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Aim: To study the prevalence of psychiatric diagnosis and psychopathology in adolescent offspring of parents with panic disorder, depression and normal controls. Methods: Adolescent offspring (11-16 years) of parents with a diagnosis of panic disorder and major depression, and normal controls were interviewed using Missouri Assessment of Genetics Interview for Children (MAGIC), Scale for Childhood Anxiety Related Emotional Disorders (SCARED), Strengths and Difficulties Questionnaire (SDQ) and the Children's Global Assessment Scale (CGAS). Results: Thirty three adolescent offspring of parents with panic disorder, 47 of parents with unipolar depression, and 37 of normal controls were interviewed. A diagnosis of simple phobia was made significantly more often in adolescent offspring of parents with panic disorder compared to controls. Adolescent offspring of parents with depression had significantly higher rates of panic disorder and depression compared to controls. The total scores on SCARED and SDQ were significantly higher among the offspring of parents with panic disorder and depression compared to controls and the former were more functionally impaired. Conclusions: There was an excess prevalence of psychopathology and a greater degree of functional impairment in adolescent offspring of parents with panic disorder and depression compared to adolescent offspring of normal controls. (Contains 2 tables.)

This study investigated the relationship between mitral valve prolapse (MVP) and panic disorder (PD), by comparing the prevalence of PD in 33 patients with MVP and 27 patients with haemodynamically insignificant atrial septal defect or patent ductus arteriosus. MVP was diagnosed using standard echocardiographic criteria and the presence of mental disorder was assessed blindly with the help of the Schedule for Affective Disorders and Schizophrenia. DSM-III criteria were used to diagnose PD. The two groups did not differ in age and sex; 12.1% of MVP patients and 3.7% of cardiac controls had PD (NS). Although the prevalence of PD in our sample of MVP patients was considerably higher than the prevalence of PD in the general population, this need not necessarily indicate a causal relationship between MVP and PD and may be due to studying a hospital-based sample. The absence of any significant difference in prevalence of PD between MVP patients and a carefully selected cardiac control group drawn from the same setting argues against any special relationship between PD and MVP.

Background: Comprehensive cognitive behavior therapies have been proved to be more effective than behavioral interventions. However, the efficacy of CBT is not studied in the Indian context and also, the amount of change brought about by CBT is not known. Aims: This study aims to examine the efficacy of cognitive behavioral intervention (CBI) in the treatment of panic disorder. Our specific objectives were to assess the effectiveness of CBI in reducing symptom severity as well as cognitions related to panic and panic-related behaviors. Design: The study adopted a two-group comparison with pre- and postassessments design. Materials and Methods: The sample consisted of 30 patients sequentially allotted to the CBI (n = 15) and behavioral intervention (BI, n = 15) groups. Assessment was done using a semistructured interview schedule, panic disorder severity scale, Texas panic attack record form, Anxiety Sensitivity Index, Agoraphobic cognitions questionnaire, Behavioral avoidance checklist, and Panic appraisal inventory. The CBI group was provided with comprehensive cognitive behavior therapy and the BI group with psycho-education and applied relaxation. Results: CBI was found to be superior to BI in the reduction of panic symptoms, behavioral avoidance, safety behaviors, and cognitions. A large percentage of the CBI group patients met the criteria for clinically significant change with a large magnitude of change. Conclusion: Multicomponent CBI is superior to BI in terms of the amount of change it brings about with respect to panic symptoms, avoidance, safety behaviors, and cognitions. [ABSTRACT FROM AUTHOR]

Background and Objectives: Anxiety disorders are the most common group of psychiatric disorders in children and adolescents. But few studies on specific anxiety disorders in children and adolescents are available in India. Therefore, this study was planned to identify anxiety disorders in children and adolescents in an Indian psychiatry outpatient setting and elicit its phenomenology and co-morbidities., Methods: 1465 persons were screened using screen for child anxiety related emotional disorders (SCARED) scale. The screen positive patients were assessed and diagnosis of anxiety disorders was established according to DSM-IV-TR. Detailed assessment of the phenomenology of anxiety disorders was done by K-SADS-PL., Results: 42 (2.86%) patients had different anxiety disorders. Out of which 16 (38.1%) patients had obsessive compulsive disorder, 10 (23.81%) patients with specific phobias, 6 (14.29%) patients with generalized anxiety disorder, 4 (9.52%) patients with social anxiety disorder and 3 (7.14%) patients each with separation anxiety disorder and panic disorder. Co-morbidities were found in 54% of patients with anxiety disorders. Dissociative disorder, specific phobias and social anxiety disorder were the common co-morbidities., Interpretation and Conclusion: Anxiety disorders are less commonly found in clinic settings (2.86%). No case of posttraumatic stress disorder or acute stress reaction was found in this study., (Copyright © 2013 Elsevier B.V. All rights reserved.)

We studied the symptom structure of panic attacks in 94 patients attending an outpatient psychiatric clinic. Autonomic symptoms of anxiety were reported by the majority of the panic patients. As compared with studies from the West, certain cognitive symptoms, such as fear of loss of control and depersonalization, and vestibular symptoms were endorsed by fewer panic patients. The majority of our panic patients tended to seek help initially from physicians and medical specialists. The majority of the patients also did not experience some DSM-IV symptoms as part of their panic attacks. Comorbid psychiatric conditions influenced the symptom structure of panic attacks. A higher number of agoraphobics as compared with patients with uncomplicated panic disorders had the symptoms of fear of loss of control and fainting. Our findings support the notion that the experience of panic attacks is variable and differs across cultures., (Copyright 2003 S. Karger AG, Basel)

Introduction: The referral of inpatients to psychiatry team is more in India due to the increase in the morbidity rates of people. The referrals to Psychiatric Department with a specific psychiatric diagnosis are considerably very low. Most often, the diagnosis made by the clinicians doesn’t match with that of the psychiatrist. Physical illness is shown to have a strong association with psychiatric co-morbidity. Such association complicates the course and outcome of both the conditions. Aim: To evaluate the pattern of inpatient referral to the Psychiatric Department and to estimate the diagnostic concordance between the referral and psychiatric team. Materials and Methods: This retrospective study, with prior permission from the Department of psychiatry, included all the inpatient referrals (n=310) to Psychiatry Department by other departments from January 2019 to December 2019. Data collection was done from March 2020 to August 2020 and data analysis from September 2020 to November 2020, in Saveetha Medical College and Hospital, Chennai, Tamil Nadu, India. Data was obtained from a psychiatry referral register and was statistically analysed using Microsoft Excel (MS Office 2013) for percentage, mean and Standard Deviation (SD) for descriptive variables. Diagnostic concordance to assess the reason for referral and diagnostic accuracy in terms of reason of referral and psychiatric diagnosis was analysed using kappa statistics. Results: The most common psychiatric disorder for referral was alcohol dependence syndrome (n=102, 32.9%) followed by depression (n=38, 12.3%) and adjustment disorders (n=34, 10.9 %). Concordance was good for intellectual disorder (κ=1.00), depression (κ=0.969) and alcohol dependence syndrome (κ=0.963). Very low concordance was observed in diagnosing acute confusional state (κ=0.195) and panic disorder (κ =0). Conclusion: Alcohol withdrawal syndrome, adjustment disorder and depression were the most common reasons in referring inpatients to psychiatry. Lower concordance for psychiatric disorders like Acute confusional state and Panic disorder could be explained by inadequate psychiatry exposure and hence be improved by better undergraduate psychiatry training. [ABSTRACT FROM AUTHOR]

Academic stress is a critical aspect of adolescent experience around the world, but particularly in countries with dense populations that lead to highly competitive college admissions. With a population of over one billion people, the competition for higher education in India is significantly high. Although research has shown that academic pressures are associated with anxiety in adolescents, this work is primarily cross‐sectional. The current study examined academic stress and anxiety symptoms over time and assessed physiological hyperarousal as a mediator and social acceptance as a moderator of this relation in a sample of adolescents from India (N = 282, 13–18 years, 84% female). Adolescents completed measures of academic stress, physiological hyperarousal, social acceptance and anxiety symptoms at two‐time points, 5 months apart. Findings demonstrate direct effects of academic stress on changes in symptoms of generalised anxiety and panic, as well as indirect effects through physiological hyperarousal. Social acceptance did not moderate the relation, although it uniquely predicted changes in panic disorder symptoms over time. The findings of this study contribute to the scientific understanding of a potential mechanism through which academic stress leads to anxiety among adolescents in India. [ABSTRACT FROM AUTHOR]

