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Background: Adherence has always been a major problem in the treatment of Schizophrenia, despite of the advances in the treatment regime. Various factors influence adherence to antipsychotics in patients of Schizophrenia. This study is the first of its kind, done on a specific group of patients of Schizophrenia on antipsychotic medication, at a tertiary referral hospital, in the Indian setting. It was done to highlight the various factors influencing adherence and non-adherence to antipsychotics which will help plan future directives to address barriers in adherence. Method: The study evaluated the socio-demographic profile, clinical features, causes of adherence and non-adherence, and their associations in 60 patients of Schizophrenia on antipsychotics, using the ICD-10 criteria for research, the modified Kuppuswamy socioeconomic scale, the MINI-PLUS and the ROMI scale. Results: The most common reason for adherence was the family member’s strong belief in the efficacy of medication (96%), while for non-adherence it was the poor financial condition of the patients (71.6%). A significant association was found between the perceived daily benefit, having a strong positive relationship with the clinician, and adherence, as per the ROMI scale. Non-adherence was found in patients who did not perceive any benefit with medication, those who had financial problems and side effects of medication. Conclusion: These findings will help in planning suitable interventions to enhance adherence to antipsychotics in patients of Schizophrenia.

Kartagener’s syndrome is a rare genetic disorder of primary ciliary dyskinesia characterized by the triad of bronchiectasis, sinusitis, and situs inversus. There is limited data on the role of Kartagener’s syndrome leading to psychotic manifestations. We would like to discuss the case of a 26-year-old male, who presented to us with psychotic symptoms of 4-year duration. Upon detailed physical examination and pertinent investigations, he was diagnosed to be having Kartagener’s syndrome. He was treated with antipsychotics and benzodiazepines. This case highlights the importance of a thorough physical examination and eliciting medical history, as it may lead to the finding of various syndromes that have been said to be associated with schizophrenia, thereby contributing to its genetic hypothesis. The neurological, biochemical, and structural malformations seen in Kartagener’s syndrome may also lead to psychotic manifestations. They could be genetically linked to loci contributing to an increased risk of psychosis. [ABSTRACT FROM AUTHOR]

Depression in men and women presents differently and there are various factors governing this. This article aims to elucidate these differences so that the management approach can be adopted as required and the morbidity be reduced. [ABSTRACT FROM AUTHOR]

Managing a severe treatment-resistant psychiatric illness in the context of pregnancy has always been a challenge for psychiatrists, especially with a comorbid medical illness. We present a case of an elderly primigravida having schizophrenia of 22 years, with high-risk pregnancy, who suffered from an acute psychotic exacerbation during pregnancy. She was managed with clozapine, aripiprazole, and amisulpiride, after a failed trial of olanzapine and electroconvulsive therapy. This case highlights the challenges in managing an elderly primigravida with comorbid gestational diabetes mellitus and fibroid who required prolonged hospitalization throughout her pregnancy. A strong liaison with an obstetrician goes a long way in ensuring smooth management. [ABSTRACT FROM AUTHOR]

Suicide is the second leading cause of death among adolescents in the age group of 15 to 19 years. As per the National Crime Record Bureau, India loses 1 student to suicide every hour. The COVID pandemic saw an alarming rise in the number of children/adolescents attempting suicide. The state of Kerala lost 173 children in the age group of 10 to 18 years, during the first wave of the pandemic (March-October 2020). This review article has been written with the aim of exploring causes of aggression, suicide, and self-harm in children and adolescents. It also strives to bring forth the various interventions which can be taken in order to reduce the rate of suicide and self-harm in children and adolescents. [ABSTRACT FROM AUTHOR]