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The hijras of India: A marginal community with paradox sexual identity
Sibsankar Mal
January-March 2018, 34(1):79-85
Transgender people in India, commonly known as the Hijras, who claim to be neither male nor female, are socially excluded in Indian society. The uniqueness of Hijras lies not only in their existence beyond social structure but also in Indian society's historical acceptance of that position. This study aims to understand the sociocultural exclusion of Hijras, depending on their gender identity disorder and their paradox sexual appearance. An exploratory cum descriptive research design with a nonrandom purposive sampling including the snowball technique was adopted, to collect information from 51 Hijras at Kharagpur town from the state of West Bengal, India. The study shows that although Hijras have a sort of sanctioned and visible place in Hindu society, but in the contemporary Indian context, it is the gender nonconformity of the Hijra that has a major impact besides lack of a gender recognition, sexual expression, employment, decent housing, subsidized health-care services, and as well as the violence they suffer, especially when they choose to take up formal works. Therefore, Hijras are controversial and minacious community in Indian society and their existence disrupts essential ideas about sex or gender. They need to be recognized as having a space on society's gender continuum. Vertical interventions of rights are greatly needed to address the unique needs of this marginalized group and recognizing them as equal citizens of India.
  88,112 2,092 6
Sexual knowledge, attitude, behaviors and sources of influences in Urban college youth: A study from India
Siddharth Dutt, M Manjula
October-December 2017, 33(4):319-326
Background: The study was undertaken as there is very less literature related to sources of influence for sexual knowledge and attitude toward sex and sexual behaviors of youth in India. Aim: The objectives of the study were to explore sexual knowledge, attitudes, behaviors and the sources of influence and also to examine the relationship between sexual knowledge, attitude and behaviors in the youth. Method: The sample was selected from colleges using purposive sampling method and from the community using snowball method (n = 300). The tools used were sociodemographic data sheet, Sexual Knowledge and Attitude Questionnaire (SKAQ-II) and Sexual Behavior and Sources of Influence (SBSI) scale. Results: Descriptive statistics and correlation was done to analyze the data. The youth had poor sexual knowledge; there was positive relationship between sexual knowledge and attitudes. Sexual behaviors through media and with self or others were found to be low. Internet was found to be the major source for gathering information and was considered the most reliable source. Conclusion: Indian college youth continue to have poor sexual knowledge. Internet is a major source of information and is considered as the most reliable one among youth. More knowledge about sex is associated with liberal attitude toward sex.
  66,631 1,799 14
Social changes in the 21st century have differentially affected the mental health scenario in the developing world
Harischandra Gambheera
July-September 2016, 32(3):238-242
The effects of social development in the 21st century have affected different countries and different social groups differently. Although social development upgraded life standards of a sector of population, it has affected adversely on poor socioeconomic groups in different parts of the world. Even though the economic status of urban cities in developing countries has gone up, standards of living have not risen parallely. The social structure has changed and risk factors for common mental illness have increased whereas poorly developed mental health services remain unchanged. Resource allocation for the development of mental health services in developing countries still appears to be minimal.
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The biopsychosocial approach and global mental health: Synergies and opportunities
Emmanuel Babalola, Pia Noel, Ross White
October-December 2017, 33(4):291-296
The biopsychosocial (BPS) approach proposed by Engel four decades ago was regarded as one of the most important developments in medicine and psychiatry in the late 20th century. Unlike the biomedical model, the BPS approach posits that biological, psychological, and social factors play a significant role in disease causation and treatment. This approach brought about a new way of conceptualizing mental health difficulties and engendered changes within research, medical teaching and practice. Global mental health (GMH) is a relatively new area of study and practice that seek to bridge inequities and inequality in mental healthcare services provision for people worldwide. The significance of the BPS approach for understanding mental health difficulties is being debated in the context of GMH initiatives. This paper critically evaluates strengths and weaknesses of the BPS approach to mental health difficulties and explores its relevance to GMH initiatives.
