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2015| January-June | Volume 31 | Issue 1
Online since
August 3, 2015
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PRESIDENTIAL ADDRESS
Advocacy in mental health: Offering a voice to the voiceless
P Joseph Varghese
January-June 2015, 31(1):4-8
DOI
:10.4103/0971-9962.161987
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AWARD PAPER: DR. G. C. BORAL AWARD I
Study of mechanisms of coping, resilience and quality of life in medical undergraduates
Mansi Somaiya, Swapnil Kolpakwar, Abhijeet Faye, Ravindra Kamath
January-June 2015, 31(1):19-28
DOI
:10.4103/0971-9962.161995
Introduction:
The period of undergraduation in the medical field is challenging, and the medical student is exposed to various stressors.
Aims
and
Objectives:
This study was designed to identify the mechanisms of coping, resilience and quality of life (QoL) and their correlations in medical undergraduates, so as to find some factors which can help to make some positive changes in medical curriculum.
Methodology:
Totally, 250 medical students representing all academic years of medical college were provided with questionnaires investigating their sociodemographic profile, coping skills, resilience, and QoL. Using appropriate statistical tests, the parameters were studied along with a search for the factors affecting them. A comparison of all these factors was also done among the students of all the academic years of medical school.
Results
and
Discussion:
Problem-solving and fatalism was more in immigrant students than native students of Mumbai. Problem-oriented mechanisms of coping, resilience, and QoL were higher in students doing internship. However, students of 3
rd
year part 2 were less resilient, used emotion-focused ways of coping and had a lower QoL. There was a good shift of positive ways of handling stress with an increase in the academic year. Problem-oriented mechanisms of coping positively correlated with resilience and QoL. High resilience was also found as a positive factor for good QoL.
Conclusion
: Along with the clinical component, an equal emphasis should be given to improve the social and personal life of a medical student helping them to cultivate more problem-based coping and increasing their resilience so as to ultimately improve their QoL.
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ORATIONS: DR. N. N. DE ORATION
From rape to sexual assault: Legal provisions and mental health implications
RC Jiloha
January-June 2015, 31(1):9-18
DOI
:10.4103/0971-9962.161992
Sexual assault in various forms has been recognized as a crime by almost all religions and cultures throughout the recorded history. It is a crime against basic human rights of an individual and a most common crime against women in India. In India, "rape laws" began with the enactment of Indian Penal Code in 1860. There have been subsequent amendments, and the main issue of focus remained the definition of rape which has been recently broadened to include a wide range of sexual activities. The inclusion of "marital rape" in the ambit of rape remains a matter of debate. With a long history, the sexual offence in the form of sexual assault has been discussed from legal and mental health perspective in this presentation. Social and psychological impact of sexual assault on the victim has also been discussed.
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LETTER TO EDITOR
Hallucination: A symptom of dissociative disorder
Kamala Deka, Hemanta Dutta
January-June 2015, 31(1):76-77
DOI
:10.4103/0971-9962.162032
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AWARD PAPER: DR. G. C. BORAL AWARD II
Psychological well-being in primary survivors of Uttarakhand disaster in India
Srikant Sharma, Satyam Sharma, Manisha Chandra, Shaily Mina, Yatan Pal Singh Balhara, Rohit Verma
January-June 2015, 31(1):29-36
DOI
:10.4103/0971-9962.161998
Introduction:
After the 2004 Tsunami, India faced the worst natural disaster in Uttarakhand causing devastating floods and landslides. Besides the material harm, the disaster also has a massive impact on individual's mental health, and the impact is perceived more in developing countries due to being densely populated with limited resources. The current study is an attempt to evaluate the psychological impact and its risk factors in Uttarakhand disaster.
Methods:
This cross-sectional study was conducted after 1 month of disaster in the primary survivors. All the included subjects were administered the semi-structured proforma for assessing the sociodemographic profile and the assessment instruments: Impact of events scale-revised (IES-R), depression anxiety stress scale and life orientation test-revised (LOT-R). Data were imputed and analyzed using Statistical Package for Social Sciences version 17.0.1 (SPSS Inc., Chicago, IL, USA). Results: About 58% subjects had posttraumatic stress disorder and significantly severe levels of depression, anxiety, and stress were noted in 45.3%, 57%, and 44.2% subjects, respectively. A physical illness was present in 36% subjects. Loss of at least one family member was reported by 12.8% subjects. LOT-R scores were negatively correlated to IES-R. Conclusion: Psychological morbidity in the immediate post-disaster period is high. Higher levels of depression, anxiety and stress with development of negative outlook regarding their future is observed with increasing age. Increasing age, lower educational levels, physical illness, loss of a family member, and pessimistic expectations were associated with adverse psychological sequelae.
