Background: Depression is a common yet often underdiagnosed psychiatric comorbidity in patients with chronic skin disorders. Presence of depression can be an aggravating and perpetuating factor for these conditions. Aim: To determine the frequency of depressive disorder and suicidal ideation in adult dermatology outpatients with acne, psoriasis, and alopecia areata and also to determine the correlation between severity and duration of the skin disease with the severity of depressive disorder. Materials and Methods: A total of 174 new patients attending the dermatology outdoor clinic of our hospital diagnosed with acne, psoriasis, and alopecia areata were assessed by the psychiatrist for comorbid depressive disorder and suicidal ideations using Beck Depression Inventory (BDI) and Beck Scale for Suicide Ideation, respectively. Results: Depressive disorder was found in 8.8%, 26.8%, and 13.2% of patients with acne vulgaris, psoriasis, and alopecia areata, respectively, whereas suicidal ideation was found in 1.2%, 5.4%, and 2.6% patients, respectively. Significant correlation of BDI score was found with the severity of psoriasis and alopecia areata and with the duration of alopecia areata. Conclusion: Diagnosing and treating the hidden psychiatric comorbidity in patients with dermatological illnesses can help achieve better control of dermatological disorder and provide holistic care to such patients.

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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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Context: Previous studies have reported high psychiatric comorbidity with physical illness. However, referral rate to consultation-liaison (C-L) psychiatry from other departments is very low. There is a paucity of literature from India in this subspecialty of psychiatry. Aims: This study was conducted to assess the sociodemographic profile and psychiatric diagnosis of patients referred to C-L psychiatric services at a tertiary care center. Settings and Design: This was a descriptive cross-sectional study conducted in a tertiary care multispecialty teaching institution. Patients and Methods: The study population comprised all the patients who were referred for psychiatric consultation from other departments to C-L services of psychiatry department for 2 months. Information was collected using semi-structured pro forma, and diagnosis was made based on the International Classification of Diseases-10 criteria. Results: A total of 160 patients were referred for C-L psychiatric services. Majority of the patients were in the age group of 31–45 years, married, educated matriculation or beyond, belonged to Hindu religion, nuclear family, and residing in urban area. The maximum referrals were from internal medicine department (17.5) followed by nephrology (15.0%) and neurology (10.6%). The most common psychiatric diagnosis was depression (12%) followed by delirium (8%). The most common reason for seeking psychiatric consultation was psychiatric clearance of prospective kidney donor and bone marrow transplant/stem cell transplant recipient. Conclusions: Psychiatric comorbidity may present with chronic physical illness. The C-L psychiatry would play a major role in the management of psychiatric comorbidity.

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Background and Aim: Available literature is inconsistent for the role of Vitamin D supplementation in depression. With scarcity of Indian data, we aimed to study Vitamin D deficiency in patients with depression, its association with time to remission and role of Vitamin D supplementation. Methods: A total of 158 outpatients with depressive disorders were consecutively assessed for Vitamin D deficiency, severity of depression, physical activity, and nutritional habits and followed-up for 1 year. Eighty-seven patients completed follow-up for 1 year (55% retention). Results: Mean serum Vitamin D level was 11.9 ng/ml and the majority of patients (85%) had Vitamin D deficiency (<20 ng/mL). Significant predictors of hypovitaminosis D were being female, unemployed or homemaker, from nuclear family and with a smaller height. Vitamin D deficient patients took significantly longer time in remission than nondeficient patients (2.86 months vs. 1.35 months, P= 0.006). Patients with Vitamin D deficiency received Vitamin D supplementation and subsequently their time to remission was comparable to nondeficient group. Conclusions: The majority of patients had Vitamin D deficiency, took a longer time to remission and reported improvement with Vitamin D supplementation. It signifies the importance of treating hypovitaminosis D for effective management of depression, to avoid delay in response, and incomplete remission.