  58,760 4,311 13
Advocacy in mental health: Offering a voice to the voiceless
P Joseph Varghese
January-June 2015, 31(1):4-8
  44,836 1,336 2
Study of internet addiction: Prevalence, pattern, and psychopathology among health professional undergraduates
Sachin R Gedam, Santanu Ghosh, Lipsy Modi, Arvind Goyal, Himanshu Mansharamani
October-December 2017, 33(4):305-311
Background: Internet has become an essential part of our daily life, especially among adolescents and youth. It is mainly used for education, entertainment, social networking, and information sharing. Its excessive use among health care providers is becoming a major concern. Aims: The aim of our study was to estimate the prevalence, understand the pattern, and to determine the association between psychopathology and internet addiction among health profession undergraduates. Materials and Methods: A cross-sectional study was conducted among 846 students of various faculties from Deemed University. Students were assessed with semi-structured data, Internet Addiction Test and Mental Health Inventory, after giving them brief instructions. Students were classified into normal students and addicted students for comparison. Results: The total prevalence of internet addiction was 19.85%, with moderate and severe addiction being 19.5% and 0.4%, respectively. Internet addiction was associated with gender, computer ownership, preferred time of internet use, login status, and mode of internet access (P < 0.05). It was also associated with anxiety, depression, loss of emotional/behavioral control, emotional ties, life satisfaction, psychological distress, and lower psychological well-being (P < 0.05). Conclusion: Significant association was found between psychopathology and internet addiction. Male gender, login status, emotional ties, and psychological distress were found to be important predictors of internet addiction among students. Hence, these parameters should be taken into consideration while promoting awareness of problematic internet use and educating students regarding healthy internet use.
  28,409 1,716 15
Study of mechanisms of coping, resilience and quality of life in medical undergraduates
Mansi Somaiya, Swapnil Kolpakwar, Abhijeet Faye, Ravindra Kamath
January-June 2015, 31(1):19-28
Introduction: The period of undergraduation in the medical field is challenging, and the medical student is exposed to various stressors. Aims and Objectives: This study was designed to identify the mechanisms of coping, resilience and quality of life (QoL) and their correlations in medical undergraduates, so as to find some factors which can help to make some positive changes in medical curriculum. Methodology: Totally, 250 medical students representing all academic years of medical college were provided with questionnaires investigating their sociodemographic profile, coping skills, resilience, and QoL. Using appropriate statistical tests, the parameters were studied along with a search for the factors affecting them. A comparison of all these factors was also done among the students of all the academic years of medical school. Results and Discussion: Problem-solving and fatalism was more in immigrant students than native students of Mumbai. Problem-oriented mechanisms of coping, resilience, and QoL were higher in students doing internship. However, students of 3 rd year part 2 were less resilient, used emotion-focused ways of coping and had a lower QoL. There was a good shift of positive ways of handling stress with an increase in the academic year. Problem-oriented mechanisms of coping positively correlated with resilience and QoL. High resilience was also found as a positive factor for good QoL. Conclusion : Along with the clinical component, an equal emphasis should be given to improve the social and personal life of a medical student helping them to cultivate more problem-based coping and increasing their resilience so as to ultimately improve their QoL.
  28,691 1,179 4
Are social theories still relevant in current psychiatric practice?
Ajit Avasthi
January-March 2016, 32(1):3-9
Current psychiatric practice is being influenced by advances in the field of molecular biology, genetic studies, neuroimaging, and psychopharmacology and the approach has become "biological." Social theories of mental illness had once revolutionized the field of psychiatry and are currently being somewhat ignored under the dazzle of biological sciences. Main social theories are functionalism, interpersonal theory, attachment theory, stress theory, and labeling theory. Each of these theories had tried to explain the genesis of psychiatric disorders in their own way. However, each theory has its own limitations and critique. Still, for a holistic approach to treat persons with mental illness, it is essential to take a biopsychosocial approach which can only be done if one understands the contribution and relevance of social theories. Nonpharmacological management has been the cornerstone of treatment of any psychiatric disorder and social theories also form the basis of various nonpharmacological modes of treatment. Overall, social theories are still very relevant in current psychiatric practice and should not be neglected. Efforts should be made to integrate social theories with other theories of mental illness for better understanding and treatment.
