Association in Toxoplasma gondii and Related Psychotic Disorders: A Primary Report.

Background: Implication of infection in etiology of psychotic disorders is an area of interest. Aim: We aimed to explore the relationship between Toxoplasma gondii and psychotic disorders in a preliminary study. Materials and methods: T. gondii immunoglobulin M (IgM) and immunoglobulin G (IgG) antibodies were measured in a sample of patients with psychotic disorders, first-degree relatives (FDR), and healthy volunteers (HV) and compared. Data were analyzed by descriptive statistics in the forms of frequency and percentage using Statistical Package for the Social Sciences (SPSS). Results: Sample size was 10. Men and women were equal. All were from rural background. One patient with psychotic disorder out of the four had anti-T. gondii IgG antibodies in comparison to none among the three each of the FDR and HV. The patient with positive Toxoplasma IgG antibody status had the diagnosis of acute and transient psychotic disorder (ATPD). Conclusion: This pioneering pilot project from this part of the globe highlights a pertinent area for further work in the future in order to have a newer understanding in proper management of psychotic disorder.

Mental and Behavioural Disorders of Childhood and Adolescence: An Observational Study.

BACKGROUND: There is overlap of symptoms in psychiatric disorders, especially in mental and behavioural disorders of childhood and adolescence. Half of all lifetime psychiatric disorders tend to arise by age 14 years and three fourths of them arise by age 24 years. AIM: To study the various types of mental and behavioural disorders of childhood and adolescence, and to find out comorbidities within and across the types. METHODS: An observational cross-sectional study was carried out over a period of one year in the psychiatry department of a tertiary care general hospital. The psychiatric diagnoses according to the World Health Organization's (WHO) tenth revision of the International Statistical Classification of Health and Related Problems (ICD-10) were categorised into type 1 (depression, anxiety, obsessive-compulsive disorder, and somatoform disorder), type 2 (attention-deficit/hyperactivity disorder, oppositional defiant disorder, and conduct disorder), type 3 (mental retardation, developmental disorders of speech and language, and scholastic skills, and pervasive developmental disorders). Descriptive statistics was used with frequency and percentage. RESULTS: Total sample size was 137. Children and adolescents were almost equally distributed. Boys were more than girls. Type 3 disorders were maximum. Adolescents had mostly type 1 disorders. Children had mostly type 3 disorders. Girls had almost same number of type 1 and type 3 disorders. Boys had mostly type 3 disorders. Within group comorbidity was mostly with type 3 disorders. Across group comorbidity was highest in type2-type 3 disorders. CONCLUSION: Mental and behavioural disorders in childhood and adolescence do vary according to age and sex, and their recognition will help in the early diagnosis and proper management.

Relationship between Toxoplasma Gondii and Psychotic Disorders with Implications toward a Brain-based Diagnostic System and Novel Treatment Approaches: A Study Protocol.

What role infectious agents play in the causation of psychotic disorders? To investigate this area, we have aimed to investigate the relationship between Toxoplasma gondii and psychotic disorders. A hospital-based cross-sectional study is designed. IgM and IgG antibodies to T. gondii in patients with psychotic disorders will be measured and presented in result. Seropositivity rates will be compared with first-degree relatives and healthy volunteers. Also, types of psychotic disorders and seropositivity rate will be compared. Here, we are presenting the study protocol with implications toward a brain-based diagnostic system and novel treatment approaches.

A novel approach to address the novel threat.

The editorial highlights the mental health initiative of the Government of Assam, India through the Monon: Assam Cares programme to deal with the coronavirus disease 2019 (COVID-19) pandemic. Through this initiative, trained mental health professionals proactively reached to people with COVID-19 to provide psychological aid.

