The unprecedented SARS-2 COVID-19 pandemic has had a profound impact on individuals, families, and societies worldwide. The impact of the illness does not only directly relate to poor health on infection but also social and political determinants of health. As such, the secondary effects of the pandemic have been profound. Mental health and well-being have been one such area of concern, with the causal links thought to occur in three ways. First: the impact on general population, particularly vulnerable groups such as BAME individuals; Second: the impact on people with pre-existing psychiatric disorders; Third: mental health of COVID patients and those who have recovered and their careers. There are lessons to be learnt from previous pandemics and the impact on mental health. There are high levels of anxiety, depression, substance use (particularly alcohol), posttraumatic stress symptoms, and survivor guilt. Within this context, there is a need to consider the differential impact on underprivileged populations. Vulnerable groups include women, children, elderly, minority racial and ethnic groups, LGBT + individuals and the poor. It is noted that these classifications are met with challenges related to definition, and there is significant heterogeneity within the groups and the focus on race, gender, and poverty must be seen through an intersectional lens.

India consists of 16% of the world's population, but sustains only 2.4% of land resources. The agriculture sector is the only livelihood to two-third of its population, which gives employment to 57% of the workforce and is a raw material source to a large number of industries. Farmer suicides account for approximately 10% of all suicides in India. The national suicide rate is 10.6/lac, whereas in Maharashtra it is 14.2/lac, in Andhra Pradesh 12.1/lac, in Telangana 27.7/lac, and in Chhattisgarh 27.7/lac. The National Crime Records Bureau data from 1995 to 2006 show that 200,000 farmers had committed suicide, with an average rate of 16,000/year. Every 7^th suicide in the country is a farmers' suicide. The first state where suicides were reported was Maharashtra with particularly in the Vidarbha region. In Maharashtra, farmers' suicide rate is 60% higher than the general suicide rate. Every 5^th farmers' suicide committed in the country had occurred in Maharashtra, Vidarbha being a particularly sensitive region but also in Punjab, Uttar Pradesh, Kerala, and Karnataka. In a country of 70 million farmers, 10 in every 100,000 farmers commit suicide. Many inquiry commissions were formed and recommendations were implemented, especially in Punjab. The problem of suicide is not only reported in India but also reported in different parts of the world like England and Wales. We adopted the psychological autopsy approach to offer some insight into the reason why these individuals resorted to such a drastic step.

Drone operations have added a new chapter to modern warfare. They may not guarantee immediate territorial gains but can significantly influence ideological and political alignment of the adversary at a cost which is much lower than conventional war. However, drone operators, which include remote pilots, intelligence coordinators, and other support staff, may face important psychological issues which may affect their mental health and operational efficiency. We conducted a nonsystematic narrative review of the articles dealing with the issue and found that drone operators and support staff have higher chances of suffering from emotional disengagement, Post Traumatic Stress Syndrome (PTSD), emotional exhaustion, and burnout. The scope of the article does not cover the psychological effect on the targeted populations or political and ethical issues dealing with drone warfare.

Aim: The aim of the study is to assess and compare depression, anxiety, stress, and sleep disturbances among doctors and general population during COVID-19 pandemic. Materials and Methods: This cross-sectional, analytical, case–control, web-based study was conducted during September 2020 to examine the impact of pandemic on mental health. The participants completed basic sociodemographic questionnaire, Depression Anxiety Stress Scale-21 (DASS-21), and Athens Insomnia Scale (AIS). Results: Of the 321 participants, 320 provided basic data, 22 were on psychotropics. Out of the 298, 286 were matched for age and sex and were included. On DASS-21, 41.27% of doctors and 30.76% of general population reported depression; 40.56% doctors and 26.57% general population had anxiety; 38.46% of the doctors and 24.48% of general population reported stress. Statistical analysis revealed that doctors had significantly higher levels of anxiety and stress as compared to general population. On the AIS, more doctors (48.25%) suffered from insomnia compared to the general population (37.06%), but the difference was not statistically significant. Conclusion: Physicians have significantly higher anxiety and stress while dealing with COVID-19 compared to general population.

Background: The coronavirus-19 (COVID-19) pandemic has affected millions of people across the world since early 2020. Besides the large number of case fatalities, this virus has produced significant health-related sequelae involving multiple systems of the body. As with previous coronavirus infections, this was also found to be associated with various neuropsychiatric symptoms. Psychosis has been uncommon, and the few reported cases across the world have forwarded association with either raised inflammatory markers or the consequences of social isolation. Materials and Methods: This is a retrospective descriptive study of 12 patients, who were admitted with COVID-19 infection and psychosis, between March 2020 and December 2020. Cases of head injury, any neurological or metabolic illnesses, and substance use disorders were excluded. Results: Cases with psychosis formed only 0.19% of all cases of COVID-19 admissions. All of them were young male and employed. Most of them had abrupt onset of psychosis with confusion, delusions, hallucinations, agitation, and sleep disturbances. Investigations including inflammatory markers (C-reactive protein) and computerized tomography scans were largely normal. Medications used were mainly benzodiazepines and antipsychotics. Most of the cases resolved within the second week, and follow-up after a month did not elicit any residual symptoms in majority. Diagnosis was acute and transient psychotic disorder (about 75%), bipolar affective disorder (2 cases), and schizophrenia (one). Conclusions: The major findings included nonreactive inflammatory markers, quick resolution of symptoms, requirement of low doses of antipsychotic drugs, and no long-term sequelae.

Background: Coronavirus disease (COVID-19) has posed a remarkable threat to mental health all around the world. This pandemic has increased the incidence of common as well as severe mental illness (SMI) all around the world. Materials and Methods: We report 10 cases presenting to the psychiatric outpatient department (OPD) of Institute of Medical Sciences, Banaras Hindu University, from August to October 2020. They were either referred by other departments (3 patients) or came primarily to psychiatric OPD (7). Results: Five out of these 10 cases presented with predominant psychotic features; 3 cases had predominant obsessive–compulsive features; and 1 case was of dissociative trance possession. Conclusion: COVID-19 can affect the psychopathology of both types of patients either with preexisting mental illness as well as new-onset SMI.

Background: Beginning of the pandemic showed our limitations in our understanding of the spread of the dreaded coronavirus-19 that had sprung from China and spread through thick and thin across the world. The measures to contain the spread of virus in the absence of specific treatment protocol had everyone grope for the solutions in a very short time frame. One such is the knowledge, attitude, and practice in the rural setup. Aim: The aim of the study is to measure the change in knowledge, attitude, and practices (KAP) regarding COVID-19 following an awareness session in rural population. Materials and Methods: A cross-section interventional study was carried out in January 2021. An interactive awareness session was conducted with the help of audiovisual aids following MOHFW guidelines for COVID-19, and the change in KAP about COVID-19 was measured by pre- and posttest standardized questionnaire. Results: Of all the participants, statistically significant change in knowledge was seen from 43% to 52%. The villagers were educated about preventive steps and a positive change was measured in the practice of changing masks regularly (84%–100%), maintaining social distancing (44%–64%), frequent handwashing (52%–64%). No change was seen in wearing of masks (92%) and negative change was seen in avoiding handshakes (32%–28%). The preventive practices regarding COVID-19 pandemic changed significantly from 50% to 58%. Our study measured positive attitude change toward getting vaccinated from 64% to 72%. Conclusion: A single, short awareness session led to significant change in KAP about COVID-19 in rural population.

