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|Year : 2017
: 59 | Issue : 6 | Page
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. Symposium Workshop. Indian J Psychiatry 2017;59, Suppl S2:154-66
Essence Of Positive Parenting In Changing Socio-economic Developmental Milieu And Paradigm Shift Of Parental Role In Indian Context.
Ranjan Bhattacharyya, Rajarshi Neogi, Kaustav Chakraborty
Department Of Psychiatry, College Of Medicine and Jnm Hospital, Kalyani, West Bengal, India. Email Id: Drrbcal@gmail.com
Background: Information regarding paternal involvement, father-child dynamic interactions and father's influence on child development is lacking. Introduction: the parental anger is linked with behavioral problems and there is a need for prevention or early interventions for fathers that builds emotion socialization and improves father-child connection.Developmental psychology characterizes parenting in terms of 'style'. Interventions attempt to make many changes at a time. The limitations of information model is it assumes that disadvantaged parents are less likely to engage with their children because they either don't know how important it is or how to do it. Methodology: the systemic review had been done with only existing recent literatures keeping in mind cross-cultural variations. The impact of PACT study (parents and child together) and dad's turning into kids program has been reviewed results: the findings of biplab (behavioural and parenting lab) conceptualizes parenting as style, but rather as a series of decisions and factors that shape those decisions. Overconfident bias-provide objective feedback on behaviour, social norming. The 'deliberate scaffolding model' helps to inculcate children's prosocial behaviour. The significant association has been found between paternal warmth and adolescent girl's self esteem, depression and close friendship quality and between paternal autonomy granting and adolescent girls general friendship quality. The parenting can influence in different life periods and their associations with parents and children's psychosocial functioning can affect in various stages of development. Conclusions: the 'optimal decision' is one that helps parents to reach their own goals. Decision making is shaped by many factors including information, various cognitive biases, mental attention and fatigue. The parents should be aware of their own emotions and accept and express their own emotions. Parents will have to recognize their child's emotions and accept that.Rnrnkey words: parenting role; pact project; behavioural and parenting lab; socio-cultural context; working parents.Rn
The Art And Science Of Being A Good Peer Reviewer
Dr. Yatan Pal Singh Bulhara, Dr. Ashwani Kumar Mishra, Dr. Rohit Verma, Dr. Siddharth Sarkar
All India Institute of Medical Sciences, New Delhi, India.
Email Id: Ypsbalhara@gmail.com
The workshop is aimed at the mental health professionals who are / plan to engage in peer review for academic journals. The workshop shall also be helpful to the residents as it will help them gain understanding in carrying out a critical evaluation of scientific literature. Additionally, the tools and resources that can help one become a good reviewer shall be discussed.
The workshop shall include the following components-
Introduction: The first section shall introduce the participants to the workshop and its layout.
Peer Review: What, why and how of it
This section shall present an overview of the peer review process, need to engage in peer review, potential benefits of being a peer reviewer and process of peer review.
Hands on exercise on peer review
This section shall focus on a hands-on exercise on carrying out review of a scientific article. The participants shall be guided through the peer review process using specimen articles. They shall carry out a hands-on exercise on conducting the review in small groups and then present their findings. These shall be discussed subsequently.
Resources for peer reviewers
This section shall present the resources on being a good peer reviewer to the participants.
Discussion and feedback
The final section shall focus on the discussion based on the workshop, including the queries on the same.
Preventive Psychiatry In India
Dr. Devashish Konar, Dr. Debjani Bandyopadhyaya, Prof. Om Prakash Singh
Manasij, Burdwan, Bengal. Email Id: Devkon59@yahoo.com
Most of the psychiatric illnesses have multifactorial etiology. Strategy to prevent them is not an easy task. This area needs attention because even small dent made will have huge impact.
Preventing on nutritional and genetic front: dr debjani bandhopadhyay
Prevention starts even before conceiving. Nutritionally sound and parents of right age are best suited to have healthy children. Nutritional problem still plagues pregnant mothers and children in a major section of indian population. Country needs to strengthen public health perspective to improve the situation.
Genetic screening is needed in vulnerable group to prevent major brain abnormalities. How and when to advise and when to refer are some of the questions that need to be addressed and guidelines formulated.
Preventing on child psychiatric front: dr devashish konar
Parenting training of would-be-parents, early detection of vulnerable children and timely interventions are some of the efforts that will give large dividend. We have very limited number of child psychiatrists. So including general psychiatrists, pediatricians, family physicians, health workers and teachers would be the most suited public health strategy for india. They need to be trained to work within their limits and need to learn to refer at the right time without wasting precious time of the growing children and adolescents.
Preventing on psychosocial front: dr om prakash singh
Long standing psychosocial distress has been identified in precipitation of psychiatric illnesses in many a case. Could there be clinics for families in distress? There can be science based places to help people in time of stress. Suicide prevention helplines should be readily available. Disaster management has to be more organized and skilled in handling the national calamities. Yoga and meditation should be helpful in improvement of mental health of the population, and of late, india is rightly focused on that.
Soundness Or Unsoundness Of Mind" An Archaic Concept ... Haunting Psychiatrists
Dr. Choudhary Laxmi Narayan,, Prof. Rajesh Kumar, Dr. Sanjay Garg, Prof. Raj Kumar Lenin Singh
A.n. Magadh Medical College, Gaya. Email Id: Drclnarayan@gmail.com
Background: Soundness of mind is described to be a healthy mental state, the quality of being prudent and sensible. In legal terms everyone is presumed to be of sound mind unless he is adjudged as of unsound mind on inquisition. Soundness of mind is an important aspect in law involving a wide range of civil and criminal cases. Soundness of mind is a factor determining the criminal responsibility in criminal cases. Fitness to trial in a criminal proceeding also depends upon soundness of mind. There are many cases in civil side as well in which soundness of mind is a deciding factor. Psychiatrists are often summoned by the courts to testify regarding the soundness or unsoundness of mind of a person in a wide variety of cases. Therefore, psychiatrists cannot afford to be ignorant of the law in this respect. Insight and the competence/ capacity in psychiatric cases are not in all or in none ratio, but lies in a continuum in between with a wide grey area in between. But in legal terms it requires to be answered either in yes or no. In many such cases it becomes very difficult to answer this question in a straight manner. The present symposium is directed towards discussion and analysis of all these aspects so as to get a clear understanding of the matter.
plan - Different Sections Of This Symposium Include
1. "Competence Or Capacity ... Two Sides Of A Coin"dr. Rajesh Kumar
2. Testamentary Capacity - Dr. Sanjay Garg
3. "Fitness To Trial - Dr. Rk Lenin Singh
4. "Capacity To Make Mental Healthcare Decisions - Dr. C.l. Narayan.
Conclusion: All psychiatrists must have a clear understanding about the legal issues involving the soundness or unsoundness of mind in the course of their clinical practice.
The Sense In Sensate Focus: Using It To Improve Sexual Relationships
Dr. Neena S. Sawant
Department Of Psychiatry, Seth Gsmc & Kem Hospital, Mumbai, India.
Email Id: Drneenas@yahoo.com
Background: One of the most useful couple oriented activities for enhancing mutual sexual enjoyment is a series of touching exercises called sensate focus. Masters and johnson labeled this technique and have used it as a basic step in treating sexual problems. The aim of sensate focus is to build trust and intimacy within your relationship, helping you to give and receive pleasure. It emphasizes on positive emotions, physical feelings and responses while reducing any negative reactions. It can be helpful in reducing anxiety caused by goal orientation and increasing communication, pleasure and closeness. This technique is by no means appropriate only for sex therapy but can be used by all couples to enhance their sexual relationships. In the sensate focus touching exercises, partners take turns touching each other while following some essential guidelines. These exercises are typically done in steps or stages over a period of several weeks. One person starts as the giver or toucher and the other is the receiver. In the indian scenario where the couple is reticent about sex and the women usually not being very forthcoming on trying out new stuff, sex therapy in general becomes difficult. It is very important to note that couples have to be taught to use their sense organs to heighten the sexual experience and this often is not discussed in sex therapy.
Aims and objectives of the symposium:
The key focus is to educate psychiatrists and sex therapists to make use of all the sense organs during sex therapy. Improving communication between the partners is the key factor in improving the sexual relationship. The presentation gives the steps of sensate focus with some modifications to make it useful for the indian population.
Keywords: Sex Therapy, Sensate Focus
Men At The Front: What Makes Them Different: Resilience Of The Combatants
Dr. Rajiv Kumar Saini, Prof. R C Das, Dr. Vinay Chauhan, Dr. Chaitanya Kodange, Dr. Vikas Gupta
Afmc, Pune. Email Id: Rks197019@gmail.com
Armed forces have primary role of guarding the boundaries of the nation. However, due to changing geopolitical and strategic demands, their role often gets re-defined. The combatant is expected to adjust quickly with his new role and perform at an optimum level. Over the years and across diverse scenarios, armed forces have excelled in the assigned tasks with minimum attrition despite overwhelming stressors which is in contrast to the popular perception across the world. So, what does it take to be an indian soldier and how are they different? Or are they really different? The point needs to be deliberated upon. The aim of the symposium is to highlight various aspects of soldiering and will be deliberated by 05 speakers from armed forces.
