Search

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]

Background: "CoviSainik Program" was implemented in collaboration with the Ambuja Cement Foundation and Community Medicine Department in rural districts of eight states of India from May to December 2021 to create a cadre of volunteers. The aim of the present paper is to describe the program and evaluate it so that the findings can be the guiding tool for policymakers to replicate a similar program. Material and Method: A cross-sectional, mixed-method – concurrent study design was adopted to evaluate the program for its short-term outcomes such as gain in the basic knowledge of COVID-19 amongst master trainers and their feedback and program output viz – the proportion of volunteers trained and their profile by census sampling. Motivational factors, experiences of volunteers, and outcomes of COVID-19 work in their villages were explored by purposive with maximum diversity sampling with 62 online in-depth interviews and 8 online focus group discussions (FGDs). Results: There was a statistically significant difference in the pre-test (12.8 ± 5.6) and post-test (25.9 ± 9.3) scores of the Master Training Program evaluation test. Out of 6534 trained volunteers, 5901 worked as volunteers, and amongst those, 47.1%, 35.1%, and 17.8% worked for ≤3 months, 3 to 6 months, and ≥6 months, respectively, in their villages. The major themes generated for motivational factors to join the program were altruism, savior nature, generating awareness, and concern for others. The major outcomes generated by trained volunteers COVID-19 vaccination were in raising awareness on COVID-19 appropriate behavior and early identification of COVID-19 cases in their villages. Conclusion: The "CoviSainik Program" was successful in creating cadres of trained volunteers. [ABSTRACT FROM AUTHOR]

Single parent adoption (SPA) is a relatively new construct worldwide and in India. The Ministry of Women and Child Development, Government of India, has laid down criteria for adoption in general and SPA in particular, in conjunction with the Juvenile Justice Act (Care and Protection of Children), 2015. There is scant literature on this topic of SPA, more so in India, that looks into the various psychological nuances of SPA from a mental health professional's (MHP) perspective. This review paper aims to assess SPA from the perspective of a MHP that will focus on its various legal nuances as well as the psychological connotations attached to it. For this, a search strategy was employed that included a thorough literature search from two databases (PubMed and Google Scholar) with relevant keywords related to the topic. The various legal issues pertaining to SPA in the current scenario, the psychological issues and challenges faced by single parents, the behavioral outcomes of adoptees who are adopted by single parents, and ways to deal with the various obstacles of SPA are discussed. [ABSTRACT FROM AUTHOR]

The article focuses on the consensus statement reached by editors of psychiatry journals published in India. Topics discussed include the expansion of the Indian Psychiatric Society (IPS) and the formation of various branches and journals, the need to improve the quality of publications and ethical standards, and issues related to cost, collaboration, and indexing of journals.

Medical professionals face high stress due to the type of work they do and the prolonged working hours. Frequent burnout results due to the challenging nature of their work. Added to the stress of work, malpractice lawsuits add to their burden. In India, most doctors work in compromised settings with poor infrastructure and manpower but are expected to follow the best practices. In court, they are judged with the Bolam and Bolitho tests being essential considerations. Several tragic incidents have been reported, including depression, anger issues, and even suicide deaths of healthcare professionals (HCPs) after accusations of negligence and subsequent inquiry. Such incidents demonstrate the multitude of challenges an HCP faces in day-to-day practice. It is crucial to find ways to tackle these problems and enhance the capacity of HCP to handle such demanding circumstances. Malpractice litigation can significantly impact the mental health of HCPs. It is common to experience emotional turmoil when faced with a lawsuit. Second victim syndrome (SVS) is a term used to describe a set of symptoms experienced by HCPs who make an error leading to injury to a patient. However, it also happens if he is traumatized by the consequences of violence during healthcare services or a lawsuit or defamation article in newspaper/social media. Following a litigation crisis in their career, many HCPs go through various stages of grief, including shock, denial, anger, bargaining, depression, and acceptance. At times, death by suicide of the HCPs is well known. SVS is known to profoundly affect the personal, family, economic, professional (defensive practice), and social life of HCPs. HCPs should accept the allegations of negligence as an occupational hazard and prepare for the eventual litigation at least once in a lifetime by knowing about the medical laws, HCP's rights, becoming aware of the emotional turmoil of the lawsuit, preparing to cope with the lawsuit, and seeking help from colleagues and indemnity insurance. Frequent training of the HCPs is strongly recommended to know about the changing laws and also to undergo periodic professional competence enhancement to reduce the incidents of errors amounting to medical negligence. Medical and hospital administration should debrief after any incident and conduct internal investigations to identify systemic flaws and prevent future recurrence, resolve issues within their control at their level, and manage media (mainstream and social media) appropriately. If established, a reporting system with online and offline services will ease the internal administrative investigation process and take appropriate, timely actions. During the crisis, HCPs should have adequate and appropriate insurance or indemnity coverage and mental health support systems. [ABSTRACT FROM AUTHOR]