Background: Individuals who suffered from COVID-19 remain stressed and worried about anxiety issues for significant changes in daily living activities, causing strong emotional distress. Aim: The aim of this study was to assess the efficacy of psychological intervention in patients with post-COVID-19 anxiety. Materials and Methods: Thirty patients recovered from COVID-19 were selected for the study of age group 20–45 years of both the sexes. Initially, sociodemographic data sheet was filled, and after that, Mental Health Inventory (MHI) was administered. The patients who scored less on MHI were taken for the study, and psychoeducation, relaxation exercises, and activity scheduling were given to them. The goal of intervention was to prepare the patients to learn, interpret, and react to physical and psychological symptoms related after recovering from COVID-19 infection. The intervention was done for 30 min twice a week for 1 month, after that again postassessment was done to see the efficacy of psychological intervention. Results: Result reveals a significant improvement in mental health-related issues after psychological intervention as assessed by the MHI. Conclusion: Psychological intervention resulted in significant improvement of post-COVID-19 anxiety and related mental health issues.

Background: The coronavirus pandemic has affected more than 14 million people in the world. Adults are somehow able to manage their stress created by the most fearful disease. However, it is the children and adolescents who are most affected by COVID-19 lockdown. Aim: This study aimed to assess the effect of COVID-19 lockdown on adolescent's psychosocial factors. Materials and Methods: Using the Google Form link, a questionnaire was developed and an online survey was conducted. This online questionnaire consisted of 40 items assessing personal, social, academic, and family domains related to adolescents. Results: A total of 223 responses were obtained. The results indicate that 6.5% of adolescents experience extreme level of anxiousness, 29.8% become little irritable and angry, affecting their personal/emotional domain. About 12.6% of the adolescents are uncomfortable with social distancing and 48.4% of them greatly miss their friends; 38.1% miss their school and 28.8% are unable to clear their doubts through online teaching. Mathematics was the most uncomfortable subject for them to deal with 49.8%. About 79% of adolescents suffer mildly from family distress, 43.3% (extremely) are eagerly waiting for the lockdown to end. Conclusion: Among all four domains, the family domain was the most affected due to COVID-19 lockdown, followed by social, academic, and personal domains.

Background: Lockdown was implemented to restrict the transmission of COVID-19. This brought upon many unforeseen hurdles, including mental health problems. Aim: The aim of the study is to assess the impact of lockdown on mental health. Materials and Methods: A cross-sectional study was conducted using Google Form, which the participants were requested to complete online. The questionnaire included sociodemographic information and general health questionnaire (GHQ)-12, which was used to screen for mental health. Results: A total of 343 participants took part in the study in which 113 participants (32.9%) were having GHQ score of less than or equal to 12. The study showed that people aged less than 41 years were able to concentrate more during lockdown (75.6%) as compared to people aged more than 41 years (65%). Younger participants who were less than 41 years reported sleep disorders associated with late-night entertainment and TV viewing (24.5%). Many experienced stress during lockdown, but it was more in people over 60 years (63.7%). Conclusions: An appreciable proportion of the participants faced stress during lockdown. Elderly people were more affected. Sleeping disorders were associated with late-night entertainment and TV viewing in younger people.

Aim: We aimed to assess the consequences of dealing with patients during the COVID-19 pandemic lockdown period on the mental state of health-care workers. Materials and Methods: An anonymous online survey was conducted with 353 participants using a self-made questionnaire comparing the prevalence of low mood, apprehension, tension, and coping skills used and the Depression, Anxiety, and Stress Scale-21. The data were analyzed to compare the mental health of male and female doctors. To identify predictors of mental health outcomes, a multivariate logistic regression was carried out. Results: Both men and women were almost equally affected in terms of developing features of low mood, with easy physical and mental exhaustion. While the feeling of being isolated and irritability was slightly higher in females, both sexes were equally affected by the media. It was observed that the prevalence of smoking (tobacco/marijuana, etc.) had increased in both with slightly higher percentage in males as compared to females while there was a considerable increase in caffeine and alcohol consumption in males. The sleeping pattern and appetite were equally affected in both sexes. The sexual drive was also altered in both male and female residents, but the change was considerably more in males. The significant predictors of anxiety were age, depression, mental exhaustion, burden of increased quantity of work, and feeling of having no choice but to work due to obligation. Conclusion: Both male and female doctors working during the COVID-19 pandemic developed anxiety and depression. While substance use and altered sexual drive were more in males, exhaustion and stress were more in females.

Background: Health-care workers (HCWs) in COVID-19 pandemic have faced the major impact in providing care to infected persons. Most of the studies on mental health impact among HCW have not incorporated paramedical staff. Furthermore, they have not compared psychological morbidity among HCW on the basis of high COVID exposure (HCE) and low COVID exposure (LCE). To address the above gap, this study aimed at evaluating mental health impact among HCW and its associated risk factors. Materials and Methods: Consecutive 200 HCWs each in the HCE and LCE groups (between the age group of 18 and 60 years) were enrolled from two tertiary care hospitals providing COVID-19 treatment from August 1, 2020. After collection of sociodemographic data, participants were administered Impact of Event Scale-Revised, Patient Health Questionnaire-9, and Generalized Anxiety Disorder-7 Scale. Results: The difference in stress, depression, and anxiety symptom scores between the HCE and LCE groups was not statistically significant. Multiple regression analysis revealed that female sex was associated with higher scores in all the three domains. The effect remained significant even after adjusting for effect of other risk factors. Conclusion: HCE or LCE was associated with similar impact in terms of stress, depression, and anxiety among HCWs. Female HCWs had a higher prevalence of stress, depression, and anxiety. Doctors, nurses, and paramedics had a similar prevalence of stress, depression, and anxiety when odds were adjusted.

Background: The worldwide COVID-19 pandemic has significantly altered our life. Doctors more so than the general public because of their involvement in managing the COVID-infected individuals, some of them 24/7 end in burnout. Burnout in doctors can lead to reduced care of patients, increased medical errors, and poor health. Burnout among frontline health-care workers has become a major problem in this ongoing epidemic. On the other hand, doctors in preclinical department have a lack of interaction with patients, with not much nonclinical professional work to boot, find the profession less gratifying which perhaps increase their stress level. Aim: The aim was to study the prevalence of burnout and measure resilience in doctors in clinical and in preclinical departments. Materials and Methods: This observational, cross-sectional, comparative study was carried out in a tertiary care teaching hospital and COVID care center. By purposive sampling 60 preclinical and 60 clinical doctors in a tertiary health care center were included in the study. After obtaining the Institutional Ethics Committee approval and informed consent, the doctors were administered a self made socio-demographic questionnaire, the Copenhagen Burnout Inventory, and the Connor–Davidson Resilience Scale. Doctors were given a self-made questionnaire, the Copenhagen Burnout Inventory, and the Connor–Davidson Resilience Scale. Results: The prevalence of burnout was seen more in clinical doctors (55.47) and the resilience was observed more in preclinical doctors (88.9). Discussion: Resident doctors are a major force to combat COVID-19 as frontline health workers; hence, one can visualize burnout amongst them. On an individual basis, the work-related burnout was severely high in the clinical group owing to the workload which has been corresponding to a number of western studies. Nonclinical department doctors from pathology, community medicine, and microbiology did show burnout but showed a greater score in resilience. Psychological resilience has been identified as a component in preventing burnout. Conclusion: Therapy sessions can be used in clinical doctors facing burnout to build up their resilience.