  22,649 1,203 2
Intellectual disability in international classification of Diseases-11: A developmental perspective
Satish Chandra Girimaji, Arul Jayendra V Pradeep
November 2018, 34(5):68-74
Historically Intellectual Disability (ID) has been included in the International Classification of Disease and related Health Problems [ICD] and Diagnostic and Statistical manual Of Mental Disorders [DSM] from the beginning. There has been a significant change in the terminology, placement of the condition, classification, and defining features as a result of advances in unraveling the development and functionality of the brain and identifying the etiologic basis of intellectual disability. Current approaches view ID from a developmental perspective and rely on both intellectual abilities and adaptive functioning. This article looks into the salient features of “Disorders of Intellectual Development” as it is termed in ICD-11 in comparison with “Mental Retardation” as it was termed in previous ICD-10 and “Intellectual Developmental Disorder” in latest DSM-5 version, and examines the commonalities and differences.
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How are social changes in the twenty first century relevant to mental health?
Krishna M Prasad, Hareesh Angothu, Manila M Mathews, Santosh K Chaturvedi
July-September 2016, 32(3):227-237
Mental health problems occur in a psychosocial context. Social dimensions significantly impact psychiatric practice and research. The twenty first century has seen dramatic urbanization, globalization, rapid advances in technology, and communications. These among several other social changes, such as nature and shift in family systems, newer patterns of relationships, migration, and social mobility will bring about novel challenges for diagnosing and managing mental health problems; nevertheless this may at the same time throw newer means and opportunities to intervene, particularly with the advancements in technology. There is likely to be greater awareness about mental health problems. The rights based and recovery oriented approaches will change the way psychiatry is practiced. Many of these changes will positively impact policies of the government and access to care. This article focuses on the social changes in the twenty first century and the impact this has had and will have on mental health, especially in India.
  21,113 993 2
Experiences of quarantine for individuals during the COVID-19 outbreak in Kashmir: A qualitative study
Zahid Maqbool
January-March 2021, 37(1):71-76
Context: The coronavirus disease 2019 (COVID-19) outbreak originally occurred from Wuhan, China, in December 2019 and gradually spread to other countries in different parts of the world. The COVID-19 outbreak has led many countries ask people who have potentially come into contact with the infection to isolate themselves at home or in administrative quarantine facilities. Thus, quarantine at different levels, from individual to community, was seen as an effective measure of preventing the spread of this disease. Aims: The aim of the present study is to explore the experiences of quarantine for individuals returning from Bangladesh during the COVID-19 outbreak in Kashmir. Settings and Design: This study follows qualitative narrative design. Subjects and Methods: This study used an in-depth, semi-structured interview guide. Purposive sampling technique was used to select the participants who varied in terms of gender and age. Results: Despite individual differences, the experiences narrated by participants followed stages beginning before, during, and after ending the quarantine. The government authorities adopted a policy of mandatory quarantine to all the incoming passengers with the aim of preventing the spread of this pandemic. However, participants reported facing several issues such as shock and fear, feeling of isolation and loneliness, frustration and boredom, and loss of routine activities during this period. Conclusions: Quarantine as a method of preventing transmission of severe disease outbreak should be carefully used after effectively weighing its potential benefits and risks. The results of the study can be used to devise a proper policy framework and practice for effectively managing future quarantine and isolation-related health emergencies.
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Stigma associated with mental illness: Conceptual issues and focus on stigma perceived by the patients with schizophrenia and their caregivers
Aakansha Singh, Surendra K Mattoo, Sandeep Grover
April-June 2016, 32(2):134-142
Among the various psychiatric disorders, schizophrenia is considered to be associated with high level of stigma. The stigmatizing experience is not only limited to the patients but is also experienced by their close relatives. This article reviews the conceptual issues in understanding stigma, mainly in relation to schizophrenia. Further, this article reviews the existing literature in terms of extent and correlates of stigma experienced by patients with schizophrenia and their close relatives. Stigma experienced by the patients can be categorized as public stigma and personal stigma. The personal stigma is further understood as perceived stigma, experienced stigma, and self-stigma. Stigma experienced by caregivers of patients with mental illness is called associative or courtesy stigma and affiliate stigma. A number of tools have been developed for assessment of stigma among patients with mental illnesses and their close relatives. Depending on the type of instrument used to assess stigma, the prevalence of stigma among patients with schizophrenia varied from 6% to 87%. Much of the literature on stigma in the patients with schizophrenia is from developed countries. There is limited literature from India and majority from Southern and Central part of the country. Stigma associated with schizophrenia is highly prevalent across regions and varies according to different sociodemographic and clinical correlates. The experience of stigma among patients of schizophrenia is influenced by the type and severity of psychopathology, insight, coping, causal beliefs, depression, social support, self-esteem, self-efficacy, and self-directness. Stigma influences medication compliance, quality of life, and social functioning. Research is scanty with regard to stigma perceived by caregivers of patients with schizophrenia. Besides the caregiver variables, different patient variables uniquely modify the stigma experienced by the caregivers. Different interventions may reduce the stigma experienced by patients and their caregivers. Studies evaluating stigma experienced by patients with schizophrenia and their caregivers suggest that stigma is highly prevalent among patients and their relatives. Data on correlates of stigma are limited. There is a need for further research on stigma for a better understanding of the concept so as to find ways to reduce it and prevent its adverse consequences.
