Mental Health Care (MHC) Act 2017 is published in the Gazette by Government of India. It is aimed at strengthening human rights of persons with mental illness. Changes such as advance directive and nominated representative are new, and review boards and responsibilities of government are clearly emphasized. The objective of this article is to give an overview of MHC act 2017 and its upcoming issues while implementing it.

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Lesions of the gangliocapsular nuclei are associated with multiple neuropsychiatric functions, and their disease presents with a variety of presentations. Purely psychiatric presentations are known, and among them, mood disorders and psychosis may be likely. Here, we describe a case series with three independent patients presenting with psychiatric symptoms attributable to basal ganglia lesions, but with three different presentations – mania, depression, and nonaffective psychosis. It is important to rule out basal ganglia lesions in all cases of psychiatric presentations where an organic etiology is suspected.

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Play is children's innate mode of self-expression and a method through which they explore the world. It has important implication for overall (physical, psychological, and psychosocial) development of any children. Play therapy capitalizes on such therapeutic powers or changing mechanisms within play and considers its strategic use through trained professionals to promote specific therapeutic outcomes within therapeutic contexts. This review article aims to provide a brief description on the use of play as therapeutic agent for change, different processes expressed in play, therapeutic powers within the play, and major approaches to play therapy. An attempt has also been made to list out some of the research studies from the available literature to prove the efficacy of play therapy in different conditions. The article concludes with highlighting the current issues and challenges faced by play therapy practice as a therapeutic medium to be used with children and way forward has been suggested.

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Background: Bipolar affective disorder (BPAD) is an episodic illness in which episodes of depression/Mania/Mixed/Hypomania occur. BPAD has been found to be associated with the following types of disability: increased suicidal behavior, higher unemployment, higher dependence on public assistance, lower annual income, and increased work absenteeism owing to illness, decreased work productivity, poorer overall functioning, lower quality of life, and decreased lifespan. The two affective disorders, major depressive disorder, and bipolar disorders were associated with the large decrements in functioning. Bipolar disorder was particularly strongly associated with having missed time at work. Depressive disorders have been associated with a larger number of disability days and poorer role functioning than several common general medical diseases – arthritis, hypertension, and diabetes. Aims: This study aims to study the disability in bipolar patients in relation to the duration of their illness and current effective state. Methodology: Clinical and sociodemographic details of patients and caregivers were collected using a semi-structured pro forma. Indian Disability Evaluation and Assessment Scale is used to assess patients' disability. The diagnosis of BPAD is made in accordance with the International Classification of Disease-10 criteria. Results: Severe disability is seen where the duration of illness is <10 years. Among depressive patients, the disability is found to of moderate level whereas patients who have a current manic episode experienced severe disability. Conclusions: Severe disability is seen where the duration of illness is <10 years.

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Context: Online game addiction has emerged as a public health concern. Effects of online game addiction on physical and mental health are well documented. Aim: The aim of this study was to find the prevalence of online game addiction and to see its correlation with emotional and behavioral problems among adolescents. Methods: This was a cross-sectional descriptive study conducted at two schools from Sonitpur and Kamrup districts of Assam using a convenience sampling technique. Total enumeration method was used to recruit a total of 415 respondents (standard 8^th, 9^th, and 10^th), out of which only 409 respondents were taken for final analysis. Sociodemographic datasheet, Strengths and Difficulties Questionnaire, Online Gaming Addiction Scale, and Short Self-Regulation Scale (SSRQ) were administered. The study was approved by the Scientific Committee and Institute Ethics Committee of LGBRIMH, Tezpur. Results: Online gaming behavior was found to have a significant positive correlation with emotional problem (r = 0.392, P = 0.01), conduct problem (r = 0.484, P = 0.01), hyperactivity problem (r = 0.335, P = 0.01), peer problem (r = 0.355, P = 0.01), and difficulty score (r = 0.506, P = 0.01). Online gaming showed a negative correlation with SSRQ (r = 0.0160, P = 0.01). Emotional problem (B = 1.139, t = 3.024, P = 0.001), conduct problem (B = 2.163, t = 5.661, P = 0.001), and total difficulty score (B = 1.196, t = 11.630, P = 0.001) contributed significantly to the prediction of online gaming addiction among adolescents (F[6,402] = 27.261, P = 0.001) accounting for 2.89% of variance. Conclusion: Online gaming behavior was found to have an association with emotional and behavioral problems among adolescents. Psychosocial interventions at individual and family levels can enhance self-regulation and control online gaming addiction among adolescents.

