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The present paper has highlighted the mental health development in Nepal. It covers the current state of mental health system and services and a throwback on the significant changes over a period of time. This review grabs a sneak into mental health plan/policies, prevalence; health facilities and human resources, monitoring and supervision, budget allocation, nongovernmental sector involvement, and international agreements. Every description in this paper is substantially based on the progression made at the different time frames, which provides clear understanding of the mental health situation in Nepal. Furthermore, this article throws insights on the main challenges to overcome the current situation on mental health and the associated treatment gap due to stigma toward mental illness, lack of appropriate budget allocation, shortage of human resources, and fear of discrimination. [ABSTRACT FROM AUTHOR]

Background: Depression is a major public health concern among Indian adolescents. Pre- and post-natal depression can often alter fetal development and have negative consequences on the physical and mental health of the mother. This paper aims to draw attention to the prevalence of depression and its correlates among currently married, ever-pregnant adolescents from two Indian States, i.e. Uttar Pradesh and Bihar. Methods: This study utilizes data from a subsample (n = 3116) of the prospective cohort study Understanding the Lives of Adolescents and Young Adults (UDAYA) among 10 to 19 year-old adolescents. Bivariate analysis was performed to assess the prevalence of depression by sociodemographic and behavioral characteristics. To further access the predictors associated with depression a logistic regression model was applied. Results: Around one-tenth (9%) of pregnant adolescents had depression. Regression analysis indicated that substance use, religion, autonomy, considering attempting suicide, premarital relationship, violence, dowry, adverse pregnancy outcome, menstrual problem, and parental pressure for the child immediately after marriage were significantly associated with depression. Conclusions: This study confirms the pre-existing annotation that teen pregnancy is linked with depression. Findings indicate that Adolescent mothers experiencing violence, and a history of adverse pregnancy outcomes are at increased risk of developing depression. These study findings call for an urgent need to address depression among adolescent mothers. [ABSTRACT FROM AUTHOR]

The article announces awards given to several papers including the Marfatia Award to "Immunological Changes in Depression Before and After Treatment," Bhagwat Award to "Are Childhood Externalising Disorders the Harbinger of Early Alcohol Dependence?" and BPSS Award to "P 300: An Electrophysiological Endophenotype in OCD."

Background: Qualitative research methods (QRMs) bear a critical role in psychiatry as they explore the phenomenology of psychiatric illness and its sociocultural dimensions. However, there is limited evidence regarding its use in psychiatric research in India. Aim: This study, under the aegis of mapping qualitative health research in India initiative, attempted to landscape the use of QRMs in psychiatry and elicited expert opinion on its potential, perceived quality, and scope for improvement. Materials and Methods: We reviewed studies using qualitative methodology published in the Indian Journal of Psychiatry (IJP) and the abstracts presented at the Annual Conference of the Indian Psychiatric Society (ANCIPS) between 2010 and 2019. Titles and abstracts were screened and shortlisted; full-text articles were checked to identify the relevant ones. In addition, ten experts comprising psychiatry journal reviewers, editors, and conference scientific committee members were interviewed to elicit their views and suggestions. Results: Out of 356 papers published in IJP between 2010 and 2019, only 12 papers used QRMs: five qualitative and seven mixed methods. Out of 2297 abstracts published between 2010 and 2019 in ANCIPS, only 28 had used QRMs, consisting of 20 qualitative and eight mixed methods. The findings reveal that qualitative research is still an understudied domain in Indian psychiatry with a substantial need for rigor and quality. Conclusions: To catalyze the use of qualitative research in Indian psychiatry, continuing medical education programs through workshops or webinar mode need to be imparted. These trainings should aim at building skills on qualitative study design, data collection, analysis, and writing. [ABSTRACT FROM AUTHOR]

