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Background: The COVID-19 pandemic has been associated with multiple psychiatric problems in the general population as well as in those admitted with the infection. Studies done so far have mainly focused on the general population. It is important to address the needs and gaps in mental and psychological aspect of health of patients admitted with the infection to improve their overall prognosis. This study was undertaken with the aim to study the pattern of psychiatric referrals of hospitalized COVID-19 patients and to find out if there is any association between their socio-demographics, severity of COVID-19 infection, inflammatory markers, and co-morbidities. Materials and Methods: A descriptive, retrospective chart analysis of the record of 160 psychiatry referrals for COVID-19 patients seen by the on-call psychiatrist from May 2020 to October 2020 in a tertiary care hospital was undertaken. Sociodemographic data, severity of COVID-19 infection, blood investigation reports, psychiatric symptoms, diagnosis and management were recorded, tabulated, and analyzed using SPSS 20. Results: Referrals were more for individuals having moderate-to-severe COVID-19 infection, in elderly patients and in males. The most common reason for referral was disorientation (27.5%) and insomnia (27.5%), followed by the patient having a preexisting psychiatric illness (15%). The most common psychiatric diagnosis was delirium secondary to general medical condition, (28%), followed by anxiety and depressive spectrum disorders (23.75%). 32.5% of the patients referred had a past history of psychiatric illness, the most common being substance use disorder, followed by major depressive disorder and mixed anxiety depression. With the increase in the age of the individuals, the number of referrals for males was significantly more as compared to females (P = 0.00). No statistically significant association was found between age (P = 0.83), gender (P = 0.99), and psychiatric diagnosis. No significant association was found between the severity of COVID-19 and psychiatric diagnosis (P = 0.69). Conclusion: It is essential to screen for psychiatric disorders in patients admitted for COVID, as it goes a long way in reducing the overall morbidity and improves patient cooperation for various procedures which could be life-saving.

Background: As a prerequisite to start a medical practice in India, Foreign Medical graduates on returning have to sit for FMGE (Foreign Medical Graduate’s Exam), organized by NBE. The time and effort involved by the students with adjustments to various changes in educational and examination pattern may manifest as psychiatric morbidities while awaiting a positive outcome. Aim: To evaluate depression, anxiety, stress, and insomnia in Foreign Medical Graduate students and to understand the various factors associated with them. Materials and Methods: A total of 80 MBBS students appearing for FMGE were enrolled during the period of April 2023 to May 2023, after obtaining their written consent on the Google form to participate in this study. The participants answered a semi-structured proforma consisting of information about sociodemographic data, DASS-21 (depression, anxiety, and stress severity scale), ISI scale (insomnia severity index), and RSES (Rosenberg self-esteem scale). Results: In this study, 76.2%, 80%, 72.5%, and 78.8% of students were found to be suffering from depression, anxiety, stress, and insomnia, respectively. A significant statistical correlation was found between anxiety and the students appearing for July FMGE 2023. Stress and depression were associated with insecurities/comparisons faced by the participants due to peers clearing the examination before them. Low self-esteem was associated with 3 or more failed attempts for FMGE and the presence of other stressors preceding/concurrent while preparing for FMGE. Clinical insomnia was found to be statistically significant with depression, anxiety as well as stress in this study. Multiple regression analysis showed that stress and anxiety predicted depression while the young age of the student, low socioeconomic status, low self-esteem, stress, and depression predicted anxiety. Stress was found to be associated with anxiety, depression, and insomnia. Insomnia was corelated with having extension in the UG course and stress while low self-esteem was corelated with students who were attempting for the July 2023 examination and anxiety. Conclusion: The significantly high proportion of psychiatric morbidities among Foreign Medical Graduates is suggestive of the need for the necessary psychological aid and counseling as these foreign medical graduates can be viewed as an opportunity to correct India’s physician shortage.

Background: Violence in psychiatric patients is a major concern to both public and mental health professionals. Risk of violence (ROV) in patients can cause a high degree of psychological stress on caregivers that may predispose them to various psychological problems. Aim: To estimate the ROV in patients with severe mental illness and to estimate the relationship between the ROV among severely mentally ill and the psychiatric morbidity in their primary caregivers. Methods: A cross-sectional study was conducted at a tertiary care center involving 308 patient subjects and their caregivers. Socio-demographic data were collected using a proforma, and caregivers were diagnosed based on the International Classification of Diseases-10 using Mini International Neuropsychiatric Interview (MINI)-Plus. ROV was assessed using Historical Clinical Risk Management (HCR)-20, Version 3. Statistical analysis was done using the Chi-square test for association and odds ratio and its 95% confidence interval for the strength of association. Results: High ROV was found in 32.5% of the severely mentally ill. Caregivers reported a high rate of psychiatric disorders (44.8%), of which 71.7% were mood disorders. A significant association was found between ROV in patients and psychiatric morbidity in their caregivers (p = 0.001). Conclusion: ROV is high among the severely mentally ill. There is a high rate of psychiatric morbidity among caregivers of patients with a high ROV. There is a significant association between psychiatric morbidity in caregivers and ROV in patients.

Introduction: Everyone has a fundamental right to enjoy the best possible level of physical and mental health, irrespective of race or gender. The incarcerated are taken away from their friends and relatives, regardless of their mental state. There is a high prevalence of mental illness among male and female prisoners, as per various studies. The aim of the study is to assess the prevalence of psychiatric morbidity among prisoners without a past history of psychiatric illnesses, to determine the association of socio-demographic factors, and to assess the prevalence of various psychiatric disorders in this population. Methods: A cross-sectional study was conducted on 200 male prisoners by simple random sampling. The assessment was done using a self-prepared socio-demographic proforma and Mini International Neuropsychiatric Interview. Result: The prevalence of any psychiatric morbidity was observed to be 86%, and the most commonly seen morbidity was substance use disorder (81%), followed by adjustment disorders (20%), and 96% had a low risk for suicide. There was almost equal representation of age groups: 74% of prisoners were married or widowed, 90% belonged to rural residences, 75% of the participants had secondary education or below, almost 95% were below poverty line, and 92% were employed previously. Conclusion: In our study, we found that the most common reason for imprisonment was murder and other causes like abkari, family law related, as well as political issues. Almost 12% and 18% reported crime in the family and crime by peers. The most commonly seen morbidity was substance use disorder (81%), followed by adjustment disorders (20%). Around 96% had a low risk for suicide.

Abstract Purpose Research suggests that women in prison have more mental health problems than men and are prone to suffer from more severe psychiatric disorders. This study utilizes national registry data to describe demographic and psychiatric gender differences in Norwegian prisons, and to investigate comorbid psychiatric disorders and time trends in psychiatric morbidity among women. Methods Longitudinal data from the Norwegian Prison Release Study linked with the Norwegian Patient Registry and data from Statistics Norway provided information on health care utilization, socioeconomic status, and history of psychiatric disorders among all individuals (nwomen = 5,429; nmen = 45,432) who were incarcerated in a Norwegian prison between 2010 and 2019. Results Women were more likely than men to have a history of any psychiatric disorder (75% vs. 59%). Substance use disorders and dual disorders were highly prevalent in both genders, yet highest among women (56 and 38% respectively, versus 43 and 24% among men). From 2010 to 2019, we found a considerable increase in the 12-month prevalence of most diagnostic categories among women entering prison. Conclusion Psychiatric and dual disorders are highly prevalent in Norwegian prisons, and especially among women. The proportion of women entering prison with a recent history of mental health problems has increased rapidly over the last decade. Women’s prison institutions need to adjust health and social services, and awareness about substance use and other psychiatric disorders in order to meet the increasing proportion of women facing these challenges.