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Recent developments in community mental health: Relevance and relationship with the mental health care bill
Rakesh Kumar Chadda, Bichitra Nanda Patra, Nitin Gupta
July-December 2015, 31(2):153-160
Community mental health refers to the treatment of persons with mental disorders in the community. In the earlier periods, treatment of patients with mental illness was limited to the mental hospitals or asylums. This paper traces the beginnings of community psychiatry in India from the time Dr. Vidya Sagar initiated his famous experiment of treating patients with mental illnesses along with family members in tents outside the mental hospital, Amritsar. It then discusses the role of the National Mental Health Program and the District Mental Health Program. The role of the United Nations Convention on the Rights of Persons with Disability in leading onto the development of the current Mental Health Care Bill, 2013 is discussed. Authors critically evaluate some of the merits and drawbacks of the Bill as related to recent developments in community mental health in India.
  16,819 1,170 1
The role of “Attributions” in social psychology and their relevance in psychosocial health: A narrative review
Debanjan Banerjee, Chehak Gidwani, TS Sathyanarayana Rao
October-December 2020, 36(4):277-283
Assigning motives or reasons to situations and actions have been the basic premise of human existence. Attributing cause to an action makes it logical and easier to comprehend. In social psychology, attribution is the process through which individuals explain the causes of behavior and events. Various theories and models have been proposed to explain this concept, starting from the early works of Fritz Heider in the early 20th century and further advances by Harold Kelley and Bernard Weiner. Attributional concepts can be used in a wide arena of behavioral science ranging from mental health stigma-related interventions to consumerism, corporate and jury psychology, and finally, attributional bias in psychosis and learned helplessness in depression. Attribution theories are viewed as the relevant concepts in the exploration and explanation of a wide repertoire of psychopathologies, especially for culture bound syndromes. Research into the translational use of attributional theories has declined in the recent years, the models being criticized for being mechanistic and reductionistic in approach. Nevertheless, the role of “attributions” in social psychology remains equally important today to explore the various facets of human behavior and reactions. The article explores the relevance of attributions in the fields of psychosocial health. It discusses various theoretical perspectives and frameworks premised on attributional models and narrates the understanding as well as the applications of the relevant theories in the realms of stigma research and consumerism. The criticism and implications in mental health are highlighted thereafter.
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A virtual reality: Technology's impact on youth mental health
Benjamin Ian Perry, Swaran Singh
July-September 2016, 32(3):222-226
2016 will mark as the year when commercially available virtual reality headsets first become available across the world. This is set to be a landmark development and will revolutionize the way we interact with technology, which is already eating up more and more of our time, and is now inextricable from day-to-day life. Adolescents, at a critical stage in both physical and psychological development, are often the first to adopt advances in technology, and therefore also any associated impact on health. We discuss some of the current and important research on the positive and negative implications of technology on the mental health of children and adolescents, and briefly outline how future technological advances may further affect how we diagnose, monitor, and manage our young patients in the psychiatric clinic.
