Several studies have reported decreased platelet 5-HT uptake in patients of major depression. The mechanism of antidepressant action of ECT is not clear. The present work was undertaken with the aim to study the active platelet 5-HT uptake and the effect of ECT on it in patients of major depression. 15 patients of major depression (DSM-lll-R) and equal number of age and sex-matched controls were included in the study. Active platelet 5-HT uptake was determined before ECT, after a course of ECT and 7 days after last ECT. Platelet 5-HT uptake was. significantly lower in der essives than normal controls. After ECT treatment there was significant increase in 5-HT uptake which came down to pretreatment level after 1 week of last ECT. The effect of ECT on serotonergic system is discussed.

Psychiatric evaluation and assessment of common physical illnesses and disabilities was carried out in elderly depressives (aged 60 years and above). Correlation, if any, was seen between depression and physical problems. The 'patient group' comprised of 40 drawn from MHI, Cuttack, having a depressive disorder (ICD-10). The 'control group' of 20 was drawn from the general population with no psychiatric disorder. The presence of physical illness was looked for in both groups. The patient group had physical illnesses, 76% of which were previously undiagnosed. The control group had physical illnesses 71% of which were previously diagnosed. Undiagnosed physical illnesses are more common among elderly patients with depression than among matched control. The physical illnesses contributed in two thirds of the patients. So careful detection and management of physical illness is of equal importance in the management of depression.

One hundred and four subjects with heroin dependence, consecutive new admission to a ward were studied prospectively to assess treatment retention. All these subjects were admitted voluntarily after pre-admission counselling wherein treatment package (four week's stay), ward routine, rules and regulation were explained. Socio-demographic parameters, drug use history, motivation as understood by "readiness to change", reasons for seeking treatment were obtained. Reasons for non completion were noted. Thirty two subjects (31%) completed treatment. Out of 72 non-completers, 38 subjects (36%) left against medical advice and 34(33%) were discharged prematurely by the treating team for violating ward norms. Multivariate analysis showed that readiness to change (being in action stage), age of onset of heroin use (late), legal problems (high) and self confidence regarding recovery (high) in order of significance, predicted treatment completion. Therapeutic strategies to minimise drop-out. are discussed.

Women alcoholics seeking psychiatric help have been increasing steadily over the years. The data on this subgroup however, is limited. Eighteen women alcoholics who presented to us over one year have been compared to twenty-eight men alcoholics who presented to us over one calendar month. Gender differences in the functions and effects of problem drinking were found. Men and women alcoholics differed in marital and occupational status, initiating and maintaining factors for drinking, course of alcoholism and alcohol related damage.

In 47 subjects having alcohol dependence syndrome, the progression of alcohol related milestones was studied in terms of age-at-onset of each milestone. The findings revealed a definable progression with three phases. The early phase, characterized by the absence of any problem, ended with the use of 1/4th bottle of spirit a day, more than once-a-week. The middle phase began with daily drinking, ended with the use of 1 bottle of spirit a day, and was characterized mainly by social problems. The late phase began with the onset of morning drinking, and was characterized by the addition of physical problems. These findings support the earlier research suggesting a definable progression of alcoholism. However the physiology identified by the present study is unlike that reported by some of the earlier research.

Out of 881 randomly selected outpatients in four rural district hospitals in Kenya who underwent a two stage screening procedure for a psychiatric disorder, 24.9 percent had psychiatric morbidity. Further analysis showed that 12.7 percent of them had an alcohol related disorder as defined by ICD-9 (WHO, 1978) under the categories 291 and 303. For the screening of alcoholic cases brief MAST was used. The author found this instrument a quick method for identifying potential alcoholics. At present, such cases go undetected and untreated. Some important issues related to alcohol drinking in rural Kenya are discussed. Most of our patients drank the locally brewed alcoholic beverages of variable ethanol contents. The health planners and primary health workers (PHW) will have to pay more attention to the widely prevalent alcohol abuse which seems to masquerade in various forms of physical, social or psychological problems. Indeed, more intensive training of the PHWs in detecting and advising alcoholics maybe the best method in the rural setting.