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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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Background: Parents of children suffering from neurodevelopmental disorders, frequently face public stigma which is often internalized and leads to psychological burden. However, there is a lack of data on the perceptions of internalized stigma among parents of children with neurodevelopmental disorders, especially from lower-middle-income countries like India. Aims: This study aims to develop an adapted version of the Internalized Stigma of Mental Illness (ISMI) scale for use in parents of children suffering from neurodevelopmental disorders and to explore the factor structure of this instrument through exploratory factor analysis (EFA). Settings and Design: A cross-sectional study was conducted in an outpatient setting in a tertiary care hospital in India. Materials and Methods: A total of 105 parents of children suffering from neurodevelopmental disorders (according to the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition) were recruited for the study after screening for psychiatric disorder using Mini International Neuropsychiatric Interview version 6.0. A modified 16-item scale was constructed Parents' Internalized Stigma of Neurodevelopmental Disorder in Child (PISNC) scale and applied on 105 parents of children suffering from neurodevelopmental disorders, after translation to Hindi and back-translation, in keeping with the World Health Organization's translation-back-translation methodology. Statistical Analysis: EFA was carried out using principal component analysis with orthogonal (varimax) rotation. Internal consistency of the Hindi version of the scale was estimated in the form of Cronbach's alpha. Spearman–Brown coefficient and Guttman split-half coefficient were calculated to evaluate the split-half reliability. Results: The initial factor analysis yielded three-factor models with an eigenvalue of >1 and the total variance explained by these factors was 62.017%. The internal consistency of the 16-item scale was 0.91 indicating good inter-item correlation. Approximately 39.4% of the parents reported some form of Internalized stigma. Conclusions: The results revealed that the PISNC scale has high internal consistency and that it is made up of three distinctive factors: social withdrawal and alienation, stereotype endorsement, and discrimination experience. These factors although similar, are not identical, to the factors that underlie the ISMI scale.

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Background: Children with chronic physical illnesses frequently have psychiatric comorbidities, which often go un-noticed and may lead to more resource utilization and morbidity. Pediatric liaison services can be effectively used to bridge this gap. Literature on pediatric liaison services is sparse. Aims: To study the referral patterns, reasons for referrals, psychiatric diagnoses and interventions in children and adolescents referred to psychiatry department in a tertiary care hospital. Materials and Methods: A retrospective chart analysis of all children and adolescents below 19 years of age, referred to psychiatry department from 2010 to 2015, was done. Data was collected and statistical analysis was done. Results: Two hundred and nine subjects were included in the study. Mean age of sample was 12.15 (±4.20) years, with about 66.02% being males. About 54.06% of the participants were referred from pediatricians. Almost three fourth (72.25%) of children had no diagnosable physical illness. Intellectual disability (19.62%) was the most common psychiatric diagnosis, followed by depressive disorders (14.35%), and dissociative disorders (12.92%). Conclusions: In our study, majority of the referrals were the adolescent males from pediatric department. Intellectual disability, depressive disorder, and stress-related disorders were the common diagnoses. The fact that three-fourth of the referred children had no physical illness implies lack of awareness, stigma toward mental illness, and pathway of care.

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Background: Obsessive-compulsive disorder (OCD) is a clinically heterogeneous disorder. The previous studies have been conducted to elucidate visuospatial and nonverbal memory deficits in OCD patients. However, they did not reach equivocal results which need to be replicated. Objectives: The current study examines the visuospatial memory in male patients with OCD as compared to normal healthy controls. Materials and Methods: It is a cross-sectional hospital-based study, in which 15 OCD patients and 15 age-, sex-, and education-matched normal healthy controls were chosen by purposive sampling technique. All the participants underwent the Extended Complex Figure Test (ECFT) for the assessment of visuospatial memory. Results: Significant difference was found between OCD patients and normal healthy controls on various domains of ECFT. OCD patients performed poorly on copy condition (t = −4.46; P< 0.001), immediate recall (t = −5.20; P< 0.001), delayed recall (t = −5.18; P< 0.001), recognition task (P < 0.001), and matching task (P < 0.001) than the controls. Conclusion: Visuospatial memory was significantly impaired in OCD that included disturbed encoding and impaired visuospatial functioning. Hence, it is important to understand the significance of visuospatial memory in the pathophysiology for OCD diagnosis and therapeutic decision.