  16,335 1,533 1
Psychology of misinformation and the media: Insights from the COVID-19 pandemic
Debanjan Banerjee, TS Sathyanarayana Rao
October 2020, 36(5):131-137
The coronavirus disease 2019 (COVID-19) pandemic has emerged as a significant and global public health crisis. Besides the rising number of cases and fatalities, the outbreak has also affected economies, employment, and policies alike. As billions are being isolated at their homes to contain the infection, the uncertainty gives rise to mass hysteria and panic. Amid this, there has been a hidden epidemic of “information” that makes COVID-19 stand out as a “digital infodemic” from the earlier outbreaks. Misinformation and fake news are invariable accompaniments to this “information pollution” which can add to the anxiety, fear, uncertainty, and agitation and lead to faulty treatments, noncompliance to precautionary measures, prejudice, and stigma. Research shows that distress and panic during pandemics can propagate and promote misinformation in various ways along with increased digital screen time and unhealthy use of technology. In that context, media is considered to be a “double-edged sword” and can either add to the misinformation burden or aid in the awareness and health communication during such a biological crisis. Lessons from past outbreaks portray media, especially social media, as a useful tool to promote health literacy and control the outbreak. This article looks at the impact of information during COVID-19, the psychology behind spread of misinformation, and finally, a balanced view of the role of media in such disasters, proposing ways for its healthy integration into public and social health.
  15,920 1,583 14
Caregiving and caregivers: Challenges and opportunities in India
R Srinivasa Murthy
January-March 2016, 32(1):10-18
Caregiving of persons with mental illness is challenging as sometimes it is demanding and at other times, it is fulfilling to caregivers. In India, family members are the caregivers for persons with mental illness as there are extremely limited alternative facilities and family members are preferred for caring. The changing social milieu in India such as urbanization and nuclear family is placing significant burden on family members. This article will discuss about the emotional dimensions of caregiving, importance of care receivers, utilizing the caregiving situations to address prevention of mental disorders, promotion of mental health, and fight stigma of mental disorders. In India, majority of the research is on the burden of caregiving on family members and there is less or no research on caregiving in different communities, population groups, and develop programs to make caregiving a positive experience on caregivers and caregiving. In India, there is a need to develop systems of sharing of skills, support, and supervision to caregivers in providing care to the individuals with chronic illnesses. This can minimize the stress of caregiving and maximize the positive feelings of caregiving.
  15,731 1,579 7
Psychosis and related disorders in international classification of Disease-11 and their relationship to diagnostic and statistical Manual-5 and international classification of Disease-10
Abid Choudry, Saeed Farooq
November 2018, 34(5):11-16
The two main classification systems, International Classification of disease (ICD) and diagnostic and statistical manual (DSM) have recently been revised. The revision of DSM-IV by the American Psychiatric Association is complete and DSM-5 has already arrived. The draft ICD-11 diagnostic guidelines for mental disorders are nearly complete and will soon be published as ICD-11. In this article we will briefly discuss the challenges in classifying psychotic disorders, the revised classification of these disorders in ICD-11 and how this differs from ICD-10 and DSM-5. Several changes to the classification of schizophrenia and other psychotic disorders have been made to increase the reliability, clinical use and validity of the diagnostic classification which are considered here.
  15,036 1,139 1
COVID-19 pandemic and emotional health: Social psychiatry perspective
R Srinivasa Murthy
October 2020, 36(5):24-42
The COVID-19 pandemic is a challenge to humanity. It is not only a health crisis but also a social crisis. As in the case of past pandemics, life, as we know, is unlikely to be the same after we come out of the pandemic. There will be changes at the level of individuals, families, communities, states, nations, international relationships, and the way all of us will deal with a range of human and environmental situations. Disasters are always associated with increased rates of emotional health needs from distress to specific disorders, such as posttraumatic stress disorder, and the vulnerabilities are associated with the way society is organized. Past experiences have shown psychosocial interventions, ranging from self-care, psychological first aid, school interventions, counseling, social support and formal psychiatric care can minimize the emotional health impact of disasters. These activities can be initiated by individuals, paraprofessionals, and professionals. In addition, there is an important role for social–economic interventions such as provision of food, healthcare, shelter, protection from harm, and relocation/rehabilitation. Spiritual resources are an important part of coping with the pandemic. An emerging area of disaster psychiatry is the possibility of posttraumatic growth and facilitating of community resilience. There is sufficient evidence, from the past, of major societal level changes, following pandemics, in healthcare, education, welfare, governance, and citizen–government relationships along with relationships across countries. The psychosocial interventions, with survivors of disasters, should be to promote mental health and prevent mental disorders and care of persons with mental disorders involving the individuals, families, communities, and the government. The pandemic also offers opportunities for understanding and addressing of the risk factors for mental health and factors contributing to resilience of individuals and communities. The current pandemic presents challenges and opportunities for the Indian Association for Social Psychiatry.
