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Context: Exponential rise in internet usage over the past two decades has fostered internet addictive behaviors, especially in young adults. In India, medical students undergo tremendous stressful situations and are a vulnerable group for such addictive behaviors. Aims: The aim of the study was to assess subjective happiness of 1^st-year medical students and their internet addiction levels Settings and Design: A cross-sectional study done in a medical college in Bangalore, Karnataka, India. Materials and Methods: Sample consisted of 150 1^st-year medical students, who self-reported about their internet addictive pattern and subjective well-being on Internet Addiction Test and Subjective Happiness Scale, respectively. Statistical Analysis: Descriptive and inferential statistical analyses were carried out. Significance is assessed at 5% level of significance. Analysis of variance, Student's t-test, and Chi-square/Fisher's Exact test have been used. Results: Of the total sample, 42.7% of students reported of experiencing subjective happiness below the average, 41.3% had average happiness levels, and only 16% had scores above the average. Out of the students, 42.1% who had no internet addiction, 36.4% who had mild levels, and 54.8% who had moderate levels of internet addiction fell below the average happiness level. Conclusions: Those who had higher levels of internet addiction showed reduced subjective happiness. Thus, those who experience decreased subjective happiness without overt psychological disturbances are still prone to have addictive patterns. This should be considered during screening for addictive behaviors.

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Background: Different infectious disease outbreaks such as bubonic plague, Asiatic flu, cholera, Middle East respiratory syndrome, and Ebola have been associated with polarization, racism, blame, and resultant psychological distress. Health-care providers involved in managing the COVID-19 crisis face challenges such as stigma and discrimination. Aim: The current study is aimed to explore stigma and discrimination related to COVID-19 among healthcare workers. Methods: A cross-sectional study was carried out during April and May 2020. Doctors working at health-care facility were approached and requested to fill semi-structured pro forma containing the following parts: (1) Demographic details of participants, (2) Brief Illness Perception Questionnaire 5 (BIPQ-5), (3) Physical Distance and Discrimination Questionnaire, (4) Avoidance Questionnaire, (5) feeling thermometer toward a person having COVID, HIV, TB, Swine flu. Statistical Analysis: Data entry and analysis was performed using Microsoft excel and SPSS 26 version software. Independent t-test was used to compare the mean and standard deviation of the BIPQ score, physical distance, and discrimination questionnaire score with various demographic variables and avoidance questionnaire. Results: A total of 323 doctors participated in the study. Out of which 51.39% reports that it is necessary to avoid persons and 30.60% have a problem if a person eats in mess/canteen when working in COVID-19 care. Participants living with family members have statistically significant (P < 0.001) a higher score on the BIPQ, and Physical Distancing and Discrimination Questionnaire. A significant positive correlation (r = 0.162, P = 0.004) of brief illness of perception with physical distancing and discrimination score. Conclusion: The study found a high threat perception of COVID-19 as well as stigma and discrimination within health-care staff. The stigma and discrimination for COVID-19 are more than other illnesses such as swine flu, tuberculosis, and HIV. This can result in the work compliance and management strategies of health-care workers.

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Most mental health researchers believe that there is a variety of contributing factors to the onset of mental health issues. Studies have found that there are physical, social, environmental, and psychological causes. This paper highlights some of the mental health issues that are prevailing in Kashmir. The research so far conducted in the valley has pointed social, environmental, and psychological issues prevailing in general in the Kashmir Valley. The prevailing disturbances in the valley from the past two decades of turmoil in Kashmir were cited by most researchers as the main reasons for mental health problems. Apart from this, the changing political parties, ethics to divide, and rule resulting economic dynamics of inhabitants are also responsible for this menace. Depression, posttraumatic stress disorder, obsessive-compulsive disorder, stress, and anxiety are diagnosed in general to cause mental trauma, and illness.

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In this systematic review, we summarize the current understanding and controversies on cognitive sequelae after traumatic brain injury (TBI) to understand the cognitive deficits such as memory, attention, executive functions, and unawareness of their deficits in TBI patients. This review presents the cognitive sequel of patients with moderate-to-severe TBI by a comprehensive focused conglomeration of research publications by searching various resources. A search strategy with specific inclusion criteria was performed in PubMed, Cochrane, Web of Science, and the WHO Global Health Library. This review noted that TBI is related with increase of various neurological and non-neurological disorders including problems with attention, inability to concentrate, speech and language dysfunctions, learning and memory impairment, impaired reasoning, impaired planning and problem-solving. This review found that patients' cognitive deficits are common in victims of moderate to severe TBI often as the long-lasting sequalae. The present review suggests that there is a need for further research to develop unique rehabilitation methods that will help to enhance brain plasticity and process of recovery after TBI.