Background: Breast cancer causes a wide range of physical and psychological issues. Breast cancer treatment affects woman's body image and sexuality which can impact psychological well-being and quality of life (QOL). Aims: This study aimed to assess body image concern among breast cancer patients and to compare it with healthy women and to assess QOL and psychological reaction among breast cancer patients. Settings and Design: This was a comparative cross-sectional study, conducted at a tertiary care hospital on breast cancer patients compared to age-matched healthy women taken as controls. Materials and Methods: Data were collected using a semi-structured questionnaire, Body Image Scale, European Organization for Research and Treatment of Cancer Breast Cancer-Specific QOL Questionnaire, Hamilton Anxiety Rating Scale, and Hamilton Depression Rating Scale. Statistical Analysis Used: Data were analyzed with Epi Info 7. Mean and standard deviation for continuous variables and percentages and Chi-square test for categorical variables were used. P < 0.05 was considered statistically significant. Results: Breast cancer patients were having high body image concern as compared to healthy women. On QOL assessment, scores of body image and future perspective were comparatively low-low level of functioning and scores were high for breast symptoms and hair loss-high level of symptomatology. More patients had significant anxiety and depressive symptoms. Conclusions: Breast cancer patients were having high body image concern and poor QOL as compared to age-matched healthy women, associated with significant depression and anxiety.

Aim: This study aims to evaluate the prevalence of psychiatric morbidity and suicidal behavior by using a structured diagnostic interview in patients of chronic kidney disease currently on dialysis. An additional aim of the study was to evaluate the impact of psychiatric morbidity on quality of life (QOL). Methodology: One hundred and ten patients undergoing hemodialysis were evaluated, at least 24 h after the last dialysis on Mini International Neuropsychiatric Interview PLUS (MINI PLUS), Columbia Suicide Severity Rating Scale (C-SSRS), and Beck Depression Inventory Second Edition. Results: On MINI-PLUS, about two-thirds (67.3%) of the study sample fulfilled at least one-lifetime psychiatric diagnosis and half of the study participants fulfilled a current psychiatric diagnosis. More than one-fourth (29.1%) of the study participants had more than one psychiatric diagnosis. Among various psychiatric disorders, depressive disorders were the most common (45.5%). About one-third of the participants had suicidality, as assessed on MINI-PLUS and C-SSRS. Compared to those without psychiatric morbidity, those with psychiatric morbidity had a poor QOL. Conclusions: In view of the high psychiatric morbidity and its negative impact on the QOL of patients undergoing hemodialysis, there is a need for close liaison between nephrologists, transplant surgeons and mental health professionals.

Aim and objective: To study the psychiatric morbidity among transgender population. Materials and methods: A cross-sectional study was done using convenience sampling. Sixty consenting transgenders, fulfilling criteria for gender dysphoria based on DSM-5 criteria, were included. The study was done for a period of 18 months. Tools used: For assessing the sociodemographic profile, semi-structured pro forma was used, and for assessing psychiatric morbidities, Mini International Neuropsychiatric Interview (MINI)-plus scale was used. Results: Among 60 participants, 36 (76.6%) had psychiatric morbidity, of which 16 (26.7%) had substance-use disorder, 10 (16.7%) among them had alcohol dependence, and 6 (10%) had nonalcoholic substance-use disorders, such as cannabis, benzodiazepines, and cocaine. Ten (16.7%) participants qualified for the diagnosis of depressive disorder among which six (10%) had mild depression and four (6.7%) had moderate depression. Dysthymia was present in four (6.6%) individuals. Eleven (18.3%) participants had adjustment disorder. Three (5%) of them had anxiety disorder and two (3.3%) had insomnia. Conclusion: Substance use and depression were found to be the most common psychiatric disorders among this population followed by adjustment disorders. As this population is at higher risk of developing other psychiatric problems, regular screening and timely intervention are needed to prevent or treat their psychiatric comorbidities. Clinical significance: The study highlights that there are various psychiatric morbidities prevalent among transgender population, mainly due to the various life adversities they face, which points toward encouraging and creating awareness toward the need for reducing discrimination and accepting the transgender persons in the families, friends, and the community groups which will help them in mainstreaming, achieve welfare, and reduce their psychosocial problems. The findings of this study may help to inform the development of appropriately targeted and tailored mental health interventions and resilience-building programs for transgender population.

Context: Gender is an important factor in determining mental health and mental disease. Women are particularly vulnerable to mental health disorders due to a lack of family support, stigma surrounding mental illness, separation, emotional stress, financial dependency, domestic violence, sexual assault, and human trafficking. Destitute or homeless women have a disproportionately high risk of mental illness. Aims: To determine the prevalence of psychiatric illness and related psychosocial determinants among inmates of a state-run home for women. Settings and Design: This is a single-center, cross-sectional descriptive study. Inmates of a state home for women in the northern part of Karnataka who met the inclusion and exclusion criteria were recruited. Materials and Methods: Eighty participants were evaluated using semi-structured proforma for psycho-social aspects. MINI-PLUS version 5.0 was used to screen the inmates for psychiatric morbidity and the diagnosis was confirmed using the International Classification of Diseases-10. Appropriate statistical tools were applied for the analysis. Results: Majority of the participants (78.75%) were diagnosed to have some psychiatric illness. The most common psychiatric morbidity was psychosis (35%), followed by affective disorders such as major depressive disorder (15%), bipolar disorders (10%), somatization disorders (7.5%), dysthymia (6.5%), and anxiety disorder (5%). Some of the psychosocial factors assessed, namely, marital status, employment status, and poor family support were significantly associated with psychiatric morbidity. Conclusion: This research focuses on psychiatric morbidity, overall clinical profile, and the impact of numerous psychosocial factors on mental health in this vulnerable population. To enhance the general mental health of such a vulnerable group, better policymaking, timely psychiatric interventions, and rehabilitation are required.

Abstract Background The number of people seeking gender reassignment (GR) has increased everywhere and these increases particularly concern adolescents and emerging adults with female sex. It is not known whether the psychiatric needs of this population have changed alongside the demographic changes. Methods A register-based follow-up study of individuals who contacted the nationally centralized gender identity services (GIS) in Finland in 1996–2019 (gender dysphoria [GD] group, n = 3665), and 8:1 age and sex-matched population controls (n = 29,292). The year of contacting the GIS was categorized to 5-year intervals (index periods). Psychiatric needs were assessed by specialist-level psychiatric treatment contacts in the Finnish Care Register for Hospital Care in 1994–2019. Results The GD group had received many times more specialist-level psychiatric treatment both before and after contacting specialized GIS than had their matched controls. A marked increase over time in psychiatric needs was observed. Among the GD group, relative risk for psychiatric needs after contacting GIS increased from 3.3 among those with the first appointment in GIS during 1996–2000 to 4.6 when the first appointment in GIS was in 2016–2019. When index period and psychiatric treatment before contacting GIS were accounted for, GR patients who had and who had not proceeded to medical GR had an equal risk compared to controls of needing subsequent psychiatric treatment. Conclusion Contacting specialized GIS is on the increase and occurs at ever younger ages and with more psychiatric needs. Manifold psychiatric needs persist regardless of medical GR.

BackgroundMental health has become a public health concern worldwide, and the number of affected individuals is rising. Therefore, further research must be conducted to identify potential risk factors to develop optimal prevention strategies to mitigate mental health disorders.MethodsUsing Taiwanese Nutrition and Health Survey data collected from 2013–2016, we conducted a cross-sectional study to examine whether adherence to the Taiwan Daily Food Guide affects mental health conditions. Study participants were adults aged ≥19 years. The dietary assessment was conducted using a validated food frequency questionnaire. The presence of psychiatric morbidity was defined as a five-item Brief Symptom Rating Scale (BSRS-5) score of ≥10. Logistic regression models were used to determine whether Taiwan Daily Food Guide adherence was related to the presence of psychiatric morbidity.ResultsAfter adjusting for potential confounders, we observed protective associations between adherence to the Taiwan Daily Food Guide and psychiatric morbidity risk.ConclusionThe Taiwan Daily Food Guide might reduce the risk associated with psychiatric morbidity and could be a reference for developing a national food guide for mental health.

