World over, more women than men, suffer from common mental disorders that arise from social, psychological, and physiological differences on account of gender-based discrimination. Gender affects not only the rates of disorders, but also risk, timing of onset and course, diagnosis, treatment, and adjustment to mental disorder. The current paper contextualizes a feminist understanding to the role of gender in mental health. It discusses the role of sociocultural factors with respect to women and mental health leading to the violation of rights of women throughout their life cycle thereby impacting their sense of well-being and overall mental health. It also suggests few eclectic strategies to promote the well-being of women and prevention of mental disorder from a feminist lens.

To explore if psychiatrists in India carry out less research as opposed to psychiatrists of Indian origin working in the United Kingdom (UK), we carried out a small-scale survey of psychiatrists practicing in India and psychiatrists of Indian origin working in the UK. In light of the findings of this survey and from the three authors' experience of teaching, training, working, and engaging in research in India and the UK, we try to answer questions such as “why do psychiatrists in India carry out less research? Should it change, and if so how? What can one learn?” Here, we do not assume or advocate that one system (East or West) has all the answers. We merely wish to discuss the place of research in psychiatric training and psychiatric practice.

Introduction: The impact of land ownership on mental health, suicidal ideation, and resilience of farmers is very big nowadays. The impact is raised when the farmer has no land and compels to farming on leasehold land. Hence, the present study was aimed to find the relationship between three groups of farmers on the dimensions of mental health, suicidal ideation, and resilience. Methods: This study is based on the primary data that have been collected from the Western Zone of Haryana state. The sample comprising 375 farmers with a minimum education of 10^th was selected. They were further divided into three different groups such as landless farmers (farming on leasehold lands), farmers with 1–9-acre land, and farmers with > 9-acre land. Goldberg and Hillier's General Health Questionnaire-28, Wagnild and Young's Resilience Scale, and Reynolds' Adult Suicidal Ideation Questionnaire were used for data collection. Moreover, for analysis, product-moment correlation and one-way ANOVA were used. Results: Using intercorrelation and ANOVA, it was found that there is a significant difference between the three groups of farmers on different dimensions of mental health (P < 0.01), suicidal ideation (P < 0.01), and resilience (P < 0.01). Mean and statistical differences were found between the three groups of farmers. Farmers, who are farming on leasehold land, show more somatic symptoms, anxiety and insomnia, severe depression, and suicidal ideation. On the other hand, farmers who have above 9-acre land scored highest on the scale of resilience and social dysfunction. Hence, it is recommended that the farmers who are farming on leasehold land may have to consider the possibility of recruiting qualified counselors.

Background: Family functions and resilience (hardiness) are two important aspects of families for keeping them stable. How those two aspects are present and operate in families having adolescents with mental retardation and psychosis is the aim of this study. Materials and Methods: A total of 45 adolescents (comprising 15 intellectually disabled adolescents, 15 adolescents with psychosis [schizophrenia and bipolar disorder], and 15 normal adolescents) and one of the key relatives of each adolescent were selected purposively. One key caregiver of each adolescent in all the three groups was selected, and the McMaster Family Assessment Device and the Family Hardiness Index were applied on them to collect data on family functioning and hardiness. Results: Families of the first two groups have reported problems in family functions. No difference could be seen in the family resilience among these three groups of families. Conclusion: Families with mentally retarded and psychotic adolescents have family problems; however, both the families show resilience against the stress of having mentally retarded or psychotic adolescents.

