Background/Objectives: There are few, if any, support groups in Nigeria serving the needs of carers of mentally ill persons. The purpose of this study was to assess the need for a support group among carers of outpatients at a neuropsychiatric hospital in southern Nigeria. Materials and Methods: This study was a cross-sectional one involving 120 respondents who had been primary carers for at least 6 months. Carers completed a sociodemographic questionnaire and a 25-item carer survey questionnaire. Results: Responses from 106 participants were analyzed. The majority of carers were female (n = 60, 56%) and 60.3% were aged 31–60 years. Ninety-four (88.6%) participants reported some degree of stress in caring for the care recipient. Eighty-five participants (80.2%) reported a need for a support service, whereas 84 (79.2%) were interested in joining a group that would enhance their caring role. A carer being female and a subjective need for some form of support were significantly associated with interest in joining a carer group (P < 0.05). Conclusion: The survey found a need for the formation of a support group for carers of mentally ill persons. The female gender was identified as a significant factor to be emphasized in the operation of such a group, and information sharing was a key content.

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Suicide survivor is a family member(s) or friend(s) who experiences the death of a loved one by suicide. Some existing literature shows the possible complications in them while some suggest on the management plans to address the reactions experienced by them. However, it is important to note here that added to the loss and grief, in suicide, there is an associated stigma that may dispose the person to fear, anger, self-blame, guilt, confusion, abandonment and may keep them away from the treatment procedures and reduce the process of ventilation and thwart the restoration of functioning. There may also be risk of suicide in the suicide survivors. The quantitative and qualitative difference in the experience of the emotional and cognitive experiences among suicide survivors require a specific plan for the intervention and more substantial research into this field.

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Introduction: Transgender persons are rejected from their families and communities; they are exploited, ridiculed, and discriminated at every aspect of the societal life due to their gender variant behavior and roles. They are at high risk for mental health problems and psychological distress. Materials and Methods: Sixty transgender persons recruited for the study through consecutive sampling method. Connor–Davidson Resilience Scale was administered. Results: Respondents have scored low (59.30 ± 15.02912) in the resilience scale, and this score is lower than any other population scored on this scale across the world. This suggests poor resilience status of the respondents. Residing at family of origin or in mainstream, having higher education status and being employed, are the factors associated with better resilience among transgender persons. Conclusion: The resilience among transgender persons need to be researched and explored further and need to be strengthened by identifying and enhancing the factors associated with better resilience level. Further, family acceptance, societal acceptance, mainstreaming to the education and employment sectors, and provision of health care and social services would bring changes in their lives.

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Background: Low rates of professional help seeking for depression by youth is a well known global challenge. The study aimed at examining whether there might be differences in the rates of recognition of a hypothetical problem as a mental health problem when depressive symptoms are depicted as occurring in the context of a negative life event as compared to when these symptoms are depicted as occurring without any negative life event. The relationship between recognition as a mental health problem and help-seeking inclination from mental health professionals was also examined. Methods: Three hundred college youths within 18–25 years of age range formed the sample. Two vignettes describing moderate depression were used for all the participants. These two vignettes had identical content except that one of these mentioned a negative life event preceding the onset of depression. Each of these vignettes was followed by items to elicit recognition of the problem and inclination to seek help from mental health professionals if one was experiencing a similar problem. Results: Depressive symptoms arising in the context of a negative life event were less likely to be labeled as mental health problem and also less likely to be identified as depression. Accurate recognition of the problem as a mental health problem went hand in hand with significantly higher inclination to seek help from mental health professionals, but this was evident only in the vignette describing depressive symptoms without negative life event. Conclusion: The findings have implications for further research and for designing programs to improve help seeking for depression in Indian youth.

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Background: The pattern and prevalence of substance use change from region to region and differ from country to country. Most of the people who abuse the drugs do not know the ill effects of their habit. Objective: This study aimed to assess the profile and health risk involved in each subject who used substances. Materials and Methods: The study was conducted in the outpatient departments of Medicine and Pulmonary Medicine of a tertiary care hospital using cross-sectional descriptive design. A screening questionnaire, “Alcohol, Smoking, and Substance Involvement Screening Test” (ASSIST) was administered to assess the type of substances that had been used and the level of health risk associated with them based on the ASSIST score. Statistical Analysis: Sociodemographic variables and the level of risk were presented as frequency and percentage. Chi-square test and Fisher's exact test were used to assess the relationship between categorical variables and ASSIST scores. Results: Most of the participants participated in the present study came under moderate health-risk category. Majority of the participants 114 (53.53%) had a family history of substance use. There was a strong association for gender with alcohol and tobacco use. Conclusion: The most widely abused substances in the present setup were alcohol and tobacco.

