COVID-19 and suicides in India: A pilot study of reports in the media and scientific literature.

BACKGROUND: Our objective was to analyze reports of COVID-19 related suicides (CRS) to identify associated factors with a broader goal to inform management and prevention strategies. METHODS: We searched scientific literature, government websites and online newspaper reports in English and nine regional languages to identify relevant CRS reports. RESULTS: A total of 151 CRS reports were retrieved. CRS was more frequently reported among males (80.8%), those whose COVID status was unknown (48.0%), and those in quarantine/isolation (49.0%). CONCLUSION: The above findings may assist identification of at-risk individuals for COVID-19 related suicidal behavior.

Comparison of psychiatric morbidity in patients with irritable bowel syndrome and non-ulcer dyspepsia.

BACKGROUND AND AIMS: The present study aimed to find psychiatric morbidity, stress, anxiety, and depression in patients with irritable bowel syndrome (IBS) and compare it with patients having non-ulcer dyspepsia (NUD). METHODS: This case NUD study compared 50 patients each with IBS and NUD. The two groups were compared on demographic data, psychiatric diagnosis using the Structured Clinical Interview for DSM-IV Axis 1 disorders, anxiety levels using the Hamilton Anxiety Rating Scale (HAM-A), and depression using the Hamilton Depression Rating Scale (HAM-D). The Presumptive Stressful Life Events Scale (PSLES) was used to measure stress. RESULTS: The cases of IBS were more likely to be of female gender (P = 0.012), married (P = 0.009), and employed (P < 0.001). Psychiatric diagnoses were more common in the cases of IBS than NUDs (88% vs. 30%, P < 0.001), the most common being major depression and somatization disorder. Symptoms of anxiety and depression were more common in patients with IBS (P < 0.001 for HAM-A and HAM-D). Logistic regression revealed that having IBS and increased age were independent predictors of having a psychiatric diagnosis. CONCLUSIONS: IBS is associated with the considerable degree of psychiatric morbidity. Adequate attention should be paid toward comorbid psychiatric illnesses, and prompt treatment should be instituted.

Prevalence and Patterns of Learning Disabilities in School Children.

OBJECTIVE: To assess the prevalence and patterns of learning disabilities (LD) in school going children in a northern city of India. METHODS: The present cross-sectional study comprised of three-staged screening procedure for assessing learning disabilities of 3rd and 4th grade students studying in government schools. The first stage comprised of the teacher identifying at-risk student. In the second stage, teachers assessed at-risk students using Specific Learning Disability-Screening Questionnaire (SLD-SQ). The third stage comprised of assessment of the screen positive students using Brigance Diagnostic Inventory (BDI) part of NIMHANS Index of Specific Learning Disabilities for identifying the cases of LD. RESULTS: A total of 1211 (33.6%) children out of the total screened (n = 3600) were identified as at-risk by the teachers at the first stage. Of them, 360 were found to screen positive on the second stage using SLD-SQ. The most common deficits were missing out words or sentences while reading, misplacing letters or words while reading or writing, and making frequent mistake in spelling while writing or reading. Of these, 108 children were confirmed to have learning disability on the third stage using BDI, which represented 3.08% of the total population. CONCLUSIONS: Learning disability is an important concern in young school aged children. Early identification of such students can help in early institution of intervention and suitable modifications in teaching techniques.

Perceptions of teachers about learning disorder in a northern city of India.

