A summer of acute and transient psychosis: A case series.

The association between the season and the occurrence of acute transient psychotic disorder (ATPD) has been sparsely studied. We would like to report five patients who presented with acute psychotic symptoms during the summer and discuss other risk factors that could be associated with this seasonal predilection.

Cost of Illness Analysis of Common Mental Disorders: A Study from an Indian Academic Tertiary Care Hospital.

Background: The cost of illness (COI) for common mental disorders (CMDs) that include depression, anxiety, and somatoform disorder is less studied in India. Hence, we studied the COI and disability of CMDs and their relationship in patients with depression, anxiety, and somatoform disorders. Methods: In this cross-sectional study, we recruited 220 patients (110 with depression, 58 with anxiety disorders, and 52 with somatoform disorders) and evaluated disability using the Sheehan Disability Scale (SDS). The schedule for the cost of illness (S-COI) was used for evaluating COI for the last year. Results: The annual COI of CMDs from the patient perspective was ₹21,620 (interquartile range [IQR], ₹47,761; ≈US$290). The median annual direct COI was ₹4,907 (IQR ₹7,502), and indirect COI was ₹12,900 (IQR ₹37744). The direct COI was 18%, whereas the indirect COI was 82%. The direct and indirect COI in the three groups were similar. In all three groups with ongoing treatment, the mean scores indicated a mild level of disability. Total and indirect COI, but not the direct COI, correlated positively with the severity of illness and disability. Conclusion: All the CMDs with ongoing treatment are associated with a mild level of disability and are a significant financial burden, with higher indirect costs.

Suicide prevention program (SPP) in South Asian Countries: A protocol for systematic review.

Introduction: Every year, over 700,000 individuals lose their life by suicide and many individuals attempt suicide. Suicide occurs in all age groups and is the fourth major cause of death among 15-29-year-olds globally in 2019. A suicide prevention program (SPP) is a capacity-building program that helps gatekeepers to identify the risk of suicide. The objective of the review is to determine the effectiveness of SPP on the improvement of knowledge, attitude, and gatekeeper behaviour among gatekeepers in South Asian countries so that the number of suicide cases will be reduced among college students in South Asia countries. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) will be followed in this review. This review will include all interventional studies (controlled and uncontrolled) that provided a suicide prevention program to the gatekeepers as an intervention. The full-text articles will be included from the following databases, Scopus, PubMed (MEDLINE), Cochrane, PsycINFO, Web of Science, and CINAHL, published in peer-reviewed, and indexed journals from the date of inception to 2022. A grey literature search and hand-search of reference lists of the included studies will also be done. A search strategy will be developed using keywords and MeSH terms for each database. Cochrane ROB-2 tool, JBI Critical Appraisal Checklist will be used to evaluate the quality of individual studies. Analysis of the data will be done using narrative synthesis. Conclusions: This review will provide information on knowledge, attitude, and gatekeeper behaviour toward suicide prevention in college students and will be helpful for the prevention of suicide. Therefore, the authors plan to publish the review outcome through a peer-reviewed journal. Registration : The review is registered in PROSPERO (CRD42023387020).

Work productivity (absenteeism and presenteeism) in persons with common mental disorders: An observational study from South India.

Background: The greatest contributor to the economic impact of common mental disorders (CMDs) is said to be the loss of work productivity. There is a paucity of studies from India that looks at the impact of CMDs on the productivity of work, which costs both patient and society significantly. Aim: To assess and compare work productivity by evaluating both absolute and relative presenteeism and absenteeism, in persons with CMDs. Materials and Methods: This was a cross-sectional observational study on 220 subjects (110, 58, and 52 patients with depressive disorder, anxiety disorders, and somatoform disorders, respectively), recruited through purposive sampling. We evaluated work productivity using the World Health Organization Health and Work Performance Questionnaire. Results: Absolute absenteeism was significantly different before and after treatment for CMDs as a group but not for individual disorders. Relative absenteeism, absolute presenteeism, and relative presenteeism were all significantly different before and after treatment among both CMDs as a group and also among individual disorders. Both presenteeism and absenteeism (absolute as well as relative) did not differ significantly across the diagnostic groups. Work productivity has been linearly associated with illness severity and disability. Conclusion: CMDs are associated with a significant loss of work productivity. Presenteeism is costlier than absenteeism in affecting work productivity. Loss of work productivity appears to be transdiagnostic across all CMDs. Also, the severity of loss of work productivity is associated linearly with the severity of illness and disability.

