Agrawal, Ravindra

Bhatia, Urvita

Nadkarni, Abhijit

Pathare, Soumitra

Velleman, Richard

English

LSHTM Research Online

Volume 62,  Number 4 July-August 2020EDITORIALAftermath of celebrity suicide – Media coverage and role of psychiatristsO. P. Singh 337REVIEW ARTICLE (INVITED)Does electroconvulsive therapy cause brain damage: An updateAmal Joseph Jolly, Shubh Mohan Singh 339ACCELERATED RESEARCHPsychological impact of COVID-19 lockdown: An onlinesurvey from IndiaSandeep Grover, Swapnajeet Sahoo, Aseem Mehra, Ajit Avasthi,Adarsh Tripathi, Alka Subramanyan, Amrit Pattojoshi, G. Prasad Rao, Gautam Saha, K. K. Mishra, Kaustav Chakraborty, Naren P. Rao,Mrugesh Vaishnav, Om Prakash Singh, P. K. Dalal, Rakesh K. Chadda,Ravi Gupta, Shiv Gautam, Siddharth Sarkar,T. S. Sathyanarayana Rao, Vinay Kumar, Y. C. Janardran Reddy 354State of mental health services in various training centers inIndia during the lockdown and COVID-19 pandemicSandeep Grover, Aseem Mehra, Swapnajeet Sahoo, Ajit Avasthi,Adarsh Tripathi, Avinash D'Souza, Gautam Saha, A. Jagadhisha,Mahesh Gowda, Mrugesh Vaishnav, Omprakash Singh,P. K. Dalal, Parmod Kumar 363Changes in sleep pattern and sleep quality duringCOVID-19 lockdownRavi Gupta, Sandeep Grover, Aniruddha Basu, Vijay Krishnan,Adarsh Tripathi, Alka Subramanyam, Anil Nischal, Arshad Hussain,Aseem Mehra, Atul Ambekar, Gautam Saha, Kshirod Kumar Mishra,Manish Bathla, Mukesh Jagiwala, Narayana Manjunatha,Naresh Nebhinani, Navendu Gaur, Niraj Kumar, Pronob Kumar Dalal,Pankaj Kumar, Purav Kumar Midha, Ritu Daga, Sai Krishna Tikka,Samir Kumar Praharaj, Sandeep Kumar Goyal, Shweta Kanchan,Siddharth Sarkar, Sourav Das, Sujit Sarkhel, Susanta Kumar Padhy, Swapnajeet Sahoo, T S Satyanarayana Rao, Vaibhav Dubey,Vikas Menon, Vishal Chhabra, Vivekanand Lahan, Ajit Avasthi 370ORIGINAL ARTICLESConfirmatory factor analysis of the Depression, Anxiety, andStress Scale among Indian adultsManoj Kumar Sharma, David John Hallford, Nitin Anand 379Integrated intervention program for alcoholism improvesimpulsiveness and disadvantageous reward processing/risk-takingRajesh Kumar, Keshav J. Kumar, Vivek Benegal,Bangalore N. Roopesh, Girikematha S. Ravi 384Which factors may differentiate lifetime suicide attempters fromideators in obsessive–compulsive disorder patients?Cagdas Oyku Memis, Bilge Dogan, Doga Sevincok,Tolga Tunagur, Seda Derici Memis, Levent Sevincok 392Network and pathway enrichment analysis of Attention Deficit/Hyperactivity Disorder candidate genesPratichi Singh 400Burnout in medical students of a tertiary care Indianmedical center: How much protection does resilience confer?Shaurya Pharasi, Suravi Patra 407BRIEF RESEARCH COMMUNICATIONGenetic association of the human GAP43 gene with schizophreniain a Northeast Chinese Han populationZhilin Luan, Wenhua Ming, Xiaoxiao Huo, Jingwei Yu,Bing Wang, Yang Sun 413CURRENT THEMESSexuality, sexual well being, and intimacy during COVID-19pandemic: An advocacy perspectiveDebanjan Banerjee, T. S. Sathyanarayana Rao 418COMMENTARYSchool-based substance use disorder prevention in India:A brief appraisalAmrit Pattojoshi, Sai Krishna Tikka 427VIEWPOINTPsychiatry postgraduate examinations for 2020 in themiddle of COVID19 crisis: Suggestions from Indianteachers of psychiatryKishor M, Henal Shah, Suhas Chandran, Ashok V. Mysore,Ajay Kumar, Vikas Menon, H. R. Vinay, Mohan Isaac, O. P Singh 431CASE REPORTSA rare case report of Lilliputian and Brobdingnagianhallucinations in a case of pemphigus vulgarisRoshan Sutar, Suman Patra, Faisal Siddiqui, Sanjeet Diwan,Abin Rajan 435Not what it seems to be: Depression versus periodic limbmovement disorderRavi Gupta, Kaustuv Kundu, Khwaja Khayyam,Lokesh Kumar Saini 437LETTERS TO