Indian Journal of Mental Health and Neurosciences
Indian Journal of Mental Health and Neurosciences (IJMHNS) aims to promote and publish research related to mental health and associated neuro-science subjects from across the world. The Journal will be published biannually – in January and in July. The journal encourages clinical and translational research, with the focus on ameliorating the mental illness burden in the community and ensuring evidence based care.
Indian Psychiatric Society - Tamil Nadu Chapter
Bloody Tears: A Rare Presentation of Munchausen Syndrome
Background: Haemolacria, or bloody tears, is a rare and alarming clinical presentation with a broad differential diagnosis encompassing ocular, systemic, and psychological causes. Factitious disorder imposed on self (previously known as Munchausen syndrome) is characterized by the deliberate fabrication of symptoms to assume the sick role and is particularly challenging to identify in adolescents. Awareness of this association is limited, often leading to extensive and unnecessary investigations. Case Presentation: A 17-year-old female presented with a six-month history of intermittent, painless bleeding from both eyes. Episodes were sudden, not associated with trauma, menstruation, or systemic illness, and caused significant distress to her family, while the patient remained relatively unconcerned. Comprehensive ophthalmic, hematological, and radiological evaluations, including CT and MR angiography, revealed no abnormalities. Mental state examination revealed anxiety related to familial stressors, particularly concerns about her father’s health and financial insecurity. Diagnosis: Following detailed psychiatric assessment and psychotherapy, the patient disclosed deliberate fabrication of symptoms using red watercolour paint to simulate bleeding episodes during periods of emotional stress, primarily to gain attention and care. A diagnosis of factitious disorder imposed on self presenting as haemolacria was established. Management and Outcome: An eclectic psychotherapeutic approach focusing on insight development, addressing maladaptive coping mechanisms, and enhancing stress management skills was initiated. Regular follow-up sessions resulted in significant symptomatic improvement and cessation of fabricated bleeding episodes. Conclusion: This case highlights haemolacria as a rare but striking manifestation of factitious disorder in adolescents. It underscores the importance of considering psychiatric etiologies after exclusion of organic causes, particularly in unexplained and recurrent presentations. Early recognition can prevent unnecessary investigations, reduce iatrogenic harm, and facilitate timely psychological intervention.
Copyright (c) 2025 https://creativecommons.org/licenses/by/4.0
Information from the external world enters the mind through the five special senses, forming perception that influences thoughts and emotions. The interaction of thoughts and emotions leads to the formation of impulses, which remain internal until expressed through speech or action, resulting in self-experience. The conversion of impulse into expression is regulated by experience derived from genetic factors, bodily sensations, others’ experiences, and self-experience. Experience guides impulse expression by considering contextual factors such asplace,meaning,andsituation,highlightingtheroleofsensoryinputandexperientialregulationinshapinghuman behavior.
Ayurveda, Homeopathy and other complementary treatments in the child and adolescent mental health: A critical review of emerging paradigms
The prevalence of child and adolescent mental health disorders, including ADHD, anxiety, depression, and autism spectrum disorders, is increasing globally, necessitating diverse treatment approaches. While conventional psychiatric interventions such as pharmacotherapy and psychotherapy remain the standard of care, their limitations—including side effects, treatment resistance, and accessibility challenges—have led to a growing interest in Complementary and Alternative Medicine (CAM). Ayurveda, homeopathy, and other CAM interventions are widely used, particularly in low- and middle-income countries, where up to 97% of the population relies on traditional medicine. Despite their popularity, scientific validation of these treatments remains limited, with inconsistent evidence regarding their efficacy, safety, and feasibility for integration into mainstream psychiatric care. This review examines the role of CAM in child and adolescent psychiatry, highlighting potential benefits and limitations based on a comprehensive literature search across major databases, expert discussions from an academic seminar, and survey responses from clinicians. Findings suggest that Ayurvedic practices such as “Sattvavajaya” (a cognitive-behavioral therapy analog), homeopathic remedies, and mind-body interventions like yoga and mindfulness show promise for managing psychiatric conditions. However, regulatory challenges, quality control concerns, and insufficient clinical validation hinder their integration into evidence-based mental healthcare. Further rigorous research, standardized treatment protocols, and interdisciplinary collaboration are essential to determine the role of CAM in pediatric psychiatry. Medical education must also incorporate CAM-related training to equip clinicians with the knowledge necessary to guide patients and caregivers effectively.