Background: Thalassemia is stress inducing, and the parents of the affected child develop a variety of coping strategies in response to that stress. Objective: The objective of this study was to find coping styles adopted by parents of thalassemic children and to identify factors associated with their coping. Materials and Methods: This cross-sectional survey was conducted in 2016–2017 involving 96 randomly selected parents of thalassemic children attending the Thalassemia Clinic of Bankura Sammilani Medical College and Hospital. Data were collected via interview using predesigned questionnaire and Brief-COPE inventory. Analyses were done estimating mean and proportion and using Pearson correlation coefficient (r), unpaired t-test, analysis of variance, and multiple linear regressions. Results: Two third of participants were mothers (66.7%) accompanying thalassemic children. Majority of them were aged within 21–30 years (55.2%), Hindu (84.4%), rural inhabitants (96.9%) and belonged to backward class (60.4%). Majority (72.9%) were from joint family of lower socioeconomic strata (94.8%). The age of thalassemic children was 80.47 ± 42.49 (mean±sd) months. Most of them were male (53.1%). Majority of thalassemic children was born in first birth order (63.0%) and diagnosed before attaining first birthday (71.0%). More than 60% of the participants were using acceptance coping “a lot.” The most commonly used coping strategies were active coping, acceptance, planning, and religion. In multivariable analyses, overall coping was found to increase by 0.331 on every unit decrease of age at diagnosis of thalassemia of children and to decrease by 0.116 unit on every unit increase of age of respondents. Conclusion: Acceptance coping was used effectively rather than behavioral disengagement, which suggests that a positive attitude toward stress is present but needs to be better handled. Counseling and psychotherapy for parents of thalassemic children can be provided through an intervention program.

Introduction: Attention deficit hyperkinetic disorder (ADHD) is a common pediatric condition which contributes to poor quality of life (QoL) among parents of children diagnosed with the same. These parents go through anxiety, stress, depression, and other psychological trauma; face a lot of social taboos and stigma. These entire psychosocial variables affect their day-to-day life functioning, productivity, and psychological health. Thus contribute to poor perceived QoL among these parents. Aim: The study's main objective is, therefore, to see the effect on an ADHD child's parent of their perceived QoL in relation to their psychological wellbeing as measured by their level of stress, anxiety, and depression. Materials and Methodology: A total of 30 parents of children with ADHD were selected as samples from the outpatient section of the PGIMER, Department of Psychiatry, using a purposive and convenient sampling method. Among these parents, QoL was assessed using the WHO QoL (BREF); whereas stress, depression, and anxiety levels were assessed using Depression Anxiety Stress Scale II. Results: Our research findings suggest the mean age of the parents to be 32 years (with the age range of 28–45), with the mean age of the child as 9 years (with the age range of 4–13). Where parents <35 years of age (86.7%); have registered better physical QoL than those over the age of 35. Nonetheless, most parents (73.3%) reported poor perception of QoL. Our research findings also showed that most parents suffer from severe depression (66.7%), stress was also perceived as high among these parents, and parents aged >35 years showed higher anxiety than compared to other age groups. The overall QoL was also found to be negatively correlated with anxiety, stress, and social relationships. The mentioned findings have been discussed further. Conclusion: The overall results of this study showed clearly that most of the parents had perceived serious burden and poor QoL in all areas. The research also indicates that these parents are more distressed, stressful, and depressed. Our research finding indicated that for these parents to keep their lifestyles healthy, they can make a difference by recognizing and embracing the fact that ADHD is more inevitable than the one caused by environmental and/or personal errors. Parents should share their workload, increase their need for assistance and encourage one another to take some time out of the care of the child to have a shift and enhance their QoL.

Context: Bullying is a problem that people, the world over, grapple with. It is manifest in different forms among different sections of people. Despite its prevalence, workplace bullying has not received much attention in scholarly literature in India. It is also not widely acknowledged as a threat to individual and organizational well-being. The purpose of this study is to add to the existing body of literature on the topic and to draw attention to the gravity of the issue. Aims: The primary objectives are to identify if there exist variations in its incidence on the basis of gender and years of experience, to identify the source of negative behavior, and the type of bullying that is most prevalent. Settings and Design: The study is a type of cross-sectional, descriptive study. Subjects and Methods: Data have been collected from a sample of 84 respondents using the Work Harassment Scale. All respondents are white-collar employees of the service sector in the cities of India. The data were analyzed using IBM SPSS v25. Results: The results find that there is no difference in the incidence of bullying on the basis of either gender or years of experience. Moreover, the source of negative behavior is generally one's superiors, and the most prevalent type is “verbal aggression.” Conclusions: The study concludes with suggestions of steps to be implemented at the national and organizational level, to combat the problem.