EDITORMore evidence and attention are needed to clarify thecorrelation between moyamoya disease and attention deficit hyperactivity disorderJin Yu, Jibo Zhang, Jincao Chen 440Neurobiology of Attention Deficit Hyperactivity Disorder inmoya moya diseasePatra Suravi, Patnaik Ashis 441Comparison of efficacy of ketamine versus thiopentone-assisted modified electroconvulsive therapy in major depressionAmit Jagtiani, Hitesh Khurana, Naveen Malhotra 442Comments on "Perspectives, attitude, and practice of lithium prescription among psychiatrists in India"Kumar Thamaraiselvan Santhosh, Hallikere S. Vishukumar 443National guidelines for media reporting of suicideSmitha Ramadas, Praveenlal Kuttichira, Chittaranjan Andrade 444Comment on "Attitude, practice, behavior, and mental healthimpact of COVID-19 on doctors"Aditya Somani, Ajay Kumar 445Authors' responses to the comments on "Attitude, practice,behavior, and mental health impact of COVID-19 on doctors"Seshadri Sekhar Chatterjee, Ranjan Bhattacharyya,Sumita Bhattacharyya, Sukanya Gupta, Soumitra Das,Bejoy Bikram Banerjee 446Comments on "Psychological impact of COVID-19 pandemicon general population in West Bengal: A cross-sectional study"Sourav Khanra, Nishant Goyal, Christoday Raja Jayant Khess 447Reply to the comments on "Psychological impact ofCOVID-19 pandemic on general population in West Bengal: A cross-sectional study"Kaustav Chakraborty, Moumita Chatterjee 448Indian Journal of Psychiatry   •   Volume 62   •   Issue 4   •   July-August 2020   •   Pages ***-***Spine 6.5mmClinical features and suicidal behavior in major depression with comorbid attention-deficit hyperactivity disorderVikas Menon, Deepika Biyyala, Moushumi Purkayastha Mukherjee 449Mental Healthcare Act, 2017, and addiction treatmentAbhijit Nadkarni, Urvita Bhatia, Richard Velleman, Ravindra Agrawal, Soumitra Pathare 450Coping strategies used by postnatal mothers with perceived stressJagadeeswari Jayaseelan, M. Prathap Mohan 451Personality characteristics of online gamersManoj Kumar Sharma, Nitin Anand, Keshava D. Murthy 453"A tale of tail": A case of lizard tail abuseSoumitra Das, Seshadri Sekhar Chatterjee, Sayantanava Mitra 454Letters to EditorIndian Journal of Psychiatry Volume 62, Issue 4, July-August 2020450Vikas Menon, Deepika Biyyala, Moushumi Purkayastha MukherjeeDepartment of Psychiatry, Jawaharlal Institute of Post Graduate Medical Education and Research, Puducherry, India. E-mail: drvmenon@gmail.comSubmitted: 03‑Feb‑2020, Revised: 18‑May‑2020, Accepted: 21‑Jun‑2020, Published:  27‑Jul‑2020 REFERENCES1. Delibas DH, Erdogan E, Gulseren S. Evaluation of clinical and suicidal behavior characteristics among urban, Turkish middle-age depressive patients with comorbid attention deficit hyperactivity disorder. Indian J Psychiatry 2019;61:612-7.2. Moffitt TE, Houts R, Asherson P, Belsky DW, Corcoran DL, Hammerle M, et al. Is adult ADHD a childhood-onset neurodevelopmental disorder? Evidence from a four-decade longitudinal cohort study. Am J Psychiatry 2015;172:967-77.3. Solanto MV. Child vs. adult onset of attention-deficit/hyperactivity disorder. JAMA Psychiatry 2017;74:421.4. Katzman MA, Bilkey TS, Chokka PR, Fallu A, Klassen LJ. Adult ADHD and comorbid disorders: Clinical implications of a dimensional approach. BMC Psychiatry 2017;17:302.5. Menon V. Multiple testing and protection against Type I error using P value correction: Application in cross-sectional study designs. Indian J Psychol Med 2019;41:197.proponents argue for the existence of a spontaneous “late onset” ADHD,[2] the naysayers suggest that many such cases are a result of “late identification” and not, “late onset.”