Evaluation of Psychological Impact of COVID-19 on Health-Care Workers.

BACKGROUND: Little information is available from India about the psychological impact of COVID-19 on helath-care workers. AIM: The current study aimed to evaluate the psychological issues among the health-care workers (HCW) during the COVID-19 pandemic. MATERIALS AND METHODS: An online survey using Survey Monkey® platform was carried out to evaluate depression (using Patient Health Questionnaire-9), anxiety (using Generalized Anxiety Disorder Questionnaire-7), and other psychological issues (using a self-designed questionnaire). RESULTS: The study sample comprised 303 participants with a mean age of 41.2 (standard deviation: 11.1) years. A majority of them were male (69%) and married (79.9%). Nearly half (46.2%) of the participants had either anxiety disorder or depression or both and 12.9% of HCW had suicidal behavior. Higher level of anxiety and depression scores were associated with being female, having undergone quarantine, directly involved in the care of COVID-19 patients, and younger age (<30 years). Higher prevalence of depression and anxiety disorder was seen in younger (<30 years) age group, being a doctor (compared to paramedics). In addition, higher prevalence of depression was seen in those who were directly involved in the care of patients with COVID-19 infection. CONCLUSION: About half of the HCWs are suffering from psychiatric morbidity, specifically anxiety, in the wake of the COVID-19 pandemic. There is a need to assess all the HCWs for psychiatric morbidity and provide them with psychological support.

Psychological impact of COVID-19 lockdown: An online survey from India.

BACKGROUND: The COVID-19 pandemic has led to a complete shut-down of the entire world and almost all the countries are presently in a "lockdown" mode. While the lockdown strategy is an essential step to curb the exponential rise of COVID-19 cases, the impact of the same on mental health is not well known. AIM: This study aimed to evaluate the psychological impact of lockdown due to COVID-19 pandemic on the general public with an objective to assess the prevalence of depression, anxiety, perceived stress, well-being, and other psychological issues. MATERIALS AND METHODS: It was an online survey conducted under the aegis of the Indian Psychiatry Society. Using the Survey Monkey platform, a survey link was circulated using the Whatsapp. The survey questionnaire included perceived stress scale, Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Warwick-Edinburgh Mental Well-being Scale to assess perceived stress, anxiety, depression, and mental well-being, respectively. The survey link was circulated starting from April 6, 2020 and was closed on April 24, 2020. RESULTS: During the survey, a total of 1871 responses were collected, of which 1685 (90.05%) responses were analyzed. About two-fifth (38.2%) had anxiety and 10.5% of the participants had depression. Overall, 40.5% of the participants had either anxiety or depression. Moderate level of stress was reported by about three-fourth (74.1%) of the participants and 71.7% reported poor well-being. CONCLUSIONS: The present survey suggests that more than two-fifths of the people are experiencing common mental disorders, due to lockdown and the prevailing COVID-19 pandemic. This finding suggests that there is a need for expanding mental health services to everyone in the society during this pandemic situation.

The Clock Drawing Test versus Mini-mental Status Examination as a Screening Tool for Dementia: A Clinical Comparison.

There is a growing incidence of dementia patients in the community, and with this growth, there is need for rapid, valid, and easily administrable tests for the screening of dementia and mild cognitive impairment in the community. This review looks at the two most commonly used tests in dementia screening, namely, the clock drawing test (CDT) and the mini-mental status examination (MMSE). Both these tests have been used in dementia screening over the past three decades and have been the subject of scrutiny of various studies, reviews, and meta-analysis. Both these tests are analyzed on their ability to assess dementia and screen for it in the community, general practice and general hospital settings. The methods of administration and scoring of each test are discussed, and their advantages and disadvantages are explained. There is also a direct comparison made between the MMSE and CDT in dementia screening. Future research needs with these tests are also elucidated.

A pilot study of MD (psychiatry) theses-based research.

INTRODUCTION: Undertaking a research project is mandatory for MD Psychiatry trainees. The present study was undertaken to assess the type of research activity being undertaken as part of MD Psychiatry dissertation, and its contribution to national and international literature. MATERIALS AND METHODS: Three medical colleges supplied the data about the topic, names of the supervisor and the candidate, collaboration, funding accrued, and publication details of MD-based research carried out between years 2000 and 2010 inclusive; 95 records were collected for the final analysis. The details of the publications provided were cross-checked on the internet, which would have taken care of missed publications as well. RESULTS: Most studies were single-point assessment clinical studies. Only 2 studies had been funded, 11 had collaboration with other departments within the same institute, and 5 had inter-institute collaborations. Majority of the studies were not published. Only 30 were published as full paper and 9 as abstracts. Of these 30 full publications, only 3 were published in journals having JCI impact factor values (1.4, 1.3, and 1.4, respectively). CONCLUSIONS: The main finding of this pilot study was that MD-based research has low contribution to the national and international literature, and those articles which are published are in low impact journals. Suggestions for modifying this state of affairs are discussed.

A Case Report of Gender Dysphoria with Morbid Jealousy in a Natal Female.