Aim: The aim was to study the correlates of depression, anxiety, self-esteem, and suicidal ideas in patients of COVID-associated mucormycosis (CAM) and effects of treatment. Materials and Methods: A cross-sectional, analytical study was performed in a tertiary care center in Western Maharashtra. By purposive sampling, 34 patients of CAM were included in the study with their informed consent and after obtaining ethical clearance. A self-made questionnaire to include demographic and clinical details was filled. Hospital Anxiety and Depression Scale (HADS), Rosenberg Self-Esteem Scale (RSES), and Suicidal Ideation Attributes Scale (SIDAS) were applied after initial diagnosis. The HADS, RSES, and SIDAS were reapplied after their operative treatment. Results: A significant reduction in anxiety and depression scores postoperatively was seen. No significant difference was found in self-esteem or suicidal ideas postoperatively in the study population. However, patients who underwent orbital exenteration showed a significant reduction in level of self-esteem with anxiety and depression postoperatively. No specific correlation was found between the computed tomography score, family history, intensive care unit admission, or orbital exenteration with anxiety, depression, self-esteem, and suicidal ideas. Conclusion: Levels of anxiety and depression in patients of CAM reduced significantly after treatment, but self-esteem worsened in males more than females owing to disfigurement. There is a need of psychological counseling in patients of mucormycosis undergoing a debilitating surgery both pre- and postoperatively for a better outcome and recovery.

Background: Cognitive impairment is a core feature of schizophrenia and has been observed in subjects with and without a family history of schizophrenia. Nonetheless, there is a paucity of research directly contrasting cognitive profiles in schizophrenia patients and normal people where family history is present and those where the family history is absent. Aim: This stydy aimed to compare cognitive functions in patients with schizophrenia who had a family history with those that did not and healthy controls. Materials and Methods: Fifty consecutive schizophrenia patients were assessed on admission and follow-up after 6 months of treatment using a specially prepared pro forma, the Positive and Negative Syndrome Scale, and the PGI Battery of brain dysfunction is the name give to the test. An equal number of age- and sex-matched normal control subjects were also assessed. Results: Visual memory scores in this study show improvement between baseline and follow-up in schizophrenia patients with/without a family history. Both verbal learning and memory increase between baseline and follow-up but do not reach control levels. Reasoning and problem-solving deficits follow a similar pattern and are causative in the inability to adapt to a changing world. Speed of processing shows improvement with treatment. Working memory deficits in patients improve with treatment. Conclusions: In this study, all six cognitive domain scores in schizophrenia improved after 6 months of treatment but did not reach the control population level. Individuals with the highest cognitive deficits in the scales were the ones who had a family history of schizophrenia.

Background: Auditory verbal hallucinations are not a unitary phenomenon and can be further differentiated into certain clinical characteristics, viz., frequency, intensity, control, tone, distractibility, distress, and clarity. These clinical characteristics manifest in varying degrees in different psychiatric disorders. Aim: To study the characteristics of auditory hallucinations in Indian patients with schizophrenia and bipolar affective disorder. Materials and Methods: By purposive sampling, 140 patients of schizophrenia and bipolar affective disorder each were included in the study. Subjects were assessed cross-sectionally using sociodemographic proforma and characteristics of auditory hallucination scale. Results: Characteristics of auditory hallucinations of schizophrenia patients were significantly different from those of bipolar affective disorder patients in the domains of frequency, intensity, tone, self-control, clarity, distractibility, and distress. Conclusion: Characteristics of auditory hallucinations differ in all domains between schizophrenia and bipolar affective disorder.

Background: Studies have suggested that repetitive transcranial magnetic stimulation (rTMS) could be efficacious in the treatment of major depression and other psychiatric indications. Alcohol-dependence syndrome is difficult to treat, and the relapse rate is high, even following the standard treatment protocol. No study has been done so far in India for the use of rTMS as an adjuvant therapy in the relapse prevention of patients with alcohol-dependence syndrome. Hence, the current study is an open-label study to explore the same. Aim: The aim of this study was to study the feasibility of rTMS in alcohol-dependence syndrome patients, the side effects if any, and the number of relapses that they may suffer from vis-a-vis patients with standard treatment protocols. Materials and Methods: In a prospective, open-label study design, 100 freshly diagnosed cases of alcohol-dependence syndrome were included, and after suitable randomization, half of them were given adjuvant rTMS along with standard treatment and the rest received only standard treatment. The rates of relapse into drinking were compared for both groups. The data were compiled and analyzed with appropriate statistical methods. Results: Participants given adjuvant rTMS showed significantly less number of relapses into drinking compared to the control group on standard treatment for alcohol-dependence syndrome. Conclusion: In the present study, though the sample size is small, a significant change with this novel treatment has been found. Whether this change is maintained over a period of time is to be seen by other longitudinal studies.

Background: Individuals with permanent orthopedic disability present with a number of physical and mental health issues. Psychiatric illnesses have been seen more frequently among people with disabilities as compared to normal population. Aim: To study psychiatric morbidity among people with permanent orthopedic disability. Materials and Methods: This cross-sectional, observational, hospital-based study was conducted at the department of psychiatry of a tertiary care hospital attached to a medical college during January 01, 2018, to December 31, 2018. The study included subjects over the age of 18 years comprising two groups: Group A (n = 50) including consecutive subjects with orthopedic disability and Group B (n = 50) including normal age- and sex-matched controls. Permission was obtained from the institutional ethics committee before the start of the study. Prior informed consent was obtained from all subjects. Sociodemographic variables were recorded, and psychiatric morbidity was screened on Mini International Neuropsychiatric Interview. Results: 62% (n = 31) of subjects in Group A had psychiatric morbidity as compared to Group B (22%, n = 11). Maximum psychiatric morbidity noted among subjects with disability was generalized anxiety disorder (22%, n = 11), followed by major depressive disorder (20%, n = 10) and alcohol dependence (18%, n = 9). Substance dependence was more in Group A (34%, n = 17) as compared to Group B (18%, n = 9). The most common substance dependence was for alcohol (18%, n = 9), followed by opioids (8%, n = 4) and tobacco (6%, n = 3). Conclusion: Psychiatric morbidity including substance dependence is more common among people with orthopedic disability as compared to normal control subjects.

Background: Late-onset depression differs significantly from early-onset depression according to clinical features, physical comorbidities, cognitive impairment, and cerebrovascular abnormalities, which suggest that these might have differing etiopathological pathways toward the depressive phenotype. Aim: The aim of the study was to identify comorbid physical disorders with late-onset depression. Methods: The present cross-sectional study was conducted in inpatients of the Department of Psychiatry during a period of 18 months. A study consisted of 60 patients of first depressive episode diagnosed using International Classification of Diseases-10 criteria, segregated 2 different groups of Early onset depression (between 40 and 65 years) and late-onset depression (LOD) (>65 years) with 30 patients each. Results: In LOD group, predominant comorbidities were hypertension 56.6%, cerebrovascular disease 36.6%, diabetes 33.3%, cardiovascular disease 23.3%, and anaemia 23.3%, followed by respiratory illnesses, arthritis, benign prostatic hyperplasia and cirrhosis. While, in early-onset depression group, common comorbidities were hypertension (13.3%), anemia (10%), arthritis (10%), and diabetes (6.6%). Conclusions: Hypertension cerebrovascular disease, diabetes, and cardiovascular disease were the predominant comorbidities in late-onset as well as early onset depression.

Background: In many reviews, it is found that parental responsiveness, parental emotion-related coaching, and parental positive demandingness are related to children's higher emotional intelligence (EI), while parental negative demandingness is related to children's lower EI. There is a lack of Indian work in this area. Aim: To study the role of EI and parenting style in predicting psychological well-being among adolescents in an Indian scenario. Materials and Methods: This cross-sectional, analytical study was carried out on 75 boys and 75 girls in the age range of 15–18 years and attending school. They were assessed with the sociodemographic data sheet, trait EI questionnaire, psychological well-being inventory, and parental authority questionnaire. After the administration on different scales, the scoring was done and data were analyzed with SPSS. Results: There were no gender differences in the scores of EI, psychological well-being, and self-reported parenting style scores. There was a significant positive co-relation between well being and authoritative, authoritarian and autonomy, positive relationship. and self acceptance. Authoritarian parenting style is highly correlated with EI in comparison to authoritative and permissive parenting styles. Conclusion: Authoritarian parenting style is most suitable for the development of EI and on the other hand, permissive parenting style has the least role in the development of EI. EI and parenting style are found to predict the psychological well-being in adolescents.

