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.

Guided imagery for anxiety disorder: Therapeutic efficacy and changes in quality of life.

Background: Patients with anxiety disorder were showing severity of anxiety symptoms as well as poor quality of life. Guided imagery (GI) provides immediate relaxation, and improves the severity of anxiety symptoms and the quality of life of patients with anxiety disorder. Anxiety is a basic emotion that is required as a motivation for everyday work of life. Anxiety presents a complex cognitive, affective, physiological, and behavioral response that is related to future harm (real or perceived). Aim: To study the efficacy of GI intervention on patients with anxiety disorder and their quality of life. Materials and Methods: This longitudinal, interventional study was done in a state institute of mental health, psychiatric unit on 20 patients (outpatients) with anxiety disorder, diagnosed according to diagnostic criteria of research ICD-10 DCR. Patients were assessed using a sociodemographic and clinical data sheet, Hamilton anxiety scale, and World Health Organization QOL instrument, short-form (WHOQOL-BREF), Hindi version. Results: Patients with anxiety disorder in the experimental group improved as compared with the control group significantly. The mean QOL-BREF score was also improved after intervention in the intervention group. Conclusion: GI intervention helps reduce the severity of anxiety symptoms and improve the quality of life in patients with anxiety disorder.

Delusional parasitosis: A case series.

Delusional parasitosis (DP) is an infrequent psychotic illness, where the patient has a false but firm belief that his body is infested with parasites. It can be primary or secondary. Usually, these patients consult nonpsychiatric specialties from where they are referred to psychiatry. The presentation of DP varies among patients, although it typically manifests as a crawling and pinpricking sensation. Hallucinations are commonly seen. Antipsychotics show good remission of symptoms. A series of seven cases of DP have been described, and the condition is briefly discussed.

Mental health concerns of interns posted in COVID-19-affected regions of Maharashtra.

Background: Healthcare providers faced the challenge of managing coronavirus disease 2019 (COVID-19)-infected patients. At the onset of the spread of the coronavirus infection across the globe, awareness of the treatment modalities was poor. Interns were relatively new to treating patients as they had just started their clinical postings in February or March 2020. Working in the COVID-19 wards with the sudden influx of a large number of patients, treating them with ever-changing guidelines did cause increased physical and mental stress. Thus, to understand the impact of coronavirus infection on interns this study was conducted. Materials and Methods: An online survey was conducted among interns of various medical colleges of Nagpur, Mumbai, Pune, and Miraj using Google Forms. Participation was anonymous and voluntary. Responses were accepted for 1 week from March 27, 2020, till April 3, 2020. Patient Health Questionnaire (PHQ-9) and Generalised Anxiety Disorder 7 Scale (GAD-7) (9) were used to assess anxiety and depression. Result: Our study showed that 36.3% of the interns who were posted for COVID-19 duty had depression, whereas 34% had anxiety symptoms. Anxiety and depression were comparable in interns posted for COVID-19 duty and those posted in other clinical departments. Young age, female gender, and perceived risk of contracting COVID-19 were the predictors for anxiety and depression. Conclusion: There was a high level of anxiety and depression among interns working in hospitals during the COVID-19 pandemic irrespective of whether they were posted for COVID-19 duty or not. Reporting such information is important to plan further management of mental health needs.

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.

Suicidal behavior in schizophrenia: A case series.

Suicide/parasuicide is seen at a greater rate in schizophrenia than in the general population, yet the psychological basis of this risk is poorly understood. It is estimated that 10% of patients suffering from schizophrenia attempt suicide. The major risk factors implicated are male gender, chronic illness with multiple relapses, family history of suicide, past suicidal and impulsive behavior, negative attitude toward treatment, and concurrent substance use. Treatment must target the identified risk factors for prevention of suicide in these patients. Here, we discuss three cases with self-inflicted cuts over the anterior aspect of the neck and wrists. They were diagnosed to have paranoid schizophrenia and were treated with antipsychotics, on which they showed improvement.

Impact of COVID-19 pandemic on healthcare workers.