Abstract Background Seasonal Affective Disorder is a recurrent depressive disorder which usually begins in the fall/winter and enters into remission in the spring/summer, although in some cases may occur in the summer with remission in the autumn-winter. In this study the authors evaluated the association between seasonal changes in mood and behavior with psychiatric disturbance. Method Descriptive, cross-sectional study. Participants, students attending higher education and vocational courses (N = 324), were evaluated with the Seasonal Pattern Assessment Questionnaire (SPAQ) and the Screening Scale for Mental Health (ER80). Results Among the respondents, 12.7% showed seasonal affective disorder (SAD), 29.0% showed subsyndromal seasonal affective disorder (s-SAD) and 58.3% did not show significant seasonal affective symptomatology. As for psychiatric morbidity, 36.6% of subjects with SAD and 13.8% of those with s-SAD were considered “psychiatric cases” whereas for subjects without SAD this value was only 3.2%. Conclusions There is a statistically significant association between psychiatric morbidity and seasonal affective disorder. This association corroborates the importance of the Seasonal Pattern Assessment Questionnaire in screening for seasonal fluctuations in mood and behavior related disorders, and the clinical need for recognition of these conditions, particularly associated suffering and disabilities.

Abstract Background The coronavirus disease 2019 (COVID-19) is influencing all segments of society, including youth. Although the physical complaints in the time of COVID-19 are broadly-studied, a paucity of research targeted psychological ones on the precious youth population. This study aimed to describe the real-time state of Egyptian youth’s psychiatric morbidity, dietary changes, and coping methods during this pandemic and explore probable factors influencing them. A descriptive cross-sectional study was conducted using an online survey among 447 Egyptian participants aged 14–24 years. Sociodemographic data, dietary habits, and coping methods during COVID-19 were collected. The Arabic versions of the Patient Health Questionnaire (PHQ-9), the Generalized Anxiety Disorder Scale (GAD-7), and the Insomnia Severity Index (ISI) were used to assess depression, anxiety and insomnia, respectively. Results Overall, 80.5%, 74.0%, and 73.8% of the participants had different grades of depression, anxiety, and insomnia symptoms. 37.4% gained weight. Emotional and night eating emerged as new habits during the pandemic among 17.9% and 29.3% of the participants, respectively. Each of depression, anxiety, and insomnia was significantly associated with each other, female gender and having a COVID-19 infected relative. Adolescents had significantly higher scores of depression and anxiety. Those with a history of physical illness had significantly higher scores of anxiety and insomnia. Bodyweight and dietary changes were significantly associated with depression, anxiety, and insomnia. Participants reported various positive and negative coping methods. Conclusion Psychiatric morbidity and dietary changes are evident in young people during COVID-19 pandemic. Psychological well-being and dietary habits are important but often overlooked components of youth well-being especially in challenging times. Depression, anxiety, and insomnia were almost always present and dietary changes were significantly associated with the presence of them.

Introduction: Psychiatric illnesses such as bipolar affective disorder, major depressive disorder, schizophrenia, and dementia can cause significant burden to patient as well as family members. About 14% of the global burden of disease is attributed to neuropsychiatric disorders. Half of the patients with psychiatric illness reported disability in all three domains of work, social, and family life. Aims: (1) To study if caring for patients with major psychiatric illness will lead to significant caregiver's burden. (2) To find the association between caregiver's burden and psychiatric morbidity among the caregivers. Materials and Methods: It is a cross-sectional study conducted at a tertiary care teaching hospital after obtaining institutional ethical clearance. One hundred caregivers of outpatients diagnosed with major psychiatric illness including schizophrenia, bipolar affective disorder, dementia, and major depressive disorder for a period not

Background: Suicide is a major public health concern and is considered one of the leading causes of death globally. Previous suicidal attempts can be considered as a predictor of underlying psychiatric illness. Identifying factors behind suicidal attempt can help mental health professionals for early diagnosis and treatment as well as designing effective suicide prevention strategies. Aim: The aim of the study is to assess sociodemographic, clinical characteristics, and prevalence of psychiatric morbidities among patients with attempted suicide. Methods: A cross-sectional study was conducted in the emergency department of tertiary care hospital; patients of attempted suicide attending emergency from January 1, 2014, to January 1, 2020, constituted the sample for the study. Data were collected using semi-structured questionnaire which contained sociodemographic and clinical variables. All the subjects were administered mini-international neuropsychiatric interview (MINI), MINI Kid was applied for subjects

Background: Mental disorders are among the strongest predictors of suicide attempts. However, little is known regarding which disorders that is uniquely associated with suicidal behavior because of high levels of psychiatric co-morbidity. The present study was planned to undertake on suicidal intent in such deliberate self-harm patients. Aims: The aim is to determine the suicidal intent and to assess the relationship with psychiatric morbidity in patients of deliberate self-harm Settings: Patients of deliberate self-harm. Design: Cross-sectional study. Materials and Methods: The sample consisted of 50 patients of deliberate self-harm admitted during study period of 6 months in appropriate in-patient unit for observation and necessary intervention, who fulfils inclusion criteria. A semi structured pro forma was used for collection of socio-demographic data, case history and Beck's Suicide intent scale was used which is designed to assess the severity of intention to die associated with an episode of deliberate self-harm. Statistical Analysis Used: Descriptive statistics such as mean, standard deviation, and percentage was used to present the data. To assess the relationship between the suicidal intent and psychiatric morbidity, Chi-square test was used. A P < 0.05 were considered significant. Data analysis was performed using software SPSS v20.0. Results: Self poisoning (80%) was found to be the most common method employed in deliberate self-harm. 74% of the deliberate self-harm attempts were impulsive in nature. Altercation with the spouse (30%) was the most common precipitating factor. Psychiatric morbidity was found to be associated with suicidal intent (P = 0.0068). Conclusions: In conclusion, even with low intent to harm self we have to be careful while examining the patients of psychiatric morbidity. They are at risk of attempting harm to self. We cannot ignore the patients just on the basis of low intent to harm self.

Abstract Background Residential mobility during childhood increases risk of psychopathology in adulthood and is a common experience among Chinese children. This study investigated associations between number and age of first move, etiological risk factors for psychopathology, and common mental disorders in adolescence and early adulthood. Methods The sample included 39,531 undergraduates (84.5% completion rate) age 15–34 years in their first year at a Chinese comprehensive university in annual cross-sectional surveys during 2014–2018. Common mental disorders measured using standardised self-report instruments. Data analysed using logistic regression models and interaction analysis. Results Half of all students experienced one or more moves of residence before age 15 years. Outcomes of Depression, Somatisation, Obsessive-compulsive disorder, Hallucinations and Delusions, and Suicide attempts showed dose-response relationships with increasing number of moves. Other etiological risk factors, including childhood disadvantage and maltreatment, showed similar dose response relationships but did not confound associations with mobility. We found interactions between reporting any move and being a left-behind child on depression and somatisation; number of moves and younger age at first move on depression, somatisation, suicide attempts and hallucinations and delusions. Conclusions Residential mobility in childhood is associated with psychopathology in adulthood and this association increases with increasing number of moves. Mobility is also associated with childhood disadvantage and maltreatment but associations with psychopathology are independent of these factors. Multiplicative effects were shown for multiple moves starting at a younger age and if the participant had been a left-behind child.