Climate change and the mental health of older adults in India: a geropsychological perspective on risk, resilience, and policy gaps
Background: Climate change is emerging as a major public health threat with significant mental health consequences. Older adults in India, due to physical frailty, cognitive decline, and limited social protection, are uniquely vulnerable to these climate stressors. Despite their heightened susceptibility, the intersection of climate change and geriatric mental health remains underexplored in India. Methods: This review synthesizes existing national and international literature on the mental health impacts of climate change among older adults, particularly in the Indian context. Databases searched include PubMed, Scopus, and Indian Journals Online. Grey literature and policy documents were also reviewed. Results: Evidence indicates that older adults are disproportionately affected by heatwaves, floods, droughts, and climate-induced displacement. Key psychiatric outcomes include depression, anxiety, post-traumatic stress disorder, and suicide. Challenges include limited access to care, infrastructural inadequacies, and the breakdown of familial support. Protective factors include community engagement, intergenerational support, and culturally sensitive mental health interventions. Conclusion: There is a pressing need for India to incorporate geriatric mental health into its climate adaptation and mental health strategies. Future research must focus on building climate-resilient mental health systems with a geropsychological lens.
Letter to editor: mental health and neuroscientific impact of the blind box toy consumption
Blind box toys are popular, but long-term addiction to such products can have negative impacts on mental health problems such as depression, anxiety, and suicide risks. Previous researchers have emphasized that players experience happiness and look forward to the blind box toy they purchase. Unpredictable contents in a blind box trigger dopamine release, and when a dopamine rush can be addictive, it leads individuals to buy more to gain potentially rare or desirable items, resulting in financial losses, buyer’s remorse, and immersion in surprise and disappointment for the gambling-like physical products. What feelings are blind box consumers pursuing? Blind box collectables offer a more exciting experience than buying transparently packaged items, and they provide participants with the hedonic value when imagining what could be inside in the pre-opening phase. That is, blind box toys’ unknown attributes were quite attractive to consumers. Blind box toys are sold in opaque packaging which allows consumers to possess a sense of mystery, as the emotional value exceeds the utilitarian value, and derive enjoyment and satisfaction from them. From a consumer behavior perspective, being blind is perceived as uncertainty; positive emotions of surprise and feelings of winning are accompanied by curious consumers because they perceive themselves as lucky, estimating outcomes optimistically.
Patterns of psychiatric morbidity in patients attendingpsychiatric OPD of Government Medical College Anantnag
Background: Psychiatric morbidity is a significant public health concern globally, with disparities in access and awareness exacerbating the burden in resource-limited settings like Kashmir. The region’s socio-political instability and cultural factors have compounded mental health issues, necessitating region-specific studies to assess psychiatric patterns. Objective: To evaluate the prevalence and patterns of psychiatric disorders among patients attending the Psychiatry Outpatient Department (OPD) at Government Medical College, Anantnag, Kashmir, and identify sociodemographic associations. Methods: This cross-sectional, descriptive study was conducted over six months, enrolling 933 patients aged =12 years using consecutive sampling. Sociodemographic and clinical data were collected through structured proformas and DSM-5 diagnostic criteria. Statistical analyses, including descriptive and inferential tests, were performed using SPSS Version 20.0. Results: Of the 933 participants (mean age 32.9 years, 61.3% females), major depressive disorder (23.7%) was the most prevalent diagnosis, followed by obsessive-compulsive disorder (19.3%) and bipolar affective disorder (10.5%). Anxiety disorders collectively accounted for 8.7%, while schizophrenia and PTSD had lower prevalence rates (2.6% and 0.8%, respectively). Females were disproportionately affected by OCD (19.9%) and major depressive episodes (15.4%). Panic disorders and dementia were more common among males. Younger participants predominantly presented with anxiety-related disorders, while older individuals exhibited higher rates of dementia and cognitive impairments. Homemakers (37.9%) and students (30.3%) formed the largest occupational groups. Conclusion: The study highlights a high burden of depressive and anxiety disorders in Kashmir, influenced by gender, age, and sociocultural factors. Females exhibited higher rates of affective disorders, while younger individuals reported anxiety-related conditions. These findings underscore the need for gender- and agespecific mental health interventions and culturally sensitive policies to address the unique challenges faced by Kashmir’s population.
