Stress, postpartum depression, and anxiety in mothers of neonates admitted in the NICU: A cross-sectional hospital-based study.

Background: Mothers of neonates admitted to a neonatal intensive care unit (NICU) experience heightened distress, anxiety, depression, and trauma symptoms. Despite their prevalence, these conditions are generally neither recognized nor treated due to the constraints of time and concerns about the social acceptability of screening. Aim: To study stress, postpartum depression, and anxiety in mothers of neonates admitted to the NICU. Materials and Methods: One hundred forty consecutive mothers having preterm and low birth weight neonates in the NICU were taken for the study as cases and an equal number of mothers of full-term neonates matched for age and socioeconomic status (SES), were recruited as controls with their informed consent. Subjects were assessed with the Acute Stress Disorder Scale (ASDS), Post-Traumatic Stress Disorder (PTSD) Symptom Scale (PSS), Edinburgh Postnatal Depression Scale (EPDS), and Perinatal Anxiety Screening Scale (PASS). Results: Mothers of preterm neonates in NICU had significantly higher scores on the ASDS, PSS, EPDS, and PASS compared to controls. There was a significant association of ASDS and PSS scores with younger age, higher education, middle SES, joint family, urban residence, unplanned pregnancy, and male child. There was a significant association of the EPDS scores with lower SES, low education, unemployment, and male child. There was a significant association of the PASS scores with younger age, lower SES, and cesarean section. Conclusion: Mothers of preterm neonates admitted to the NICU compared to controls have significantly higher levels of stress, anxiety, and depression.

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.

Quality of online media reports of suicide and attempted suicide in India.

Background: News media reporting of suicide may influence the masses toward or against suicidal behavior. So, responsible reporting by news media is important to protect vulnerable people from the deleterious effects of media reporting. World Health Organization has issued guidelines for media reporting of suicide in this regard. We planned this research to evaluate the quality of online news media reports of suicide and attempted suicides in India. Material and Methods: We assessed a total of 210 news reports about suicide and attempted suicides (70 English, 70 Malayalam, and 70 Hindi) to evaluate the reporting of harmful and protective characteristics in news according to the World Health Organization guidelines for reporting suicide in media. Results: We found all three language media reported almost all potentially harmful characteristics with gender (100%), location/site of suicide in the headline (97.61%), precipitating life events (95.24%), mentioning term 'Suicide' in the headline (98.10%), monocausal explanation for suicidality (90.95%), suicide method in the headline (90.95%), an accompanying photo (92.38%), and suicide method (93.81%) being reported with highest frequency. Potentially protective characteristics were not included in most news reports with poor focus on awareness information. Vernacular language media were poor as compared to English news media about the quality of reporting suicide. Conclusion: We found poor adherence to reporting guidelines by online news media for reporting of suicide with poor coverage of educative and awareness information for the general public. It underlines the need for improving awareness among media professionals about responsible reporting of suicide.

Biopsychosocial correlates of emotional problems in women during pregnancy and postpartum period.

Background: Transition to motherhood is associated with several emotional problems that can have long-term consequences on the mother and baby. Aim: To examine the association of various biomedical and cultural factors with the new onset of emotional problems during pregnancy and postpartum period. Materials and Methods: This prospective longitudinal study included 300 pregnant women interviewed in the third trimester. Results: The prevalence of emotional problems in the study group was 31.58%. The prevalence of anxiety disorder NOS and mixed anxiety and depressive disorder in the last trimester of pregnancy in our study was 4% and 1.33%, respectively, and 0.67% and 1.33%, respectively, at 4 days postpartum. At 6 weeks postpartum, the prevalence of anxiety disorder NOS was 1.33%, generalized anxiety disorder was 0.67%, and major depression was 1.33. The prevalence of postpartum blues in our study was 25.33%. Conclusion: There was a significant association between psychiatric disorders during and postpartum period and the following factors: higher parity, increased maternal age, low hemoglobin levels, cesarean section, planned pregnancy, and extended family. Postpartum blues was associated with higher parity and low blood pressure.

The effect of the COVID-19 pandemic and lockdown on the psychosocial health of medical students.