A close critical look of India's National Mental Health Survey 2016.

The National Mental Health Survey 2016 (NMHS 2016) was a large epidemiological study, one of its kind, conducted by the National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru to overcome the shortcomings of the previous surveys. The detailed report of the study is available in two parts- 'mental health systems' and 'prevalence, pattern and outcomes'. Though done comprehensively, there are some inevitable limitations. The private sector, a substantial health care provider in the country was not a participant in the survey. Though MINI version 6.0 is a standard and structured instrument, it does not cover many commonly encountered mental illnesses like somatoform disorders. Further, the methodology of the survey makes it difficult for an accurate calculation of the prevalence of individual major psychiatric disorders. The survey has been appraised using a standard checklist for prevalence studies. The detailed qualitative data has not been shared in the report. The contribution of the traditional indigenous systems of healthcare and accessibility of services in rural areas have not been elaborated. Thus, the need for a comprehensive and culturally sensitive assessment tool, involvement of the private sector, and enhancing funding provision to improve the infrastructure are emphasized as future directions for the subsequent phases of the survey.

Psychiatric Morbidity and Correlates in Postpartum Women in a Tertiary Care Hospital.

BACKGROUND: A range of psychological disorders occur in women in the postpartum period apart from the traditional blues, postpartum depression and psychosis. These include obsession of infanticide, PTSD, morbid preoccupations regarding child birth and disorders of mother-infant relationships, though they are under emphasized. METHODS: it is a cross-sectional study conducted in the tertiary maternity care hospital. A total of 152 study subjects were interviewed on MINI (Mini International Neuropsychiatric Inventory) and GAF (Global Assessment of Functioning) within 2 weeks after delivery. RESULTS: The psychiatric morbidity was seen in 67 (44%) of the study subjects. About 26% of subjects had Depressive disorder NOS. Obsessive harm to the child, Panic disorder, Social phobia were the other disorders identified. There were no cases of Mania, Bipolar disorder, psychosis, post traumatic stress disorder or substance use disorder diagnosed across the sample. The Global Assessment of Functioning (GAF) score averaged 87.8. Statistically significant association was seen to be present between psychiatric illness and number of previous still births and dead children before this delivery (P = 0.045). CONCLUSIONS: The study reveals that psychiatric co-morbidity is very common in the postpartum period and can be detected as early as first week after delivery. Social phobia identified as a common association is a new finding and needs further replication. It needs a larger sample with a prospective assessment to generalize the findings of our study.

Female sexuality.

Sex is a motive force bringing a man and a woman into intimate contact. Sexuality is a central aspect of being human throughout life and encompasses sex, gender identities and roles, sexual orientation, eroticism, pleasure, intimacy, and reproduction. Sexuality is experienced and expressed in thoughts, fantasies, desires, beliefs, attitudes, values, behaviors, practices, roles and relationships. Though generally, women are sexually active during adolescence, they reach their peak orgasmic frequency in their 30 s, and have a constant level of sexual capacity up to the age of 55 with little evidence that aging affects it in later life. Desire, arousal, and orgasm are the three principle stages of the sexual response cycle. Each stage is associated with unique physiological changes. Females are commonly affected by various disorders in relation to this sexual response cycle. The prevalence is generally as high as 35-40%. There are a wide range of etiological factors like age, relationship with a partner, psychiatric and medical disorders, psychotropic and other medication. Counseling to overcome stigma and enhance awareness on sexuality is an essential step in management. There are several effective psychological and pharmacological therapeutic approaches to treat female sexual disorders. This article is a review of female sexuality.

The mystery of reincarnation.