Background: User satisfaction in healthcare is an important measure of the quality of services provided to the patient and their carers. Since treatment of psychiatric patients requires long follow-up periods, and this long follow-up treatment patients depends on their initial experience with health service,therefor user satisfaction is of increasing importance in the mental health field. Aims and Objectives: Assess the user satisfaction and perceptions of the attitude of emergency health- care professionals (including paramedical staff and physicians of respective specialties) toward psychiatric and nonpsychiatric patients as experienced by the patients and carers. To compare the user satisfaction and perceived attitude of emergency staff in patients with psychiatric illness and nonpsychiatric illness. To determine the service users' decision to revisit the same health-care facility in case of the same problem. Materials and Methods: This study was done in the hospital wing of a tertiary care teaching university hospital in northern India, and ethics approval was obtained from the institutional ethics committee patients' sociodemographic details and psychiatric and other relevant medical history after obtaining informed consent. The psychiatric diagnosis was made according to the ICD-10. A self-report questionnaire, comprising 9 questions, and was designed to assess the perceived attitudes of health-care workers toward the patient of psychiatric illness. The questionnaire was designed in Hindi. Descriptive statistics for categorical variables were done. Inferential statistics were calculated using the Chi-square test. Results: Out of a total of 95 respondents, 69 patients were diagnosed with a psychiatric disorder and the remaining 26 patients had medical illness or other non-psychiatric disorders. Females were a majority in both groups. Our study majorly showed that service users perceived the attitudes of medical and paramedical staff in emergency units mostly as satisfactory or extremely satisfactory, as well as the majority of service users reported that they were satisfied with the reaction of emergency paramedical staff towards the emotional well-being of the patient. Conclusions: The major strengths of this study were the quantitative analysis of health workers' attitudes toward patients with psychiatric illnesses, which showed user-rated satisfactory attitudes. There was less stigma and more of a positive impact noted. The semi-structured questionnaire was designed in the local language and tailored to cover topics such as emotional well-being and psychoeducation that can all affect the user experience. [ABSTRACT FROM AUTHOR]

Introduction: Suicide has become a societal crisis owing to the recent increasing trends globally. Of the total suicide deaths globally, two-thirds occur in the developing countries including India. The available data on suicide in India reflect a rate of 11% (according to the National Crime Records Bureau 2013) with the highest rates in older adult males and an increasing trend of suicide deaths in younger age groups. Much of the literature is from the southern part of India with a relatively sparse data from North India. Aim and Methodology: The aim was to examine the 15-year (2004-2019) trend of suicide (age and gender distribution, methods used, and reasons) in an urban city in North India. Information was collected from the leading newspapers (English, Hindi, and Punjabi) of the area. Duplication of information was avoided, and statistical analysis was done using SPSS version 20. Results: Fluctuations in the total number of suicide cases over the 15-year period were observed with nearly 63% of people committing suicide being younger than 30 years of age, of whom 53% were male. More females in the younger age group and more males in the older age group were suicide victims. Of all the methods used, hanging was the most common (70%), followed by consuming poisonous substance, jumping from height, shooting self, and stabbing in the descending order. A ceiling fan was used for hanging by 32% of victims who hanged themselves, of whom 65% were male. Among the cited reasons, stress/depression was experienced by 19% of victims. Discussion and Conclusion: The trends with respect to age distribution, gender, and method used that is reported in the current study are in line with the trends reported globally. The preventive measures, especially using technological advances in designing fans not suitable for tying noose around it, can be explored. [ABSTRACT FROM AUTHOR]