Gender dysphoria is a new entity introduced in the Diagnostic and Statistical Manual of Mental Disorder V to address the distress of the previously labeled gender identity disorder patients. It is less commonly seen in natal females, often starting in their childhood. Adults and adolescent natal females with early-onset gender dysphoria are almost always gynephilic. This case report is presented to discuss the interesting evolution of the symptoms in gender dysphoria case with difficulties in adjusting to the assigned sexual role, relationship problems, morbid jealousy, and severe depressive features with suicidal ideations.

Incidence and outcomes evaluation of endophthalmitis management after phacoemulsification and 3-piece silicone intraocular lens implantation over 6 years in a single eye unit.

PURPOSE: To evaluate the incidence and outcomes of management of endophthalmitis following phacoemulsification and 3-piece silicone intraocular lens (IOL) implantation in a single eye unit over a 6-year period. SETTING: Shrewsbury and Telford Hospital, NHS Trust, Shrewsbury, United Kingdom. METHODS: Forty-four cases of endophthalmitis following phacoemulsification and 3-piece silicone IOL implantation were identified between January 1, 1998, and December 31, 2003. All the data related to the endophthalmitis cases were prospectively collected. The total number of cataract surgeries was identified from the hospital information technology department through coding data. RESULTS: There were 44 cases of endophthalmitis following 12 362 phacoemulsification cataract extractions (incidence 0.36%). The incidence of endophthalmitis with a silicone polypropylene IOL (0.67%) was significantly higher (P<.0005) than with a silicone poly(methyl methacrylate) (PMMA) IOL (0.24%). Thirty-six patients (81.8%) had vitreous tap while 8 patients (18.2%) had vitrectomy. Twenty cases (45.5%) were culture positive. Visual acuity was 6/12 or better in 30 patients (68.8%). There was weak correlation between visual acuity at presentation and final visual outcome (Pearson correlation r = 0.33, P = .029). Final visual acuity was not significantly related to culture results (P = .85, Mann-Whitney U test) or type of presentation (P = .52, Mann-Whitney U test). CONCLUSIONS: In this first single-center study to report incidence of endophthalmitis following phacoemulsification and silicone IOL implantations alone, the incidence of endophthalmitis was significantly higher with silicone polypropylene IOLs than with silicone PMMA IOLs and the overall incidence of endophthalmitis following phacoemulsification surgery was higher than most of the published data.

Brain-Derived Neurotrophic Factor and Suicide in Schizophrenia: Critical Role of Neuroprotective Mechanisms as an Emerging Hypothesis.

Suicide is a common occurrence in psychiatric disorders and is a cause of increased healthcare utilization worldwide. Schizophrenia is one of the most common psychiatric disorders worldwide and posited to be seen in 1% of the population worldwide. Suicide is a common occurrence in schizophrenia with 25%-30% patients with schizophrenia attempting suicide and 8%-10% completing it. There is a need for valid biological markers to help clinicians identify patients with schizophrenia that may be at a risk of suicide and thus help in them receiving better care and interventions at the earliest even before a suicide attempt occurring. There are clear neurobiological changes at a genetic, neuroimaging, and neurochemical level that occurs in patients with schizophrenia that attempt suicide. There is a new theory that postulates neuronal plasticity and neuroprotection to have a role in the biological changes that ensue when suicidal thoughts and feelings occur in patients with schizophrenia. Neurotrophic growth factors like brain-derived neurotrophic factor (BDNF) have been documented to play a role in the protection of neurons and in the prevention of neurobiological changes that may lead to suicide both in schizophrenia and depression. The present paper presents a commentary that looks at the role of BDNF as a protective factor and neurobiological marker for suicide in schizophrenia.

The Indian "girl" psychology: A perspective.

India has one of the fastest growing youth populations in the world. Girls below 19 years of age comprise one-quarter of India's rapidly growing population. In spite of India's reputation for respecting women, to an extent to treat her as a goddess, the moment a baby is born, the first thing comes to mind is "boy or girl?" as the differences are beyond just being biological. This article examines the significance of various psychological constructs and psychosocial issues that are important in the life of a "girl" baby born in our country.

Risk factors for suicidal attempts among lower socioeconomic rural population of telangana region.

BACKGROUND: Suicide is an act of intentionally causing one's own death. Number of suicidal incidences is proportional to attempted suicide cases hence if attempt cases are reduced, number of suicidal death can also be decreased and for that purpose risk factors should be identified and reduced. Therefore, this study is planned to identify risk factors among lower socioeconomic rural population of surrounding areas of Hyderabad in India. MATERIALS AND METHODS: This was a prospective study in which all the suicide attempt cases reported at Bhaskar Medical College and General Hospital were included. The study period was from January 2013 to July 2013. They were undergone a detailed psychiatric interview, including their demographic details, and complete suicide risk assessment was done using Beck's suicide intent scale. RESULTS: It was found that females in the age group of 20-30 years, uneducated, married and daily laborers by occupation had higher incidence of suicidal attempts. Depressive disorder is the most common associated psychiatric disorder in both the genders, followed by alcohol use related problems. Family disputes are the other major risk factors. Most common mode for attempt was organophosphorous poisoning followed by ingestion of calotropis. CONCLUSION: Risk of suicide attempt is almost equal in terms of medium and high category of suicide assessment scale in both genders. We suggest that all individuals with alcohol related disorders must be screened for suicidal ideation so that appropriate methods can be adopted to reduce the risk.