Profile of distress callers and service utilisation of tele-counselling among the population of Assam, India: an exploratory study during COVID-19.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has affected people globally by causing psychological, social, and economic chaos. The Assam Police, India started telephone helplines to address the psychological issues. AIMS: To evaluate the sociodemographic profile of the distress callers, their psychosocial concerns, the interventions provided by the service provider, and whether the service users were satisfied with the intervention(s) or not. METHOD: It was a cross-sectional study done during the period of lockdown (7-24 April 2020). All the callers who called the helpline were screened for anxiety, depression, suicidal thoughts (when required), and the psychosocial issues which they were facing were explored. They were provided the psychological intervention(s) at the appropriate time, and they were asked to rate their experience at the end. RESULTS: A total of 239 callers used the tele-counselling services. The majority of callers were male (79.1%). Most of the callers were between 19-35 years of age group (66.5%), married (52.5%), and graduates (31%). Two-thirds of the callers called to seek guidance for their own issues and one-third for their relatives or friends. Callers had anxiety (46%), depressive disorder (8.3%), and depressive symptoms not qualifying for depressive disorder (14%), and suicidal thoughts (5.44%). The commonest intervention provided to the callers was supportive (77.8%), followed by psychoeducation (30.5%), cognitive behaviour therapy (24.7%), relaxation (23.6%) and behaviour therapy (13.4%). Most of the callers utilised more than one type of therapy. Overall, most of the callers were satisfied and appreciated the tele-counselling services. CONCLUSION: The findings could help in formulating psychological interventions to improve the mental health of vulnerable groups in the post-COVID-19 period to reduce psychiatric morbidity and mortality.

The psychological impact of the COVID-19 pandemic and associated risk factors during the initial stage among the general population in India.

BACKGROUND: In the absence of treatment and unclear prognosis, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) itself, and public health measures like lockdown enforced by the government to limit the spread of the virus poses a threat to the psychological health of the general population. AIM: To assess the psychological status of the Indian population during the initial phase of lockdown. METHOD: It was a cross-sectional online survey where the questionnaire was disbursed by snowballing. The link to the survey was shared in different social networking platforms between 6th and 22nd of April 2020. The questionnaire collected responses related to the sociodemographic variables, exposure history, precautionary measures used, and the Depression, Anxiety, and Stress Scale (DASS-21) score. RESULTS: A total of 541 participants responded to the questionnaire. Only 422 respondents' responses from 23 states of India who completed the questionnaire were included for assessment. The mean age of the participants was 30.5 (SD=10.9) years. Female constituted 60.4% (n=255) of the respondents. The pre-existing medical illness that the respondents had were diabetes mellitus, four per cent (n=17), hypertension, five per cent (n=21), thyroid dysfunction, nine per cent (n=38), and mental illness, five per cent (n=21). The median (IQR) of the DASS-21 item scale was found to be 16 (4-32). The percentage of the respondents who reported stress was 35.5% (n=149), anxiety, 32% (n=135), and depression, 34.7% (n=146). Respondents with sociodemographic variables like being single, student status, competed education till graduation, homemakers, working in public sector, and history of mental illness were more likely to experience stress, anxiety, and depression. A majority of the respondents were practicing hand hygiene and social distancing. Respondents who were unaware of their exposure status were more likely to have depression. CONCLUSION: The Indian population is experiencing the psychological impact of the coronavirus disease 2019 (COVID-19), which may increase with the spread of the infection. India needs to gear up to face mental health consequences. People with a pre-existing physical and psychological illness needs extra care and precaution to prevent any relapse or development of complications.

A STUDY OF THE SOCIODEMOGRAPHIC AND CLINICAL PROFILES OF PSYCHIATRIC PATIENTS LEAVING AGAINST MEDICAL ADVICE.

AIM OF THE STUDY: We aim to assess the prevalence of psychiatric patients leaving against medical advice (LAMA), the sociodemographic and clinical profiles of the LAMA psychiatric patients, and reasons for LAMA. MATERIAL AND METHODS: An observational cross-sectional study was undertaken for six months extending from April 2019 to September 2019 in the Department of Psychiatry, Gauhati Medical College Hospital, Guwahati, Assam, India. The study used a semi-structured proforma to collect the sociodemographic variables and clinical characteristics according to ICD-10. The data were analysed by descriptive statistics. RESULTS: Out of the 523 admitted patients during the study period, 60 chose for LAMA. LAMA was more in young adults, men, those from urban region, less educated, admissions through outpatient department (OPD), diagnosis of mental and behavioural disorders due to psychoactive substance use. Majority of LAMA patients left after one day of hospital stay. Dissatisfied with treatment was the commonest reason for LAMA. CONCLUSION: In a country with more faith on quacks than modern medicine and a rising expectation of immediate sense of well-being, it was deemed a necessary study to probe more into the issues in order to avoid a revolving door phenomenon. To tackle this problem, prior information constitutes the cornerstone of dealing with this problem.