Background: Suicide is a major public health concern and is considered one of the leading causes of death globally. Previous suicidal attempts can be considered as a predictor of underlying psychiatric illness. Identifying factors behind suicidal attempt can help mental health professionals for early diagnosis and treatment as well as designing effective suicide prevention strategies. Aim: The aim of the study is to assess sociodemographic, clinical characteristics, and prevalence of psychiatric morbidities among patients with attempted suicide. Methods: A cross-sectional study was conducted in the emergency department of tertiary care hospital; patients of attempted suicide attending emergency from January 1, 2014, to January 1, 2020, constituted the sample for the study. Data were collected using semi-structured questionnaire which contained sociodemographic and clinical variables. All the subjects were administered mini-international neuropsychiatric interview (MINI), MINI Kid was applied for subjects <18 years, and MINI Plus was applied for subjects above 18 years. Patients were diagnosed according to the ICD-10 Classification of Mental and Behavioral Disorders for research. Results: Suicide attempt was seen more commonly in males, and the most common age group is between 21 and 40 years residing in urban settings. The most common method was consumption of unknown substances (75.35%). Factors leading to suicide are multidimensional in nature. 30.4% of the patients had impulsive traits. 86.5% of people who attempted suicide had a history of psychiatric illness. Detailed assessment of patients for psychiatric illness and psychosocial factors is crucial for planning suicide prevention strategies and policymaking. Conclusions: Young population is at high risk for suicide. More than 80% of these have diagnosable psychiatric illness.

Aim: The aim of the study was to study the association of childhood psychological trauma with eating disorders (EDs) and to assess and compare the relationship with food, concerns about weight gain, and restrictive or compensatory practices in male and female undergraduate medical students. Materials and Methods: A cross-sectional, analytical study was performed in a Tertiary Care Medical College and Research Hospital in a suburban area of India. After obtaining ethical clearance, 100 final-year undergraduate students were included in the study with their informed consent. Self-made questionnaire, Childhood Trauma Questionnaire, Stirling ED Scale with Disordered Eating Attitude Scale were used. Spearman's correlation coefficient (Rho) was calculated. Results: There was a significant correlation of history of childhood psychological trauma in the form of emotional abuse, emotional neglect or physical abuse and physical neglect with higher prevalence of disordered eating behaviors and relationship with food, concern about weight gain, and compensatory practices. No significant relationship was found in a history of sexual abuse. Conclusion: The importance of a healthy psychosocial upbringing and nurturing by parents to prevent development of psychiatric comorbidities is an important finding in this study.

Background: Postpartum depression (PPD) is one of the most common puerperal psychiatric illnesses impairing quality of life and mental health of the mother and also the child. Aim: The aim is to study the prevalence and risk factors of PPD. Materials and Methods: This cross-sectional observational study was done on a sample of 295 mothers who delivered and were followed up at a tertiary care hospital. The mothers were administered Edinburgh Postnatal Depression Scale, and demographic, psychosocial, and clinical data were collected. Results: The age of the participant mothers ranged from 18 to 35 years and age at marriage ranged from 21 to 24 years. In most of the mothers, the parity was 2 and they had institutional vaginal delivery. The prevalence of PPD in this population of mothers was 30.84%. The factors that had a statistically significant association with PPD included: lower educational status of mother, lower family income, rural place of residence, higher parity, preterm delivery, and adverse events in newborn. Conclusion: PPD is a common mental health problem in the postpartum period. Sociodemographic factors such as low educational status of mothers, rural population, and low monthly family income were found to be associated with PPD. Primipara status, preterm delivery, and adverse events in newborn were also significantly associated.

Background: Cannabis is the most widely used drug in the world. An association between cannabis use and mental illness, in particular psychotic illness, was recognized since long. Various cultures have traditionally used cannabis for different purposes, and continuous increasing use of cannabis is promoting psychosis also. Aim: The present study has tried to identify the differences in profile between the two groups and thus proposing possible variables underlying cannabis and psychosis. Materials and Methods: This cross-sectional descriptive hospital-based study included 50 consecutive cannabis-using patients with psychosis and equal number of age-matched patients with schizophrenia but no cannabis intake. Permission was taken from the institutional ethics committee. All subjects gave written informed consent. Detailed history regarding psychotic symptoms and different parameters of cannabis use were collected from the key informant as well as the patients in the ward. Both the groups' psychotic symptoms were assessed using scale for assessment of the positive symptoms. Results: There is no significant difference between both the groups with respect to age. Cannabis-using patients with psychosis showed high symptomatology in the areas of pressure of speech, distractible speech, and clanging. On the other hand, patients with schizophrenia but no cannabis intake showed high symptomatology in the areas of derailment, incoherence, illogicality, and global rating of positive formal thought disorder. Conclusion: Continuous heavy use of cannabis can induce a psychotic disorder distinct from acute schizophrenia. Cannabis-induced psychosis has distinct demographic, premorbid, and clinical features.

Background: A high prevalence of psychiatric disorders, particularly depressive and anxiety disorders among women is observed through the postmenopausal stage. Aim: The aim of this study is to compare the safety and efficacy of tibolone (TIB) and escitalopram (ESCIT) in postmenopausal women (PMW). Materials and Methods: It was an interventional, open-label, hospital-based, follow-up study conducted on 60 PMW with the diagnosis of depression as per the Diagnostic and Statistical Manual of Mental Disorder-5 criteria. Patients were divided into two groups of 30 each, i.e. Group I (TIB-2.5 mg/day) and Group II (ESCIT-10–20 mg/day). The primary outcome was assessed for change in climacteric symptom scores on Greene's Climacteric Scale (GCS), severity of depression and anxiety on Hamilton Rating Scale for Depression (HAM-D) and Hamilton Anxiety Rating Scale (HAM-A), and sexual functioning on Arizona Sexual Experience Scale (ASEX). The secondary outcome of well-being was assessed on World Health Organization Quality of life (QOL)-BREF. All the observations were carried out from baseline and at 2, 4, 8, and 12 weeks. Results: Both the groups showed significant improvement in climacteric and depressive symptoms. However, at the 8^th and 12^th weeks, mean ± standard deviation scores were significantly lower in Group I (GCS score - 24.80 ± 4.92, 20.30 ± 3.56; HAM-D score - 16.57 ± 5.83, 10.2 ± 5.67) compared to Group II (GCS score - 27.27 ± 5.83 and 23.33 ± 5.70, HAM-D score - 19.97 ± 7.98 and 16.17 ± 10.11). No significant difference between the groups was seen for anxiety on HAM-A scores. Only in Group I, there was significant improvement in ASEX scores. QoL in Group I had shown significant improvement in physical and psychological domain compared to Group II at different time interval, i.e. 4^th and 8^th week onward. In Group I, Alternative Dispute Resolution was reported to be 23.3%, whereas it was 56.7% in Group II. However, none were serious to warrant discontinuation. Conclusion: TIB was better than ESCIT in improving depression, climacteric symptoms, and physical and psychological domain of QoL with an additional benefit of restoring sexual functioning.

