Compulsive masturbation is a type of paraphilia related disorder in which a person engages in masturbatory behavior to such an extent that it causes socio-occupational dysfunction. The psychiatric co-morbidities associated with it include mood and anxiety disorders, substance use disorders, etc. Here, we report a case of a patient with the delusional disorder having compulsive masturbation.

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This article discusses case of Mr. Ernst Lanzer known as the “Rat Man” in the history of psychoanalysis. He was diagnosed as a case of obsessive-compulsive disorder by Sigmund Freud known as obsessional neurosis that time. The patient presented to Freud with number of distressing obsessions of which the main one was fear of a corporal punishment to his loved ones using rats. The patient underwent psychoanalytic treatment for his symptoms for 6 months following which he was declared cured. Freud has discussed the case in a published case note. Over the subsequent years, the case received wider attention from the psychoanalytic community and continues to be interpreted and discussed from different perspectives after nearly one century of his clinical interaction with Freud.

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This section provides a historical perspective and contributions from one of the most studied patients in neuroscience, Henry Molaison (1926-2008), known as H.M during his life to protect his privacy. The peculiar memory deficits seen after an experimental operation for intractable epilepsy led to some critical discoveries pertaining to memory organization in human brain.

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Treatment resistance to what is often deemed the last line of schizophrenia treatment, clozapine, is a burgeoning problem in psychiatric practice, with estimates of clozapine resistance standing at 40–70% of the treated population. This paper, a comprehensive review of available literature, looks at augmentation strategies to clozapine for such patients, with pharmacological and nonpharmacological modalities considered and reviewed. With a preponderance of open-label trials and case reports, our conclusion is that more research in this field via randomized clinical trials is crucial. Every case of clozapine resistance should be managed in an evidence-based and multidisciplinary manner, with augmentation only used once optimal dosage and duration of clozapine monotherapy is reached, and the psychosocial environment is optimized.

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Background: Schizophrenia is a chronic psychiatric disorder which has a profound effect on the patient's life course. Marriage has been shown to be both protective and detrimental to the course of recovery in schizophrenia. The study was planned to elucidate the factors that influenced marriage and the sustainability of marriage in patients with schizophrenia. Materials and Methods: The study sample was 101 patients with schizophrenia that attended the outpatient department of tertiary general hospital. Informed consent was taken and data collected from the patients and/or relatives on a special semi-structured pro forma. The data collected were subjected to appropriate statistical analysis after further subdividing the sample into subgroups. Results: About 69.3% of the total samples were married while 30.7% were unmarried. A significantly greater number of patients who were educated were unmarried (P = 0.026). Age of onset of illness below 25 years (P = 0.002) was a significant factor in those who were unmarried. When marital outcomes were considered, it was noted that greater male patients had stable marriages though not statistically significant, whereas earlier age of onset of illness was a significant factor that resulted in poor marital outcome (t = 2.96, df = 68, P = 0.0021). Conclusions: The effect of marriage on schizophrenia and factors that may influence marital sustainability in patients with schizophrenia need further study and are multipronged. Larger studies in this area of research are warranted.

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Objective: There exists a plethora of researches which have identified the role of Locus of Control in maintaining sound mental health and adjustment. The present study examined the relationship of Locus of Control with Mental Health & overall Adjustment among adolescent females. Method: The participants consisted of 50 adolescent females. Mental Health Battery designed by Singh, Gupta (2000), Rotter's Locus of Control Scale (1966) & Adjustment Inventory for College Students by Sinha & Singh (1995) were administered. Findings: The findings of the study revealed that adolescent females who possess internal locus of control showed better mental health & overall adjustment pattern which includes home, social, emotional, educational domains and health adjustment domain than those who possess external locus of control. Conclusion: The study highlights the pervasive influence of internal & external locus of control on mental health & adjustment among adolescent females.

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Shared paranoid disorders, a relatively rare psychiatric disorder in which paranoid delusions are transferred from one individual to one or more other susceptible person(s) in close association. Folie a deux is characterized by a complex dependent relationship between the involved individuals, yet a challenging diagnosis. In the paradigm of changing nosology, where the term shared/induced psychotic disorder is going obsolete, it is important to recognize such cases due to the potential for recovery in the submissive partner. Here, we present a case report and discussion of folie a deux involving inducer mother and induced daughter. In the clinical case presented, folie á deux was easily diagnosed, but its treatment proved to be a bigger challenge.