The COVID-19 pandemic is a healthcare crisis that has led to unprecedented impact on healthcare services. At the heart of the unparalleled crisis, doctors face several challenges in treating patients with COVID-19. The psychological burden and overall wellness of healthcare workers (HCWs) have received heightened awareness, with research continuing to show high rates of burnout, psychological stress, and suicide. Detrimental effects include high rates of infection and death, excessive financial hardships, stress related to known and particularly unknown information, and fear of uncertainty regarding continued impact. Some researchers focused specifically on COVID-19's impact on HCW sleep. Anxiety and stress were significantly increased, leading to negative impacts on both self-efficacy and sleep. Stress is an important factor in drug use. Efforts should be made to explore the factors that are associated with psychological distress, which may lead to symptoms of anxiety, depression, or provoke suicidal ideation, and efforts should be made to control the factors that are modifiable. There needs to be more awareness among doctors and further long-term studies focusing on their mental health as adverse mental health conditions will further affect them as the disease advances.

Memory: Neurobiological mechanisms and assessment.

Memory is the process of retaining of knowledge over a period for the function of affecting future actions. It can be divided into declarative and procedural types. The process of memory consolidation is done in the hippocampus. The long-term memories are spread among various areas of the cerebrum depending on the different perceptual properties. The process of long-term potentiation and molecular changes occurring during memory formation are discussed in detail below. The steps involved in memory formation include encoding, storage, and recall (retrieval) in that order. Amnesia is a phenomenon in which there is the problem in memory formation which can be due to trauma to the brain, certain diseases, or stressors. While the assessment of memory has greatly improved, we are only beginning to understand the underlying mechanisms.

Correlation of motivations for selfie-posting behavior with personality traits.

BACKGROUND: The widespread popularity of selfie-posting behavior has led to increasing academic interest in exploring psychological determinants for this behavior. AIM: The study aimed to evaluate sociodemographic factors, personality traits, and psychological motivations associated with selfie-posting behavior and to evaluate the association of psychological motivations for selfie-posting with personality traits. MATERIALS AND METHODS: This cross-sectional study assessed 727 medical and physiotherapy students with a semi-structured questionnaire consisting of information about sociodemographic factors, selfie-posting, and editing behavior, the Big Five Inventory and motivations for selfie-posting scale. RESULTS: There was a positive correlation of female gender, extraversion, and agreeableness with selfie-posting and editing and a negative correlation of neuroticism with both types of behavior. Communication was the most common motivation for selfie-posting followed by attention seeking. Extraverted people post selfies for attention seeking, communication, and archiving motive while agreeable individuals post them only for communication and archiving. CONCLUSION: Females as well as individuals with high extraversion and agreeableness engage in selfie-posting and selfie-editing more frequently while neurotic individuals tend to avoid engaging this behavior. Motivation for posting selfies most commonly was for communication followed by attention seeking. Individuals with different personalities use selfies differently to fulfill their inner psychological needs.

A study of psychiatric referrals for fitness for work.

BACKGROUND: There are very few Indian studies regarding the psychiatric evaluation of state government workers referred for psychiatric fitness for work. AIM: This study aimed to examine the reasons for referral, psychiatric diagnosis, and outcome of psychiatric referrals for fitness for work at a tertiary-level referral government hospital. MATERIALS AND METHODS: The study evaluated consecutive psychiatric referrals at a tertiary-level referral government hospital with their informed consent utilizing a specially prepared pro forma, Kuppuswamy's Socioeconomic Status Scale and the Mini International Neuropsychiatric Interview plus. Psychiatric diagnoses were based on the International Classification of Diseases 10th Edition Diagnostic Criteria for Research. RESULTS: The study included 67 male and 8 female psychiatric referrals with a mean age of 39.5 years. Most of the psychiatric referrals were married (82.6%), Hindu by religion (97.3%), from urban areas (80%), belonged to upper middle class (46.7%), and had rotating shifts or emergency duties (50%). Psychiatric referrals were usually made for a single reason (57%), most commonly absenteeism (84%) followed by undisciplined behavior (38%). A past history of disciplinary action taken against them was given by 56% of the referrals. The most common psychiatric diagnosis was psychoactive substance-use disorder (21.3%) followed by psychotic disorders (20%) and mood disorders (14.7%). No psychopathology was detected in 18.7% of the referrals. Most of the psychiatric referrals (68%) were fit for work, though 22.67% were declared unfit for work (permanent invalidation). Psychiatric referrals with multiple reasons for referrals, longer duration of psychiatric illness (>5 years), and diagnosis of organic mental disorder or psychotic disorder received invalidation (permanent unfitness) on psychiatric grounds. CONCLUSIONS: Psychiatric referral for fitness for work is most commonly for absenteeism. The most common psychiatric diagnosis was substance-use disorder followed by psychoses. The majority (68%) were found fit for work after treatment though 22.6% required invalidment from service.