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ORIGINAL ARTICLES
Associations between sociodemographic characteristics, pre migratory and migratory factors and psychological distress just after migration and after resettlement: The Indian migration study
Sutapa Agrawal, Fiona C Taylor, Kath Moser, Gitanjali Narayanan, Sanjay Kinra, Dorairaj Prabhakaran, Kolli Srinath Reddy, George Davey Smith, Shah Ebrahim
January-June 2015, 31(1):55-66
DOI
:10.4103/0971-9962.162028
Background
/
Objectives:
Migration is suspected to increase the risk for psychological distress for those who enter a new cultural environment. We investigated the association between sociodemographic characteristics, premigratory and migratory factors and psychological distress in rural-to-urban migrants just after migration and after resettlement.
Methods:
Data from the cross-sectional sib-pair designed Indian Migration Study (IMS, 2005-2007) were used. The analysis focused on 2112 participants aged ≥18 years from the total IMS sample (
n
= 7067) who reported being migrant. Psychological distress was assessed based on the responses of the 7-questions in a five-point scale, where the respondents were asked to report about their feelings now and also asked to recall these feelings when they first migrated. The associations were analyzed using multiple logistic regression models.
Results:
High prevalence of psychological distress was found just after migration (7.3%; 95% confidence interval [CI]: 6.2-8.4) than after settlement (4.7%; 95% CI: 3.8-5.6). Push factors as a reason behind migration and not being able to adjust in the new environment were the main correlates of psychological distress among both the male and female migrants, just after migration.
Conclusions:
Rural-urban migration is a major phenomenon in India and given the impact of premigratory and migratory related stressors on mental health, early intervention could prevent the development of psychological distress among the migrants.
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AWARD PAPER: DR. B. B. SETHI AWARD II
Internet addiction: Do two diagnostic criteria measure the same thing?
Vijay Parkash, Debasish Basu, Sandeep Grover
January-June 2015, 31(1):47-54
DOI
:10.4103/0971-9962.162003
Aim
and
Objective:
To assess the agreement or concordance between two diagnostic criteria for Internet addiction (IA) and to study the relationship between IA as per these criteria and socio-demographic and Internet use profile.
Methodology:
A cross-sectional design was followed. Six hundred participants, aged 18-40 years, having a personal Internet connection and using Internet for at least 1 year were evaluated using a semi-structured interview, on the Young's Diagnostic Questionnaire, and IA diagnostic criteria developed by Tao
et
al
., (2009).
Results:
Prevalence of IA varied from 1.2% to 21% depending on the assessment instrument. There is good level of concordance between Young's IA criteria and Tao
et
al
. "2 + 1" criteria, but the level of concordance reduced with the use of course and dysfunction criteria of Tao
et
al
. Among the different Internet variables, age at first use, age at which the person starts regular use and total duration of nonessential use were related to development of IA.
Conclusion:
Findings of the present study suggest that there is good level of concordance between Young's IA criteria and Tao
et
al
. "2 + 1" criteria but the level of concordance reduces with the use of course and dysfunction criteria. This study also suggests that chances of IA increases with regular use of Internet and for a longer duration for nonessential uses.
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AWARD PAPER: DR. B. B. SETHI AWARD I
Structuring and self-competence: How they can make a difference in assessing and managing risk
Virtu Chongtham, Nitin Gupta, BS Chavan
January-June 2015, 31(1):37-46
DOI
:10.4103/0971-9962.161999
Background:
Assessing risk is a mandatory part of standard mental health practice in the West, but is fraught with difficulties. Structuring and self-efficacy are important factors, but there is near absence of work on this aspect from India. This study aimed to determine how these two concepts can make a difference in assessing and managing risk.