Copyright (c) 2025 Nadeem Bashir, Syed Zuhare, Mansoor Ahmad Dar, Javed Ahmad Sheikh, Rehana Amin, Muntaqueem ul kousar, Mehroosh Roub, Rasikha Rasool Khan https://creativecommons.org/licenses/by/4.0
The Role of Psychiatrists in Mental Health Care Delivery Spectrum: Addressing the Challenge sand Expanding the Scope
Copyright (c) 2024 The Author(s). https://creativecommons.org/licenses/by/4.0/
Copyright (c) 2024 The Author(s). https://creativecommons.org/licenses/by/4.0
The research interface between psychiatry and medicine: Evolving paradigms and their implications
Copyright (c) 2024 Indian Journal of Mental Health and Neurosciences https://creativecommons.org/licenses/by/4.0/
ENCHANT - Enhancing Psychiatric History Taking: A Comprehensive Approach
Factors Affecting Adherence to Oral Medications in Chronic Psychiatric Patients at a Tertiary Care Hospital in Western India: A Cross-Sectional Study
Background: Adherence to Medications has been identified as an important factor in determining the course of psychiatric illness and future recovery. Despite this fact, lower adherence rates have been reported. Aim: To determine the level of adherence to oral medications in chronic psychiatric patients and to assess factors affecting adherence. Methods: A cross-sectional study was conducted on 225 patients diagnosed with and on treatment for Psychiatric Conditions for more than three months at the Outpatient Department of Psychiatry of a tertiary care hospital in Western India from September to October 2023. Data were collected using a Case Report Form and a standardized Adherence to Refills and Medications Score (ARMS) Questionnaire. Both bivariate and multivariate logistic regression were used. Variables with p-value < 0.05 were considered statistically significant. Results: Majority of the study population (87.6%) was found to be non-adherent. Through univariate logistic regression, it was found that the female gender (OR: 2.425; 95% CI: 1.020 – 5.766), higher education of head score (OR: 2.410; 95% CI: 1.063 – 4.758), and lesser number of class of medications (OR: 2.315; 95% CI: 1.037 – 5.166) were significant predictors of adherence. Multivariate logistic regression showed that higher education of head score (AOR: 2.705; 95% CI: 1.144 – 6.398) and lower frequency of consumption of medications (AOR: 0.335; 95% CI: 0.135 – 0.829) were associated with better adherence. Conclusion: The study showed that further improvements in adherence are required. Factors contributing to non-adherence should be assessed and intervened.
Assessment of association between pregnancy induced hypertension and cognitive function: Before and after one month of delivery: Cohort study
Introduction: Pre-eclampsia is a leading cause of morbidity and death in mother and baby. This also leads to endothelial dysfunction in large and small vessels, which leads to cognitive impairment. This is the first kind of study from India on the assessment of cognitive function in the Pregnancy-induced hypertension (PIH) group. Materials and Method: We recruited cases from the obstetric department’s antenatal care. We applied Socio-demographic data and a Cognitive assessment battery (Trail Making Test (TMT) A and B, PGI memory scale, Porteus maze, and Digit Symbol Substitution Test (DSST)) to collect information on cognitive function. The data was collected from May 2021 to November 2021. Assessment was done during pregnancy and one month after Delivery. Data was assessed using SPSS software. Results: The TMT A and B values were 27.32 & 57.08 predelivery and 23.34 & 48.74 post-delivery. In PGI memory scale (pre and post-delivery values), Remote memory (6.76 & 6.81), recent memory (4.99 & 5.00), mental balance (6.26 &6.75), attention and concentration(7.42 & 8.27), delayed recall (6.29 &6.9), immediate recall(5.13 & 5.70), verbal retention-dissimilar word (9.52 & 10.18) and recognition (6.75 & 7.62) & DSST (88.0 & 91.31), verbal retention for similar words (5.19 &5.34 &)and visual (2.19 & 2.22) retention. The Maze Test-1 (17.29 & 13.06) Maze Test-2 (21.44 & 16.83). Before Delivery, cognitive impairment was present in the Pregnancy Hypertension (PIH) group in trail making, MAZE test, and certain areas of the PGI memory scale, which were statistically significant (<0. 001) compared to the healthy control group. It continues even after one month of Delivery. Conclusion: This study has shown that there was an association between the pregnancy-induced hypertensive group and the healthy control group in certain domains of cognitive function before Delivery. The cognitive impairment persists even after one month of Delivery, which signifies microvascular damage persists for a longer duration.