Background: Adolescent mental health problems are vast and varied and early identification and intervention can be of utmost help. There is sparse data on mental health issues in the adolescent population from India in general and J&K in particular; thus, it was decided to embark on this study. Results: The prevalence of various psychiatric disorders among school-going adolescents was as major depressive disorder 13.7%, obsessive compulsive disorder 4.0%, panic disorder 1.4%, self-harming behavior 2.5%, generalized anxiety disorder 2.5%, social anxiety disorder 2.2%, dysthymia 1.7%, and adjustment disorder 0.8%. There was no statistically significant difference in the overall psychiatric morbidity group among males and females (P = 0.90). However, panic disorder and borderline personality disorder as a group were more commonly found among females compared to males (P = 0.016 and 0.001 respectively). Also, 34% from urban and 28% from rural areas met the criteria for any psychiatric disorder (P = 1.38). Conclusion: Children and adolescents represent a tender part of the human life cycle and they may be at a higher risk of psychiatric disorders. There is a very high prevalence of psychiatric morbidity of any kind among adolescents in Kashmir, many of which are unidentified and thus untreated. Depression is the most common psychiatric illness among adolescents with a higher prevalence in males while anxiety disorders are more common among females. There is a need for further research in this age group and teachers and parents need psycho-education for the identification of such children. [ABSTRACT FROM AUTHOR]

Studies of psychiatric out-patients from India have found that diagnosis of some of the subcategories of the dissociative and conversion disorders of the ICD and DSM classificatory systems are rarely made in this setting. Moreover, it was found that a significant percentage of patients seen in psychiatric practice may not fit into the defined subcategories of dissociative (conversion) disorders of these systems of classification. We studied the prevalence of various ICD-10 and DSM-IV categories of dissociative (conversion) disorders and our own proposed category of 'brief dissociative stupor' (BDS), among all the in-patients of a psychiatric unit in a general teaching hospital, over a 2-year period. There were 18 patients who fulfilled our criteria for BDS and 18 patients in the second group which included all of the remaining subjects with a diagnosis of any other subcategory of dissociative disorder according to ICD-10. Our analysis revealed that there were no patients with a diagnosis of dissociative amnesia, fugue, stupor, trance and possession disorders or identity disorders. There were significantly more female patients in the BDS group, and they also had significantly more comorbid Axis-I diagnoses and panic attacks. Since 50% of our patients fulfilled the criteria for BDS, there is clearly a need for further studies to establish the prevalence of this subcategory in patients from other centres. The classification of these patients with this phenomenology is problematic. Inclusion of a subcategory of dissociative non-epileptic seizures, instead of dissociative convulsions, should improve the classification of dissociative (conversion) disorders.

Introduction: Behavioral emergencies constitute an important component of emergencies worldwide. Yet, research on behavioral emergencies in India has been scarce. This article discusses the burden, types, and epidemiology of behavioral emergencies in India., Methods: A computerized search of Medline, Psychinfo, and Cochrane from 1975 to 2009 was performed, and all articles were evaluated and collated. The results were summarized., Results and Conclusions: There is an acute need for psychiatric emergency services in India. Suicides, acute psychoses, and substance-related problems form the major portion of behavioral emergencies, while current trends show a rise in disaster- and terrorism-related emergencies.

About 70% of noncardiac chest pain (NCCP) patients have mental disorders as reported from Western countries. The phenomenon of somatization is considered to be aetiologically important in the genesis of NCCP. Though somatization is generally considered as more prevalent among non-Western cultures, systematic studies of mental disorder among NCCP patients are rare from developing countries. Based on treadmill test, 54 male inpatients in a cardiology general ward in India were divided into a group having ischaemic heart disease (IHD) and another group of NCCP. A psychiatric interview was conducted blindly on these subjects with the help of a structured interview schedule, and DSM-III-R diagnosis was made. Sixty-eight percent in the NCCP group and 27% in the IHD group had a mental disorder. The total number of subjects with a mental disorder, including panic disorder and major depression, were significantly more in the NCCP group. Mental disorders appears to be equally common among NCCP patients in developing countries also and detailed psychiatric assessment is warranted in patients with chest pain of non-IHD origin.

There is limited literature from India on effect of fathers' deployment on the mental health of children. This cross-sectional analytical study investigates the difference in anxiety levels of children whose fathers are deployed in a field location and compares it with children currently located with their fathers. Data were collected in an army school from 200 children aged 10–17 years with fathers deployed in field locations (n = 99) and fathers currently residing with the children (n = 105) via interviewer administered and self-completed Screen for Child Anxiety-Related Disorders (SCARED) questionnaire. Anxiety scores were on an average, minimally raised above the cut-off level for children who had fathers deployed. In addition, panic disorder scores were also above the cut-off levels for these children. While scores were normal in all other domain, they were higher than that for children residing with their fathers, although the difference was not significant. Girls with fathers deployed had scores higher than cut-off scores for domains such as panic, separation anxiety and school avoidance, while boys had scores higher than cut-off scores only for panic disorders. However, the girls had significantly higher scores than boys in all domains. Girls in both groups (with and without father deployed) had higher scores than cut-off scores for panic disorders. Anxiety levels in children were not found to be unduly affected by the deployment of fathers. But girls were found to have clinically relevant panic disorder, school avoidance and separation anxiety scores as compared with boys in the similar situation of parental separation. [ABSTRACT FROM AUTHOR]

Introduction: Psychiatric morbidity has an increased prevalence in chronic obstructive pulmonary disease (COPD). Patients overall psychosocial status plays an important role in the development of depression which, when major, is said to occur in 19%–42% of cases of COPD. We aimed to study patterns of psychosocial issues in patients with COPD. Materials and Methods: This study was conducted over a period of 6 months in an Outpatient Department of Government Chest Disease Hospital Srinagar. A total of 100 COPD patients and 100 sex- and age-matched controls were included in this study and compared. The diagnosis of COPD was assessed by spirometry. Patterns of psychiatric morbidities were assessed using the Mini-International Neuropsychiatric Interview. Results: The frequency of psychiatric comorbidities was significantly higher (P < 0.001) in COPD patients (47%) as compared to controls (12%). The highest frequency of psychiatric morbidities in COPD patients was major depressive episode in 28% in comparison to 9% of controls. Other morbidities include panic disorder, dysthymia, generalized anxiety disorder, and suicidality. Conclusion: The frequency of psychiatric morbidities is increased in COPD patients as compared to controls. We recommend that all patients with COPD should be screened for psychiatric morbidity as there is enough scope for psychiatric services to be made available to these patients. [ABSTRACT FROM AUTHOR]

Adolescent mental health problems have been recognised as a major issue in low-income countries including India. Through a meta-analytic approach, the present review delineate the overall prevalence of each of the most discussed mental health problems among rural adolescents in India, comprising depression, anxiety disorders, generalised anxiety disorder, panic disorder, separation anxiety, social anxiety disorder, suicidality, hyperactivity, emotional problems, conduct problems and peer problems. The review also presents the potential determinants of such mental health problems. Using PRISMA guidelines, a total of thirty-five studies were finalized from databases such as PubMed, Science Direct, JSTOR, Web of Science, Google Scholar and ProQuest. From the findings, it is observed that male and female adolescents does not differ significantly in the prevalence of most mental health problems. However, social anxiety was found to be more prevalent among females when compared to males. In meta-regression, factors like tools used (screening tools vs diagnostic interviews), sample size, setting (school-based vs community-based), sampling technique and year of publication were found to influence the prevalence rates of certain mental health problems, reported in the studies. Major determinants influencing the prevalence of mental health problems in rural adolescents were age, socio-economic status, academic and family environment. Individual factors such as social media usage, physical activity, and substance use also contribute to mental health problems. As India accounts for one-fifth of the world's adolescent population, the findings of this review can have global implications. [ABSTRACT FROM AUTHOR]