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Context: A distinctive recruitment strategy named “Sumangali scheme” operates in the textile industries of Tamil Nadu, where adolescent girls are lured to work for a specified period of time in return for a bulk amount of money at the end of the tenure, which can be used for their marriage expenses. Aims: We aimed to assess the causes and consequences of such employment on the lives of adolescent girls. Settings and Design: The study was conducted at Sirkazhi, Sembanarkoil, and Kollidam blocks of Nagapattinam district, Tamil Nadu. Qualitative study methodology was chosen for the study. Subjects and Methods: A total of nine focus group discussions (FGD) among adolescent girls and three FGD among their parents were conducted. Six in-depth interviews were conducted among key stakeholders. Statistical Analysis Used: The content of discussions and interviews was transcribed and qualitative content analysis was used to analyze the transcripts. Data analysis was a continuous process with generation of categories and subcategories and revision and re-examination by the authors. Results: The qualitative study among adolescent girls, their parents, and key stakeholders revealed that poverty, lack of livelihood opportunities in the study area, violence and alcoholism in family, and disinterest in studies are factors responsible for employment in textile industries during adolescence. Consequences of employment in textile industries include musculoskeletal pain, frequent sickness, abuse at workplace, and complexity in marriage due to social taboos. Conclusions: Employment during the age of adolescence for women causes negative impacts on their lives which are to be addressed at workplace and the community through awareness creation and education.

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Context: Substance use disorder coexisting with other psychiatric disorders poses complex diagnostic and therapeutic challenges. Comorbidity is often associated with high rates of continued substance use, greater psychosocial impairment, and increased utilization of services. The intervention for coexisting psychiatric morbidity may improve outcome for the drug dependent. Aims: The aim is to study psychiatric comorbidities and the relation of psychiatric comorbidities with sociodemographic factors and pattern of opioid use in opioid-dependent patients. Settings and Design: This study was conducted in the department of psychiatry in a tertiary hospital. It was a hospital-based cross-sectional study. Subjects and Methods: Eighty consecutive patients with a diagnosis of opioid dependence syndrome made as per the International Statistical Classification-10 diagnostic guidelines were included. All patients were administered with a semi-structured questionnaire to collect sociodemographic profile and pattern of opioid use. MINI PLUS English version 5.0.0 scale was administered to find out psychiatric comorbidities among them. Statistical Analysis Used: Data collected were analyzed using descriptive statistics and Chi-square test using SPSS version 21. Results: In the study population, psychiatric comorbidities were found to be 77.5%. Depression and suicidality were found to be present in majority of the study population followed by generalized anxiety disorder and panic disorder. Conclusions: Our findings have implications for treatment intervention and better management. Proper treatment of comorbidities can probably help to decrease the severity, duration, and complications of drug dependence. Hence, there is a need for screening all opioid dependents for psychiatric disorders who come for detoxification.

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Background: Common mental disorders (CMDs) are the most frequently encountered mental health problems. A relevant cultural formulation requires consideration of how such patients understand their illness and the kind of help they prefer. We aimed to clarify patient's priority symptoms, perceived causes (PCs), and help-seeking (HS) behavior for CMDs in a psychiatry outpatient clinic in West Bengal, India. Methods: We conducted a cross-sectional survey of consecutive patients with clinically confirmed depression, anxiety, or somatoform disorders in a psychiatry outpatient department in a hospital in North 24 Parganas district. An explanatory model interview based on the Explanatory Model Interview Catalogue was used to assess qualitative and quantitative data regarding sociodemographic characteristics, pattern of distresses, PCs, and HS experience. Results: Among 124 patients, 69% were women, mean age 34.5 years. Half of the patients had monthly income less than USD 32, and 22% were illiterate. Clinically, 42% had depression, 32% somatoform disorder, 10% anxiety, and 17% mixed disorders. Most common symptoms were headache (93%), disturbed sleep (93%) and anxiety or tension (92%). Most common PCs were psychological (96%), family problems (64%), and physical injury (42%). The preferred first providers were private allopathic doctors (50%), traditional healers (28%), and public sector doctors (22%). Conclusions: Clinicians need to recognize both physical and psychological presentations of CMDs. Brief clinical assessment only for pharmacotherapy may be inadequate to address the underlying psychological impact of social and financial causes, which require clinical attention to issues associated with poverty, family, and community.