Methods:
A prospective cross-sectional study over 2 months was conducted with 35 participants (dealing with patients with mental illnesses) from Department of Psychiatry, Government Medical College and Hospital-32, Chandigarh and 30 participants in comparison group (dealing with people with intellectual disabilities) from Regional Institute of Mentally Handicapped-31, Chandigarh using Risk Assessment and Management Self-efficacy Scale (RAMSES).
Results
: In overall sample (
n
= 65), only 17% reported using a screening instrument while 62% reported use of screening questions thereby making the total prevalence of use of screening instruments and/or questions as 79%. Total RAMSES score and mean score for all three domains was 7.14 and between 7 and 8 respectively for the study group; while for the comparison group, the total RAMSES score was 7.92 and the mean score for all three domains was between 7 and 9 respectively indicating above average level of reported self-efficacy. For the individual RAMSES items, a lower competency (<7 for study group) and (<8 for comparison group) was reported for formal or written process related to synthesis of risk assessment and risk management. The study group showed lower self-efficacy scores on majority of individual RAMSES items, 2/3 domains and overall score.
Conclusions:
Indian mental health professionals of different backgrounds with varying duration of experience reported reasonable degree of competence regarding risk assessment (primarily for the risk toward self and others). Hence, we recommend that they embrace the western concept of "risk assessment" by incorporating structuring as a concept and ensuring more robust and appropriate documentation.
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ORIGINAL ARTICLES
An exploratory study assessing reasons behind initiation, continuation or stoppage of alcohol after first use
BS Chavan, Subhash Das, Tanuja Kaushal, Sumant Arora, Nitin Gupta
January-June 2015, 31(1):71-75
DOI
:10.4103/0971-9962.162030
Objective:
Few studies have investigated the reasons for alcohol initiation and continuation. The present study examined reasons for trying alcohol for the first time and its subsequent use. Furthermore, the study attempted to discover the possible predictors that make an individual vulnerable to alcohol use.
Methodology:
A total of 280 first-year college students from six different colleges were contacted. Using the method of equal probability, every third subject from each class was selected. All the selected subjects were interviewed and administered semi-structured questionnaire for gathering information regarding their experience with alcohol.
Results:
In our study, experimentation and peer pressure were found to be the main reasons for both alcohol use and its re-use. The first time drinkers differed a lot from those with multiple users in terms of reasons for trying alcohol, the effect of alcohol, family history of alcohol use, and self-view about alcohol use. The results depicted that the gender, educational stream, and family history of alcohol use are the factors that make an individual vulnerable to alcohol use.
Conclusion:
First-year of college is a unique transitional period. First-year students with high levels of sensation seeking may be especially at high-risk to begin or escalate heavy drinking. Studying the nature of alcohol initiation may not only be helpful in planning awareness programs but also in preventing underage drinking and alcohol abuse.
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BOOK REVIEW
Book review: The sense of an ending
Sayantanava Mitra, S Haque Nizamie, Anjana R Kavoor
January-June 2015, 31(1):78-79
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ORIGINAL ARTICLES
Psychopathology in a migrant population visiting a psychiatric outpatient clinic in Punjab, India
Navkiran S Mahajan, Jaspreet Kaur, Ranjive Mahajan
January-June 2015, 31(1):67-70
DOI
:10.4103/0971-9962.162029
Background:
Migration is a risk factor for psychosis in international migrants.
Objectives:
We compared the psychiatric morbidity in first and second generation interstate migrants in India.
Methods:
Psychiatric morbidity was assessed in 18-64-year-old first and second generation migrants of both the gender using Mini International Neuropsychiatry Interview. Total 70 subjects were included in the study. Males and females of both the generation compared.
Results:
Mood disorders are found to be most common disorder in second generation migrants. Where females of second generation migrants have a major depressive episode with melancholic features, as compared to males who have manic episode significantly higher in second generation migrants.
Conclusion:
Migration is a risk factor for mood disorders especially in second generation migrants. As adversity of migration, discrimination, and acculturation faced from birth and early life leads to higher rates of psychiatry morbidity in second generation migrants.
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EDITORIAL
The times they are a-changin'…
Debasish Basu
January-June 2015, 31(1):1-3
DOI
:10.4103/0971-9962.161986
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th
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