Schizophrenia is a chronic illness that causes significant impairment in various areas of life. Patients with schizophrenia typically develop symptoms in their second to third decades of life and have a waxing-waning course. The combination of genetics and the environment is essential in developing schizophrenia. Despite proper treatment trials, many patients remain sick and dysfunctional. In patients with schizophrenia, cognitive impairment is a prevalent symptom. Patients frequently display a variety of cognitive abnormalities, including those affecting verbal fluency, executive function, working memory, attention, focus, visuospatial skills, and social cognition. Neuroplasticity is impaired in schizophrenia, and cognitive remediation procedures have improved neuroplasticity. Evidence suggests that cognitive remediation procedures can help patients with schizophrenia address their cognitive difficulties. This review attempts to evaluate the scope of various noninvasive brain stimulation to treat cognitive impairment in schizophrenia.

The present meta-analysis was performed to compare Five-Factor Model (FFM) personality factors between (i) patients with a bipolar mood disorder (BMD) and healthy controls (HC), (ii) patients with borderline personality disorder (BPD) and HC, and (iii) two diagnostic categories of BMD and BPD. The literature systematic search was performed on PubMed (Medline) for all articles published in English from January 1990 to June 2021 (PROSPERO-CRD42021267855). The pooled effect sizes were obtained by the standard mean differences (Cohen's d) between cases with BMD and BPD and HC using the random-effects method. Egger's test and I² >50 were used to detect possible publication bias and heterogeneity, respectively. Due to the limited number of studies to compare FFM factors between these two diagnostic categories, we compared the standard z-scores extracted from two separate analyzes for each disorder. Eleven case-control studies were entered into the meta-analysis. The results show that there are significant differences between the two diagnostic categories and HC in all FFM factors, except openness for BMD. Based on z-scores, we found that the two diagnostic categories are different in neuroticism (BMD<BPD), extraversion (BMD>BPD), openness (BMD>BPD), and agreeableness (BMD>BPD). There was no difference between the two disorders in conscientiousness (P= 0.279). Our results suggest that profiles of personality factors distinguish BMD and BPD from HC and each other. Except for the conscientiousness factor, in other factors, BPD shows a greater tendency toward general personality psychopathology.

Autism is a complex neurodevelopmental disorder consisting of a number of pervasive developmental disorders. Symptoms of autism spectrum disorders can often be very confusing and enmeshed with other neurodevelopmental disorders. This makes the diagnosis and treatment of these disorders quite challenging. Unfortunately, the awareness of this disorder is poor in not just general population but also in number of doctors, leading to such children not getting adequately and properly diagnosed. Early diagnosis can benefit the child to a great extent which can lead to a better quality of life for the patient and their family. Hence, an in-depth examination of these patients is a must which should include a holistic review from a number of different specialties. Patients diagnosed with autism also need a multidisciplinary mode of treatment which is not easily available. The Government of India also recognizes this disorder as a disability and provides multiple services and facilities for such individuals. Here, in this article, we have summarized all the various types of autism services in Maharashtra in the hope that this would be helpful for physicians to guide such patients for appropriate diagnosis and management.

Background: Shift workers have various physical and psychological adverse effects due to their work schedule. Some of them are reporting poor sleep quality. Our study aimed to measure sleep quality and its relation with sleep hygiene awareness and chronotype in nursing shift duty workers. Materials and Methods: A cross-sectional survey had been carried out in nursing shift duty workers working at a tertiary care center. A total of 300 participants were recruited through convenient sampling. After taking ethical approval, consented participants were made to fill the pro forma which contained basic demographic details and scales such as Pittsburgh Sleep Quality Index, Sleep Belief Scale, and Composite Scale of Morningness. Data were entered and analyzed using trial version of SPSS. Results: Around 40% of the participants had poor sleep quality. Sleep quality had been statistically significantly associated with sleep hygiene awareness and chronotype of shift workers. Sleep quality had also been associated with needle stick injury and usage of sleeping pills. Conclusion: shift workers with poor sleep quality were more likely to have lower sleep hygiene awareness and evening type of chronotype. Elder shift workers had good sleep quality, better sleep hygiene awareness, and better morning-type chronotype as compared with younger shift workers.