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Social networking sites are commonly used for self-disclosure. It provides the user the opportunity for catharsis. The present case is going to highlight the implications of Facebook storytelling. Clinical interview and NIMHANS psychiatric morbidity screening tool were used to assess the pattern of Facebook usage and psychiatric caseness. Facebook storytelling helps in coping with psychiatric distress. It implies the need to screen and encourage the users to use offline method receiving psychological support as well as develop the offline healthy coping behaviors.

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Mixed affective episodes can be misdiagnosed, especially in patients with intellectual disability (ID). We describe the case of an 18-year-old girl with mild ID, who presented with features of catatonia during the first mixed episode. These symptoms responded well to electroconvulsive therapy, following which clear affective symptoms emerged. Her affective episode did not respond adequately to olanzapine but improved significantly after the addition of sodium valproate. The difficulties of diagnosing affective episodes in persons with intellectual disabilities are discussed. This case suggests that mixed affective episodes should be considered in the differential diagnosis when poorly elaborated affective and psychotic symptoms are present in a patient with ID.

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The concept of “Alcoholics Anonymous” (AA) is familiar to mental health professionals and the general populace. The premise of the organization lies in individual suffering from problems related to alcohol embarking on a journey to submit before the almighty, taking cognizance of the effects caused by alcohol, making amends in life to people who have been harmed and taking action to prevent relapse to alcohol. The AA was formed after a fortuitous meeting of Bill Wilson and Dr. Bob Smith in Ohio. The duo subsequently embarked on the journey of helping others with alcohol-related problems. Since then, AA has grown gradually and how has more than 2 million members in its fold. This write-up traces the events that led to the meeting of Bill and Bob and the formation of AA, which led to a significant impact on individuals with alcohol use problems.

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Background: Despite the rights of persons with mental illnesses (PwMI) are protected by law in India, human rights of PwMI is being violated in many ways. There is dearth of literature on the human rights of PwMI in India. Materials and Methods: This cross-sectional study was conducted to understand the perceived human rights temperature of community in PwMI. Data were collected from PwMI (diagnosed with schizophrenia, bipolar disorder and schizoaffective disorder, and symptomatically stable for 3 years) seeking outpatient psychiatric treatment from private psychiatric hospitals and clinics in Kozhikode (Calicut) district of Kerala state, India. Data were collected using “Taking the Human Rights Temperature of Your Community” which was modified and validated in Indian population and a sociodemographic schedule which was prepared by the researchers. Results: The majority were males (54.2%). Mean duration of illness as 10.42 ± 6.43 years. Mean score of the human rights temperature was 68.31 ± 5.95. Perceived major concerns in the areas of career opportunity (59.5%), discrimination in hiring for work (61.3%), help and care in development of PwMI (64.5%), equal opportunity to avail treatment and cost incurred in it (60.5%), involvement in decision making (46.7%), and responsiveness of the community when any rights violation happens (44.9%). Conclusion: Human rights of PwMI are a major concern. Functioning of the mental health authority and legal aid clinics has to be strengthened to address rights issues of PwMI.

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Background: Earlier, the scholars of family studies have primarily focused on the problems and weaknesses of the families. However, during these days, there is a shift from problems to strength-based perspective. Methodology: Search of literature was carried out through internet-based Google Scholar search engine. Of the 112 titles obtained 21 titles fit the criteria of the study objectives, of which 9 full-text articles were finally selected for the purpose of this review. Results: In this review, nine full-text articles were reviewed. Nine of these researches investigated different facets of strengths perspective among the homeless adolescents. Chronologically, nine of these reviewed studies delineated the following thematic facets of strengths perspective among the homeless adolescents. These include personal strength and informal resources, personal strength in high-risk environment, strengths perspective during the transition of adolescence to adulthood, personal and social strengths that refrained the homeless adolescents form intravenous drug use, resilience and self-esteem, religion as an important strength, “hope” as a way of living among the homeless adolescents, coping strategies of street-involved youth, and usage of internet and social media as an important strength among homeless adolescents. Conclusion: Strengths perspective helps the youth to become a master of their own lives and helps to deal with all the adversities in life.

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