Background: The COVID-19 pandemic had many psychological adverse effects due to fear and panic of infection. However social distancing and lockdown restrictions imposed to curb the spread of infection had an impact on the social life of people. The effects of this on the psychosocial health of the population were less explored area. Aim: To study the effect of the COVID-19 pandemic and lockdown on the psychosocial health of medical students. Materials and Methods: A cross-sectional observational study was conducted on medical students with the help of an online Google Form administering a questionnaire consisting of sociodemographic information; Coronavirus Social Distance Attitudes Scale and Attitude toward lockdown measure to assess favorable or opposing attitudes of participants toward social distancing and lockdown; Bergen Social Relationship Scale, Evaluation of Social System scale and Social Support Questionnaire to measure quality of social relations and social support satisfaction; and three item loneliness scale to evaluate feeling of loneliness. Results: The loneliness levels in participants were high (mean = 6.74 ± 0.79). There was a gender difference in the variables measured. Male students showed a favorable attitude toward social distancing (Positive social distance attitude scale P < 0.001, negative social distance attitude scale P < 0.001) and a better quality of social relations (Bergen Social relationship P < 0.001, evaluation of social system P < 0.001, SSQN P < 0.001, SSQS P < 0.001). However, male students scored more for loneliness as compared to females during the lockdown period (P < 0.001). Conclusion: The loneliness levels were high in medical students during the COVID-19 pandemic and lockdown and even higher in males who were considered a non-vulnerable group. So the balanced approach between preventive restriction measures and the social connectedness of the population is advised for making social distancing policies in the future.

Attitudes toward the use of facemasks during the COVID-19 pandemic in the Indian community.

Background: The use of face masks by all community members for the prevention of COVID-19 infection is considered one of the most effective strategies. However, the use of masks by community members was influenced by many factors which affected its efficacy as a preventive measure. Aim: To evaluate the attitudes toward the use of masks during the COVID-19 pandemic in the Indian community. Materials and Methods: We did an online survey with the help of a questionnaire which included information about demographic data, awareness and attitudes about COVID-19 infection and its preventive measures, and attitudes towards mask use in particular. Results: Participants had a positive attitude towards mask use. However, there were certain reasons for not using masks some of which were gender specific. Conclusion: People had good awareness and attitude towards mask use. However, some gender differences in perception of masks used in various settings should be addressed for future awareness and education of the community about mask use.

Sexual dysfunction in men with alcohol dependence.

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.

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.

Clinical correlates of regional gray matter volumes in schizophrenia: A structural magnetic resonance imaging study.

Objectives: The objective of this study is to investigate the correlation between the regional gray matter volumes and length of Para Cingulate Sulcus (PCS) with the clinical profile of patients with schizophrenia. Materials and Methods: In this hospital-based, cross-sectional study, thirty consecutive in-patients diagnosed with schizophrenia and equal number of healthy volunteers matched for age- and sex- were recruited as controls. Detailed clinical assessment and magnetic resonance imaging (MRI) of the brain were carried out within 2 days for controls and within 2 weeks of hospitalization for patients. The Positive and Negative Syndrome Scale and Montreal Cognitive Assessment were applied to schizophrenia patients to assess symptoms and cognitive function, respectively. Results: Schizophrenia patients had significant volume deficit in bilateral amygdalae, bilateral superior temporal gyri, anterior cingulate cortex and bilateral hippocampi, along with a highly significant reduction in the length of right PCS. Schizophrenia patients with the duration of untreated psychosis (DUP) of 6-12 months showed a significantly greater volume of the right superior temporal gyrus (STG). First-episode schizophrenia patients had a significant reduction in the length of the left PCS. The volume of bilateral superior temporal gyri in schizophrenia patients showed a significant direct correlation with positive symptoms and an inverse correlation with negative symptoms. Conclusion: Schizophrenia patients have significant volume deficit in some brain regions. DUP of 6-12 months is associated with significantly greater volume of the right STG. First-episode schizophrenia patients have a significant reduction in the length of the left PCS. In schizophrenia patients, the volume of bilateral superior temporal gyri showed a significant direct correlation with the positive symptoms and an inverse correlation with the negative symptoms.

Depression, anxiety, stress, and sleep disturbances in doctors and general population during COVID-19 pandemic.

AIM: The aim of the study is to assess and compare depression, anxiety, stress, and sleep disturbances among doctors and general population during COVID-19 pandemic. MATERIALS AND METHODS: This cross-sectional, analytical, case-control, web-based study was conducted during September 2020 to examine the impact of pandemic on mental health. The participants completed basic sociodemographic questionnaire, Depression Anxiety Stress Scale-21 (DASS-21), and Athens Insomnia Scale (AIS). RESULTS: Of the 321 participants, 320 provided basic data, 22 were on psychotropics. Out of the 298, 286 were matched for age and sex and were included. On DASS-21, 41.27% of doctors and 30.76% of general population reported depression; 40.56% doctors and 26.57% general population had anxiety; 38.46% of the doctors and 24.48% of general population reported stress. Statistical analysis revealed that doctors had significantly higher levels of anxiety and stress as compared to general population. On the AIS, more doctors (48.25%) suffered from insomnia compared to the general population (37.06%), but the difference was not statistically significant. CONCLUSION: Physicians have significantly higher anxiety and stress while dealing with COVID-19 compared to general population.

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.

Impact of COVID-19 pandemic on mental health of health-care workers in a tertiary care teaching and dedicated COVID-19 hospital.

