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Background: Sunlight contains ultraviolet B (UVB) radiation that triggers the production of vitamin D by skin. Vitamin D has widespread effects on brain function in both developing and adult brains. However, many people live at latitudes (about > 40 N or S) that do not receive enough UVB in winter to produce vitamin D. This exploratory study investigated the association between the age of onset of bipolar I disorder and the threshold for UVB sufficient for vitamin D production in a large global sample., Methods: Data for 6972 patients with bipolar I disorder were obtained at 75 collection sites in 41 countries in both hemispheres. The best model to assess the relation between the threshold for UVB sufficient for vitamin D production and age of onset included 1 or more months below the threshold, family history of mood disorders, and birth cohort. All coefficients estimated at P ≤ 0.001., Results: The 6972 patients had an onset in 582 locations in 70 countries, with a mean age of onset of 25.6 years. Of the onset locations, 34.0% had at least 1 month below the threshold for UVB sufficient for vitamin D production. The age of onset at locations with 1 or more months of less than or equal to the threshold for UVB was 1.66 years younger., Conclusion: UVB and vitamin D may have an important influence on the development of bipolar disorder. Study limitations included a lack of data on patient vitamin D levels, lifestyles, or supplement use. More study of the impacts of UVB and vitamin D in bipolar disorder is needed to evaluate this supposition., (© 2023. The Author(s).)

Objective: Circadian rhythm disruption is commonly observed in bipolar disorder (BD). Daylight is the most powerful signal to entrain the human circadian clock system. This exploratory study investigated if solar insolation at the onset location was associated with the polarity of the first episode of BD I. Solar insolation is the amount of electromagnetic energy from the Sun striking a surface area of the Earth., Methods: Data from 7488 patients with BD I were collected at 75 sites in 42 countries. The first episode occurred at 591 onset locations in 67 countries at a wide range of latitudes in both hemispheres. Solar insolation values were obtained for every onset location, and the ratio of the minimum mean monthly insolation to the maximum mean monthly insolation was calculated. This ratio is largest near the equator (with little change in solar insolation over the year), and smallest near the poles (where winter insolation is very small compared to summer insolation). This ratio also applies to tropical locations which may have a cloudy wet and clear dry season, rather than winter and summer., Results: The larger the change in solar insolation throughout the year (smaller the ratio between the minimum monthly and maximum monthly values), the greater the likelihood the first episode polarity was depression. Other associated variables were being female and increasing percentage of gross domestic product spent on country health expenditures. (All coefficients: P ≤ 0.001)., Conclusion: Increased awareness and research into circadian dysfunction throughout the course of BD is warranted., (Copyright © 2022 Elsevier Inc. All rights reserved.)

India consists of 16% of the world's population, but sustains only 2.4% of land resources. The agriculture sector is the only livelihood to two-third of its population, which gives employment to 57% of the workforce and is a raw material source to a large number of industries. Farmer suicides account for approximately 10% of all suicides in India. The national suicide rate is 10.6/lac, whereas in Maharashtra it is 14.2/lac, in Andhra Pradesh 12.1/lac, in Telangana 27.7/lac, and in Chhattisgarh 27.7/lac. The National Crime Records Bureau data from 1995 to 2006 show that 200,000 farmers had committed suicide, with an average rate of 16,000/year. Every 7 th suicide in the country is a farmers' suicide. The first state where suicides were reported was Maharashtra with particularly in the Vidarbha region. In Maharashtra, farmers' suicide rate is 60% higher than the general suicide rate. Every 5 th farmers' suicide committed in the country had occurred in Maharashtra, Vidarbha being a particularly sensitive region but also in Punjab, Uttar Pradesh, Kerala, and Karnataka. In a country of 70 million farmers, 10 in every 100,000 farmers commit suicide. Many inquiry commissions were formed and recommendations were implemented, especially in Punjab. The problem of suicide is not only reported in India but also reported in different parts of the world like England and Wales. We adopted the psychological autopsy approach to offer some insight into the reason why these individuals resorted to such a drastic step., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Industrial Psychiatry Journal.)