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The work of early pioneers like Dorothea Dix was instrumental in the establishment of institutions dedicated especially for the care of the mentally ill. Originally from the United States, she became acquainted with the idea of humane treatment of the mentally ill during her visit to England. After her return to the United States, she conducted a statewide investigation of care for the insane poor in Massachusetts and began to extensively lobby for reforms and establishment of more state-funded institutions for the care of mentally ill. Her efforts led to setting up of several mental health institutions, which became the cornerstone of care of psychiatrically ill, and for training of mental health care providers. Though subsequently, the hegemony of the institutions was challenged, and the era of deinstitutionalization was ushered in, the work of Dorothea Dix is important as it vouched for humane care of patients with mental illnesses.

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Background and Objectives: The vicissitudes and stresses of medical education in India have been suggested to be different from that of the Western world. Several studies have attempted to assess the psychological morbidity among medical students in India. This systematic review attempted to collate the findings relating to the prevalence of depression, anxiety, and stress among medical students in India. Materials and Methods: Studies were identified using PubMed, Embase, MedInd, and Google Scholar databases. Those studies conducted in India which reported the prevalence of depression, anxiety, and stress among the medical students were included. Pooled prevalence rate was calculated for depression, anxiety, and stress. Results: The prevalence rate of depression varied from 8.7% to 71.3%, while the pooled prevalence rate of depression from 16 studies (n = 3882) was 39.2% (95% confidence interval: 29.0%–49.5%). Similarly, the pooled prevalence rate of anxiety from four studies (n = 686) was 34.5% (95% confidence interval: 10.1%–58.9%), and the pooled prevalence rate of stress from 28 studies (n = 5354) was 51.3% (95% confidence intervals: 42.8%–59.8%). Female students had higher rates of depression and stress as compared to males. Conclusions: Depression, anxiety, and stress affect a considerable proportion of undergraduate medical students in India. Systemic efforts are needed to address their concerns and make mental health care easily accessible to them.

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Context: Depression and anxiety are the most common mental disorders existing today among the youngsters owing to academic excellence pressure and societal living expectations. They are overlooked most of the times and can have a grave impact on a student's personal, academic, and social life. Aim: The aim of the study was to find the prevalence of depression and anxiety in college students. Methods: A prospective study was done in 400 college students in the age group of 18–25 years. A self-made questionnaire, along with the Beck's Depression and Anxiety Inventory, was administered. Results: We found that depression was prevalent in about 48.30% of the students, whereas anxiety was prevalent in 50% of these students. Conclusion: Hence, moderate-to-severe levels of depression and anxiety exist in college students, which need to be confirmed and diagnosed clinically and treated at the earliest.

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Owing to the popular misconception that all ayurvedic preparations are completely safe, a vast majority of these are indiscriminately consumed by people procured as over the counter drugs. These preparations are combinations of multiple products that are often unidentified and dangerous and can precipitate various psychiatric symptoms. Hereby, we present a case of adolescent male in acute manic excitement after consumption of ayurvedic preparation containing "konchbeej" (Mucuna pruriens) which is rich in l-3,4 dihydroxyphenyl alanine; precursor of dopamine.

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Disulfiram is a drug that has been used as a deterrent agent in the treatment of alcohol use disorders. This section ventures into the journey of the discovery of the molecule, starting from the accidental discovery of its potential pathophysiological effects, thereafter becoming obscure due to lack of indications (alcohol use was not considered a problem!); and finally making a comeback and standing the rigorous test of time due to the determination of a few researchers, which makes it a story worth revisiting.

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The prevalence of autism spectrum disorders has increased in recent years and so has the focus on high functioning autism and Asperger syndrome. A subset of Asperger individuals appears to have a propensity to engage in acts of violence, particularly sexual crimes, which may best be attributed to the core features of their pathology such as “mind-blindness” and paucity of central coherence. This paper is an account on five such cases encountered in our hospital for whom various assessments were done including Mini International Neuropsychiatric Interview, intelligence quotient assessment by Binet Kamat test of intelligence, Montreal Cognitive Assessment, Ritvo Asperger's and Autism Diagnostic Scale, and Gillberg's criteria for diagnosis. These cases gained legal attention and “undeserved” outcomes. By drawing parallels from other countries, a few suggestions have been highlighted in the paper that can be considered to discard glaring deficits in the criminal law system in India in this context.

