The Mad Genius is a recurring stereotype of contemporary cultural expression, and many famous personalities and creators have suffered from psychopathology. Creativity and genius may be a sought-after trait; however, it is also commonly believed to be associated with psychopathology. This has been examined, starting with Lombroso's investigation of genius and madness in 1800s followed by a dearth of literature debating the association between the two. This evidence for this polarizing issue ranges from psychometric to neuroscientific disciplines and creates ambiguity neither refuting nor accepting this association completely. Through this article, we briefly review the literature on this subject and try to decipher what is written in between the lines, how creativity and psychopathology may fuel each other, and what may be its clinical implications.

Background: There is a growing evidence of increased prevalence of psychological problems (stress, depression, anxiety, and substance abuse) and feelings of burnout among medical professionals all over the world and this has been shown to be associated with lapses in patient care. Data from India in this regard are limited. Aims: To assess the various psychological problems (depression, perceived stress, and burnout) among medical professionals working in a government-funded tertiary care institute of India. Materials and Methods: An online e-mail survey was carried out among resident doctors and faculty members (a total of 1721 doctors). A total of 445 doctors (response rate-27.69%) responded to the survey. The survey included Patient Health Questionnaire-9 (PHQ-9), Cohen's Perceived Stress Scale, and Maslach Burnout Inventory. Results: Of the eligible 1607 participants, 445 responders, 376 (77.75%) were resident doctors and 69 (15.5%) were faculty. As per the PHQ-9, 30.1% of participants were found to have depression and 16.7% of participants reported suicidal ideations. About two-thirds of the sample experienced moderate level of stress (67.2%) and another 13% of participants reported high level of stress. More than 90% of the participants reported some level of burnout. Compared to faculty, higher proportion of the residents reported stress, depression, and burnout. Presence of depression, stress, or burnout was associated with lower indulgence in recreational activities, experiencing verbal or physical abuse in the hand of patients/caregivers, feelings that seniors do not show empathy toward patients, and seniors do not show empathy toward them. Conclusions: The present study suggests that a significantly higher proportion of doctors in Indian setting experience stress, depression, and burnout. The presence of stress, depression, and burnout is associated with long working hours and negative patient-related outcomes, adverse doctor–patient interactions, and interpersonal interactions among the colleagues.

Background: Worldwide, alcohol is the most frequently used and socially accepted hepatotoxin. However, not everyone who has alcohol dependence develops alcoholic cirrhosis, and does quantity/type or pattern of alcohol intake determine the development of cirrhosis? A study of this nature would help in delineating similarities/differences in the drinking pattern between alcohol dependence and alcohol-induced cirrhosis groups. Aim: The aim was to study the drinking pattern of persons with alcohol dependence syndrome (ADS) and alcohol-induced cirrhosis. Materials and Methods: Alcohol Intake database and Severity of Alcohol Dependence Questionnaire (SADQ) were administered to eighty male inpatients with a reliable family member of which forty were in ADS group and forty were in alcohol dependence with cirrhosis group. Results: Persons in the cirrhosis group were older with longer duration of drinking. There is no statistically significant difference in the educational status, religion, occupation, socioeconomic class, mean age of onset of drinking, mean age of development of dependence, type of beverage preferred, and initiating/maintaining factors between the two groups. The amount of alcohol consumed was significantly high in the cirrhosis group, with 33.5% in the high severity of dependence. They usually were drinking alone, outside meal times with regular and intermittent binge pattern. Conclusion: Alcohol dependence and alcohol-induced cirrhosis may be on a continuum but form a different group of heavy drinkers who may require different approaches to management.