Background  This study aims to evaluate association between suicidal ideation and pesticide exposure in rural communities of Wardha district of Central rural India compared with villagers who are not exposed to it. Method  It was a cross-sectional study done in rural community of Wardha district in Central India. About 100 farmers who were exposed to pesticides and 100 controls who were not exposed to pesticides were included. A Semistructured proforma to record sociodemographic variables and Indian version of the Self Reporting Questionnaire-20 was used. Results  Of these 200 subjects, data were available for 85 farmers in study group and 74 in control group. In the farmers group, 31% of farmers had suicidal ideas, while 8% of controls felt like ending their life. Conclusion  Measures must be taken to store pesticides at a safer place thus reducing long-term exposure. Organic farming is a better choice to avoid suicidal ideas., Competing Interests: Conflict of Interest None declared., (Association for Helping Neurosurgical Sick People. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ).)

Background: Bipolar disorder is associated with circadian disruption and a high risk of suicidal behavior. In a previous exploratory study of patients with bipolar I disorder, we found that a history of suicide attempts was associated with differences between winter and summer levels of solar insolation. The purpose of this study was to confirm this finding using international data from 42% more collection sites and 25% more countries., Methods: Data analyzed were from 71 prior and new collection sites in 40 countries at a wide range of latitudes. The analysis included 4876 patients with bipolar I disorder, 45% more data than previously analyzed. Of the patients, 1496 (30.7%) had a history of suicide attempt. Solar insolation data, the amount of the sun's electromagnetic energy striking the surface of the earth, was obtained for each onset location (479 locations in 64 countries)., Results: This analysis confirmed the results of the exploratory study with the same best model and slightly better statistical significance. There was a significant inverse association between a history of suicide attempts and the ratio of mean winter insolation to mean summer insolation (mean winter insolation/mean summer insolation). This ratio is largest near the equator which has little change in solar insolation over the year, and smallest near the poles where the winter insolation is very small compared to the summer insolation. Other variables in the model associated with an increased risk of suicide attempts were a history of alcohol or substance abuse, female gender, and younger birth cohort. The winter/summer insolation ratio was also replaced with the ratio of minimum mean monthly insolation to the maximum mean monthly insolation to accommodate insolation patterns in the tropics, and nearly identical results were found. All estimated coefficients were significant at p < 0.01., Conclusion: A large change in solar insolation, both between winter and summer and between the minimum and maximum monthly values, may increase the risk of suicide attempts in bipolar I disorder. With frequent circadian rhythm dysfunction and suicidal behavior in bipolar disorder, greater understanding of the optimal roles of daylight and electric lighting in circadian entrainment is needed., (© 2021. The Author(s).)

Objectives  Can undergraduate medical students (UGs) adopt a village model to identify mentally ill persons in an adopted village successfully? Materials and Methods  UGs during their first year adopt a village, and each student adopts seven families in the villages. During the visit, they look after immunization, tobacco and alcohol abuse, nutrition, hygiene, and sanitation. They help in identifying the health needs (including mental health) of the adopted family. The Indian Psychiatric Survey Schedule containing 15 questions covering most of the psychiatric illnesses were used by UGs to identify mental illness in the community. Persons identified as suffering from mental illness were referred to a consultant psychiatrist for confirmation of diagnosis and further management. Statistical Analysis   Calculated by percentage of expected mentally ill persons based on prevalence of mental illness in the rural community and is compared with actual number of patients with mental illness identified by the UGs. True-positive, false-positive, and true predictive values were derived. Results  In Umri village, UGs were able to identify 269 persons as true positives and 25 as false positives, whereas in Kurzadi village, UGs were able to identify 221 persons as true positives and 35 as false positives. It suggests UGs were able to identify mental illnesses with a good positive predictive value. In Umri village, out of 294 mentally ill patients, it gave a true positive value of 91.49% and a false positive value of 8.5%, whereas in Kurzadi village, out of the 256 mentally ill patients, it gave a true positive value of 86.3% and a false positive value of 13.67%. Conclusion  The ratio of psychiatrists in India is approximately 0.30 per 100,000 population due to which psychiatrists alone cannot cover the mental health problems of India. Therefore, we need a different model to cover mental illness in India, which is discussed in this article., Competing Interests: Conflict of Interest None declared., (Association for Helping Neurosurgical Sick People. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. https://creativecommons.org/licenses/by-nc-nd/4.0/.)