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Background: Albert Bandura is a renowned psychologist and has contributed a lot to the field of psychology. He is famous for social learning theory and the theoretical construct of self-efficacy the influential Bobo Doll experiment. Bandura supported a style of psychology which was based on investigating psychological phenomena through repeatable, experimental testing. In his wide spanning career he published many books and was honoured with many awards. He started his life in Canada and finally settled in America.

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Background: Police personnel form an important occupational group who constantly work under stressful situations. Preventive programs in the government organizations and studies investigating the occupational stress among police officers in India, particularly in the state of Andhra Pradesh, are still limited. Materials and Methods: Demographic details such as age, educational qualification, years of service, and number of children etc of Demographic details such as age, educational qualification, years of service, and number of children etc of Male police constables (n = 123) working in the Bellampalli subdivision of Adilabad district of erstwhile Andhra Pradesh were captured. Details of height, weight, body mass index (BMI, kg/m²), blood pressure (BP), pulse, the status of addiction, and type of illness were extracted from the records. Descriptive statistics were calculated, and Chi-square test to find an association between categorical variables was performed using SPSS version 16. Results: About 72.4% of the constables were addicted to at least one habit such as alcohol consumption, smoking, and chewing smokeless tobacco and pan. Nearly 20.3% were addicted to chewing tobacco/pan followed by addition to alcohol consumption 14.6%. With the increase in age, the prevalence of hypertension also increased showing a significant association (systolic BP [SBP]: P = 0.001; diastolic BP [DBP]: P = 0.001). Similarly, higher BMI (SBP: P = 0.008; DBP: P = 0.001) and increased number of service years (SBP: P = 0.001; DBP: P = 0.001) were associated with higher prevalence of hypertension. Conclusion: Developing an adequate evaluation of the association between chronic diseases and mortality in addition to a hazard surveillance system for tracking the risks for occupational injury and illness among police officers should be considered.

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Most mental health researchers believe that there is a variety of contributing factors to the onset of mental health issues. Studies have found that there are physical, social, environmental, and psychological causes. This paper highlights some of the mental health issues that are prevailing in Kashmir. The research so far conducted in the valley has pointed social, environmental, and psychological issues prevailing in general in the Kashmir Valley. The prevailing disturbances in the valley from the past two decades of turmoil in Kashmir were cited by most researchers as the main reasons for mental health problems. Apart from this, the changing political parties, ethics to divide, and rule resulting economic dynamics of inhabitants are also responsible for this menace. Depression, posttraumatic stress disorder, obsessive-compulsive disorder, stress, and anxiety are diagnosed in general to cause mental trauma, and illness.

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Functional gastrointestinal disorders (FGIDs) are chronic, recurrent, frequently debilitating disorders with no identifiable underlying pathology. They occur due to a complex interplay between biological, psychological, and social factors and are some of the most common conditions encountered in general clinical practice as well as the specialist gastroenterological clinic. The top-down regulation of visceral sensations plays an important role in the pathophysiology of the disease, i.e., the central processing of emotions and stressors altering the sensory and motor components of the gut, which increases hypersensitivity and therefore symptom severity. In addition, the core personality traits of the individual play their part in the way symptoms are perceived, further providing proof for the long-prevailing belief that the gut and emotions are linked, the so-called “gut feeling.” The current diagnostic criteria for FGIDs are entirely based on subjective symptoms, challenging in itself due to the varied presentations, and further complicated by the current unavailability of objective laboratory tests which could confirm its presence in the symptomatic individual. The various treatment modalities include psychotherapies ranging from cognitive behavioral therapy to mindfulness, along with appropriate pharmacotherapy to treat physical and psychiatric comorbidities. Addressing all these underlying causes, in addition to weighing in the genetic makeup of the individual, is necessary for delineating accurate prognosis, reducing attending health-care costs, and improving overall outcome of the individual.

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Romantic relationship is one among the defining feature and developmental task of adolescence, often considered to have significant influence on the course of other developmental tasks, overall health and wellbeing. Thus the present paper made an attempt to review different mental health promotion manuals developed for adolescence in India with the aim to understand whether those manuals address the emerging issues of adolescence in romantic relationship. Seven manuals were selected for this purpose and reviewed based on its content, methodology, target population and how issues pertaining to romantic relationship has been addressed. It was observed that all the manuals covered different aspects related to developmental needs and concerns of adolescents in general; especially the developmental significance of romantic relationship with its socio-cultural background has received little attention. Therefore this article implied for developing comprehensive manuals on emerging issues of adolescents in romantic relationship as a great need of the time.