1. Chairperson : Dr R C Das
2. Presentation Outline: Convener Mil Psy: Dr Rajiv Kumar Saini
3. Perspectives From The Land: Dr Vinay Chauhan
4. Perspectives From The Sea: Dr Chaitanya Kodange
5. Perspectives From The Air: Dr Vikas Gupta
Dr(brig) D Saldanha, Dr. Bushan Chaudhari, Dr. Ekram Goyal, Dr. Spandanadevabhaktuni, Dr. Vivekpratap Singh
Dr D Y Patil Medical College Hospital And Research Centre Pimpri, Pune. Email Id: D_saldanha@rediffmail.com
Moderators: dr(brig) D Saldanha And Dr B Chaudhari
Objective: The goal of this workshop is to give a detailed review of the various aspects of the new and upcoming discipline of psychoneuroimmunology which lends solid research in our understanding of the mind and body connection
The field of psychoneuroimmunology (pni) is the interaction between behaviors, the brain and the immune system. It addresses how the psychological factors affect the immune system and physical health through neural and endocrine pathways.The immune system and the brain talk to each other through signaling pathways. Two major pathways are involved, i.E hypothalamic-pituitary-adrenal axis and the sympathetic nervous system . Molecules called pro-inflammatory cytokinescan affect brain growth as well as neuronal function. Stress is thought to affect immune function through emotional and/or behavioral manifestations such as anxiety, fear, tension, anger and sadness and physiological changes such as heart rate, blood pressure, and sweating. They are beneficial if they are of limited duration but when stress is chronic, the system is unable to maintain equilibrium or homeostasis. Various stressors like marital conflict, loneliness, caring for a person with a chronic medical condition can dysregulate the immune function. Psychoneuroimmunology research is relevant in psychiatric diseases and many immunologically mediated health problems including infectious diseases, cancer, autoimmunity, wound healing and allergy.Recent studies show pro-inflammatory cytokine processes take place during depression, mania and bipolar disease, in addition to autoimmune hypersensitivity and chronic infections. Clinical depression is associated with reduced nkcc, decreased lymphocyte proliferation and decreased delayed hypersensitivity.Various drugs like glutamate agonists, cytokine inhibitors, catecholamine modulators are being studied for their psychoneuroimmunology effects. Psychological interventions like classical conditioning, relaxation and hypnosis, emotional disclosures, cognitive behavioral strategies can be used to modulate the immune function. Psychoneuroimmunology embodies the biopsychosocial approach which has come to define health psychology.This symposium will address these issues.
Indian Psychiatric Society, Child and Adolescent Psychiatry Subspecialty Section
Theme: Externalizing Spectrum In Children And Adolescents
Dr. Anweshak Das, Dr. Preeti K, Dr. R Venkateswaran, Dr. Anirban Ray
Email Id: Drdasanweshak@yahoo.co.in
Topic 1: Aggression and self- harm behaviors in children and adolescents with mood disorders
Aggression and self-harm behaviorism children often pose a challenge in clinical settings. The clinical presentation of mood disorders varies with the developmental age of the child, with high rates of co morbidity. Evaluation includes developmental, behavioral and risk assessment. Management includes combination of pharmacological and psycho-social interventions. Evidence is limited regarding effective management. Controversies continue to exist regarding ssris and suicidality in children. Warnings are meant to emphasise on proper education and regular monitoring and not to reduce the use of medications when indicated.
Topic 2: ADHD and DMDD: Challenges in identification in children and adolescents.
Introduction: The clinical presentations of disorders to child and adolescent psychiatric services are complex. Co morbidity is the rule. ADHD and DMDD are the two disorders that have significant challenges in diagnosis and management. Adhd is one of the neuro developmental disorders. Dmdd, presents with episodes of temper tantrums on a background of persistent irritability. Developmental delay or autism can present with hyperactivity, which need not necessarily be labeled as adhd. Likewise, dmdd is often confused with adhd or pediatric bpad. Due to overlap in symptoms and differences in management, proper identification is necessary for good outcomes.
Topic 3: Aggression in high functioning autism.
For ASD children, aggression is double trouble for parents as developmental issues are coupled with behavioral issue. Multiple reasons can contribute to increased aggression. Deficit in language and communication may add to the frustration. Sensory issues, need for sameness, stereotypic thinking, focus on relatively trivial issues can result in aggression. Co morbid disorders like adhd, mood disorder, dmdd, ocd, anxiety may contribute. Learning can also contribute to add some instrumental quality into such aggression. Behavioral management with medications either symptomatic or for co-morbidities may help.
Violence Risk Assessment In Psychiatry - Practical Issues
Dr. Indu V. Nair, Dr. Anil Prabhakaran, Dr. Akshara Mishra
Govt. Mental Health Centre, Trivandrum. Email Id: Indunairv2008@gmail.com
Background-prediction of violence is very difficult, especially if its about the future. School shootings, domestic violence, criminal behaviour, predatory sexual misconduct" a list of violent behaviours and the often repeated question" why did they do it?, And more importantly, will they do it again? Clinical evaluation for prediction of future dangerousness has become an integral function of the legal system. Psychiatrists are increasingly being called upon to evaluate an ever growing number of persons exhibiting violent and aggressive behaviour.
Substance abuse and several demographic variables have clearly been demonstrated to be significant risk factors for violence. The data on link of various specific symptoms of psychiatric disorders to violence are inconclusive, though suggestive , because of conflicting research findings. Mental disorders represent a modest risk factor.
This symposium aims at looking into the main predictors of violence, assessment of violence risk and the practical difficulties encountered in practice.
Key Words - Prediction, Violence Risk, Mental Disorders
Neuro-imaging In Patients With Schizophrenia In Clinical Practice
Dr. Rahul Ramdas Tadke, Dr. Vivek Kirpekar, Dr. Sudhir Bhave, Dr. Rahul Tadke, Dr. Sushil Gawande, Dr. Abhijeet Faye
Department Of Psychiatry, NKPSIMS and LMH, Nagpur. Email Id: Rahultadke@vsnl.net
Symposium Title: neuro-imaging in patients with schizophrenia in clinical practice.
Subtopics: - 1. Introduction & concept, 2. Clinical indicators for neuroimaging, 3. Structural neuroimaging, 4. Functional neuroimaging and 5. Dos and donts.
Schizophrenia nowadays has been considered as a disorder with neuro-developmental origin having biological, psychological and social aspects and has close differential with neurological conditions. Patients with schizophrenia are susceptible to have various other problems which include neurological, systemic, age and treatment related phenomena and pose a challenge in clinical setting. Careful and judicious use of neuroimaging in clinical practice can help in early detection of associated conditions and subsequently reduce morbidity in them.
The present symposium aims at discussing various types of neuroimaging methods available for patients with schizophrenia. Detailed clinical evaluation and assessment with highlight on the clinical pointers which lead towards required right investigation will be discussed. At what point or at which clinical suspicion should one think of neuroimaging? This will also be explained with help of a clinical case vignettes and imaging samples. The findings of ongoing research related to this will be discussed. Structural neuroimagings like CT Scan and MRI, their modifications and interpretation, and role will be discussed in-depth. Functional neuroimaging like SPECT and PET and their role in assistance in diagnosis and management will be explained in detail. Then the authors will speak on the monitoring of the patients in follow up or maintenance phase and share the updates available in the medical literature. In the end there will be guidance on dos and donts related to neuro-imaging in schizophrenia.
At the end of the symposium the participating delegates will get idea about various clinically relevant aspects of neuroimaging in patients with schizophrenia, the knowledge and expertise one should have about minimum essential use and its role in acute as well as in maintenance phase in clinical practice.
National Survey On Extent And Pattern Of Substance Use In India: Methodology And Operational Issues
Dr. Atul Ambekar Dr. Ravindra Rao, Dr. Alok Agrawal, Dr. Ashwani Mishra
NDDTC, AIIMS, New Delhi, India. Email Id: Atul.firstname.lastname@example.org
Despite a sizable burden of substance use in india the exact dimensions of this problem remains unknown. Last national drug use survey was conducted in 2001. Considering the burning need of credible data, the ministry of social justice and empowerment, govt. Of india has commissioned a national survey on extent and pattern of substance use in india (2016-2018).
This is the largest epidemiological study of its kind in india˜ever. We aim at (1) providing the estimates of proportion and number of people using drugs as well as those dependent on drugs in all the 36 states/uts and national level (2) data on gaps in treatment-services.
For less socially stigmatized drugs (like alcohol, tobacco) in the general population, a household survey is being conducted on the representative sample (n=155,000 households; 600,000 people, nationally) in each of the 36 states / uts. Probability proportionate to size (pps) methodology will be employed to select the districts, wards, and households to interview eligible members (10-75 year old, any gender).