A community based study in South India of the association between Common Mental Disorders(CMD) and Cognitive Impairment(CI) in urban elderly.
Background: Unprecedented aging in India has brought with it a host of difficulties for the elderly, including urbanization, breakdown of the joint family system, economic distress, poor nutrition and significant unpreparedness to manage their increasing needs. This urgent need was addressed through a formal research proposal aimed to study the prevalence of CMD and CI in community living elderly, their associations and sociodemographic correlates. This detailed analysis thus provides a framework to stimulate policy decisions for elder care in the country. Materials and methods: A prospective cross-sectional study was conducted across six old age homes in Chennai, India where 273 community living elderly aged 65 and older were assessed using the Clinical Interview Scale-Revised and the Mini Mental State Examination (Hindi version). Results: Most of the subjects were female (71.1%), had at least ten years of education and were of high socio-economic status; 52% were positive for CMD and 14.28% had CI. There was a statistically significant association between CMD and CI (t=5.115, p=0.000, 95%CI 8.453-19.034). Conclusions: The prevalence of CI is in keeping with the published literature. However, the prevalence of CMD in this population was found to be higher than that published in literature from India and low- and middle-income countries (LAMIC). Older age, female gender, low educational attainment and middle socio-economic status were factors associated with CI. This study validates the extensively reported finding that CMD and CI are important in the public health implications of human ageing that health planners and policy makers need to focus on.
The role of artificial intelligence in psychiatry
Manganese toxicity presenting as acute psychosis- A case report
Manganese poisoning is a toxic condition due to excessive exposure to manganese which can present with neurological or psychiatric symptoms. Here is a case report of a 51 years old male with occupational history, brought to the Emergency Room with two days history of acute onset behavioural disturbances. There was a history of taking Siddha medications for the last 4 months for polyarthralgia with minimal improvement. A diagnosis of organic psychotic disorder due to Manganese intoxication was made. MRI Brain plain and contrast were normal. The heavy metal screen was suggestive of high Manganese of 42 mg/ml and Cobalt of 4.4 ng/ml EEG was suggestive of generalized epileptiform abnormality. The patient was asked to refrain from further exposure to heavy metals and treated with Sodium valproate and neuro vitamins with gradual improvement in symptoms. This case report emphasizes the need for detailed evaluation and ruling out other medical conditions in a case presenting with the first episode of psychosis.
Impact of COVID-19 outbreak on mental health of undergraduate and postgraduate medical students.