Background: The amount and frequency of internet use are often used to forecast its pros and cons, with mixed findings. After COVID-19, technological advances and sociological upheavals have shown the internet's ability to support numerous activities, necessitating a change in internet use. Beyond internet use frequency, it has been advised to examine why people use it and how it affects their well-being. Hence, we aimed to investigate the various mediators and moderators in the relationship between the quality of internet use (type of activity) and well-being. Further, we investigated whether user attributes such as initial age and frequency of internet use moderate the influence of internet use quality on problematic internet use, loneliness, and well-being. Methods: 131 students in Manipur who were 18 years old were included in this cross-sectional study. Self-rated measures of the Adult Internet Usage questionnaire, Internet Addiction Test, and Mental Health Continuum-Short Form assessed internet use, dependence, and well-being. Results: Loneliness mediates the association between well-being and internet behaviors related to personal use-self-actualization (BootSE = .53, BootLLCI = .10, BootULCI = 2.18), cultural use-belonging (BootSE =.57, BootLLCI = -2.23, BootULCI = -.02). Average online hours moderate economic use-education, loneliness, and well-being (BootSE =.13, BootLLCI = -.55, BootULCI = -.04). Conclusion: To conclude, the effectiveness of internet use affects well-being differently depending on the type of activity. After a certain point, even seemingly good internet activities may have diminishing returns. [ABSTRACT FROM AUTHOR]

Introduction: There is a dearth of data on common multimorbidity clusters and the healthcare costs for individuals with mental health disorders. This study aimed to identify clinically meaningful physical-mental multimorbidity clusters, frequently occurring clusters of conditions, and healthcare utilization patterns and expenditure among patients attending a psychiatric outpatient clinic. Materials and Methods: Data were collected in the psychiatric outpatient department among patients aged 18 years and above in February-July 2019 (n = 500); follow-up data on non-communicable disease incidence were collected after 18 months. For analysis, morbidity clusters were defined using two approaches: 1) agglomerative hierarchical clustering method to identify clusters of diseases; and 2) non-hierarchical cluster k mean analysis to identify clusters of patients. Self-reported healthcare costs in these clusters were also calculated. Result: Two disease clusters were identified: using the 1st approach were; 1) hypertension, diabetes, and mood disorder; 2) Neurotic, stress-related, and somatoform disorders, and acid peptic disease. Three clusters of patients identified using the 2nd approach were identified: 1) those with mood disorders and cardiometabolic, musculoskeletal, and thyroid diseases; 2) those with neurotic, substance use, and organic mental disorders, cancer, and epilepsy; and 3) those with Schizophrenia. Patients in Cluster 1 were taking more than six medicines and had more hospital visits. Within 18 months, 41 participants developed either one or two chronic conditions, most commonly diabetes, hypertension, or thyroid disease. Conclusion: Cardiometabolic diseases are most commonly clustered with mood disorders. There is a need for blood pressure and sugar measurement in psychiatric clinics and mood disorder screening in cardiac, endocrinology, and primary care clinics. [ABSTRACT FROM AUTHOR]

Context: Empathy and self-esteem are essential in delivering quality health care, particularly for women in labor and giving birth. Aims: The aim of this study was to determine the empathy quotient and self-esteem of the second-year and final-year medical and nursing students and labor room staff. Settings and Design: This cross-sectional study was conducted at a teaching hospital in southern India between September and December 2021. Materials and Methods: The inclusion criteria for the study were (i) nursing or medical students currently in their second or final year and (ii) obstetrician or nursing officer or intern currently posted in the labor room. Empathy quotient and self-esteem were measured using the Cambridge Behavioral Scale and Rosenberg's Self-Esteem Scale, respectively. Statistical Analysis Used: The scale scores were summarized as mean (standard deviation), percentages, and 95% confidence intervals. The association between empathy quotient, self-esteem, age, gender, designation, and experience duration was analyzed. We performed multivariable analysis using binary logistic regression. P <0.05 was considered statistically significant. Results: Of the 400 participants included in the study, 36.8% (42.7% - medical, 26.2% - nursing personnel) had lower than average empathy quotient scores, and 13.3% (18.4% - medical, 4.1% - nursing personnel) had low self-esteem. Self-esteem had a statistically significant, independent effect on empathy quotient, as noted in the multivariable analysis among medical and nursing personnel. There was a significant difference between empathy quotient and self-esteem scores in medical and nursing personnel across various designations (P < 0.05). Conclusion: A third of the participants had empathy quotient ratings that were below average, and one-eighth of participants had low self-esteem. Self-esteem and empathy quotient are interdependent; hence has to addressed together. The empathy quotient and self-esteem vary across different designations emphasising the need to take measures to nurture it. [ABSTRACT FROM AUTHOR]