On March 11, 2020, the World Health Organization declared the SARS-CoV-2 outbreak to be a pandemic which has sent all countries in a frenzy. We cannot be callous about treatment of non-COVID-19-related patients. The Wardha district of Maharashtra is a declared "dry area" which makes the sale, purchase, and consumption of alcohol illegal. On March 24, 2020, Indians were informed of a 21-day long lockdown which was subsequently extended for another 3 weeks during which all modes of public transportation, educational institutions, offices, and other nonessential businesses were closed and people expected to remain at home unless necessary. Since then admissions of alcohol-dependent patients showed a spike from14% in the prelockdown period to 27% of patients of alcohol dependence syndrome. It is most likely due to poor availability of liquor, inability to earn money to buy the alcohol, or restricted movement of individuals., Competing Interests: Conflict of Interest None declared.

Background: To find any association between family structure and rates of hospitalization as an indicator for behavior problems in children., Methods: Retrospective chart review of 154 patients who were admitted to the preadolescent unit at Lincoln Prairie Behavioral Health Center between July and December 2012., Results: We found that only 11% of children came from intact families living with biological parents while 89% had some kind of disruption in their family structure. Two-third of the children in the study population had been exposed to trauma with physical abuse seen in 36% of cases. Seventy-one percent had reported either a parent or a sibling with a psychiatric disorder. Children coming from biologically family were less likely to have been exposed to trauma. Children coming from single/divorced families were less likely to have been exposed to sexual abuse but more likely to have a diagnosis of attention deficit hyperactivity disorder (ADHD) compared to other types of families. Strong association was found between exposure to trauma and certain diagnoses in respect to hospitalization. ADHD predicted a 4 times likelihood of having more than one previous hospitalization, with mood disorder, oppositional defiant disorder, and physical abuse increasing the risk by more than twice., Conclusions: Significant differences in family structure were demonstrated in our study of children being admitted to inpatient psychiatric hospitalization. The presence of trauma and family psychiatric history predicted higher rates of readmission. Our study highlighted the role of psychosocial factors, namely, family structure and its adverse effects on the mental well-being of children., Competing Interests: There are no conflicts of interest.

In this chapter, the relation between religion and mental health and vice versa has been described. From primitive times different religions have different beliefs and systems of worshipping. Every religion with their belief system has implications on mental health and illness. We described how Hindu system of beliefs and rituals may have an effect in causation of various mental illnesses. It is also described how religion can help an individual to sustain one's life in various domains. The relationship between different religion and symptomatology is described. The impact and outcome of religion on mental health have been highlighted.

The perfect balance of mind, body and soul is considered as complete health in Ayurveda. Ayurveda has its own identity as most ancient and traditional System of Medicine in India. Even Ayurveda emphasizes its treatment modalities into three parts viz. Satwawajay Chikitsa, Yuktivyapashray and Daivyapashray Chikitsa. Sattvavajaya therapy mentioned in Charakasamhita and it used as new concept of psychotherapy in Ayurveda. The effectiveness of "traditional mental health promoting practices" was identified as health regimens (swasthvrtt), correct behavior (sadvrtt), and yoga. Sattvavajaya as psychotherapy, is the mental restraint, or a "mind control" as referred by Caraka, is achieved through "spiritual knowledge, philosophy, fortitude, remembrance and concentration. Ayurvedic psychotherapy would play a dual role: First, as a revival of authentic medical culture, the exercise of a practice with an assumed primordial dimension, and second as a discovery of authentic subjectivity, the revelation of a self with an assumed interior depth. When we integrate the contemporary art of psychotherapy with the ancient science of Ayurveda, it becomes a powerful combination that is called Psycho Veda. The integration of Psycho and Veda is motivated by the complete integration of the immense but fairly contemporary view of the mind, emotions and psyche and how this performs in our lives. Integrating Psychotherapy and Vedic principles teaches us how to rediscover critical knowledge and awareness of the natural forces and rhythms that compliment and strengthen our human experience, through the understanding of the psyche and what our inner experiences are and also involving practical daily activities with thorough attention to our total environment to bring about radical changes in our mental outlook and in physical health.