Internet addiction and its effects on psychological wellbeing: A community-based study.

Background: The internet has become an essential part of life, and it has both beneficial and detrimental effects. There is a plethora of evidence relating to the effect of internet addiction on psychological health. There is also an unmet need to lay the foundation for the differences in usage and the effects on mental health in regard to the use of the internet for rural and urban students. Materials and Methods: The present study was conducted on 200 adolescent subjects belonging to the urban and rural areas around the city of Varanasi to establish the pattern of use of the internet as well as its psychological implications. The participants were evaluated upon the Internet Addiction Test (IAT) and General Health Questionnaire-12 (GHQ-12), and information pertaining to socio-demographics as well as accessory information related to internet usage were captured through semi-structured proforma. Results: The results indicated no significant differences in the pattern of internet usage (mean IAT score) as well as psychological health (mean GHQ-12) between urban and rural youth. There was a significant positive association between the overall severity of internet use with poor psychological health (GHQ-12 score). There was a significant difference in the overall mean age as well as the mean age of onset of internet use between both groups (rural versus urban). This study highlighted an important issue of the digital divide based on gender-wise differences in the pattern in the overall sample. Conclusion: This study highlighted the important differences in the pattern of internet use among the rural and urban populations with its clinical implication being a need to educate the youth regarding the healthy use of technology.

Effect of COVID-19 and sociocultural milieu on the psychopathology of mental health disorders: A hospital-based study.

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.

Effect of Motivational Enhancement Therapy (MET) on the self efficacy of Individuals of Alcohol dependence.

INTRODUCTION: Motivational enhancement therapy is characterized as a directive, client-centered intervention which helps in modification of behavior by helping subjects in identifying and resolving the ambivalence toward a change in self. In order to free one from the vicious cycle of the alcohol trap one needs self-efficacy, which serves a protective role to prevent from relapses. The study aims to assess and compare the effectiveness of MET on the self-efficacy of individuals pre and posttest with control design were applied. METHODS: A total of 40 subjects, alcohol-dependent persons fulfilling International classification of Diseases-10 criteria were selected through purposive sampling method from Outdoor and Indoor Service of Psychiatry Department IMS BHU, Varanasi, were randomly divided into two groups. 1st group 20 subjects were given motivational enhancement therapy session for 10 sessions along with treatment as usual (MET + TAU), whereas 2nd group control group were given treatment as usual (TAU) at the end of intervention post level of self-efficacy were measured through self-efficacy scale. Modified Kuppuswamy Socioeconomic Status Scale, Alcohol use disorder identification test, Self-Efficacy Scale as tools were used. RESULT: The result shows that the mean value of self-efficacy in (MET + TAU) group before intervention was 56.30 ± 2.99 and mean value of self-efficacy in (MET + TAU) after intervention was 60.75 ± 2.65 which shows significant difference is found in self-efficacy after intervention. CONCLUSION: Motivational enhancement therapy tries to decrease ambivalence so as to enhance the change in the subject's self-efficacy which assists the individuals in abstinence from alcohol.

Substance use among outdoor treatment-seeking patients with mental illness: A case-control study from a tertiary care hospital of northern India.

BACKGROUND: Substance abuse and mental disorder often coexist and may cause several consequences in sociooccupational functioning and health care and management. Indian data are sparse in this area. OBJECTIVES: The aim of the study was to examine the sociodemographic profile, pattern, and prevalence of alcohol and substance use among person suffering with mental illness and to compare with those without mental illness. METHODS: A total of 80 treatment-seeking patients with mental illness and 80 nontreatment seeking healthy accompanying persons were assessed for current substance use. Mental illness was screened using Structured Clinical Interview for DSM-IV Axis I Disorders and the diagnosis was made as per DSM IV, semi-structured sociodemographic pro forma was also applied. The data collected were analyzed using the Chi-square and Student's t-test. RESULTS: Substance use was found 2.5 times higher among cases (56.2%) than controls (22.5%). Substance-using participants comprised mainly males belonging to rural residence. The substance using cases were more unmarried, less educated, poorer economically, and more nuclear family structures that substance-using controls. When compared with non-substance using cases, cases with substance use had more males than females and lower education. Although both groups were almost similar in term of marital status, family structure, residence, and socioeconomic status. Among both groups, most common substance use was tobacco, followed by alcohol and cannabis. Although all the substances were more prevalent among cases than controls. The prevalence of any substance use was highest among cases with psychotic disorder (77.3%), followed by unipolar depression (62.5%), bipolar affective disorder (41.7%), and anxiety disorders (21.4%). Tobacco and cannabis use was most prevalent among cases suffering with psychotic disorders, whereas alcohol use was most prevalent among cases suffering with unipolar depression. CONCLUSIONS: Mentally ill individuals are vulnerable to develop substance use, thus they are doubly jeopardized. The susceptibility of these individuals stem from lesser insight, need for stimulation, to decrease the anhedonia induced by psychoactive medicines and poor awareness hence this group of individuals has several health and social consequences; therefore, they require due attention. A better care, support, and education are needed for substance using patients with mental illness to improve their prognosis and also help in their appropriate rehabilitation.