Background: The causal impact of income shocks on mental well-being in developing countries is an under-researched area. The COVID-19 pandemic, along with the economic recession caused by the lockdowns to reduce transmission, provides a natural experimental setting to examine the causal impact of a decline in monthly per capita expenditure (MPCE) on mental health of the general population in India during the pandemic. Aim: To evaluate the impact of income shocks on mental health of adults in metro cities during the COVID-19 pandemic. Materials and Methods: The data were collected using the abridged version of the Depression Anxiety Stress Schedule administered through a telephonic survey on adult residents of six metropolitan cities in September-August 2020 and July-August 2021. Results: In the present study, 994 adults participated from six metropolitan cities. Average treatment effects were estimated using Propensity Score Matching. The mean normalized scores are significantly higher for respondents whose MPCE had fallen (treated) vis-à-vis respondents whose MPCE had remained same or increased (control): anxiety (0.21 for treated vs -0.19 for control), stress (0.16 vs -0.14), and depression (0.04 vs -0.19). Propensity score matching reveals that the normalized scores for anxiety, stress, and depression were 33 (95% confidence intervals, CI: 20.0-46.7), 25 (95% CI: 12.9-36.9), and 36 (95% CI: 18.6-53.1) higher among the treated group vis-a-vis control group. The ATET was 34 (95% CI: 18.9-48.9), 26 (95% CI: 10.1-42.9), and 32 (955 CI: 12.3-50.7) for these three outcomes, respectively. The post-estimation tests indicated that the results are valid. Conclusions: The study advocates that policies to ensure income security should be made an integral part of the response packages to tackle pandemics like COVID-19. [ABSTRACT FROM AUTHOR]

Background and Aim: A questionnaire-based study was conducted to assess the knowledge, understanding, and perception of dental undergraduate students toward child abuse and neglect in an Indian setup. Materials and Methods: The data were collected through a 38-item questionnaire to investigate the self-reported knowledge, understanding, and perception in relation to child abuse among 3rd, final-year, and interns among private and government dental colleges in India. There were 1277 responses to the questionnaire. Results: The responses were obtained from all regions of India, including both government and private dental institutes. 10% each of all government and private institutes in India participated in this survey. It was observed that the level of knowledge and awareness of BDS students increased from BDS 3rd year through the final year and internship. The amount of awareness regarding child abuse is better among the interns. Although 50.9% of the respondents were aware of nongovernmental organizations working actively for victims of child abuse and neglect in India. Conclusion: There is a restricted level of knowledge and awareness regarding child abuse and neglect among BDS students, wherein BDS interns were comparatively familiar with the facts. Although the majority of dental students were aware of organizations working for child abuse victims but were still confined to approaching legally and ethically. [ABSTRACT FROM AUTHOR]

Background: The unprecedented onset of coronavirus disease 2019 (COVID-19) had a huge impact on health-care facilities, leading to different psychosocial challenges among health-care workers (HCWs) during this pandemic. Aim: This study aimed to explore the impact of COVID-19 on the work, family, and personal life of HCWs engaged in COVID-19 duties during the first wave in India and gain insights on the coping strategies. Materials and Methods: The findings from 12 qualitative in-depth interviews were analyzed and presented in this article. This study is a part of a mix-method design study conducted at two hospitals and one community site in Mumbai, Maharashtra. The present qualitative sample was drawn conveniently from the randomly selected quantitative sample chosen from the three sites. Results: This study highlights that in the early stage of the COVID-19 pandemic, HCWs experienced transition in work life, burnout, disruption in family life, negative emotions such as fear, and experiences of stigma. The findings also reveal that while institutional workers faced discrimination and stigma outside their workplace, noninstitutional workers faced discrimination at multiple sites during traveling and at in their residential places and additionally faced harassment while working in the community. The findings also suggest that despite numerous challenges faced by HCWs, they were driven by a sense of responsibility and displayed resilience. Conclusion: Considering the HCWs as the backbone of the health-care system, it is crucial to boost and maintain the mental well-being of HCWs by providing timely and tailored interventions to sustain their resilience and build better responses to future pandemic. [ABSTRACT FROM AUTHOR]