Background: Individuals with permanent orthopedic disability present with a number of physical and mental health issues. Psychiatric illnesses have been seen more frequently among people with disabilities as compared to normal population. Aim: To study psychiatric morbidity among people with permanent orthopedic disability. Materials and Methods: This cross-sectional, observational, hospital-based study was conducted at the department of psychiatry of a tertiary care hospital attached to a medical college during January 01, 2018, to December 31, 2018. The study included subjects over the age of 18 years comprising two groups: Group A (n = 50) including consecutive subjects with orthopedic disability and Group B (n = 50) including normal age- and sex-matched controls. Permission was obtained from the institutional ethics committee before the start of the study. Prior informed consent was obtained from all subjects. Sociodemographic variables were recorded, and psychiatric morbidity was screened on Mini International Neuropsychiatric Interview. Results: 62% (n = 31) of subjects in Group A had psychiatric morbidity as compared to Group B (22%, n = 11). Maximum psychiatric morbidity noted among subjects with disability was generalized anxiety disorder (22%, n = 11), followed by major depressive disorder (20%, n = 10) and alcohol dependence (18%, n = 9). Substance dependence was more in Group A (34%, n = 17) as compared to Group B (18%, n = 9). The most common substance dependence was for alcohol (18%, n = 9), followed by opioids (8%, n = 4) and tobacco (6%, n = 3). Conclusion: Psychiatric morbidity including substance dependence is more common among people with orthopedic disability as compared to normal control subjects.

Background: Caregivers of children with thalassemia major experience higher caregiver burden and psychiatric morbidity. Aims: The aims of this study were as follows: (1) to assess the caregiver burden and psychiatric morbidity among caregivers of children with thalassemia major and (2) correlation between caregiver burden and psychiatric morbidity. Settings and Design: This was an observational, cross-sectional study carried out at the tertiary care hospital setup among 245 caregivers of children with thalassemia major. Subjects and Methods: Sociodemographic details of children and their caregivers and clinical variables of children were obtained. The Caregiver Burden Scale and General Health Questionnaire (GHQ)-12 were applied. Psychiatric diagnosis was made after clinical interview as per the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Statistical Analysis Used: Chi-square test, t-test, analysis of variance, and Pearson coefficient correlation were used for statistical analysis. Results: 33.06% were having severe burden, 30.61% moderate-to-severe burden, 27.34% mild-to-moderate burden, and 8.97% were having little or no burden. 13.46% of caregivers had psychiatric illness, out of which 8.57% had major depressive disorder, 4.08% generalized anxiety disorder, and 0.8% alcohol use disorder. “Weakly positive correlation” (P = 0.0284) was found between GHQ score and burden score. Conclusions: Higher caregiver burden and presence of psychiatric morbidity among caregivers of thalassemia children suggest that caregivers should be screened at regular intervals for early detection and management of psychiatric morbidity. Social and professional networks for psychosocial support and self-help groups should be planned for caregiver burden.

Background: The high occurrence of psychiatric disorders amongst adolescents within the Juvenile Justice System (JJS) has been confirmed. Most of the available data are from developed countries and some of them focus on just a single psychiatric disorder which may not be representative of the situation in low-income countries, hence the need for more studies in developing countries, including Nigeria. Aim: The study aimed to determine the prevalence of psychiatric disorders amongst adolescent residents of a correctional facility. Setting: The study was carried out at a Borstal Institution in North-Central Nigeria. Methods: A descriptive cross-sectional study design was used. One hundred and twenty adolescents were assessed using the socio-demographic pro forma questionnaire designed by the researcher and the Kiddies Schedule for Affective Disorders and Schizophrenia (KSADS-PL). Data were analysed using EPI-INFO 4.06 d version 6.04 software. Results: A total of 62.5% of the male respondents were older than 15 years. The percentage of respondents with a psychiatric disorder was 82.5%. The rate of psychiatric disorders was high with disruptive behaviour disorders being the most common at 40.8%, others were substance use disorders (15.8%), anxiety disorders (14.2%), psychosis (6.7%) and mood disorders (5%). Conclusion: This study has established a high prevalence rate of psychiatric disorders amongst incarcerated adolescents. This is in line with the findings of numerous studies worldwide. This study has identified the need to increase awareness and knowledge about the high morbidity of mental disorders in growing juvenile detainee populations. This will allow early identification of adolescents at risk of psychiatric disorders and ensure efficient resource distribution of both JJS service and mental healthcare. Effective and appropriate interventions have shown to improve overall health, quality of life and reduce the rate of recidivism amongst incarcerated juveniles.

Background: The undeniable impact of the COVID-19 pandemic on the educational sector has left the students perplexed and uncertain. Infection-related fears, inevitable loneliness, disturbed routine making way for adverse lifestyle habits, stressors such as financial crisis faced by their families, and many more further accentuate their vulnerability to mental health issues. Aim: The aim was to assess the knowledge, attitude, and behavior of medical undergraduate students about the COVID-19 outbreak, and to assess their stress, anxiety, depression, and quality of life (QOL). The study also explored the correlation between the knowledge, attitude, and behavior of the medical undergraduate students about the pandemic and their mental health issues. Materials and Methods: An online questionnaire-based survey was carried out on medical undergraduate students. The survey tool comprised a semi-structured proforma; General Health Questionnaire-12 items; Depression, Anxiety, and Stress scale-21 items; and European Health Interview Survey-Quality of Life-8 items. Results: Nearly 61.8% of the students seemed well read and had good knowledge about the medical aspects of the pressing issue of COVID-19, and majority of the students had adaptive attitudes and behaviors toward the pandemic. Almost 23.2% of the students had depression, 20.7% had anxiety, and 13.0% had stress ranging from mild to extremely severe. Nearly 75.1% of the students experienced changes in appetite and 53.6% had changes in appetite. Nearly half of the students expressed excessive worries regarding studies. The mean score of QOL of students was 3.9 ± 0.6. Students with adaptive attitudes and behavior experienced relatively less severe depression, anxiety, and stress compared to their counterparts. Conclusion: A significant portion of the medical undergraduates are experiencing mental health issues and study related concerns due to the adversity brought by the pandemic. The concerned educational bodies and institutes must take up necessary steps to mitigate the adverse effects of the pandemic on students.

Background: Adverse psychological effect of pandemic includes not only increased levels of stress, anxiety, and depression but also cyberchondria - the problematic online health research behavior. It is thought that the distress and uncertainty of pandemic clubbed with information overload and its ambiguity have paved the way for cyberchondria. Students being the vulnerable population, the present study was an effort at understanding cyberchondria in students. Aim: The aim of the study is to assess cyberchondria and its association with depression, anxiety, stress, and quality of life (QOL) in dental students during the pandemic. Materials and Methods: An online questionnaire-based survey was carried out on dental students. The survey tool comprised a semi-structured pro forma, General Health Questionnaire-12, Depression Anxiety and Stress Scale 21, Cyberchondria Severity Scale 15, and European Health Interview Survey QOL 8. Results: The study revealed that 98.7% of the students were affected by one of the constructs of cyberchondria, viz., “excessiveness” (93.7%), followed by “distress” (84.3%) and “reassurance”-seeking behavior (83.7%). Cyberchondria affected girls more than boys and shared robust positive correlation with depression, anxiety, and stress but not QOL. Factors such as stress, anxiety, QOL, and changes in appetite were associated with higher severity of depression. Family financial losses, preexisting psychiatric illness, and media adverse effect shared robust positive associations with severity of depression, anxiety, and stress and an inverse association with QOL. 76.0% of the students expressed excessive worries regarding missing out on clinical exposure, and nearly half of the students were dissatisfied with eLearning. 78.3% of the students experienced changes in sleep; 68.7% had changes in appetite; and 89.0% reported reduction in the level of physical activity. Conclusion: Cyberchondria is affecting the large majority of students. Educational institutions must put efforts to sensitize students about cyberchondria.