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Background: Alcohol dependence is a maladaptive pattern of substance use for a period of 12 months, which is characterized by tolerance, withdrawal symptoms, loss of control, and craving. Burden is defined as the presence of problems, difficulties, or adverse events which affect the life (lives) of the psychiatric patient's significant others. Objective burden is used to identify anything that occurs as a disrupting factor in family life owing to the patient's illness while subjective burden refers to the feeling that a burden is being carried in a subjective sense. Aims: To compare the amount of burden among the caregivers with the severity of alcohol dependence in patients. Methodology: Severity of Alcohol Dependence Questionnaire is used to determine the severity of their condition in alcohol-dependent patients. Caregivers were administered Family Burden Interview Schedule to assess the burden experienced by them. The diagnosis of alcohol dependence syndrome is made in accordance to the ICD-10 criteria. Results: Severe burden is more seen in females, unemployed, in families where domestic violence is present. Conclusions: More severe is the dependence, more is the amount of burden experienced by the caregivers.

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Context: Exponential rise in internet usage over the past two decades has fostered internet addictive behaviors, especially in young adults. In India, medical students undergo tremendous stressful situations and are a vulnerable group for such addictive behaviors. Aims: The aim of the study was to assess subjective happiness of 1^st-year medical students and their internet addiction levels Settings and Design: A cross-sectional study done in a medical college in Bangalore, Karnataka, India. Materials and Methods: Sample consisted of 150 1^st-year medical students, who self-reported about their internet addictive pattern and subjective well-being on Internet Addiction Test and Subjective Happiness Scale, respectively. Statistical Analysis: Descriptive and inferential statistical analyses were carried out. Significance is assessed at 5% level of significance. Analysis of variance, Student's t-test, and Chi-square/Fisher's Exact test have been used. Results: Of the total sample, 42.7% of students reported of experiencing subjective happiness below the average, 41.3% had average happiness levels, and only 16% had scores above the average. Out of the students, 42.1% who had no internet addiction, 36.4% who had mild levels, and 54.8% who had moderate levels of internet addiction fell below the average happiness level. Conclusions: Those who had higher levels of internet addiction showed reduced subjective happiness. Thus, those who experience decreased subjective happiness without overt psychological disturbances are still prone to have addictive patterns. This should be considered during screening for addictive behaviors.

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Objective: To determine the attitude toward mental illness among medical students and nonpsychiatric doctors of Mamata Medical College. Materials and Methods: The study was cross-sectional, conducted in Mamata Medical College, Khammam, from September 2016 to March 2017. Our study sample contains 150 medical students doing internship and 100 nonpsychiatric doctors working in Mamata Medical College, Khammam, who are willing to participate in the study. Results: In the present study, we observed negative attitude toward mental illness among both medical students and nonpsychiatric doctors. When compared attitude toward mental illness among medical students and nonpsychiatric doctors, we found that there was no statistically significant difference. Compared to nonpsychiatric doctors, the medical students had stigma that people with severe mental illness are dangerous and it is more discomfortable talking to a person with a mental illness. Compared to medical students, the nonpsychiatric doctors had stigma that being a psychiatrist is not like being a real doctor and it is not important that any doctor supporting a person with mental illness also assesses their physical health. Nonpsychiatric doctors also had stigma that they do not want to work with a colleague if they had a mental illness. Conclusion: This study demonstrates the need for educational programs aimed at medical and nonpsychiatric doctors for providing basic information and thus demystifying mental illness.

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Context: The sleep is an important biological function, and the students are especially vulnerable to sleep-related problems which may have an impact on their health and well-being. Aims: The aim of this study was to assess the quality of sleep (QoS) and to study the relationship among QoS, physical health, psychological health, and quality of life (QoL) in undergraduate (UG) students. Settings and Design: In a cross-sectional study, 625 UG students filled out a semi-structured questionnaire. Subjects and Methods: The participants were administered the Pittsburgh Sleep Quality Index, WHO-5 Well-Being Index (WHO-5), and Rotterdam Symptom Checklist. Statistical Analysis Used: The data were compared using percentages and proportions. Results: A higher number of participants were with poor QoS in the categories of poor physical health (P = 0.003) and poor QoL (P = 0.001). The psychological distress in the group with poor QoS was found to be greater than the psychological distress in the group with good QoS (P = 0.001). Conclusions: In UG students, QoS was found to be positively associated with physical health, psychological health, and QoL. There is a need for longitudinal studies in this field to establish the causality.

