Over the years Consultation-Liaison (C-L) psychiatry has contributed significantly to the growth of the psychiatry and has brought psychiatry very close to the advances in the medicine. It has also led to changes in the medical education and in the providing comprehensive management to the physically ill. In India, although the General Hospital Psychiatric units were established in 1930s, C-L Psychiatry has never been the main focus of training and research. Hence there is an urgent need to improve C-L Psychiatry services and training to provide best and optimal care to the patients and provide best education to the trainees.

Catatonia was delineated only as a type of schizophrenia in the many American Psychiatric Association DSM classifications and revisions from 1952 until 1994 when "catatonia secondary to a medical condition" was added. Since the 1970s the diagnosis of catatonia has been clarified as a syndrome of rigidity, posturing, mutism, negativism, and other motor signs of acute onset. It is found in about 10% of psychiatric hospital admissions, in patients with depressed and manic mood states and in toxic states. It is quickly treatable to remission by benzodiazepines and by ECT. The DSM-V revision proposes catatonia in two major diagnostic classes, specifiers for 10 principal diagnoses, and deletion of the designation of schizophrenia, catatonic type. This complex recommendation serves no clinical or research purpose and confuses treatment options. Catatonia is best considered in the proposed ICD revision as a unique syndrome of multiple forms warranting a single unique defined class similar to that of delirium.

Background: Intimate partner violence against women is seen in all cultures. It has wide-ranging effects on the physical and psychological health of women. In the local language, available questionnaires are either too exhaustive or inadequate to assess domestic violence comprehensively. Objective: To develop a Domestic Violence Questionnaire in Malayalam and validate it for married women aged 18-55 years in the local population. Study design: Descriptive study - Validation of questionnaire. Materials and Methods: A 29-item questionnaire, to identify domestic violence over the past 1 year, was developed in the local language, by selecting items from two other questionnaires and based on expert opinion. Item reduction was done after pilot testing. Then, this 25-item questionnaire was administered to 276 married women aged 18-55 years. Reliability and validity were estimated. Factor analysis was done for item reduction. Poor-loading, wrong-loading and cross-loading items were removed from the questionnaire. Taking the subjective perception of the participants regarding themselves experiencing domestic violence as the gold standard, a Receiver Operator Characteristic curve was drawn to decide the cut-off score with optimum sensitivity and specificity. Results: The final questionnaire had 20 items - 13 items for psychological and 7 items for physical violence. Internal consistency reliability was 0.92. At a cut-off score of 5, sensitivity was 89.5% and specificity 87.2%. Conclusions: The Domestic Violence Questionnaire in Malayalam has adequate psychometric properties to identify intimate partner violence against women in the local population.

Context: A causal association between media reporting of suicides and the subsequent actual suicides has been observed. There are no studies from India regarding media reporting of suicide. This study examines whether educating media professionals about responsible reporting of suicides can change the quality of reporting. Aims: To study the impact of a guideline on the reporting style of suicides by journalists. Settings and Design: Newspaper reports in the local language examined by psychiatrists. Materials and Methods: The Department of Psychiatry of a Teaching Hospital conducted a workshop for journalists, with the collaboration of media and mental health professionals and came out with a guideline about responsible reporting of suicide. Using this, a proforma was designed for assessing newspaper reports of suicides. All the suicide reports in the leading newspapers in Kerala were analyzed for one year prior to the workshop, the immediate next year, the second year, and six years later, using the 15 item proforma and whether each report was concordant or discordant to each item in the proforma was noted. Results: The total concordant responses were 43.7% in the year prior to the workshop, 45.2% during the first year following the workshop, 46.2% in the next year, and 45.7% after six years. When the trend of each item was examined, the concordance rates were increasing in each item, except two. There was no statistical significance. Conclusions: A workshop for journalists could bring about positive changes in the media reporting of suicides. The changes persisted over the years, although they did not reach statistical significance.