Background: Children of alcoholics (COAs), particularly experience life uniquely in the families of alcoholic parents. They are more likely than others to suffer from various physical, emotional, and mental health problems. Aims: The aim of this study is to estimate the prevalence of psychiatric morbidity among the children of alcohol-dependent patients attending our tertiary health care center, and further determine the association between clinical-sociodemographic background and psychiatric morbidities among these children. Methods: It was a cross-sectional study consisting of 100 COAs. Data collections tools used were: Pro forma for sociodemographic details, the Kiddie – Schedule for Affective Disorders and Schizophrenia for school-aged children (6–18 years) Present and Lifetime version (K-SADS PL), Learning Disability Checklist and Wechsler's Intelligence Scale for Children. The data were entered using statistical software Epi-Info (version 3.7.2.1) software package, analyzed using the SPSS software version 24.0. Results: About 60% of COAs assessed had the presence of psychiatric morbidity, with anxiety spectrum and depressive disorders being the most commonly associated diagnosis. It was noted that female gender had a positive association with anxiety spectrum disorders. Further, a history of child abuse had a positive association with evidence of psychiatric morbidity in these children. In addition, family history of antisocial personality traits had a significant association with conduct disorder in COAs. Conclusions: To conclude, psychiatric morbidities were identified in about 60% of children whose fathers were alcohol dependent. These COA's commonly manifested with two major psychiatric morbidities, namely anxiety and depression. Nearly 1/10th of these children were noted to have substance use as well.

Background: Hematopoietic stem cell transplantation (HSCT) is an established treatment for a number of malignancies. Quality of life (QOL) is an important marker for assessing arduous treatment modalities. Diagnosis of cancer, HSCT, and the physical and psychosocial sequelae of the intensive treatment lead to a deficit in the QOL of the recipient. This study aimed to assess the impact of HSCT on psychiatric morbidity and QOL in patients with hematological malignancies. Methods: A longitudinal pre-post study was conducted at a cancer research center. Thirty patients with hematological malignancies were assessed at three different time points for psychiatric symptoms and QOL. Sociodemographic and clinical variables were collected using a semi-structured questionnaire. Comprehensive psychopathological rating scale was used to assess the psychiatric symptoms. WHO QOL Bref and cancer-specific European Organisation for Research and Treatment of Cancer Quality of life Questionnaire (EORTC-QLQ) were used to measure the quality of life.Results: The mean (SD) age of the sample was 42.3 (12.8) years, with 24 males and 6 females. Most patients reported anxiety and depressive symptoms, reaching a peak at 3 week post-HSCT. The maximum deficit in QOL scores was seen at 3 weeks, with further improvement at 3-month post-transplant. Conclusions: HSCT leads to an increase in symptoms and a decrease in QOL during the acute phase. In the long run, it leads to improvement in physical and psychological wellbeing, with improvement in QOL. The recent surge in the long-term survivors of the procedure calls for further research in this direction so as to aid in their full recovery.

Abstract Background Rhinoplasty is one of the most common cosmetic surgeries performed on the face; seeking this operation can be influenced by socio-cultural factors, personality factors, and psychiatric morbidity. The purpose of this study is to identify the prevalence and profile of psychiatric morbidities that would present among those individuals seeking rhinoplasty and to recognize the importance of preoperative psychiatric assessment. Results 50.8% of the study sample fulfilled the DSM-IV criteria for Axis I and Axis II psychiatric disorders. The most prevalent diagnosis among the whole group was mixed personality disorder (15.2%) followed by body dysmorphic disorder (10.2%), borderline personality disorder (6.8%), and then anxiety disorders (5%). Data revealed that female non-married subjects who were performed with a previous cosmetic operation suffered significantly from psychiatric morbidity. Subjects with psychiatric morbidity showed significant (P, 0.000) higher scores in MBSRQ health orientation and weight preoccupation than their non-psychiatric counterparts. Conclusion This study demonstrated a high prevalence of psychiatry morbidity in individuals requesting rhinoplasty. It seems important to screen individuals for mental health problems preoperatively to detect crucial psychiatric problems; thus, we can avoid subsequent risk for both individuals and cosmetic surgeons.

Abstract Background Living donor liver transplantation is an effective line of therapy for patients with end-stage liver disease. While there are various psychiatric complications that affect donors, only a few studies investigated such complications among Egyptian living donors. Results The study showed psychiatric morbidity in 15% of donors, especially anxiety disorders and major depression. Donors had high mean scores on psychoticism, neuroticism, impulsivity, and extraversion subscales of the EPQ. Female gender, younger age group, low educational level, managerial work, being the sibs of the recipients, and obtaining high scores in the EPQ were found to be independent risk factors correlated with the development of psychiatric morbidity in liver donors. Conclusion The increased frequency of psychiatric morbidity among liver donors raises the need for thorough pre- and postoperative psychiatric assessment and monitoring. It is mandatory to investigate the donors’ personality traits preoperatively to assess the decision-making process for donation and postoperatively to plan appropriate protective and treatment programs.

Introduction The Nigerian tertiary education system admits mostly teenagers and young adults from different ethno-religious and family backgrounds, some of whom may have inherent risks and predisposition to mental illness. They then undergo stressful conditions related to the university life such as long durations of lectures, over-crowding, and lack of social amenities, haphazard lecture schedules as well as incessant industrial strike actions of academic and non- academic staff. In spite of these, there appears to be few studies on the burden of emotional and mental disorders among Nigerian University students, and none was cited suggesting interventions that may be appropriate. Objectives The objectives of the study is to determine the prevalence of psychiatric morbidity and its associated factors among undergraduate students of Univesity of Ilorin Methods This is a cross-sectional study using multi staged systematic randomization. A self-administered socidemographic questionnaire and the 12 item general health questionnaire (GHQ -12) was administered on 3,300 students. Results Psychiatric morbidity was found to be 23.6% of the 3179 analyzable returned questionnaires. Factors found to be significantly associated with psychiatric morbidity included female gender, relationship with parents, parental employment status and family structure. Students on scholarship were more likely to have mental illness. Other associated factors include whether course of study was the preferred one and relationships with peers and lecturers on campus. About 46.6% of the students were willing to have internet based mental health intervention programmes. Conclusions The data obtained from this study is relevant for the formation of mental health promotion and prevention programs on our campus. Disclosure this study is part of the first phase of a three phase study. it aims to explore the factors associated with psychiatric morbidity among University student as a precursor for determining appropriate mental health interventions. it was partly funded by the

Introduction In this crisis situation when everybody has been emphasizing on preventive measures, screening, early recognition and provision of necessary equipment, less emphasis has been laid on the mental health of the sufferers who have been listening news and following social media reporting catastrophe linked with COVID 19. Objectives To look for the psychiatric morbidity and associated socio-demographic factors among patients tested positive and isolated for covid-19 Methods All patients tested positive for covid-19 and admitted in Covid-19 ward of Malir hospital without any associated complications were included in the study. General Health Questionare-12 (GHQ-12) was administered to look for the presence of psychiatric morbidity. Chi-square test and binary logistic regression analysis were the tests applied to look for the relationship of various socio-demographic factors with presence of psychiatric morbidity among the target population. Results Out of 61 patients included in the study, 45 (73.7%) showed the presence of psychiatric morbidity while 16 (26.3%) did not show psychiatric morbidity when screened with GHQ-12. 43 (70.4%) were male while 18 (29.6%) were female. Mean age of the patients was 35.21 ±2.355 years. Regression analysis revealed that advanced age and female gender have statistically significant relationship (p-value

Context: This hospital-based study attempts to explore the morbidity load of categorized mental disorders along with the pattern of substance use in the adolescent group of people presenting to a tertiary hospital of Manipur, India. Aims: This study aims to document sociodemographic profiles, psychiatric morbidity, and substance use pattern among the adolescents attending the Department of Psychiatry of a tertiary hospital of Manipur, India. Settings and Design: This study was a cross-sectional, hospital-based study. Subjects and Methods: This cross-sectional study included 474 consecutive adolescent patients (10–19 years) attending both outpatient department and inpatient department of the Department of Psychiatry of a Tertiary Hospital of Manipur, India, were enrolled during the study. Diagnoses were made according to the ICD-10. Statistical Analysis: The statistical software, namely SPSS 22.0 and R environment ver. 3.2.2 were used for the analysis of the data. Results: Almost 68.4% were within 16–19 years, 51.3% lived with their families, 56.1% were male, 62% of them were Hindus, and majority of them were from urban background (54.4%). Neurotic, stress-related, and somatoform disorders were the highest (41.4%), followed by psychotropic substance use in 21.3%, mood disorders in 14.8%, schizophrenia and delusional disorder in 12.2%, behavioral and emotional disorder in 9.3%, and disorders of adult personality and behavior (F60-69) in 0.4%. The most common categorical psychiatric diagnosis in males due to psychotropic substance use (37.2%) while neurotic, stress-related, and somatoform disorders (61.1%) were the most common categorical diagnosis in females. Conclusions: Very few studies have been conducted to reflect the scenario and pattern of psychiatric morbidities in the state of Manipur. We hope this study will be helpful in reflecting the psychiatric morbidity load in the adolescent group for helping them with early diagnosis and intervention.