Introduction: The COVID-19 pandemic was confirmed to have spread to Slovakia on 6th March 2020. To date of paper submission, it has very favorable course. However, since the beginning healthcare workers have been working under increasing pressure, anxiety and fear. Aim: Authors evaluated the psychosocial impact of COVID-l9 pandemic on mental health experts and their clinical practice in Slovakia. Materials and Methods: A total of 157 mental health experts (79% women) submitted their responses via online questionnaire. Results: The most frequent occupation categories were 38.2% outpatient psychiatrists, 26.1% inpatient psychiatrists and 20.4% psychologists. The mental health experts felt maximum of stress during the peak of Slovak COVID-19 crisis, which was identified as the situation just after the declaring the state of emergency by Slovak government. The main sources of stress were statistical data, prognoses and other public presented information. Mental health experts felt mainly personal stress, then general and working stress. They identified also pathological effect of COVID-19 pandemic on the mental status of their patients, especially with anxiety and affective disorders and advantages of use of telemedicine. Conclusion: Psychosocial support in Slovakia was newly organized in COVID-19 pandemic for medical professionals, patients and other inhabitants under high stress within a very short time. This unexpected situation has revealed to Slovakia the need for reform of the mental healthcare system. [ABSTRACT FROM AUTHOR]

Psychiatric practice in India is marked by an increasing gulf between largely urban-based mental health professionals and a majority rural population. Based on the premise that any engagement is a mutually constructed humane process, an understanding of the culture of psychiatry including social process of local knowledge acquisition by trainee psychiatrists is critical. This paper reviews existing literature on training of psychiatrists in India, the cultural construction of their professional identities and autobiographical reflections. The results reveal a scarcity of research on how identities, knowledge, and values are constructed, contested, resisted, sustained, and operationalized through practice. This paper hypothesizes that psychiatric training and practice in India continues to operate chiefly in an instrumental fashion and bears a circular relationship between cultural, hierarchical training structures and patient--carer concerns. The absence of interpretative social science training generates a professional identity that predominantly focuses on the patient and his/her social world as the site of pathology. Infrequent and often superfluous critical cultural reflexivity gained through routine clinical practice further alienates professionals from patients, caregivers, and their own social landscapes. This results in a peculiar brand of theory and practice that is skewed toward a narrow understanding of what constitutes suffering. The authors argue that such omissions could be addressed through nuanced ethnographies on the professional development of psychiatrists during postgraduate training, including the political economies of their social institutions and local cultural landscapes. Further research will also help enhance culturally sensitive epistemology and shape locally responsive mental health training programs. This is critical for majority rural Indians who place their trust in State biomedical care. [ABSTRACT FROM AUTHOR]

Information about several papers discussed at symposiums titled Challenges for Indian "Teachers of Psychiatry" (iTOP), Impact of Residential Mobility o Borderline Personality Traits, is presented. Topics include post-graduate training in teachers for psychiatry, intra-urban migration and traits in military families.

Health systems are adapting to the unique challenges posed by the COVID-19 pandemic. Social distancing has forced clinicians to provide their services through online platforms in high income countries. Similar trends have been noticed in Low and middle-income countries (LAMIC). Digital health can help LAMIC address traditional barriers to care by overcoming issues related to stigma, discrimination, staffing, and physical and geographical resource constraints. Mobile phone subscriptions exceed 80% of the population in many LAMICs. Mobile platforms represent a viable resource in overcoming the significant mental health gap in LAMIC. This paper discusses the enormous potential that digital health has to transform healthcare delivery in LAMICs, as well as numerous challenges to implementation. We also discuss the need to develop national digital health strategies and suggest solutions to some of the barriers. [ABSTRACT FROM AUTHOR]

