Epidemic of Depression and Anxiety in child and adolescent population during COVID-19 pandemic: A systematic review and meta analysis of the prevalence of depression and anxiety.

COVID-19 has caused mayhem in the life of people. It has disrupted the social fabric of life. The children and adolescent population has been particularly affected by its direct and indirect effects. This systematic review aims to find the prevalence of depression and anxiety in children and adolescent age groups. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for finding the prevalence of depression and anxiety. We found the total number of participants to be 71,016. A random effect model was used for conducting meta-analysis. The prevalence of depression was mentioned in 17 studies of 23 and the pooled prevalence was 27% [95% confidence interval: 21%-36%] and heterogeneity (I2 statistics; P <.00001) was 100%. The prevalence of anxiety was found in 20 studies of 23 and the pooled anxiety prevalence was 25% (95% confidence interval: 16%-41%) and heterogeneity (I2 statistics; P < .00001) was found to be 100%. The summary of the findings has been provided. Due to high heterogeneity, moderator analysis was performed separately for depression and anxiety subgroups. The study design consisted of cross-sectional studies and some studies conducted through online surveys. The age range varied considerably from 1 year to 19 years; 5 studies had participants aged more than 19 years, but the mean age of the total sample was less than 18 years. We conclude that indeed there is a mental health epidemic among the child and adolescent population. We recommend early intervention and tailored made strategies should for management. As the pandemic is enduring, rigorous monitoring should be done. This age group is under extra pressure owing to a large uncertainty about their studies as well their future.

Internet addiction and its effects on psychological wellbeing: A community-based study.

Background: The internet has become an essential part of life, and it has both beneficial and detrimental effects. There is a plethora of evidence relating to the effect of internet addiction on psychological health. There is also an unmet need to lay the foundation for the differences in usage and the effects on mental health in regard to the use of the internet for rural and urban students. Materials and Methods: The present study was conducted on 200 adolescent subjects belonging to the urban and rural areas around the city of Varanasi to establish the pattern of use of the internet as well as its psychological implications. The participants were evaluated upon the Internet Addiction Test (IAT) and General Health Questionnaire-12 (GHQ-12), and information pertaining to socio-demographics as well as accessory information related to internet usage were captured through semi-structured proforma. Results: The results indicated no significant differences in the pattern of internet usage (mean IAT score) as well as psychological health (mean GHQ-12) between urban and rural youth. There was a significant positive association between the overall severity of internet use with poor psychological health (GHQ-12 score). There was a significant difference in the overall mean age as well as the mean age of onset of internet use between both groups (rural versus urban). This study highlighted an important issue of the digital divide based on gender-wise differences in the pattern in the overall sample. Conclusion: This study highlighted the important differences in the pattern of internet use among the rural and urban populations with its clinical implication being a need to educate the youth regarding the healthy use of technology.

Cannabis use and its relationship with bipolar disorder: A systematic review and meta-analysis.

Cannabis use has been stated as a causal risk factor for the occurrence of schizophrenia and other psychotic disorders. There is a dearth of literature stating the association of cannabis with bipolar disorder. This review aimed to find the repercussion of cannabis use on the onset of the first episode of bipolar disorder and the worsening of the symptoms in pre-existing illness. A thorough systematic review of the existing literature was carried out using the PRISMA guidelines. PubMed, Medline, EMBASE, SCOPUS, and Google-scholar databases were searched for studies fitting our study's inclusion and exclusion criteria. A total of 25 studies were included in the systematic review and out of these 25 studies, five prospective studies met the inclusion criteria for the primary outcome meta-analysis. A total sample of 13,624 individuals was included in these five studies. A fixed effect model was used in the meta-analysis of these five studies and it revealed an association between cannabis and bipolar disorder with an effect size of 2.63 (95% CI: 1.95-3.53) (heterogeneity: chi² = 3.01, df = 3 (P = 0.39); I² = 0%). Our findings propose that cannabis use may precipitate or worsen bipolar disorder. This highlights the importance of the detrimental effect of cannabis use on bipolar disorder and the need to discourage cannabis use in the youth culture. High-quality prospective studies are required to delineate the effect of cannabis use on bipolar disorder.

COVID-19 moral dilemmas viewed through Eastern and Western philosophy.

COVID-19 has been a considerable major stress factor and has led to a great increase in psychological illnesses. Literature related to spirituality and philosophy can provide solace in times like these. We have taken excerpts from Bhagwad Gita which is a spiritual and philosophical scripture, existential philosopher Albert Camus's La Peste and the myth of Sisyphus and writings of the philosopher Immanule Kant. These literary masterpieces can provide a wealth of guidance and solace to both the medical fraternity and affected people and their caregivers. "We tell ourselves that pestilence is a mere bogy of the mind, a bad dream that will pass away. But it doesn't always pass away and from one bad dream to another, it is men who pass away." -Albert Camus.

Effect of COVID-19 and sociocultural milieu on the psychopathology of mental health disorders: A hospital-based study.

BACKGROUND: Coronavirus disease (COVID-19) has posed a remarkable threat to mental health all around the world. This pandemic has increased the incidence of common as well as severe mental illness (SMI) all around the world. MATERIALS AND METHODS: We report 10 cases presenting to the psychiatric outpatient department (OPD) of Institute of Medical Sciences, Banaras Hindu University, from August to October 2020. They were either referred by other departments (3 patients) or came primarily to psychiatric OPD (7). RESULTS: Five out of these 10 cases presented with predominant psychotic features; 3 cases had predominant obsessive-compulsive features; and 1 case was of dissociative trance possession. CONCLUSION: COVID-19 can affect the psychopathology of both types of patients either with preexisting mental illness as well as new-onset SMI.

Behavioral presentations of focal onset seizures: A case series.

Seizures can have varied presentations and may have different etiological factors. A multidisciplinary approach should be used to treat them. It becomes difficult to diagnose seizures if they have an atypical presentation, particularly so when they manifest as behavioral disturbances. This case series demonstrates four cases with different psychiatric and behavioral manifestations of seizures where the diagnosis had to be done in a multi-disciplinary approach. Two of the cases highlight the fact that in the light of normal investigations, paying attention to detailed history is of prime importance.

Caffeine addiction: Need for awareness and research and regulatory measures.

Caffeine consumption has been constantly growing in India especially among children and youngsters. Addictive potential of caffeine has long been reported, still there is lack of awareness about caffeine abuse in India. There is an intense need for appropriate public health regulatory measures and awareness about addictive potential & harms related to caffeine. To the best of our knowledge this is first case from India highlighting several important issues with progressive caffeine abuse resulting in dependence leading to physical, psychological, academic and social consequences; psychotic symptoms during intoxication; predisposing factors as impulsivity and novelty seeking traits in pre-morbid personality; psychosis in family; poor awareness of health hazards even among medical professionals. Widely variable caffeine containing products are available but caffeine content or its safety limit is not mentioned on caffeine products in India. Due to harmful consequences, legal availability to children, growing consumption of caffeine products, it is utmost essential to recognize caffeine as addictive substance and impose regulatory measures on sale, advertisement, maximum caffeine content, health consequences and safety limits of caffeine containing products. Further school teachers, parents and medical practitioners need to be made aware of health hazards of caffeine. Caffeine use shall always be enquired from patients presenting with psychiatric complaints. Further research and survey are required on caffeine use and related problems.