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Neurocysticercosis (NCC) is an infection caused by the larval stage of the parasite, Taenia solium. Seizures, psychosis, Parkinsonism, and other movement disorders have been described in the literature pertaining to NCC; however, no reports were available on tics. A young female presented to the outpatient department with headache, psychotic symptoms, and tics for a duration of 15–20 days. On examination, she was noted to have fluctuating orientation and was hypervigilant. She also presented with irrelevant speech, ideational perseveration, paranoid ideation, visual/auditory hallucinations, and motor/vocal tics. Following a detailed evaluation with investigations such as magnetic resonance imaging of the brain and ELISA, a diagnosis of NCC with psychosis and tics was made. She was treated with mannitol, steroids, albendazole, and antipsychotics. Psychosis and tics improved within 1 week of treatment. This case highlights an uncommon presentation of NCC as well as the significance of a high index of suspicion and the need for a careful workup to catch these cases.

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Introduction: Coronavirus disease-19 (COVID-19) is a novel infection that sets off a pandemic in a short period. Research has been going on to develop safe and effective vaccines and around 150 are in the process of development. In India, two vaccines have been given emergency approval. There has been a rise in hesitancy toward vaccination not only in India but also worldwide. Materials and Methodology: The study included 697 participants who were not vaccinated. The study questionnaire was administered through online Google Forms and included informed consent, sociodemographic details, questions related to COVID-19 infection and vaccine, and vaccine attitude examination (VAX) scale. Results: Among the 697 participants, 216 (31%) were not willing to get vaccinated. Those with prevailing mental (P = 0.011) or physical health (P < 0.001) problems were of negative opinion toward vaccination because of unforeseen complications. Participants with lower education (P = 0.041), skilled to semi-skilled job (P = 0.028), and joint family (P = 0.006) opined that vaccination was more of commercial profiteering for manufacturing companies. Participants who were married (P = 0.010) and living in a joint family (P = 0.009) setting were more inclined toward a preference for natural immunity. Conclusion: The study highlights that 69% of participants were willing to take the COVID-19 vaccine. Various measures can be taken by different stakeholders to improve the positive attitude. As medical professions, we can improve the positive attitude by actively taking the vaccine and educating the local people about the benefits.

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Aims and Objectives: The aim and objective of this study are to study the major barriers to seeking mental health care among medical undergraduates and to understand the correlation between barriers and demographic factors. Materials and Methods: This was a cross-sectional study that was conducted with a sample that consists of 100 participants in Mamata Medical College, Khammam and Pratima Medical college, Telangana, India, during the period of 6 months (2019). A semi-structured pro forma was used to collect the sociodemographic details, and the Barriers to Access to Care Evaluation Scale was used to assess the reasons for not seeking mental health services. Results: This study found that 26% of the participants did not seek any kind of mental health care despite needing it. The analysis revealed that stigmatizing beliefs, difficulty in sharing one's concerns, preference for self-reliance, and difficulty in accessing help were the prominent barrier themes among responders. Conclusions: This study highlights the vast discrepancy in the number of individuals in need of mental health care and the actual number of people seeking it. The present findings indicate that interventions are required to improve mental health literacy and knowledge of local services.

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Background: A caregiver is an individual who provides assistance and assumes the responsibility for the physical and emotional needs of another individual who is incapable of self-care. Caregiver burden is a universal phenomenon and more than half of the caregivers experience burden in their role as caregivers. There is a paucity of studies to understand the burden and coping strategies of caregivers in chronic psychiatric illness and chronic medical illnesses, especially in the Indian scenario. Aims and Objectives: (i) To compare the caregiver burden in chronic psychiatric illness and chronic medical illness (ii) To compare the caregiver efficacy in chronic psychiatric illness and chronic medical illness. Materials and Methods: The study sample included caregivers of inpatients admitted in a tertiary care hospital in South India. A total of 120 caregivers were included in the study with 60 caregivers from psychiatric ward and medicine ward, respectively. The caregivers were then assessed using the Caregiver Burden Scale and the Revised Caregiver Self-efficacy Scale Results and Conclusion: We found that majority of the caregivers were first-degree relatives and women constituted a major part of the caregiver group. Caregiver burden was significantly higher in psychiatric illnesses compared to medical illnesses. Caregiver efficacy was similar in both study groups. Interventions to reduce caregiver burden and to improve caregiver efficacy should be implemented to ensure optimal management of both patient and caregiver.