Background: International Classification of Mental and Behavioural Disorders (ICD)-10 has been serving its purpose in the spheres of diagnosing psychiatric patients, research, and education since long. With ICD-11 is on the horizon, this is the right time to assess issues in the application of these guidelines in routine clinical practice. Aim: In this study, an effort was made to find out day-to-day difficulties in application of ICD-10. Materials and Methods: A total of 130 patients attending for the first time the outpatient Department of Psychiatry, CSMMU, Lucknow, were taken as sample for the present study. The "provisional diagnosis," which was made after the usual assessments on a single day at the clinical setting was recorded. The selected patients were later assessed in detail and a "final diagnosis was recorded for these patients. The diagnoses were matched with ICD-10 and rated on a five-point scale. Statistics: The direct count and percentage analysis was done. Results: Results show that 67.69% "provisional diagnosis" were fully matched, while 8% and 5% diagnosis had no match and some match, respectively with the "final diagnosis." There were also some cases that had significant match (1.5%) and almost match (17.69%). Conclusion: In a busy clinical setting, the focus of the clinicians is more on management and accurate diagnosis based on ICD-10 may be ignored.

Background: Patients with mental health problems in the nonwestern world seek help from a variety of sources, such as the family physicians, psychiatrists, psychologists, traditional faith-healers, or alternative medicine practitioners. Understanding the help-seeking behavior is important from the public health perspective. Materials and Methods: Two hundred new patients visiting a psychiatric outpatient service at a tertiary care hospital were interviewed on a semi-structured questionnaire for various services contacted by them for their mental health problems. Results: Psychiatrists were the first choice in 45% of the cases followed by nonpsychiatric physicians and religious faith healers. Important reasons to seek help from different sources included easy accessibility, belief in the system, or particular healer and good reputation. Mean duration of treatment varied from 2.35 months with the alternative system practitioners to 16.63 months with the psychiatrists. The mean expenditure per visit to a service was highest for the nonpsychiatric physician and lowest for alternative system practitioners. Conclusion: Patients with mental health problems seek help from psychiatrists, nonpsychiatric physicians, faith healers, alternative system practitioners, and traditional faith healers for multiple reasons. It is important to sensitize various nonpsychiatric physicians with early identification and optimum management of mental disorders.

Background: Neuropsychiatric adverse effects of interferon (IFN) alpha are well known. There is little clinically relevant research on animal models of depression with recombinant human IFN alpha 2b (rhIFN-α2b). Aim: To identify an appropriate dose and duration of administration of recombinant human interferon alpha-2b (rhIFN-α2b) to establish a convenient and clinically relevant murine model of chronic rhIFN-α2b-induced depression using the forced swim test (FST). Materials and Methods: Using a 4΄3 factorial design, rhIFN-α2b was administered subcutaneously to mice (n=180) in the dose range of 400, 800, and 1600 IU/g/day for 5, 10, and 15 days; saline-treated mice formed the control groups. In each group, 1 day after the last dose, the mice were assessed for immobility in the FST. In another experiment, at these same doses and time points, the effect of rhIFN-α2b on murine motility was assessed in the small open field. Results: We found that rhIFN-α2b significantly increased immobility in the FST. The immobility was detectable by day 5 and did not increase with duration of IFN treatment. The immobility was apparent with the 400 IU/g/day dose and was not greater at higher IFN doses. At no dose or time point did rhIFN-α2b alter murine motility in the small open field. Conclusion: We conclude that rhIFN-α2b-induced behavioral despair, represented by immobility in the FST, is not due to reduced basal motility. The FST may therefore be used as a convenient Swiss albino mouse model of chronic rhIFN-α2b-induced depression with a 400-1600 IU/g/day dose administered subcutaneously for 5-15 days. The most economical model is 400 IU/g/day administered for 5 days

Aim: To determine whether brief intervention and contact (BIC) is effective in reducing subsequent suicidal behavior among suicide attempters. Materials and Methods: Suicide attempters (n=680) admitted in a general hospital in Chennai were randomly allocated to treatment as usual and BIC whose components include brief intervention at the time of discharge and contact for 18 months. Results: Completed suicide was significantly lower in the BIC group, OR 35.4 (CI 18.4 - 78.2) as also attempted suicide, OR 17.3 (CI 10.8 - 29.7). Conclusions: This low-cost intervention which can be readily implemented may be an important suicide prevention strategy in healthcare settings in India.