For more socially stigmatized drugs (like opioids, stimulants) the methodology, respondent driven sampling (rds) with multiplier will be conducted in about 100 districts nationally (n=600 drug dependent people; about 60,000 total).˜Proportion of people admitted to a addiction-treatment centre in last one year constitutes the multiplier for size-estimation. Focused studies will be conducted on special themes / populations (such as sex-workers, prisons, homeless, transport-workers etc.). An online-survey of service providers is being conducted in each state.
All the data shall be collected by trained interviewers, using electronic hand-held devices after informed consent and ethics clearance.
A network of reputed government academic institutes and ngos is collaborating under overall leadership of nddtc, aiims to provide reliable and credible estimates for the entire country. This will pave the way for evidence-based policies and programs.
A Quantum Approach To Cognition
Dr. Anand Mishra, Dr. Parul Prasad, Dr. Nishant Goyal
Central Institute Of Psychiatry, Ranchi.
Email Id: Anandmishraxxxxxxx@gmail.com
Historically research in cognitive modelling was principally based on the classical theories of probability and mathematics which have led to great progress in the field of cognitive science but at the same time several findings have accumulated which are difficult to explain from the classical theory of probability. Classical laws of logic and probability are not always able to define the functioning of human cognition and judgment. Due to its flexibility and richness of structure, the quantum interaction approach was introduced as an interdisciplinary perspective in modelling theories in disciplines other than physics, and the field dealing with its application to cognition was named quantum cognition. This approach led to a better visualization of cognitive processes like conflicts, uncertainty and ambiguity in judgment and decision making. No doubt that some of the pioneers of quantum theory, especially bohr, were firmly in support of the idea that the core concepts of quantum mechanics would be meaningful even in areas beyond the realms of physics, like psychology and philosophy. With constantly increasing interest in this interdisciplinary field, phenomena like decision making, concept combination etc. Which have been stubborn to the traditional models are now showing promise in the light of this new modelling approach inspired by formalisms of quantum mechanics. With a different perspective it provides to consciousness, its utility in building models of common psychiatric illnesses and their management in future cant be denied.
The audience will be familiarized with the important concepts of quantum theory, along with a discussion focusing on the understanding of human cognition and consciousness from the perspective of quantum theory. For a better understanding of this novel concept, apt examples from latest research in this field will be highlighted and compared to the traditional approaches in cognitive science.
Early Detection Of Child Sexual Abuse In A Community Setup
Dr. Kshirod Kumar Mishra Dr. Sally John, Dr. Kanika Kumar
Department Of Psychiatry, JNMC, Wardha.
Email Id: Drkkmishra2003@yahoo.co.uk
Childhood abuse has been associated with increased risk of adult psychiatric disorders including major depression , substance abuse, anxiety disorder, ptsd, personality disorder and many more.
Childhood trauma is known to influence brain development and increase the risk of future psychiatric disorders .Many children who are sexually abused takes years to disclose about it or sometime they may never disclose.
Child sexual abuse sometimes involves multiple episodes till the problem is detected and corrective measures taken .The psychological sequelae and lack of self esteem caused by child sexual abuse is much more than any other psychiatric disorder.
Through this workshop we intend to sensitize the mental health professionals about this sparsely reported and undetected malady and to throw light on the early detection to prevent the long term consequences.
The Enigma Of Catatonia In Setting Of Bipolar Affective Disorders
Dr. Nitin Gupta Dr. Rajesh Nagpal Parmod Kumar
Govt Medical College and Hospital, Sector 32, Chandigarh.
Email Id: Nitingupta659@yahoo.co.in
Catatonia as an entity is not that common in the west nowadays. Nevertheless, such is not the case in a country like india where catatonic states are still encountered frequently. Abundant evidence suggests that patients with mood disorders regularly get afflicted with catatonia, but the syndrome may go unrecognized which complicates the management. Most recently, as per dsm-5, catatonic symptoms can be present in any severe phase of bipolar disorder (bd), when the specifier with catatonic features is applied to describe the particular episode. However, in icd-10, catatonia is not diagnosed separately in the˜affective disorder (f30-f39) category. In fact, analysis of various studies has found that the commonest psychiatric condition underpinning catatonic states is bipolar affective disorder. Hence, there is a need to try and understand the syndrome of catatonia in relation to the commonly occurring mental illness like bipolar affective disorder. This symposium proposes to address some of these issues.
In the course of the presentations, dr rajesh nagpal will discuss the clinical features, etiopathogenesis and biological construct of catatonia in setting of bipolar affective disorder. Dr parmod kumar will follow this up by discussing the short-term and long-term management strategies for catatonic states in the setting of bipolar affective disorder. The last presentation by prof nitin gupta will focus on the overlap of catatonia and neuroleptic malignant syndrome: the dilemma in diagnosis and management.
Module Of Psychiatric Education For Interns Posted At The Psychiatry
Dr. Nimesh Chandrakant Parikh
Department Of Smt. MHLMMC, Ahmedabad.
Email Id: Drnimeshparikh@yahoo.com
Worldwide, psychiatry is subjected to negligence, prejudice, social stigma and undue suppression, inspite of the fact that the point prevalence of mental illness in adults is nearly 10 % at any given point of time. Around 20 % of all the patients seen by the primary health care providers have one or more mental health problems. Even then, unfortunately, the current mci guidelines do not give any standardized weightage to psychiatry in the undergraduate curriculum. As a result, a very important subject of psychiatry is under-represented in the curriculum.
This under-representation is amenable to change, by providing knowledge to the interns in their clinical rotation.
In our department we implement an innovative module
1. Audio-visual Slides Of Important Psychiatric Disorders,
2. Practical Training,
4. Involving Interns By Making Them Case Managers, And
5. At The End Of The Term, Taking A Small Exam Related To Their Training In Psychiatry.
We have implemented such a module in our department since the last 3 years, with very encouraging and promising results. Additionally, we do a pre-post assessment of the interns regarding their attitude and knowledge towards psychiatry and take their written feedback about the module.
In this symposium, we wish to share the details of our module, present the findings of our data related to the change in attitude of the interns towards psychiatry, and their feedback. We wish to emphasize that this is the need of the hour so that the future practitioners/future consultants are aware of and capable of identifying the common mental illnesses, manage them in a better way and refer them to psychiatrist if needed. We wish to discuss the pros and cons of such a module, the challenges faced in its implementations and to invite suggestions and feedback to further improvise on it.
Implementation Of Suicide Prevention Program In India
Dr. Naresh Nebhinani, Dr. Anju Mathew, Prof. R K Solanki
All India Institute of Medical Sciences, Jodhpur.
Email Id: Drnaresh_pgi@yahoo.com
Rising suicide rate is a global concern. Although suicide is considered deeply personal and an individual act, suicidal behaviour is determined by a number of biological, psychological and social factors. Despite the burgeoning research on risk factors of suicide, information on suicide prevention and protective factors is limited. Suicide is a multifaceted problem and hence suicide prevention programs should also be multipronged. Collaboration, coordination, cooperation and commitment are needed to develop and implement a suicide prevention program, which is cost-effective, available, accessible, appropriate and relevant to the needs of the individuals and community.
In india, suicide is seen more from a social and public health perspective in line with this year world suicide prevention days theme-˜connect, communicate and care, the time is ripe for mental health professionals to accept and adopt proactive role in suicide prevention. Several promising empirically based suicide prevention strategies have been identified, including school-based skills training for students, screening for at-risk population, health professional education, gate keeper training, media education and guidelines for reporting suicide, mental health literacy, lethal-means restriction, enhancing resilience, connectedness and stress management skills etc.
In this symposium, we will highlight current face of suicide prevention services in india, available support, experiential learning from professionals running suicide prevention clinics and programs and wiser words by senior psychiatrist about how to fill these gaps in existing services, implementation of multidisciplinary team approach and working together for this humane cause.
Key Words: Suicide, Prevention, Program, India
A) Building Up Suicide Prevention Program At Jodhpur" Dr. Naresh Nebhinani,
B) Experience Of Suicide Prevention Clinic At Trivandrum- Dr. Anju Mathew,
C) Suicide Prevention Services In India: Current State, Gaps And Opportunities- Prof. R.k. Solanki
Publication Ethics: Nuts And Bolts Of Doing It Right
Dr. Adarsh Tripathi, Dr. Sandeep Grover, Dr. Siddharth Sarkar
King George\'s Medical University, Chowk, Lucknow, India -226003.
Email Id: Dradarshtripathi@gmail.com
Ethics is knowing the difference between what you have a right to do and what is right to do. ~Potter stewart
Publishing outcome of scientific research is vital for several purposes. This is primary goal of scientific research and no research is complete, no matter how impressive the results, until it is published. Published paper is a structured, factual and comprehensive summary of research finding and additions of new knowledge to the science. Publications are useful as these are permanent, can be referred repeatedly and cannot be altered once in public domain. It is a major source of promoting scientific advancement and currently keeps the scientific trends largely uniform throughout world. For personal reasons, publications are required for recognition, getting educational degree, job and promotions, funds for further research as well as overall progress of institution and individual etc. Coolidge used a phrase publish or perish in 1932 and it is becoming an exact reality now. It is perhaps due to these reasons, there is immense pressure to publish on scholars and may be the reason for certain unethical publication practices. Dubious research practices such as salami slicing, plagiarism, duplicate publication, fraud, guest/ghost/gift authorship and peer review fraud etc. Are seem to be on rise in the recent times. Along with this, predatory journals are also on the rise. These journal charge high prices for publication with them without any meaningful editorial or peer review process. They promise quick, effortless publication and are often considered reservoir of authors misconduct. These journals seems to cause maximum damage in the low to middle income countries. Many researchers in low to middle income countries especially young ones may fall prey to these practices knowingly/unknowingly in absence of appropriate guidance, support and mentor-ship in research and publications. Urgent steps are needed to curtail these phenomenon.