Prevalence of depression and anxiety among children in rural and suburban areas of Eastern Uttar Pradesh: A cross-sectional study.

BACKGROUND: Psychiatric morbidity in children and adolescents is a major concern as they become more complex and intense with children's transition into adolescence. AIM: The aim of this study is to assess and compare the prevalence of depression and anxiety among children residing in rural and suburban area of eastern Uttar Pradesh and understand the burden of these problems in our society. MATERIALS AND METHODS: Children, in the age group 11-18 years, were divided into 2 groups: Group I - 100 children from rural area Tikri; Group II - 100 children from suburban area Sunderpur. Their sociodemographic details were recorded. Children's Depression Inventory and Revised Children's Manifest Anxiety Scale were used to screen for depression and anxiety in children, respectively. The final diagnosis was done using present state examination in accordance with International Classification of Mental and Behavioral Disorders 10. Data were statistically analyzed using Chi-square test. RESULTS: The prevalence of depression was found to be 14.5% while that of anxiety disorder was found to be 15%. There was no significant difference in the prevalence of depression or anxiety in rural and suburban areas (P > 0.05). Depression and anxiety were more prevalent in middle adolescence, in females, and in lower-middle socioeconomic group. Depression was more prevalent in the students of class 9th -12th, whereas anxiety was more in students of lower classes. Depression was more prevalent in joint families. These differences show some important trends regarding factors affecting these problems. CONCLUSION: This study yields useful information which could be of use in early management of psychiatric disorders present in the community and prevent their development into chronic disorders.

A pilot study of MD (psychiatry) theses-based research.

INTRODUCTION: Undertaking a research project is mandatory for MD Psychiatry trainees. The present study was undertaken to assess the type of research activity being undertaken as part of MD Psychiatry dissertation, and its contribution to national and international literature. MATERIALS AND METHODS: Three medical colleges supplied the data about the topic, names of the supervisor and the candidate, collaboration, funding accrued, and publication details of MD-based research carried out between years 2000 and 2010 inclusive; 95 records were collected for the final analysis. The details of the publications provided were cross-checked on the internet, which would have taken care of missed publications as well. RESULTS: Most studies were single-point assessment clinical studies. Only 2 studies had been funded, 11 had collaboration with other departments within the same institute, and 5 had inter-institute collaborations. Majority of the studies were not published. Only 30 were published as full paper and 9 as abstracts. Of these 30 full publications, only 3 were published in journals having JCI impact factor values (1.4, 1.3, and 1.4, respectively). CONCLUSIONS: The main finding of this pilot study was that MD-based research has low contribution to the national and international literature, and those articles which are published are in low impact journals. Suggestions for modifying this state of affairs are discussed.

PRUNE is crucial for normal brain development and mutated in microcephaly with neurodevelopmental impairment.

PRUNE is a member of the DHH (Asp-His-His) phosphoesterase protein superfamily of molecules important for cell motility, and implicated in cancer progression. Here we investigated multiple families from Oman, India, Iran and Italy with individuals affected by a new autosomal recessive neurodevelopmental and degenerative disorder in which the cardinal features include primary microcephaly and profound global developmental delay. Our genetic studies identified biallelic mutations of PRUNE1 as responsible. Our functional assays of disease-associated variant alleles revealed impaired microtubule polymerization, as well as cell migration and proliferation properties, of mutant PRUNE. Additionally, our studies also highlight a potential new role for PRUNE during microtubule polymerization, which is essential for the cytoskeletal rearrangements that occur during cellular division and proliferation. Together these studies define PRUNE as a molecule fundamental for normal human cortical development and define cellular and clinical consequences associated with PRUNE mutation.

Plight of street children: An explorative study from Varanasi, India.

Rapid pace of unplanned urbanization in the developing countries has resulted in a large proportion of children becoming homeless, leading to multiple children living on the streets. These children are highly vulnerable to exploitation and abuse. Against this background, studies on the situational analysis of street children across India are needed; therefore, a study to assess the condition of street children in the city of Varanasi was planned. Street children registered with a nongovernmental organization were contacted. Four hundred and fifteen children were selected by random sampling, and this group was administered a semi-structured interview containing 35 items. It was found that all forms of abuse were common, but physical abuse (74%) was highest and the police (25.5%) was an important perpetrator. Younger children were much more vulnerable. The sample commonly had boys and between the ages of 10 and 15 years. It was concluded that these children need policies to be incorporated into the mainstream.