[3] This being a cross-sectional study, it is not possible to ascertain which disease condition (MDD or ADHD) occurred first. However, the Wender–Utah rating scale, which the authors have used, assesses childhood ADHD symptoms. It can therefore be surmised that, in this sample, all adult ADHD cases represented those with symptom continuation from childhood and adolescence. Given this fact, we argue that the author’s major finding about earlier age of onset of depression in those with depression and concurrent ADHD may actually be a methodological artefact, because ADHD symptoms usually start earlier in life than depression and depression is commonly comorbid with ADHD[4]2. We are also concerned that the authors have not defined a suicide attempt, their major outcome variable, anywhere in the text of the paper. In fact, Table 3 in the paper clearly indicates the operational definition of attempt employed - attempts requiring medical attention. This definition is not a standard one. It is more suitable for medically serious attempts and clearly excludes attempts at the lower end of the severity spectrum3. When study groups are matched for certain variables (in this case, age and gender), comparing the same parameters between groups (Table 1 in the paper), without providing adequate justification, appears redundant. Equally superfluous are the comparison of variables such as total ADHD score, number of ADHD criteria, and ADHD rating scale scores between groups divided on the basis of a diagnosis of ADHD.A relatively minor, yet significant, issue in the context of the study hypothesis is the lack of statistical correction for multiple comparisons of related suicidal constructs (Table 3 in the paper), an approach that has been previously recommended.[5] After applying a Bonferroni correction (0.05/3 = 0.017), lifetime suicidal ideation would no longer be different between groups.Financial support and sponsorshipNil.Conflicts of interestThere are no conflicts of interest.Access this article onlineWebsite:www.indianjpsychiatry.orgQuick Response CodeDOI:10.4103/psychiatry.IndianJPsychiatry_90_20How to cite this article: Menon V, Biyyala D, Mukherjee MP. Clinical features and suicidal behavior in major depression with comorbid attention-deficit hyperactivity disorder. Indian J Psychiatry 2020;62:449-50.© 2020 Indian Journal of Psychiatry | Published by Wolters Kluwer - MedknowThis is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.Mental Healthcare Act, 2017, and addiction treatmentSir,We write with reference to the following article: Rao R, Varshney M, Singh S, Agrawal A, Ambekar A. Mental Healthcare Act, 2017, and addiction treatment: Potential pitfalls and trepidations. Indian J Psychiatry 2019;61:208-12. The authors raise several concerns about the Mental Healthcare Act (MHCA) with reference to addiction psychiatry. We would wish to focus on correcting misconceptions regarding the two most critical points related to the daily practice of clinicians.Letters to EditorIndian Journal of Psychiatry Volume 62, Issue 4, July-August 2020 451Financial support and sponsorshipNil.Conflicts of interestThere are no conflicts of interest.Abhijit Nadkarni1,2, Urvita Bhatia2,3, Richard Velleman2,4, Ravindra Agrawal2,5, Soumitra Pathare61Department of Population Health, London School of Hygiene and Tropical Medicine, London, 3Department of Psychology, Health and Professional Development, Oxford Brookes University, Oxford, 4Department of Psychology, University of Bath, Bath, UK, 2Addictions Research Group, Sangath, 5Antarman, Goa, 6Centre for Mental Health Law and Policy, Indian Law Society, Pune, Maharashtra, India. E-mail: abhijit.nadkarni@lshtm.ac.ukSubmitted: 23‑Apr‑2019, Revised: 11‑Feb‑2020,Accepted: 