Most of the autistic disorder patients are also mentally retarded and many mentally retarded persons exhibit autistic symptoms. By using a standard instrument (Ritvo-Freeman Real Life Rating Scale) the autistic features of the mentally retarded children were studied. The study also examined the influence of age, sex and level of mental retardation on the occurrence of autistic symptoms. Children who came for consultation to child psychiatric unit were compared with those at a school for children with mental retardation receiving stimulation. Male children from child psychiatric unit had significantly higher scores than those from the school. Social and language impairment could be reliably identified and grouped. It was possible to diagnose the syndrome of autism in children with mental retardation in a significant number (9.6%)as compared to that was possible only clinically (1.9%). More number of children with severe/ profound mental retardation could be diagnosed as autistic. The autistic syndrome in children with mental retardation can be picked up more effectively by the use of structured instrument.

Hyperkinesis is associated with deficits of attention (poor allocation of attention resources, susceptibility to interference and perseveration); vigilance and perceptual sensitivity. Three boys aged 7-8 years with simple hyperkinesis were given cognitive tasks to improve the above functions in daily one hour sessions for a month. The children improved significantly in the above functions and behaviour. Three other children aged 5-8 years with simple hyperkinesis who were on medication improved only slightly in their behaviour during this period. Behavioural intervention and parental counselling were additional inputs to the children in both groups. Neuropsychological remediation combined with parental counselling and behavioural intervention shows promise in treating hyperactive children.

Twenty-five subjects, who had undergone amputation within last 6 weeks, were studied for psychiatric complications, including phantom limb phenomena. The patients were interviewed on SCID, HRSD and HARS. Out of a total of 25 subjects, 8 (34.6%) developed psychiatric disorders - PTSD and major depression. The whole sample was thus divided into 2 groups-sick and nonsick. Phantom limb was seen in 88% subjects. No significant difference was present between the two groups with regard to presence of phantom, its associated phenomena of pain, telescopy and movement. A statistically significant difference was seen in psychiatric sickness in relation to upper and lower limb.

Psychiatric sequelae present after 6 months to 2 years following amputation were studied in a group of 25 subjects. The subjects were screened on SCID, HRSD and HARS. The most common diagnoses were depressive disorder NOS (20.6%) and major depressive disorder (10.3%). Patients having right sided amputation were more psychiatrically ill than those with loss of a left limb. Phantom limb was seen in about two-thirds of the total sample-more in the sick group (about 88%) than in the non-sick group (about 55%). Pain in the phantom limb was seen more in the sick group, but telescopy and movement were more frequently complained of by subjects of the non-sick group.

Obsessive-compulsive (OC) symptoms during the course of schizophrenia have been reported, yet the incidence and significance of this finding is still unclear. This study was undertaken to determine the prevalence of OC symptoms among chronic schizophrenic patients and to systematically identify them. 101 patients satisfying DSM-IV diagnosis of chronic schizophrenia were assessed for OC symptoms. All patients were also rated on the Yale-Brown Obsessive Compulsive Scale for the severity of their symptoms. The study revealed that 26.7% of the chronic schizophrenic patients had significant OC symptoms with a high prevalence in the age group below 35 years. OC symptoms were more severe in patients with duration of illness more than 5 years. The OC symptoms were more prevalent among paranoid schizophrenics with the frequent obsessions being that of contamination, sexual and aggressive thoughts and frequent compulsion was need to ask or confess.

54 patients who sought consultation at this centre after developing psychiatric illness following local panchayat elections in Rajasthan were studied. The study aims to find out whether election is a stressful life event, relationship of socio-demographic characteristics, role of process of election, and nature of psychiatric illness as related to election stress. This group was compared to general psychiatric patients randomly selected from the same hospital, with or without other stressful life events (n=60). Socio-demographic variables, nature of their illness, ways of coping with the stress and relationship of predisposition to mental illness have been studied in both groups. Findings have been discussed and implications highlighted.

Induced delusional disorder or folie a deux in a 19 year old girl from India whose 16 years old younger sister had paranoid schizophrenia is described. Transient sharing of delusional beliefs by those living with the patients may be an extension of unsubstantiated beliefs held by the community.

The textbook description of comorbid depressive and obsessive compulsive disorders is that of onset of one following the onset or peak severity of the other, and recovery of one usually following recovery of the other. We describe a case who developed first onset obsessive compulsive disorder at tail of first onset major depression. This case highlights need for studies on the course of comorbid depressive and obsessive compulsive disorders.