Across India, there have been multiple studies conducted to address the issues of the mental health of healthcare workers during the COVID-19 pandemic. The present study estimated the pooled prevalence of psychological morbidity among healthcare workers during the early phase of the COVID 19 pandemic in India. We searched the following electronic bibliographic databases: PubMed, ScienceDirect, Wiley online library, and Google scholar for studies conducted from the onset of the COVID 19 pandemic until 25 September 2021. The methodological quality of each study was scored and outcome measures with uniform cut off scores as per various screening measurements were evaluated. According to the current meta analysis, the pooled estimates of depression, anxiety, stress, and insomnia among Indian healthcare workers during the COVID 19 pandemic are 20.1% (95% CI: 15.6 to 24.6%; n = 21 studies), 25.0% (95% CI: 18.4 to 31.6%; n = 20 studies), 36% (95% CI: 23.7 to 48.2%; n = 22 studies) and 18.9% (95% CI: 9.9 to 28.0%; n = 6 studies) respectively. In subgroup analyses, low quality studies based on the JBI checklist (Score < 3/9) and studies using DASS 21 showed a higher pooled prevalence of depression and anxiety. About 20–36% of the healthcare workers in India reported having depression, anxiety, and stress during the early phase of the COVID 19 pandemic. The present study provides a comprehensive review of the overall burden of mental health problems among healthcare workers during the COVID 19 pandemic in India necessitating appropriate intervention strategies to protect these frontline groups before the memory of the pandemic crisis starts to fade. [ABSTRACT FROM AUTHOR]

Background: Women are at greater risk for depressive disorders than men. They are also known to be genetically and biologically vulnerable. Indian women mostly express their mental stress as somatic complaints and many other psychosocial factors influence as well as maintain the depressive symptoms. The psychosocial needs of women are often projected through the presentation of their depressive symptoms. Aim: The present study aimed to explore the psychosocial problems of married women diagnosed with depressive disorder. Methods: The study used a qualitative approach with exploratory research design. This study was carried out in the outpatient department of Lokopriya Gopinath Bordoloi Regional Institute of Mental Health in Tezpur (Assam). Purposive sampling was used and eight women were selected for the study. In-depth interviews were conducted to explore the psychosocial stressors, experiences, and illness narratives (idioms of distress) of these women. Among eight women who consented to participate in the study, six completed the study. Results: The salient findings of this study are that the women diagnosed with mild to moderate depressive disorders conveyed their mental health issues through various physical and emotional problems. Women expressed their problems primarily through somatic complaints, typically a variety of aches in different body parts, lethargy, excessive thinking, and decreased enthusiasm. Psychosocial factors centered around various social contexts and interpersonal issues, economic difficulties, marital difficulties and housing problems. Conclusion: The women's narratives focuses predominantly on the socioeconomic and interpersonal difficulties as the underlying cause of their distressing symptoms is projective of psychosocial aberrations. Experiences expressed by women are located in their social world. [ABSTRACT FROM AUTHOR]

Background and Objectives: Students with borderline intellectual functioning ("slow learners") underperform in all school subjects. The primary objective of this study was to evaluate the parental-perceived health-related quality of life (HRQoL) of these students. Its secondary objective was to analyze the impact of sociodemographic variables on their HRQoL. Settings and Design: Cross-sectional single-arm questionnaire-based study was conducted in the learning disability clinic in a public medical college in Mumbai. Subjects and Methods: One hundred parents of slow learners aged 8 to 16 years were recruited by non-probability sampling. Their HRQoL scores were measured using the English DISABKIDS chronic generic module parent (proxy) long-version ("DCGM-37-P") instrument. Statistical Analysis: Multiple regression analysis was carried out for determining the "independent" impact that sociodemographic variables had on a poor facet and total score outcomes. Results: Clinically significant deficits were detected in 4 facets, namely: small deficit in "social inclusion"; medium deficits in "independence", "emotion", and "social exclusion"; and large deficit in "total score". Multivariate analysis revealed that: (i) being an only child predicted a poor "emotion" and "social exclusion" facet score outcomes (P = 0.039 and P = 0.024, respectively); (ii) being a female predicted a poor "social inclusion" facet score outcome (P = 0.022); and, (iii) studying in a single-gender school predicted a poor "limitation" facet score outcome (P = 0.020). Conclusions: Parents of slow learners perceive their psychosocial and total HRQoL to be significantly compromised. There is a need to evaluate the HRQoL of slow learners so that optimum rehabilitation can be facilitated. [ABSTRACT FROM AUTHOR]

