Mental retardation is a permanent condition unlike many other diseases. It is a highly prevalent and highly disabling condition. In this study an attempt has been made to study both positive and negative impact on parents so as to help manage this problem in the best possible way. The study was conducted at the outpatient department of P.G.I. Behavioral and Medical Sciences, Raipur, and two special schools of mentally challenged children and it was done by purposive sampling method. Using specially designed semi-structured sociodemographic and clinical data sheet, information was gathered about mentally challenged children and their parents. Vineland Social Maturity Scale (VSMS) and Developmental Screening Test (DST) were used to assess their intelligence. Parents fulfilling inclusion and exclusion criteria consenting for the study were selected. National Institute for the Mentally Handicapped Disability Impact Scale (2003) was then administered on them. The results are reported and discussed.

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India, with a population of a billion, has very limited numbers of mental health facilities and professionals in providing mental health care to all the people. The disability associated with mental or brain disorders stops people from working and engaging in other creative activities. Gradual implementation of district mental health programme in a phased manner with support of adequate managerial and financial inputs is the need of the day. Trained mental health care personnel, treatment, care, and rehabilitation facilities should be made available and accessible to the masses. The voluntary organizations should be encouraged to participate in mental health care programme.

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The paper strives to elucidate the complex yet intimate relation between spirituality and mental health from contemporary perspectives. The diverse and constantly evolving views that spiritualists and mental health professionals have held toward each other over last century are discussed with special accent on the transpersonal spiritual framework within psychology. The role of spirituality in promoting mental health and alleviating mental illness is highlighted. The paper is concluded with an increasing need to integrate spirituality within the mental health field albeit there are several impediments in achieving the same, which need to be worked through circumspectly.

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There is long-standing debate about superiority of mind over brain, in other words about superiority of mind over matter. And outcome of this debate is going to decide future of psychiatry. The psychiatrists believing in materialism may say that brain is all and by changing neurotransmitters level with new molecules of drugs would cure all illnesses. On the other hand, antipsychiatry activists and some psychotherapists oppose all types of treatment despite of convincing evidence that drug therapy is effective (although sometimes it is not as effective as it claims to be). However, truth lies somewhere in between. Pharmacotherapy and psychotherapy are like two legs of psychiatry and psychiatry cannot walk into a future on one leg. The studies have shown that judicious use of pharmacotherapy along with psychotherapy gives better outcome than any one of them used alone. We must heal dichotomy between mind and brain before we heal the patients.

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The Central Industrial Security Force (CISF) provides security cover to several of the Nation's vital industrial sectors and the CISF personnel are trained so as to meet expected and unexpected emergencies for varied periods of time. The present study is undertaken at the National industrial security Academy, NISA, Hyderabad with the objectives of assessing the psychiatric morbidity and the factors contributing to stress among the CISF personnel. A Random stratified sample of 500 subjects stratified to include personnel from all ranks such as SI's, Executive officials and constables are screened using the Goldberg's General Health Questionnaire. A detailed screening Questionnaire adapted from Channabasavanna S.M etal (1996) to assess the stress and coping was used. Those who are screened positive are further evaluated using the Mini International Neuro-psychiatric Interview, M.I.N.I to confirm the psychiatric diagnosis and using detailed personal interviews the factors contributing to stress in the CISF personnel are identified. The results of the study have shown that personnel posted in stressful areas and of the Rank of constables had perceived stress and more morbidity compared to those posted in nonstressful areas.