Background: There are very few specialised hospital with quality assurance services catering to the needs of the elderly with mental illness. The concept of 'Appointment adherence' has received little attention in the field of geriatric mental health from India. There is a need to study the pattern of 'drop-out' amongst geriatric patients. Method: An initial cohort of first 105 cases presenting to the clinic were followed up to explore their socio-demographic and clinical variables, overall functioning and satisfaction with the services. Adopting a 'naturalistic approach,' and using the 'service evaluation framework', at the assessment period of about 36 months, tools like socio-clinical profile, Hindi Mental State Examination (HMSE), Everyday Abilities Scale for India (EASI), Global Assessment of Function (GAF) scale, WHOQOL-BREF-Hindi version, Patient Satisfaction Scale (PAT-SAT) and 'Service Evaluation (SSS-16 and SSS-10 Practitioner Versions)' were administered. Result: 68 cases were available for assessment of functional outcome and satisfaction parameters were assessed for 78 of the cases. 75% had functional disorders and medical morbidity was present in more than 50% of cases. The mean score for WHOQOL-BREF and GAF were 44.4 (poor quality of life) and 72.91 (slight impairment in socio-occupational functioning) respectively. PAT-SAT score in all the sub-categories were above average. 'Organic' diagnosis patients had lower QoL on certain domains compared to 'functional' patients. Only 30.47% patients were coming for follow-up with 25.71% having died. Of the 32/68 (34.29%) cases who had dropped out, 50% were adherent to treatment in different ways. Additionally, GAF scores were lower in 'drop-out' group. Conclusions: There is a relatively high rate of 'drop-out' over a 3-year period. However, if patients keep coming for follow-up (i.e. do not 'drop-out'), they are more likely to show improvement in their level of social and occupational functioning.

Background/Objectives: Road traffic accident affects people more in terms of disability with prolonged treatment than premature death. More people suffer from nonfatal injuries, with many incurring a disability as a result of their injury. The study aims to report the quality of life among nonfatal road traffic accident victims of Karnataka state, India. Methodology: Consecutive data of 6 years (2013–2018) on road traffic injuries of the state of Karnataka were collected from the States Crimes Records Bureau of Karnataka. The contact details of victims categorized as nonfatal were traced out. Finally, 286 nonfatal cases were selected as respondents. Data were collected using WHO-QOL-BREF questionnaire to measure the quality of life. Results: The better quality of life in all the four domains, that is, physical health, psychological health, social relationships, and environmental health, was found among the less injured category of victims. There was a statistically significant difference (P < 0.05) among the different categories of accidents as well as the types of postaccident occupation of the respondents for all the four domains. A significant variation was found across different age groups for the physical health domain. Respondents of below 18 years were found with the better mean score for all the domains. Similar differences are observed for education for all the domains, except the social relation domain. The Mann–Whitney U-test revealed a significant difference between those who received the compensation and those who did not receive the compensation for the psychological domain. Conclusions: The study warrants policy-related measures with ease of compensation procedures by simplifying the insurance processes and counseling. Indeed, rehabilitation measures need to be taken seriously by the government as the support system is vital for the improvement for quality of life among road traffic accident victims.

Background: Disasters have a great and lasting impact on children physically and psychologically because of their particular physiological and social developmental stage. Disasters are recognized as potential risk for the overall development of children, and children exposed to disasters require some abilities or protective factors which serve as a shield to buffer the risk. The present study was aimed at studying the role of sociodemographic factors on psychological impact and resilience among children exposed to disasters. Materials and Methods: A cross-sectional descriptive research design was used to accomplish the study. The study included 100 out of 502 children, 25 each from four schools from four villages selected randomly of four zones of district Anantnag using multi-stage sampling and systematic sampling. The Children Revised Impact of Events Scale-13 and Connor–Davidson Resilience Scale-25 were used to assess the posttraumatic symptoms and resilience among the children. Results: The results showed that children had mild-to-moderate level of posttraumatic symptoms, and majority of the children had intermediate to high resilience. This study provided interesting results that female children were found high on resilience and low on posttraumatic symptoms, which is not usual. Significant differences were found between resilience and gender, education, socioeconomic status, income, and domicile as well. Similarly, differences were found between posttraumatic symptoms and displacement, family type, domicile, and education. Conclusion: Flood disasters increase the psychological vulnerability for children. To prevent the potential risks, children need protective factors. The present study highlighted that psychological resilience can be improved by looking and improving the sociodemographic factors and making promising ways of establishing resilience-building strategies to regain the spirit of children and families at individual and community level.