AIM: We aimed to assess the consequences of dealing with patients during the COVID-19 pandemic lockdown period on the mental state of health-care workers. MATERIALS AND METHODS: An anonymous online survey was conducted with 353 participants using a self-made questionnaire comparing the prevalence of low mood, apprehension, tension, and coping skills used and the Depression, Anxiety, and Stress Scale-21. The data were analyzed to compare the mental health of male and female doctors. To identify predictors of mental health outcomes, a multivariate logistic regression was carried out. RESULTS: Both men and women were almost equally affected in terms of developing features of low mood, with easy physical and mental exhaustion. While the feeling of being isolated and irritability was slightly higher in females, both sexes were equally affected by the media. It was observed that the prevalence of smoking (tobacco/marijuana, etc.) had increased in both with slightly higher percentage in males as compared to females while there was a considerable increase in caffeine and alcohol consumption in males. The sleeping pattern and appetite were equally affected in both sexes. The sexual drive was also altered in both male and female residents, but the change was considerably more in males. The significant predictors of anxiety were age, depression, mental exhaustion, burden of increased quantity of work, and feeling of having no choice but to work due to obligation. CONCLUSION: Both male and female doctors working during the COVID-19 pandemic developed anxiety and depression. While substance use and altered sexual drive were more in males, exhaustion and stress were more in females.

Burnout and resilience in doctors in clinical and preclinical departments in a tertiary care teaching and dedicated COVID-19 hospital.

BACKGROUND: The worldwide COVID-19 pandemic has significantly altered our life. Doctors more so than the general public because of their involvement in managing the COVID-infected individuals, some of them 24/7 end in burnout. Burnout in doctors can lead to reduced care of patients, increased medical errors, and poor health. Burnout among frontline health-care workers has become a major problem in this ongoing epidemic. On the other hand, doctors in preclinical department have a lack of interaction with patients, with not much nonclinical professional work to boot, find the profession less gratifying which perhaps increase their stress level. AIM: The aim was to study the prevalence of burnout and measure resilience in doctors in clinical and in preclinical departments. MATERIALS AND METHODS: This observational, cross-sectional, comparative study was carried out in a tertiary care teaching hospital and COVID care center. By purposive sampling 60 preclinical and 60 clinical doctors in a tertiary health care center were included in the study. After obtaining the Institutional Ethics Committee approval and informed consent, the doctors were administered a self made socio-demographic questionnaire, the Copenhagen Burnout Inventory, and the Connor-Davidson Resilience Scale. Doctors were given a self-made questionnaire, the Copenhagen Burnout Inventory, and the Connor-Davidson Resilience Scale. RESULTS: The prevalence of burnout was seen more in clinical doctors (55.47) and the resilience was observed more in preclinical doctors (88.9). DISCUSSION: Resident doctors are a major force to combat COVID-19 as frontline health workers; hence, one can visualize burnout amongst them. On an individual basis, the work-related burnout was severely high in the clinical group owing to the workload which has been corresponding to a number of western studies. Nonclinical department doctors from pathology, community medicine, and microbiology did show burnout but showed a greater score in resilience. Psychological resilience has been identified as a component in preventing burnout. CONCLUSION: Therapy sessions can be used in clinical doctors facing burnout to build up their resilience.

Cognitive deficits in familial schizophrenia.

BACKGROUND: Cognitive impairment is a core feature of schizophrenia and has been observed in subjects with and without a family history of schizophrenia. Nonetheless, there is a paucity of research directly contrasting cognitive profiles in schizophrenia patients and normal people where family history is present and those where the family history is absent. AIM: This stydy aimed to compare cognitive functions in patients with schizophrenia who had a family history with those that did not and healthy controls. MATERIALS AND METHODS: Fifty consecutive schizophrenia patients were assessed on admission and follow-up after 6 months of treatment using a specially prepared pro forma, the Positive and Negative Syndrome Scale, and the PGI Battery of brain dysfunction is the name give to the test. An equal number of age- and sex-matched normal control subjects were also assessed. RESULTS: Visual memory scores in this study show improvement between baseline and follow-up in schizophrenia patients with/without a family history. Both verbal learning and memory increase between baseline and follow-up but do not reach control levels. Reasoning and problem-solving deficits follow a similar pattern and are causative in the inability to adapt to a changing world. Speed of processing shows improvement with treatment. Working memory deficits in patients improve with treatment. CONCLUSIONS: In this study, all six cognitive domain scores in schizophrenia improved after 6 months of treatment but did not reach the control population level. Individuals with the highest cognitive deficits in the scales were the ones who had a family history of schizophrenia.

Characteristics of auditory hallucinations in Indian patients with schizophrenia and bipolar affective disorder.