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The prevalence of the obsessive-compulsive symptoms in schizophrenia (OCSS) appears to be higher than that expected on the basis of comorbidity rates. Review of brain abnormalities in schizophrenia and obsessive-compulsive disorder (OCD) reveals involvement of similar regions namely the frontal lobe, the basal ganglia, the thalamus, and the cerebellum, in both the disorders. Neurodevelopmental etiopathogenesis has been proposed to explain schizophrenia as well as OCD. Significant overlap in neurotransmitter dysfunction (serotonin, glutamate, and dopamine) has been documented between schizophrenia and OCD. The New-onset obsessive-compulsive (OC) symptoms have been reported with the use of atypical antipsychotics in the schizophrenia patients In this background, OCSS is an emerging area of recent interests. This article attempts to review the literature on the neurobiology of OCSS. Neuroimaging, neuropsychological, and neuromotor abnormalities in OCSS discussed in the context of neurodevelopmental etiopathogenesis suggest glutamate abnormalities in OCSS. Atypical antipsychotic induced OCSS points towards the possible roles of glutamate and serotonin. Dopamine may be responsible for the beneficial role of antipsychotics in the treatment of OCD. In summary, we propose that glutamate, serotonin, and dopamine abnormalities may be the probable basis for OCSS.

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The objective of this study was to examine the coping patterns followed by the junior college students. Further, an extensive effort was done to study the gender differences in coping patterns used by the students. This study was conducted in Christ College, Bangalore and on the first and second-year students of pre-university studying in either of the branches (Bachelor of Arts, Science, or Commerce). A total of 120 samples were collected from study population of junior college students using the random sampling method. The sample comprised, 40 students from each group of Arts, Science, and Commerce, including both of the sexes. The tools such as, socio-demographic data sheet and coping checklist, were used. The study findings revealed that majority of the students adopted emotion- and problem-focused coping strategies. Most of the female students adopted emotion-focused coping strategies, whereas the male students mostly used problem-focused coping strategies.

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Psychiatrists suffer professional stress. This is being studied for about four decades in the West, but not in India. The reported etiological factors are related to the nature of the profession and clinical situations, characteristics of the psychiatrist, and of the patient. But, there are many unanswered questions. This article briefly overviews the topic, poses few questions, and suggests certain remedial paradigms. The theme of this article applies equally well to mental health profession in general.

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Coprophagia or the ingestion of feces, considered to be a variant of pica, has been associated with medical disorders like seizure disorders, cerebral atrophy, and tumors and with psychiatric disorders like mental retardation, alcoholism, depression, obsessive compulsive disorder, schizophrenia, schizoaffective disorder, fetishes, delirium, and dementia. But entomophagy or the practice of eating live or dead insects as food by humans has only been reported as part of eating habits by some cultures in the world and not in association with any medical or neuropsychiatric disorders. Till date, there is no report in medical literature of entomophagy as an association with any neuropsychiatric or medical illnesses. Coprophagy and entomophagy has not been together reported as well. We describe the first ever case report of a 19-year- old male patient diagnosed with undifferentiated schizophrenia and associated with both entomophagy and coprophagy. His schizophrenic symptoms, the entomophagic, coprophagic behaviors improved with olanzapine therapy. Entomophagy and coprophagy, two very unusual human behaviors, can be seen in association with schizophrenia.

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Background: This study was carried out to evaluate the effect of long-term administration of a commonly prescribed antidepressant, fluoxetine from different group on memory and psychomotor functions in patients of various psychiatric disorders using a battery of simple tests that can be conveniently applied to the Indian population. Materials and Methods: Memory was evaluated using the PGI memory scale and psychomotor functions were evaluated using six letter cancellation test. Statistical analysis was carried out using Wilcoxon signed-rank test. Results and Conclusion: The results of the study reveal that there was significant improvement in some cognitive function. Cognitive functions are improved at first follow-up and they improved continuously up to last follow-up that is at one month. It is observed that there was improvement in the primary disease. So, final score of the cognitive parameters is because of the resultant activity of direct drug action and improvement in the underlying disease.

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Social disability has been found to be a potent predictor of symptom exacerbations and re­hospitalizations. It is clear that social skills training is an effective strategy. Accessibility for the mental health consumers and the availability of services are the two main reasons which highlights the felt need of the brief skill development program in the GHPU during their hospitalization. This article reviews the need for brief skills training to enhance client's social competence to reach optimal functioning which in turn may decrease the risk of relapse or revolving door syndrome and may prevent further deterioration of individual's skills during their long stay in a GHPU's.