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Introduction: Shift work is associated with impaired sleep patterns, poor quality of life (QOL), and several medical conditions. Shift work disrupts the sleep-wake cycle and biological rhythms. Poor sleep quality and disruption of the normal circadian cycle are likely to cause cardiovascular disorders, obesity, diabetes mellitus, anxiety, depression, lethargy, and fatigue. It is also associated with diminished vigilance and work performance. Aim: The aim of the study is to evaluate the impact of shift work on quality of sleep and QOL in industrial workers. Methodology: This is a cross-sectional, comparative study conducted on 147 rotating shift work employees and 132 regular nonshift day workers in various industries. Semi-structured pro forma was used for sociodemographic data. Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale were used to assess the quality of sleep. The WHO-5 Well-Being Index and WHOQOL-BREF were used to assess the QOL. Appropriate statistical methods were used to analyze the data. Results: Compared with nonshift day workers, those work for variable shifts exhibited higher rates of heavy smoking and increased caffeine consumption. Variable shift workers reported persistent sleep disturbance, poor sleep quality, and daytime sleepiness compared to fixed day shift workers (P < 0.05). The overall QOL score and well-being index were also significantly (P < 0.05) low in shift workers compared to nonshift day workers. Conclusion: Shift work has a significant negative impact on quality of sleep and QOL and results in poor functioning and disturbances in mental and physical health of the individual. Hence, attention must be paid to the strategies that can improve the quality of sleep and QOL.

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Cellular therapies represent a new frontier in the therapy of neurological diseases. Earlier, regeneration of neurons has been admitted as an impossible event. Thus, neurodegenerative disorders (e.g., Alzheimer's disease, Parkinson's disease, and multiple sclerosis), vascular events (e.g., stroke), and traumatic diseases (e.g., spinal cord injury) have been identified as incurable diseases. Later on, tissue reparative and regenerative potential of stem cell researches for these disorders drew attention of scientists to replacement therapy. Now, there are hundreds of current clinical and experimental regenerative treatment studies. One of the most popular therapies is cell transplantation. Transplanted neural stem/precursor cells protect the injured central nervous system using a variety of articulated mechanisms, a mode of action named ''therapeutic plasticity,” encompassing both bystander effects (immunomodulation and enhancement of endogenous repair mechanisms) and cell replacement. An extensive search was made using PubMed, Scopus, and Google Scholar using the following search terms: stem cells, neurodegenerative disorders, Alzheimer's disease, and stem cell therapy. In this review, we presented the possible benefits of stem cell therapy in neurodegenerative disorders.

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Anorexia Nervosa, an eating disorder having first been identified in the 17^th Century Europe has been considered a western syndrome with emphasis on slimness as a measure of feminine beauty. Global development and rapid changes in South-East Asian countries in economy, mindsets, and Adoption of Western attitude has occurred there have been sporadic reports of Anorexia Nervosa in the past few years in India mostly in cities. Our case report digresses from the familiar theory of Anorexia Nervosa being a westernized concept in presenting a case from Rural South India. We report of a 12-year-old girl child from rural district, South India, belonging to a traditional South Indian family of middle class status, presented with somatic complaints of pain abdomen and vomiting with background of progressive weight loss over 3 months with amenorrhea of 3 months, precipitating factor of comments from relatives about weight gain and menarche. Diagnosis of Anorexia Nervosa was made, with Body Mass Index 14.9. A multidisciplinary approach to treatment was commenced. Authors aim to point out the need to screen for eating disorders irrespective of patients' geographic or cultural affiliations to ensure prompt intervention.

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Solar retinopathy is a rare complication of damage to the retina due to unnatural exposure to bright light. Few cases have been reported in international literature in special groups like in children, psychiatric patients, direct gazing of solar eclipse and in certain occupations like arc welding. Of the few that are reported in mental institutions, majority had a diagnoses of schizophrenia. Along with the review of the reported cases, we report the first case of solar retinopathy in a patient who indulged in sun gazing during acute manic phase in our country.