20‑Mar‑2020, Published:  27‑Jul‑2020REFERENCE1. Ameen S. Comments on “Mental Healthcare Act, 2017, and addiction treatment: Potential pitfalls and trepidations”. Indian J Psychiatry 2019;61:423.The authors describe a vignette of a man with alcohol use disorder (AUD) who is unwilling to get admitted to hospital for the treatment of his AUD and go on to assert that “As the various requirements of Section 89 of the MHCA, 2017, are met, one can argue that the individual can be admitted without his consent.” We are afraid that this limited information does not meet requirements of Section 89 (1) (c) which can only be fulfilled if the person lacks capacity to make mental healthcare and treatment decisions. The mere fact that he does not believe he has a substance use problem is not proof of lack of capacity, and so, a “wrong” decision by the husband (in this case, based on his belief he does not have a substance use problem, and also, does not need admission) by itself is not enough to prove lack of capacity to trigger supported admission. This point has already been tackled in detail by Ameen in his “Comments”[1] on the article under discussion.The second point the authors make is “Studies show that brief interventions delivered in an outpatient setting are effective for harmful use of alcohol and can be delivered in primary care settings. How justifiable, then, is compulsory (supported) admission in this case?”This is equally incorrect interpretation of the Act. Section 89 (1) (b) requires that the psychiatrist or the mental health professionals or the medical practitioner, as the case may be, certify, after taking into account an advance directive, if any, that admission to the mental health establishment is the least restrictive care option possible in the circumstances (emphasis added).If the psychiatrist certifying the admission believes that brief interventions delivered in an outpatient setting are effective, then admission to the mental health establishment is not the least restrictive care option and there is no reason for the psychiatrist to certify a supported admission.The MHCA has been notified less than 12 months ago. As with any new legislation, there will be need for clarification on various sections of the law, how they should be interpreted in particular circumstances and the challenges in its implementation. Having accepted that, we strongly urge our fellow clinicians to appraise the law in detail. One of the ways forward is to engage with the urgent challenges in implementation through partnership and discussion with the wider mental health fraternity so that we can provide optimum care as enshrined in this progressive Act.Access this article onlineWebsite:www.indianjpsychiatry.orgQuick Response CodeDOI:10.4103/psychiatry.IndianJPsychiatry_263_19How to cite this article: Nadkarni A, Bhatia U, Velleman R, Agrawal R, Pathare S. Mental Healthcare Act, 2017, and addiction treatment. Indian J Psychiatry 2020;62:450-1.© 2020 Indian Journal of Psychiatry | Published by Wolters Kluwer - MedknowThis is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.Coping strategies used by postnatal mothers with perceived stressSir,Important life events such as childbirth often bring about a lot of stress, which requires coping and adaptation for the mothers. Moments after a stressful event lead to psychological trauma and have a traumatic perception. If the concerned individual had a good level of coping, the event that caused the stress will no 

Mental Healthcare Act, 2017, and addiction treatment.

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Mental Healthcare Act, 2017, and addiction treatment.

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