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Social cognition, the ability to act wisely in social interaction, is being actively researched in various fields besides the clinical, behavioral, and psychological sciences. The objectives of this paper are to review the conceptual basis of social cognition and its applicability in the areas of social competence and effectiveness in interpersonal environments. Social cognitive skills enable understanding of social situations. The relationship between social cognitive skills and ability of emotional decoding of self and others has been explored. The paper discusses various processes that are operative in the interactional scenarios and have relevance in individual effectiveness. Concepts such as emotional intelligence, trait transference, person-perception, categorical thinking, and knowledge construction have been discussed in relation to social cognition and effectiveness. The role of thoughts, feelings, expectations, and relational schemas in interpersonal situations has been linked to performances. In addition, effectiveness is influenced by motivated social cognitions, ego-tasks, global, and context-specific goals. Various strategies such as cognitive and social problem-solving and proactive-coping have been elaborated which lead to better outcomes in interpersonal environments.

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The themes of delusion have been a subject of interest due to the complex underpinning of several socio-cultural aspects. Although it is defined to be out of keeping with the socio-cultural background, the interplay often poses a diagnostic dilemma. Here, we report an unusual case of persistent delusional disorder involving surgically inserted “Gas” in the background of beliefs arising from relatives, lay press, and nontraditional medicine.

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Introduction: The emergence of Anorexia Nervosa (AN) in India been sporadically reported and till date, no epidemiological study has been reported. Global Burden of Disease Study 2016 (GBD 2016) offers a unique opportunity to study the AN as well as to estimate its burden quantification. Materials and Methods: Using the GBD 2016 approach and accounting for gender, age, and disability weight were accounted to calculate the disability-adjusted life years (DALYs). Results: As accounted in the model, the prevalence rate of AN for males was 10/100,000, whereas for females, it was 37.2 and combined gender burden was 22.3/100,000. A loss of 73782.7 DALYs was estimated. An estimated 55 deaths due to AN was observed. Most of the burden of the AN was borne by females in the age of 15–19 years than others with a male:female ratio of 1:4. The prevalence rate was observed to increase from 1990 to 2016. Discussion: Within the confines of the current mathematical modeling and secondary data analysis, the Indian burden of AN is significant, particularly among young females. AN is least studied mental illness in India. With increasing distorted body image perception and “western” style living, eating disorder in reported to increasingly prevalent among Indians. Mental health professions need to include AN for screening at the community level. Nonavailability of specific literature and parameters to quantify disability. Conclusion: A mathematical estimate of the AN in India is presented with its implication using a secondary data approach. In wake of rapid changes in society, the mental health community should realize that India shall not be immune to AN in the present and future.

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Background: Research in the field of parenting has grown in the recent decade. Parenting style scales are used to measure the perception of parenting style either from the child's viewpoint or parent's viewpoint. The previous review of scales affirms the parenting style scales in the western context. The current review examines the scales available to measure the same from a young adult's perspective and throws light on the need to have a scale which can bring out cultural aspect. Methodology: Searches of PubMed, EBSCO, PROQUEST, and Google Scholar to identify scales that focus on the perception of parenting styles and find publications that assess their criterion-related validity. Results: Almost 10 numbers of instruments assessing parenting style among the young adults were located. Searches identified 10 scales and the publication that assesses the validity. The evident approach to item generation was available literature, focus group discussion, and interviews prominently on the foundation of Baumarind's theory of parenting style. Findings raise methodological concerns, which inform recommendation for future development. Conclusion: Scales perceiving parenting styles have been developed in the western context and validated for Indian context, hence there is a need for developing indigenous scales suiting our collectivistic culture.

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Writer's cramp (WC) is a focal dystonia causing impairments in daily life. The chief symptom is the inability to use the hand, or difficulty in using it, for writing or other occupational purposes. Behavioral treatment approaches have been shown to improve handwriting performance. The purpose of this study was to examine the effects of behaviour therapy in WC. In the current study three cases of writer's cramp were treated with eclectic therapy which included relaxation technique, retraining and pharmacotherapy (anxiolytic drugs). The handwriting performance was examined before and after treatment. In all the three cases, the response to treatment was good, and the improvement was maintained at 6 months follow-up. The patients could write comfortably and legibly without tension in hand muscles after undergoing the intense therapy. Results suggest that patients with WC benefit from the use of behavior therapy combined with pharmacotherapy (anxiolytics).