Background: To better understand the psychiatric disorders and cognition in Parkinson's disease (PD) and its impact on quality of life (QoL), patients need to be studied soon after diagnosis, before initiation of dopamine replacement therapy. Aim: This study aims to compare the nature and frequency of psychiatric morbidity, cognitive dysfunction, and quality of life in drug-naive patients with PD and healthy controls. Materials and Methods: The cross-sectional, comparative study was conducted in tertiary care center. Fifty drug-naive PD patients and fifty healthy controls were included and assessed on Modified Hoehn and Yahr scale, PD Questionnaire 8, Kolkata cognitive screening battery, General Health Questionnaire-12, and Hamilton Anxiety and Depression Rating Scale (HAM-A and HAM-D). Results: The mean scores of HAM-A and HAM-D of patients with PD were significantly higher than that of the comparison group. The patients with PD had statistically significant impairment in verbal fluency, Mini-Mental State Examination, calculation, memory immediate recall, visuoconstructional ability, and memory (delayed recall and recognition) in comparison to patients without PD. No statistically significant difference was observed with respect to object naming between the two groups. Conclusion: QoL of a PD patient is adversely affected by both the motor and nonmotor symptoms of the disease such as depression, anxiety, apathy, sleep disturbances, and cognitive impairment. The link between nonmotor symptoms and reduced QoL has important implications for the management of PD because the nonmotor symptoms often appear before patients are given anti-parkinsonian therapy. Screening of nonmotor symptoms in early stage of disease will decrease the morbidity and mortality and improve the QoL.

Abstract Background Psychiatric morbidity is commonly associated with HIV disease and may have adverse effects. This aspect may be overlooked at comprehensive HIV care centers in Low and Middle-Income Countries. Objectives The aim of this study was to determine the prevalence of undetected psychiatric morbidity among HIV/AIDS adult patients attending Comprehensive Care Centre in a semi-urban clinic, in Nairobi, Kenya. Design Descriptive cross-sectional study of adult HIV patients not receiving any psychiatric treatment was conducted. Participants/methods The participants consisted of consecutive sample of adults (n = 245) attending HIV Comprehensive Care Clinic at Kangemi Health Centre, Nairobi. The Mini International Neuropsychiatric Interview (MINI) was administered to screen for undetected psychiatric morbidity. Socio-demographic characteristics were recorded in a questionnaire. Sample descriptive analysis was performed and prevalence of undetected psychiatric morbidity calculated. Chi-square test for independence was used to examine the associations between patient characteristics and undetected morbidity. Multivariable logistic regression analysis was performed to determine independent predictors of undetected psychiatric morbidity. Results The mean age of our participants was 37.3 years (SD 9.2) Three-quarters (75.9%) of participants were females and median duration of HIV illness was 5 years. The prevalence of (previously undetected) psychiatric morbidity was 71.4% (95% CI 65.3–77). The leading psychiatric disorders were MDD (32.2%), PTSD (18.4%), Dysthymia (17.6%), and OCD (17.6%). Overall psychiatric morbidity was associated with low income (

Background: Geriatric population is on a steady rise since the past decade especially in densely populated countries like India. Elderly form a significant proportion of patients presenting to the medical emergency department and they warrant more attention in terms of mental health conditions as they are more predisposed to conditions such as delirium and cognitive impairment. Aim of this Study: This study aimed to evaluate the prevalence of psychiatric morbidity including substance use disorders among elderly (age ≥60 years) presenting to emergency medical outpatient services. Methodology: A total of 300 patients aged 60 years and above attending the medical emergency department of tertiary care hospital were approached, out of which, 232 participated. All the patients were assessed by Confusion Assessment Method, Modified Mini Screen and Alcohol, Smoking, and Substance Involvement Screening Test. Those found positive on any of the screening instrument were further evaluated on International Classification of Diseases-10 criteria, by a semi-structured interview to confirm the psychiatric diagnosis. Results: At least, one psychiatric diagnosis, i.e., either axis-I psychiatric disorder or substance dependence disorder was seen in 62% of cases. Nearly, half of the patients (47.4%) fulfilled at least one axis-I psychiatric diagnosis other than the substance dependence disorder at the time of assessment, with delirium being the most common, seen in about one-third (34.1%) of the participants. Other psychiatric diagnoses in the study sample included dementia (9.5%), depressive disorders (8.2%), adjustment disorder (3%), and anxiety (not otherwise specified) disorder in 3.4% of participants. About one-third (31%) of the participants had tobacco dependence, currently, using and one-fifth (19.8%) of patients had alcohol dependence syndrome currently using. Higher prevalence of delirium and dementia was noted among patients who were aged ≥70 years. Conclusion: The present study shows that elderly patients presenting to medical emergency department have a high prevalence of psychiatry morbidity. Accordingly, there is a need to reorganize psychiatric services and training to improve the identification and management of mental disorders among elderly patients presenting to emergency.

Background: Psychiatric disorders are ubiquitous and affect not only adults but also children and adolescents. The age factor plays an important role in the pattern of these psychiatric disorders. The objective of our study was to find the pattern of psychiatric morbidity in children and adolescents at the child and adolescent outpatient service of a tertiary care hospital. Materials and Methods: A semi-structured questionnaire was used to record the sociodemographic status. The state of mental health and psychiatric morbidity was assessed after a thorough clinical assessment. Intelligence quotient was assessed by a clinical psychologist as and when needed. All the diagnoses were made on the basis of Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision criteria. Results: A total of 529 patients were included. Most patients belonged to the age group of 6–16 years (70.5%). Boys (67.9%) outnumbered girls. Most of the patients were from rural background (56.7%) and from nuclear families (53%). Attention-deficit hyperactivity disorder (31%) and mental retardation (29%) were the most frequent diagnoses, followed by pervasive developmental disorders (10%). Comorbidity was present in about 18% of our patients. Conclusion: The child psychiatry is gaining acceptance, and children and adolescents with minor mental health issues are being identified and referred for specialized services.

Background: Numerous studies have established a higher incidence of psychiatric disorders among general hospital inpatients. Hence we explored if patients in the Intensive Care Units have more psychiatric morbidity due to their longer stay, more critical health conditions, and other stressors. Materials and Methods: A total of 100 patients in the MICU were interviewed using the Symptom Checklist Revised (SCL-90-R) once they got stabilized and just before they were transferred to a step-down ward. Results: Nearly 52% of the participants had no psychiatric morbidity. 36% had mild and 12% had moderate psychiatric morbidity as per the SCL-90-R Scale. There was no participant with severe psychiatric morbidity. Factors such as age, gender, educational level, or duration of stay had no significant influence on the outcome. Among the psychiatric manifestations, interpersonal sensitivity and somatization were found to be the most prevalent symptoms at 60.3% and 59.1%, respectively. Conclusion: Psychiatric morbidity is high among patients in Intensive Care Units, and severity of presentation may also be more than that in general medical patients. Identifying them early and prompt intervention may be necessary to reduce the cost, the duration, and the suffering of the patients.