Background: By 2040, dementia is projected to rise exponentially by 300% in India. Studies addressing the need for psychiatric care in the community being few and those focusing in old age homes even fewer, a study was undertaken to study the prevalence of dementia and the association with sociodemographic factors and psychiatric morbidity. Materials and Methods: A total of 558 elderly aged 60 years and above, residing in old age homes in Pune were studied. 179 inmates were included based on the inclusion and exclusion criteria. Those who scored a predetermined cut-off score on the screening tool were included to undergo a detailed physical and neurological examination, cognitive profile using subtests from the cognitive test (community screening instrument for Dementia of 10/66 group). Results: Mean age of the sample was 75.02 years majority (39.7%) was in the 60–70 years group. Males 25.7% versus females 74.3%. The sample consisted of the following socioeconomic groups: 40.2% middle, 26.3% low middle, 24% high middle, 8.4% high income, and 1.1% in low income. 60.3% widow/widower category, 36.3% never married, 4.5% had family history of dementia. Mean scores of mini mental state examination in the overall sample was 26.02 compared to 18.02 in those cut-off point of 23. The prevalence of dementia in the sample was 22.9%. There was the high prevalence of psychiatric symptoms and psychiatric morbidity in the dementia group than the rest. Frontal lobe dysfunction and impairment of orientation with increasing severity of dementia were observed. Conclusions: Sociodemographic factors, which were considered protective against the prevalence of dementia, identified were less restriction in physical activity and having fish in the diet regularly.

Background: Absenteeism refers to a worker's unscheduled absence from the workplace. Around the world, a large share of mental disorders can be attributed to work productivity losses. Despite industries working on improvement in employees' wages, better work environment and improved health care to improve their mental health. Absenteeism continues to be a global burden. Aim: The aim of the study was to explore the factors influencing absenteeism. Materials and Methods: A sample size of 100 workers was selected and standardized, and reliable research tools were employed. Factors influencing absenteeism such as the sociodemographic factors, personality traits, psychiatric morbidity, family typology, and interactions were studied using relevant scales, i.e., Eysenck's Personality Inventory and Family Typology by Batti and Channabasavanna. Results: Study found that absentees were more emotionally stable, whereas regulars were found to be emotionally unstable. Factors were found to be associated with absenteeism such as low income, 11–20 years of service, low mean neuroticism score, chronic physical disease, high psychiatric morbidity among the workers, egoistic and anomic family typology. This study reveals that a significantly higher proportion of absentees had a low pay scale. Paradoxically, a high proportion of absenteeism had a longer duration service, indicating that the low pay scales could have resulted from disciplinary actions against absentees, like loss of increments, etc. Conclusion: Psychosis, alcoholism, and chronic physical illnesses are among the illnesses which contribute to absenteeism.

Background: Despite the fact that every girl has to deal with menstrual hygiene, there is a lack of awareness about the process of menstruation and proper menstrual hygiene among adolescent girls, especially from tribal backgrounds. Aim: The aim of the study was to assess the knowledge and practices related to menstruation among tribal (Munda) adolescent girls. Materials and Methods: This was a community-based cross-sectional study. The sample for the study consisted of 150 girls belonging to Munda tribe in the age group of 13–18 years, recruited by purposive sampling from various schools of Khunti district of Jharkhand state. Interview guide was predeveloped, validated, and used to study the knowledge and practices related to menstruation among adolescent girls. The data were collected by a personal interview of the study subjects. Results: The mean age of menarche of the study subjects was 14.1 years. It was evident that only 48.67% of the participants were aware about menstruation before menarche and the most important source of the information about menstruation for them was their friends (53.33%) followed by mothers. Conclusions: Knowledge about menstruation is poor among tribal adolescent girls and practices included various myths and misconceptions.

Background: Caregiver burden is defined as the physical, psychological or emotional, social, and financial problem that can be experienced by the members of family caring for impaired person. In India, women are twice more likely to become caregivers than men, despite emergence of men as caregivers. Aim: The aim of the study is to assess burden of illness among working women and homemakers taking care of psychiatric patients. Materials and Methods: This hospital-based, descriptive, cross-sectional comparative study was conducted on the caregivers who were recruited from outdoor patient department of psychiatry department of a tertiary care hospital attached to a medical college. Women who were 30–45 years old, working or homemakers and who were taking care of psychiatric patients diagnosed with schizophrenia and Bipolar affective disorder (BAPD) of either sex. Caregivers were first-degree relatives of patients. Sociodemographic data were recorded using a special performa and caregiver burden was assessed using caregiver burden questionnaire. Results: Overall mean caregiver burden scores in Group 1 and Group 2 were 55.66 ± 4.09 and 58.16 ± 3.97, respectively, with statistically significant difference (P < 0.05). Conclusion: Caregiver burden was more among working women compared to homemaker women.

Background: Internet gaming disorder (IGD) is an entity of clinical attention prominent among schoolgoing students. The reported nature and extent of Internet gaming varies widely, as does the extent of its effects. Aim: This study aimed to assess the prevalence of IGD and factors associated with it. Methods: After institution ethics approval, individual assent, and parental consent, a cross-sectional study was conducted among 142 students of a school in western Maharashtra. A specially designed sociodemographic pro forma and IGD Scale were administered to the students. Data thus generated were statistically analyzed and compared with published literature. Results: The prevalence of IGD was 10.6% among 13–19-year-old students. It was significantly higher among male students (15.3%) than female students (3.5%). Multivariate logistic regression found IGD to be significantly associated with male gender and lower age at first gameplay. Conclusions: IGD affects a tenth of our schoolgoing population with a male preponderance. Lower age at first gameplay had an adverse association.

Background: The concept of burden of care came from the realm of behavioral sciences primarily in the context of looking after a psychiatrically ill person. Caregivers of schizophrenia and bipolar affective disorder (BPAD) have to take over the totality of patient care since most of these patients are treated at home. As a result of this, they are exposed to negative consequences of caregiving. Aim: This study aims to assess and compare the pattern of burden among the families having patients with schizophrenia and bipolar disorder. Materials and Methods: This cross-sectional, observational study was conducted on the outpatient department level at Ranchi Institute of Neuropsychiatry and Allied Science. This study included 30 patients with schizophrenia and equal number of age- and sex-matched patients with bipolar disorder. The diagnosis was made as per criteria of International Classification of Diseases 10 diagnostic criteria for research. Their caregivers who gave consent for their participation in the study and satisfy the inclusion and exclusion criteria were included in the study by purposive sampling. Tools administered were socio-demographic datasheet and family burden inventory schedule. Statistical Analysis Used: Chi-square test, Fisher's exact test, and Mann–Whitney U test. Results: Total caregiver burden, financial burden, disruption of routine family activities, family leisure, family interaction, and subjective burden felt by caregiver were significantly more in caregivers of schizophrenia patients compared to caregivers of BPAD. There was no significant difference in the two areas of burden, i.e., effect on physical health of the caregivers and effect on mental health of caregivers. Conclusion: Caregivers of schizophrenia patients have significantly higher family burden as compared to caregivers of subjects with BPAD.

Background: Addiction to alcohol not only affects the quality of life of the individual abusing it but also of the people living with them. Enormous research has been done on various aspects of alcoholism, but the lives of their caretakers are always considered secondary by society and researchers alike. Very few studies have been done on wives of alcoholic men in the Indian settings. Aim: This study aimed to assess the quality of life and suicide ideation in wives of men with alcohol dependence. Materials and Methods: This is a cross-sectional study conducted in a tertiary care hospital. A study group of 50 wives of men with alcohol dependence were included in the study along with an age-matched control group of 50 wives of nonalcoholic men without any medical comorbidities. They were assessed by the perceived quality of life scale, Hospital Anxiety and Depression Scale, and Suicidal Behaviors Questionnaire-revised and the results were then correlated. Results: Results revealed poorer perceived quality of life in the study group than in controls. The wives of alcoholic men scored significantly more on depression as compared to control group but not on anxiety. Suicidal ideation and attempts were significantly more common in wives of men dependent on alcohol. Conclusion: Alcohol dependence in the husbands is associated with poorer quality of life and higher levels of depression and suicidal ideation in their wives.