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A cross-sectional study was conducted to get an insight into the psychological world of adolescence and to study the influence of locality and school-going activity on it. The study group comprised of 240 girls in the age group 12-18 years equally representing urban and rural areas. Using two psychological tests, namely Strengths and Difficulty Questionnaire and Health-Related Quality of Life Inventory, the results revealed that two-third of them were in the problematic and borderline category as per SDQ and one-third as per PedsQL. Further, there was a definite linear relationship between the total problem score of both scales. This was irrespective of the locale and school-going activity. The results indicate the need for building psychological infrastructure into the social system to help adolescents girls grow to their potential.

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Background: Informed consent forms are required in all clinical trials which are approved by an independent Ethics Committee before practical use in the trials. However, how much the average subject actually understands of the information contained in these informed consent forms is uncertain. Aim: In a cross sectional study, the translated informed consent forms used in psychiatric clinical trials were assessed with respect to their ease of readability. Materials and Methods: We analyzed 30 informed consent forms translated from English to Hindi used in multinational and multicentre psychiatric clinical trials sponsored by different sponsors. We examined consent forms for readability scores and factors that might relate to readability. Results: The mean readability score for the informed consent forms, determined by the Flesch-Kincaid Grade Level Index (FKGL) was grade levels of 13.66. The ease of readability assessed by the Flesch Reading Ease Score (FRES) was 46.08 suggesting significant complexity of the texts. These values carry even more significance when the average years of schooling for India as a whole are 6.2 years. Conclusion: Our results show that the most informed consent forms were too complex to understand by an average adult subject. We suggest reducing this complexity and increasing the ease of readability so those average subjects receive the intended information as exactly as it could be. This can be achieved by few simple measures like improving the deficiencies in translation processes, encouraging the investigators to participate while preparing these forms, and enhanced understanding of the site specific requirements, namely culture, language (dialect), general literacy rate, etc.

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Depression is one of the commonest disorders encountered in general hospital psychiatry. Acromegaly is a condition with excessive growth hormone secretion that may at times present with oversychopathology. We present the case of a 33-year-old lady with depression and acromegaly that successfully resolved after treatment with escitalopram and cognitive therapy.

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Aims: To assess the impact of family and peers on both initiation and continuation of substance use among eighth, ninth and tenth grade adolescent high school students. Design: Population based cross-sectional study. Setting: Two high schools of West Bengal, India. Participants: 416 students in class VIII, IX, and X in two schools. Interventions: None. Measurements: Substance use: initiation, sources, reasons for continuation. Then proportions and chi-square test was used for statistical analysis. Materials and Methods: This was a population based cross sectional study conducted among 416 students from class VII, IX and X in two high schools( urban and rural) of West Bengal, India selected by Multistage random sampling. A self administered anonymous pretested close ended questionnaire was used with the main outcome measures of initiation, sources, reasons for continuation of substance use based on WHO study team questionnaire. Results: Prevalence of substance use was found to be higher among the urban students (15.1%) than their rural counterparts (10.7%). The proportion of users was higher in the higher grades as compared to the lower grades. Among urban as well as rural students, 16 years and above were significantly more likely than their counterparts aged 15 years and below to report lifetime use. The mean age of initiation ranged from 12.6 to 13.9 years. Family members and friends were found to have a considerable influence not only on initiation but also important sources for money as well as the substance. Easy availability in the neighborhood was also an important correlate to continuation of substances. Conclusions: Family environment as well as peer groups has an important bearing on initiation and continuation of substance use. Experimentation of substance use motivated by peer groups is common among adolescents and starts early in life. Hence, it is necessary to provide health promotion programs directed toward students and their families which encourage attitude shaping among school children towards self-confidence and adequacy.