Background: Compared to other professions, nurses experience the greatest degree of job stress. Persistent stress is harmful to physical and mental health resulting in apathy, sleep disturbance, frequent absence from work, drug abuse, feelings of inadequacy, physical and nutritional problems, increased health-care cost, and loss of job satisfaction. Hence, this study was done to find the prevalence of occupational stress and its effect on mental health of nurses working in a tertiary care center. Materials and Methods: This was a cross-sectional study conducted among staff nurses after approval from the Institutional Ethics Committee. Sociodemographic data along with their occupational history was collected in a semistructured pro forma. The Professional Life Stress Scale by David Fontanna (PLSS) was used for evaluating occupational stress, and the Mental Health Questionnaire was prepared for evaluating mental health issues. Results: One hundred and eighty-seven nurses were included in the study, with a mean age being around 40 years and mean duration of service being around 18 years. About 45% of them had stress as per DFPS and departments in which they were working did not affect the stress levels. 8.5% of them had elevated paranoia scores and 7.4% had high depressive scores. DFPS had no significant correlation with age of staff nurses and years of experience but had a significant correlation with scores of all domains of mental health. Conclusions: It is concluded from the present study that professional stress has a great impact on health of staff nurses. There is a need for hospital management to develop appropriate intervention programs to reduce workload, make regular shift schedules, and provide positive reinforcements for nurses to reduce anxiety, stress, and depression.

Background: Chronic obstructive pulmonary disease (COPD) is characterized by chronic airflow obstruction and is one of the leading causes of death globally. The changes in pulmonary functions in COPD are irreversible with devastating consequences. Cognitive functioning in COPD patients is often found impaired and postulated to happen due to hypoxemia, i.e., oxygen deprivation to the brain. An impaired cognitive functioning can have direct impact on functional abilities as well as quality of life of patients and could be a vital treatment goal. The study aimed to explore the attention, memory, and executive functioning in hypoxemic COPD patients in backdrop of dearth of studies from India. Materials and Methods: Using purposive sampling, 30 patients with COPD, having mild-to-moderate level of illness severity, and having minimum illness for duration of 5 years were compared with 30 healthy controls. Participants were assessed for cognitive functioning in the domains of sustained attention, processing and psychomotor speed, working memory, verbal learning, and memory and executive functions using neuropsychological tests, namely, Digit Symbol Substitution Test, Trial Making Test, Verbal N Back Test, Rey's Audio Visual Learning Test, Controlled Oral Word Association Test, Animal Naming Test, Stroop Neuropsychological Test, and Modified Wisconsin Card Sorting Test. Results: Findings suggest significant differences between COPD patients and healthy controls over processing and psychomotor speed, working memory, memory, learning, and executive functioning. Conclusion: In addition to pulmonary distress, COPD patients also have compromised cognitive functions affecting overall daily functioning and quality of life. Understanding the nature of decline in cognitive functions could be vital in improving daily psychosocial functioning of the patients with COPD, and the exploration could help professionals in intervention of specific cognitive functioning.

Context: Human population is afflicted with Coronavirus disease (COVID-19) pandemic for last more than 1 year. Various measures were taken and restrictions were imposed by countries to break the chain of infection and to control this pandemic. Medical education has conventionally been considered challenging. Adding to it; hassles in teaching and fears and uncertainty about COVID-19 adversely affected the mental health of medical students during this pandemic. Aim: The present study aimed to investigate the mental health of undergraduate medical students during the COVID-19 pandemic. Settings and Design: This cross-sectional online survey was carried out on medical undergraduate students of Western Rajasthan using Google Form. Informed consent (online) was taken before enrolment for study. Materials and Methods: The students were sent the link to respond to the Google Form, which comprised questions seeking demographic details and items from depression, anxiety, and stress scale (DASS-21). Statistical Analysis Used: Frequencies and mean scores of depression, anxiety, and stress components of the DASS-21 scale were computed for the severity of scale according to the guidelines. The sociodemographic reasons predisposing the students to depression, anxiety, and stress were assessed using the Chi-square test. Statistical significance was set a priori at P < 0.05. Results: About 32.3% of the participants reported moderate-to-extremely severe depression, 41.5% reported moderate-to-extremely severe anxiety; while 11.6% reported moderate-to-extremely severe stress. Participants in the higher age group, younger batch, and urban residents were more likely to have depression. On the other hand, participants in higher age groups and females were more likely to have anxiety. Stress was found statistically higher in females and younger batch students. Conclusion: Students are facing challenging times and need to adapt to newer ways of distance education. Efficient time management, e-learning skills, following COVID norms, and getting vaccinated timely are the need of the hour for medical students. They should be provided regular psychological counseling and guidance to deal with stressful situations to prevent any untoward incidences.