Background: Use of smartphone is on the increase worldwide. They have revolutionized our lives to an extent that was unimaginable before the pandemic. Excessive use of smartphones reaching the levels of potential addiction among medical students and its relation to individual's sleep quality and self-esteem led us to study this prevalence. Aim: This stuay aimed to study the prevalence of smartphone addiction and its relation with self-esteem and sleep disturbance in medical college students. Materials and Methods: A cross sectional analytical study was carried out and the prevalence of smartphone addiction, self- esteem, and sleep disturbance was measured using standardized questionnaires smartphone addiction scale short form, Rosenberg self esteem scale, Pittsburgh sleep quality index assessment respectively. Results: Prevalence of smartphone addiction among medical college students was 52%. Smartphone addiction was seen more in boys than girls. There was a significant association between the smartphone addiction and sleep disturbance. However, there was no significant association between smartphone addiction and low self-esteem. Conclusion: The prevalence of smartphone addiction among medical students is found to be high and is associated with poor sleep.

Background: Rheumatoid arthritis (RA) is a disabling condition that results in considerable suffering and negatively impacts an individual's psychological, financial, social, and quality of life (QoL). Pain, fatigue, and disabilities, which may be considered as stress factors, are common challenges that may subsequently lead to psychological distress. Aim: Assessment of Depression, Anxiety, Stress, and QoL in RA patients and Comparison with healthy individuals. Materials and Methods: This cross-sectional analytical study included 50 RA patients who have reported to a tertiary health care center on outpatient basis and an equal number of age- and sex-matched healthy individuals. The study was conducted after obtaining Institutional Ethics Committee approval and informed consent of the participants. Patients were assessed based on Disease Activity Score incorporating erythrocyte sedimentation rates, Depression Anxiety Stress Scale (DAS21), Health Assessment questionnaire, Visual Analog Scale, and Multidimensional scale of Perceived Social Support. Results: Levels of anxiety, depression, and stress in patients with RA were significantly higher as compared to age- and sex-matched healthy controls. RA patients had significantly lower scores on total social support, as well as social support of family and friends. However, there was no difference between RA patients and healthy controls on social support from significant others. Conclusion: Patients with RA had significantly higher levels of anxiety, depression, and stress and significantly lower levels of social support compared to age- and sex-matched healthy controls. The therapeutic implications of these findings need further evaluation.

Patients with systemic lupus erythematous that suffers from one or more of several neuropsychiatric symptoms represent a subcategory termed “neuropsychiatric systemic lupus erythematosus” (NPSLE). Different environmental factors, such as infection, stress, and ischemia, mediated by inflammatory cytokines, may damage the blood–brain barrier, further contributing to neuropsychiatric symptoms. Antiribosomal-P antibodies are specifically related to psychosis in NPSLE. Three patients of systemic lupus erythematosus who developed features of psychosis are presented and the condition is briefly discussed.

Seizures can have varied presentations and may have different etiological factors. A multidisciplinary approach should be used to treat them. It becomes difficult to diagnose seizures if they have an atypical presentation, particularly so when they manifest as behavioral disturbances. This case series demonstrates four cases with different psychiatric and behavioral manifestations of seizures where the diagnosis had to be done in a multi-disciplinary approach. Two of the cases highlight the fact that in the light of normal investigations, paying attention to detailed history is of prime importance.

Manifestation of abnormal excessive synchronous cortical activity, which is what defines epileptic seizures, is typically absent in seizures with psychological etiology, a heterogeneous set of factors that have been identified. Distinguishing psychogenic nonepileptic seizures (PNES) from epileptic seizures may be difficult at the bedside. We report a case series of PNES which presented with diagnostic dilemma. Diagnostic delay of years with PNES is common. The exact choice of treatment is often difficult and should be based on individual differences in the underlying factors. Outcome can be measured in terms of seizure occurrence (frequency, severity), but other measures might be of greater importance for the patient. Prognosis is varied but studies consistently report that 1/3^rd to 1/4^th of these cases become chronic.

Hepatic encephalopathy (HE) is an important and potentially life threatening complication in alcoholic patients with decompensated liver function that develop even as they continue drinking. Delirium tremens, on the other hand, is an acute condition resulting from alcohol abstinence in a person dependent on alcohol, making it a life threatening diagnosis that requires intensive care and successful management of the withdrawal. Often in medical wards, these two conditions are mistaken and so is the management plan confused with each other. Making the right diagnosis early on during the hospital course is extremely important in these critical conditions so as to make an appropriate schedule for treatment and a better outcome for the same. A case series of patients who presented with a diagnostic dilemma is reported. Clinical examinations, diagnostic tools to measure the levels of ammonia and liver function tests and hemogram, West Haven criteria and Child–Pugh grading, and clinical scales of these patients are reported. Increased levels of ammonia were present in all the cases. The subtle similarities in the presentation of the two conditions often make it confusing for the clinician to distinguish between them. Using a simple test of measuring ammonia levels in the blood helps in such situations. The detection of raised levels of ammonia in cases of chronic liver disease helps in not just the diagnosis but also is an important prognostic indicator for development of HE.

Child sexual abuse (CSA) occurs when a person involves the child in sexual activities for his/her sexual gratification, commercial gain, or both. We report a series of 12 cases of CSA, who presented to the psychiatry department with diverse psychiatric presentations associated with CSA. In most of these cases, the perpetrator was unmarried and known to the child. The presentation was varied with patients being diagnosed with obsessive–compulsive disorder, schizophrenia, acute and transient psychotic disorder, dysthymic disorder, recurrent depressive disorder, acute stress reaction, conversion disorder, borderline personality disorder, and moderate depressive episode with somatic symptoms. Individual and family counseling was an important part of management of these cases along with pharmacotherapy. More vigilance about CSA and mental health in all categories of health–care personnel would help in early detection and timely management of these cases.

Substance use and abuse in adolescents is a major public health concern in India where a high proportion of the population are in this age group. The most common substances used by adolescents are tobacco, alcohol, and marijuana, but include a wider range of substances. Two patients with polysubstance abuse are presented. After initial detoxification, both were started with dialectical behavioral therapy and motivational enhancement therapy along with family therapy; both have been on regular follow-up and currently maintaining well.

Suicide/parasuicide is seen at a greater rate in schizophrenia than in the general population, yet the psychological basis of this risk is poorly understood. It is estimated that 10% of patients suffering from schizophrenia attempt suicide. The major risk factors implicated are male gender, chronic illness with multiple relapses, family history of suicide, past suicidal and impulsive behavior, negative attitude toward treatment, and concurrent substance use. Treatment must target the identified risk factors for prevention of suicide in these patients. Here, we discuss three cases with self-inflicted cuts over the anterior aspect of the neck and wrists. They were diagnosed to have paranoid schizophrenia and were treated with antipsychotics, on which they showed improvement.

Catatonia is a psychomotor behavioral syndrome characterized as a complex syndrome of bizarre motor behavior, impaired volition, and vegetative abnormalities. Catatonia is a medical emergency and if not recognized on time may have potentially fatal outcomes. We present a case series of three patients with catatonia, in whom Injection lorazepam 4 mg administered intravenously (Lorazepam Challenge) produced quick, optimum outcome.

A public health emergency of international concern, novel coronavirus disease (COVID-19), began in Wuhan, China, in December 2019. Since then, it has been caused a pandemic along with serious mental health problems. No other disorder is more vulnerable to the current situation than obsessive–compulsive disorder (OCD). Our case series focuses on the effects of COVID-19 on OCD along with its various manifestations. Most of our patients had exacerbated symptoms during the current situation, but there were also new onset OCD cases triggered by a variety of stressors.