Background: Personality disorders (PDs) comprise deeply ingrained and enduring behavioral patterns, manifesting themselves as inflexible responses to a broad range of personal and social situations. Our aim was to study sociodemographic profile and parental attitudes in patients with PDs and their comparison with healthy controls. Materials and Methods: It was an observational case–control study conducted in Department of Psychiatry, Government Medical College, Srinagar, J and K, India. A total of 41 cases and 163 controls were selected. Patients were diagnosed using Diagnostic and Statistical Manual-5 (DSM-5) criteria. Childhood Trauma Questionnaire was used for parental attitudes. Results: The mean age of patients and controls was 22.41 (standard deviation [SD] = 4.14) and 22.52 (SD = 4.15), respectively. Majority of the participants were females, single, were from nuclear families, and belonged to upper-middle socioeconomic class. Most of the patients were borderline PD (BPD), followed by histrionic PD. The frequency and inappropriateness of punishment by parents was more in patients than controls. Conclusion: A positive correlation was seen between PDs and inappropriate parental attitudes and rearing styles. Therefore, it is required to have a better understanding of PDs and to help parents to develop skills to handle their children with utmost care in distress.

Background: Children with attention-deficit hyperactivity disorder (ADHD) have severe impairment in their social functioning, and such literature from their sibling relations is limited. Sibling relations have several dimensions to them and a more detailed assessment into their impairment in ADHD is needed. We compared quality of sibling relations among ADHD sibling dyads and healthy controls. We also correlated the quality of sibling relations with severity of inattention and hyperactivity in ADHD. Materials and Methods: The present case–control study enrolled 30 cases of ADHD and 30 healthy controls from a child guidance clinic. The quality of their sibling relations was assessed by parent-rated version of the sibling relationship questionnaire (SRQ) on four domains of warmth, power struggle, conflict, and rivalry as well as their respective sub–domains. Their severity of inattention and hyperactivity was assessed using the Vanderbilt ADHD Diagnostic Parents Rating Scale (VADPRS). Results: ADHD sibling pairs had significantly lower warmth, prosocial behavior, affection, companionship, and competition as compared to their healthy counterparts. ADHD child was admired less by the sibling, and they were also seen to nurture each other less. The most significant difference was seen in affection (r = 0.59), followed by nurturance (r = 0.56). Intersibling conflict correlated positively with hyperactivity scores on VADPRS (ρ = 0.410, P = 0.04). Conclusions: Sibling relations are significantly affected in ADHD, with lower warmth and nurturance. Most significant impairment is noted in affection followed by nurturance. Intersibling conflict correlates significantly with severity of hyperactivity.

Introduction: Alcohol use disorder has many negative effects on the wives of patients including domestic violence. The wives are in a position where their mental state can be severely compromised, leading to suicidal behavior. The purpose of the study is to assess the prevalence and types of domestic violence in the wives of patients with alcohol use disorder. The study examined the extent of perceived stress, nature of coping strategies used, suicidal risk, and their relationship with domestic violence. Methodology: A cross-sectional study of 100 wives of patients diagnosed with alcohol use disorder as per the Diagnostic and Statistical Manual, Fifth Edition, recruited using purposive sampling technique was conducted over 6 months. The wives were administered a semi-structured pro forma along with Severity of Violence against Women Scale, Perceived stress scale-14, Columbia Suicide Severity Rating Scale (C-SSRS), and Coping Questionnaire-30. Contingency tables and linear regression analysis helped examine the associations and correlations. Results and Discussion: Domestic violence was highly prevalent (87%) in the wives of patients with alcohol use disorder. A statistically significant correlation was seen between domestic violence and perceived stress. It was seen that those who experienced domestic violence used predominantly tolerant inactive coping mechanism. The wives facing domestic violence had a four-fold greater prevalence of suicidal behavior. Statistically significant relationships were seen between domestic violence and intensity as well as severity of suicidal ideation. Conclusions: The study highlights the importance of screening for domestic violence in the wives of alcohol use disorder patients as it is highly prevalent. Psychoeducation to effectively deal with the stress and adopting healthy coping ways to improve psychological health is essential. Spreading awareness about both, domestic violence in the community and the need for treating patients with alcohol use disorder, may prove to be helpful.