Clinical variation in the expression of panic disorder, depression and anxiety, and posttraumatic stress disorder (PTSD) has have been documented across cultures. However, local (emic) cultural models that explain how people make sense of their illness experiences remain relatively understudied in India among trauma-exposed populations. Further, the integration of emic findings into clinical care is limited, underscoring the need for emic perspectives following trauma to improve the development or adaptation of trauma-focused treatments in India. This study describes an emic explanatory model of distress, which includes idioms of distress, perceived causes of distress, and coping/help-seeking behaviors among Indian women from slums reporting gender-based violence. This explanatory model can be used as a culturally grounded way to develop clinical case conceptualizations to adapt and deliver psychological treatments for this under-served population. [ABSTRACT FROM AUTHOR]

Background: Depression is common among primary care patients in LMIC but treatments are largely ineffective. In this cluster-randomized controlled trial, we tested whether depression outcomes are different among recipients of a collaborative care model compared to enhanced standard treatment in patients with co-morbid chronic medical conditions. Methods: We conducted a cluster randomized controlled trial among participants 30 years or older seeking care at 49 primary health centers (PHCs) in rural Karnataka, diagnosed with major depressive disorder, dysthymia, generalized anxiety disorder, or panic disorder on the MINI-International Neuropsychiatric Interview plus either hypertension, diabetes, or ischemic heart disease. From a list of all PHCs in the district, 24 PHCs were randomized a priori to deliver collaborative care and 25 PHCs enhanced standard treatment. The collaborative care model consisted of a clinic-based and a community-based component. Study assessment staff was blinded to treatment arm allocation. The primary outcome was the individual-level PHQ-9 score over time. Results: Between May 2015 and Nov 2018, 2486 participants were enrolled, 1264 in the control arm, and 1222 in the intervention arm. They were assessed at baseline, 3, 6 and 12 months. The mean PHQ-9 depression score was around 8.5 at baseline. At each follow-up PHQ-9 scores were significantly lower in the intervention (5.24, 4.81 and 4.22 at respective follow-ups) than in the control group (6.69, 6.13, 5.23, respectively). A significant time-by-treatment interaction (p < 0.001) in a multi-level model over all waves, nested within individuals who were nested within PHCs, confirmed that the decrease in depression score from baseline was larger for collaborative care than enhanced standard care throughout follow-up. Conclusions: The collaborative care intervention resulted in significantly lower depression scores compared to enhanced standard care among participants with co-morbid physical conditions. The findings have potential implications for integrating mental health and chronic disease treatment in resource constrained settings. Trial registration: ClinicalTrials.govNCT02310932, registered on December 8, 2014, and Clinical Trials Registry India CTRI/2018/04/013001, registered on April 4, 2018. Retrospectively registered. [ABSTRACT FROM AUTHOR]

Background: The WHO Global Burden of Disease study estimates that mental and addictive disorders are among the most burdensome in the world, and their burden will increase over the next decades. The mental and behavioral disorders account for about 12% of the global burden of disease. However, these estimates and projections are based largely on literature review rather than cross-national epidemiological surveys. In India, little is known about the extent, severity and unmet need of treatment mental disorders. Thus, there was a need to carry out rigorously implemented general population surveys that estimate the prevalence of mental disorders among urban population at Pune, Maharashtra. The study attempted to address unmet need and to form a basis for formulating the mental health need of the community. Objective: The study was undertaken to estimate the lifetime prevalence and 12 month prevalence of specific mental disorders in urban population, socio-demographic correlates of mental disorders and to assess the service utilization in individuals with mental disorders. Materials and Methods: The study was undertaken among adults aged 18 years and above living in house hold and in geographical area of Pune, Maharashtra. A minimum sample of 3000 completed interviews was planned using representative probabilities to population size (PPS) sampling method which ensured equal probability for every eligible member. Data listing was obtained from Census Office from recent census of 2001 data. The face to face interviews were undertaken in homes using fully structured interview schedule of World Mental Health Survey Initiative duly revised Version of WHO- Composite International Diagnostic Interview (CIDI 3.0) by trained investigators. Clinical reappraisal was carried out using Schedules for Clinical Assessment in Neuropsychiatry (SCAN) among ten percent of diagnosed cases selected randomly. Data were entered into DDE (Blaize Software) and analyzed using SPSS software package. Results: Overall lifetime prevalence of mental disorders was found to be 5.03%.Rates among males (5.30%) were higher as compared to females (4.73%). Among the diagnostic group , depression(3.14%) was most prevalent followed by substance use disorder (1.39%) and panic disorder (0.86%). Overall 12 month prevalence of mental disorder was found to be 3.18% which was 3.47% among males and 2.85% among females. Prevalence of depression (1.75%) was the most 12-month mental disorder, followed by substance use mental disorder (0.99%) and panic disorder (0.69%).Lifetime and twelve month prevalence of any mental disorder was the highest among employed group, followed by home makers and depression was more among married, followed by separated/divorced/widowed group and the least in unmarried group in the study. Treatment gap due to low prescription received indicated the most of the ill person did not acknowledge their need for treatment or do not received the appropriate care. Conclusion: The figure of 5.03% prevalence of diagnosable psychiatric disorders in adult population points to the great need to increase the prevention strategies both at primary and secondary level to overcome the disability and economic loss to society due to mental disorders. [ABSTRACT FROM AUTHOR]

Background: Anxiety is one of the most common mental disorders among school-going children and adolescents worldwide. Multiple factors like internalization of the symptoms, lack of proper objective assessment, societal stigmatization, and influence of parental pressure may alter the prevalence and incidence. Aim: The current study is done to identify the prevalence of anxiety disorders in school children and their associated risk factors. Method: A total of 550 students (266 boys and 284 girls), studying in grades 8 to 12 in urban and rural schools chosen by stratified random sampling, were subjected to a questionnaire survey by the team of trained investigators using "Screen for Child Anxiety and Emotion-related Disorder (SCARED)--child Version.". Results: Total prevalence of anxiety assessed using the SCARED scale was 51%. The prevalence of subtypes of anxiety disorders was also identified viz, generalized anxiety disorder--16%, panic disorder--23%, school phobia--17%, separation anxiety--31%, and social phobia--13%. All the disorders showed higher incidence in girls (P < .01). Discussion: The anxiety disorders were associated significantly with students from rural schools, those studying in the Tamil medium, those staying in hostels, students who had mothers who were employed, and living in extended family environments. Students who walked to school and who had neither of their parents as caregivers were more likely to have panic disorder, school phobia, social phobia, and separation anxiety disorder. Conclusion: This study documented a higher prevalence of anxiety disorders and subtypes and highlighted the factors associated with anxiety disorders in school students of the adolescent age group. [ABSTRACT FROM AUTHOR]

Introduction: Anxiety disorders (ADs) impact the quality of life and productivity at an individual level and result in substantial loss of national income. Representative epidemiological studies estimating the burden of ADs are limited in India. National Mental Health Survey (NMHS) 2016 of India aimed to strengthen mental health services across India assessed the prevalence and pattern of public health priority mental disorders for mental health-care policy and implementation. This article focuses on the current prevalence, sociodemographic correlates, disability, and treatment gap in ADs in the adult population of NMHS 2016. Materials and Methods: NMHS 2016 was a nationally representative, multicentered study across 12 Indian states during 2014-2016. Diagnosis of ADs (generalized AD, panic disorder, agoraphobia, and social AD) was based on Mini-International Neuropsychiatry Interview 6.0.0. Disability was by Sheehan's Disability Scale. Results: The current weighted prevalence of ADs was 2.57% (95% confidence interval: 2.54-2.60). Risk factors identified were female gender, 40-59 age group, and urban metro dwellers. Around 60% suffered from the disability of varying severity. The overall treatment gap for ADs was 82.9%. Conclusions: The burden of AD is similar to Depressive disorders, and this article calls for the immediate attention of policymakers to institute effective management plans in existing public health programs. [ABSTRACT FROM AUTHOR]