Context: The trend of participating in online games which used to be quite prevalent in children and adolescents is now being seen commonly in college students. Heavy usage of these online games leads to various dysfunctional symptoms and socio-occupational impairment. Aim: The aim of the study is to find the prevalence of Gaming Disorder in college students and its correlation with self-esteem, perceived stress, and sleep quality. Methodology: A cross-sectional study was performed on 347 college students; in age range of 18–25 years. After obtaining Ethics Committee Approval, the selected participants were asked to fill in a questionnaire. The students having positive online gaming behavior were further evaluated for gaming disorder, self-esteem, perceived stress, and sleep quality. Statistical Analysis Used: Descriptive statistics were used to find the prevalence and correlations were done using Pearson's correlation coefficient. Results: The prevalence of online Gaming disorder was found to be 4.6% among the college students. An average of 2 h was spent on gaming per day with a positive, significant correlation with internet gaming disorder (IGD) score (r = 0.28, P = 0.00). Self-esteem was found to be weakly negatively correlated (r = −0.15, P = 0.02), perceived stress to be highly positively correlated (R = 0.87, P = 0.01), and poor sleep quality to be highly positively correlated (r = 0.92, P = 0.01) with IGD scale score. Conclusions: Online gaming behavior was found to be related to lower self-esteem and higher perceived stress and affecting sleep quality. Hence, we need to formulate preventive and treatment measures keeping these areas in mind.

Context: Narcissism has become a pejorative term in recent years. It may be developmentally appropriate, depending upon the phase of life cycle in which the person is. However, it can also be pathological in some people and is known as Narcissistic personality disorder. Individuals with narcissistic personality disorder generally have a lack of empathy and have difficulty recognizing the desires, subjective experiences, and feelings of others. Despite this range of concerns, literature shows an average of <10 studies per year on narcissistic personality disorder. Hence, there is a need to study and compare narcissism between different generations. Aims: The objective of the study was to compare the levels of Narcissism between Generation X and the Generation Y (Millennials) and to determine if there is any association between Narcissism and usage of Social Media Networking sites. Settings and Design: This was a 4-month cross-sectional comparative study conducted online from April 2021 to July 2021. A Google Form was used to record the response from all the participants. Subjects and Methods: Two hundred and sixty-two participants were included in study after obtaining institutional ethical clearance. Among them, 96 were of generation X and 166 participants were of generation Y. Participants who were having the access to any type of social media networking sites were included in the study, if they fulfilled the operational definition of Generation X and Y. Narcissistic Personality Inventory-16 (NPI-16), a self assessment tool, was used to evaluate narcissism. The social media networking site usage measure was assessed based on number of social media networking site they are active on, time spent on social media networking site, frequency of status updates, number of friends or followers, and pictures of self or selfies uploaded by them in span of 1 month. Statistical Analysis: Independent student t-test, Chi-square test, and Pearson's correlation analysis were used for analyzing variables in the study. Results: Among enrolled participants, 51.1% were females and 48.1% were males. There was statistically significant difference in the mean NPI-16 score (P = 0.016) with the score being more in Generation X (3.92) than Generation Y (3.04). There was a positive correlation between NPI-16 score and number of the social media networking sites (r = 0.175, P = 0.005), Frequency of Status Updates in a week (r = 0.165, P = 0.007), Number of Friends/Followers (r = 0.140. P = 0.025), and Selfies uploaded in a month (r = 0.282, P < 0.001). Conclusion: There is a positive correlation between the levels of narcissism and the self reported Social Media Networking site use among the participants in the study. Furthermore, the levels of narcissism were higher among Generation X than Generation Y.