BACKGROUND: Auditory verbal hallucinations are not a unitary phenomenon and can be further differentiated into certain clinical characteristics, viz., frequency, intensity, control, tone, distractibility, distress, and clarity. These clinical characteristics manifest in varying degrees in different psychiatric disorders. AIM: To study the characteristics of auditory hallucinations in Indian patients with schizophrenia and bipolar affective disorder. MATERIALS AND METHODS: By purposive sampling, 140 patients of schizophrenia and bipolar affective disorder each were included in the study. Subjects were assessed cross-sectionally using sociodemographic proforma and characteristics of auditory hallucination scale. RESULTS: Characteristics of auditory hallucinations of schizophrenia patients were significantly different from those of bipolar affective disorder patients in the domains of frequency, intensity, tone, self-control, clarity, distractibility, and distress. CONCLUSION: Characteristics of auditory hallucinations differ in all domains between schizophrenia and bipolar affective disorder.

Association of childhood psychological trauma with eating disorders in undergraduate medical students.

AIM: The aim of the study was to study the association of childhood psychological trauma with eating disorders (EDs) and to assess and compare the relationship with food, concerns about weight gain, and restrictive or compensatory practices in male and female undergraduate medical students. MATERIALS AND METHODS: A cross-sectional, analytical study was performed in a Tertiary Care Medical College and Research Hospital in a suburban area of India. After obtaining ethical clearance, 100 final-year undergraduate students were included in the study with their informed consent. Self-made questionnaire, Childhood Trauma Questionnaire, Stirling ED Scale with Disordered Eating Attitude Scale were used. Spearman's correlation coefficient (Rho) was calculated. RESULTS: There was a significant correlation of history of childhood psychological trauma in the form of emotional abuse, emotional neglect or physical abuse and physical neglect with higher prevalence of disordered eating behaviors and relationship with food, concern about weight gain, and compensatory practices. No significant relationship was found in a history of sexual abuse. CONCLUSION: The importance of a healthy psychosocial upbringing and nurturing by parents to prevent development of psychiatric comorbidities is an important finding in this study.

A study of dementia in old age homes.

BACKGROUND: By 2040, dementia is projected to rise exponentially by 300% in India. Studies addressing the need for psychiatric care in the community being few and those focusing in old age homes even fewer, a study was undertaken to study the prevalence of dementia and the association with sociodemographic factors and psychiatric morbidity. MATERIALS AND METHODS: A total of 558 elderly aged 60 years and above, residing in old age homes in Pune were studied. 179 inmates were included based on the inclusion and exclusion criteria. Those who scored a predetermined cut-off score on the screening tool were included to undergo a detailed physical and neurological examination, cognitive profile using subtests from the cognitive test (community screening instrument for Dementia of 10/66 group). RESULTS: Mean age of the sample was 75.02 years majority (39.7%) was in the 60-70 years group. Males 25.7% versus females 74.3%. The sample consisted of the following socioeconomic groups: 40.2% middle, 26.3% low middle, 24% high middle, 8.4% high income, and 1.1% in low income. 60.3% widow/widower category, 36.3% never married, 4.5% had family history of dementia. Mean scores of mini mental state examination in the overall sample was 26.02 compared to 18.02 in those cut-off point of 23. The prevalence of dementia in the sample was 22.9%. There was the high prevalence of psychiatric symptoms and psychiatric morbidity in the dementia group than the rest. Frontal lobe dysfunction and impairment of orientation with increasing severity of dementia were observed. CONCLUSIONS: Sociodemographic factors, which were considered protective against the prevalence of dementia, identified were less restriction in physical activity and having fish in the diet regularly.

Quality of life and suicidal ideation in wives of men with alcohol dependence: A hospital-based study.

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.

Prevalence of smartphone addiction and its relation with sleep disturbance and low self- esteem among medical college students.

BACKGROUND: Use of smartphone is on the increase worldwide. They have revolutionized our lives to an extent that was unimaginable before the pandemic. Excessive use of smartphones reaching the levels of potential addiction among medical students and its relation to individual's sleep quality and self-esteem led us to study this prevalence. AIM: This stuay aimed to study the prevalence of smartphone addiction and its relation with self-esteem and sleep disturbance in medical college students. MATERIALS AND METHODS: A cross sectional analytical study was carried out and the prevalence of smartphone addiction, self- esteem, and sleep disturbance was measured using standardized questionnaires smartphone addiction scale short form, Rosenberg self esteem scale, Pittsburgh sleep quality index assessment respectively. RESULTS: Prevalence of smartphone addiction among medical college students was 52%. Smartphone addiction was seen more in boys than girls. There was a significant association between the smartphone addiction and sleep disturbance. However, there was no significant association between smartphone addiction and low self-esteem. CONCLUSION: The prevalence of smartphone addiction among medical students is found to be high and is associated with poor sleep.