Background: Despite their higher prevalence, the Common Mental Disorders (CMDs) are under-recognized and under-treated resulting in huge disability. India, home to one-fifth of the global population, could offer insights for organizing better services for CMDs. However, the prevalence and resultant disability in the general population is unknown, and consequently, gaps in management or plan for services are enormous, by default overlooked. Aim: Estimating the current prevalence, disability, socioeconomic impact, and treatment gap of CMDs in a nationally representative sample from India. We attempt to identify the missed opportunities and list priorities for planning. Methodology: The National Mental Health Survey of India (2016) is a multisite nationwide household survey conducted across India using a uniform methodology. Overall, 39,532 adults were surveyed with a response rate of 88%. Diagnoses are based on the Mini International Neuropsychiatric Interview 6.0.0. CMDs for this analysis include depressive and anxiety disorders (generalized anxiety disorder, social phobia, agoraphobia, panic disorder, obsessive-compulsive disorder, and posttraumatic stress disorder). Results: The weighted prevalence of current CMDs was 5·1% (95% CI: 5.06–5.13). Prevalence was highest in females, among the 40–59 years of age group, and in metros. Nearly 60% of them reported disabilities of varying severity. The treatment gap was 80·4%. On average, patients and their families spent ₹1500/month towards the treatment of CMDs. Conclusions: This survey gives valuable insights regarding the disability and treatment gap due to CMDs and is imperative for reframing mental health policies and planning interventions. This study also suggests an international investigation to understand the difference in the prevalence of CMDs in developing versus developed countries. [ABSTRACT FROM AUTHOR]

Background: Testing for human immunodeficiency virus (HIV) infection has become a mandatory and routine regimen for various reasons. Literature suggests that the level of psychiatric morbidity is high among HIV-infected individuals. However, often psychiatric problems are undetected and untreated among these people and this is possible by the simple measure of screening when these people contact a health-care facility such as an integrated counseling and testing center (ICTC). The paucity of published data in this arena necessitates exploring the facts related to this issue. Hence, this study was aimed to identify the psychiatric morbidity among people undergoing HIV testing by a screening method. Methods: A cross-sectional, descriptive study was carried out among 384 individuals, those who were undergoing HIV testing at an ICTC facility of a tertiary care hospital in South India. They were assessed for psychiatric morbidity by a structured clinical diagnostic interview using mini international neuropsychiatric interview. Those people who were identified as having psychiatric problem were referred to psychiatric clinic for further management. Results: The mean age of the patients was 40 (±13.27) years and the males (n = 254, 66.1%) predominated than the females (n = 130, 33.9%). Psychiatric illness was identified in many patients (n = 91, 24%) including major depressive disorder (n = 64, 16.7%), suicidal ideas (n = 31, 8%), panic disorder (n = 26, 6.8%), and substance abuse (n = 15, 3.9%). Conclusion: The findings imply the need to integrate screening and referral services for the people undergoing HIV testing. Early screening of psychiatric morbidity among individuals utilizing the ICTC facility may help identify and treat the illness at an early stage. [ABSTRACT FROM AUTHOR]

Purpose: We examined the correlates of disability among people with non-communicable diseases (NCDs) and comorbid common mental disorders (CMDs) from rural India.The sample comprised 2,486 participants enrolled in a cluster randomized trial (cRCT), Healthier OPtions through Empowerment (HOPE). Participants were 30 years or older, with a diagnosis of major depressive disorder, dysthymia, generalized anxiety disorder, and/or panic disorder on the MINI-International Neuropsychiatric Interview, with hypertension, diabetes, dsylipidemia and/ or ischemic heart disease. Disability was measured with the 12-item version of WHODAS 2.0. The severity of depression and anxiety was measured using the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder Scale (GAD-7), respectively. Multiple linear regression analyses were used to examine associations.The mean age was 59 ± 10.0 years, three quarters (1864) of the participants were female, and 64.0% were married. More than half of the participants had no formal education (57.9%). Most of the participants had two or more chronic medical conditions (73.0%). The mean disability score was 24.3. The mean depression score was 8.5, and the mean anxiety score was 6.7. Higher levels of disability were reported by participants ≥ 60 years of age, those with moderate and severe depression, and moderate anxiety. Among female participants, being unmarried was associated with greater disability. Male participants without formal education reported greater levels of disability.Higher severity of CMDs is significantly associated with higher levels of disability. For women, being unmarried and for men having no formal education was associated with higher levels of disability.ClinicalTrials.gov NCT02310932 [URL: https://clinicaltrials.gov/ct2/show/record/NCT02310932] registered on December 8, 2014, and Clinical Trials Registry India CTRI/2018/04/013001, registered on April 4, 2018. Retrospectively registered.Methods: We examined the correlates of disability among people with non-communicable diseases (NCDs) and comorbid common mental disorders (CMDs) from rural India.The sample comprised 2,486 participants enrolled in a cluster randomized trial (cRCT), Healthier OPtions through Empowerment (HOPE). Participants were 30 years or older, with a diagnosis of major depressive disorder, dysthymia, generalized anxiety disorder, and/or panic disorder on the MINI-International Neuropsychiatric Interview, with hypertension, diabetes, dsylipidemia and/ or ischemic heart disease. Disability was measured with the 12-item version of WHODAS 2.0. The severity of depression and anxiety was measured using the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder Scale (GAD-7), respectively. Multiple linear regression analyses were used to examine associations.The mean age was 59 ± 10.0 years, three quarters (1864) of the participants were female, and 64.0% were married. More than half of the participants had no formal education (57.9%). Most of the participants had two or more chronic medical conditions (73.0%). The mean disability score was 24.3. The mean depression score was 8.5, and the mean anxiety score was 6.7. Higher levels of disability were reported by participants ≥ 60 years of age, those with moderate and severe depression, and moderate anxiety. Among female participants, being unmarried was associated with greater disability. Male participants without formal education reported greater levels of disability.Higher severity of CMDs is significantly associated with higher levels of disability. For women, being unmarried and for men having no formal education was associated with higher levels of disability.ClinicalTrials.gov NCT02310932 [URL: https://clinicaltrials.gov/ct2/show/record/NCT02310932] registered on December 8, 2014, and Clinical Trials Registry India CTRI/2018/04/013001, registered on April 4, 2018. Retrospectively registered.Results: We examined the correlates of disability among people with non-communicable diseases (NCDs) and comorbid common mental disorders (CMDs) from rural India.The sample comprised 2,486 participants enrolled in a cluster randomized trial (cRCT), Healthier OPtions through Empowerment (HOPE). Participants were 30 years or older, with a diagnosis of major depressive disorder, dysthymia, generalized anxiety disorder, and/or panic disorder on the MINI-International Neuropsychiatric Interview, with hypertension, diabetes, dsylipidemia and/ or ischemic heart disease. Disability was measured with the 12-item version of WHODAS 2.0. The severity of depression and anxiety was measured using the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder Scale (GAD-7), respectively. Multiple linear regression analyses were used to examine associations.The mean age was 59 ± 10.0 years, three quarters (1864) of the participants were female, and 64.0% were married. More than half of the participants had no formal education (57.9%). Most of the participants had two or more chronic medical conditions (73.0%). The mean disability score was 24.3. The mean depression score was 8.5, and the mean anxiety score was 6.7. Higher levels of disability were reported by participants ≥ 60 years of age, those with moderate and severe depression, and moderate anxiety. Among female participants, being unmarried was associated with greater disability. Male participants without formal education reported greater levels of disability.Higher severity of CMDs is significantly associated with higher levels of disability. For women, being unmarried and for men having no formal education was associated with higher levels of disability.ClinicalTrials.gov NCT02310932 [URL: https://clinicaltrials.gov/ct2/show/record/NCT02310932] registered on December 8, 2014, and Clinical Trials Registry India CTRI/2018/04/013001, registered on April 4, 2018. Retrospectively registered.Conclusion: We examined the correlates of disability among people with non-communicable diseases (NCDs) and comorbid common mental disorders (CMDs) from rural India.The sample comprised 2,486 participants enrolled in a cluster randomized trial (cRCT), Healthier OPtions through Empowerment (HOPE). Participants were 30 years or older, with a diagnosis of major depressive disorder, dysthymia, generalized anxiety disorder, and/or panic disorder on the MINI-International Neuropsychiatric Interview, with hypertension, diabetes, dsylipidemia and/ or ischemic heart disease. Disability was measured with the 12-item version of WHODAS 2.0. The severity of depression and anxiety was measured using the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder Scale (GAD-7), respectively. Multiple linear regression analyses were used to examine associations.The mean age was 59 ± 10.0 years, three quarters (1864) of the participants were female, and 64.0% were married. More than half of the participants had no formal education (57.9%). Most of the participants had two or more chronic medical conditions (73.0%). The mean disability score was 24.3. The mean depression score was 8.5, and the mean anxiety score was 6.7. Higher levels of disability were reported by participants ≥ 60 years of age, those with moderate and severe depression, and moderate anxiety. Among female participants, being unmarried was associated with greater disability. Male participants without formal education reported greater levels of disability.Higher severity of CMDs is significantly associated with higher levels of disability. For women, being unmarried and for men having no formal education was associated with higher levels of disability.ClinicalTrials.gov NCT02310932 [URL: https://clinicaltrials.gov/ct2/show/record/NCT02310932] registered on December 8, 2014, and Clinical Trials Registry India CTRI/2018/04/013001, registered on April 4, 2018. Retrospectively registered.Trial registration: We examined the correlates of disability among people with non-communicable diseases (NCDs) and comorbid common mental disorders (CMDs) from rural India.The sample comprised 2,486 participants enrolled in a cluster randomized trial (cRCT), Healthier OPtions through Empowerment (HOPE). Participants were 30 years or older, with a diagnosis of major depressive disorder, dysthymia, generalized anxiety disorder, and/or panic disorder on the MINI-International Neuropsychiatric Interview, with hypertension, diabetes, dsylipidemia and/ or ischemic heart disease. Disability was measured with the 12-item version of WHODAS 2.0. The severity of depression and anxiety was measured using the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder Scale (GAD-7), respectively. Multiple linear regression analyses were used to examine associations.The mean age was 59 ± 10.0 years, three quarters (1864) of the participants were female, and 64.0% were married. More than half of the participants had no formal education (57.9%). Most of the participants had two or more chronic medical conditions (73.0%). The mean disability score was 24.3. The mean depression score was 8.5, and the mean anxiety score was 6.7. Higher levels of disability were reported by participants ≥ 60 years of age, those with moderate and severe depression, and moderate anxiety. Among female participants, being unmarried was associated with greater disability. Male participants without formal education reported greater levels of disability.Higher severity of CMDs is significantly associated with higher levels of disability. For women, being unmarried and for men having no formal education was associated with higher levels of disability.ClinicalTrials.gov NCT02310932 [URL: https://clinicaltrials.gov/ct2/show/record/NCT02310932] registered on December 8, 2014, and Clinical Trials Registry India CTRI/2018/04/013001, registered on April 4, 2018. Retrospectively registered. [ABSTRACT FROM AUTHOR]