A long-acting oral glucagon-like peptide-1 (GLP-1) receptor agonist, semaglutide is a new armamentarium to glycemic treatments. The Peptide Innovation for Early Diabetes Treatment (PIONEER) 3, 4, 5, 6, and 10 provided the necessary evidence on the efficacy of semaglutide in type 2 diabetes. The American Diabetes Association considers GLP-1 receptor agonists and insulin a high glycemic efficacy therapy. Further, a GLP-1 receptor agonist is recommended when there is a need for minimizing weight gain or promoting weight loss. There are no reports or clinical trials on oral semaglutide in Indian subjects with type 2 diabetes. We present seven case reports where semaglutide was initiated with other antidiabetic medications to bring the glycated hemoglobin (HbA1c) under target and promote weight loss. Between 45 days and 60 days of treatment with antidiabetic drugs, including semaglutide, resulted in a 1.5% reduction in HbA1c. A reduction in body weight ranged from 1.7kg to 10kg. Large-scale randomized trial in Indian patients is warranted to confirm our findings. [ABSTRACT FROM AUTHOR]

Background: Nonsuicidal self-injury (NSSI) refers to intentional, deliberate, and socially unexpected harming acts to oneself without any intention to die. It is a growing concern among recent mental health professionals. NSSI behaviors have an impact primarily on the individual, family, and ultimately on society. This problem is prevalent among the clinical population, but it has also become a threat to the general population, specifically adolescents and the young population. Aim: In this present study, we have explored the relationship between family environment and NSSI and investigated the predictable family factor for NSSI. Materials and Methods: Mixed method sequential research design was used for this research work. First, we did quantitative data collection; a total of 535 college students aged 18–26 years were selected and assessed using the Family Environment Scale and Functional Assessment of Self-Mutilation Scale. Second, thematic analysis was performed, followed by interviews with six participants. Results: There is a significant relationship between family conflict and NSSI χ2 = 33.47 (P < 0.001). Family conflict can be most reliable to predict NSSI, χ2(16, n = 499) = 57.78, P < 0.001. In addition, the Thematic Analysis highlighted family interpersonal relationship, lack of expressiveness, and lack of sense of belongingness in the role of NSSI. Conclusion: Family conflict can be a crucial factor in detecting NSSI. This study can be a good source of information for clinicians and social scientists, but more studies should be conducted to control and prevent NSSI. [ABSTRACT FROM AUTHOR]

The article focuses on mental capacity including testamentary capacity.

An editorial is presented which discusses the rationale for enhancing psycho‑social interventions to support people facing discrimination, addressing public stigma, and achieving higher level social and political structural change. It mentions that people need to move on to developing models of intervention targeted at various sections of the community to tackle stigma and discrimination related to mental disorders.

Background: The unprecedented first wave of the COVID-19 pandemic severely impacted mental health services globally. However, the negative impact of such disruptions on people with substance use disorders (SUD) seeking treatment remains unclear. We aim to explore the behaviors adopted by these individuals to overcome the service disruptions. Materials and Methods: We explored the changes related to substance use behavior (quit attempts, withdrawal experienced, treatment-seeking, and risky behaviors), and behavioral changes in response to COVID-19 lockdown. A cross-sectional survey was conducted among 404 people with SUD seeking treatment from seven centers across India. They were assessed by a specially designed structured questionnaire during the first wave (June–September) of the pandemic. Results: An overwhelming majority experienced withdrawal symptoms, with close to half making quit attempts and seeking treatment during the lockdown. Three-fourth of the sample reported difficulty in accessing treatment services and medications. Patients with opioid use were significantly more likely to think about quitting (χ2 = 20.408, P = 0.000), make attempts (χ2 = 12.436, P = 0.000), seek treatment (χ2 = 7.536, P = 0.006), and self-medicate for withdrawal symptoms (χ2 = 5.885, P = 0.015). In turn, those with alcohol use were more likely to use telepsychiatry services (χ2 = 35.143, P = 0.000) and experience stigma by family members (χ2 = 29.951, P = 0.000) and neighbors (χ2 = 17.725, P = 0.000). Among COVID-19 safety precautions, majority practised wearing masks and social distancing but not others. Conclusion: COVID-19 lockdown led a significant proportion of substance users, especially opioid users, to make quit attempts and seek help. However, these could not be sustained due to difficulty in accessing treatment services. Further, significant proportion failed to adhere to COVID-19 safety precautions. [ABSTRACT FROM AUTHOR]

