RFP Indian Journal of Medical Psychiatry

We report a case of an adolescent girl who had changes suggestive of encephalomalacia in the magnetic resonance imaging (MRI) of the brain but presented with psychiatric symptomatology instead of neurological manifestations. Encephalomalacia is softening of brain tissue which may lead to brain changes and present with varied clinical manifestations. Most of the cases reported previously were on infants & children and almost all of them were related to neurological disorders. But cases with psychiatric symptomatology were rarely reported, that too in adolescents. The authors discussed the psychiatric symptom profile, their management and emphasized the importance of imaging of the brain and its association with psychiatric manifestations.

Keywords: Encephalomalacia; Psychiatric Morbidity; Brain Imaging.

Our personal knowledge of the horrors of child sexual abuse does not necessarily mean that we are any better equipped to teach our children about child safety or to identify the warning signs of sexual abuse in children. In fact, many of us are so worried about “history repeating itself” that our anxiety gets in the way, and we either avoid the subject altogether and keep our fingers crossed – or we become very overprotective and try to wrap our children in so much cotton wool that they are not given the skills to protect themselves. Unfortunately, our laws are failing them and, consequently, ignoring opportunities to prevent child abuse. This article is intended to give you some ideas about how to protect your children from sexual abuse or paedophiles. And also to Acknowledge that pedophiles have a mental disorder, and removing the obstacles to their coming forward and seeking help, is not only the right thing to do, but it would also advance efforts to protect children from harm.

Keywords: Childsexual Abuse; Perpetrators; Pedophiles.

It is a pattern of behavior that is characterized by excessive acquisition and inability to discard large quantities of objects that cover the living areas of the home and cause significant distress.Reasearchers have only recently started studying hoarding and taking into consideration its severity at later stages it was defined as a mental disorder in the 5th edition of the DSM in 2013.Hoarding appears to be more common in people with psychological disorders such as depression, anxiety, ADHD, etc. The author here wishes to bring into light the better way of analyzing severity and style of hoarding and devise a treatment plan that is more suitable to specific cases of hoarders.

Keywords: Hoarding; Clutter; Psychotherapy; Cognitive Therapy.

Background: Negative attitude of interns toward psychiatry has been highlighted by multiple studies all over the world and there has been significant educationabout mental illnesses at various stages of under graduation in the recent times. The objective of this study is to identify the situation in this region by studyingthe attitude of interns toward various areas of psychiatry and to study the gender differences if any. Objectives and Methodology: Aim was to assess the attitude of medical interns towards psychiatry and to know the gender differences in the attitude. This was a cross-sectional study. Participants consisted of interns working in aprivate medical college and hospital. Subjects weregiven specially designed socio-demographic proforma and ATP-30 questionnaire which is a five-point attitude scale for assessing the attitude. The data collected was analyzed with the help of SPSS version 16. Result: The sample consisted of 84 subjects of which 34 were males and 50 were females. In total, 90.5%(n=76) subjects reported to have positive attitude towards psychiatry. Female interns had more positive attitude than male. Conclusion: Even though the interns overall shared a positive attitude towards psychiatry.Adequate modification is still required in the existing medical curriculum by encouraging more exposure to the subject. More number teaching sessions is very much essential for improving the attitude of tomorrow’s doctors towards psychiatrists and mental illnesses so to fight stigma and eventually promote the human rights of the mentally ill.

Keywords: Interns; Mental Disorders; Psychiatry; Social Stigma.

Ageing is a multidirectional change involving the physical, social, psychological and social spheres of a person’s existence. Ageing is not a steady state but a dynamic process. Theories of ageing, therefore, lead to a body of knowledge that facilitates the description, explanation, modification or optimization of ageing behavior. However, it is unlikely that any one theory of ageing can fully explain the ageing process and behavior and it is evidently possible that an ageing individual can be governed by small portions of multiple theories of ageing at the same time. This phenomenon was observed when life experiences of senior citizen convicts in Tihar prison, New Delhi were recorded and then analyzed in the context of various theories of ageing including the Disengagement theory, Activity theory, Continuity theory, Role theory, Labeling theory, Exchange theory, Subculture theory and Personality theory. Activity theory came out as the strongest and the most apt conceptual framework which governs the life of senior citizen convicts while glimpses of role theory, labeling theory, subculture theory and Exchange theory could also be seen influencing the life of senior citizen convicts and their behavioral traits and attributes.

Keywords: Activity Theory; Role Theory; Labeling Theory; Senior Citizen Convict.