Background: Polycystic ovary syndrome (PCOS) is one of the common endocrine disorders and is associated with reproductive, metabolic, and psychological disturbances affecting one in five women of reproductive age group. Objective: To investigate the prevalence of psychiatric disorders among women in ambulatory treatment with a diagnosis of PCOS. Materials and Methods: One hundred and ten patients of PCOS were evaluated using Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition criteria by means of Mini International Neuropsychiatric Interview, English version 5.0.0. Diagnosis of PCOS was confirmed according to the National Institute of Health/National Institute of Child Health and Human Development, 1990 consensus conference criteria. Forty subjects without PCOS who were matched for age and body mass index were taken as a comparison group. Results: About 23% of cases had major depressive disorder as compared to 7.5% of controls, 1.8% had dysthymia, 15.45% had panic disorder compared to 5% of controls, 6.36% had obsessive compulsive disorder compared to 2.5% of controls, 8% cases had suicidality, 2.72% of cases were bipolar affective disorder, and 15.45% had generalized anxiety disorder (GAD). Conclusion: A high prevalence of mental disorders was observed, especially major depression, panic disorder, and GAD in patients with PCOS in our study. The results suggest that screening and appropriate management for psychiatric disorders should be part of the routine evaluation of these patients. [ABSTRACT FROM AUTHOR]

Introduction: Acute coronary syndrome (ACS) caused by coronary atherosclerosis include ST-segment elevation myocardial infarction (STEMI), non-STEMI, and unstable angina. The relation between psychiatric disorders and coronary artery disease is a complex one which includes the effect of the psychosocial factors on heart and vice versa. Point prevalence studies have been reported, but there is paucity of follow-up studies from India. Materials and Methods: The study is a follow-up evaluation at discharge of 248 consecutive patients presented with ACS at JSS Hospital, Mysuru, Karnataka, over a period of 6 months to assess the psychiatric comorbidities. The patients were assessed on a structured and validated pro forma before discharge, at 3 months, and at 6 months. Screening of psychiatric disorders was done using Mini International Neuropsychiatric Interview PLUS 5.0.0 and assessment of depression was done using Hamilton Depression Rating Scale. ANOVA, Student's t-test, and SPSS 21 were used for statistical analysis. Results: The most common psychiatric comorbidities include major depressive disorder (44%), it persisted at the end of 3 (P < 0.001) and 6 (P < 0.001) months. A spectrum of anxiety disorders including panic disorder (12.10%), dysthymia (3.60%), agoraphobia (2.40%), social phobia (2%), obsessive-compulsive disorder (1.6%), specific phobia (1.2%), and posttraumatic stress disorder (0.8%) in descending order at the end of 6 months were found. Significant reduction in substance use of nicotine (66.1%) and alcohol (56.0%) was reported on follow-up. Conclusion: Depression, anxiety, and substance use occur in patients with ACS which persist on follow-up. Early recognition at discharge and appropriate counseling on follow-up improve the clinical outcomes. [ABSTRACT FROM AUTHOR]

Background and Objective: Migraine is one of the most common types of headache leading to significant disability; still people do not seek early help in developing countries. Therefore, we planned to conduct a study to assess the clinical profile of migraine, its triggers, comorbidities, and related disability in rural India. Design: An observational study in which 1,245 men and women suffering from migraine were recruited at a tertiary care hospital and were asked to complete a questionnaire related to migraine, its triggers, comorbidities, and disability. Results: Out of 1245 patients, females constituted 75% (937) of the patient pool and rest 25% were males (308). Fatigability (52.7%), nausea/vomiting (42.7%), phonophobia (33.57%), numbness (28.2%), and vertiginous sensation (20.8%) were accompanying features. Stress was the most common trigger impacting 44.9% of the patient population, followed by noise in 44.3% of cases. Exertion and sleep disturbance acted as triggers in 36.1%, smells in 20.5%, hormonal factors in 11.5%, and visual stimuli in 5.1% of patients. Anxiety was identified as the most common comorbidity affecting 542 patients (43.5%), followed by depression in 25.7%of patients. Around 103 patients (8.2%) had other psychiatric illnesses such as panic disorder and bipolar mood disorder. Conclusion: The migraine-related disability is high; therefore we conducted a study to understand its triggers and clinical profile. This was the first observational study conducted in a tertiary care hospital on migraine in north India catering to a sizeable rural population however, larger population studies are required to understand migraine more exhaustively. [ABSTRACT FROM AUTHOR]

Background and Objectives: Students with borderline intellectual functioning ("slow learners") underperform in all school subjects. The primary objective of this study was to evaluate the self-perceived anxiety symptoms of slow learners. Its secondary objective was to analyze impact of sociodemographic variables on their symptoms. Settings and Design: Cross-sectional single-arm questionnaire-based study was conducted in the learning disability clinic of a public medical college in Mumbai. Subjects and Methods: One hundred slow learners aged ≥8 to <18 years were recruited by non-probability sampling. Their anxiety symptoms scores were measured using the Screen for Child Anxiety Related Disorders-Child version (SCARED-C) instrument. Statistical Analysis: Multivariate regression analysis was performed for determining the "independent" impact that variables had on the SCARED-C ("individual subscales" and "overall") scores. Results: Symptoms of "separation anxiety" were present in 40%, followed by "social anxiety" in 32%, "generalized anxiety" in 31%, "panic" in 26%, "significant school avoidance" in 24%; and "overall anxiety" in 38% of slow learners. Multivariate analysis revealed that: (i) co-occurring attention-deficit/hyperactivity disorder was significantly associated with having panic symptoms (P = 0.040), and, (ii) studying in a Secondary School Certificate or Higher Secondary Certificate educational board-affiliated school was significantly associated with having symptoms of "generalized anxiety," "social anxiety," and "overall anxiety" (P = 0.009, P = 0.026, and P = 0.046, respectively). Conclusions: Many slow learners in our city have symptoms of anxiety disorders and overall anxiety. There is an urgent need to screen them for anxiety disorders to facilitate their optimum rehabilitation. [ABSTRACT FROM AUTHOR]