Various psychosocial factors play a vital role in mental health. India's rich cultural, traditional, and social value system is well-known throughout the world. However, a considerable proportion of women are disadvantaged in these systems, and as a result, they are more likely to experience a significant psychosocial burden that affects their physical, mental, social, and spiritual well-being. These psychosocial burden also have an impact on their quality of life, personal well-being, and some fundamental human rights. In the light of the current Indian situation, this narrative review depicts the psychosocial burden that a significant proportion of Indian women are likely to face. [ABSTRACT FROM AUTHOR]

Background: No review has been attempted, so far, on Indian psychological autopsy (PA) literature. There is also a dearth of interview guides which is at the heart of a PA procedure. Materials and Methods: Electronic searches of MEDLINE through PubMed, PsycINFO, and Google scholar databases were carried out from inception till February 2020 to identify relevant English language peer-reviewed articles from India, as well as global literature that provided information on best practice elements in PA. Abstracts generated were systematically screened for eligibility. Relevant data were extracted using a predesigned structured proforma, and a semi-structured interview guide was developed. Results: A total of 18 original articles, one case report, and three reviews/expert opinion articles which tried to give a description of PA procedure were found from India. Most Indian studies are of suicide PA (SPA), done to assess risk factors associated with suicide. There was a wide variation in reported rates of psychiatric morbidity among suicide decedents, while the other major risk factor for suicide in the Indian setting was stressful life events. An optimal approach to PA involves systematically collecting information from key informants and other sources using a narrative interviewing method, supplemented with psychological measures, and is probably best carried out within 1–6 months after the death. Conclusion: There have been limited attempts to standardize PA. Most Indian studies use SPA. We propose a semi-structured PA interview guide, suitable for both research and investigational purposes. [ABSTRACT FROM AUTHOR]

Background: Coronavirus disease 2019 (COVID-19) has emerged as a global health threat. The South-Asian (SA) countries have witnessed both the initial brunt of the outbreak as well as the ongoing rise of cases. Their unique challenges in relation to mental health during the pandemic are worth exploring. Materials and Methods: A systematic review was conducted for all the original studies on the impact of COVID-19 and lockdown on psychological health/well-being in the SA countries of the World Psychiatric Association Zone 16. PubMed, Google Scholar, PSYCHINFO, EMBASE, and SCOPUS were searched till June 2020. Studies conducted in the age group of 18-60 years with a minimum sample size of 10, and statistically significant results were included. Results: Thirteen studies were included in the review. They showed increase prevalence in nonpsychotic depression, anxiety, somatic concerns, alcohol-related disorders, and insomnia in the general population. Psychological symptoms correlated more with physical complaints of fatigue and pain in older adults and were directly related to social media use, misinformation, xenophobia, and social distancing. Frontline workers reported guilt, stigma, anxiety, and poor sleep quality, which were related to the lack of availability of adequate personal protective equipment, increased workload, and discrimination. One study validated the Coronavirus anxiety scale in the Indian population while another explored gaming as a double-edged sword during the lockdown in adolescents. Another study from Bangladesh explored psychosexual health during lockdown. Most studies were cross-sectional online surveys, used screening tools and had limited accessibility. Conclusion: The ongoing COVID-19 crisis and its impact serve as an important period for adequate mental healthcare, promotion, research, and holistic biopsychosocial management of psychiatric disorders, especially in vulnerable groups. Mental healthcare and research strategies during the pandemic and preparedness for postpandemic aftermath are advocated subsequently. [ABSTRACT FROM AUTHOR]