Ethical And Legal Aspects Of Mental Health In Special Populations
Dr. Sivakumar Palanimuthu Thangaraju, Dr. Suresh Bada Math, Dr. C. Naveen Kumar
N.I.M.H.A.N.S., Bengluru. Email Id: Sivakumar.email@example.com
Mental health problems in general may contribute to specific ethical and legal issues. Special populations like elderly, substance use, women and
Prisoners have specific ethical and legal concerns. These can pose significant challenges to mental health professionals in clinical management. Though these issues have been extensively studied in western contexts, there is only limited awareness, knowledge and formal training in india. This symposium would highlight these issues that are relevant for indian context. Further, these issues will be discussed from the perspective of mental health care bill, 2016.
Ethical & legal issues in geriatric psychiatry - dr pt sivakumar
Legal issues in substance use - dr arun k
Mental health care bill, 2016 - dr suresh bm
Ethical and legal issues in women's mental health - dr naveen c kumar
Suicide And Its Prevention- The Way Forward
Dr. Lakshmi Vijayakumar, Prof. Yogesh Dwivedi, Dr. G. Prasad Rao
Email Id: Lakshmi@vijayakumars.com
Suicide is a public and global health problem and is a major cause of mortality among young people. Self harm was the first or second leading cause of death for both males and females between 15-24 years of age since 1990. Hence there is an urgency to better understand and prevent suicide.
The symposium will focus on current biological research on suicide which has clinical implications. The association between bipolar disorder and suicide will be discussed in detail and current knowledge on assessing and managing a suicidal patient will be explained.
Psychiatry-reaching The Unreached
Dr. Abhay Prof. N M Patil, Dr. Swaminath G
SDM Medical College,Dharwar. Email Id: Drabhaymatkar@hotmail.com
India continues to be dogged by the low psychiatrist to patient ratio despite the soaring need. . The predominance of underserved rural population clubbed with illiteracy and poverty results in mental health care not being accessible, affordable or acceptable to the majority. This results in a treatment gap which urgently needs to be bridged. This need is now being slowly met by more specialists graduating every year. However at present there is a need for advances in delivery of mental health care urgently. The organisers of ancips 2017 have aptly chosen a topic a major concern--psychiatry--reaching the unreached.
Three speakers, who have worked predominantly in both academic and private sector, have in addition been addressing this important issue of bridging the gap and serving the needy. One is catering to predominantly private sector, the second in academics primarily & the third caring for the homeless mentally ill, in addition to private practice. Each one of us an expertise in this field of
About 20 years at-least. We would like to share innovation in delivery of quality mental health care to the underprivileged and reaching the unreached.
Dr abhay matkar will speak on serving the home for destitutes in a missionary setup for almost 20 years. Dr n m patil will speak on his journey of serving the unreached narrating how & why people in rural area are left out, how the government schemes & infrastructure do not help the persons & what & how a practitioner can help.Dr swaminath g will speak on his work in challenges in provision of free psychiatric medications to free mental health camps, being run in unreached rural and tribal areas.
We request wider participation and inputs for furtherance of the cause of reaching the unreached.Long live ips.
Stress Related Infertility And Infertility Related Stress
Dr. Vijaya Wakodkar
Email Id: Vijayawakodkar@gmail.com
Stress is any change in the environment that requires your body to react and adjust in response. The body reacts to these changes with physical, mental, and emotional responses. Stress is a normal part of life. Many events that happen to you and around you -- and many things that you do yourself -- put stress on your body.
What is relation between stress and infertility ?
Today i am trying to discuss this issue as it is very crucial and delicate. Everyone experiences some sort of stress on daily basis for some or other occasion. Infertility is the problem that affects not only couple but whole family. Brings fear, anxiety, anger guilt and disturbance in emotional relationship there is definite involvement of body, mind, emotions and ends in abnormal behavior.
The new field of psychoneuroimmunology has emerged, which focuses on how hormones can affect mind and the body. While the exact pathways between fertility and stress remain a mystery, morgan believes hormones like cortisol or epinephrine -- which rise and often remain high during times of chronic stress -- play a key role.
For some women, chronic stress can affect ovulation by altering signals to the hypothalamus, the center of the brain that regulates some of the hormones that trigger the ovaries to release eggs each month. Women under nonstop stress may ovulate less regularly, making it more difficult to plan baby making for the exact window when they're most fertile. Some research shows that stress may also affect testosterone levels and sperm production in men. Other research indicates that stress may have an impact on other aspects of fertility beyond ovulation, including problems with fertilization and implantation in the uterus.
Banning Pornography: Is It The Solution To Sexual Violence?
Dr. Soumitra Das, Dr. Sayantanava Mitra, Dr. Anjana Rao Kavoor
Email Id: Soumitratdmc@gmail.com
There has been a stimulating debate from past few days to ban porn in india according to a petition filed in supreme court to justifying that porn is one of the causes for exponential increase in sexual crime in india. But, it is next to impossible where, 30000 people are watching porn each second around the world and roughly 30 percent of all web traffic is porn. Also, there has been no scientific basis until now that every case of sexual violence in india relates to watching porn. Moreover study says that 30% of women around globe watch porn as well. Also, sec.292 Of the indian penal code, which came about by act 36 of 1969, watching or possessing pornographic materials is legal, but distributing such materials is illegal and banned. So, even if we consider that we can actually ban internet porn, it wouldn't lead to a diminution in the number of crimes against women. Probably, banning pornography would yield in 2 scenarios: a) creation of an illicit market: when we prohibit the access to a commodity by the whims of passing a law, there is definitely going to a set of people who would like to capitalize the opportunity and try to run an illegal system. B) creates a perception of sex as a taboo: if we curtail the access to pornography on the internet, we are attaching an element of stigma to sex. There is a healthy chance of people now considering sex as taboo. It will only impede the spread of sex education. Finally, if we think of crimes against women, the offender achieves his gratification primarily from the thrills of domination, power and control. Therefore with a ban on porn, there might be an increase in the number of crimes as women might be
Sex Education In India: Why, What, When, Where, Whom?
Dr. Sujita Kumar Kar, Dr. Abhisek Pratap Singh, Dr. Om Prakash, Dr. Adarsh Tripathi
Email Id: Drsujita@gmail.com
Sex education in india refers to sex education targeted at adolescents in school. It also refers to material aimed at adults regarding family planning and safe sex. The introduction of sex education in schools has been surrounded with controversies in india. The curriculum of the indian educational system spares sex education. It is difficult to say, whether it is a deliberate attempt or ignorance or simply an effort of avoidance. Whenever efforts had been taken to consider sex education in educational curriculum, it had given birth to lots of controversies. However, sexuality education helps young people to make informed decisions about their life choices related to sexuality and health. The researches have shown that timely and appropriate sexuality education increases responsible sexual behaviour as well as reduces disease burden linked to sexual behaviour. Proper sex education also promotes human rights, gender equality and empowerment for young people. The arguments and counter-arguments related to imparting sex education in child and adolescent in india often centred on several questions like "what should be included in sex education?, why we need sex education?, when to start sex education?, where to begin sex education (home or school)? Andœwhom to address (children or parents)?. This symposium aims to address the above questions.
1. Sex Education In India: Status And Obstacles
Dr.sujit Kumar Kar, Assistant Professor In Psychiatry, King Georges Medical University, Lucknow, U.p
2. Sex Education: Why Do We Need It At All?
Dr.abhisek Pratap Singh, Assistant Professor In Psychiatry, Heritage Institute Of Medical Sciences, Varanasi, U.p
3. Sex Education: Dealing With Children And Adolescents
Dr.om Prakash, Associate Professor Of Psychiatry, Institute Of Human Behavior And Allied Sciences, Delhi
4. Sex Education: Role Of Parents, Teachers And Media
Dr. Adarsh Tripathi, Associate Professor In Psychiatry, King Georges Medical University, Lucknow, U.p
Psychiatric Treatments Of The Future
Dr. Shivaji Mrella Dr. Vasdev Singh Kalkat, Dr. Gagandeep Singh, Dr. Vinayak Pathak,
Dr D Y Patil Medical College, Pimpri, Pune. Email Id: Shivas.firstname.lastname@example.org
There is a move away from syndromal diagnoses in psychiatry towards the underlying neural and cognitive processes. Our arsenal now includes many techniques of neuroimaging and electrophysiology which are growing in power and scope to help us fathom the mind. Initiatives like the human connectome project have already brought a sea of change in the understanding of the brain. We are able to use induced pluripotent stem cells along with cell reprogramming to translate the extensive data from genome wide studies and pharmacology into patient-specific in vitro models.