Background: The aim of this pilot study was to assess the effectiveness of a computer-based intervention on children who were average in academic performance. Materials and Methods: Twenty-one children aged between 8 and 11 years, in classes 3 ^rd , 4 ^th or 5 ^th formed the sample with 12 in the experimental (who underwent the computer-based training) and 9 in the control group (who did not undergo the training). Pre- and post-assessment was done for all children using a battery of intelligence tests, and the marks obtained by the child at school. The difference in performance of the two groups was compared using the t test. Result: There was significant improvement within the performance of the experimental group in cognitive functioning (P<0.05) and school marks (P<0.05), as compared with the children in the control group. The limitations of the study include the small sample size, non-random allocation to groups and the (pre and post) assessments being carried out by the researcher. However, the trend of results is promising. Conclusion: Thus, a brief computer-aided intervention for improving neuropsychological functions such as attention and working memory has had a positive impact on the cognitive and academic skills of children who were average in scholastic performance.

Context: The prevalence of psychiatric illness in correctional settings is significantly elevated, with higher than community rates reported for most mental disorders. Aims: (1) To examine the socio-demographic profile of convicted prisoners. (2) To evaluate the prevalence of psychiatric disorders in convicted prisoners. Materials and Methods: 500 convicts were assessed for psychiatric morbidity with the help of (a) Socio-demographic proforma, (b) Pareek Udai and Trivedi G's socio-economic status scale (rural) (household schedule), (c) Kuppuswamy's economic status scale (urban) and (d) Present State Examination (PSE). Results: 23.8% of the convicted prisoners were suffering from psychiatric illness excluding substance abuse. 56.4% of the prisoners had history of substance abuse / dependence prior to incarceration. Conclusions: The results suggest that a substantial burden of psychiatric morbidity exists in the prison population of India and the burden of psychiatric illness in this vulnerable and marginalized population poses a serious challenge to psychiatrists.

For decades, films across the world have entertained people and affected their attitudes regarding certain issues and conditions. Documentary films have been used by governments in different parts of the world to educate the general public and promote health and prevent the spread of disease as part of public health programs. Psychiatry as a branch of medicine like the rest of medicine continues to develop. With an increasing awareness among the general population and popularity of films showing various aspects of mental illnesses on the rise, educators and teachers are turning their attention to using films for education of medical students and psychiatric trainees. Although films may be stereotypical and prejudiced, they can be used successfully in teaching psychiatry trainees. In this paper, development of a movie club and its use are described and suggestions made to improve the use of films in this process.

Mental disorders impose a massive burden in the society. The National Mental Health Programme (NMHP) is being implemented by the Government of India to support state governments in providing mental health services in the country. India is facing shortage of qualified mental health manpower for District Mental Health Programme (DMHP) in particular and for the whole mental health sector in general. Recognizing this key constraint Government of India has formulated manpower development schemes under NMHP to address this issue. Under the scheme 11 centers of excellence in mental health, 120 PG departments in mental health specialties, upgradation of psychiatric wings of medical colleges, modernization of state-run mental hospitals will be supported. The expected outcome of the Manpower Development schemes is 104 psychiatrists, 416 clinical psychologists, 416 PSWs and 820 psychiatric nurses annually once these institutes/ departments are established. Together with other components such as DMHP with added services, Information, education and communication activities, NGO component, dedicated monitoring mechanism, research and training, this scheme has the potential to make a facelift of the mental health sector in the country which is essentially dependent on the availability and equitable distribution mental health manpower in the country.

The content of a delusion is of special interest to mental health professional and is still expanding. The concept of delusional procreation syndrome (DPS), containing delusions in all possible sequential steps in procreation, has been recently proposed. The authors report the case of a married woman harboring a delusion that her husband has been having 10 wives (ie, married once every year in last 10 years) and, as an extension to that, of having two children from each wife. The authors name this as "delusion of polygamy in proxy," and describe it as another dimension of DPS.

Obsessive-compulsive disorder (OCD) is a psychiatric disease characterized by anxiety-provoking thoughts (obsessions) leading to repeated, time-consuming behaviors (compulsions) that may or may not provide temporary relief. With an approximate prevalence of 2-3% of the general population and 0.6% in the Indian population, OCD is a debilitating disorder that can significantly affect nearly every aspect of a patient's life, and in some cases, lead to suicide.