  15,033 1,111 4
Video game use among schoolchildren and its impact on the study habits
Janardhana Navaneetham, Juna Chandran
July-September 2018, 34(3):208-212
Background: Children usually play video games for entertainment, excitement, challenge seeking, emotional coping, and escaping from reality to virtuality to fulfill their unsatisfied needs or motivations. Video game is a ‘medium’ through which young children can make sense of, and feel at home in the present modern generation where in parents are too busy with their own career choices. Methods: The present study aims at understanding prevalence and how it impacts on the academics among the school children and to understand about mental health problems among the pathological user. The present study likes to explore the addiction of video and internet games among students and establish fact about its effects. Students were selected from two schools with state syllabus. Video game addiction scale and study checklist was used for the present study. 200 students in the classes of 8th and 9thgrades and those who can read and write English were invited to participate in the survey. Results: Almost half of the children reported that they did not play Video Game, 18% of students are using video game with control, 20% students are excessively using video games and 17.5% of the students fall under addiction category. The study indicated that 19% of the children were spending more than 3 hours for game. Conclusion: In conclusion, playing video and internet games is a widespread activity among young children, and a substantial proportion of their time is spent on this activity, affecting their relationship and the time spent on learning.
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A survey of suicidality and views on suicide in an Indian sample of adults
Nilamadhab Kar, Jagadisha Thirthalli
July-December 2015, 31(2):100-106
Background: Suicide is a major public health concern in India. There is limited information regarding views about suicide and suicidality in the community. Aims: It was intended to study the suicidal cognitions and behavior in a sample of adults in India along with views about suicide. Methodology: It was a cross-sectional, questionnaire-based, anonymous survey conducted in four tertiary level medical centers. The subjects included patients and their attendants and health professionals in the organizations. The questionnaire included items on suicidal cognitions, suicide attempt history, current and past physical and mental illness, stress, views on suicide and the interventions along with information on the sociodemographic variables. Results: A considerable proportions of participants reported lifetime suicidal cognitions: Life not worth living, 44.2%; death wish, 26.9%; suicidal ideas, 24.6%; made suicidal plans, 12.4%; and 7.1% had a history of suicide attempt. These cognitions were significantly associated with suicide attempt. There was a general awareness of risks and supportive measures. The finding that 29.7% of participants might consider suicide for themselves in certain circumstances suggested the degree of acceptability of suicide in the community. Contrasting views were also present where suicide was considered as a sin by 66.2%, but 10.4% felt that their religion allows it in certain situations. The majority of participants felt that suicide is preventable. Conclusions: Suicidal thought and behaviors were common in the community. The results suggest that there is still a need for public education increasing awareness about the risks, support systems available in the local community and timely help-seeking that may improve the scope for suicide prevention.