BACKGROUND: Teachers are perhaps the closest observers of child's academic performance and can be instrumental in detecting learning disorder (LD) early. OBJECTIVES: The present study aimed to assess the teachers' perceptions about LD. MATERIALS AND METHODS: This is a cross-sectional questionnaire-based study in the public schools located in the urban, rural and slum areas of Chandigarh. Teachers were recruited from 20 randomly selected schools out of a total of 103 schools in the Union Territory by proportionate sampling. The sample size required for α of 0.05 and power of 0.80 to detect a difference of 15% from base rate of 35% was 80. Eighty teachers of 3(rd) and 4(th) grades of these schools were recruited using purposive sampling. Teachers were briefed for 5 minutes about the symptoms of LD. They were asked questions using a structured questionnaire about their socio-demographic status, methods of teaching, and students' progress and their perception about LD. Descriptive statistics was mainly used to represent nominal and ordinal data using frequency and percentages. Non-parametric statistical tests were used to assess relationship between the variables. RESULTS: Eighty teachers were recruited, 87.5% were females, 57.5% had more than 5 years teaching experience; 56.3% of teachers thought that they were aware of LD, 67.5% of teachers perceived that they do encounter children with LD in the school, 43.8% endorsed educating such children in special schools, while 36.3% endorsed integration to regular schools. Interestingly, more than three fifth of teachers were willing to undergo special training for LD intervention. CONCLUSION: Teachers acknowledge that there is a need for further steps to be taken to help children with LD. They perceive opening special cells or sending such children to special schools for appropriate intervention which may not tally with the perception of clinician who may wish to provide LD intervention in hospital setting.

Mental health effects of climate change.

We all know that 2014 has been declared as the hottest year globally by the Meteorological department of United States of America. Climate change is a global challenge which is likely to affect the mankind in substantial ways. Not only climate change is expected to affect physical health, it is also likely to affect mental health. Increasing ambient temperatures is likely to increase rates of aggression and violent suicides, while prolonged droughts due to climate change can lead to more number of farmer suicides. Droughts otherwise can lead to impaired mental health and stress. Increased frequency of disasters with climate change can lead to posttraumatic stress disorder, adjustment disorder, and depression. Changes in climate and global warming may require population to migrate, which can lead to acculturation stress. It can also lead to increased rates of physical illnesses, which secondarily would be associated with psychological distress. The possible effects of mitigation measures on mental health are also discussed. The paper concludes with a discussion of what can and should be done to tackle the expected mental health issues consequent to climate change.

Relationship of premenstrual syndrome and premenstrual dysphoric disorder with major depression: relevance to clinical practice.

BACKGROUND: Premenstrual syndrome (PMS), premenstrual dysphoric disorder (PMDD) and depressive disorder are fairly common; symptoms do overlap, often under-identified and under-emphasized, particularly in rural India. OBJECTIVE: The objective was to assess the occurrence of PMS and PMDD in a sample of students and staff of a nursing college and to find their correlation with depression. MATERIALS AND METHODS: A prospective cohort study; Tertiary Care Hospital in Rural India (Wardha, Maharashtra); 118 female nursing students or staff aged between 18 and 40 years, who were likely to stay within the institution for the study period. The participants were rated on Penn daily symptom report prospectively for a period of 3-month. Those who scored positive were applied diagnostic and statistical manual of mental disorders, 4(th) edition, text revision (DSM-IV TR) criteria for PMDD; and were applied primary care evaluation of mental disorders depression screening followed by DSM-IV TR criteria for depression. Severity of depression was measured using Hamilton Depression Rating Scale. RESULTS: Main outcome measures were frequency and severity of depression in individuals with PMS and PMDD and their clinical and sociodemographic correlation. The age range of the sample was 18-37 years. Some PMS symptoms were observed in 67%; diagnosis of PMDD in 10%; depressive symptoms in 28% of the sample. 46.4% of those with depressive symptoms had major depression. The diagnosis of major depression was significantly associated with the severity of PMS symptoms as well as the presence of PMDD. CONCLUSION: Premenstrual syndrome is present in a substantial proportion of young females. Concurrent depression is increased by the severity of PMS symptoms and the presence of PMDD. Gynecologist needs to screen such subjects for depression and refer to mental-health professional early, in routine clinical practice.

Aripiprazole monotherapy in an adolescent worsens psychosis.

Early detection and treatment of early onset schizophrenia (EOS) can lead to better outcome. Aripiprazole, a partial agonist of dopamine and a second generation antipsychotic, has been approved specifically for treatment of children with schizophrenia of aged 13-17 years. Though the use of this drug in adults may be associated with worsening of psychosis in occasional cases, no such data is available in adolescents. We report a case of EOS, who had worsening of psychosis with aripiprazole monotherapy. We discuss the possible mechanisms and clinical implications relevant in adolescents, and alert the clinicians to be vigilant in monitoring the patients on aripiprazole, especially after an increase in the dose of this medication.