Introduction: Chronic kidney disease (CKD) is a global health problem with a high economic burden on the health-care system. Considering the chronic nature of disease patients undergoing hemodialysis are at risk of developing psychiatric disorders. In this study, we aimed to evaluate the incidence of depression and anxiety in CKD patients undergoing hemodialysis. Methods: This was a prospective, cross-sectional, observational study conducted between June 2016 and September 2017. Patients of either sex having CKD and undergoing hemodialysis were included in the study. Sociodemographic and depression and anxiety related details were collected. Results: A total 150 patients were enrolled in this study, of which 92 (61.3%) patients had depression and 42 (28%) had anxiety. Overall, depression was higher in males, but the difference was not significant; similarly, the anxiety was higher in males, but the difference was statistically significant (P = 0.050). Majority of patients with depression were aged more than 80 years; however, anxiety was more common in patients aged between 40 and 60 years. A total of 59.4% of depressive patients were Hindus, and 27.3% of anxiety patients were Hindus. The correlation between depression and marriage was significant; however, the relationship was not significant between anxiety and marriage. Among patients with depression 55.9% of patients were illiterate, and among patients with anxiety, 25.4% were illiterate. Conclusions: This study provides extensive information on the relationship between depression or anxiety and sociodemographics features among patients with CKD undergoing hemodialysis.

Context: The increased demand on long-term old age care homes in urban India is a result of demographic transition together with the disintegration of joint family system and changing social values which make them increasingly vulnerable to mental health problems. Aims: This study attempted to find out an array of mental health problems and associated morbidity among inhabitant of government old age homes. Settings and Design: This was a cross-sectional study which included government run old age homes (OAHs) in Delhi. Subjects and Methods: The sample comprised a total of 148 elderly in four OAHs with a mean age of 72.81 years. The World Health Organization Quality of Life-BREF Scale (QOL), Mini-Mental State Examination, Geriatric Depression Scale, Hamilton Anxiety Rating Scale, Brief Psychiatric Rating Scale, and Kesseler-10 Scale were administered. Statistical Analysis: Data were analyzed through SPSS version 20.0 version. Frequency distribution and cross-tabulation used to create summary tables and compare items. Results: Female constituted two-third of study population whereas one-third of subjects were illiterate and two-third without income. The study demonstrated psychiatric morbidity profile among OAH inhabitants and exhibited mild-moderate anxiety symptoms in almost 95% followed by mild-severe depression reported by 85%, mild-moderate psychotic illnesses, psychological distress, cognitive impairments, and poor QOL. Low income and education, low social connections and loss of spouse were key risk factors. Conclusions and Recommendation: Psychiatric morbidity profile and QOL among OAH residents is influenced by various psychological, social, and economic factors. This emphasized the need for better management of the government-run OAHs to ensure better overall mental health of the residents.

Background/Objectives: Orphanages are emerging as an important source of care and child-raising for the ever-increasing number of orphans in the conflict-ridden Kashmir. These children are generally prone to develop psychiatric disorders even reared in well run institution. Objective is to highlight the psychosocial differences in children living in orphanages of Kashmir with and without psychiatric morbidity. Materials and Methods: Cross-sectional descriptive study was carried out where 348 children were recruited from eight registered orphanages of Srinagar, Jammu and Kashmir. Semistructured questionnaire was used to collect data related to sociodemographic profile of the children. Development and Well-Being Assessment (DAWBA) was used for one stage structured assessment of psychopathology. Data analysis was done by Statistical Package for Social Sciences for windows 20.0 version. Results: A total of 97.87% among those having psychiatric morbidity were males as against those without psychiatric morbidity where 28.99% were females. While 8.51% among those having psychiatric morbidity were double orphans, it formed only 1.45% of those without psychiatric morbidity. Likewise 25% among those having psychiatric morbidity had parental deaths due to fire-arm injury, while only 11.67% of them fall in the group without psychiatric morbidity. Among the group with psychiatric morbidity 31.91% had spent less than a year in an orphanage and 10.64% had spent ≥ 9 years as against those without morbidity where percentages were 14.49% and 4.35%, respectively. While 21.28% among those with psychiatric morbidity were enrolled in high education, it formed only 13.04% of those without psychiatric morbidity. Gender, type of orphan, length of stay, cause of parental death, and grade (education level) were significantly associated with the psychiatric morbidity (40.52%). Conclusion: The psychosocial differences in children with and without psychiatric morbidity may help in understanding the factors associated with the emerging psychopathology. Early timely intervention to the children especially “at risk” can be provided to alleviate their mental health problems.

Background: Psychiatric stressors and morbidity can be both cause and effect of myocardial infarction. Various life events acting as psychological stressors can precipitate acute myocardial infarction. Acute MI can lead to plethora of psychiatric morbidities, including various degrees of depression and anxiety. Studies from India are scarce on the subject. Aims and objectives: To assess the occurrence of stressful life events and level of psychiatric morbidity (anxiety and depression) in the post myocardial infarction period among myocardial infarction patients and to compare them with a randomly selected non-myocardial infarction control group. Methods: The study was an analytical cross sectional study, conducted in a tertiary care teaching hospital. The study subjects consisted of 50 patients with present acute MI episode, 50 post MI subjects after 6 months of MI episode and 50 healthy controls. Presumptive Stressful Life Event Scale (PSLES) was used to assess stressful life events, DSM-IV TR Diagnostic criteria and Hamilton Depression Rating Scale (HAM-D) and Hamilton Anxiety Rating Scale (HAM-A) were used to assess the severity of depression/anxiety. Results: The proportion of people with 2 or more stressors was higher in MI group, compared to non MI group (82% Vs 60%). The proportion of moderate and severe depression was 34% and 10% in post MI group, where as it was 2% and 0% in control group. The proportion of subjects with anxiety was higher among post MI group, compared to controls. The proportion of moderate and severe anxiety was 12% and 24% in post MI group, where as none of the subjects in control group had anxiety. Conclusions: There is a strong association between stressful life events, depression, anxiety and Myocardial infarction.

Background: Women in the perimenopausal period are reported to be vulnerable to psychiatric disorders. Aim: To assess the psychiatric morbidity in perimenopausal women aged 45–55 years. Materials and Methods: This cross-sectional, observational, hospital-based study was conducted at the Department of Psychiatry in a tertiary care hospital attached to a medical college. The study sample consisted of consecutive women in perimenopause as diagnosed by a gynecologist and written informed consent for inclusion in the study. Women with a previous history of psychiatric illnesses, with a major medical illness, or who had undergone surgical menopause were excluded from the study. All women were evaluated with a brief questionnaire for collecting demographic and clinical information and the Mini International Neuropsychiatric Interview for assessing psychiatric disorders. Results: Of the 108 women in perimenopause included in the study, 31% had depressive disorder, 7% had anxiety, while 5% had depressive disorder with anxiety features. Psychiatric morbidity was significantly more in women having lesser education, from rural background, with a history of psychiatric illness in the family, a later age of menarche, and in the late stage of perimenopause. Conclusions: Women in the perimenopause affected by psychiatric morbidity were most commonly diagnosed with depression. As perimenopause is a time of vulnerability in women, attention to signs and symptoms of depression may be required so that they may lead a more productive life.