Background: Activities of daily living (ADLs) refer to the ongoing behaviors that occur on a daily basis. Such behaviors include eating, cooking, bathing, social interactions (such as leisure activities, attending school or work, or assisting with chores), and other activities that one might routinely expect an individual to perform or participate in. Some of the major ADL tasks include personal hygiene, toileting, dressing, and eating. Researchers have documented delayed self-care performance in children with autism spectrum disorder (ASD). Parents report their child to have difficulties with feeding and toileting in particular. Objective: This qualitative pilot study endeavored to understand the difficulties faced by the parents of children with ASD in conducting their children's ADL. Study Design: Qualitative descriptive study was chosen for the research. Methods: The qualitative descriptive study included participants (n = 20) whose children were primarily diagnosed as ASD. Convenient sampling method was used for study sample calculation. The study included parents of children of age group between 5 and 9 years (mean ± standard deviation [SD]: 6.9 ± 1.57 months) with intelligence quotient of ≥80%. The study was conducted in a tertiary care hospital. The parents (fathers = 9 and mothers = 11) were given a semistructured questionnaire to understand difficulties faced by the parents of children with ASD (mean ± SD: 5.56 ± 33.6 months). Results: According to the study, it was observed that most of the parents have reported that their child had maximum difficulties in eating, followed by brushing and grooming and least for toileting. This study also found the priority list of difficulties in ADL. It was noted that early and proper training of the child gives good results in managing a child with ASD. Many parents reported that early training is beneficial. Conclusion: The outcome of this study shows the hierarchy of difficulties in ADL reported by the parents of children with ASD. This study also found that early ADL training gives good results in managing child with ASD. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to present a comprehensive profile of clinical and psychosocial characteristics of children with psychogenic nonepileptic seizures and to assess the short-term outcome of these patients. Materials and Methods: The subjects were consecutive cases of children with a diagnosis of nonepileptic seizures (N=17, mean age = 10.7 years, S.D. = 1.26) and two groups of control groups matched on age and sex: true seizure group and healthy controls. All the children were recruited from the out-patient services of the Department of Pediatrics of a tertiary care teaching hospital in North India. Detailed history taking and clinical examination was done in the case of every child. A standard 18 channel EEG was done in all the children and a video EEG was done in 12 cases of children with nonepileptic seizures. The Childhood Psychopathology Measurement Schedule (CPMS) and Life Events Scale for Indian Children (LESIC) were used to measure the children's emotional and behavioral functioning at home, and the number of life events and the stress associated with these events in the preceding year and the year before that. Short-term outcome was examined three to six months after the diagnosis of nonepileptic seizures was made. Results: Unresponsiveness without marked motor manifestations was the most common "ictal" characteristic of the nonepileptic seizures. Pelvic thrusting, upper and lower limb movements, head movements, and vocalization were observed in less than one-third of the patients. Increased psychosocial stress and significantly higher number of life events in the preceding year were found to characterize children with nonepileptic seizures, as compared to the two control groups. The nonepileptic seizures and true seizures groups had a higher proportion of children with psychopathology scores in the clinically significant maladjustment range, as compared to those in the healthy control group. A majority of the patients (82.4%) either recovered completely or had more than 50% reduction in the frequency of their symptoms, after three to six months of initiation of therapy. Conclusions: Psychosocial stress is common among children with nonepileptic seizures. Confirmatory diagnosis by video EEG, along with prompt psychosocial intervention, often results in a favorable outcome for most children with nonepileptic seizures. [ABSTRACT FROM AUTHOR]

Occupational injuries create a lot of trouble not only in the management of wound but also in the process of integration too. Some of the industrial accidents are not life-threatening, but the impact is larger than that, i.e., permanent damage to the body part which reduces one or more major functions. A patient came with occupational injury to us with badly damaged hind foot (mid of foot to heel, tendo achilles, and lower calf) but fortunately forefoot was spared. He was a young man and a bread earner for his family. With multiple surgeries, somehow wounds are managed, but the question arises was the patient is able to walk? As per surgeon, discretion, he estimated at least 6 months to initiate weight bearing for walking. 10 days (postwound healing for rehabilitation), 3 weeks (hospital stay). Sole of the foot was so badly damaged that weight-bearing bulk and muscles are lost, resulting into loss of cushion at sole. The patient could stand with the unconventional splints and modified walking aid on the 3rd day after dressing removal and able to walk by walker on the 5th day. He took 7 days for independent walking and stair 1W climbing. Since the patient was made to walk during hospitalization, he did not require conventional follow-ups. With the use of so, he was quite comfortable in walking. Periodically, change in shoes was required and status of scar has to be monitored every time to ensure proper mobility. It was important to keep hopes alive even in difficult situations. Sometimes, a consultant may not sure about prognosis in rehabilitation, due to low awareness in tier 2 cities about occupational therapy. Here, with the use of optimum knowledge and application, the patient is not only able to walk, but he also resumes his job to earn bread within 45 days of injury. A successful discharge requires a multidisciplinary approach. [ABSTRACT FROM AUTHOR]

The article discusses a study on the relationship between psychosocial workplace factors and occurrence of musculoskeletal discomfort (MSD) in computer operators in Anand, India. The prevalence of self reported symptoms related to MSD such as tiredness and neck and shoulder pain ranged from 0.7% to 34.8%. The study found no association between the subject's perception regarding promotion opportunities and occurrence of MSD.