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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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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Background: Aphasia is a language disorder which may disrupt an individual's functioning. To plan a mode of therapeutic/rehabilitative work, it is important to assess problems from a neuropsychological perspective focused on remediation of the impaired processes or compensation through the intact processes or both. Aim: Due to the paucity of tests available for the assessment of aphasia in the Indian population with specific colloquial expression, the aim of the present study was to develop an aphasia test for Hindi-speaking population and to provide evidence with its reliability and validity. Methods: The conception of the test took place in two phases: Phase 1 was the development of Indian Aphasia Battery (IAB) and Phase 2 was its standardization. IAB was administered along the Hindi adaptation of the Western Aphasia Battery (WAB-H) on participants with aphasia, probable aphasia, and healthy volunteers. Outcomes and Results: Based on the results of this study, IAB has a high concurrent validity and test–retest reliability in comparison to WAB-H. The subtests are sensitive enough to contribute to global aphasia quotient as a functional measure of aphasia in Indian brain-damaged patients. Conclusion: IAB is a quick and easy to administer measure for assessment of aphasia in Hindi-speaking population with high reliability and validity.

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Background and Aims: Very little information is available on how needs and perceptions to service utilization may change with duration of medical training. Our objective was to compare the self-reported barriers to health-care seeking for mental and physical health services separately between 1^st year and final year medical students. Methods: In this cross-sectional study, we invited all medical students of the concerned cohorts to complete a prevalidated checklist and 28-item self-reported questionnaire about perceived barriers to health-care seeking. The questionnaire had separate items pertaining to usage of mental and physical health-care services. Results: The response rate of the 1^st year and final year cohorts were 83.8% and 86.6%, respectively. Lack of time, unawareness about where to seek help, cost issues, and fear of future academic jeopardy were more common concerns among 1^st year students to the usage of mental health services (odds ratio [OR] 0.27, 0.45,0.09, and 0.49, respectively) whereas issues of stigma were more commonly reported by final year students for using mental health services (OR = 2.87). In contrast, the barriers in using physical health services were broadly comparable between the two cohorts. Conclusion: Differences exist between medical students in various years of training particularly with regard to self-reported barriers and perceptions particularly about using mental health-care services. This may have key implications for designing and delivery of service provisions in this group.

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Background: WhatsApp (WA), a free cross-platform smartphone application has revolutionized social communication over the virtual world. It enables information sharing, both personal and professional, individually and across social groups. Despite these positive changes, there have been concerns about excessive WA use, especially among college students, resulting in the neglect of important social and academic commitments. However, there is lack of quality research on WA use in this vulnerable population. Aims: The aim of this study is to understand the patterns and attitudes toward WA use and measure the level of dependence among college students. Materials and Methods: In a sample of 150 undergraduate medical college students who provided informed consent, comprehensive questionnaires were administered to assess the patterns, attitudes, and dependence toward WA use. Results: WA was the most common social media platform used (70%) which eclipsed the time spend on other apps (Facebook, Twitter, etc). While half of the students spent 1–2 h/day, a significant minority (10.67%) spent almost 6–7 h/day on WA. Nearly 12% (n = 18) of students qualified for WA dependence. There were no significant differences in patterns of WA use between students with or without WA dependence. Students with WA dependence had significantly lesser negative attitudes toward its use compared to the rest. Scores on all dimensions of WA addiction, namely, salience, mood modification, tolerance, withdrawal, conflict, and relapse were significantly higher in students with WA dependence. Conclusion: WA dependence is an emerging behavioral addiction among college students. With no specific pattern of use to distinguish dependent users, it is difficult to recognize this problem. Changing the attitudes towards WA use by creating awareness about it's addictive potential, monitoring and restricting the use of mobile phones especially during class hours, encouraging face to face interactions with friends and family can help reduce the progression of this behavioral problem. It is essential for clinicians to equip themselves to deal with technological addictions. Research on the the management of WA dependence using biopsychosocial principles suited to the Indian context are needed.

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The most critical need in the field of clinical psychology is unifying the firmly grounded theoretical principles with the real-time clinical practice and modern day neuroimaging advances. The present paper purports at determining the applicability of functional near-infrared spectroscopy (fNIRS) as a tool to supplement the cognitive and affective assessment, social functioning, psychotherapy, and rehabilitation through a rigorous review of the literature. fNIRS is used to measure cortical activation by recording changes in oxygenated and deoxygenated hemoglobin. Given the advantages and wide applicability of neuroimaging techniques, fNIRS can be effectively employed to assess real-time affective, perceptual, visual, and motor and language functioning of adults as well as infants. Summarily, fNIRS is a potential measure for comprehensive assessment of both healthy and pathological cortical working.

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Background: Specific learning disorder (SLD) in the past decade has gained recognition as a disabling condition among children by parents and teachers in India. However, there are still gaps in knowledge about its clinical presentation and understanding. Therefore, the present study was planned to evaluate the clinical and academic profile of children with SLD. Methods: The sample comprised 30 children with their age range between 7 and 12 years with a diagnosis of SLD-mixed type. All children were assessed through specifically designed structured pro forma for clinical details (i.e., nature of birth, developmental milestones, and comorbidities) and academic history (i.e., history of failure, promoted in next class, repetition in the class, school change, etc.) and SLD-comprehensive battery. Results: The mean age of the participants was 9.6 years (standard deviation [SD] = 1.5). 76.7% of participants were male and their mean years of education was 4.7 (SD = 1.5). Thirty percent of children had a history of delayed developmental milestones in terms of speech (16.7%), walking (6.7%) and in speech and walking (6.7%), 23% of children had comorbid conditions of attention-deficit/hyperactivity disorder/attention-deficit disorder. Thirty percent of children repeated classes in their academic career. Conclusions: A significant number of children had delayed milestones and other problems. Moreover, it is important to understand the clinical and academic profile in the cultural context so that early identification and intervention can be planned.

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Usher's syndrome is a heterogeneous autosomal recessive disorder characterized by dual sensory impairment in the form of profound congenital hearing loss and progressive visual loss due to retinal degeneration. There are only a few reports describing patients with Usher's syndrome presenting with psychotic features, and the exact etiology of its psychiatric manifestation is not clearly known. Herein, the authors report a case of Usher's syndrome with psychotic symptoms. Furthermore, the authors discuss the possible etiologies of psychotic symptoms in such cases and the challenges faced while assessing these symptoms in patients with sensory impairment.

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Intracranial injuries related to trauma, homicidal attacks, gunshot, or accidental injuries are commonly seen in emergency department. However, self-inflicted intracranial injuries are rarely described. In this report, we present a case of self-inflicted injury to the brain, by a male, under the influence of alcohol without any behavioral or cognitive sequelae.

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Intellectual disability (mental retardation) is a common mental health morbidity, worldwide. These groups of individuals are often a neglected cluster in the society. Intellectual disability often disables their ability to express their needs and distress, which becomes more evident with increasing severity of intellectual disability. Individuals with intellectual disability may show challenging behaviors such as self-injurious behavior. Dermatitis artefacta may result from repeated self-injurious behavior, which may mimic with various dermatologic conditions. Improvement in self-injurious behavior may bring improvement in the skin lesions.

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