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Mental well-being is now an increasingly researched and discussed topic that primarily involves taking care of mental health in a preventive manner and is more of a subjective concept. Mental well-being ensures mental health and measures taken toward it can protect the person's overall health. Discussing and researching this concept is of paramount importance as this will not just safeguard an individual life but the society at large. The lifetime of a woman is multidimensionally unique with a complex interplay of biological, sociocultural, and environmental aspects. This demands a diverse variety of factors required to ensure mental well-being in a woman. In addition to this, these determinants vary on the life stage the woman is in. Factors that influence this well-being are also specific when it comes to an Indian context. This chapter considers and discusses in detail the various aspects of the mental health and well-being of women in the pubertal, perinatal, and menopausal age groups. Determinants are unique to particular age groups of women, and measures to focus on and ensure it will be elaborated on. Finally, recommendations towards policy making are also suggested.
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Background: Attention deficit hyperactivity disorder (ADHD) is one of the most commonly diagnosed developmental disorders and is common among referrals to child guidance clinics. Aim: This study aimed to study the impact of the lockdown during the coronavirus disease 2019 (COVID-19) pandemic on the mother's understanding of ADHD and the burden faced by her. Materials and Methods: A mixed-methods design with a combination of a qualitative and quantitative approach was adopted. An in-depth in-person semi-structured interview with the participant's mother was conducted. The qualitative and quantitative part of the study consisted of burden assessment by the Zarit Caregiver Burden Scale. The responses were transcribed, and themes were identified. Results: As far as understanding the disorder was concerned, the major themes identified were "Knew about the child's problems from teachers but online schooling made me see the child's issues in person" and "Knew about the illness but more time led to bonding and understanding the child." When questioned about the burden faced, the major themes that evolved were "Increased exhaustion taking care of a child 24/7" and "Increased burden as one felt angry and irritated with the child, the school, and the family." The Zarit caregiver questionnaire revealed a statistically significant difference in the burden of care before and after the pandemic, with a greater number of mothers falling in the mild to moderate and severe categories of burden. Conclusion: The COVID-19 pandemic increased the caregiver burden for mothers of children with ADHD. Their understanding of their child's disorder increased significantly as they could spend more time and devise different ways and means of helping their child in academics and other areas.
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Background: Prolonged and excessive use of alcohol can affect the sexual function. The occurrence of sexual dysfunction has adverse psychological and interpersonal consequences. Aim: To assess the occurrence and correlates of sexual dysfunction in individuals suffering from alcohol dependence. Materials and Methods: Seventy male subjects hospitalized in a tertiary care hospital for treatment of alcohol dependence syndrome with simple withdrawal symptoms were included in the study with their informed consent. Their sexual function was evaluated utilizing a 14-item changes in sexual functioning questionnaire. Results: According to the findings of the current study, sexual dysfunction is quite prevalent in alcohol-dependent people (75.7%). Erectile dysfunction was the most common disorder, followed by diminished sexual desire and early ejaculation. Conclusion: Alcohol-dependence patients have a high prevalence of sexual dysfunctions. In routine clinical practice, this may be overlooked. Clinicians must be made aware of the frequent occurrence of sexual disorders in alcohol dependence patients.
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Geophagia, a form of pica, is often associated with iron and zinc deficiency. However, a number of environmental, cultural, and psychological factors are also implicated. Pica in children is common with those having intellectual disability. In adults, it is most commonly associated with pregnancy. No specific screening tests for pica exist, but many nutritional and psychological complications can be avoided by accurate and timely diagnosis. Even when pica is diagnosed, no proven treatments exist. Two patients who reported to the psychiatry outpatient department with habit of eating nonnutritive substances for a prolonged period associated with apprehension and decreased appetite are reported. Both the patients were diagnosed with adult pica and were treated with selective serotonin-reuptake inhibitors and psychotherapy with considerable improvement.
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Trichotillomania is a psychodermatological disorder characterized by an uncontrollable urge to pull one's own hair. It is often associated with depression and obsessive-compulsive disorder. We report five cases, a young male and four females, who presented with an increased desire to pluck out their hair, leading to large patches of baldness. Despite distinct forms of presentations and different comorbidities, the management more or less remained the same.
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BACKGROUND: Addiction to alcohol not only affects the quality of life of the individual abusing it but also of the people living with them. Enormous research has been done on various aspects of alcoholism, but the lives of their caretakers are always considered secondary by society and researchers alike. Very few studies have been done on wives of alcoholic men in the Indian settings. AIM: This study aimed to assess the quality of life and suicide ideation in wives of men with alcohol dependence. MATERIALS AND METHODS: This is a cross-sectional study conducted in a tertiary care hospital. A study group of 50 wives of men with alcohol dependence were included in the study along with an age-matched control group of 50 wives of nonalcoholic men without any medical comorbidities. They were assessed by the perceived quality of life scale, Hospital Anxiety and Depression Scale, and Suicidal Behaviors Questionnaire-revised and the results were then correlated. RESULTS: Results revealed poorer perceived quality of life in the study group than in controls. The wives of alcoholic men scored significantly more on depression as compared to control group but not on anxiety. Suicidal ideation and attempts were significantly more common in wives of men dependent on alcohol. CONCLUSION: Alcohol dependence in the husbands is associated with poorer quality of life and higher levels of depression and suicidal ideation in their wives.
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Hepatic encephalopathy (HE) is an important and potentially life threatening complication in alcoholic patients with decompensated liver function that develop even as they continue drinking. Delirium tremens, on the other hand, is an acute condition resulting from alcohol abstinence in a person dependent on alcohol, making it a life threatening diagnosis that requires intensive care and successful management of the withdrawal. Often in medical wards, these two conditions are mistaken and so is the management plan confused with each other. Making the right diagnosis early on during the hospital course is extremely important in these critical conditions so as to make an appropriate schedule for treatment and a better outcome for the same. A case series of patients who presented with a diagnostic dilemma is reported. Clinical examinations, diagnostic tools to measure the levels of ammonia and liver function tests and hemogram, West Haven criteria and Child-Pugh grading, and clinical scales of these patients are reported. Increased levels of ammonia were present in all the cases. The subtle similarities in the presentation of the two conditions often make it confusing for the clinician to distinguish between them. Using a simple test of measuring ammonia levels in the blood helps in such situations. The detection of raised levels of ammonia in cases of chronic liver disease helps in not just the diagnosis but also is an important prognostic indicator for development of HE.
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AIM: The aim is to study the quality of life (QoL) and disability in persons with alcohol dependence syndrome (ADS). MATERIALS AND METHODS: This cross-sectional, analytical, case-control study in a tertiary hospital in a suburb of Maharashtra included 100 cases of ADS and equal number of age- and sex-matched healthy controls fulfilling the various inclusion and exclusion criteria. RESULTS: The study revealed that individuals commonly initiate drinking alcohol between 20 and 30 years and first present to the hospital for seeking medical attention in the age group of 30-40 years after 10-12 years of drinking when they are moderately or severely dependent on alcohol. Alcohol dependence is associated with lower educational levels and lower levels of employment. Many have problems in their marital and intimate relations, making it difficult for them to stay in long-term relationships. As a consequence of their frequent aggressive and violent behaviors, they are more commonly involved in legal matters. Having a positive family history of alcohol dependence and familial psychiatric disorders makes them have a higher chance of developing alcohol dependence. As the number of years of drinking increases, so does the dependency level. CONCLUSION: Alcohol dependence is associated with lower QoL and higher levels of disability levels. The severity of alcohol dependence is inversely proportional to the QoL experienced by them and directly proportional to their disabilities.