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Background: Nutrition and depression among elderly have emerged as a major public-health problem, and depression is one of the leading causes of disease burden worldwide. The evidence shows that more than 50% of the elderly population is underweight and more than 90% has an energy intake below the recommended intake. Objective: The objective of this study is to determine the prevalence and correlates of malnutrition and the relationship with disability and psychological well-being, and to assess the pattern of morbidity, co-morbidity, among the elderly in Udupi taluk of Karnataka. Methodology: This cross-sectional study conducted during January–June 2017 included 570 participants of ≥60 years of age. The data were analyzed for percentages, mean, and standard deviation. The tests of significance such as analysis of variance and Independent t-test were used; P < 0.05 was considered statistically significant. Results: It was observed during the study that the majority belonged to the young old age group (63.2%), were financially dependent (55.8%) and most of them are from rural (61. 1%). The prevalence of malnutrition based on the malnutrition indicator score was found to be (11.22%) and (44.73%) are at risk of malnutrition. The mid-upper arm circumference and calf circumference measurements were (8.24%) and (11. 75%), respectively. The prevalence of depression in the elderly was found to be 6.6%. Conclusion: The care of the elderly should also include the nutrition and mental healthcare components for better addressal of the health needs of elderly which requires to be brought on the national health care agenda.

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Romantic relationship is one among the defining feature and developmental task of adolescence, often considered to have significant influence on the course of other developmental tasks, overall health and wellbeing. Thus the present paper made an attempt to review different mental health promotion manuals developed for adolescence in India with the aim to understand whether those manuals address the emerging issues of adolescence in romantic relationship. Seven manuals were selected for this purpose and reviewed based on its content, methodology, target population and how issues pertaining to romantic relationship has been addressed. It was observed that all the manuals covered different aspects related to developmental needs and concerns of adolescents in general; especially the developmental significance of romantic relationship with its socio-cultural background has received little attention. Therefore this article implied for developing comprehensive manuals on emerging issues of adolescents in romantic relationship as a great need of the time.

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Functional gastrointestinal disorders (FGIDs) are chronic, recurrent, frequently debilitating disorders with no identifiable underlying pathology. They occur due to a complex interplay between biological, psychological, and social factors and are some of the most common conditions encountered in general clinical practice as well as the specialist gastroenterological clinic. The top-down regulation of visceral sensations plays an important role in the pathophysiology of the disease, i.e., the central processing of emotions and stressors altering the sensory and motor components of the gut, which increases hypersensitivity and therefore symptom severity. In addition, the core personality traits of the individual play their part in the way symptoms are perceived, further providing proof for the long-prevailing belief that the gut and emotions are linked, the so-called “gut feeling.” The current diagnostic criteria for FGIDs are entirely based on subjective symptoms, challenging in itself due to the varied presentations, and further complicated by the current unavailability of objective laboratory tests which could confirm its presence in the symptomatic individual. The various treatment modalities include psychotherapies ranging from cognitive behavioral therapy to mindfulness, along with appropriate pharmacotherapy to treat physical and psychiatric comorbidities. Addressing all these underlying causes, in addition to weighing in the genetic makeup of the individual, is necessary for delineating accurate prognosis, reducing attending health-care costs, and improving overall outcome of the individual.

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Mental Health Care (MHC) Act 2017 is published in the Gazette by Government of India. It is aimed at strengthening human rights of persons with mental illness. Changes such as advance directive and nominated representative are new, and review boards and responsibilities of government are clearly emphasized. The objective of this article is to give an overview of MHC act 2017 and its upcoming issues while implementing it.