Effect of Tocopheryl Acetate on Maternal Cigarette Smoke Exposed Swiss Albino Mice Inbred Fetus.

INTRODUCTION: Cigarette smoking is worldwide problem which can be correlated with teratogenicity. Tocopheryl acetate plays as an antioxidant against the oxidative stress evolved by cigarette smoke exposure during pregnancy. AIM: To study the effect of maternal exposure to cigarette smoke and Tocopheryl acetate on fetuses of mice. MATERIALS AND METHODS: Pregnant mice randomly assigned to different groups (Group I (control), Group II (Tocopheryl acetate), Group III(soyabean oil used as vehicle for Tocopheryl acetate), Group IV (Cigarette smoke Exposed), Group V (Cigarette smoke exposed plus Tocopheryl acetate) and Group VI(Cigarette smoke exposed plus soyabean oil) were exposed to cigarette smoke 3 times a day for 20 minutes each time and Tocopheryl acetate with dose of 200mg/kg/day in 0.3ml of soyabean oil as vehicle orally through oral gavage from the 5th day of gestation to 15th day. RESULTS: Cigarette smoke exposed mice showed significant fetal weight loss, resorption, placental anomalies, severe growth retardation, venous congestion, haemorrhage, limbs defects and enphalocele. Negligible abnormalities were seen among the control and Tocopheryl acetate group. Cigarette smoke exposed group with Tocopheryl acetate exhibited weight gain among the fetus as well as no gross abnormalities. The oxidative stress was significantly increased by increasing Malondialdehyde (MDA) 293±81.57 µmol/mg (p<0.0001) and decreasing Superoxide Dismutase (SOD) 1.43 ± 0.23mg/ml, (p<0.0001) Reduced Glutathione (GR) 0.017±0.002mg/ml, (p<0.01) and Catalase (CAT) 0.248±0.005mg/ml, (p<0.0001). Tocopheryl acetate induced group significantly maintained the oxidative stress with all p <0.0001. CONCLUSION: It can be concluded that Tocopheryl acetate may have an ameliorating effect on the cigarette smoke during pregnancy on fetus.

Quality of life and health of opioid-dependent subjects in India.

BACKGROUND AND OBJECTIVES: The quality of life (QoL) of substance abusers is known to be severely impaired. This study was carried out to assess the impact of opioid dependence on the QoL of subjects and compared it with the normal subjects. MATERIALS AND METHODS: Based on specified inclusion criteria a total of 47 subjects were recruited from a tertiary care center from India. The WHOQoL-BREF scale domain scores obtained at baseline were compared to that of normal subjects. An assessment of dysfunction and reasons for continuing and other parameters were assessed. RESULTS: WHOQoL-BREF domains (Physical, Psychological, Social relationships and Environment) showed significantly lower scores and the difference was statistically significant. INTERPRETATION AND CONCLUSIONS: The results showed that QoL is an important parameter in assessment of substance abusers and can be used for long-term prognosis of these individuals.

Oxidative stress and major depression.

BACKGROUND: Major causative factor for major depression is inflammation, autoimmune tissue damage and prolonged psychological stress, which leads to oxidative stress. The aim of this study was to know the association of free radicals and antioxidant status in subjects suffering from major depression. MATERIALS AND METHODS: Sixty patients diagnosed as a case of unipolar depression as per DSM IV, fulfilling the inclusion and exclusion criteria were compared with 40 healthy age and sex matched controls. The sera of both the groups were collected taking aseptic precautions and were evaluated for the markers of oxidative stress and for the antioxidants. The age group of the sample and the controls was between 18-60 y, both males and females were equally represented in the groups. RESULTS: A significantly high level of malondialdehyde (MDA) was found in the patients with major depression (1.95 ± 1.04 mmol/L) as compared to healthy controls (0.366 ± 0.175 mmol/L) (p < 0.0001). The serum level of nitrite was found to be lower in cases (23.18 ± 12.08 µmol/L) in comparison to controls (26.18 ± 8.68 µmol/L) (p = 0.1789). Similarly the serum level of ascorbic acid and superoxide dismutase (SOD) were significantly below as compared to healthy controls (all p < 0.0001). Ceruloplasmin levels were also depressed in cases (p = 0.3943). CONCLUSION: The study concluded that in the absence of known oxidative injury causative agents, the lowered levels of antioxidants and higher levels of MDA implicate the high degree of oxidative stress in unipolar depression.

