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Electroconvulsive therapy (ECT) is considered relatively contraindicated in patients with intracranial space-occupying lesions. A 53-year-old male presented with a 5-year history of medication-refractory major depressive disorder. Brain imaging findings suggested the presence of a ruptured dermoid cyst in the transverse sinus and a calcified meningioma in the temporal lobe sulcal space. There was no evidence of mass effect. Neurofibromatosis was the only other clinical condition present. The patient had no clinical neurological deficits. Since the depression was severe and he was suicidal, ECT was advised. There was a substantial improvement after four bilateral and then eight right unilateral brief-pulse ECTs administered on alternate days, thrice weekly. There were no complications associated with ECT. The treatment gains were maintained with maintenance antidepressant medication at a 1-year follow-up. This is probably the first reported case of the use of ECT in a medication-refractory, severely depressed patient with a ruptured intracranial dermoid cyst and with a calcifying meningioma. The results testify to the safety of ECT even in high-risk patients.

Compulsive sexual behavior consists of sexual obsessions and compulsions that are recurrent, distressing, and interfere with daily functioning. It has been called hypersexual disorder in the upcoming diagnostic and statistical manual 5(th) edition. Though hypersexuality is commonly seen in mania, it can also be seen in depression and anxiety disorders. This case report describes a case that presented with depression and had underlying compulsive sexual behavior in the form of frottage.

Interpersonal violence whether it is sexual or nonsexual, remains a major problem in large parts of the world. Sexual violence against children and women brings with it long-term sequelae, both psychiatrically and socially. Apart from sexual gratification itself, sexual violence against women is often a result of unequal power equations both real and perceived between men and women and is also strongly influenced by cultural factors and values. Within sociocentric and ego-centric cultures, the roles and representations of genders, and attitudes toward sexual violence differ. Cultures which are described as feminist, provide equal power to both men and women. Sexual violence is likely to occur more commonly in cultures that foster beliefs of perceived male superiority and social and cultural inferiority of women. Although culture is an important factor to understand sexual violence in its entirety, we need to look at, as well as beyond cultural structures, their strengths and weaknesses.

Sikhism is a relatively young religion, with Guru Granth Sahib as its key religious text. This text describes emotions in everyday life, such as happiness, sadness, anger, hatred, and also more serious mental health issues such as depression and psychosis. There are references to the causation of these emotional disturbances and also ways to get out of them. We studied both the Gurumukhi version and the English translation of the Guru Granth Sahib to understand what it had to say about depression, its henomenology, and religious prescriptions for recovery. We discuss these descriptions in this paper and understand its meaning within the context of clinical depression. Such knowledge is important as explicit descriptions about depression and sadness can help encourage culturally appropriate assessment and treatment, as well as promote public health through education.

Attention deficit hyperactivity disorder is a developmental disorder with an age onset prior to 7 years. Children with ADHD have significantly lower ability to focus and sustain attention and also score higher on impulsivity and hyperactivity. Stimulants, such as methylphenidate, have remained the mainstay of ADHD treatment for decades with evidence supporting their use. However, recent years have seen emergence of newer drugs and drug delivery systems, like osmotic release oral systems and transdermal patches, to mention a few. The use of nonstimulant drugs like atomoxetine and various other drugs, such as α-agonists, and a few antidepressants, being used in an off-label manner, have added to the pharmacotherapy of ADHD. This review discusses current trends in drug therapy of ADHD and highlights the promise pharmacogenomics may hold in the future.

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 21 st century. We review the evidence and the existing literature.