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Background: Pandemics such as COVID-19 (with or without lockdown) can cause considerable stress to individuals, testing their coping resources. To contain the pandemic, there was a nationwide lockdown in India from March 25, 2020, severely limiting movement of the 1.3 billion population till the first relaxation came on April 21. This study was done in the 3rd week of April, just before relaxations were announced, to study the perceived stress, sources of stress, and coping strategies of adults during this core lockdown period in Kerala, India. Materials and Methods: We gathered data from 1073 adults using sociodemographic information, perceived stress scale, sources of stress checklist, and COVID-19 coping strategies scale. Correlation analyses, t-test, and one-way analysis of variance were employed for data analyses. Results: 65.7% of respondents scored high on the stress scale with 8.3% experiencing severe stress and 57.4% reporting moderate stress. Stress was negatively correlated with age, education level and income. Anxiety about the impact of the pandemic on the world and their own personal future were the main sources of stress. This was followed by financial worries, stress due to frustration of limited movement, and fear about contracting COVID. The five most common coping strategies used were increased hygiene, social distancing, increasing awareness about the disease, increased communication with family, and distraction through movies and books. Conclusion: During the core lock down period in April 2020 in India, there was high levels of stress among the people primarily due to the worry about the future impact of the pandemic as well due to the restrictions imposed.

Comorbidities are seen with obsessive-compulsive disorder (OCD) across the lifespan. Neurodevelopmental comorbidities are common in young children, followed by mood, anxiety, and obsessive-compulsive related disorders (OCRDs) in children, adolescents and adults, and neurological and degenerative disorders in the elderly. Understanding comorbidity prevalence and patterns has clinical and research implications. We conducted a systematic review and meta-analysis on comorbidities in OCD across the lifespan, with the objective to, first, estimate age-wise pattern and prevalence of comorbidities with OCD and, second, to examine associations of demographic (age at assessment, gender distribution) and clinical characteristics (age of onset, illness severity) with comorbidities. Four electronic databases (PubMed, EMBASE, SCOPUS, and PsycINFO) were searched using predefined search terms for articles published between 1979 and 2020. Eligible studies, across age, reported original findings on comorbidities and had an OCD sample size of ≥100. We excluded studies that did not use standardised diagnostic assessments, or that excluded patients on the basis of comorbidity. We adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The review protocol has been registered on the International Prospective Register of Systematic Reviews. A comorbidity rate of 69% was found in a pooled sample of more than 15,000 individuals. Mood disorders (major depressive disorder), anxiety disorders (generalised anxiety disorder), neurodevelopmental disorders (NDDs) and OCRDs were the commonest comorbidities. Anxiety disorders prevailed in children, mood disorders in adults, whereas NDDs were similarly prevalent. Higher comorbidity with any psychiatric illness, NDDs, and severe mental disorders was seen in males, vs. females. Illness severity was inversely associated with rates for panic disorder, tic disorders, OCRDs, obsessive compulsive personality disorder, and anorexia nervosa. This systematic review and meta-analysis provides base rates for comorbidities in OCD across the lifespan. This has implications for comprehensive clinical evaluation and management planning. The high variability in comorbidity rates suggests the need for quality, multi-centric, large studies, using prospective designs.Systematic Review Registration: Unique Identifier: CRD42020215904.

Background Employment is a significant stepping stone towards recovery for persons with severe mental illness. In the last two decades there has been increasing focus on obtaining professional courses and degrees for employment in India. Aim To understand the challenges faced by persons with severe mental illness with professional degrees in obtaining and maintaining employment. Methods We interviewed 31 individuals with severe mental illness, who had professional degrees, using qualitative interviews. These interviews explored factors that facilitated as well as those that hindered the process of obtaining and sustaining jobs. Results Factors that were identified as facilitators for obtaining and maintaining employment included personal strengths, social support, accommodative work environment, disclosure, support from mental health professionals and services. Factors that were identified as hindering for obtaining and maintaining employment included symptoms of the illness, side effects of medications, stigma, poor social support, academic underachievement, disjointed work history, poor workplace environment and specific cultural, gender issues. Conclusion Factors such as workplace accommodations, creating an environment that is permissive of disclosure, using family support and support from mental health professionals will facilitate employment. Addressing factors that hinder such as stigma, academic under-achievement, improving workplace environments, social support will also be important in vocational recovery.