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The present study holds hardiness as the independent variable and depression as the dependent variable. The immunological role of hardiness was ascertained on depression. Sample constituted of 320 people aging 21­­ to 65. Subjects were administered hardiness scale and depression scale. Based on the scores obtained on hardiness scale, subjects were categorized specifically into three hardy groups: high, moderate, and low to see their differential effects on depressive feelings. The differences between the means of three hardy groups were found to be significant and the immunological role of hardiness on depression is thoroughly highlighted.

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Disability in the area of psychosocial role functioning is found to be present even while getting discharged from the hospitals or GHPU's; since the current scenario in India focus primarily on pharmacological/somatic treatment with less emphasis on structured psychosocial therapies/interventions during hospitalization. This poses a challenge for the care givers and burdens them with additional duties of assisting the unproductive family member after discharge. This in turn creates misconception about the progress of the client or the expectation of treatment efficacy. The importance of structured psychosocial interventions during the hospitalization in a GHPU has been discussed elsewhere, however, the premises/existing settings pause as a challenge to introduce such programs even with the awareness of the benefits. It's also noticed that in India, majority of consumers prefer to avail treatment from GHPU than any alternative patters of care. Also, the related publications reveal the availability and the benefits of daycare center attached to a GHPU. This highlights the felt-need of having a daycare center attached to every GHPU in India for improving mental healthcare system of the country.

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To find out Sociodemographic profile of obese & overweight females and compare their psychiatric profile, eating behavior & quality of life. Methods and Material: The study was conducted at obesity clinic (specialty clinic) at SMS hospital, Jaipur. Females meeting the inclusion criteria were divided in 3 group obese, overweight & normal weight according to BMI. After collecting Sociodemographic data they were subjected to Hindi version of MHQ, Eating attitude test-26 & short form health survey. Statistical analysis used: mean, standard deviation, chi square test & ANOVA Results: In obese subjects, scores on subscale of MHQ were significantly different except for hysterical subscale. The obese females scored higher on EAT-26, showing more abnormal behavior. There was significant difference on all domains of quality of life except social functioning & role impairment due to emotional factors. Conclusions: Clinically obese and overweight females are vulnerable to psychological ill health. They also show different Sociodemographic characteristic, impaired quality of life and eating attitude. These aspects should be considered, so that obesity can be managed in a better way.

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Defects in social cognition which includes Facial Emotion Recognition Deficits [FERD] have been consistently demonstrated in most neuropsychiatric disorders. Influences of culture, age & sex on emotional expression and perception necessitates that a tool standardized in the Indian population be developed to study these deficits in Indian patients. Four experienced and trained actors (one young male, one young female, one older male and one older female) emoted six basic emotions, namely happy, sad, fear, anger, surprise and disgust at two different intensities [i.e. high and low] along with neutral facial expressions. 52 still images and 28 video clips were obtained. These images were then validated by 51 students from various mental health disciplines and five qualified psychiatrists. On statistical analysis the tool was found to have good inter­rater agreement and internal consistency. TRENDS is a tool validated for use in the Indian population, which captures the full range and nature of emotional expressions akin to real life situations and can be utilized for future behavioral and functional imaging studies in Indian patients. Such research can give useful insights into the neurobiological basis of neuropsychiatric disorders and has important implications for improving socio-occupational functioning.

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Neurobehavioral approach uses behavioral paradigm towards comprehensive rehabilitation by identifying the neurological or neuropsychological constraints that can interfere with learning and behavior of an individual. The present case study highlights the role of functional skills approach in neurobehavioral management towards cognitive rehabilitation to manage behavioral deficits in a 55-year-old man with nicotine dependence having frontal lobe lesions owing to gliosis of fronto-temporal brain regions. Based on detailed neuropsychological and behavioral assessment, a behavioral package was made involving techniques like behavioral counseling, chaining, shaping and operant methods and was carried out with the patient daily (with the help of primary caregiver) over a period of 2 months. Results showed improvement in his self-care and decrease in behavioral problems, on 12-month follow-up.

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