Background: Breast cancer is the most frequently diagnosed cancer and the leading cause of cancer deaths among females worldwide. Once an individual encounters this diagnosis, she may go through a mix of emotions such as shock, disbelief, fear, anxiety, guilt, sadness, grief, depression, and anger. The present study attempts to find the prevalence of anxiety and depression in female breast cancer patients presenting in a tertiary care hospital. Methods: A total of 100 consecutive cases of female breast cancer patients, who were admitted to the oncology ward at the time of evaluation, either for follow-up or treatment, were taken as cases, in a tertiary care hospital over a period of 1½ year. Baseline demographic data of cases were entered in a semi-structured pro forma on admission. The General Health Questionnaire (GHQ-12) was used to assess distress. The prevalence and severity of anxiety and depression were assessed with the Hospital Anxiety and Depression Scale. The patients were also evaluated for relationship between depressive and anxiety symptoms and various other sociodemographical factors. Chi-square test was used as the statistical tool to analyze the data. Results: The mean GHQ-12 score was 16.44 (standard deviation = 4.66), with 26% of patients showing evidence of distress and 18% evidence of severe problems and psychological distress. Nearly 36% of the breast cancer patients had significant anxiety scores (mean = 8.34). Almost 34% of the breast cancer patients had significant depression scores (mean = 8.27). Younger patients (<50 years) showed significantly high incidence of depression. Conclusion: The results of the study showed that both anxiety and depression were significantly higher in breast cancer patients, emphasizing the need for dedicated service provision (psych-oncology units at cancer centers). Various sociodemographic factors studied (except age) did not show any statistically significant difference in the incidence of anxiety or depression.

Obsessive–compulsive disorder (OCD) is a commonly encountered psychiatric illness. Cognitive behavior therapy (CBT)/exposure and response prevention (ERP) is first-line treatment option for OCD. When facilities are available, CBT/ERP monotherapy may be recommended in mild to moderately ill patients. However, in severely ill patients, the management comprising CBT and pharmacotherapy is more efficacious than single treatment alone. Behaviorists practicing ERP recommend that exposure in real-life situations (vivo) is more effective than in imaginative situations (vitro). Here, we present a case of a middle-aged female with obsessions regarding contamination by menstrual blood and compulsions of checking and cleaning, causing marked sociooccupational deficit. The index patient who was suffering from debilitating form of OCD failed to respond to pharmacotherapy alone and later with combination of pharmacotherapy; brief in vivo flooding and ERP in vitro responded well; which is sustained at 6 months' follow-up.

Introduction: The COVID-19 pandemic and the subsequent lockdown declared by the Indian Government in March 2020 lead to an unexpected turn of events for many, causing a huge psychosocial impact on them. Methodology: The study focused on evaluating a family from Kerala with major language difficulties and the distress being faced by them during their stay in the government provided shelter home in Delhi. The family was assessed by the multidisciplinary team from the Institute of Human Behavior and Allied Sciences visiting various shelter homes across the state. The study was aimed to assess the importance of psychological first aid (PFA) on the individual and the family in distress. Results: The family was assessed by the student counselor, who was well versed in their native language Malayalam. They were able to connect well, and hence, an appropriate psychosocial intervention was provided to them under the guidance of her supervisor. The family was highly distressed and had almost developed xenophobia. They were very happy to get a Malayalam-speaking counselor and were provided with all possible support. The authorities were also explained about their specific needs, which was not possible earlier due to the language barrier. They were ultimately successfully integrated with the other residents and returned to their home state, i.e., Kerala. Conclusion: Although PFA is definitely not a substitute for mental health care, ample research and experience has shown that it is a useful tool to assist people in acute distress when applied with a truly professional yet sensitive, empathetic approach.