Jean Piaget was a developmental psychologist. He is famous for his epistemological studies with children, and is one of the proponents of the concept of “genetic epistemology”. He did a systematic study of cognitive development, and is well known for observational studies of children.

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Children born with ambiguous genitalia have to endure serious and potentially lifelong consequences secondary to wrong assignment of their gender. A 26 year old female presented to psychiatry department with symptoms suggestive of severe depression. On detailed history, and physical examination the patient was found to have grade three hypospadiasis. She was brought up as a female, but had ‘male’ patterns of secondary sexual characteristics. This paper discusses about the systematic team management of the above individual.

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Incorrect attribution of somebody else's work or idea as one's own without adequate citation of the original source is called plagiarism. This is considered a serious ethical problem. Most authors do not know that this is unacceptable. Most of them, who know, are not aware what exactly constitutes plagiarism. This editorial is written with an intention to increase awareness regarding this important issue. I discussed the concept and various types of plagiarism, focussing only on biomedical research. Some suggestions on how to be at guard against plagiarism have been discussed.

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Background: There are a number of reasons for the discrepancy that exists when people are assessed using standard cognitive assessment tools for cognitive impairment and their actual presentation. Case description: The authors describe the case of Mrs P who is a 72 years old lady of Polish descent but has lived in the United Kingdom (UK) for most part of her life. Mrs. P was removed from her job where she used to work as a cashier as she would miscalculate the money. She scored 3/30 on Mini Mental State Examination (MMSE), which was remarkably low probably due to language and cultural issues. According to the family she did not face any challenges and problems due to her language, as she was able to speak good English though she would revert to Polish language in between. Discussion: British Minority Ethnic groups respond poorly on MMSE due to language issues. There is a need for culturally appropriate assessment tools to assess people with dementia who belong to different ethnic background. There is a need for training professionals in understanding the language and cultural issues of BME groups. Conclusion: Cultural sensitivities of dementia patients need to be understood and respected.

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Background: Majority of the antipsychotics including some of the atypical antipsychotics are associated with adverse effects related to blockade of dopamine (D2) receptors. Of them, galactorrhoea can be a very distressing and embarrassing symptom. A constant search is therefore on for antipsychotics with lesser adverse effects. Case description: A thirty year old married lady suffering from Unspecified Nonorganic Psychosis of three years duration had developed troublesome galactorrhoea while on treatment with trifluperazine. It was changed over to risperidone in an effort to reverse galactorrhoea but without benefit. She was then switched over to aripiprazole while tapering off the previous medication. Her mental condition improved while her galactorrhoea too stopped within three weeks. Discussion: Unlike other antipsychotic drugs, aripiprazole as a partial D2 agonist, may not result in the severe hypodopaminergic state in the tubero-infundibular pathways and thus does not increase prolactin levels. This mode of action is unique to aripiprazole and explains how it can ameliorate the galactorrhoea induced by other antipsychotic drugs. Conclusion: Aripiprazole is an effective and a safer atypical antipsychotic more so for its low propensity for galactorrhoea. It may also reverse the galactorrhoea induced by other antipsychotics such as risperidone.

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Background: Disability associated with mental illness is a major contributor to the global burden of diseases, accounting for 25% of total disability and 16% of total burden as reported by World Health Organisation (WHO). Aim: To assess and compare the level of disability in various psychiatric disorders. Methods: A semi structured interview consisting of socio demographic details, and the Indian Disability Evaluation and Assessment Scale (IDEAS) were used to assess the level of disability among patients attending the psychiatric out- patient department. Results: Majority of the sample had mild and moderate disability. Conclusion: Appropriate intervention programmes of management and rehabilitation can improve the outcome.

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Sexual dysfunction due to use of selective serotonin reuptake (SSRI) are reported since the time they have been introduced in the 1980's. Studies have shown the prevalence to be in the range of 30-70%. They effect all phases of sexual functioning and have been found to persist long after the drug has been withdrawn. Persisting sexual dysfunction leads to non compliance with treatment and has a negative impact on the quality of life. Various methods have been documented on how to reduce this effect. Commonly used methods are switching the antidepressants or adding another drug to counter this side effect.

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The word paranoia and its usage have transgressed beyond the boundary of psychiatry. It has assumed the form of a social cognition. Psychiatric researchers have looked into it either in the form of an attenuated psychopathology or a distinctive cognitive style in individual's socio-cultural-political-economic background. Studies have been conducted to measure paranoia in non-clinical population by different scales. Psychoanalytic theories have been put forward regarding paranoia emerging from childhood developmental process. Social theorists have suggested that paranoids might have real enemies. Aaron Beck in his cognitive-evolutionary model speculated that paranoia conferred some adaptive advantage towards mankind's evolution. At the end, nobody considered paranoia as healthy and cognitive behaviour therapists provided some remedial measures.

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Antiepileptic drugs (AEDs) are increasingly being used for psychiatric indications. Few of them have FDA approval, while many others are used off-label. The objective of this article is to give an overview of the use of newer AEDs in the treatment of psychiatric disorders.

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Relaxation therapy is the buzz word in mental health parlance. Several therapies have been developed by the related professionals. Most of these therapies focus on the importance of relaxing the muscles with the expectation that the relaxed muscles would calm the mind through bio-feedback mechanism. Muscle relaxation certainly makes sense and is beneficial to many; but this type of therapy does not address the psychological components of anxiety, and therefore may be considered incomplete and deficient. That which could make it complete is available in the first half of Patanjali Yoga Sutras, as the Bahiranga Saadhana. The word Bahiranga in Sanskrit means external, open or public; saadhana means habituate/practice. Here it relates to the external aids to the practice of yoga. The steps advocated by Yogi Patanjali as the Bahiranga Saadhana, in his Ashtaanga yoga sutras, lead to total muscle as well as mind relaxation. Relaxation therapists and their patients would benefit if the basics of this science is borrowed and incorporated in their therapies. The relaxation therapists often instruct their patients to ‘let go’ in an attempt at achieving relaxation of the muscle and the mind; but they do not specify what to let go. This article attempts at clearing such a dilemma; it deals with the importance of putting in practice the yoga sutras, step by step, as a prerequisite to successful and sustained relaxation of the body and the mind.

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The burden of psychiatric illness in the country is very high. The progress of a country is linked closely with the mental health of its individuals. Mental health and poverty form a vicious circle and there cannot be development without good mental health. Promoting mental health is thus very critical and this cannot happen without quality psychiatric training in the country. There are very few studies addressing the quality of psychiatric training in the country. Though there is a recent increase in the number of medical colleges offering psychiatric training with the mushrooming of the private institutions, the quality and standards of psychiatric education is not uniform in all of them. There is an urgent need for reforming postgraduate and undergraduate training in the country. There are definite pitfalls but there is a scope for improvement also.

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Background: Metabolic syndrome is a constellation of risk factors that enhance the risk for coronary artery disease, cardiovascular accident, and diabetes mellitus. Persons with severe mental illness have a higher risk for metabolic syndrome, particularly when they are treated with certain antipsychotics. Objective: We appraise the metabolic syndrome in persons with mental illness and suggest lines for future research. Conclusions: Metabolic disturbances are common in patients with a psychotic illness, especially when maintained on antipsychotic medications, yet regular monitoring and management of these adverse effects remain below acceptable levels. There are many gaps in our understanding of the causes and predictors of the syndrome in psychiatric patients, yet we argue that there are sufficient reasons why mental health clinicians should monitor metabolic problems in their patients and facilitate appropriate therapeutic interventions. We outline strategies that could usefully be adopted by services to this end.

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