Background: General hospital psychiatry units (GHPUs) are the major providers of mental health services in India. Unlike in high-income countries, GHPUs in India are also the main training centers for providing postgraduate training in psychiatry and allied disciplines. Aim: This paper traces the history of the GHPUs in India from beginning to the present. Material and Methods: PubMed, old issues of the Indian Journal of Psychiatry and related sources were searched with key words general hospital and psychiatry both electronically and manually to look for the related literature. Results: The history of the development of GHPUs is discussed under 3 phases: beginning to the preindependence period, independence to the year of the launch of the National Mental Health Programme of India, and afterward. Contributions of the GHPUs towards service development, teaching, research, community awareness and reducing stigma, and their future scope are discussed. Conclusion: GHPUs have been a revolutionary development in India with great contribution in the field of mental heath [ABSTRACT FROM AUTHOR]

The paper is an autobiographical account of growth of Psychiatry in India, during the last six decades. It highlights on the development of treatment modalities in psychiatry especially on psychopharmacological drugs. The establishment of general hospital psychiatry and manpower development in the field of mental health are other areas which are discussed. [ABSTRACT FROM AUTHOR]

This conceptual, perspective and review paper on Indian scales and inventories begins with clarification on the historical and contemporary meanings of psychometry before linking itself to the burgeoning field of clinimetrics in their applications to the practice of clinical psychology and psychiatry. Clinimetrics is explained as a changing paradigm in the design, administration, and interpretation of quantitative tests, techniques or procedures applied to measurement of clinical variables, traits and processes. As an illustrative sample, this article assembles a bibliographic survey of about 105 out of 2582 research papers (4.07%) scanned through 51 back dated volumes covering 185 issues related to clinimetry as reviewed across a span of over fifty years (1958-2009) in the Indian Journal of Psychiatry. A content analysis of the contributions across distinct categories of mental measurements is explained before linkages are proposed for future directions along these lines. [ABSTRACT FROM AUTHOR]

Publication of papers related to psycho-social interventions in general and Behavior Therapy, in particular, in Indian Journal of Psychiatry has been limited. Though the first paper related to Behavior Therapy was published in 1952, a manual search of all available issues of the journal from 1949 showed that only 42 papers related to Behavior Therapy have been published till 2009. Among them 10 are case reports. Methodological limitations abound even in the papers on larger groups of patients. Studies using operant conditioning have been very few. Aversion therapy and progressive muscle relaxation have been very frequently used. The published articles are reviewed under the various diagnostic categories. Publications in the recent years have been mostly on Cognitive Behavior Therapy. Even after 57 years of co-existence, the relationship between Behavior Therapy and Indian Psychiatry remains a tenuous one. [ABSTRACT FROM AUTHOR]

The contribution of researchers from India in the field of electroconvulsive therapy (ECT) has been substantial. Over 250 papers have been published by authors from India in the past five decades on this issue; about half of these have appeared in the Indian Journal of Psychiatry. This article summarizes the papers on ECT research that have appeared in the Journal. A bulk of these articles has focused on establishing the efficacy in different disorders. Considerable numbers of papers describe refinement in the ECT procedure, including anesthetic modification, ECT machine and EEG monitoring. Papers on neurobiology of ECT and long-term follow-up of ECT-treated patients form a minority. Despite the decline in the use of ECT across the globe, papers on ECT have only increased in the recent decades in the Journal. [ABSTRACT FROM AUTHOR]

Care and treatment outside the setting of mental hospitals have been termed community psychiatry. This paper, based largely on publications on this subject in the IJP, discusses work on development of mental health services outside the hospitals, National and District Mental Health Programs, some accounts of Indian families, alternative modes of treatment in communities and a few miscellaneous issues. Very few papers are data driven and most of them are descriptive and opinionated. [ABSTRACT FROM AUTHOR]

Women's mental health is closely linked to their status in society. This paper outlines the clinical features of women with schizophrenia and highlights the interpersonal and social ramifications on their lives. There is no significant gender difference in the incidence and prevalence of schizophrenia. There is no clear trend in mortality, although suicides seem to be more in women with schizophrenia. In India, women face a lot of problems, especially in relation to marriage, pregnancy, childbirth, and menopause. Most studies have shown better premorbid functioning, and social adjustment for women compared with men. There is a great need to plan for gender‑sensitive mental health services targeting the special needs of these women. Women caregivers also deserve due attention. [ABSTRACT FROM AUTHOR]