Background: Attitude of doctors towards specific medical conditions plays a crucial role in patient care. Internship, being the final stage in undergraduate medical students' training, can have a bearing on the attitude they develop towards various specialties. However, there is dearth of Indian studies comparing the attitude of interns towards psychiatric illness and other chronic medical conditions. In this background, the study was conceived with the objective of comparing the attitude of interns towards psychiatric illness and other chronic medical conditions. Aims: (1) To compare the attitude of interns towards Psychiatric illness and Diabetes Mellitus. (2) To compare the attitude of interns towards Psychiatric illness and HIV/AIDS. Setting and Design: Conducted at Sri Siddhartha medical college, Tumakuru as a cross sectional study. Methodology: The sample for this cross sectional study comprised of 130 interns in a tertiary care teaching hospital who had completed their postings in Psychiatry. Medical Condition Regard Scale (MCRS) was used to assess the attitude of interns towards Psychiatry, Diabetes Mellitus and HIV/AIDS. Statistical Analysis: SPSS 20 was used with Descriptive statistics and non-parametric tests to analyze the data obtained. Results: There was no significant difference between the overall MCRS scores for Diabetes Mellitus and psychiatric illnesses. However, many individual items and the overall scores of MCRS were significantly higher for psychiatric illnesses when compared to those for HIV/AIDS. Conclusions: The attitude of interns towards Psychiatric illness was comparable to that towards Diabetes Mellitus. However, their attitude towards Psychiatric illness was more favorable than that towards HIV/AIDS. Further studies need to focus on the various aspects of stigma/ attitude and the effect of undergraduate medical training on those aspects.

Introduction: Psychological interventions have established competence in the enrichment of mental health, controlling, and diminishing manifestations in mild or moderate mental illnesses. It is evident that psychological therapies, in particular, cognitive behavioural therapy, have quantitatively and qualitatively alleviated the symptoms of mood disorders and anxiety disorders. Depression, a mood disorder, contributes to defi cit cognition, behavioral, and emotional malfunctioning in children. Specific aspects of positive affect were used in conjunction with psychotherapy, implied for depression treatment of 9–12-year-old children. The paper outlines the aspects of positive affect in psychotherapy and their role in behavioral modification, stimulation of positive emotions, cognitive flexibility, and effective interpersonal associations. Methodology: The research is based on pre–post research design, t-test was calculated. Results and Conclusion: It was found that integration of positive affects such as “Fake, Fake and Duchenne Smile” and “improvising the pleasurable activities” in psychotherapy were effective in alleviating depression.

Background: Obsessive–compulsive disorder (OCD) is a common psychiatric illness in children and adolescents. Till date, the sample sizes in the Indian studies have been relatively small. Methodology: The present study is a retrospective chart review of a large sample of children and adolescents diagnosed with OCD in a tertiary care center Objectives: The objectives of this study were to characterize the clinical profile and to evaluate outcome of OCD in children and adolescents Results: Fear of contamination and washing/cleaning compulsions were the most common presenting symptoms. Most of the patients were male with two-thirds having a comorbid disorder. Major depressive disorder was the most common comorbid disorder. The rates of attention deficit hyperactivity disorder, disruptive behavioral disorders, and tic disorders were low when compared to Western studies. One-third of the patients received adequate trial of serotonin reuptake inhibitors and 36% received cognitive behavior therapy. Fifty-four percent of patients had a poor outcome with hospitalization, longer duration of illness, earlier onset of OC symptoms, and family history of OCD being the predictors of poor outcome. Conclusion: The present study of a large sample of patients with juvenile OCD highlights the low rate of comorbid disruptive behavior disorders as reported in the earlier Indian studies and a favorable short-term outcome in approximately 56% of the patients.