Background: The nicotine dependency is related to many factors in terms of sociodemographic and smoking practices. Objective: The aim of the study was to assess the levels of nicotine dependency among adult smokers in Malaysia and to identify the association of nicotine dependency with sociodemographic factors and with challenges to quit smoking, respectively, among adult smokers in Malaysia. Methodology: A cross-sectional electronic survey was conducted through an electronic survey including all adult smokers in Malaysia. Standard questionnaires such as 21-item Challenges to Stopping Smoking questionnaires to assess the challenges to quit smoking and the Fagerstrom test were used to assess the nicotine dependency. The validated electronic online questionnaires were distributed, which comprised sociodemographic characteristics, assessment on smoking status, challenges to quit smoking, and nicotine-dependence test. Multiple logistic regression was used to identify the association of nicotine dependency with the challenges to quit smoking, respectively, among adult smokers in Malaysia. Results: Regarding the levels of nicotine dependence among current smokers based on Fagerstrom Nicotine-Dependence Score (n = 830), a total of 345 (41.6%) respondents had low-to-moderate nicotine dependence, followed by 312 (37.6%) who had moderate nicotine dependence; 158 (19%) respondents had low nicotine dependence, and 15 respondents (1.8%) were found to have high nicotine dependence. Conclusion: Smoking cessation services should be designed and implemented with the degree of nicotine dependence and pattern usage in mind. There should be more public health education about the dangers of smoking as well as more focus on motivation among smokers and their families.

Background: Electroconvulsive therapy (ECT) remains the most effective modality of treatment in many major mental health disorders, which calls for a rapid response. However, the media's portrayal of ECT as inhumane has resulted in a flawed opinion among public and reduced exposure has led to lesser knowledge about ECT among the medical health professionals working in a nonpsychiatric setting. Aims: To assess the knowledge and attitude toward ECT among MBBS students doing internship. Design and Setting: This was a cross-sectional study conducted at the department of psychiatry in a tertiary care teaching institute. Materials and Methods: The study was conducted among 100 MBBS students who were undergoing internship from a tertiary teaching hospital. The students were recruited from various clinical postings, and after obtaining informed consent, their knowledge and attitude toward ECT was assessed. Statistical Analysis: SPSS version 20.0 was used. Results: Majority (59%) of the students rated their psychiatry knowledge as minimal and around 70% reported to have minimal knowledge regarding ECT. 73% of the study population felt that ECT was used to control violent patients. Almost 91% of the students felt that they needed more exposure toward ECT in their undergraduate curriculum. Conclusion: MBBS interns had some knowledge about ECT; however, they still have some misconceptions and negative attitudes about the treatment. Novel teaching strategies could be inculcated in the existing curriculum which could help with more exposure and better understanding of the subject.

Background: TikTok is a mobile application that had become very popular among youth in college and adults alike. Many people have used TikTok as an alternate form of social media and share videos from there on different social media platforms. This study was aimed as survey to ascertain the knowledge, attitudes, and practices toward TikTok as an application. Methodology: A semi-structured questionnaire was prepared to consist of questions regarding demographic details, knowledge regarding TikTok, frequency of usage of TikTok, attitudes toward its use and suggestions for change required in it. The questionnaire was circulated among students through e-mails and Whatsapp. The form was distributed three times in all within a gap of 7 days. The data collected were subjected to descriptive statistical analysis and percentages. Results: Seven hundred students in all were mailed and received the questionnaire. We received 583 responses, of which 81 responses being incomplete were removed, and the final analysis was done with 502 responses. Three hundred and three (60.4%) participants felt that it could be used for entertainment and only 11 (2.2%) mentioned education or awareness. Two hundred and seventy-two (54.2%) participants felt that TikTok use could be a media for boosting self-esteem and self-image. Conclusion: Further studies in detail about various facets of TikTok need to be studied in diverse population to generalize our findings and know how this application has influenced the youth in various sectors.

