Mental Health Problems among Medical Students during COVID-19 Lockdown: A Cross- Sectional Study

Background: COVID-19, which originated in China, became a pandemic affecting more than 180 countries. By April 2020, India had announced lockdown in an attempt to control the spread of the virus. Lack of social interaction and apprehension about the studies had created emotional disturbances among medical students. Methods: The study was done in a medical college situated in Central Travancore, Kerala, between 2020 April 20 to May 31. Depression Anxiety Stress Scale (DASS) and Impact Event Scale-Revised (IES-R) were administered in Google forms to the MBBS batch WhatsApp groups. Results: Out of 320 responses from medical students, 239 were females, and 82 were male students. 56% of male students and 54% of female students have mild to severe depressive symptoms, 58% of male students and 54% of female students have symptoms of anxiety, and 63% of male students and 50% of female students experienced mild to severe stress.68% of males and 62% of females have higher Impact events scale. Conclusion: There is a high prevalence of anxiety and depression among medical students during the COVID lockdown period. There is a significant difference between genders in scores of anxiety, stress and impact of events. This shows the need for resilience training among medical students

A study of intent of suicide in people with major depression

Background: Depression is most important underlying diagnosis among the cases of suicide. There is dearth of information regarding suicidal intent among people of depression and its relationship with hopelessness among Indians. Aims & Objective: To describe the intent of suicide in people with depression among the north Indian population. Material & Methods: This was a cross-sectional study at department of psychiatry, King George's Medical University, Lucknow. Subjects between age group of 18-60 years with major depressive disorder as per DSM-IV TR criteria were screened and included in the study. Each subject was assessed using Hamilton Depression Rating Scale (HRS), Beck’s Hopelessness Scale (BHS) and Suicide Intent Questionnaire (SIQ). Results: Suicidal intent was observed among 68.1% (n=49) of sample (n=72). There was no significant (p>0.05) association of suicidal intent with socio-demographic factors except domicile status. Suicidal intent was common among people with moderate to severe depression and those with hopelessness. The hopelessness was present among 70.8% of subjects. Conclusion: Suicidal intent is common among people with major depression. The authors emphasize the need of exploration of suicidal intent in people with depression

A Call for a Rational Polypharmacy Policy: International Insights From Psychiatrists

OBJECTIVE: Recently, rational polypharmacy approaches have been proposed, regardless of the lower risk and cost of monotherapy. Considering monotherapy as first-line treatment and polypharmacy as rational treatment, a balanced attitude toward polypharmacy is recommended. However, the high prevalence of polypharmacy led the Japanese government to establish a polypharmacy reduction policy. Based on this, the association between the policy and psychiatrists' attitude toward polypharmacy has been under debate. METHODS: We developed an original questionnaire about Psychiatrists' attitudes toward polypharmacy (PAP). We compared the PAP scores with the treatment decision-making in clinical case vignettes. Multiple regression analyses were performed to quantify associations of explanatory variables including policy factors and PAP scores. The anonymous questionnaires were administered to psychiatrists worldwide. RESULTS: The study included 347 psychiatrists from 34 countries. Decision-making toward polypharmacy was associated with high PAP scores. Multiple regression analysis revealed that low PAP scores were associated with the policy factor (β=-0.20, p=0.004). The culture in Korea was associated with high PAP scores (β=0.34, p<0.001), whereas the culture in India and Nepal were associated with low scores (β=-0.15, p=0.01, and β=-0.17, p=0.006, respectively). CONCLUSION: Policy on polypharmacy may influence psychiatrists' decision-making. Thus, policies considering rational polypharmacy should be established

Lessons in social psychiatry at unexpected times!

Social psychiatry remains an integral and essential component of core psychiatry. The author, who was an earlier president of the Indian Association for Social Psychiatry, and now the president of World Association of Social Psychiatry, discusses some of the key influences in his career developmental trajectory which oriented him to the necessity of the social component of psychiatry in patient care and organizational work. It is expected that these lessons, shared with the readers, will motivate others too in the area of social psychiatry

Prioritizing rural and community mental health in India

With a huge population of 1.3 billion and deficient mental health personnel and infrastructure, India needs newer strategies for rural and community mental health care. There is a huge and unmet gap in mental health services, which needs our immediate attention. The National Mental Health Program and District Mental Health Program have made very welcome beginnings, but they are a long way off from even remotely reaching an optimal coverage. Nongovernmental organizations have been playing their important part as well. However, an important impetus can potentially come from the new mental health policies and legislation, which are in keeping with the United Nations Convention on Rights of Persons with Disabilities. Still, there is a lot to be done. The rural mental health services are often neglected and need immediate attention considering the burden of disease and treatment gap. Identifying the economic, social, and political barriers to the utilization of existing services would strengthen the delivery and utilization of these services. The mental health professional should be at the helm of leading and heralding the changes needed. This provides us with the challenge, as well as an opportunity

Mental health legislation: does it facilitate or hinder mental healthcare in countries of South Asia?

Research and clinical information pertaining to mental health needs of South Asians countries (SEAR) is limited but growing. There is a tendency to group all persons of Asian descent together and, therefore, the empirical literature does not sufficiently address the mental health needs in specific subgroups. The focus of this article is to understand the mental health needs of SEAR and to understand the present legislation by examining historical, cultural, and contextual challenges. Despite the well-documented mental health needs for these countries, most do not present for mental health services