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Recently, a dangerous new designer drug mephedrone has fast gained popularity among the youth and teens of India. Its abuse has soared to mount to an epidemic. It has psychoactive properties and is believed to bring about effects similar to the use of cocaine, amphetamine, and 3,4-methylenedioxy-N-methylamphetamine. The aim of this review is to discuss how mephedrone acts, health risks with its use and its emergence in India. The past and the emerging PubMed and Internet literature on mephedrone, and synthetic cathinones are reviewed. Recent studies suggest that use of synthetic cathinones lead to not just serious psychiatric but serious neurological, cardiovascular, and sexual health sequelae as well. Use of these designer drugs may lead to multi-organ failure and death. It has become increasingly evident that mephedrone is highly dangerous to public health. This warrants educating and training healthcare providers to provide optimum management.

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Context: Internet addiction is less researched entity in developing countries. There has been an explosive growth in the use of internet worldwide including India in the last decade. Aims: To study the relationship of internet addictive behavior with personality characteristics among medical students. Settings and Design: This was a cross-sectional observational study carried out on 140 medical students. Subjects and Methods: All the students were taken randomly. Assessment of sociodemographic details was done with the help of  semi-structured pro forma, and internet addiction test and big five inventory were used to assess internet addictive behavior and personality traits. Statistical Analysis Used: For comparison of dichotomous variables, Chi-square test was used. Correlation and linear regression were applied to see association. Data analysis was done with the help of  statistical software SPSS 23. 0 (Statistical Package for the Social Sciences by IBM Corporation). Results: Mean score of internet addiction scale among medical students was 33.94 (standard deviation 13.592). It was found that higher neuroticism (β =0.242, P = 0.004) and less extroversion (β = −0.210, P = 0.011) displayed significant associations with internet addictive behavior. Conclusions: Neurotic individuals tend to experience increased levels of stress and interpersonal conflict because of this personality trait. Internet addictive behavior was lower on extroversion traits because they are more in social activities, making friend easily, and cheerful.

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The concept of "Tarasoff duty" is familiar to mental health professionals. Entwined with the name of Tarasoff, is that of Prosenjit Poddar, the other important character in the story which led to the courts giving directions for mental health professionals with regard to their duty of warn. Prosenjit Poddar killed Tatiana Tarasoff when his advances toward her were rebuffed. However, the court ruled that the mental health professional who was treating Poddar and was in knowledge of his intentions to harm Tarasoff, did not take adequate measures to warn the potential victim. This led to courts laying statutes for warning the potential victims by mental health professionals when their clients disclose such threats. However, the ruling has been a matter of debate about when to take any threat seriously and how to tread cautiously given the therapist-client privilege. The case of Prosenjit Poddar throws light on complex issues related to balancing confidentiality and potential harm to others.

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Background: Traumatic brain injury (TBI) and Subarachnoid Hemorrhage (SAH) are the leading cause of death and disability in both developed and developing countries. They have significant cognitive and behavioral consequences, affecting the quality of life of both patients and their families. Aim: To compare the memory functioning of TBI and SAH and study the effect of demographics on the same through a retrospective study. Materials and Methods: A sample of 210 patients clinically diagnosed as TBI (N = 165; M = 145/F = 20) and SAH (N = 45; M = 35/F = 10) were using post graduate institute of memory scale (PGI-MS) which assesses 10 memory domains. Results: Odds Ratio (OR) was calculated by categorizing the scores as average and impaired on PGI-MS, the percentage of impaired cases of SAH were significantly less as compared to TBI (8.9% vs. 22.4%; OR = 0.34) Moreover, only two domains were found to have significant results, i.e. delayed recall and recognition. When the scores were adjusted for age, education and gender, memory impairment was found to be statistically significant in domains of remote memory (OR = O.10) recent memory (OR = 0.32), delayed recall (OR = 0.26), immediate memory (OR = 0.30), new learning ability (OR = 0.38), and recognition (OR = 0.17). Conclusion: A primary prevention (awareness program about risk factors) and tertiary prevention (holistic rehabilitation) would play a crucial role in improving the quality of life of both patients as well as the population at risk.

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