Background: There is limited evidence to support use of fixed dose combination (FDC) drugs in the treatment of psychiatric disorders. This study aimed to examine the sales and regulatory status of psychotropic FDCs in India, in the context of two government regulatory initiatives. Methods: Official documents were searched to establish an account of the initiatives and measures targeting psychotropic FDCs. This was integrated with private market data (2008 to 2020). Descriptive statistics were used to examine changes in FDC numbers/formulations and sales volumes in standard units (SU) over time. Results: Psychotropic FDC sales volumes (percentage market share) increased from 0.8 billion SU (18.4%) in 2008 to 1.4 billion SU (20.1%) in 2020. The numbers (formulations) of FDCs also increased, from 28 (101) in 2008 to 33 (143) in 2020. Unapproved FDCs accounted for 69.3% of psychotropic FDC sales in 2008, decreasing slightly to 60.3% in 2020. Of 21 psychotropic FDCs considered under the regulatory initiatives, three went on to be banned, and two of these remained on the market in 2020. Conclusions: Unapproved FDCs continue to account for most psychotropic FDC sales, potentially putting the public at risk because their safety and efficacy have not been evaluated. [ABSTRACT FROM AUTHOR]

Background: Anabolic-androgenic steroids (AASs), when taken in supraphysiologic doses, increase muscle strength and athletic performance. Evidence suggests that long-term use of AAS in supraphysiologic doses have adverse effects on health. Therefore, the study was conducted to find crude estimate of the prevalence of AAS use among attendees of the gymnasium, the factors that could have influenced them for AAS abuse and to assess the short- and long-term side effects as perceived by them. Methods: A cross-sectional study was conducted in selected gymnasiums of a smart city of India using a predesigned and pretested questionnaire. Snowball sampling method was undertaken. The study was from July 2015 to June 2016. Informed written consent was taken. The analysis was done using SPSS v. 20.0. Results: Of 84 bodybuilders approached, 74 participants used AAS. All users were male with mean age of 26.5 + 0.55 years. The mean age of initiation of AAS abuse was 23 years, and 66.2% (49) were unmarried. Eighty-five percent (63) preferred injectable. Seventy percent (52) abusers were influenced by trainers for abuse. Most commonly abused was Nandrolone decanoate (55.4%). Seventy-three percent were not aware of any legal ban on steroids. Reported benefits include increased strength, muscle size, and power, while harms were increased acne, deepening of voice, swelling of feet, increased irritability, depressive thoughts, impaired judgment, panic disorder, and withdrawal effect. Conclusions: Frequency of ASS use was substantial among young bodybuilders. Awareness about side effects was not a deterrent factor. Abusers were highly influenced by coaches. Efforts should be made for preventing easy access to AAS. [ABSTRACT FROM AUTHOR]

Introduction: Premenstrual dysphoric disorder (PMDD), a severe form of premenstrual syndrome (PMS), is a of emotional, behavioral, and physical symptoms that cause severe functional impairment. This prospective, observational study was performed on students to assess the prevalence, the factors associated with PMS and PMDD, and the functional impairment caused by PMDD in various aspects of life. Methodology: The present study was conducted on 224 consenting college students who attained menarche using standardized instruments such as the Daily Record of Severity of Problems, the Carolina Premenstrual Assessment Scoring System, and the Sheehan Disability Scale. Results: The prevalence of PMS and PMDD was 19.64% and 4.46%, respectively. disability scores and functional impairment in the study were comparable to other major mental illnesses. Conclusion: This study therefore emphasizes the need for identification and prompt management of PMS and PMDD so as to improve the quality of life. [ABSTRACT FROM AUTHOR]

Introduction: Anxiety disorders have a prevalence rate of 2.57% and significantly impact well-being and productivity. The course of anxiety disorders is characterised by fluctuating symptom severity, a high relapse rate, and chronicity. Patients with anxiety disorders are typically prescribed antidepressants or anti-anxiety medications, but these treatments often have limited long-term efficacy. Combining pharmacotherapy with non-pharmacological techniques, such as Progressive Muscle Relaxation (PMR), may enhance the effectiveness of treatment for anxiety disorders. Aim: To assess and compare the Hamilton Anxiety Rating Scale (HAM-A) scores at six-month between Group-E (who received Escitalopram exclusively) and Group-E+PMR (who received Escitalopram in addition to PMR). Additionally, the aim was also to compare the baseline HAM-A scores with those obtained after six months within each group. Materials and Methods: A randomised clinical study was conducted in the Department of Psychiatry at Sri Guru Ram Das Institute of Medical Sciences and Research in Amritsar, Punjab, India, from March 2020 to March 2021. The study was carried out following approval from the Institutional Ethics Committee (IEC). Participants were individuals aged 18 to 45 years who visited the Psychiatry Department's Outpatient Department (OPD) and met the ICD-10 criteria for Neurotic, stress-related, and somatoform disorders (F40-F48). One hundred and seventeen participants were randomly allocated to the two groups using a simple randomization method. Group-E received a daily dose of 10 mg Escitalopram for six months, while Group-E+PMR received the same dosage of Escitalopram along with Jacobson's PMR exercises lasting 20 minutes, twice daily, at their place of residence. The HAM-A scale was employed to assess anxiety levels in both groups. Paired t-tests were conducted to compare pre- and post-treatment HAM-A scores within each group, while independent t-tests were used to compare scores between the groups. Statistical analysis was carried out using SPSS version 24.0 and a significance level of p<0.05 was adopted for the statistical assessments. Results: Both groups were comparable in terms of sociodemographic variables, mean age, and baseline HAM-A scores. The majority of participants, 70 (70%), were females. Significant improvements were noted in the HAM-A scores at six-month mark compared to baseline for both, Group-E and Group-E+PMR (p<0.001). Furthermore, Group-E+PMR exhibited a significant decrease in the HAM-A score at six months compared to Group-E (p<0.001), indicating more substantial improvements. Conclusion: Escitalopram and Escitalopram combined with PMR treatment effectively lowered anxiety. However, the incorporation of PMR Exercises alongside Escitalopram demonstrated more favourable outcomes in individuals with anxiety disorders. [ABSTRACT FROM AUTHOR]

Aim: To review the international evidence base on interventions to support the mental health of family carers of children with brain injuries in low and middle income countries (LMIC). Methods: Searches were conducted with five electronic databases (Pubmed, Web of Science, Embase, PsycINFO, CINAHL) using search terms related to "family carers", "brain injury", "children" and "low and middle income countries". Studies were independently screened using predetermined eligibility criteria by two authors. Data were extracted from included studies using standardised data extraction and quality appraisal tools. These data were then subjected to narrative synthesis. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were used to govern the review process. Findings: One study met our inclusion criteria and described an acquired brain injury called nodding syndrome which occurs in Sub-Saharan Africa. The study was conducted in Ghana and provided group-based psychotherapy to carers and their children. As such we found no study which sought to solely support the mental health of family carers. Conclusions: There has been a lack of focus in the literature on the mental health of family carers of children with brain injuries in LMIC. Considering the vital importance of caregivers in supporting their children it is imperative that service providers and researchers devise programmes to better meet their needs. The mental health of family carers should be better supported to improve their overall wellbeing, which will in turn improve the wellbeing of their children. [ABSTRACT FROM AUTHOR]

"There is no such thing as pure pleasure; some anxiety always goes with it" (43 BC) A study was conducted to assess the prevalence of anxiety and anxiety disorders among adolescents of a selected senior secondary school, Ludhiana, Punjab, India. A self structured questionnaire was prepared to assess the prevalence of anxiety and anxiety disorders on the basis of literature review and expert opinion. To assess anxiety disorders a standardized tool-Screen for Child Anxiety Related Disorder (SCARED) developed by Boris Birmahar (1999)was used. The items of tool were formulated to diagnose anxiety disorders - Panic Disorder, Generalized Anxiety Disorder, Separation Anxiety Disorder, Social Anxiety Disorder and School Avoidance among adolescents. Before data collection a formal permission was taken from school and verbal consent was taken from adolescents for participation in the study. Pilot study was done on ten adolescents to ensure reliability of the tool and feasibility of study. For final study Stratified random sampling (lottery without replacement) was used to collect a sample of 201 adolescents. The purpose of study was explained to them and confidentiality was assured. The data gathered were analyzed by calculating mean, mean percentage, SD and 'z' test. [ABSTRACT FROM AUTHOR]