There is extensive evidence of the role of the immune system in cognition coupled with a knowledge of the microbiome within us.
Computerized cognitive remediation and computerized cognitive behavioural therapy have proven effective in improving outcomes in depression, anxiety and schizophrenia. The ability of ccr and ccbt to be rolled out in a manpower deficient country like india could be pivotal in future mental health gains.
Neuroprosthetics are artificial devices or systems designed to generate, restore or modulate a range of neurally mediated functions. These include cognitive and affective functions that have been impaired or lost. Cognetics and cognetic devices are haptic interfaces with the ability to render and combine artificial multisensory stimuli with related motor signals. Cognetic interfaces are key to investigate and enhance bodily perception, consciousness, and related cognitive functions.
Virtual reality and augmented reality transform our external experience by focusing on the high level of personal efficacy and self-reflectiveness generated by their sense of presence and emotional engagement.
This symposium will cover the latest research and research modalities in neuroscience related to psychiatry. The speakers will then outline the possibilities for new treatments arising from
1. Regenerative Medicine
2. Ccr & C-cbt
4. Virtual Reality & Augmented Reality
5. Immune Therapies In Psychiatry.
Deconstructing Dementias: Connecting Symptomatology, Functional Neuroanatomy and Diagnostic Entities
Dr. Neelanjana Paul Prof. Malay Kumar Ghosal, Prof. Om Prakash Singh
Departent. Of Psychiatry, Icare Institute Of Medical Sciences & Research, Haldia, West Bengal. Email Id: Neelanjana.email@example.com
Criteria for various neurocognitive disorders or erstwhile dementias are being described in DSM V, based on symptoms, observations and assessments of defined cognitive domains. However, caregivers and patients use various idioms to express their complaints, based on their socio-educational background, and lay understanding of what brain functioning is, and what it is expected to be in the age group of the patient concerned. There are instances when associated behavioral manifestations and alterations of personality become more prominent and confound the situation. The onus is on the clinician to scrutinize the symptoms and discriminate between abnormalities pertaining to various cognitive domains in order to arrive at a coherent picture of the cognitive disorder that this index patient might be suffering from. One common complaint of˜forgetfulness may indicate disparate conditions like depression, impairment of autobiographical memory, language disturbances or executive dysfunction.
The rationale behind highlighting separate cognitive domains is that there are distinct but interrelated neural circuits, and one can competently use the symptoms to localize affected brain areas. In resource crunched countries like ours, this may help clinicians to diagnose whether there is dementia, and possibly the type of dementia. An efficient association between symptomatology and functional neuroanatomy, may also help identifying in milder cognitive impairment, those individuals who are at a greater risk of developing frank dementia.
Case vignettes will also be presented illustrating detailed analysis of presenting symptoms of cognitive impairments as described by guardians, their anatomical localization, with radiological and laboratory evidences supporting diagnoses.
Skill Development Workshop On Sensory Integration Therapy For Autistic Children
Dr. Jayaprakash Rusell Ravan Dr. Biswranjan Mishra, Dr. Durga Prasad Mishra, Dr. Sayali Mishra
Email Id: Jpr_219@yahoo.co.in
Introduction: Autism and asd are included under neuro-developmental disorders as per dsm v (2015). Children with autism proposed to have different etiological models by different schools of scientists. The parents and the child suffer endlessly due to lack of understanding of the etiological models and absence of specific standardised international programmes. As per the current research, one of the accepted cause of austism is due to sensory dis- integration with the sensory processing abnormalities.
It is matter of great concern that the principle and practice of sensory integration are mostly unknown to the paediatrician and psychiatrist.Though they are the physician of first contact for these children.
Hence we need to learn the skill of sensory integration so that we can deliver better professional care and guidance. The proposed workshop would provide comprehensive understanding regarding si therapy and give the confidence to deal with autistic children in more scientific ways.
1. Understanding The Neurobiology Of Autism By Dr Br Mishra, Md( Cip Ranchi), Dpm, Associate Professor Aiims Bhubaneswar.
2. Assessment Of Sensory Processing Of A Autistic Child : Dr Sayali Mishra, Mphil Manipal, Phd Assistant Professor Kims Bhubaneswar.
3. How The Si Therapy Is Done In A Clinical Setting- Priciples And Practice. Dr Jp R Ravan, Md Cmc Vellore, Associate Professor Pg Dept Of Psychiatry,kalinga Istitute Of Medical Sciences, Kiit University.
4. Other Special Techniques For Neuro Developmental Disorder With Video Clips. By Dr Durga Prasad Mishra, Joint Director Paripurnata, Bhubaneswar
Interactive Session And Question And Answer Session.
Comorbid Tobacco Dependence And Psychiatric Disorders
Dr. Sonali Jhanjee Dr. Prabhoodayal, Dr. Gaurishankar Kaloiya
All India Institute Of Medical Sciences. Email Id: Sonali_arj@hotmail.com
Tobacco use is the single greatest cause of preventable death worldwide and it disproportionately affects psychiatric patients. Rates of cigarette smoking among people with psychiatric disorders (e.G., Schizophrenia, mood and anxiety disorders) are 2- to 4-fold higher than in the general population. A meta-analysis of 42 epidemiological studies across 20 different countries showed that people with schizophrenia have more than five times the odds of current smoking than the general population and estimates of the prevalence rate of current smoking among individuals with bd range from 30% to 70%. Many reasons are postulated for these high rates of smoking including social, environmental, psychological and neurobiological factors that may account for this high rate of comorbid smoking. As persons with mental illnesses use tobacco at greater rates, they suffer greater tobacco-related medical illnesses and mortality. It is imperative that mental health clinicians learn to address tobacco issues more aggressively, given the health risks of tobacco to our patients.
The high rate of comorbidity between tobacco use and other mental illnesses calls for a comprehensive approach that identifies and evaluates both these disorders. Current treatments for tobacco dependence have demonstrated utility in dual diagnosis populations (eg, nrts, bupropion sr, and varenicline in schizophrenia, bipolar disorder, alcohol, opioid, and cocaine addictions). However these treatments remain underutilized in this population. Several behavioural therapies have shown promise for treating comorbid conditions. These approaches can be tailored to patients according to age, specific drug abused, and other factors. Group CBT programs that produce the most successful quit rates for the mental health population generally have groups of approximately 8-10 individuals that meet once a week for 7-10 weeks. Psychosocial adjunct treatment appears key to develop long-term strategies of abstinence.
Novel Treatment Modalities In Depression
Dr. Parmod Kumar Prof. Nand Kumar, Prof. Nitin Gupta, Dr. Rajesh Nagpal
Email Id: Drparmod@yahoo.com
Depression is projected to be one of the leading cause of disability worldwide. Although several treatment modalities are available, almost 1/3 person, suffering from depressive disorder fails to respond to available conventional line of treatment. These group of patients posses significant clinical challenges to the clinician and markedly contribute to the burden caused by depressive disorder.Clinical research has shown that several newer treatment modalities like non invasive brain stimulation (repetitive transcranial magnetic stimulation, transcranial direct current simulations),administration of ketamine and other newly introduced pharmacological agent is being used by clinician in persons not responding to conventional antidepressant therapy. In this symposium we would like to discuss clinical evidence base,safety considerations and possible limitation for these novel modalities including effectiveness of recently introduced antidepressant medications..
Maintaining Sexual Boundaries In The Doctor Patient Relationship - Workshop On Training Psychiatrists To Teach Undergraduate Medical Students
Dr. Sunita Simon Kurpad, Dr. Ajit Bhide
St Johns Medical College, Bengaluru. Email Id: Simonsunita@gmail.com
Brief Background: The indian psychiatric society has taken a leadership role in india by drafting guidelines for doctors on sexual boundaries in the doctor patient relationship in india. As it is important that all doctors are aware of the importance of sexual boundaries, the medical council of india- based on the recommendation of the bangalore declaration group, has incorporated the topic of boundaries in in the proposed undergraduate medical curriculum. As far as we are aware, only one medical college in india has been teaching this topic to its undergraduates as part of its medical ethics curriculum for the last several years. Psychiatrists are in a unique position to effectively teach this topic to medical undergraduates- not just by already having an understanding of the importance of this issue, but also an understanding of how doctors can begin to move down the avoidable slippery slope towards sexual boundary violations.
This workshop aims to address the ethical imperative of training young medical students on how to reduce any future risk of boundary violations in themselves and colleagues, by training psychiatrists on how to teach this topic to them.
Specific Learning Objective
At the end of this workshop, participants (both senior and junior psychiatrists), will know how to take a session on sexual boundaries to medical undergraduates.
Participants will be able to take at least one seminar on this topic for their post graduate students (which will serve as a further practice/ training session) and then one session of one hour duration for their medical undergraduate students over the next one year.