A Comparative Study of Attitude of Mental Health Versus Nonmental Professionals toward Suicide.

BACKGROUND: Suicide is a major public health problem. Suicide can be prevented by understanding the disorder. Attitude plays a significant role in doing so. AIM: To assess the attitudes of mental health professionals and non-mental health professionals towards an act of suicide and to compare the two groups regarding their attitudes. MATERIALS AND METHODS: A semistructured questionnaire having yes/no type questions was administered to 30 mental health and 30 nonmental health professionals. A blind analysis of the data was done. STATISTICAL ANALYSIS: Comparative analysis using mean and standard deviation and analysis of variance was performed to rate significance in differences of responses to questions that rate attitudes. RESULTS: The results show a significant positive attitude of mental health professionals toward dealing with the patients who attempted suicide. DISCUSSION: Considering the magnitude of the problem, simple training and education of nonmental health professionals can change their attitude toward patients who attempt suicide, which in turn leads to an optimal management. CONCLUSION: The study shows that the mental health professionals are much more positive in their approach towards a patient of parasuicide.

Structural Changes in the Insular Cortex in Alcohol Dependence: A cross sectional study.

OBJECTIVE: This study was conducted to determine the changes in the insular cortex in alcohol dependent subjects, and to compare the same with controls, the associated clinical findings. METHODS: The study group consisted of 30 subjects with alcohol dependence syndrome (ADS) selected randomly from the out patient services of the department of psychiatry of a tertiary care hospital. The control group consisted of 30 matched subjects selected randomly from the out patient department and from patients screened for uncomplicated headache. Both groups were examined by a computerized scan (CT), and Mini Mental Status Examination (MMSE). RESULTS: Chi square, and 't' test were done after calculating the Evan's ratio. The two groups were compared to assess the cortical atrophy and ventricular enlargement. Cognitive functions were tested by MMSE, and the scores were compared. Atrophy was significantly higher in the experimental group; however, it was not significant. Cognitive functioning was found to be significantly impaired in the experimental group. DISCUSSION: The study showed that alcohol dependence leads to cortical atrophy which is age independent. The statistically significant disturbance in the MMSE scores along with the frontal and parietal cortical atrophy is also indicative of the insular cortex involvement in the experimental group. CONCLUSION: Alcohol dependence leads to cerebral atrophy along with the involvement of the insular cortex.

The many faces of trichotillomania.

Trichotillomania is a poorly understood complex disorder of multifaceted pathology which often requires an interdisciplinary approach for management. While sharing similarities with obsessive-compulsive disorder, compelling differences between these have also been noted. We present three cases of trichotillomania highlighting the remarkable variability seen in the presentation of this disorder. In doing so, we discuss on resolving the classificatory issues and call for a consensus on the understanding of the disorder.

Predictors and prevalence of nicotine use in females: A village-based community study.

BACKGROUND: Nicotine use and abuse is gaining increasing attention due to its negative and serious medical consequences. Multiple morbidities occur due to the intake of nicotine in various forms. AIMS: To find the prevalence and type of nicotine use/abuse in females. SETTINGS AND DESIGN: House to house survey in a village in Purvanchal, i.e. eastern part of Uttar Pradesh and bordering Bihar. MATERIALS AND METHODS: Semi-structured performa was used to collect data; a house to house visit was made to collect data. STATISTICAL ANALYSIS: Simple percentages were calculated. RESULTS: Tooth powder form of nicotine use is common and the need to address this problem is urgent. CONCLUSIONS: Widespread dissemination of knowledge and legislative measures have to be undertaken to stop the problem.

Atypical presentation of pediatric bipolar mood disorder : two case reports

Objective: This case reports highlight atypical presentation of pediatric bipolar mood disorder. Pediatric bipolar disorder is said to be a rare condition with some distinct differences from adult bipolar disorder. Despite the ongoing controversy regarding its exact typology, pediatric bipolar mood disorder is being reported in the form of case reports and in systematic research. Pediatric bipolar disorder is difficult to diagnose because its presentation of symptoms overlaps considerably with conduct problems, and ADHD (attention deficit hyperkinetic disorder). Methods: We report two cases which met a diagnosis of pediatric mood disorder where the presentation of symptoms was unique and atypical. Results: The cases are presented so that they help to raise pertinent questions regarding phenomenology, duration, episodic nature of the illness and management of this important group of disorders. Conclusion: Pediatric bipolar disorder should be viewed with seriousness and pediatric mania should be given importance in the assessment of the typology, prognosis and management of this important group of childhood disorder.