Background: The COVID-19 pandemic, the largest crisis of modern era has subjected medical students and healthcare workers to immense amount of stress due to myriad problems like exposure risk, health concerns and subsequent economic repercussions. Aim: The aim of this study was to estimate the prevalence of depressive symptoms among medical students studying in the sub-continent and in foreign medical universities during the height of the COVID-19 pandemic. Setting and design: This was a cross sectional study. Materials and methods: A web-based survey was conducted using a specially constructed questionnaire pertaining to COVID-19 pandemic. Depressive symptoms were assessed using DASS-21 questionnaire and sleep quality with Pittsburgh Sleep quality index (PSQI), respectively. Statistical analysis: Chi-square tests was used for proportions. Pearson’s correlation analysis was done to evaluate the correlation between study DASS-21 subscales and PSQI. Multiple logistic regression was done to assess the association between study variables and the likelihood of having depressive symptoms. Results: Postgraduate medical students and those studying in foreign universities had a significantly higher prevalence of depression than undergraduates and students studying in Indian universities, respectively. These two sub-groups also had poorer sleep quality (P<0.001). A statistically significant correlation (P<0.001) was observed between depressive symptoms and sleep quality. On multiple logistic regression, post-graduate medical students (OR=3.4), lockdown duration (OR=4.3), poorer PSQI(OR=1.2) and female gender (OR=4.1) had significantly higher odds to exhibit depression. Conclusion: Post-graduate medical students and those studying in foreign medical universities had significantly higher prevalence of depression during the COVID-19 lockdown.
COVID-19; lockdown duration; depression; post-graduates; foreign universities.
Atropine induced delirium in young female with unknown snake bite : Case report
Venomous snakebites account for many deaths in developing countries. Administration of an Acetylcholinesterase Inhibitor (ACEI) has been recommended by WHO as a part of neurotoxic snakebite treatment. With atropine being used to reduce the undesirable muscarinic effects of ACEIs, adverse effects like delirium can occur. Delirium is characterized by acute decline in level of consciousness and cognition involving perceptual disturbances, abnormal psychomotor activity, and sleep cycle impairment. This case report describes a 17-year-old female with unknown snakebite who developed atropine induced delirium despite being under the cover of ACEIs and at a lower dose (4.5 mg) than usual for the drug to cause delirium. Though there are reports in literature about atropine induced delirium in organophosphate poisoning, to our knowledge none were reported snakebite cases. Hence, clinicians need to be cautious while encountering with such patients and should always consider the possibility of atropine induced delirium even in snakebite cases.
Prevalence and sociodemographic correlates of depression and anxiety among secondary school students in Chennai, South India: A cross-sectional study
Background: Anxiety and depression are common mental disorders affecting adolescents worldwide and in India. Various factors are associated with the prevalence of anxiety and depression among adolescents, which vary between geographic, socio-cultural, and economic backgrounds. Hence, the aim of the study was to estimate the prevalence of depression and anxiety and assess the socio-demographic factors associated with them among secondary school students in Chennai, south India. Materials and methods: A cross-sectional study was conducted among grade 9 students from four schools in Chennai. Written informed consent was obtained from the parents/guardian and assent from the students before recruitment into the study. The following tools were used to collect data: semi-structured proforma to collect the socio demographic details, perception of stress by Cohen’s Perceived Stress Scale, mental wellbeing by The World Health Organisation- Five Well-Being Index (WHO-5) and anxiety and depression assessed using General Anxiety Disorder (GAD-7) and Patient Health Questionnaire (PHQ-9), respectively. Results: A total of 569 students (323 (56.8%) boys, 246 (43.2%) girls) participated in the study. Prevalence of anxiety and depression among study participants was 46.3% and 39.6%, respectively. On the multivariate analysis, it was observed that students whose father had a blue-collar job and higher perceived stress were significantly more likely to have anxiety and depression.
depression, anxiety, prevalence, predictors, school, students, Chennai, south India
Economic burden in patients with dementia attending a geriatric care clinic in Chennai: A cost of illness study
Background: Dementia is one of the major causes of dependency and disability among the elderly. With an increase in life expectancy, the burden of dementia is also on the rise especially in countries like India. There are economic concerns to the family as health expenses are majorly borne by them. There are few cost of illness studies for dementia from low- and middle-income countries. Our study aims to estimate the burden of costs of dementia in patients attending a geriatric clinic in a private hospital setting. Methods: This retrospective observational study assessed the economic burden of dementia by estimating both direct and indirect costs of illness from the caregiver's perspective. Results: Direct costs from medical services and social costs are higher when compared to indirect costs. Not all people have incurred social costs as many are provided care by the families and their inputs are not paid or accounted. The costs of informal care were under evaluated in the study. Conclusion: The direct health care cost of illness of Dementia from caregiver perspective is more than one seventh of the per-capita income of Indian population provided indirect costs and direct social costs are not included. Evaluating various costs incurred in various health care settings is important to understand the economic burden of Dementia. There is a need for well-designed prospective studies to inform policy decisions towards better service development for persons with dementia.