One of the mysteries puzzling human mind since the origin of mankind is the concept of "reincarnation" which literally means "to take on the flesh again." As the civilizations evolved, beliefs got discriminated and disseminated into various religions. The major division manifested was "East" and "West." The eastern religions being more philosophical and less analytical, have accepted reincarnation. However, the different eastern religions like Hinduism, Jainism, and Buddhism have differed in their faith on rebirth. Further, the Islam as well as the most dominant religion of the world, Christianity, having its origin in the west, have largely denied reincarnation, though some sub-sects still show interest in it. Also many mystic and esoteric schools like theosophical society have their unique description on rebirth. This article describes reincarnation as perceived by various religions and new religious movements as well as some research evidence.

Osho - Insights on sex.

Sex is a mysterious phenomenon, which has puzzled even great sages. Human beings have researched and mastered the biology of sex. But that is not all. Sex needs to be understood from the spiritual perspective too. The vision of Osho is an enlightening experience in this regard. Out of the thousands of lectures, five lectures on sex made Osho most notorious. Born into a Jain family of Madhya Pradesh, Rajneesh, who later wanted himself to be called Osho, is a great master. He has spoken volumes on a wide range of topics ranging from sex to super-consciousness. His contributions in the area of sex are based on the principles of "Tantra" which has its origin from Buddhism. This article focuses on his life and insights on sex, which if understood properly, can be a stepping stone for enlightenment.

A comparative study of sexual dysfunction involving risperidone, quetiapine, and olanzapine.

BACKGROUND: With the advent of newer antipsychotic drugs, side effects such as sexual dysfunction have been a major contributor toward treatment compliance. There are only a few studies that have compared different atypical antipsychotic agents regarding sexual dysfunction. We have not come across any data in this area on Indian population. AIMS: To determine and compare the frequency of sexual dysfunction associated with risperidone, olanzapine, and quetiapine, among patients with clinically stable schizophrenia. SETTINGS AND DESIGN: It is a cross-sectional hospital-based study. The subjects were recruited for the study by the purposive sampling technique. MATERIALS AND METHODS: The total sample size was 102, consisting of 25 each in the quetiapine and risperidone groups, 22 in the olanzapine group, and 30 healthy volunteers. A Brief Psychiatric Rating Scale and Sexual Functioning Questionnaire (SFQ) were administered. The Kruskal Wallis test was used to compare the variables in the demographic data and the mean chlorpromazine equivalent doses of the study groups. To analyze the sexual dysfunction, the mean scores on all the domains of sexual functioning in SFQ were compared across the study groups using the Chi square test, for proportions. RESULTS AND CONCLUSION: Twenty-three percent of the healthy volunteers had some impairment in one or more domains of sexual functioning. For the medication groups this was 96, 88, and 90%, respectively for risperidone, quetiapine, and olanzapine. However, there was statistically no significant difference across the study groups although it was relatively less with quetiapine.

A Comparative Study of Sexual Dysfunction due to Typical and Atypical Antipsychotics in Remitted Bipolar-I Disorder.

In the remitted phase of bipolar I disorder, sexual dysfunction is commonly due to drugs used in the treatment rather than the disease itself. There are very few studies, especially in the Indian population, addressing the frequency of sexual dysfunction due to antipsychotics in bipolar I disorder. Hence this study was done to determine the sexual dysfunction due to antipsychotics and to compare the same among typical and atypical antipsychotics. A cross sectional study with 108 male patients of remitted bipolar I disorder (DSM-IV), chosen by purposive sampling technique was done. Psychopathology was assessed using the Brief Psychiatric Rating Scale, Structured Interview Guide for the Hamilton Depression Rating Scale and Young Mania Rating Scale. Sexual side effects due to antipsychotics were assessed using the Udvalg for Kliniske ndersogelser (UKU) side effect rating scale. The total sample size was divided into two groups of those on typical antipsychotics (n = 53) and atypical antipsychotics (n = 55). The two groups were compared for sexual dysfunction using Chi-square test. Results showed dysfunction in at least one phase of the sexual response cycle, comprising of desire, arousal and orgasm, was present in 66% of the sample population. Erectile dysfunction was present in 42% of the sample population and it was the most common type of sexual dysfunction reported. It was also significantly different across the two groups (p = 0.025). There was no significant difference in other aspects of sexual dysfunction across the two groups. In conclusion patients of Bipolar I disorder experience sexual side effects of antipsychotics frequently. Erectile dysfunction is the most common sexual dysfunction among men and this is significantly higher with typical than atypical antipsychotics.