The mother’s emotional adjustment when she assumes work outside home is the key to whether she succeeds or fails. Although working mothers have become the norm in the society, disapproving attitudes from various strata of the society contribute to the torn and guilty feelings many working mothers experience. The mother’s status as a working woman may consistently have either positive or negative effects on children’s development and educational outcomes.In the present comparative study done on employed and unemployed mothers with children in the age group of 2½-5 years, it was seen that maximum children of employed mothers exhibit moderate behavioural problems 24 (80%) while those of unemployed mothers exhibit mild behavioural problems 22 (73.33%).

Keywords: Comparative Study; Behaviouralproblems; Mother’s Employment.

Background: Worldwide there is a rising trend in number of people who resort to substance use at an early age. The percentage of population that drinks at an early age has increased from 2% to more than 14%. Research is needed to optimize treatment strategies especially in the understudied group of Asian Indians based on local epidemiology of alcohol use. Objectives: To study the clinical and socio-demographic profile of males diagnosed with alcohol dependence syndrome. Materials and Methods: A descriptive study comprising of 50 subjects attending psychiatry de-addiction clinic in a private medical college in Bagalkot, Karnataka during 1st April 2016 to 30th September 2016 was done after taking institutional ethical committee clearance. A semi-structured proforma was used to determine the socio-demographic details and clinical determinants. Descriptive analysis using appropriate statistical test will be done. Results: The mean age of starting drinking was 23.58 years. Most of the patients have not sought any previous help, 48.7% patients were brought by family members for de-addiction, withdrawal symptoms being the reason for seeking help. Most common cause (60%) for initiation of alcohol was peer influence followed by experimentation. Family history of alcoholism was positive in 68% of patients. Conclusion: Results showed an urgent need of interventions that are family centered. Early age of first use of alcohol greatly increases the risk of progression to the development of alcohol dependence and therefore is a valid target for intervention strategies. The dreadful consequences of substance abuse justify the need to evolve a comprehensive strategy.

Keywords: Alcoholism; Peer Influence; Substance Related Disorders.

Suicide is occasionally considered as a common final pathway for an individual facing diverse adverse circumstances. Suicide is a major concern across the globe. As per WHO(2013), around 8, 00 000 people die due to suicide every year and an even larger number attempt self- harm. Suicide is one of the leading causes of death among adolescents and young adults globally. It is a health problem which needs to be addressed. Among developing nations, India witnesses significant number of suicide. As per National Crime and Records Bureau (NCBR, 2015) in India nearly 1,33,623 deaths occur due to suicide [1]. The major risk factor for suicide is mostly an untreated and frequently undiagnosed mental disorder [2]. Although suicide is one of the major causes for mortality among psychiatric patients, in the Indian context research efforts in this area have been sparse. It is found that role of biological factors also equally important in determining the biological vulnerability for suicide attempt in psychiatric ill patients. Preventive measures have to be taken at all the levels from primary to tertiary. At the primary level,efforts have to be made to decrease the modifiable risk factors such as more restrictive and effective alcohol/drug policy/legal policy like banning over-the-counter sale of drugs and decreasing the availability of lethal methods. At the secondary level there is need for early identification and effective management of psychiatric disorders. Finally at the tertiary level intervention are required for the suicide survivors. History of past suicide attempt being an important predictor of future attempts, it is important to have trained mental health professionals for risk assessment for suicidal behaviour at various health services.There is dearth of published data on number of structured suicide prevention clinics or services in India. Despite increasing awareness and decriminalization of suicide attempt under the Mental Health Act 2017, help-seeking by suicide survivors is uncommon. It may be due to fear of stigma or lack of suicide prevention clinics by trained mental health professionalswho are trained to handle such issues sensitively, resulting them to be guarded about further risk assessment later. Psychiatry services are available at the Tertiary care health centres are often underutilized. Owing to less than optimal understanding of the nuances of treating a case like this among the accident and emergency department (A & E) staff, these patients may not be referred to Psychiatry at all during their treatment in the emergency room. It is necessary to have a trained mental health professional to assess them during entry level at the accident and Emergency (A&E) Department to ease there [3]. Assessment at an A&E department is a key opportunity to engage with a young person who selfharms. A retrospective chart review of suicide attempters brought to the A&E Department of the Teaching Hospital, M S Ramaiah Medical College from January 2014-July 2017 showed none of the 397 attempters referred for evaluation by a psychiatrist at the entry to A&E department and only 6 of them being referred later before discharge. The reason for not accessing mental health services could be also denial from patients and their caregiver probably due