  14,896 795 5
A study to assess the prevalence and pattern of substance use among male adolescents in suburban area of Delhi
Liza Thankam Daniel, Ganesh Krishnan, Sandhya Gupta
July-September 2017, 33(3):208-212
Aim of the Study: To assess the prevalence and pattern of substance use among male adolescents in Sunder Nagari, New Delhi. Materials and Methods: A cross-sectional survey was designed to assess the prevalence and pattern of substance use among male adolescents in New Delhi. One hundred and ten adolescents were conveniently selected from Sunder Nagari, New Delhi. Adolescents aged more than 11 years and able to read and write Hindi or English were included in the study. A structured questionnaire for demographic variables was developed by researchers. To assess the prevalence and pattern of substance use, a structured questionnaire was prepared with the reliability coefficient of 0.94 (test-retest reliability) with a content validity index of 0.90 between the experts. Data were collected from the subjects after getting their written consent. Data analyzed using statistical package SPSS version 17.0. The level of significance was set as P < 0.05. Results: The study findings revealed that nearly more than half (55.6%) of the male adolescents reported the use of one or more substances in their lifetime. About 44.26% of the adolescents started to use substances before 13 years of age. Most common reason specified by the subjects to take substance were to be liked by friends (57.38%), to feel like an adult (24.6%), and few of them reported: “like the feeling of substances” (13.11%) as reason for taking substances. Common substances used by the subjects were any kind of tobacco (77.05%), inhalants (26.23%), and alcohol (11.47%). Most of the subjects were getting substances from their friends (85.25%) and only a few (14.75%) by themselves. Association analyses revealed that adolescents who studied less than 10th standard reported more usage of any kind of substances than who studied more than 10th standard. More prevalence of substance use was seen among adolescents who were from nuclear family. Subjects who had less than two siblings reported more substance use. Conclusion: Early onset of substance use is seen among adolescents. Low educational status and the nuclear family are associated with their substance use. Friends are the key source of substances and their initiation of substance use. Based on these findings, following recommendations can be considered. (i) Maintaining the substance use control through legislation by which controlling of selling substances under 18 years of age and prohibition of substance use in public places seem to be effective and (ii) early onset of substance use calls for effective measures directed against the younger age groups. Therefore, educational intervention at the school level appears to be the most feasible measure to prevent the initiation of substance use among adolescents.
  14,174 1,066 4
Mood disorders in the international classification of Diseases-11: Similarities and differences with the diagnostic and statistical manual of mental Disorders 5 and the international classification of Diseases-10
Subho Chakrabarti
November 2018, 34(5):17-22
The revision of diagnostic requirements for mood disorders in the forthcoming International Classification of Diseases-11 (ICD-11) classification was governed by the same principles that applied to the rest of the draft. Precedence was given to clinical utility and universal applicability of the classification. Other guiding principles included ensuring scientific validity of the revision and harmonizing it with the Diagnostic and Statistical Manual of Mental Disorders-5. These fundamentals led to considerable reorganization, restructuring, and expansion of the contents of the revision including the section on mood disorders. The mood disorders section now follows a much simpler format than the ICD-10 and is expected to be easier to use. Its simplicity, notwithstanding descriptions of individual diagnostic categories in the revision are more elaborate and precise and in consonance with the current state of knowledge regarding the different mood disorders included in the section. The draft guidelines are undergoing comprehensive field testing on a very large scale across many countries including a majority from the developing world. Results up to now have been encouraging in terms of user acceptability, clinical utility, and global and cross-cultural relevance. However, one has to await the results of further testing and actual use of the final version of the ICD-11 by all stakeholders to determine if the revision indeed meets the high standards it has set for itself.
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Frontline health workers: The warriors of the COVID-19 pandemic
Anwesha Mondal, Manish Kumar
January-March 2021, 37(1):123-124
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Cost-of-treatment of clinically stable severe mental lilnesses in India
Siddharth Sarkar, K Mathan, Sreekanth Sakey, Subahani Shaik, Karthick Subramanian, Shivanand Kattimani
July-September 2017, 33(3):262-268
Background and Aims: The cost-of-treatment studies can help to make informed decisions while planning health-care services. This study is aimed to assess direct costs of outpatient treatment of four common chronic severe mental illnesses in a tertiary care hospital in South India. Methods: The patients with ICD-10 diagnoses of schizophrenia, unspecified nonorganic psychosis, bipolar disorder, and recurrent depression were recruited by purposive sampling from a government teaching hospital in South India. The total cost-of-treatment to the patient and the hospital was computed for each disorder as a percentage of the per-capita income of an individual patient. Results: The study comprised a total of 140 patients. The average monthly total cost-of-treatment was Indian Rupees (INR) 770 (95% confidence interval of 725 to 815), or approximately US$ 12.8. The monthly total cost-of-treatment was INR 720 for schizophrenia, INR 750 for unspecified nonorganic psychosis, INR 830 for bipolar disorder, and INR 790 for recurrent depression, with no significant differences between groups. On an average, 22.8% of total cost-of-treatment was borne by the patient, and the rest by the hospital. The patients spent a median of 12% of their per-capita income on treatment related to direct costs. Conclusions: Despite substantial government subsidies, patients do incur some expenses in treatment of chronic psychiatric illnesses. The attempts to reduce treatment and travel costs can facilitate psychiatric care to larger number of individuals.
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