak positive correlation between ADS and BABS, which was statistically significant (r-value=0.578 and p-value <0.001) (Table/Fig 8). The median BABS of low level was 0 (0 to 11). The number of median of interdicted, substantial and severe level was 0, 0 and 20 (6 to 24), respectively. The difference between BABS and ADS statistically significant (p-value=0.008) (Table/Fig 9),(Table/Fig 10).


In the present study, 56.67% strongly displayed conviction, perception of others views of belief, explanation of differing views, fixity of ideas and attempt to disapprove ideas individually. A weak positive correlation was found between the ADS and BABS, which was statistically significant (r-value=0.578 and p-value <0.001). It was also found that, the difference between BABS and ADS was statistically significant (p-value=0.008).

Jealousy is an, affective state that is normal. It is an emotion that if not present for an individual can be interpreted as having been repressed and hence may play a role in unconsciously causing certain behavioural disturbances (16). Delusions of infidelity can be seen in many psychiatric disorders. A recent study of 8134 psychiatric Inpatients from Munich, Germany (17) showed the prevalence of delusional jealousy in different psychiatric disorders (1.1) organic psychoses (7.0%), paranoid disorders (6.7%), alcohol psychosis (5.6%), and schizophrenia (2.5%); whereas affective disorders, showed only 0.1% (17). As schizophrenia and affective disorders were the most common diagnoses, most patients with delusions of jealousy were schizophrenics. In schizophrenia, women were more likely to suffer from delusional jealousy, while in alcoholic psychosis men were more likely to suffer. In the current study, authors compared the correlation between these delusions with alcohol dependence, instead of assessing it’s prevalence.

There is a lack of literature in India to show, the effect alcohol has on their personal life, as well as, the socio-cultural consequences, as male alcoholics are prone to develop delusions of infidelity. It is well-known that, morbid jealousy is responsible for a great number of crimes of violence against women (18). Somasundaram O, reported approximately 526 murderers in Tamil Nadu. Out of 500 male murderers, 71 killed their wives and 10 killed their wives’ paramours. Six offenders were below 17 years, of which three killed their wives. Of the 20 murderesses, four killed their husbands, three had killed the paramours, and one had killed the co-wife (18). Another study by Somasundaram O, about the ‘Men who kill their wives,’ reported of 41 murderers, of which 13 were due to sexual jealousy and four were due to morbid delusional jealousy (19). The above study did not address the correlation with alcohol dependence, but instead highlighted the forensic aspects of murders. In the indexed study, no person murdered their wife, but a high number of alcoholic males were found to be more physically abusive towards spouse. This interpretation was based on the history, taken by the clinician from patients visiting the psychiatric OPD during the time of the study.

In a study done by Michael A et al., studied 71 morbidly jealous individuals and found that alcohol brought about jealousy in 28% of the cases, while the rest were jealous, even when sober. They concluded that, alcohol plays an etiological role in the development of morbid jealousy and once detected when an individual is under the influence of alcohol has preventive implications (20). Another study by Soyka M and Schmidt P, reported 72 individuals with delusional jealousy (0.5% of the whole sample). The prevalence was most significant in those with schizophrenia and other psychoses (1.3%). In addition, it was noted that most with delusional jealousy were men (43 of 72, 59.7%) (21). In the present study, the authors found that out of a total of 30 male alcoholics, 13 patients had delusions of infidelity (43.33%).

Mooney HB concluded that, chronic alcoholism and the occurrence of jealousy were found in 22.5% and 15.9% of the combined sample of delusional and non delusional jealousy subjects, respectively (22). Control group was not included in the present study, out of the 30 males meeting the criteria for alcohol dependence, 43.33% had delusions of infidelity.

Another study, on the cultural differences and similarities on the correlates of infidelity, by Valor-Segura I et al., reported that infidelity by women is evaluated more negatively than men. It also showed, the effect of various factors like personality characteristics, socioeconomic status, religiosity, gender and relational satisfaction had on infidelity (23). There is no study that, specifically studied the influence of alcohol use and its severity on infidelity.


The present study sample size was small, due to which there was a positive correlation. The study can be done in a community setting, as it may be biased in this sample, as it was conducted at a tertiary hospital, where more severely ill patients come for treatment.


A weak positive correlation between the delusions of infidelity and alcohol dependence was found in the present study. All physicians must have sufficient knowledge in identifying ADS and its consequences, as well as, prompt referrals to the Psychiatrist.


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DOI and Others

DOI: 10.7860/JCDR/2022/59486.17363

Date of Submission: Aug 04, 2022
Date of Peer Review: Oct 28, 2022
Date of Acceptance: Nov 22, 2022
Date of Publishing: Dec 01, 2022

• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. NA

• Plagiarism X-checker: Aug 05, 2022
• Manual Googling: Nov 16, 2022
• iThenticate Software: Nov 21, 2022 (22%)

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