There is an urgent need for development of methods of assessment and management of sex offenders (rapists, child sex offenders, other sexual offenders, and murderers) to mount a society-wide battle against the scourge of sexual offences in India. This paper provides an overview of theories, models, and assessment methods of rapists. It draws upon literature from psychiatry, psychology, criminology, probation, and ethics to provide a framework for understanding reasons behind rape, how mental health issues are implicated, what mental health professionals can do to contribute to crime management, and why this is ethically right and proper. [ABSTRACT FROM AUTHOR]

The present paper is an attempt to understand emotions and the affect from Indian traditional point of view. In the Indian philosophical texts' detailed descriptions of emotions are not available nor are dealt with as a separate concept. This view of emotions lays emphasis on desires as the root cause of emotional upheavals. They are seen as modification of desire and attachment. The desires are seen as arising from the contact and attachment of the ego or ahamkara with the external world and are caused by a sense of imperfection, incompleteness or non-fulfillment. Ego or ahamkara is differentiated from the true Self or atman. Emotions are viewed as springs of action and are bipolar in nature. According to Patanjali's Yoga Shastra, suffering is due to ignorance about one's true "self" (avidya). Hence, suffering or dukha arises from within and not from the outside world. Bhagvadgita traces all emotional experiences to the gunas, i.e., sattva, rajas, and tamas. Works of Bharathmuni have contributed to the understanding of emotional experiences. Concept of rasa or aesthetic relish is central to this approach to understanding affective experiences as dealt with in the Natyashastra of Bharathamuni. These views underline the recommended path for self-transformation. Regulating emotions, both emotional experience and emotional expression, is an integral part of the recommended "principles of living". [ABSTRACT FROM AUTHOR]

Substance use among creative artists is very common. In this paper, such use by the great Tamil poet, Subramani Bharathi, is considered. [ABSTRACT FROM AUTHOR]

Sexual and non-sexual boundary violations occur in the health professional-patient relationship all over the world as well as in India. However, the issue is rarely, if ever, discussed here in a frank and rational manner. This paper discusses the challenges faced by all health professionals and particularly mental health professionals in handling this problem in India. Health professionals can now either let things remain as they are or try to change things for the better, despite the inherent risks in attempting the latter. Since knowledge about boundary issues is essential for effective healthcare, prevention of boundary violations by oneself and reducing harm to patients should a violation occur by another professional, it is important that all health professionals are aware of the issues involved. [ABSTRACT FROM AUTHOR]

The objective of this paper is to review all articles related to psychiatric disability that have been published in the Indian Journal of Psychiatry since its inception till date. We have also added up some more relevant literature in the area of mental disability of Indian psychiatric patients. Finally the article ends up with discussion related to challenges associated with mental disability, persons with Disability Act and future directions in the area of psychiatric disability. [ABSTRACT FROM AUTHOR]

The articles that appeared in Indian Journal of Psychiatry were related to different areas of psychotherapy. Case reports dealt with a wide variety of cases. The review papers focused on the suitability of psychotherapy in the Indian context, different approaches in psychotherapy, psychotherapy training and supervision. Psychotherapy has been viewed very close to faith orientation. There were attempts to identify the indigenous concepts that are applicable to psychotherapy. Empirical studies are low in number. Concerted effort is needed to generate interest in psychotherapy, conduct more research on evidence-based therapies as well as on psychotherapeutic process variables. [ABSTRACT FROM AUTHOR]

HIV/AIDS has gained prominence in India as a growing public health issue. There is a complex but significant interaction between mental health and HIV/AIDS. HIV affects mental health by its direct neurobiological action, the impact of having the illness, by its treatment including that for opportunistic infections and by its impact on the family. In addition, substance use and mental illness as vulnerability factors add to the complexity of assessment, differential diagnosis and management. This paper reviews literature published in India on the topic. [ABSTRACT FROM AUTHOR]