Brief Presentation Of Background
Identifying Key Messages To Medical Students
Sharing resource material- papers, free link to sensitization video and a website with some faqs
Symposium On Challenges In The Current Format Of Assessment Of Disability, Job Matching And Reservations In Government Jobs For Persons With Mental Illnesses In India
Dr. Hareesh Angothu Dr. Krishna Prasad M, Dr. Deepak Jayarajan, Dr. Siva Kumar T, Dr. Naveen Kumar C, Dr. Suresh Bada Math
Nimhans, Bengluru. Email Id: Hareesh.firstname.lastname@example.org
Indian scale for disability evaluation and assessment (ideas) has been in use for more than 15 years for the purpose of assessment of disability due to mental illnesses. Its brevity and focus on functionality rather on symptom severity has helped the clinicians in rating the disability percentage, as 40% disability is a mandatory requirement for availing social security benefits in india. Though guidelines for applying ideas were issued by the ministry of social justice and empowerment, there are certain issues on which confusion persists. Utilization of this instrument for persons with substance related disorders, personality disorders appears to be very less and fraught with controversies. There are concerns regarding instances when there is a need to certify persons who suffer from disorders with episodic remission courses and in situations where patient who have never been treated and they have not been adequately addressed.
In this regard, there was a national expert consensus meet under the aegis of ips organized at nimhans and its recommendations are to be released soon. More importantly, the rights of persons with disability 2014 draft bill pending in the parliament has recommendations for reservations in jobs for persons with mental illness, autism and intellectual disability. Though this could be a significant step towards inclusive employment of persons with disabilities, there can be several challenges in practical implementation of this in the areas like job matching prior to notification considering the dynamic nature of disability due to mental illness.
In this background we wish to conduct a symposium on challenges related to assessment of disability in persons with mental illness using ideas, challenges related to assessment of job matching and retention in persons with mental illness and the concept of job reservations for persons with mental illness as a measure to facilitate social inclusion.
Telepsychiatry - Update And Overview About Opportunities And Challenges
Dr. Laxmi Naresh Vadlamani, Dr. K.Ashok Reddy, Dr. Naresh Vadlamani, Dr. K.p. Jayaprakashan, Mr. Chaitanya Joysula
Government Medical College, Mehboobnagar. Email Id: Nareshvadla@yahoo.com
Introduction: Telepsychiatry is gradually making its mark in psychiatric practice across the world and in recent times in india as well. India has attempted to draft some guidelines for telemedicine practice.But telemedicine in psychiatric practice i.E, telepsychiatry is a different player altogether.
Aims: To provide an overview and latest updates about opportunities, challenges and technological issues related to current practice of telepsychiatry in india.
Opportunities: Opportunities of telepsychiatry is still in a nascent stage stage in india and many arenas are utility still unexplored like in prisons, rural areas, in geriatric population and in children
Challenges: Challenges of telepsychiatry in india includes outdated technologies, lack of regulated guidelines arising out of telepsychiatric practice in legal, ethical, privacy, confidentiality and emergency areas.
Advances In Technology: Video-conferencing, updated software, synchronous and asynchronous data, latest equipment and security, storage,and encryption of data are some of the advanced technological issues that need to be appropriately scrutinized and evaluated.
Conclusion: Telepsychiatry poses a unique opportunity to serve the population in under served areas irrespective of cost-effectiveness and availability of appropriate technology but challenges do need to be addressed adequately.
Community Participation For Good Mental Health: Formulation & Implementation Of Promising Strategies For India & Developing Countries
Dr. Sanjay Gupta, Dr. Mukesh Jagiwala, Dr. Vd Meel
Institute of Medical Sciences, BHU,Varanasi. Email Id: Sanjayguptabhu@hotmail.com
Growing population is a problem. Global human population growth amounts to around 75 million annually, or 1.1% Per year. The global population has grown from 1 billion in 1800 to 7 billion in 2012 and 7.5 Billion in 2016. It is expected to keep growing, and estimates have put the total population at 8.4 Billion by mid-2030, and 9.6 Billion by mid-2050. Much of this population growth is concentrated in low-income countries with india expected to become the largest country in population size, surpassing china around 2022.
While the present rates of population growth already compromise provision of health care, education, food security, etc for people, and take a toll on the quality of life. On the other hand, at the same time, population & people are the most valuable community assets as well. If professionals were to work with them and properly utilize & empower them in various facets of good mental health & disease awareness, these enormous populations & people could prove to be the most valuable community assets for mental health advocacy, awareness dissemination, etc and could be a major solution for problems instead of posing as problems themselves. The symposium will be divided into an initial part with 3 presentations from experts working in the community followed by a public forum in which attendees can also offer their valuable inputs so as to formulate a model of community participation into various facets of mental health..From advocacy to care.
Mental Health Services In Uk: Similarities, Differences And Focus On Specialisms
Dr. Arun Kumar Gupta, Dr. Dr R Nadkarni, Dr. Dr A Sharma
Email Id: Drakgupta@hotmail.com
Indian psychiatrists have a history of being involved with academic institutions and in migrating to work in the nhs in the uk. Over the past two decades a number of close working relationships have been developed between clinicians, academics and institutions working in both countries. Core principles of clinical practice especially involving diagnostic formulations and pharmacotherapy are not dissimilar, however cultural, legal, political and societal practice do influence service development and psychiatric approaches in both countries. An attempt will be made in this symposium to present some areas within the uk which are influenced by such factors. Dr nadkarni will chair and speak about the statutory structures involving management of risk and safeguarding of vulnerable individuals including those with mental health problems. He will also share his experience of assessing and managing stalking offenders over the past 16 years. Dr gupta will discuss the conceptualisation of multi-disciplinary teams, systemic approaches, devolved responsibilities and bio-psychosocial approaches in treatment of severe mental illnesses and personality disorders. He will also discuss how general adult psychiatry is practiced in our trust and uk. Dr sharma will give an overview of specialisations within psychiatry in uk, and discuss recent advances in management of bipolar illness in adolescents, including british association of psychopharmacology guidelines for this disorder.
Autism Spectrum Disorder And Attention Deficit Hyperactivity Disorder: Conceptual Issues And Management Approaches
Dr. Suravi Patra, Dr. Naresh Nebhinani, Aiims Bhubaneswar
Email Id: Patrasuravi@gmail.com
Dsm5 has now allowed the diagnosis of attention deficit hyperactivity disorder with autism spectrum disorder. Traditionally, asd and adhd were conceptualized as different disorders. There are issues and concerns regarding overlapping presentation and differences between the disorders. There are neuropsychological findings and neuroimaging findings which are overlapping and specific to the disorders.
A better understanding of the two disorders would mean better management of the patients having comorbid symptoms.
Key Words:˜autism Spectrum Disorder; Attention Deficit Hyperactivity Disorder;˜co-morbidity;˜treatment.
1. Conceptual Issues
Dr Suravi Patra
Department Of Psychiatry
Autism spectrum disorder (asd) comprises of difficulties in social interaction, communication and stereotyped behavior whereas attention deficit hyperactivity disorder (adhd) manifests with hyperactivity, inattention and impulsivity. Upto 30% children with asd have symptoms of adhd. Similarly, in children with adhd, symptoms of asd are also reported. Various models of co-morbidity have been suggested to explain this: three independent disorders, two disorders are alternate manifestations of the same underlying risk factor, specific risk factors for both disorders are correlated and presence of one disorder increases the prevalence of other. Studies on risk factors, biological, neuropsychological and brain imaging findings support different models of comorbidites. This section of the symposium would elaborate on these issues.
2. Clinical Practice
Dr Naresh Nebhinani
Dept. Of Psychiatry
Email: Drnaresh_pgi@yahoo.com, Nnebhinani@gmail.com
Management of adhd co-morbid with asd is similar to other child psychiatric disorders in terms of multiple modalities. Need for specialized treatment strategy which is determined by the clinical presentation. Pharmacological treatment includes stimulants and non-stimulant medications. Response to pharmacotherapy and adverse reactions need careful monitoring and dosage titration. Addition of psychosocial treatment including behavior therapy and parent training is known to improve child outcomes even autistic behavior.
Are First Rank Symptoms Still Relevant In Diagnosing Schizophrenia
Dr. Sujit Sarkhel, Dr. Vikramaditya Jaiswal, Dr. Neha Singh, Dr. Joyita Sinha
Email Id: Sujitsarkhel@gmail.com
Schneider's first rank symptoms have remained the backbone of diagnosis of schizophrenia till icd 10 and dsm iv .However, with the publication of dsm v, the importance of first rank symptoms has gone down and it has been mentioned that they lack specificity for diagnosis of schizophrenia.We are going to critically analyze whether these symptoms deserve to retain their previous importance or should be considered equal to any other psychotic symptom.The first speaker shall trace the origin of first rank symptoms as per schneider's work and briefly outline their definitions as per various authorities in psychopathology.The second speaker shall track the changing status of first rank symptoms and their evolution across various nosological systems.The third speaker shall highlight the points in favour and against of assigning special importance to first rank symptoms in diagnosing schizophrenia in light of the existing literature.The final speaker shall conclude the symposium by discussing the evolving diagnostic systems for schizophrenia and future directions for research in terms of first rank symptoms.
