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Background and Aims: Assessment of the severity of substance use disorders (SUDs) in a culture-sensitive manner can help gauge the current condition of the substance user and assess change with time. The present study aimed to develop a scale for the assessment of the severity of SUDs in the Indian clinical context. Methods: Based upon the review of literature on previously available instruments and a consultative meeting of experts, a clinician-rated scale was developed that finally comprised 41 items. A briefer 5-item scale with current and lifetime versions was also developed. The scales were applied to patients with SUDs at six different clinical sites. Results: The instrument was applied to 720 patients (98.2% males, mean age: 34.6 years). The Cronbach's alpha of the full scale was 0.852. The inter-rater reliability Pearson correlation coefficient of the full-scale was r = 0.821 (P < 0.001), and the intra-class correlation coefficient single measure was 0.800 (95% confidence interval: 0.724-0.956). A four-factor solution was suggested to be the most tenable. The mean application duration of the full scale was 13.4 minutes, and that of the briefer version was 2 minutes. Conclusion: This validated scale could be a potentially useful assessment measure for the severity of SUDs in the Indian context. The utility lies in the simplicity of administration and scoring and the balance between brevity and thorough assessment. [ABSTRACT FROM AUTHOR]

Background: Studies have shown increase in health-risking behavior and a decline in health-promoting behavior among medical students during their stay in medical school. This study aims to determine the prevalence and reason for substance abuse among the undergraduate medical students in a selected medical college in Puducherry. Material and Methods: This was a facility-based explanatory mixed method study conducted from May 2019 to July 2019. Assessment of their substance abuse was done using ASSIST questionnaire. Substance use was summarized as proportions with 95% CI. Results: A total of 379 participants were included in the study. The mean age of the study participants was 20 years (± 1.34). The most prevalent substance use was alcohol (10.8%). About 1.9% and 1.6% of students surveyed consume tobacco and cannabis, respectively. Conclusion: Facilitating factors for substance use as perceived by the participants were stress, peer pressure, easy availability of substances, socialization, curiosity, and awareness knowledge about safe limits of alcohol and tobacco. [ABSTRACT FROM AUTHOR]

: To assess the incidence of postpartum depression, maternal confidence about parenting and maternal–infant bonding characteristics in first-time mothers. : First-time mothers are usually unprepared for the transition into motherhood and may find it difficult to cope-up with this challenge leading to parenting stress, maternal–infant bonding disorders, and mental health problems. : This cross-sectional study was conducted in a tertiary centre in South India, on 151 primigravid mothers who delivered a live-born healthy infant after 37 weeks' gestation. Assessment was done using Patient Health Questionnaire scale, Tamil version of the Postpartum Bonding Questionnaire and Maternal Confidence Questionnaire on the 2nd or 3rd postpartum day. : Incidence of postpartum depression was found to be 18.5%, with 6% having features of severe depression. All mothers had good perceived maternal confidence. Nearly one-third had one or more of the maternal–infant bonding disorders. Those who had a vaginal delivery were associated with bonding disorders (OR = 10.3; 95% CI 2.13–47.21) whereas moderate to severe postpartum depression was not associated with it on multivariate analysis. : First-time mothers were found to have good confidence in the transition to motherhood. However, the high incidence of maternal–infant bonding difficulty, especially in those with moderate to severe depression, suggests the need for initiating systematic and routine screening for postpartum mental health problems. [ABSTRACT FROM AUTHOR]

Vitamin B12 and folate deficiency leads to accumulation of homocysteine that increases the risk of adverse pregnancy outcomes like preterm birth and low birth weight (LBW) of the neonate. We explored the association of genetic variants of key vitamin B12 and folate metabolising enzymes (MTHFR C677T and A1298C, MTR A2756G, TCN-2 C776G) with preterm birth and LBW in South Indian women. MTHFR A1298C heterozygotes (AC) were at higher risk for preterm delivery, whereas TCN-2 C776G heterozygotes (CG) were at higher risk for both preterm delivery and LBW. MTHFR C677T, A1298C and MTR A2756G haplotype CAG was protective for preterm delivery (p=.036, OR = 0.475; 95% CI: 0.233–0.97), whereas, haplotype CCG increasing the risk of preterm birth by 1.8 folds (p=.018, OR = 1.81; 95% CI: 1.09–2.98). These results underscore the significance of vitamin B12 and folate in the pathophysiology of preterm birth and LBW. What is already known on this subject? Polymorphisms of vitamin B12 and folate metabolising genes have been reported to influence preterm birth and LBW, but the reports are not consistent. What do the results of this study add? We observed a relationship of MTHFR A1298C and TCN-2 C776G with preterm birth, and significant association of TCN-2 C776G with LBW in infants. What are the implications of these findings for clinical practice and/or further research? Identification of women carrying these polymorphic risk alleles may benefit from early nutritional modifications. [ABSTRACT FROM AUTHOR]

Background: Schizophrenia and bipolar affective disorder (BPAD) have been identified as two severe mental disorders that are associated with a considerable amount of disability. These disorders create significant impairment in many aspects of an individual's life. Objective: This study was undertaken to compare the disability associated with schizophrenia and bipolar affective disorder (BPAD). Materials and Methods: A descriptive cross-sectional study was carried out among patients with a diagnosis of schizophrenia spectrum disorder (F20.0-F20.9) (n = 30) or BPAD (F30.0-F39) (n = 30) as per the International Classification of Diseases-10. The level of disability was assessed by the Indian Disability Evaluation and Assessment Scale. A semi-structured pro forma was used to assess the sociodemographic and clinical parameters. Results: The level of disability was mild in 17 (56.7%) subjects, moderate in 12 (40%) subjects among patients with BPAD. In Schizophrenia, 20 (66.7%) subjects had a mild disability and 10 (33.3%) had a moderate level of disability. The mean global disability score among patients with BPAD was significantly higher than in those with schizophrenia (7.57 + 2.84) versus 6.93 + 2.94, t = 0.846, P = 0.033. Conclusion: The level of disability among individuals diagnosed with BPAD was higher mostly related to self-care and work-related domain disability. [ABSTRACT FROM AUTHOR]

The article provides information on the management of psychiatric disorders during the perinatal period. Topics discussed include an overview of psychological conditions in the perinatal period, general approach to the patient in perinatal psychiatry, and risk benefit analysis of medications and management planning.

Background and Aims: Relapse is a major clinical concern in alcohol use disorders. The magnitude of the problem, poor access and availability of treatment, and changing social milieu placed India in a challenging position. This was a systematic review of Indian studies on rates and determinants of relapse to alcohol. Methods: Systematic search (January 1980-May 2020) was carried out on PubMed and Google Scholar to select studies that presented either rates or predictors (or both) to alcohol. Relapse was broadly defined based on the characterization in the included articles. We adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses standard for reporting systematic reviews. Results: Thirty-six studies were selected for the qualitative synthesis from the 68 studies. In the pooled sample of 2481 participants, the relapse rate ranged from 3.4% to 90%. The study duration varied from 1 to 36 months. Results suggested that the rates were overall higher in the observational than interventional studies and in studies from states with community prevalence of alcohol use >15% than in those <10%. There was significant heterogeneity among studies. Risk factors of relapse identified were demographic (e.g., younger age), psychological (e.g., craving), situational (e.g., peer influence), stressful life situations (e.g., financial problems), and family history of alcohol use. Conclusion: Relapse is likely in a substantial proportion of participants. Addressing the risk factors might help in delaying relapse. Future studies could concentrate on inclusive study design and robust methodology, to examine and understand the rates and risk factors of relapse. [ABSTRACT FROM AUTHOR]