Background: Cutaneous disorders are frequently seen in psychiatric patients. This may be attributed to the common ectodermal origin of skin and neurons. There is a paucity of data on cutaneous comorbidity in primary psychiatric disorders. Aims: The aim of this study is to determine the pattern of cutaneous manifestations in patients with primary psychiatric disorders Settings and Design: This was a hospital-based observational study. Subjects and Methods: A total of 210 patients suffering from various psychiatric disorders along with associated skin disease were recruited. Patients with an age <18 years and with history of substance abuse were excluded from this study. Statistical Analysis: IBM SPSS Statistics, version 22 (IBM Corp, Armonk, NY, USA) was used for the statistical analysis. Results: A total of 314 cutaneous manifestations were observed in the psychiatric patients recruited in this study. Among the patients surveyed, 88 patients were male (41.9%) and the remaining 122 patients (58.1%) were female. Primary psychiatric conditions observed were schizophrenia (25.7%), major depressive disorder (23.8%), bipolar mood disorder (23.3%), and psychosis not otherwise specified (11.9%). A majority (63.06%) of the cutaneous manifestations were noninfective dermatoses, and the rest (36.94%) were infective dermatoses. Fungal skin infections and eczema were seen in 33.8% and 24.8% of the cases, respectively. Seborrheic dermatitis (16.2%) was the most common eczema encountered. Nearly 75.2% of cases were found to have an insight into their skin problems. The common medical comorbidities seen in our patients were diabetes mellitus and hypertension. Conclusions: In our study, cutaneous manifestations were quite common in primary psychiatric disorders. A collaborative approach, between psychiatry and dermatology, should be an integral part of management in such cases.

Background: Twenty percent of pregnant women undergo an abortion. Reviews of previous studies on the effects of abortion on mental health have been inconclusive. Little research has been carried out in this direction in our country. Aims: This study aims to study the psychological effects of abortions and the associated sociodemographic and other parameters. Setting and Design: It is a cross-sectional study, conducted in five different government hospitals of Hyderabad. Materials and Methods: After identifying the participants, an interview was conducted. First, sociodemographic and other parameters were collected by an interviewer. Then, another interviewer conducted the interview using diagnostic tools (Impact of Events Scale-Revised [IES-R] and Goldberg Health Questionnaire-12 [GHQ-12]). Analysis was carried out using SPSS software. Results: Sixty cases of spontaneous abortion, 31 therapeutic and 9 elective abortions, were collected. Overall, on GHQ-12, 57% women had no distress, 11% had typical distress, while 14% had more than typical distress, 15% had psychological distress, and 3% of them had severe distress. On IES-R, 16% women had little or no symptoms of posttraumatic stress disorder PTSD, 57% had several symptoms, while 27% of them were likely to have PTSD. Conclusions: Women who underwent elective abortion showed less distress than the other types. Those that underwent a late abortion were more likely to suffer from psychological distress than those having an early one. The medical history was a significant factor in determining the mental health outcome of the women who underwent abortion.

Introduction: Female Sexual dysfunction is an important health concern caused by several factors. This study aimed to compare the sexual function of women who have primary headaches in order to investigate the relationship between sexual dysfunction and the features of headaches. Materials and Methods: 95 consecutive patients aged 18 to 65 years with a history of headache for at least 1 month and sexually active in the last 6 months presenting to Psychiatry OPD of a tertiary care hospital in New Delhi giving informed consent were taken. The diagnosis of headache type was confirmed according to the 2^nd edition of International Headache Society (IHS) International Classification of Headache Disorders (ICHD-II) in 2004. The Female Sexual Function Index (FSFI), visual analog scale (VAS) score and Migraine disability assessment scale score (MIDAS) were applied. Results: Those with migraines reported a greater intensity of pain than those with tension headaches. Individuals with tension headaches reported more frequent headaches. The mean MIDAS score in the migraine group was 14.64 (±2.59); 30% of the migraine group fell into the most severe category in MIDAS. Women with headaches had lower scores (indicating impaired sexual functioning) on all FSFI subscales, as well as on the total score when the prescribed cutoffs were applied as compared to controls (66.3% vs. 30% in controls). Conclusion: The present study showed that patients with either type of primary headache experience problems in several aspects of sexuality compared with controls.

