Positive mental health is, and should continue to be the basis of all the mental health policies of any country. The scarcity of well-documented school mental health (SMH) activities and the data for the region of Maharashtra is the main rationale behind this review article. After reviewing some important studies related to SMH in India, the SMH data at Child Guidance Centre of Yashwantrao Chavan Memorial Hospital in Maharashtra, will be used to discuss and propose a guideline for further SMH activities in Maharashtra. SMH program is the best way to cater to the current and future demand of mental health services and to improve overall child and adolescent mental health.

Pimavanserin is a drug with a novel mechanism of action that has recently received approval management of patients with Parkinson's disease psychoses [PDP]. It is a 5HT2A inverse agonist that has been shown in a randomized controlled trial to be superior to placebo and also reasonably safe and effective. It significantly reduces positive symptoms seen in Parkinson's disease patients with psychosis with no evident impairment of motor function. It offers hope for patients and caregivers with this otherwise distressing and difficult to manage condition and has also paved the way for the use of 5HT2A inverse agonists in this condition.

Specific learning disability (SLD) is a common and invisible yet highly impactful disability. There have been many changes in the field of SLD. These range from changing concepts, introduction of newer diagnostic systems, presentation of the Rights of Persons with Disability Act, of 2016, an increasing awareness in parents, teachers, and public, filing of legal case, and the Honorable High Court issuing orders regarding this disability. All these happenings require reflecting and implementing new strategies. This will not only to benefit all the concerned people but also make the process of diagnosis and intervention streamlined. In the past, Maharashtra has been a forerunner in granting help to these children. Keeping this in mind, it seemed necessary to look at the current scenario of SLD in our state and suggest a way forward.

Background: Medical students do postgraduation in a specific branch for a particular motive and goal in life. Due to workload, they have less desire to do research or even pursue academics. This study was undertaken to study the differences among the clinical and nonclinical postgraduate students in the intrinsic and extrinsic motivation to learning and the attitudes to research. Methods: This study was conducted in 373 postgraduate students in a tertiary care hospital after written informed consent and ethics approval. A semi-structured questionnaire, academic motivation scale, and attitudes toward research scale collected the information about aims of the study. Results: Two groups were formed depending on the disciplines being pursued by the students, namely, clinical (n = 245) and nonclinical (n = 128). The nonclinical group showed significant differences on extrinsic motivation (t = 2.886, P = 0.0004), total motivation (t = 2.92, P = 0.0024), and attitudes to research students (t = 11.14, P = 0.0001) as compared to the clinical disciplines. However, on the intrinsic motivation subscale, no significant differences were seen. Discussion: The nonclinical postgraduate students were influenced by extrinsic factors to pursue learning and gain mastery as well as to do research. Students pursuing clinical disciplines had lower scores for academic motivation as well as attitudes to research. Time constraints, lack of infrastructure, and clinical workload add to the woes of clinical students. Conclusion: The results of this study will help us in determining the ways of improving motivation of postgraduate medical students toward academics and research.

Background: Medically ill elderly patients are more prone to develop depression. Stressful life events which the patient experiences as well as the absence of perceived social support all act as risk factors for developing depression. Moreover, if the coping mechanisms are faulty the risk of developing depression increases. Aim: This study was conducted to assess the prevalence of depression in medically ill elderly patients and the risk factors associated with faulty coping mechanisms, perceived social support, and stressful life events. Materials and Methods: This was a cross-sectional study conducted at a tertiary care hospital, wherein 100 patients fulfilling the inclusion and exclusion criteria were chosen. Patients were administered a semi-structured questionnaire to obtain details about sociodemographic profile and diagnosed medical illnesses. Geriatric Depression Scale, Coping Inventory for Stressful Situations, Multidimensional Scale of Perceived Social Support, and Presumptive Stressful Life Event Scale were used. Results: Prevalence of depression was 72% among the medically ill elderly patients. Depressed patients used more of emotion-oriented coping and less of task-oriented and avoidance coping mechanisms the perceived social support in the form of family and friends was significantly less in depressed patients. The more the number of stressful life events experienced by the patients the more depressed they were. Conclusion: Early identification of risk factors and early diagnosis of depression may help us in carrying out timely interventions and thus improve the quality of life of our patients.

Background: Alopecia is known to have an impact on psychosocial health of an individual. Besides depression, anxiety is commonly associated with it and can add significantly to the burden due to it. The present study was carried out in the patients attending dermatology outpatient department, which looked into anxiety symptoms and its correlations with various demographic and clinical factors. Materials and Methods: Thirty consecutive patients diagnosed with moderate alopecia not requiring any major intervention participated in the study. Each patient was individually interviewed using a semi-structured pro forma which included sociodemographic profile, clinical and psychiatric profile, and dermatological diagnosis, and rating scales of Brief Psychiatric Rating Scale (BPRS) and Hamilton Anxiety Rating Scale (HAM-A) were administered. Results and Discussion: Mean age was 30.86 years (standard deviation 11.89), 50% males and majority married with urban background. Many had complaints of uneasiness, excessive worries, and disturbed sleep. The mental status examination in the majority of them revealed anxious mood and preoccupation with worries. None of them satisfied the diagnostic criteria for any anxiety disorder as per Diagnostic and Statistical Manual of Mental Disorders-5. The mean BPRS score was 22.80 with the participants scored significantly on anxiety, tension, and somatic concern and the mean HAM-A score was 10.30 with the majority of participant had score in the range of significant anxiety. Their correlation with factors of gender, marital status, duration, and pattern of alopecia was found to be not significant. Conclusion: Although no diagnosable anxiety disorder was present in patients of moderate alopecia, majority of them had significant anxiety found during the assessment.