Direct medical costs, Social costs, Indirect costs, LMIC nation
The Principles and Practice of Psychiatric Rehabilitation
People with severe mental disorders experience difficulty in functioning in several domains of life that are all not related to the illness and the symptoms. Medical management for severe mental disorders leads to improvement in symptoms and distress that may not always correlate with functional improvement. A comprehensive rehabilitative care is necessary to reengage the person in life activities and full participation in mainstream life. The Rehabilitation interventions are to be person centered with supports from the environment and removal of barriers to progress recovery. Rehabilitative care should be enhanced by integrated recovery-orientated practices that sustain hope, promote self-agency. This paper discusses the definition of psychiatric rehabilitation and a model of the processes involved.
Psychiatric Rehabilitation-Recovery-Mental illness- Mental Health Services
Copyright (c) 2018 Indian Journal of Mental Health and Neurosciences
A cross-sectional study of factors associated with anti-depressant medication adherence in women attending an out patient psychiatry department
Introduction: Treatment adherence and illness may not be related only by the severity of the illness but by so many other factors which impact on seeking and continuing treatment; yet severity of the illness will be one of the major factors influencing treatment adherence. Methods: Female patients attending the psychiatric OPD, diagnosed with depression as per ICD-10 guidelines and provided informed consent participated in this questionnaire-based study. A total of 135 patients who attended the OPD in 9 months were assessed for the severity of depression and medication adherence by administering scales to assess the severity of depression and medication adherence was assessed by questioning about the drug taking and hospital attending behaviour. Out of this, thirty-one were attending for the first episode and hence were excluded from the analysis. Results: Out of the 104 female patients diagnosed with depression of more than one episode, 44 (42.3%) had mild depression, 52 (50%) had moderate depression and 8 (7.7%) had severe depression. Twenty-nine women (27.9%) were on medications and 75 (72.1%) women were not taking their medications. While greater proportion of women with mild depression were adherent to medication (51.7%), more women with moderate depression didn’t adhere to medication (54.7%), even though such difference was statistically not significant. Older age, having a paid work and married status were significantly associated with medication (antidepressants) adherence. Conclusions: Our results indicate that medication adherence is associated with factors other than severity of depression. Work and marital status played a significant role in determining the adherence to antidepressant medications among women. Keywords: Depression, medication adherence, compliance, female patients
Depression, medication adherence, compliance, female patients
Copyright (c) 2021 Indian Journal of Mental Health and Neurosciences
The inaugural issue of Indian Journal of Mental Health and Neurosciences is being published. A brief overview of the journal's aspirations and goals along with an overview of the contents is being provided.
Elderly Mental Health in Developing Countries
Geriatric Psychiatry deals with specific issues and challenges that arise in the assessment and management of mental health problems in elderly. As a specialty it has not received much attention in developing countries until recently. Elderly will soon be major consumers of mental health care in developing countries. Common psycho-social issues among the elderly and their impact on the mental health in the developing regions of the world and the complex interplay between physical health and mental health in the elderly are described. Dementia and depression are described in some detail focussing on relevant research to highlight the challenges in developing countries. Potential solutions to address the challenges of elderly mental health in developing countries are discussed.