A Study on the Patterns of Psychiatric Referrals in a Tertiary Care Hospital in the North-Eastern Part of India.

BACKGROUND: Consultation-liaison psychiatry holds a special place, especially in general hospital setting. We wanted to study the socio-demographic variables, reasons for referral, and clinical correlates of psychiatric referrals from different wards in a tertiary care hospital. METHODS: This was a retrospective chart-review study carried out in the Gauhati Medical College Hospital, Guwahati, for a period of one month (May 2019). Demographic data of the participants was collected. Their primary medical / surgical diagnoses were noted along with the department where they were admitted. The reason for psychiatric consultation as well as the psychiatric diagnoses were analysed by descriptive statistics with the use of GraphPad InStat. RESULTS: Most of the sample was men (men: women: 106:72), mostly between 11 to 30 years (44.38%) and Hindus (Hindu: Muslim: 140:38). Majority of the consultations was from the Department of Medicine (47.19%), followed by Orthopaedics (15.17%) and Surgery (14.61%). Among the surgical/medical illnesses, most of them had fractures (ten), closely followed by neurological conditions like cerebrovascular accident (five) and head injury (four). Deliberate self-harm was the most common reason for psychiatric liaison (56), that constituted a high number with poisoning (45) as well as hanging (six) and cut neck (five). Psychiatric consultation was asked for use of alcohol in a substantial number of patients (45). CONCLUSIONS: Addressing the psychiatric comorbidity while continuing treatment for the surgical/medical illnesses gives a holistic approach towards our patients that can influence not only the course but also the quality of life of them.

Out of the closet.

An editorial on lesbian, gay, bisexual, and transgender (LGBT) community and the initiatives of an activist for the community with those of the Society for Mental Health in LAMIC (SoMHiL) as well as the Open Journal of Psychiatry & Allied Sciences (OJPAS®).

Ten.

An editorial on completion of ten years for the journal.

DEGREE AND FACTORS OF BURNOUT AMONG EMERGENCY HEALTHCARE WORKERS IN INDIA.

OBJECTIVE: 'Burnout' among emergency healthcare workers needs focus as they make crucial life changing decisions every day and thus, their state of physical and mental wellbeing is an absolute necessity. We aimed to find the level and factors contributing to burnout among the healthcare workers in the busiest Emergency Department of Northeast India. This is the first study done in this department to assess burnout. METHOD: This cross-sectional, questionnaire-based study assessed burnout of the doctors, nurses, and paramedics working in an emergency department of a busy tertiary care teaching institute. Association of demographic variables and factors influencing burnout was explored. Results were analyzed by descriptive and inferential statistics. RESULTS: Low level in emotional exhaustion, moderate level in depersonalization, and moderate level in the lack of personal accomplishment was reported by participants. Children and partner were found to be protective factors. Working hours, duration and status (permanent/contractual) of service influenced burnout. CONCLUSION: Knowing the level of burnout and their determinants can help in formulating measures of improving the work environment. A healthy workforce ensures high quality of healthcare and patient satisfaction.

Policy of the Open Journal of Psychiatry & Allied Sciences (OJPAS®) related to plagiarism.

This editorial highlights the pertinent issue of intentionally or unintentionally using other sources without proper citation in scientific literature and how the journal stringently tries to follow zero tolerance towards such practice with the active cooperation of the authors, reviewers, and editors.

PATTERN OF SUBSTANCE USE IN A DRUG DEADDICTION CENTRE IN DIPHU- NORTHEAST INDIA-BASED STUDY.

BACKGROUND: India is a multicultural and multilingual democracy; the use of different substances is found to be regionally diversified. Ethnic variations have contributed to this diversification and so a single study on a particular region cannot be generalised to the whole Indian population. Alcohol is one of the most popular substances used in India which can be traced backed to the scriptures. The local homemade liquor is the most common form of liquor used by the Indian population. The traditional winemaking process is common among the different ethnic tribes of Northeast India and thus most of the alcohol use is unrecorded in this part of the country. MATERIALS AND METHODS: An observational study was conducted in the Drug Deaddiction Centre of Diphu Civil Hospital, Assam where patients' recorded data over a four-year period was used. The data was reviewed retrospectively to understand the pattern of substance use in this region and the results were described using descriptive statistics. RESULTS: Alcohol was found to be the most used substance and significant gender difference was noted among the users. Both tribal and nontribal groups were almost equally seen to use alcohol while around one-fifth of the population belonged to the age group of less than 30 years. Early initiation of alcohol use due to cultural reasons was suspected. Various health issues ranging from gastrointestinal (GI) symptoms to death due to alcohol misuse were reported. Due to the retrospective review process, missing data was found to be a significant limitation to this study. CONCLUSION: Adequate health promotion focusing on effects of alcohol on health should be undertaken in this region and proper follow-up of the treated patients should be done to prevent relapse.