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In this paper, we report the case of 7-year-old female, diagnosed wih mild intellectual disability and attention-deficit hyperactivity disorder who developed tongue rolling movements following the use of methylphenidate treatment. The onset of tongue movements started 2½ h after starting methylphenidate and subsided in 3–4 h. Recurrence was noticed only when she was exposed to the medication. This case report highlights the importance of noticing orofacial dyskinesia with methylphenidate use and its discontinuation leading to subsidence of these movements.

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Introduction: Emotional intelligence (EI) impacts many different aspects of daily life, such as the way one behaves and interacts with others. Empathy, one of the five elements of EI, is considered to be the most important psychosocial factor of inpatient care. An assessment of EI and empathy would help health-care professionals give better patient-centered care. Aims and Objectives: This study aims to assess the various components of EI among medical students and professionals and study its relation with personal and social factors. Materials and Methods: This is a cross-sectional study conducted with a sample that consists of 200 participants in Mamata Medical College, Khammam and Pratima Medical College, Karimnagar, Telangana during a period of 6 months (2018). A semi-structured pro forma is used to collect sociodemographic profile and the emotional quotient self-assessment checklist by Sterrett is used to measure EI and empathy. Results: There is a significant negative correlation between work hours and empathy, individuals with lesser work hours scored higher on empathy and social competence. There is also a significant negative correlation between motivation and sleep hours, individuals with more number of sleep hours scored lesser on motivation. Those who exercised scored higher on self-awareness and social competence as compared to those who never exercised. Individuals with a greater number of friends in the workplace scored significantly higher in confidence and motivation. Conclusion: The current study supports that good work relations, empathy, and exercise have a positive correlation with various domains of EI.

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Aims and Objectives: The aim of the study is (1) To assess the prevalence of nicotine dependence and its impact on quality of life and severity of symptoms in patients with schizophrenia. (2) To determine the association between ND and clinical symptomatology of schizophrenia. (3) To explore the impact of ND on the quality of life (QOL) of patients with schizophrenia. Materials and Methods: The current study is a cross-sectional study done among 100-male schizophrenic patients conducted in the Department of Psychiatry, Mamata General Hospital, Khammam, Telangana, from July 2017 to December 2017. The tools used are the Fagerstrom test for ND (FTND) was administered to assess ND. The Positive and Negative Syndrome Scale (PANSS) for assessing the clinical symptomatology, and the abbreviated World Health Organization QOL (WHOQOL-BREF) for assessing their QOL. Results: The prevalence of smoking in schizophrenics was 68.75%. Prevalence of ND is higher in illiterates, unemployment, nuclear family, low-socioeconomic status, and hailing from the rural background when compared to that of the nicotine nondependence. Nicotine-dependent were found to be having higher mean scores on the positive subscale and the General Psychopathology Subscale and lower mean scores on negative domain. Within the ND group, correlation testing between the FTND scores and PANSS revealed a negative co-relationship between ND and negative symptoms, whereas the correlation testing between the FTND scores and WHOQOL-BREF scores revealed a negative relationship between ND and psychological, social, and environment domains of QOL. There was a negative correlation between (a) Negative symptoms and all the domain of QOL. (b) General psychopathology and social relationships, environmental among ND. Summary and Conclusion: Nicotine-dependent patients suffer from the higher levels of symptoms and enjoy a worse QOL compared to that of the nondependent patients with schizophrenia. Bearing in mind the innumerable harms of ND, the evaluation and management of ND must become an integral aspect of the evaluation and management of patients with schizophrenia.

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Context: The sleep is an important biological function, and the students are especially vulnerable to sleep-related problems which may have an impact on their health and well-being. Aims: The aim of this study was to assess the quality of sleep (QoS) and to study the relationship among QoS, physical health, psychological health, and quality of life (QoL) in undergraduate (UG) students. Settings and Design: In a cross-sectional study, 625 UG students filled out a semi-structured questionnaire. Subjects and Methods: The participants were administered the Pittsburgh Sleep Quality Index, WHO-5 Well-Being Index (WHO-5), and Rotterdam Symptom Checklist. Statistical Analysis Used: The data were compared using percentages and proportions. Results: A higher number of participants were with poor QoS in the categories of poor physical health (P = 0.003) and poor QoL (P = 0.001). The psychological distress in the group with poor QoS was found to be greater than the psychological distress in the group with good QoS (P = 0.001). Conclusions: In UG students, QoS was found to be positively associated with physical health, psychological health, and QoL. There is a need for longitudinal studies in this field to establish the causality.