Geriatric, elderly, mental health, developing countries, dementia, depression
Suicidality in children with Mild Intellectual Disability and Autism Spectrum Disorders admitted in an inpatient tertiary care centre in India
Challenges in management of Major Depression in patients with co-morbid medical conditions
Depression is a heterogeneous illness and depression with co-morbid physical illness may represent a phenotype of depression. Concurrent medical illness in depression is associated with greater functional and social impairment and significantly higher health care costs. A variety of mechanisms including lifestyle factors, immune-inflammatory pathways, medications and psychological factors have been proposed to explain the association between depression and physical illness. However, each of these pathways engenders unique challenges in managing such patients. Of utmost importance is to establish the nature of the underlying medical or psychological cause(s) which will inform customized management plans. This article initially reviews the prevalence of depression in medical conditions and vice versa. Subsequently, we move on to discuss specific approaches to diagnosis of depression in the context of medical co-morbidity. Finally, we describe evidence based pharmacological and psychosocial intervention strategies with some recommendations for common clinical scenarios. Evidence based care models to manage depression with physical illness are described which may be adapted for use in low resource settings
Depression, depressive disorder, co-morbidity, psychosomatic medicine; consultation-liaison psychiatry; psychiatry
First-episode psychosis research in India: A review
Background: With the growth of early intervention services for psychosis worldwide, it is imperative to understand the current knowledge on first-episode psychosis (FEP) from Indian context. Hence, the purpose of this review is to comprehensively examine the research studies on FEP from India. This would help to compare and contrast with other countries, develop specialist early intervention services and enlist research priorities pertaining to FEP. Methods: A Boolean search of articles published from January 1990 to March 2018 in electronic database of PubMed and Google Scholar was carried out and original research studies done on first-episode psychosis in India were incorporated in the current review. Case reports and review articles were excluded. Results: A total of 31 research studies were included for the review and classified into different subheadings of convenience. Conclusion: Even though the number of studies in Indian context pertaining to FEP is comparatively less than other western literature, the available results indicate certain characteristic similarities and differences in FEP from other parts of the world. We have also discussed on the importance of early intervention in FEP and the necessity for the creation of specialist early intervention services for mental health disorders.
Copyright (c) 2019 Indian Journal of Mental Health and Neurosciences
A protocol of a cross sectional study to assess depression in antenatal mothers
Background: Maternal depression is associated with a number of adverse maternal outcomes such as preterm birth, maternal dysfunction, maternal suicide and perinatal outcomes such as low birth weight, lower rates of breastfeeding, increase in diarrheal disease, hospitalisations, poor emotional, social development, lower academic achievements in adolescence and future mental health problems for the children of the mothers. Maternal depression has rightly been identified as a priority mental health condition and large scale community interventions in low and middle income countries (including India) have been shown in RCTs to be effective in not only improving maternal depression but also improve the perinatal outcomes. Given the scale, severity of the problem and strength of evidence available for effective interventions in the Indian context, there is a great opportunity for implementation research in this area. As a first step there is a need to understand the prevalence of the problem and associated risk factors in our context. Aim: Aim of this study to understand the prevalence of maternal depression and associated risk factors among antenatal mothers attending Sri Ramachandra Medical College (SRMC) Obstetrics outpatient department. Methods: A cross-sectional design will be employed for determining the prevalence, while a case control framework will be used for the risk factor analysis. Antenatal mothers will be startified according to the trimester of the pregnancy. Semi-structured socio demographic proforma; Patient Health Questionnaire (PHQ-9 Tamil version), Generalised Anxiety Scale (Tamil Version) and Brief COPE (Tamil version) questionnaire will be administered for antenatal mothers who offer informed consent. Those who score above 10 points on the PHQ scale will be interviewed using the MINI diagnostic interview schedule for clarifying diagnosis. Those who are diagnosed with depression will be referred to the SRMC psychiatry department for treatment & follow up. Analysis: Statistical analysis is to be done using computer software, to assess the prevalence of antenatal depression and the associated risk factors. Descriptive statistics will be used to describe the sample. Mean, standard deviation and range will be employed to describe continuous variables, while frequency distributions will obtained for categorical variables. The chi square and fisher’s exact tests will be used to assess the significance of associations between categorical variables. Multivariate analysis will be performed using stepwise backward logistic regression models
Crossroads in postgraduate psychiatry training in India
The specialist training program for psychiatrists in India is in need of an overhaul to enhance the competenecy of trainees.This will help future psychiatrists to keep themselves uptodate with the growing demands of the expanding field and ensure unifrom standards of teaching and assessment during examinations across the country. While continuing to support the core strengths of the training program, a robust system for periodic reviews to addess the lacunae in training is the need of the hour.