Aims and Objectives: The aim of this study was to evaluate knowledge and attitudes toward suicide and suicidality behavior among medical and paramedical students. Materials and Methods: A cross-sectional study was conducted in a medical college of western India where undergraduate medical (238), physiotherapy (25), and nursing (137) students were enrolled. After taking informed consent, detailed assessment of knowledge, attitude towards suicide using Suicide Opinion Questionnaire and suicidality behavior using mini-international neuropsychiatric interview were done. Data were analyzed using appropriate statistical tests. Results: Ninety-three percent students agreed “people who are at risk can't be easily identified.” Eighty percent students believed “potentially anyone can be a suicide victim.” Acceptability of suicide was highest in nursing students; B.P.T students had highest knowledge regarding suicide. None had active suicidal ideation or planning. Only at a thought level, one-third of total population reported feeling of hopelessness sometime in their life. Sixteen percent, nearly double females (n = 299) thought sometimes in their life that “it would be better off dead” compared to 8% males (n = 101). Among three groups, nursing students showed highest suicidality behavior. Conclusions: Attitudes toward suicide and suicidality behavior differ among the groups with significant gender differences. Although acceptability is the highest among nursing students, the group is at higher risk with higher suicidal ideation. Students believe, “people who are at risk can't be easily identified;” hence, further exploration, awareness, and interventions are suggested.

Transference and countertransference are key diagnostic concepts in psychoanalysis which are unacknowledged in categorical diagnostic systems in psychiatry. This may also highlight the fundamental differences in understanding clinical presentation in the context of the individual. In psychoanalysis, the clinician's response to each patient is carefully thought about. Three vignettes are used to illustrate how clinicians use their countertransference to ask key questions which address the sense of the uncanny that the patients' stories evoke. This is then linked, using the theoretical notion of projective identification, to unconscious communication between doctor and patient. I conclude by describing an ICD-10 category of patients who present a disturbance in articulating emotions, tending to evoke and manifest powerful bodily experiences. The examination of countertransference is suggested as adding depth to a diagnostic process that risks losing the value of data from individual patients.

H-syndrome is an autosomal recessive disorder with characteristic features of hyperpigmentation, hypertrichosis, hepatosplenomegaly, heart anomalies, hearing loss, hypogonadism, and low height. The manifestations of the syndrome are seen usually in the childhood, and most of the components of the syndrome are evident by adolescence. Till date, there is no mention in the literature of psychosis as a part of syndrome nor as a comorbidity. Here is a case report of H-syndrome diagnosed patient presenting with psychosis. Whether psychosis is a part of the syndrome or comorbid is not clear and hence to be observed in future.

Trichotillomania is a compulsive disorder of recurrent hair-pulling that may be seen in children and adolescents in the setting of obsessive-compulsive disorder, psychosis, and mental retardation or other developmental disabilities. Child and adolescent trichotillomania has been understudied in India and studies on its features and management from India are rare. We report here a case of pubic hair trichotillomania in an adolescent with autism that responded successfully to fluvoxamine.

Art is a creative form of expressing personal thoughts, opinions, feelings, and often a reflection of prevailing ethos and has been around for almost as long as man's existence. Today motion pictures (movies) are the most popular forms of artistic expression. They touch upon various issues of human interest like our society, fantasy, sci-fi, and in recent times, emotions. Every artwork induces unique emotional and cognitive experiences within the creator, participant and observer through novel techniques like therapeutic film making, participatory arts therapy and cinema therapy, respectively. Movies are also engaging instruments of education for medical and psychology students. Cinema allows for active learning through fantasy, expressing emotions, exploring one's own feelings and those of others, providing a safe environment for problem-solving strategies and dealing with unresolved emotions. Indian mental health professionals must now begin using this multimodal and integrative medium of cinema to its full potential.

Faith healing has been a silent topic in the sense that we as psychiatrists often cross our paths with faith-healers, and yet, we seem not to make much practical effort in understanding the psychological roots behind it. We often come across patients and their relatives who would prefer the miracles of a faith-healer over evidence-based medicine. We observe that people are inclined to approach the uncertainty of faith-healing remedies with utmost optimism while the medical interventions suffer the brunt of critical and at times cynical scrutiny by patients. As a resident in psychiatry, I have come across patients who sought faith-healing as their first choice as well the ultimate one. On close observation and open-minded reflection, we can learn what makes our minds tick when they are plunged into ambivalence between demons and decompensated neural circuits and this article is intended to touch on these gray lines.