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Objective: The objective was to study the reasons for referral, to study diagnostic categories of psychiatric referrals, and to study the associations if any between reasons for referral and diagnostic categories of psychiatric referrals. Materials and Methods: The present study was conducted at the Department of Psychiatry, Mamata General Hospital, Khammam. The present study consists of 112 psychiatric referrals; 12 referrals were excluded from the study as they are not willing to give consent, so the study was conducted on 100 psychiatric referrals. The study protocol was approved by the Institutional Ethics Committee. Results: In the present study, based on the sources of referrals, it was found that majority of the patients were from the Department of General Medicine (38%). In the present study, the most common reason stated for referral was suicidal/self-harm act by 29% of the sample. The most common psychiatric disorder diagnosed in the present study was found to be substance use disorder which is seen in 33% of the sample. On evaluation of diagnostic categories with reference to reasons for referral, it is found that most of the referrals with a history of excessive alcohol intake were diagnosed as substance use disorders (91.6%). Majority of referrals with a history of suicidal attempts were diagnosed as intentional self-harm (58.6%). Referrals with a history of altered sensorium were diagnosed with organic mental disorders (50%), substance use disorder (37.5%), and 12.5% had no psychopathology. Conclusion: Suicidal attempts are most commonly diagnosed to have intentional self-harm. Substance use disorder came to be high in referrals which are referred for excessive alcohol intake. Regarding referrals to psychiatry department, majority of the patients were from the Department of General Medicine. The most common reason stated for referral to psychiatry was suicidal/self-harm.

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Background: Each individual will have a unique way of perceiving, processing, and retrieving information provided, which could have an impact on one's performance. Medical education is undergoing reformation in terms of focusing on skill-based learning. Hence, understanding the pattern of brain dominance could influence the teaching and learning styles. Aims: The aim of this study is to assess brain dominance and its correlation with academic achievement among medical students. Settings and Design: A cross-sectional study was conducted in a recently opened medical college in South India. Materials and Methods: The study sample consists of two batches of medical students of 150 each, of which 245 students consented to participate in the study. Sociodemographic pro forma, alert scale of cognitive style and first-year MBBS final examination results were used. Statistical Analysis: Results were interpreted in the form of frequencies, Chi-square test, and Spearman's correlation test. Results: Of the study group, 60% were female students (n = 147) and 40% were male students (n = 98). Left brain, bilateral, and right brain dominance was seen in 37.55%, 33.06%, and 29.39% of the population, respectively. The r- value was correlated with brain dominance and academic achievement; however, it did not differ significantly at 0.05 level and was found to have a negligible relationship between the two. Conclusion: Female students were predominantly left side brain dominant. Brain dominance and academic achievement did not show any correlation. The importance is attributed to implementing the different teaching methods/styles, as it is believed to influence and promote better learning among medical students.

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Background: Cognition is defined as the mental processes of perception, memory, and information processing. Cigarette smoking could contribute to cognitive impairment through atherosclerotic and hemodynamic processes. Aims and Objectives: The aims and objectives were to study the cognitive dysfunctions in chronic smokers and to compare cognitive dysfunctions in chronic smokers with nonsmokers who are matched for age, sex, and socioeconomic status. Settings and Design: This is a cross-sectional study conducted using purposive sampling on participants recruited from the Outpatient Department of Psychiatry, Narayana Medical College and Hospital. Materials and Methods: The study was conducted on a sample of sixty patients. Out of this, thirty participants who are current smokers were taken as cases and the other thirty participants who are the attenders of the patients who never smoked cigarette were taken as controls. Informed consent was taken from the cases and controls. Brief Cognitive Rating Scales (BCRSs), digit symbol substitution test (DSST), and Trial-Making Test-A and B were used to assess the cognitive functions, and Fagerstrom Test for Nicotine Dependence (FTND) was used to confirm the diagnosis of nicotine dependence. Statistical Analysis Used: To test the association between the groups, Chi-square test was used. To test the mean difference between the groups, Student's t-test and ANOVA were used. To test the correlation between the scores, Spearman's rank correlation was used. Results: Smokers when compared to nonsmokers took longer time in the completion of both trail-making tests A and B and gave less correct responses on DSST. Significant impairment in all the five axes of BCRS was observed. Comparison was statistically significant between FTND score, the trail-making tests A and B, BCRS, except axis-ii. Conclusions: The higher the nicotine dependence, the greater is the chronicity of cigarette smoking, which has significant cognitive dysfunction.