Background: Children and adolescents comprise a significant proportion of people living with HIV. The effects of HIV on the growing brain have generated interest among researchers in this field. Deficits arising during this crucial phase of neuromaturation due to HIV infection need to be assessed and addressed. Neurological soft signs (NSSs) can act as a proxy marker for underlying neuropsychological deficits. The present study aims to study the NSSs in pediatric patients with HIV and compare with healthy controls (HCs). Materials and Methods: Forty-eight children aged between 6 and 16 years diagnosed with HIV were selected by purposive sampling, and the Physical and Neurological Examination of Soft Signs (PANESS) scale was applied. Fifty children matched by age and sex were recruited from a nearby school, and the PANESS scale was applied. Children were divided into age- and gender-specific groups. The outcome scores of cases and controls groups were compared. Results: Males and females aged 13–16 years with HIV showed more soft signs as compared to HCs, with respect to gait errors, dysrhythmia, impersistence, speed of repetitive and sequenced movements, overflow with gaits, overflow with sequenced movements, total overflow, and overflow in excess of age. The differences in scores were less marked in younger age groups among both the genders. Conclusions: The persistence of NSSs in older age group in HIV-infected children may point toward the presence of HIV-associated neurological disorder.

Background: Primary Care Doctors (PCDs) are the first contact for majority of patients with psychiatric disorders across the world including India. They often provide symptomatic treatment which is naturally inadequate. Absence or inadequate exposure to psychiatric training during undergraduate medical education is one of the prime reasons. Classroom training (CRT), a standard practice to train PCDs is driven by specialist based psychiatric curriculum and inherently lacks clinical translational value. Aim and Context: The 'Department of Psychiatry' of 'National Institute of Mental Health and Neurosciences', Bengaluru, India has recently come up with an innovative digitally driven modules of 'Primary Care Psychiatry Program' (PCPP) for practicing PCDs. Goal of this paper is to provide an overview of all these (five) modules with its various stages of implementation. Methods: Authors briefly discuss the current status of primary care psychiatry in India and also narrate the newly designed five modules of PCPP in this paper. Results and Discussion: An adopted psychiatric curriculum is designed in 'Clinical Schedules for Primary Care Psychiatry' (CSP) which is an integral part of PCPP. This is brief clinical schedules contains culturally appropriate screening questionnaire, transdiagnostic classification of 8 core psychiatric disorders, diagnostic, referral and management guidelines. PCPP contains 5 modules named as orientation module, basic module, advanced module [Tele-psychiatric 'On-Consultation Training' (Tele-OCT)], videoconference based continuing skill development module, and collaborative video consultation modules which covers all essential areas of primary care psychiatry for practicing PCDs. Last three modules are fully designed digital modules in hub and spoke model of Tele Medicine. In this designed program, the CSP and Tele-OCT are two path braking innovations having inbuilt higher clinical translation value. The challenges and opportunities that could be faced during its implementation across India are also discussed. Conclusion and Future Directions: Innovative PCPP is pragmatic in nature and has potential for higher clinical translational value. Once validated thoroughly, PCPP has potential for pan-India expansion. There is a need for artificial intelligence-based modules for next phase of PCPP in India considering her population and lesser number of available psychiatrists.

The issue of culture in Indian psychiatry has endured increasing neglect with the burgeoning biological paradigm. This viewpoint debates and demystifies the connotation of “culture” in mainstream psychiatry. As a template to infer dominant thinking in mainstream psychiatry about culture, DLN Murty Rao Oration in 2011, “Indianizing Psychiatry – Is there a case enough?” by Avasthi (2011) (published in the Indian Journal of Psychiatry) has been used. Engaging a broad interdisciplinary view helps unravel the inherent biases in psychiatry and opens up space for analysis of the Indian psyche from a different philosophic tradition and ways of researching it. Effort here is to open up dialog with cultural psychiatry, make efforts to involve traditional and folk therapies, and use available theoretical and empirical resources within cultural psychiatry for a refined practice of psychiatry in India.