Sexual variation has been reported across cultures for millennia. Sexual variation deals with those facets of sexual behavior which are not necessarily pathological. It is any given culture that defines what is abnormal and what is deviant. In scriptures, literature and poetry in India same sex love has been described and explained in a number of ways. In this paper we highlight homosexual behavior and the role of hijras in the Indian society, among other variations. These are not mental illnesses and these individuals are not mentally ill. Hence the role of psychiatry and psychiatrists has to be re-evaluated. Attitudes of the society and the individual clinicians may stigmatize these individuals and their behavior patterns. Indian psychiatry in recent times has made some progress in this field in challenging attitudes, but more needs to be done in the 21st century. We review the evidence and the existing literature. [ABSTRACT FROM AUTHOR]

The objective of this paper is to provide a review on the psychiatric comorbidity research in India based on the data published in the last six decades. The comorbidity data world over reflects that it is a much more common phenomenon than observed in routine clinical practice. In India, research into this domain of psychiatry has been limited, with comorbidity reported to be as high as 60%. In the few publications in this area, most of the authors have looked into substance related comorbidity. Small numbers of studies have looked into comorbid conditions in child psychiatry, especially mental retardation and very few studies have looked at other comorbidities. The landmarks in the studies in the area of psychiatric comorbidity have been highlighted in this review article. [ABSTRACT FROM AUTHOR]

The paper discusses research on various issues related to mental health specific to women, published mainly in the Indian Journal of Psychiatry. We carried out a manual search of all the issues of the journal. Indian psychiatrists have worked in a wide range of areas including psychological aspects of different reproductive phases like pregnancy, puerperium, menopause, menstrual cycle, psychological consequences of contraception, infertility and surgical loss of uterus or breast. Most of the studies are cross sectional with very few prospective studies. There is a need for longitudinal, epidemiological and intervention studies. [ABSTRACT FROM AUTHOR]

The Indian Journal of Psychiatry published three articles in its first issue way back in 1958. Since then, it has steadily published more than 200 papers on one or the other aspect of schizophrenia. From rudimentary research methodology and descriptive approach, schizophrenia research, as published in the Journal, seems to have come of age with more and more sophisticated research designs and methodologies. Our ardent researchers have made significant contributions in the understanding of this riddle called schizophrenia. Notable contributions have been made in the field of epidemiology, course and outcomes and phenomenology of this disorder. However, research in psycho-social rehabilitation of schizophrenia and related areas is sparse and sporadic. The need to conduct research that impacts health policies and planning of services for this disorder is evident and our researchers would do well to provide impetus in these areas. [ABSTRACT FROM AUTHOR]

The objective of this paper is to provide a systematic review on the epidemiology of psychiatric disorders in India based on the data published from 1960 to 2009. Extensive search of PubMed, NeuroMed, Indian Journal of Psychiatry website and MEDLARS using search terms "psychiatry" "prevalence", "community", and "epidemiology" was done along with the manual search of journals and cross-references. Retrieved articles were systematically selected using specific inclusion and exclusion criteria. Epidemiological studies report prevalence rates for psychiatric disorders varying from 9.5 to 370/1000 population in India. These varying prevalence rates of mental disorders are not only specific to Indian studies but are also seen in international studies. Despite variations in the design of studies, available data from the Indian studies suggests that about 20% of the adult population in the community is affected with one or the other psychiatric disorder. Mental healthcare priorities need to be shifted from psychotic disorders to common mental disorders and from mental hospitals to primary health centers. Increase in invisible mental problems such as suicidal attempts, aggression and violence, widespread use of substances, increasing marital discord and divorce rates emphasize on the need to prioritize and make a paradigm shift in the strategies to promote and provide appropriate mental health services in the community. Future epidemiological research need to focus on the general population from longitudinal prospective involving multi-centers with assessment of disability, co-morbidity, functioning, family burden and quality of life. [ABSTRACT FROM AUTHOR]