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Introduction: The prevalence of metabolic syndrome is more in patients with schizophrenia receiving first- and second-generation antipsychotics. Aim and Objectives: The aim is to study the prevalence of metabolic syndrome in patients with schizophrenia treated with first-generation and second-generation antipsychotics and to compare the prevalence between two generations. Materials and Methods: The study sample was obtained from the patients attending the outpatient clinic or admitted to the inpatient unit of the department of psychiatry at tertiary care unit. Patients with schizophrenia, 50 each on treatment with first- and second-generation antipsychotics for a minimum of 4 months were measured for fasting blood glucose, blood triglycerides, high-density lipoprotein, blood pressure, and waist circumference. Adult treatment panel diagnostic guidelines were used to diagnose metabolic syndrome. Results: The prevalence of metabolic syndrome in first-generation group was (18%) and second-generation group was (40%). Comparison of the prevalence between the two groups showed Mann–Whitney value of −2.412*, which was statistically significant at P < 0.05. There was significant difference found in the chlorpromazine equivalent dosage of antipsychotics at P < 0.001. It signifies that though the second-generation group had received lesser amount of antipsychotic dose when compared to first-generation group, the prevalence of metabolic syndrome was more in the second-generation antipsychotic group. Conclusion: Metabolic syndrome is seen in both the group of patients taking antipsychotics. In line with previous studies, our study also found that the prevalence of metabolic syndrome is more in patients taking second-generation antipsychotics.

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Background: The objective of this review is to discuss the current advancements, and critical issues, in the area of studying disturbances of self in schizophrenia. The critical and systematic review of the self in schizophrenia is significant because it has been regarded as a prodrome and a predictor of the development of future psychosis. In addition, it has been found to be over and above clinical symptoms and is common in people with schizophrenia. Methodology: A systematic electronic literature search was done using PubMed, MEDLINE, and PMC (PubMed Central) databases were searched systematically, and relevant articles published in English peer-reviewed journals were selected. Results: The findings were discussed, and critical analysis of the studies revealed methodological and conceptual issues in the literature studying self in schizophrenia. Conclusion: The review has concluded with the discussion on future directions in terms of research and clinical applications.

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Play is children's innate mode of self-expression and a method through which they explore the world. It has important implication for overall (physical, psychological, and psychosocial) development of any children. Play therapy capitalizes on such therapeutic powers or changing mechanisms within play and considers its strategic use through trained professionals to promote specific therapeutic outcomes within therapeutic contexts. This review article aims to provide a brief description on the use of play as therapeutic agent for change, different processes expressed in play, therapeutic powers within the play, and major approaches to play therapy. An attempt has also been made to list out some of the research studies from the available literature to prove the efficacy of play therapy in different conditions. The article concludes with highlighting the current issues and challenges faced by play therapy practice as a therapeutic medium to be used with children and way forward has been suggested.

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Gender is the social, behavioral, and cultural attributes, expectations, and norms associated with being a woman or a man. The aim of gender equality is the empowerment of women, thus enabling them to manage their lives. Gender equality is a fundamental issue. The lives of people are heavily influenced by the societal stereotyping of gender. While there are differences in the biological makeup of men and women, the gender roles that are played are determined both socially and culturally. Despite major changes in the attitudes of people over the years, the issue of gender is still very much alive in society today. Gender inequalities impact women over their lifetime, their health, educational attainment, and economic conditions. Gender equality will be achieved only when women and men enjoy the same opportunities, rights, and obligations in all spheres of life. The paper is a study on the existing literature on gender and equality to understand the existing social and psychological paradigms that act as a barrier to equality among the different genders. The present study aims at understanding an overall picture of the psychosocial paradigms that infringe on gender equality. Journal articles and texts on gender inequality were identified and reviewed. psychological, sociological, and psychosocial perspectives of gender inequality are presented in the paper. Gender inequality in health, education, and work is present to date.

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