Psychotherapy is being increasingly recognised as an important treatment modality for various mental health problems. However, minimal efforts have been made to examine the utility of psychotherapy from the public health perspective, especially for developing countries. This paper outlines the present situation in developing countries with respect to the magnitude of mental health and related problems requiring psychotherapeutic help, the existing health and mental health facilities, the current training in psychiatry and psychotherapy in different training programmes, and the current state of mental health knowledge and skills of primary care personnel. A number of strategies for public health action are delineated to enhance the availability of this form of treatment to the large number of people requiring psychotherapeutic help. The needs for systematic research in this area are highlighted.

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This study describes two surveys of psychotropic drug prescribing patterns for long stay patients in a teaching institute at an interval of 4 years. Polypharmacy was found to be at a low key, with minimal use of anticholinergics. The chief difference between the two surveys was in the significantly more use of once a day medication in 1988 compared to two divided doses in 1984. The importance of conducting such surveys periodically as a form of self audit is discussed.

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The present study has been carried out to assess the smoking habit among medical students and its relationship to demographic, social and psychological characteristics. Prevalence of smoking was found to be 30.79% in 854 students who responded to the questionnaire adequately. Smoking habit was more common among student who were married hailed from rural areas and the intensity of smoking increased with advancement in the career in medical profession. A strong association was observed between the habit and family history of smoking. The psychological factors associated with smoking were worry about examination unhappiness without justified cause and failure in friendship.

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The study was carried out in 25 mentally retarded children and compared with equal number of normal children. They were subjected to detailed psychiatric evaluation and dental examination. The dental anomalies were corroborated with cephalometric analysis of lateral cephalograms. It was concluded that all mentally retarded children had some dental abnormality in them in form of dental malocclusion, wide inter dental spaces, absence of teeth etc. We suggest early dental management for such patients for reinforcing their neuromuscular coordination modifying the mastication power, swallowing, speech, stomatognathic function and above all their facial profile for better social acceptance.

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During the study period of three months, out of 425 patients attending the psychiatric clinic of a general hospital, for the first time, 165 (38.8%) did not complete the treatment as prescribed by the doctors and were considered as dropouts. They were contacted at their homes to find out the reasons of the dropping out, were compared with patients, who completed the treatment fully on socio-demographic variables and attitude towards treatment. Dropouts significantly differed from treatment acceptors regarding their income, place of domicile and occupation. Maximum number of patients (59.9%) dropped out after the first visit. Dropouts were the maximum among epileptics, and minimum among the mentally retarded patients. Dropouts were dissatisfied with their experience at the clinic as treatment advised was not of their choice, and they feared bad side effects from ECT and drugs. Long distance of residence from clinic was an important reason for dropping out, besides social and economic reasons.

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The Central Institute of Psychiatry provides extension consultation services at two coalfield hospitals of Bihar, representing the intermediate and central level of health care delivery system. Analysis of data covering a period of one year, from September 1988 to August 1989, revealed significant differences in the utilization pattern of the two centres. The differences relate to the proportion of population observed, their demographic characteristics, diagnostic break-up, and follow-up pattern. The provision of psychiatric extension services at the intermediate level is recommended.

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Twelve patients with organic delusions during recovery from head injury were studied in comparison to a control of non-deluded head injured patients. Clinical data such as duration of unconsciousness, length of post traumatic amnesia and occurrence of brain-stem signs pointed to the presence of subcortical functional disruption in these patients. Clinical and psychometric data indicated that left hemispheric functions were more impaired than those of the right. Recent concepts in the biomechanics of head injury indicated that subcortical and left sided dysfunction following head injury was significantly associated with the occurrence of delusions.

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Eleven patients who evinced hallucinations during the early recovery after head injury were studied in detail in comparison to the head injured controls. All of them had suffered from acceleration injuries. Among the clinical variables, post traumatic amnesia was significantly longer in these patients. Length of FTA was found to be correlated with duration of occurrence of hallucinations. Severity of coma, skull fracture, early seizures and alcohol dependence were not discriminatory between the hallucinated patients and the controls. The disorder tended to be self-limiting and patients recovered without the aid of psychopharmacological measures. Theoretical significance of the findings are discussed in the context of recent literature on head injury.

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Dermatoglyphic features, qualitative as well as quantitative, of finger and palm prints of 50 male I. C. D.-9 diagnosed catatonic schizophrenics and as many ethnically matched normal controls of the same sex were examined. Patients were found to differ from the control group in qualitative as well as quantitative features quite similar to the findings of the past three investigators. These differences in the dermatoglyphic features of catatonic schizophrenics and normal controls might be a genetic marker for catatonic schizophrenia. A larger sample study is required to put this hypothesis on strong footing.

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Search for a safe and effective analgesic is long and elusive. Buprenorphine was marketed as a potent and non-addictive narcotic drug. In recent years there have been various case reports highlighting its abuse potential. As the drug will be used more widely and particularly with its use in the detoxification of heroin dependence there is an eminent possibility of its abuse at larger scale in future. Physicians should be careful in its prescription and cases of its abuse should be actively sought tor. A case report along with literature review is presented here.

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The prevalence of non-psychotic 'minor' mental morbidity in primary care setting is high. They often go undetected due to several factors in the patient and the clinician. Studying personal, social and clinical characteristics of non-psychotic patients attending a general hospital outpatient department several factors could be identified which might be helpful in screening of such patients. The factors are sex (female), age (≥40 years), marital status (married/ widowed) education (less than primary school), occupation (unskilled labour) presenting complaint (somatic nature of ≥3 months duration), presence of 4 or more somatic complaints lasting ≥3 months, and presence of dyspeptic symptoms.

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