Context: Health-care workers (HCWs) are facing stigma during the COVID-19 pandemic. Stigma is associated with poor mental health. Aims: This study aimed to assess the prevalence and psychological impact of COVID-19-related stigma and different coping mechanisms among physicians in Mumbai. Settings and Design: An online cross-sectional survey was conducted. Subjects and Methods: One hundred and seventy physicians from Mumbai were administered questionnaires on perceived stress, anxiety, COVID-19-related stigma, and coping strategies. Statistical Analysis Used: Data were analyzed using descriptive statistics, correlation tests, and binary logistic regression in the SPSS, version 20.0. Results: The prevalence of stress and anxiety was 57.6% and 20.0%, respectively. 34.7% of physicians felt stigmatized due to COVID-19. Stress was significantly associated with COVID-19-related stigma (P = 0.009), and emotion-oriented coping (P = 0.000), as was anxiety (P = 0.000, P = 0.000, respectively). Conclusions: COVID-19-related stigma is a major issue among physicians. Stigma and emotion-oriented coping mechanisms are predictive of mental distress in this population.

Regular and excessive use of alcohol can produce dependence over a period of time. Individuals who stops or reduces the alcohol use suddenly can have withdrawal symptoms ranging from tremors, altered sensorium, Delirium and seizures. Few cases of self injurious behavior were also reported during Delirium due to alcohol withdrawal. This is a rare and a severe form of inflicting injury to one's own body part, usually described in psychotic disorders, with delusions and hallucinations. The present case series describes the self injurious behavior during alcohol withdrawal complicated by Delirium.

Transsexuals, who form a part in LGBT community, face a great amount of distress due to social stigma and lack of family support. This case series emphasizes the effect of family stigma in three such transsexuals, who presented with psychiatric complaints. A definitive need for scientific research and its application exists to address this stigma and discrimination. ICD-10 criteria were used to diagnose the psychiatric morbidities. Standard scores (Hamilton Depression Rating Scale and Suicidal Affect Behavior Cognition Scale) were used to assess the severity. Familial, individual, and interpersonal level interventions were administered. Significant improvements were seen in two patients (received family therapy) and one patient who did not receive therapy continued to be distressed. Psychological interventions resulted in reducing the family stigma and psychiatric morbidities suffered by them. This is an effort to show the need for implementation of such standard protocols in health-care facilities to address the stigma faced by transsexuals.

Drug-induced skin reactions are familiar with older epileptic drugs such as phenytoin, lamotrigine, and carbamazepine (CBZ); the newer antiepileptic drugs are less likely to cause. Oxcarbazepine (OXC), the successor of CBZ, has a better safety profile with respect to side effects and adverse drug reactions (ADRs). The StevensJohnson syndrome (SJS), an ADR, is less common with OXC, and there are few case reports in the literature. Here, we report a case of OXC-induced SJS/toxic epidermal necrolysis overlap in line with CARE guidelines.

Kartagener's syndrome is a rare genetic disorder of primary ciliary dyskinesia characterized by the triad of bronchiectasis, sinusitis, and situs inversus. There is limited data on the role of Kartagener's syndrome leading to psychotic manifestations. We would like to discuss the case of a 26-year-old male, who presented to us with psychotic symptoms of 4-year duration. Upon detailed physical examination and pertinent investigations, he was diagnosed to be having Kartagener's syndrome. He was treated with antipsychotics and benzodiazepines. This case highlights the importance of a thorough physical examination and eliciting medical history, as it may lead to the finding of various syndromes that have been said to be associated with schizophrenia, thereby contributing to its genetic hypothesis. The neurological, biochemical, and structural malformations seen in Kartagener's syndrome may also lead to psychotic manifestations. They could be genetically linked to loci contributing to an increased risk of psychosis.