An exploratory study from eastern India on neurological soft signs and spontaneous movement disorders in schizophrenia spectrum disorders.

BACKGROUND: Apart from the traditional symptoms of delusion and hallucination, soft signs of neurological dysfunction in psychotic disorder has the potential for addressing neurodevelopmental and neurodegenerative aetiology. AIM: The study explored the neurological soft signs (NSS) and spontaneous movement disorders (SMD) in the same patient population of schizophrenia spectrum disorder (SSD) and other psychotic disorders. MATERIALS AND METHODS: Patients were diagnosed with SSD and other psychotic disorders as per ICD-10 diagnostic criteria and were evaluated with the Heidelberg manual for NSS and Modified Abnormal Involuntary Movement Scale (AIMS), Simpson-Angus Rating Scale (SARS), Barnes Akathisia Rating Scale (BARS) for assessing dyskinesia. RESULTS: Total 16 patients with mean age of 28.7 (±7.7) years had a mean duration of 63.2 (±68.8) months' disorder. Patients with schizophrenia had the mean Heidelberg score of 6.75 (±3.304). The scores of complex motor task, right/ left spatial orientation, integrative functions, and hard signs varied but the motor coordination score was unwaveringly high in all the participants with SSD. Sixty six per cent of SSD patients had dyskinesia. None had scored more than the upper limit of normal range in SARS. None of the participants had scored enough to qualify for akathisia. CONCLUSION: NSS and SMD emerge as distinct objective parameters for a group of psychotic disorder patients, especially SSD.

A COMPREHENSIVE STUDY REGARDING CONTRIBUTION OF SOCIAL NETWORKING SITES (SNS) TO MENTAL STRESS, ANXIETY, AND DEPRESSION AMONG ADOLESCENT SCHOOL STUDENTS IN GUWAHATI: THE RESEARCH DESIGN.

BACKGROUND: The study was designed to measure the degree of depression, anxiety, and stress amongst adolescent school children with respect to addiction to Social Networking Sites (SNS) as well as to study the various factors that could predispose to SNS addiction, and to study the habits and behaviour that places them at risk to SNS addiction. METHOD: Adolescent school children who fall under the age group of 14-18 years studying in various schools of Guwahati will form the study population. Data would be collected through questionnaire. RESULT: The analysis is planned by both descriptive as well as inferential statistics. CONCLUSION: The impact of SNS to mental health can be ascertained. The underlying factors predisposing to addiction would be found out. Formulation of strategies to counter the problem could be arrived at. Thus, restoring the health and wellbeing of the students.

Impact of stress, coping, social support, and resilience of families having children with autism: A North East India-based study.

Children with autism (CWA) is a segment of population in North East India who are marginalized due to lack of resources like skilled manpower and perceived stress. In comparison to other states and countries whether these children are unique in terms of care and rehabilitation from adult caregivers was the focus of our study. The study assessed level of parental stress, social support, coping mechanisms used by family and resilience in meeting the challenges as caregivers. Parents were selected by simple random sampling from a multi-specialty center dedicated to CWA. They were assessed with the help of structured tools like the Parental Stress Scale, the social support appraisals scale, the coping self-efficacy scale, and the Family Resilience Assessment Scale. Results were analyzed with descriptive statistics and findings suggest definite stress among the parents of CWA. Personal time constraint was noticed in majority of parents, which had adversely affected their professional lives. Despite wide array of stress factors, family members had satisfactory coping skills to work in harmony in adverse circumstances. Regarding secondary social support in terms of family, friends, and neighbors, responses were mixed; religious and spirituality were often resorted avenues. Social desirability, fatigue and the sample being restricted to only one center were though the limitations but, this study throws light on pertinent issues related to families with CWA from a region where specialty centers are a rarity. The future implication could focus on CWA's future, rehabilitation, care and parental concerns which are grossly neglected in North East India.