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Introduction: The prevalence of metabolic syndrome is more in patients with schizophrenia receiving first- and second-generation antipsychotics. Aim and Objectives: The aim is to study the prevalence of metabolic syndrome in patients with schizophrenia treated with first-generation and second-generation antipsychotics and to compare the prevalence between two generations. Materials and Methods: The study sample was obtained from the patients attending the outpatient clinic or admitted to the inpatient unit of the department of psychiatry at tertiary care unit. Patients with schizophrenia, 50 each on treatment with first- and second-generation antipsychotics for a minimum of 4 months were measured for fasting blood glucose, blood triglycerides, high-density lipoprotein, blood pressure, and waist circumference. Adult treatment panel diagnostic guidelines were used to diagnose metabolic syndrome. Results: The prevalence of metabolic syndrome in first-generation group was (18%) and second-generation group was (40%). Comparison of the prevalence between the two groups showed Mann–Whitney value of −2.412*, which was statistically significant at P < 0.05. There was significant difference found in the chlorpromazine equivalent dosage of antipsychotics at P < 0.001. It signifies that though the second-generation group had received lesser amount of antipsychotic dose when compared to first-generation group, the prevalence of metabolic syndrome was more in the second-generation antipsychotic group. Conclusion: Metabolic syndrome is seen in both the group of patients taking antipsychotics. In line with previous studies, our study also found that the prevalence of metabolic syndrome is more in patients taking second-generation antipsychotics.

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Context: Despite extensive research on the attitudes of medical students toward psychiatry in India as well as worldwide, the actual reasons due to which medical graduates finally select psychiatry for their future careers is still unclear. Aims: To explore the lived experiences of postgraduate psychiatry students pertaining to their reasons for choosing psychiatry for future specialization. Settings: In an Indian medical college general hospital psychiatry setting. Methods and Materials: A qualitative study using focus group discussions and in-depth interviews with postgraduate psychiatry students. Statistical Analysis: Content analysis was used to identify direct and latent themes and develop a model. Results: Major themes underlying the reasons for choosing psychiatry are categorised into candidate related factors, medical college related factors, those related to process of Indian postgraduate medical selection, factors relating to psychiatry as a subject and social factors. Conclusion: The interaction between potentially interested medical under-graduates, their experiences of psychiatry during medical college along with the current system of postgraduate medical selection plays a major role in medical graduates pursuing psychiatry. Key Message: In order to improve future psychiatry recruitment rates in India, the quality of undergraduate psychiatry teaching should be improved. Professional psychiatry organizations should systematically engage with interested medical under-graduates and try to participate in the postgraduate selection process.

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Aims and Objectives: The aim of the study is (1) To assess the prevalence of nicotine dependence and its impact on quality of life and severity of symptoms in patients with schizophrenia. (2) To determine the association between ND and clinical symptomatology of schizophrenia. (3) To explore the impact of ND on the quality of life (QOL) of patients with schizophrenia. Materials and Methods: The current study is a cross-sectional study done among 100-male schizophrenic patients conducted in the Department of Psychiatry, Mamata General Hospital, Khammam, Telangana, from July 2017 to December 2017. The tools used are the Fagerstrom test for ND (FTND) was administered to assess ND. The Positive and Negative Syndrome Scale (PANSS) for assessing the clinical symptomatology, and the abbreviated World Health Organization QOL (WHOQOL-BREF) for assessing their QOL. Results: The prevalence of smoking in schizophrenics was 68.75%. Prevalence of ND is higher in illiterates, unemployment, nuclear family, low-socioeconomic status, and hailing from the rural background when compared to that of the nicotine nondependence. Nicotine-dependent were found to be having higher mean scores on the positive subscale and the General Psychopathology Subscale and lower mean scores on negative domain. Within the ND group, correlation testing between the FTND scores and PANSS revealed a negative co-relationship between ND and negative symptoms, whereas the correlation testing between the FTND scores and WHOQOL-BREF scores revealed a negative relationship between ND and psychological, social, and environment domains of QOL. There was a negative correlation between (a) Negative symptoms and all the domain of QOL. (b) General psychopathology and social relationships, environmental among ND. Summary and Conclusion: Nicotine-dependent patients suffer from the higher levels of symptoms and enjoy a worse QOL compared to that of the nondependent patients with schizophrenia. Bearing in mind the innumerable harms of ND, the evaluation and management of ND must become an integral aspect of the evaluation and management of patients with schizophrenia.

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