Glimpses Of Researches In Relation To Icd-11 At Aiims, New Delhi
Dr. Pratap Sharan Dr. Yatan Pal Singh Balhara, Dr. Ravindra Rao, Dr. Rachna Bhargava
Aiims, New Delhi. Email Id: Pratapsharan@yahoo.com
The Icd-11 classification of mental and behavioural disorders is integrally linked to whos public mental health. Who has developed and implemented a series of studies using a variety of methodologies intended to improve the clinical utility of the icd-11 classification of mental and behavioural disorders. Aiims has participated in a few of these studies. Results of formative field studies regarding the metastructure of overall classification, methodology of summative ecological implementation field studies to test the reliability and clinical utility of the proposed classification in clinical settings in relation to mental disorders and sexual disorders; and studies in relation to dissemination strategies will be described.
Formative field studies informed early decisions about the best architecture or structure for a classification of mental and behavioral disorders. The first study used a method of paired comparisons, on how mental health professionals organize clinically relevant information towards classification; while the second formative study investigatedœnatural taxonomies, or the ways in which relevant phenomena are classified by specific cultures or populations.
The ccological implementation field studies aim to evaluate the impact of proposed changes to the diagnostic guidelines on clinicians diagnostic decision-making in clinical settings in which they will be utilized. One arm of the ecological implementation studies will evaluate the clinical utility of the proposed icd-11 diagnostic guidelines. The second arm will evaluate the inter-rater reliability of diagnostic conclusions based on the proposed icd-11 diagnostic guidelines for five groups of disorders: mood disorders, psychotic disorders, disorders specifically associated with stress, anxiety disorders, and common disorders of childhood. Similar, studies are being conducted for sexual health conditions.
A study was implemented among global clinical practice network (developed by who) participants to examine their use of classification systems as a part of day-to-day clinical practice, in support of disseminative strategies for icd-11.
Neuropsychology Of Face Recognition
Dr. Sharmila Sarkar (ghosh), Ms Jayita Saha
Kolkata, India. Email Id: Dr_ghoshs@yahoo.co.in
Is said that˜face is the mirror of our mind. Face provides a unique indication of the identity of a person. Indeed, the remarkable capacity of human beings is to recognize and discriminate the myriad of faces they see in a lifetime which has been a subject of interest to both psychiatrists and psychologists for many years. We can remember hundreds if not thousands of individual faces, with memories that endure decades of separation . The ability to remember large numbers of individual exemplars within a category of objects distinguishes faces from other familiar visual object categories . From the time we are born, faces are the preferred objects of our attention . With a quick glance at a face, we can easily guess the age, race, sex, and ethnicity of a person . The face also provides us with information regarding the emotional state of a person. All of this information is effortlessly and instantaneously accessible to us from a single static image of a person. Errors in face-recognition can have catastrophic consequences as in eye-witness testimony. It is noteworthy that the right hemisphere plays an important role in face recognition and funtional imaging shows that there is increased activation in the fusiform gyrus . The objectives of the present symposium would be to highlight the different neuro-cognitive models, role of motion in face recognition, emotional expression and face recognition, social cognition,developmental issues, gender differences, assessment, and impairment of face recognition in different neuropsychiatric presentation.
Biomarkers In Bipolar Disorder ?: A Critical Appraisal, Challenges And Future Directions
Dr. Rajesh Sagar, Dr. Raman Deep Pattanayak, Dr. Ananya Mahapatra
Email Id: Drrajeshsagar@gmail.com
Bipolar disorder (bd) is a severe, recurrent, mood disorder, associated with significant morbidity and suicide risk. Presently, the diagnosis of bd is mostly based on clinical gathering of information using history-taking, psychiatric interview and observation, thereby lacking a biological validation. Considering the huge burden of bipolar mood disorder, often this approach results in delayed diagnosis, under-diagnoses, misdiagnosis and eventually poorer outcomes. Further, apart from family history, there is no objective parameter to gauge the biological vulnerability of family members to develop mood disorder in future. Due to the well known heterogeneity of bd, the possibility of developing a single, 'accurate' biomarker 'hitting the bull's eye' is still remote; however, there are a set of promising biomarkers which have shown some potential to be predictive, prognostic or treatment markers. This may help in journey from benchside to bedside with clinical applications. The symposium shall present a critical appraisal of research aspects of these candidates for biomarkers, including neuroimaging markers, peripheral biomarkers and genetic markers and cognitive endophenotypes in recent indian and international literature. The lessons learnt from other medical specialty fields need to be applied to psychiatry in an effort to translate the knowledge from research to clinically useful biomarkers. The use of biomarkers may help in pushing the shift towards 'personalized medicine' for psychiatric patients.
National Mental Health Survey Of India 2016
Dr. Varghese Mathew, Prof. G Gururaj, Prof. Vivek Benegal 1 , Prof. N, Girish 2
Center For Public Health, 1 Dept Of Psychiatry, 2 Center For Public Health, NIMHANS, Bangalore
Epidemiological studies of the prevalence of mental disorders and their patterns were carried out in india over a decade ago. There was a need to evaluate the problem currently so as to plan for delivery of the NMHP. In 2014-15 the ministry of health, initiated a survey to study the prevalence of mental disorders and their pathways to care, treatment gap, burden and costs. The study also aimed to look at the mental health system of each of the states surveyed in terms of the number of professionals, treatment facilities, policies and programs.
The survey was carried out in 12 states of india; two states each from the six different regions (north, south, east, west, central and the north-east) from 2015 to 2016. The main survey was preceded by a pilot survey carried out in early 2015 in karnataka. The study instruments used were loaded onto tablets and comprised the mini, screening tools for tobacco dependence and epilepsy, instruments to evaluate the burden of illness, pathways to care, utilisation of services and socioeconomic costs. In addition, a tool to assess the mental health system in each state was used.
Over 3000 adults over 18 years were interviewed from households in randomly selected clusters from 3 districts in each state. The subjects were diagnosed on the icd-10 and categorised as severe mental disorders, common mental disorders including substance use disorders, suicidal behaviour, tobacco dependence and epilepsy. Women had a higher preponderance of cmds and suicidality while alcohol dependence/harmful use were more common among men. These mental disorders caused high degree of burden and there was poor utilisation of health services with a treatment gap of over 80% for most disorders. The mh systems differed in different states. The detailed findings and implications would be discussed.
Burden And Correlates Of Common Psychiatric Disorders: The Untold Story Of Rural Bengal
Dr. Pradeep Kumar Saha , Dr. Rajarshi Neogi, Dr. Soumyadeep Saha , Dr. Tanmay Mahapatra
Introduction: Upsurge of global epidemic of mental ill-health seem to have worsened in developing world given the associated stigma, denial and neglect. About 6-7% indians suffer from psychiatric disorders while by 2020, the count will reach 50 million. Still, epidemiological investigation remained under-emphasized, more so in rural sub-population of the eastern india. Dearth of representative data thus called for a community-based investigation in rural bengal to quantify the problem and identify the action points.
Methodology: To minimize social-undesirability and non-response, using the first-ever on-and-offline synchronized, android-based, algorithm-defined, community-based, pre-validated psychiatric diagnostic approach in india, a cross-sectional study was conducted in rajbolhut 1 and 2 gram panchayat of hooghly district in west bengal. Using stratified, cluster-random sampling nested in a population-based cohort, through door-to-door visits, a representative data from 4856 consenting adults were collected and analyzed with sas-9.4.
Results: The burden of current major depressive disorder (mdd) was 24.0%(22.83-25.23), Suicidal risk was 12.3%(11.41-13.26), Agoraphobia was 12.6%(11.67-13.54). About 12.0%(11.09-12.92) Had obsessive-compulsive symptoms while 6.1%(5.40-6.75) Were suffering from psychotic disorders and 5.9%(5.23-6.55) Had social phobia. Middle aged [aor=1.37(1.03-1.81)], Women, minority religion, marginalized caste [aor=1.63(1.24-2.15)], Middle [aor=1.48(1.15-1.89)] And upper [aor=1.75(1.21-2.54)] Socio-economic class (ses), less educated, unemployed subjects had higher odds of suffering from mdd. Suicidal risk, agoraphobia and social phobia were more common among females, non-marginalized caste, higher ses and divorced/widowed/separated. Middle-aged [aor=1.70(1.19-2.42)], More educated subjects [aor=2.55(1.45-4.49)] Were more likely to have obsessive-compulsive symptoms. Odds of psychotic disorders was higher among non-marginalized caste [aor=3.27(1.98-5.39)], More educated [aor=2.97(1.23-7.18)] And divorced/separated [aor=4.22(1.42-12.55)].
Conclusion: Quite alarming burden of psychiatric ailments was observed among rural adults of bengal. Provision for appropriate treatment and counselling along with targeted intervention to enhance awareness and coping seemed to be the need of the hour.