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Background: Television viewership is being seen as a modality of mood elevator but do leads to excessive watching of available programs. It leads to neglect of other day-to-day demands of life. The present study explored the television addiction as well as its relationship with psychosocial variables. Materials and Methods: Two thousand seven hundred and fifty-five participants (1392 males and 1363 females) in the age group of 18–65 years were approached for the administration of schedule in the house-to-house survey for screening television viewership from urban localities. Results: The study document the presence of television addiction among 79/2755 (2.9%; 3.3% males, 2.4% females). The significant difference was seen in relation to marital status, higher among the unmarried, widowed and divorced group. TV addiction had a significant negative relationship with age and years of marriage, whereas the positive relationship with a number of members in the house. Conclusions: It has implication for evolving intervention program for enhancing the media literacy of the users.

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Background/Objectives: A pilot study was conducted with an aim to evaluate the effectiveness of video-assisted teaching program (VATP) on knowledge and attitude regarding screening of mental illnesses among leaders of women self-help groups in selected blocks of Tiruchirappalli District. Methods: A true experimental design (pretest posttest control group) was chosen with the scope of improving the internal validity of the study. Multistage random sampling was used to select a sample of 30 participants, 15 each in experimental and control groups. VATP regarding screening of mental illnesses was developed by the investigator and validated by the experts. Sociodemographic profile, a checklist to assess the participants' experience with mentally ill patients, a structured knowledge questionnaire, a set of case vignettes, and community attitudes toward Mentally Ill-III (CAMI-III) was used for data collection. Pretest was conducted to measure the baseline variables, then VATP on screening of mental illnesses was delivered, and the posttest was administered at three points, that is, immediately after VATP to assess the extent to which the participants have learnt the information, 15 days after VATP to assess the level of retention of the learnt information and 45 days after VATP to measure the outcomes of the study. Results: A comparison of posttest mean score differences between the groups revealed that the participants of the experimental group made a statistically significant difference (P < 0.001) in the knowledge and attitude than those of control group. Comparison of pretest and posttest mean scores within the experimental group showed that the VATP has made a statistically significant difference (P < 0.001) in knowledge and attitude. Conclusions: Innovative and realistic teaching strategies to be initiated to improve mental health literacy among the general population.

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Objective: The objective of this study was to determine the prevalence of depression, anxiety, and stress among medical students. Materials and Methods: Students underwent face-to-face interview using predesigned, pretested, anonymous interview schedule using standardized survey instrument and Depression Anxiety Stress Scale 21 item. Information was also collected on sociodemographic, academic profile, and personal characteristics of students. All the students enrolled in the medical college from first to final year were invited to participate, and the study was conducted during mid-semester to ensure that there was no university examination or college festival/event. Results: A total of 187 students participated in the study giving a response rate of 94%. The participants were predominantly male (66%) and majority (65.8%) residing in hostel. It was noted that 7.5% reported parental conflict; 15.0% were “always” fearful about future life; 21.9% had poor relationship with family members; 22.5% were not satisfied with their body image; and 18.7% were globally dissatisfied. It was observed that 60 (32.0%), 75 (40.1%), and 82 (43.8%) students were affected by symptoms suggestive of depression, anxiety, and stress, respectively. On bivariate analysis, higher proportion of students with anxiety had a history of some medical condition (P < 0.05). Similarly, family history of chronic noncommunicable disorder was significantly (P < 0.05) associated with stress only while students with family history of mental illness had a higher proportion of depression (P < 0.05) only. It was also found that dissatisfaction with body image and global dissatisfaction with life was statistically (P < 0.05) associated with depression and anxiety while fair (poor) relationship with family members was statistically (P < 0.05) associated with depression only. Subjective (self) assessment of ability to cope with medical syllabus was inversely associated (P < 0.01) with ability, i.e., as the student's ability to cope with syllabus increases by one unit, the probability of occurrence of depression and anxiety decreases by 1.29 units and 0.71 units, respectively. Conclusion: It is noted that emotional distress is common among medical students, and there is an urgent need for attention, support, and personalized counseling.

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Introduction: Higher studies in general and postgraduate medical studies in particular carry a lot of stress. Some of it must be accepted, but a lot of it is modifiable by pertinent personal, institutional and policy changes. Hence, as a basic prerequisite, we have tried to assess the level of depression, anxiety, and stress suffered by the resident doctors of a teaching hospital in urban Gujarat. We also tried to find the various correlates. Aims and Objectives: (1) To find the prevalence of depression, anxiety, and stress in resident doctors of a tertiary care teaching hospital. (2) To study demographic characteristics among residents and its correlates with depression, anxiety, and stress. (3) To study the correlation of postgraduate training-related factors and personal factors with depression, anxiety, and stress. Materials and Methods: After taking informed consent and explaining the procedure, self-report forms were distributed to all 520 resident doctors of our institute. It constituted of a sociodemographic datasheet and Depression, Anxiety, and Stress Scale (DASS)-42, having 14 questions each of depression, anxiety, and stress. The data from the returned completely filled 462 forms were entered in Microsoft Excel version 2007 and analyzed using Epi Info and Chi-square test. Results: Higher than average prevalence of depression (27.71%), anxiety (36.58%), and stress (24.24%) was found among the resident doctors. Furthermore, variables such as being junior, long duty hours, no job satisfaction, residents of clinical branches, not having any hobbies, and staying at hostel were significantly associated with higher scores on DASS. Conclusion: Postgraduate medical studies engender a lot of stress which can result in personal tragedies, poorer patient care, and overall loss to the society. If doable strategic changes are brought about, the scenario can be improved.