Geophagia, a form of pica, is often associated with iron and zinc deficiency. However, a number of environmental, cultural, and psychological factors are also implicated. Pica in children is common with those having intellectual disability. In adults, it is most commonly associated with pregnancy. No specific screening tests for pica exist, but many nutritional and psychological complications can be avoided by accurate and timely diagnosis. Even when pica is diagnosed, no proven treatments exist. Two patients who reported to the psychiatry outpatient department with habit of eating nonnutritive substances for a prolonged period associated with apprehension and decreased appetite are reported. Both the patients were diagnosed with adult pica and were treated with selective serotonin-reuptake inhibitors and psychotherapy with considerable improvement.

Trichotillomania is a psychodermatological disorder characterized by an uncontrollable urge to pull one's own hair. It is often associated with depression and obsessive–compulsive disorder. We report five cases, a young male and four females, who presented with an increased desire to pluck out their hair, leading to large patches of baldness. Despite distinct forms of presentations and different comorbidities, the management more or less remained the same.

Erotomania is an unusual psychotic disorder exemplified by an individual's delusions of another person being infatuated with them. The condition is usually, but not exclusively, observed in females who are shy, dependent, and sexually inexperienced. The object of the delusion is usually beyond reach, being of much higher social or financial status, already married or disinterested. We present a case series of three patients suffering from this uncommon disorder.

Psychogenic vomiting is a syndrome in of recurrent vomiting without any organic pathology. It must be differentiated from cyclical vomiting syndrome, functional vomiting, and chronic idiopathic nausea. It occurs as a result of an emotional or psychic disturbance. This condition is highly disabling, increasingly recognized, and under-researched. In India, the number of patients reporting to the psychiatric outpatient department with eating disorders is comparatively very less. We describe how two patients with diagnostic dilemmas who were treated successfully after psychiatric intervention.

People with intellectual disability (ID) have a greater frequency of psychiatric illnesses, ranging from 10% to 80%, as compared to the general population. It has been proven that mood stabilizers are beneficial in the management of behavior issues in people with ID. Here, we report a series of five cases with mild and moderate ID with behavioral disturbances including mood and psychotic symptoms managed successfully with sodium valproate as the part of the treatment.

Obsessive–compulsive disorders (OCDs) are one of the top 10 contributors of debilitating medical illnesses and are the fourth most common psychiatric disorder. Blasphemous thoughts, also known as scrupulosity, as an obsessional theme has piqued curiosities long before it was considered a neurosis. Such obsessions may or may not have an accompanying compulsion and comprise 5% of the patients of OCD. The case series is of three patients suffering from repetitive, intrusive, ego-dystonic, and distressing blasphemous thoughts, which are extremely distressing to them, rendering them unable to perform any other activity. The symptoms also indicate the presence of comorbid depressive and anxiety disorders, developing secondary to the blasphemous thoughts. Inadequate knowledge in this subtype of OCD mandates the need for more studying and research, especially with new texts suggesting the implementation of faith-assisted psychotherapy in addition to the conventional psychotherapy and pharmacotherapy.

Phenomenon of induced delusional disorder has a relatively long, controversial history of conceptualization. It is a rare entity and goes undiagnosed mostly as only the primary partner is brought to clinical attention. We present a case series of induced delusional disorder with different presentations. For effective management, understanding the dynamics of relationship shared by the partners and addressing the biopsychosocial factors are crucial. Failure to adhere to treatment poses additional challenge in these cases.

Although much has been talked and written about the respiratory menace that Coronavirus disease causes, a close examination reveals that gut symptoms are equally important diagnostic markers for COVID-19. Almost 53% of COVID-19 patients experience gastrointestinal (GI) symptoms. The entry of the SARS Cov-2 virus is mediated through angiotensin-converting enzyme receptors which are abundant in the GI tract. The virus also affects the GI tract through the gut lung axis. In addition to the GI tract epithelium, hepatobiliary and pancreatic systems are also affected in COVID through multiple mechanisms. GI manifestations vary from relatively benign symptoms such as nausea vomiting diarrhea to rare cases of life-threatening mesenteric vein thrombosis. The relationship of the symptoms with morbidity and mortality is not clear. Anorexia is related to inflammation, and agneusia and anosmia carry a good prognosis. Psychiatric manifestations may be more common in those with GI affection, inflammation being the common pathogenic factor. Treatment is symptomatic, and proper hygiene precautions are necessary considering the possible fecal shedding of the virus, especially during endoscopic procedures on the GI tract.

A number of incurable, deadly, and disfiguring diseases are associated with stigma which worsens the quality of life of the sufferer. Unfortunately, at the beginning of the COVID-19 pandemic, the disease was associated with severe stigma and extreme prejudice. Stigma of COVID-19 and its adverse effects are briefly discussed and solutions suggested.

COVID-19 has been a considerable major stress factor and has led to a great increase in psychological illnesses. Literature related to spirituality and philosophy can provide solace in times like these. We have taken excerpts from Bhagwad Gita which is a spiritual and philosophical scripture, existential philosopher Albert Camus's La Peste and the myth of Sisyphus and writings of the philosopher Immanule Kant. These literary masterpieces can provide a wealth of guidance and solace to both the medical fraternity and affected people and their caregivers. “We tell ourselves that pestilence is a mere bogy of the mind, a bad dream that will pass away. But it doesn't always pass away and from one bad dream to another, it is men who pass away.” –Albert Camus

Quarantine is an age old methods of preventing the spread of infection by restricting the movement of persons or goods. It has again come to global attention due to its widespread implementation during the COVID-19 pandemic. While the public health utility of quarantine is well established, it is associated with few psychological effects which are neither well known nor recognized. In this communication, the psychological side-effects of quarantine and their prevention are briefly discussed.

The COVID-19 pandemic is a healthcare crisis that has led to unprecedented impact on healthcare services. At the heart of the unparalleled crisis, doctors face several challenges in treating patients with COVID-19. The psychological burden and overall wellness of healthcare workers (HCWs) have received heightened awareness, with research continuing to show high rates of burnout, psychological stress, and suicide. Detrimental effects include high rates of infection and death, excessive financial hardships, stress related to known and particularly unknown information, and fear of uncertainty regarding continued impact. Some researchers focused specifically on COVID-19's impact on HCW sleep. Anxiety and stress were significantly increased, leading to negative impacts on both self-efficacy and sleep. Stress is an important factor in drug use. Efforts should be made to explore the factors that are associated with psychological distress, which may lead to symptoms of anxiety, depression, or provoke suicidal ideation, and efforts should be made to control the factors that are modifiable. There needs to be more awareness among doctors and further long-term studies focusing on their mental health as adverse mental health conditions will further affect them as the disease advances.

COVID-19 pandemic is generating considerable stress in the population. Uncertain prognosis, looming severe shortages of resources for testing and treatment, imposition of unfamiliar public health measures (infringing on personal freedoms), large and growing financial losses, and conflicting messages from authorities are few of the major stressors due to COVID-19. The effect due to COVID varies from individual to individual. Healthcare providers are more vulnerable as there is increased risk of exposure to coronavirus, concern about infecting and caring for loved ones, shortages of personal protective equipment, and longer working hours. Yashwantrao Chavan Memorial Hospital started functioning as Dedicated COVID-19 hospital since April 2020. Psychiatric services were also active and were delivered by means of telepsychiatry outpatient services, consultation-liaison psychiatry for COVID-19 patients, group counseling, supportive counseling, and psychosocial counseling center for relatives. Our experience is briefly described

From the beginning of COVID-19 pandemic, concerns have been raised about its effect on mental health and on patients with psychiatric illnesses. A few reports suggest that patients with COVID-19 have increased symptoms of anxiety disorders, post-traumatic stress disorder, depression, increased substance use, and insomnia. There is an increased trend seen in flare-up of psychotic symptoms and new emergence of psychotic symptoms in previously healthy adults. There is extensive research available on the impact of COVID-19 on physical health, but there is a paucity of studies on the effects of COVID-19 on psychiatric illness.