Background: Research on climatic parameters contributing to psychiatric disorder seasonality is limited, particularly in subtropical, arid climates like Rajasthan, necessitating investigation into seasonal variations in psychiatric disorder incidence in the region. This study investigates seasonal variations in psychiatric disorder prevalence over 2 years at a Rajasthan tertiary healthcare center, aiming to uncover links with climatic factors. Aims: To investigate seasonal variations in the utilization of outpatient psychiatry services and elucidate potential determinants contributing to these temporal variations. Settings and Design: This is a hospital-based study. A retrospective chart review of all new patients who utilized psychiatry outpatient services from July 2021 to July 2023 was conducted. Methods and Material: Data were gathered from psychiatric outpatient records of adults (July 2021 to July 2023), diagnosed using ICD-10. Seasons were categorized: winter (November-January), spring (February-April), summer (May-July), and rainy (August-October). Meteorological data, temperature, and day length were obtained. Statistical analyses, including Pearson correlation and Chi-square fitness, assessed seasonal associations with psychiatric disorders. Results: A total of 29,164 patient records were observed. Depression correlated with temperature and photoperiod. Mania peaked in August, linked to day length. Schizophrenia showed seasonal variation without environmental correlation. Anxiety peaked in March with no statistical significance. Obsessive compulsive disorder cases spiked in June, moderately correlated with temperature and photoperiod. Alcohol-related disorders peaked in December, while opioid dependence remained steady. Cannabis-induced psychosis peaked in summer, strongly correlated with temperature and day length. Headaches surged in August, positively correlated with temperature and day length. Conclusions: This study reveals complex relationships between seasonality, environmental factors, and psychiatric disorders, emphasizing their importance in mental health research and practice. [ABSTRACT FROM AUTHOR]

Background: Exposure to extreme weatherly events potentially develops mental disorders among affected individuals. Aim: To synthesize the burden of mental disorders following impact of extreme weather events in South-east Asian (SEA) countries. Methods: Proposal was registered in PROSPERO register [CRD42023469788] and reported as per PRISMA-2020 guidelines. Studies reporting prevalence of mental health disorders following extreme weather events from SEA countries during 1990 and 2023 were searched on Embase, PubMed, and Scopus databases. Study quality was assessed using Appraisal tool for Cross-Sectional Studies. Overall pooled prevalence was computed using DerSimonian-Laird method for random-effects model and reported as 95% confidence intervals. Results: On screening 12,046 records, we included 155 studies (2,04,474 participants) for analysis. Overall burden of mental disorders was 35.31% (95%CI: 30.42%-40.21%). In subgroup analysis, studies on cyclones, India, local residents, children and adolescents, rural settings, and community settings reported higher burden of mental disorders. Depression (28.58%; 95%CI: 24.05%-33.1%) and PTSD (29.36%; 95%CI: 26.26%-32.46%) had similar prevalence. Visiting tourists to SEA region experienced fear, fear of recurrence of tsunami, nightmares, and sense of helplessness. Mental health outcomes were relatively higher in studies conducted within 1 year of events. Heterogeneity and possibility of publication bias exists among the reported studies. Conclusion: With the significant rise in episodes of extreme weather events in SEA region over the last three decades, mental disorders are documented in different proportions. We suggest prioritizing well-informed policies to formulate inclusive and resilient strategies on effectively identifying and treating mental health concerns among victims of extreme weather events. [ABSTRACT FROM AUTHOR]

BACKGROUND: In the working population especially among older adults, anxiety problems have grown dramatically. This element has a significant impact on employee absenteeism and problems with physical and mental health. It was widely known that security personnel had several physical and mental difficulties during their various work hours. It is important to investigate the effects of anxiety on them. OBJECTIVE: The present study aims to provide insights into the prevalence of anxiety disorders and explore the correlations between anxiety symptoms, sleep, and memory during the COVID-19 pandemic. METHODS: To conduct a cross-sectional study, 42 older adult participants between the ages of sixty to seventy years were chosen and the procedure was explained.Data were gathered by giving instructions on how to complete the self-reported Generalized Anxiety Disorder Assessment -7 (GAD-7), the Epworth Sleepiness Scale, and the revised Everyday Memory Questionnaire. RESULTS: A total of 36 out of 42 participants (85.71%) experienced moderate to severe anxiety. Anxiety and sleep had a correlation of 0.8, while anxiety and memory had a correlation of 0.87 with a positive EMQ-R relationship. Moreover, there was a statistically significant association between sleep and memory, with a positive correlation of 0.73. CONCLUSION: The study concludes that, there is a substantial prevalence of anxiety accompanied by notable insomnia and memory problems in elderly security officers. Our findings indicate a clear relationship between sleep disturbances, memory issues, and most prevalent anxiety symptoms. These results emphasize the importance of incorporating mental health assessments and addressing an effective treatment for anxiety. [ABSTRACT FROM AUTHOR]

Background: Nomophobia is a situational phobia evoked by unavailability of smart phone or the thought of the possibility of not having it, not being able to use it and losing it. Currently used instruments for assessment of severity of nomophobia offers challenges of administration and have limited applicability in the Indian setting. Therefore, this study was aimed to depict and understand the lived experience of college students with nomophobia and making sense of it. Methods: This interpretative phenomenological analysis research design study was carried out on 17 undergraduate students belonging to different academic streams including Science, Social science and Commerce from the three study sites situated in different locations of India. An in-depth interview guide was prepared. The students who scored more than 90 on nomophobia questionnaire (NMP-Q Questionnaire) were included in the study. The data was recorded in audio and video format, it was transcribed, and translated from Hindi to English language. Coding was done and the theme were extracted. Results: The findings identified six superordinate themes: Digital Obsession, Digital Compulsion, Approval Motivation, Digital Intensement, Digital Well-being and Insight. Conclusion: The lived experiences of the students with nomophobia had explicitly shown a strong inclination towards the smartphone. They also focused on some of the significant aids provided by the smartphone. Further the intensive use of the smartphone was posing major challenges to the students when they were away from it. [ABSTRACT FROM AUTHOR]

Background: Mental illness (MI) remains stigmatized globally, including in India, where suicide and suicidality have been rising. Internalization of society's negative stereotypes by people with MI is known as internalized MI stigma. Aims: The present paper examined the prevalence of internalized MI stigma in a large sample of rural Indian participants with comorbid chronic medical conditions and previously undiagnosed, mostly mild-to-moderate depression/anxiety. It further examined correlates of internalized MI stigma and its association with suicidality. Subjects and Methods: Face-to-face interviews were conducted at four-time points with adults with depression/anxiety and chronic physical illness in primary health centers in Ramanagaram, Karnataka. Topics included demographics, social support, depression (9-item Patient Health Questionnaire scale), anxiety (7-item General Anxiety Disorder scale), suicidality (Mini-International Neuropsychiatric Interview), and internalized MI stigma (Internalized Stigma of Mental Illness [ISMI] scale). Data analysis included linear and hierarchical logistic regression. Results: At baseline, 29.1% of participants showed a high level of internalized stigma, and 10.4% exhibited at least moderate suicidality. Hierarchical logistic regression showed that every 1-point increase on the ISMI scale more than tripled the odds of moderate to high suicidality (adjusted odds ratio [AOR] 3.24). Those being at least moderately depressed/anxious were 2.4 times more likely to be at least moderately suicidal than participants with no-mild depression/anxiety. Social support lowered the odds of suicidality (AOR 0.44). Conclusions: Internalized MI stigma and suicidality were substantial among these rural adults with mostly mild-to-moderate anxiety/depression. Higher stigma was associated with increased suicidality, independently of depression/anxiety. Therefore, efforts to reduce internalized MI stigma should be included in mental health treatment. [ABSTRACT FROM AUTHOR]