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Background: Although clinical and demographic patterns in presentation of autism in the developed world have been extensively studied, comparable data from developing countries remain scarce. While a few attempts have been made previously to describe autistic children in some areas in Sri Lanka (SL), there are gaps in the understanding of autism in the local setting. Methods: Data on all patients diagnosed with autism in two child mental health clinics at a tertiary care center in central SL were abstracted retrospectively from clinic records over a period of 30 years since the inception of the clinics. Diagnosis of autism in these clinics has been based on criteria in the International Classification of Diseases-10^th version. Results: Autism had been diagnosed in 77 patients. Of them, 58.4% were male. The mean age at first presentation was 6.7 years. While the number of autistic patients presenting to the clinic has increased over time, the age of presentation has remained largely unchanged. Delayed speech (23.4%) and poor social interactions (23.4%) were the two common primary concerns of parents leading to referral. Among medical comorbidities, epilepsy was the commonest (19.5%). The majority of patients (85.7%) had needed help with activities of daily living. In 62.3% of patients, no therapeutic interventions were documented. Conclusions: There are a substantial dearth and delay in presentation of autism in SL. Multiple deficiencies noted in the management of these patients indicate the need to improve awareness as well as resources and services dispensed for autism in SL.

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Background of the Study: Free legal aid clinics (LACs) are functioning in few hospitals in India under the provision of Legal Services Authorities Act, 1987. Currently, no literatures are available on the service user's (SUs) perspectives on services at free LACs. Methodology: The current study aimed to understand the perspective of SUs of free LAC working at National Institute of Mental Health and Neuro Sciences, Bangalore, India. Forty SUs were randomly selected, their records were examined, and they were contacted over the phone to understand their perspectives on availed services from LAC. Results: Authors could contact and completed telephonic interviews with 32 SUs. Majority (53.1%) were diagnosed with psychiatric disorders and intellectual disability. They approached LAC for various legal issues related to property, labor laws, mental health act, family/marital issues, and others. Legal advices and referrals to appropriate centers were the few among the various services offered. Telephonic calls to understand perspectives of SUs showed; legal problems solved (15.6%), in the process (37.5%), not solved (15.6%), and yet to start the legal process (31.3%). Majority (87.5%) reported LAC service is useful, 65.6% were able to follow the instructions, 56.3% reported that they do not require any additional help, and 96.9% reported that they will recommend LAC service to others. An average score of 7.72 (±1.67) on visual analog scale was rated by the SUs which indicated high satisfaction. Conclusion: Free legal aid services are essential in hospitals, especially in psychiatric hospitals, to protect legal rights, and to address legal issues of the poorer sections in the society.

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Disorders of the skin affect the psyche of a person significantly. The interplay between internal and external world can be depicted through the various skin reactions in regard to psychological or physiological stimuli. Psychocutaneous illness could be exclusively psychological or stress related or due to strong psychogenic factors. As per biopsychosocial model, it could be primary, multifactorial, or secondary to disfigurement. Whichever is the condition, invariably stress is a major contributing factor in prognosis and onset of disorders of the skin. Self-explanation, myth, stigma, and diminished self-confidence often lead to depression and suicidality followed by active avoidance of the workplace, in turn, causing significant disability in the individual. The conflict between self-image and perceived image frequently causes fear of rejection leading to social anxiety, reduced self-confidence, interpersonal communication, and impaired sexual intimacy with a partner. Maladaptive sets of coping strategies such as alexithymia, shame proneness, avoidance, concealment, and escape are very common among the sufferers which impair the attachment with family and friends. Children are the extreme sufferers as they develop inferiority, low self-esteem, loss of body image, and social withdrawal leading to rejection from parents and faulty development of attachment pattern. Hence, disorders of the skin can lead to impaired coping, impaired compliance, limitations in quality of life, negative body image, and stigmatization which invariably cause psychological comorbidities such as depression, anxiety, phobia, and somatoform and adjustment disorders. Hence, there is a direct relationship between skin, mind, and society which we are going to explore in a detailed fashion to understand its impact on the psyche and the society.

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