“Necessity is the mother of invention:” An adage was brought to life with the emergence of the mRNA vaccine against the backdrop of the foreboding and mercurial COVID-19 pandemic. Considering a negligible adverse-effect profile and a break-neck manufacturing speed, it shone bright as the ideal vaccine candidate. However, “all that glitters is not gold,” as was evidenced by the significant reactogenicity, a host of multi-systemic side-effects, that are being reported by the vaccine recipients; which is palpably resulting in a shift of emotions for the vaccine, accounting for vaccine hesitancy. Anaphylaxis, antibody-dependent enhancements, and deaths, comprise the most serious side-effects, albeit occurring in sparing numbers. Storage and transportation require fastidious temperatures, rendering it substantially inaccessible to a country like India. The biggest jolt, however, was the unfolding of the biases in reporting vaccine efficacy, as only the attractively high numbers of the relatively equivocal relative risk reduction were reported while keeping at bay the meager numbers of the more forthright absolute risk reduction. Notwithstanding the fallacies, the mRNA vaccine still promises hope; and with the right precautions and finesse, can be potentiated, as “a watched pot never boils.”

Despite the dubious results of the nationwide lockdown in India state after state continue to clamp lockdowns indiscriminately and claim that it is a panacea for all their ills. Unverified claims abound and myths are perpetuated without any basis. It is time to take a close look at the hard data and come to logical conclusions regarding the utility of prolonged open-ended lockdowns. Unfortunately, the evidence does not support the use of prolonged lockdowns as a useful strategy to combat the COVID-19 pandemic.

Since decades, there is a change in concept of the gut–brain axis. There is differential increase in evidences focusing on the bidirectional communication between the gut microbiome and the brain. It supports existence of far-reaching model of “gut–brain axis.” This axis is attaining more adherence to fields investigating biological and physiological footing of psychiatric, neuro-developmental, age-related, and neurodegenerative disorders. Many factors can change microbiota composition in early life as well as with the increasing age. Stress can affect the microbiota–gut–brain axis at every stages of life. Recent advances have involved the gut microbiota in many conditions including severe mental illness, autism, anxiety, obesity, Parkinson's disease, and Alzheimer's disease. The current studies target on elaborating the underlying mechanisms of microbiota–gut–brain axis and attempt to exemplify intervention and therapeutic strategies for neuropsychiatric disorders.

The mental health of the worker population has been given special focus in the last few decades, mostly due to workplace stress and its related consequences on productivity and management. The impact of poor mental health of industrial workers on their families remains largely unexplored. Families have been found to get affected due to issues related to work-family and family-work conflict. Balancing between work and family has been found to be the major source of stress in industrial workers leading to a multitude of mental health issues and substance addiction. Families play a significant role in identifying the mental health problems in their working members and also can act as a bridge between the worker and the organization/industry in facilitating mental health care. The family members play key roles in providing significant support and care to persons suffering from serious mental illness/psychological distress. The focus of holistic management of mental health issues in industrial workers should include proper psycho-education of family members and taking into consideration their mental health needs. In this brief communication, we had tried to highlight the key issues pertaining to the impact, role, and contribution of family in the mental health of industrial workers.

Complex psychological trauma is more complicated and pervasive than the isolated traumatic event, occurring mainly in vulnerable periods resulting in severe compromise of childhood development. It causes increased activation of the survival-focused brain leading to alterations in brain structure and function. It has an impact on behavioral, biological, and cognitive domains resulting in sequelae of complex trauma exposure. The assessment of complex trauma is demanding as the clinician is required to be patient, transparent, noncoercive, and corroborative in approach. The management depends on a good therapist-client alliance, appropriate evidence-based treatment models and emerging pharmacotherapy for treatment as well as prevention.

Emotion is a stirred-up state caused by physiological changes occurring as a response to some event and which tends to maintain or abolish the causative event. Understanding the neuroanatomical basis of the genesis and control of emotions is quintessential in understanding how biology affects the mind and in turn, helps in understanding our own nature. We present a short communication explaining the neurological basis of emotions.

Memory is the process of retaining of knowledge over a period for the function of affecting future actions. It can be divided into declarative and procedural types. The process of memory consolidation is done in the hippocampus. The long-term memories are spread among various areas of the cerebrum depending on the different perceptual properties. The process of long-term potentiation and molecular changes occurring during memory formation are discussed in detail below. The steps involved in memory formation include encoding, storage, and recall (retrieval) in that order. Amnesia is a phenomenon in which there is the problem in memory formation which can be due to trauma to the brain, certain diseases, or stressors. While the assessment of memory has greatly improved, we are only beginning to understand the underlying mechanisms.

Fifty million people are affected with dementia worldwide with Alzheimer's disease (AD) accounting for 70%–80% of these cases. In India alone, 4.1 million people suffered from dementia in 2015. To date, there are no definitive treatment options for AD and the overall treatment gap in India stands at 90%. Attempts have been made to define AD biologically. This has been made possible due to advances in the identification of biomarkers that indicate the neuropathological changes responsible for AD. Identification of these biomarkers has implications for disease staging, prognostication, and identifying drug targets. Here, we summarize the advances in the field of biomarkers in AD.

Magnetic seizure therapy is a novel form of focal convulsive treatment wherein magnetic field passes through the scalp and skull without impedance. In many ways, it has the potential to be superior to electroconvulsive therapy (ECT) as the anesthesia-associated side effects and cognitive impairments are less. It also may be an alternative for those who do not opt for ECT because of the stigma associated with it.

Clinical features of schizophrenia and cannabis-induced psychosis (CIP) share many overlapping characteristics. We present a case of Cannabis Dependence Syndrome, whose first presentation was with first-rank symptoms of schizophrenia in the form of thought insertion, withdrawal and delusion of control.

Wilson's disease (WD) or hepatolenticular degeneration is a rare inherited disorder of copper metabolism affecting both the liver and the central nervous system. Psychiatric manifestations may precede neurological signs in the early stages of WD, but catatonia is a rare presentation. Here, we report a case of an 18-year-old girl who presented to the psychiatry outpatient department with catatonia. She was subsequently diagnosed to have WD. Her symptoms improved on treatment with trientine, trihexyphenidyl, zinc acetate, and benzodiazepine.

A 25-year-old female was hospitalized subsequent to an attempt to hang herself. She was unconscious for a few minutes but responded to initial resuscitative measures. Relevant investigations, including X-ray neck, computed tomography scan brain, and electroencephalogram were normal. Physical examination was consistent with attempted hanging. On mental status examination, speech was relevant. Mood was euthymic. Attention was arousable, but concentration was impaired. Orientation to time and recent memory were impaired. Remote memory, insight, and judgment were unimpaired. Serial Mental Status Examination (MSE) revealed improvement in concentration and orientation. Due to sudden onset memory loss of <24 h in duration without other signs of cognitive impairment or concomitant focal neurological symptoms, she was diagnosed as a case of transient global amnesia. The pathophysiology of the condition is briefly reviewed.

A lot of comorbidities exist in patients with dependence on alcohol, psychoactive, or other substances. Many times, their comorbidities go undiagnosed or neglected due to the stigma prevalent with dependence. A 22-year-old person with alcohol dependence who was detected to have a parietal lobe space-occupying lesion which proved to be a tuberculoma is reported.