Background: Globally there is an increase in elderly population. Psychiatric morbidity is also increasing in elderly owing to increased longevity and changing social circumstances. Aims: To study the prevalence of psychiatric disorders in rural geriatric population living in an old age home and in the community. Methodology: Mini Mental Status Examination, Geriatric Depression Scale, Patient Health Questionnaire and Brief Psychiatric Rating Scale were used to screen for psychiatric disorders. Hamilton Rating Scale for Depression was used to quantify depression. SPSS 20 was used for statistical analysis. Results: Psychiatric disorders were more prevalent in individuals aged > 80 years(72%). Predominant psychiatric diagnoses were depression, dementia, somatic complaints, alcohol dependence, panic attacks and GAD. Presence of dementia was associated with increased age. Depression was associated with Low education status, female sex, involuntary admission in old age home, presence of physical illness and visual impairment. Individuals in old age home had lesser prevalence of psychiatric disorders than those in community. Conclusion: The overall prevalence of psychiatric morbidity was 59.2%. Psychiatric morbidity was less in old age home population owing to better availability of care, less number of social stressors etc. The study highlights the importance of delivery of structured care facilities in elderly population.

Background: A lot of stigma and misconceptions about pulmonary tuberculosis still persist, in spite of the advances in treatment. Thus, a mere diagnosis of pulmonary tuberculosis can be a psychological trauma to an individual. The situation has aggravated with the association of tuberculosis with HIV infection. Aim: To study the psychiatric morbidity due to the various psychological stresses faced by a patient of pulmonary tuberculosis. Materials and Methods: The study group consisted of 100 inpatients admitted to pulmonary ward with diagnosis of pulmonary tuberculosis. The control group consisted of 100 inpatients admitted to pulmonary ward with nontuberculous pulmonary diseases. Psychiatric history and mental status were recorded on a specially designed proforma and diagnosis of any psychiatric illness, if present, arrived at as per International Classification of Diseases (ICD-10). The psychiatric tests applied were beck's depression inventory (BDI) and Taylor's Manifest Anxiety Scale (TMAS). Results: Of the patients of pulmonary tuberculosis, 24% could be given a diagnostic category, as per ICD-10, as compared to only 8% of the controls (P < 0.005). On BDI, 44% of patients of pulmonary tuberculosis showed depression as compared to 27% of the controls (P < 0.02). On TMAS, 38% of patients of pulmonary tuberculosis showed anxiety as compared to 24% of controls (P < 0.05). A greater incidence of depression (on BDI) and anxiety (on TMAS) was seen in those with longer duration of illness (P < 0.02) and in those with greater severity of illness (P < 0.02). Conclusion: In view of the high psychiatric morbidity associated with pulmonary tuberculosis, there is enough scope for psychiatric services to be made available to these patients. In addition, personnel involved in the treatment of these patients should be trained for early detection of psychiatric symptoms.

Purpose: To present the descriptive data on the frequency of medical and psychiatric morbidity and also to discuss various pertinent issues relevant to the disaster management, the future challenges and psychosocial needs of the 2013 floods in Uttarakhand, India. Materials and Methods: Observation was undertaken by the disaster management team of National Institute of Mental Health and Neurosciences in the worst affected four districts of Uttarakhand. Qualified psychiatrists diagnosed the patients using the International Classification of Diseases-10 criteria. Data were collected by direct observation, interview of the survivors, group sessions, individual key-informant interview, individual session, and group interventions. Results: Patients with physical health problems formed the majority of treatment seekers (39.6%) in this report. Only about 2% had disaster induced psychiatric diagnoses. As was expected, minor mental disorders in the form of depressive disorders and anxiety disorders formed majority of the psychiatric morbidity. Substance use disorders appear to be very highly prevalent in the community; however, we were not able to assess the morbidity systematically. Conclusions: The mental health infrastructure and manpower is abysmally inadequate. There is an urgent need to implement the National Mental Health Program to increase the mental health infrastructure and services in the four major disaster-affected districts.

Background: The inter-generational transmission of violence (ITV) hypothesis and polyvictimisation have been studied extensively. The extant evidence suggests that individuals from violent families are at increased risk of subsequent intimate partner violence (IPV) and that a proportion of individuals experience victimisation across multiple rather than single IPV domains. Both ITV and polyvictimisation are shown to increase the risk of psychiatric morbidity, alcohol use, and anger expression. Objective: The current study aimed to 1) ascertain if underlying typologies of victimisation across the life-course and over multiple victimisation domains were present and 2) ascertain if groupings differed on mean scores of posttraumatic stress disorder (PTSD), depression, alcohol use, and anger expression. Method: University students (N=318) were queried in relation to victimisation experiences and psychological well-being. Responses across multiple domains of IPV spanning the life-course were used in a latent profile analysis. ANOVA was subsequently used to determine if profiles differed in their mean scores on PTSD, depression, alcohol use, and anger expression. Results: Three distinct profiles were identified; one of which comprised individuals who experienced “life-course polyvictimisation,” another showing individuals who experienced “witnessing parental victimisation,” and one which experienced “psychological victimisation only.” Life-course polyvictims scored the highest across most assessed measures. Conclusion: Witnessing severe physical aggression and injury in parental relationships as a child has an interesting impact on the ITV into adolescence and adulthood. Life-course polyvictims are shown to experience increased levels of psychiatric morbidity and issues with alcohol misuse and anger expression.

Background: Female sterilization a popular contraceptive procedure that results in loss of reproductive function whereas hysterectomy, the surgical removal of uterus results in loss of both reproductive and menstrual function. These are important events in women that are found to be contributing for psychological problems as these are related with feminine identity. Though the usual age at operation is different for both the groups, the concerns are same like feminine identity and sexual life. Aim: To compare and study the psychological problems in terms of depression and anxiety and sexual problems in women who have undergone female sterilization and hysterectomy and also to find out whether these procedures affect quality of life; and, also to study whether better information education communication (IEC) activities, round the clock medical services and careful selection of cases have impact on outcome of these procedures. Methods: A cross sectional epidemiological Study conducted in urban slums by administering semi structured questionnaire and instruments like Hospital Anxiety and Depression scale(HADS), World Health Organization Quality of Life-BREF scale (WHOQOL-BREF). Results: Though the hysterectomy group showed slightly higher mean scores in terms of anxiety and depression but they are not statistically significant. Quality of life was good in all domains in both groups where as sexual problems are slightly more in hysterectomy group. Conclusion: Thus the knowledge about procedure, round the clock medical facility, careful selection, pre procedural distress has impact on outcome.

Background: Psychiatric morbidity in human immunodeficiency virus (HIV) patients is being studied all over the world. There is paucity of Indian literature particularly in asymptomatic HIV individuals. Aim: The aim of the following study is to establish the prevalence and the determinants of psychiatric morbidity in asymptomatic HIV patients. Materials and Methods: A cross-sectional study was undertaken to assess psychiatric morbidity as per ICD-10 dacryocystorhinostomy criteria in 100 consecutive asymptomatic seropositive HIV patients and an equal number of age, sex, education, economic and marital status matched HIV seronegative control. All subjects were assessed with the general health questionnaire (GHQ), mini mental status examination, hospital anxiety and depression scale (HADS) and sensation seeking scale (SSS) and the scores were analyzed statistically. Results: Asymptomatic HIV positive patients had significantly higher GHQ caseness and depression but not anxiety on HADS as compared to HIV seronegative controls. On SSS asymptomatic HIV seropositive subjects showed significant higher scores in thrill and adventure seeking, experience seeking and boredom susceptibility as compared to controls. HIV seropositive patients had significantly higher incidence of total psychiatric morbidity. Among the individual disorders, alcohol dependence syndrome, sexual dysfunction and adjustment disorder were significantly increased compared with HIV seronegative controls. Conclusion: Psychiatric morbidity is higher in asymptomatic HIV patients when compared to HIV seronegative controls. Among the individual disorders, alcohol dependence syndrome, sexual dysfunction and adjustment disorder were significantly increased compared with HIV seronegative controls. High sensation seeking and substance abuse found in HIV seropositive patients may play a vital role in engaging in high-risk behavior resulting in this dreaded illness.