Prevalence of Psychiatric Morbidity and Alcohol use Disorders Among Adolescent Indigenous Tribals from Three Indian States.

Background: Among the Indian adolescents, the prevalence of psychiatric morbidity and alcohol use disorders (AUD) are 7.3% and 1.3%. However, no separate data are available for indigenous tribal populations. This study estimated the prevalence of psychiatric morbidity and AUD and associated socio-demographic factors among adolescents in the tribal communities in three widely varying states in India. Methods: Using validated Indian versions of the MINI 6.0, MINI Kid 6.0, and ICD-10 criteria, we conducted a cross-sectional survey from January to May 2019 in three Indian sites: Valsad, Gujarat (western India); Nilgiris, Tamil Nadu (south India); and East Khasi Hills district of Meghalaya (north-east India) on 623 indigenous tribal adolescents. Results: Aggregate prevalence of any psychiatric morbidity was 15.9% (95% CI: 13.1-19.0) (males: 13.6%, 95% CI: 10.0-18.1; females: 17.9%, 95% CI: 13.9-22.6), with site-wise statistically significant differences: Gujarat: 23.8% (95% CI: 18.1-30.2), Meghalaya: 17.1% (95% CI: 12.4-22.7), Tamil Nadu: 6.2% (95% CI: 3.2-10.5). The prevalence of diagnostic groups was mood disorders 6.4% (n = 40), neurotic- and stress-related disorders 9.1% (n = 57), phobic anxiety disorder 6.3% (n = 39), AUD 2.7% (n = 17), behavioral and emotional disorders 2.7% (n = 17), and obsessive-compulsive disorder 2.2% (n = 14). These differed across the sites. Conclusion: The prevalence of psychiatric morbidity in adolescent tribals is approximately twice the national average. The most common psychiatric morbidities reported are mood (affective) disorders, neurotic- and stress-related disorders, phobic anxiety disorder, AUD, behavioral and emotional disorders, andobsessive-compulsive disorder.

A Three-Site Study of Alcohol Consumption among Adolescents from Indigenous Tribes in India.

BACKGROUND: Alcohol use disorder is elevated among members of indigenous tribes in India, like native populations in several other countries. Despite constituting 8.6% of the Indian population, tribals are among the most geographically isolated, socioeconomically underdeveloped, and underserved communities in the country. Based on the experience from our centers (in Tamil Nadu, Meghalaya, and Gujarat), we are aware of escalating alcohol use among tribal communities. The aims of this study are (a) to estimate alcohol use and psychiatric morbidity among teenagers from indigenous tribes, and (b) pilot test a psychoeducational efficacy study. METHODS: The biphasic study is being conducted in three states of India: Tamil Nadu in South, Meghalaya in Northeast, and Gujarat in West. Phase 1 is a cross-sectional study of tribal adolescents at each site. The MINI 6.0/MINI Kid 6.0 questionnaire was used to estimate extent of psychiatric morbidity and substance addiction. Phase 2 is an intervention trial of 40 participants at each site to assess the effectiveness of NIMHANS LSE module in protecting the tribal adolescents from alcohol use. CONCLUSIONS: The desired primary outcome will be forestalling the onset of alcohol use among this group. This paper focuses on the methodology and strategies to be used to achieve the objectives.

Follow-up Assessment of Under-nourished Children Under Integrated Child Development Services Scheme in Tapi District, India.

BACKGROUND: India shares the largest burden of under-nutrition in world. The aim of this study was to conduct follow-up assessment of under-nourished children attending anganwadi center (AWC). METHODS: This was a retrospective cohort study conducted in 50 AWC of Tapi district. Total 529 children aged 1-6 years diagnosed as under-nourished before 1 year were included. Pre-structured questionnaire was used for present day assessment of these children followed by Epi-info mediated analysis. RESULTS: Children of literate mothers had higher weight gain. Ninety percent of children attended anganwadi regularly, however 25% of children dropped out for more than 1 month. In 1 year, growth had faltered in 20% children and was stagnant in 63% of them. Children who were treated for under-nutrition; that completed course at Child Development and Nutrition Center; and whose parents were counseled about the under-nourished status of child had higher weight gain than their counterparts. CONCLUSIONS: Parents of under-nourished children must be counseled about the nutritional status of their child. In cases of under-nourished child, referral to higher center must be ensured by health worker. Supplementary feeding as a long-term solution to country's under-nutrition problem should be studied in detail with the alternative solutions.