Background: Despite alcohol use being a risk factor for numerous health-related conditions and alcohol use disorder (AUD) recognized as a disease, there was limited research in India until 2010. This narrative review aims to evaluate AUD-related research in India from 2010 to July 2023. Methods: A PubMed search used key terms for AUD in India after 2010. Indian and international journals with regional significance that publish alcohol-related research were searched by each author individually. These were then collated, and duplicates were removed. In addition, we also conducted a gray literature search on focused areas related to AUD. Results: The alcohol-related research in India after 2010 focused on diverse areas associated with alcohol use. Some areas of research have received more attention than others. Two major epidemiological surveys conducted in the past decade reveal that around 5% have a problematic alcohol use pattern. Factors associated with alcohol use, like genetic, neurobiological, psychological, and sociocultural, were studied. The studies focused on the clinical profile of AUD, including their correlates, such as craving, withdrawal, alcohol-related harm, and comorbid psychiatric and medical illnesses. During this period, minimal research was conducted to understand AUD's laboratory biomarkers, course, and prognosis. While there was a focus on generating evidence for different psychological interventions for alcohol dependence in management-related research, pharmacological studies centered on anticraving agents like baclofen. Research on noninvasive brain stimulation, such as rTMS, has shown preliminary usefulness in treating alcohol dependence. Very little research has been conducted regarding alcohol policy. Conclusion: In the past decade, Indian research on alcohol has focused on diverse areas. Epidemiological and psychological management-related research received maximum attention. Considering the magnitude of the alcohol-related burden, it is essential to prioritize research to other less studied areas like pharmacological management of alcohol dependence and alcohol policy. [ABSTRACT FROM AUTHOR]

This paper considers the way the outbreak of coronavirus and the subsequent lockdown has egregiously impeded the Hindu death ceremonies and mourning rituals in India. It makes a comparative analysis of how Hindu death rituals get renegotiated, modified and reinterpreted across two vastly different regions of India, both of which have their local customs. Whilst death rituals in India are contingent on the deceased's caste, community, class, gender and age, the impediment to the major death rituals creates a central conundrum for all mourners. It results from the substitution of 'sacred' ritual guidelines with new 'profane' ones for the 'disposal' of deceased COVID-19 patients. Departure from many significant pre-liminal rites, specific transition rites, and post-liminal rites has eschatological, ritual and cultural ramifications. The inability to grieve in unison during a Shraddh ceremony denies mourners any scope to quell distressing feelings about mortality which serves as a source of consolation. [ABSTRACT FROM AUTHOR]

Introduction: Though a substantial number of studies indicate the nexus between childhood trauma, PTSD, and dissociative disorders among adolescents, Indian literature is mostly silent. As reported incidents of child abuse are alarming in India, it was important to explore further on the subject. Objective: To explore the relationship between childhood trauma and other clinical correlates like anxiety, PTSD and behavioural problems in adolescents diagnosed with dissociative disorder. Method: 50 adolescents aged 13-18 years with a medical diagnosis of dissociative disorder were included. A convenient sampling technique was used to recruit the patients from a child guidance clinic of a tertiary care hospital. Child Dissociative Checklist (CDC), Children's Impact of Events Scale (CRIES -13), Screen for Child Anxiety Related Disorders (SCARD), and Youth self-Report (YSR from Child Behaviour Checklist) were administered. Results: The sample consisted of 62% females and 38% males. A significant relationship was found between dissociation and anxiety, panic disorder and separation anxiety disorder. CDC had a positive correlation with internalisation, externalisation and behaviour problems. Regression analysis showed that behavioural problems and PTSD (CRIES-13) as two significant predictors of anxiety. Although there was no significant difference between adolescents with childhood trauma and without it, still the presence of trauma emerged as a significant predictor of dissociative disorders. Conclusion: The findings indicated that dissociation had a significant association with childhood trauma, behaviour problems, anxiety and post-traumatic stress. Thus, culturally appropriate trauma-focused interventions for the treatment of mental illnesses and the underlying trauma should be designed for addressing dissociative disorders in this age group. [ABSTRACT FROM AUTHOR]

Background: Common mental disorders (CMDs) among adolescents may hamper their psycho-social development. Aim: This study evaluated the prevalence and determinants of CMD like depression and anxiety among late adolescents of an age of 15-19 years residing in an urban resettlement colony of southeast Delhi. Methods: A community-based cross-sectional study was carried out among 556 randomly selected adolescents. CMD was assessed using Mini International Neuropsychiatry Interview -- Kid version 6 (MINI-Kid) based on DSM-IV TR and compliant with ICD-10 definitions of CMD. The associated risk factors were studied using a self-developed semi-structured interview schedule and analyzed using multi-variable logistic regression. Results: A total of 491 adolescents were interviewed (a response rate of 88.3%), of whom 247 (50.3%) were female and 210 (42.8%) belonged to a lower-middle socio-economic status. The lifetime prevalence of CMD was 34% [95% confidence interval (CI): 29.8-38.2]. Of the total, 22.4% (95% CI: 18.7-6.1) of the participants reported depression and 6.7% (95% CI: 4.5-8.9) reported generalized anxiety disorder during their lifetime. Female sex [adjusted odds ratio (aOR) 2.1, 95% CI: 1.4-2.2], experiencing a stressful event in the past 6 months (aOR 4.7, 95% CI: 3.1-7.3), and smoking tobacco (aOR 2.0, 95% CI: 1.2-7.4) significantly increased the odds of having CMD in multi-variate analysis. Conclusion: There is a high prevalence of CMD among adolescents residing in urban resettlement colonies of Delhi, which is composed mostly of people belonging to lower socio-economic strata. Hence, tailored intervention at stress management with promotion of healthy lifestyle is needed for this age group. [ABSTRACT FROM AUTHOR]

Suicide is a global health concern. The risk of suicide is more in females compared to males. Reproductive health related factors are the major reason for this increasing risk. The aim of the study is to find out the relationship between menstruation and suicide and to find out if there is any relationship exists between any of the other phases of menstrual cycle and suicidal behaviour. Hospital based cross sectional study was conducted in the Department of Forensic Medicine, Government Medical College, Thrissur which is a tertiary care centre. The study was done for a period of one year, from August 2015 to July 2016. The final sample size attained i.e the uterus specimens of reproductive age group during the study period is 100. Thus 50 were taken as cases and the other 50 who died of any other cause other than suicide were taken as control. Majority of the study participants belongs to 20 years of age group among cases. Most of our study participants were married in our study, majority of the study participants were above poverty line, no specific history of motivation towards suicide was found in majority of the study participants followed by psychiatric problems and family problems. Hanging was the most common method used for suicide. Among the cases majority of the study participants were in the late proliferative phase. In our study majority of the study participants committed suicide in the early proliferative phase. [ABSTRACT FROM AUTHOR]

Background: Suicide is a primary health concern worldwide, and has a negative impact on the individual, family, and society. The literature suggests that females are more prone to attempt suicide and have more suicidal inclinations; however, males are more serious suicide attempters compared to females. Objective: The objective of this study was to assess the sociodemographic and clinical profile of patients admitted to acute care with the current suicide attempt. Materials and Methods: One hundred consecutive patients, aged between 18 and 60 years, who were medically stable and presented to the emergency or medical wards at the hospital with suicidal attempt, were included in this study. Beck's Suicide Intent Scale (SIS), Beck Scale for Suicidal Ideation, Beck Hopelessness Scale, and Beck Depression Inventory--II were administered to assess the current suicidal intent and ideation, depression, and hopelessness. Results: The diagnostic breakup was -- 69% mood (affective) disorders, 21% adjustment disorders, 4% schizophrenia, and 6% other disorders. Most suicide attempters were female (66% vs. 34%) and belonged to a younger age group (28.30 ± 10.08 years vs. 34.73 ± 13.97 years) compared to males (P < 0.05). Although both genders displayed high suicide intent, a significant difference in the SIS score was noted between females and males (36.53 ± 7.68 vs. 41.47 ± 8.82; P < 0.05). Conclusion: There is a difference in the clinical and demographic profile among male and female suicide attempters. Hence, appropriate interventions can be devised to prevent the future suicide attempts as per the demographic and clinical characteristics specific to the study population. [ABSTRACT FROM AUTHOR]