DISSOCIATIVE DISORDERS IN CHILDREN WITH SPECIAL REFERENCE TO INDIAN SCENARIO
Dr. Indira Sharma, Dr. Nupur Niharika 1 , Dr. Kailash Jagatpal 2 , Dr. Dinesh Kataria 3 , Dr. Ganesh Shanker 4
Former, Professor and Head Department of Psychiatry, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 4 Lecturer in Psychiatry, GSVM Medical College, Kanpur, UP, 1 Lecturer in Psychiatry, Head Department of Psychiatry, Patna Medical College, Patna, Bihar, 2 President, Medical Council of Mauritius, Mauritius, 3 Prof and Head, Dept of Psychiatry, Lady Hardinge Medical College, New Delhi, Delhi, India. Email Id: email@example.com
Back ground: The manifestations of dissociative disorder in children are not the same as in adults.
Aim: To describe the manifestations of dissociative disorders in children
Method: The literature on conversion disorders in children (up to 20 years) of leading journals and text books was retrieved and studied.
Results: Children may present with somatic (conversion) or mental (dissociative) symptoms; both may manifest in the same episode.
Conclusion: Children may present with varied dissociative symptoms, conversion and dissociative, which differ from adults
Differentiating Conversion Disorder in Children from other Diagnoses, by Ganesh Shanker
Management of Conversion Disorders in children, by Indira Sharma & Nupur Niharika
Psychosocial Other Determinants Of Dissociative Disorder In Children
Prof and Head, Dept of Psychiatry, Lady Hardinge Medical College, New Delhi, Delhi, India
Background: There is limited literature on the psychosocial determinants of Dissociative Disorders (DDs) in children.
Aim: To present an overview of the major psychosocial and other determinants of Dissociative Disorders in children
Method: The literature relating to etiology of dissociative disorders in children was retrieved and reviewed.
Results: The main etiologies include a recent psychosocial stressor (clustering of events in common); an 'adaptation' to a frustrating life experience; to permit the expression, though in disguised form, of a forbidden wish or impulse; to impose punishment on oneself of a forbidden wish via the disabling symptom.
Conclusion: The etiology of DDs is multifactorial.
Differentiating Dissociative Disorders In Children From Other Diagnoses
Lecturer in Psychiatry, GSVM Medical College, Kanpur, UP, India
Background: Differentiating Dissociative Disorders from other disorders can sometimes very challenging because 4-50% of patients diagnosed with conversion symptoms are found to have neurological illness on follow up.
Aim: To present the differential diagnosis of DDs
Method: The literature relating to differential diagnosis of dissociative disorders in children, from recent journals and test books of childhood psychiatric disorders was retrieved and reviewed Results:
Results: Conversion symptoms need to be differentiated from neurological disorders (eg polyradiculopathy, parietal or thalamic lesions), medical conditions (eg multiple sclerosis, systemic lupus erythematosis, acute intermittent prophyria, cervical spondylosis), undiagnosed physical disorders, factitious disorder and malingering. Conversion symptoms need to be differentiated from psychosis. Meticulous history, examination and appropriate investigations are needed to confirm the diagnosis.
Conclusion: Dissociative Disorder is a positive diagnosis which needs to be differentiated from a wide range of disorders, factitious disorder and malingering by means of a through clinical examination.
Management Of Dissociative Disorders In Children
Indira Sharma 1 , Nupur Niharika 2
1 Former, Professor and Head Department of Psychiatry, Institute of Medical Sciences, Banaras Hindu University, Varanasi, UP, 2 Lecturer in Psychiatry, Head Department of Psychiatry, Patna Medical College, Patna, Bihar, India
Background: Dissociative Disorders are often mismanaged, both in medical and non-medical settings (community).
Aim: To review the recent literature with respect to major principles and techniques employed in the management of DDs in children.
Method: The literature relating to management of DDs in children was surveyed.
Results: Management of DDs in children may be done through the following strategies.
1. Decrease anxiety of the patient and that in the immediate environment:
2. Minimize the secondary gain
4. Medication for associated symptoms of depression and anxiety.
5. Prompt Removal of the symptom:
6. Behavioural management
7. Dealing with the psycho social stress
Conclusion: A comprehensive management plan, individually tailored, with an eclectic approach, is required for children with DDs.
Skill enhancement for Indian "Teachers of Psychiatry" (iTOP): What can be done?
Dr. Mohan Issac, Dr. M V Ashok, M Kishore 1
Professor of Psychiatry, St John's Medical College, Bangalore), 1 Associate Professor of Psychiatry, JSS Medical College, and Mysore. Email Id: firstname.lastname@example.org
In the recent past, due to efforts at various levels, there has been an eight fold increase in the number of postgraduate (PG) training positions in the country. From 66 PG seats in 2002, the number of PG positions has increased to the current number of 576 (MD - 434, DPM - 128 and DNB - 14). Similarly, the number of medical colleges too have increased steadily, to 426 with an annual intake of 53455. The National Mental Health Policy and the National Mental Health Programme envisage improved mental health care at the general health services, delivered by mental health informed and sensitive general doctors, supported by psychiatrists. This can be achieved only if the undergraduate teaching of psychiatry is uniformly improved in all medical colleges and the quality and standards of postgraduate training in psychiatry is maintained at all centres.
Surveys of training in psychiatry in the country have shown marked variations in the way psychiatry is taught across medical colleges and universities. There is also marked variation in the number of experienced and qualified teachers interested in teaching psychiatry and resources available for optimal teaching of psychiatry.Quality of psychiatry teaching can significantly impact the overall competence of both undergraduates and post graduates
The urgent need to enhance opportunities for teachers of psychiatry to discuss and learn from each other as well as improve their teaching skills was identified and efforts have been on to create a Forum for Teachers of Psychiatry.
The three presentations in this symposium on psychiatry teaching skills enhancement will explore global trends in this area, present the results of a survey of psychiatry teachers carried out in Karnataka in 2016 and the process and outcome of a "one day psychiatry teaching skills enhancement "programme conducted for psychiatry teachers from Karnataka Medical Colleges
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Presenters and titles of presentations:
1) Mohan Isaac (Professor of Psychiatry, The University of Western Australia and Visiting Professor, NIMHANS, Bangalore) - "Advances in teaching of psychiatry at undergraduate and postgraduate levels: a global overview"
2) M V Ashok (Professor of Psychiatry, St John's Medical College, Bangalore) - "Challenges of teaching psychiatryat undergraduate and postgraduate levelsin India"
3) M Kishore (Associate Professor of Psychiatry, JSS Medical College, and Mysore) - How can teaching skills of psychiatry teachers be enhanced: Results of a survey and a "skills enhancement" programme.
Trying To Understand Consciousness From Different Perspectives
Dr. Debashish Sanyal, Dr. Bhaskar Mukherjee
Department Of Psychiatry, Maldah Medical College, Maldah, West Bengal, India
Developing understanding about human consciousness is possibly one of the most complex challenges facing mankind. While great hopes were repeatedly raised with advent of imaging, electrophysiological and neuropsychological assessments, consciousness still remains mostly unexplained. With advent of computers and information technology, hope of modeling human minds and concept of artificial intelligence gained ground. Computers were able to defeat human players in the game of chess which is regarded as a game involving high level of intelligence. However, proper understanding of consciousness remained elusive.
Gradually, it has become apparent that any attempt to understand consciousness involves need to involve multiple perspective. Some of the important perspectives are cognitive, philosophical(both Indian and Western), developmental, evolutionary, anthropological, linguistic, psychodynamic, neural correlates of consciousness, computer modelling and artificial intelligence and quantum mechanics.
In our symposium, we will try to cover these perspectives and try to explore possibility using these to develop some basic understanding of consciousness.
Clozapine: The Multi-Faceted Molecule In Psychiatry
Dr. Sarmishtha Chakrabarti 1 , Dr. Subir Bhattacharjee 2 , Dr. Sujit Sarkhel 3 , Columbia Asia Hospital, Kolkata
1 Consultant Psychiatrist, 2 RMO Cum Clinical Tutor, 3 Assistant Professor, Institute of Psychiatry, Kolkata
This symposium shall delve into various aspects of clozapine, which is indeed a unique molecule in psychiatry. Dr Sujit Sarkhel shall open the discussion with a brief introduction and exploring the various indications and specific uses of clozapine in various psychiatric conditions. Dr Subir Bhattacharjee will discuss the recent guidelines for monitoring the various adverse effects of clozapine and a brief overview of their management. Finally, Dr Sarmishtha Chakrabarti will explore the use of clozapine in special populations like women (including pregnancy and lactation),children and the geriatric age group.
Guideline Development For Community Psychiatry: The Ips-community Psychiatry Speciality Section Initiative
Prof. Rs Murthy, Dr. Alok Sarin, Prof. B S Chavan, Prof. NG Desai, Prof. RK Chadda, Prof. Nitin Gupta
Email Id: Nitingupta659@yahoo.co.in
The government has been taking initiatives in the form of nmhp, dmhp, international collaborative projects to further the development and progress of community mental health in india. However, the initiatives by the indian psychiatric society (ips) have not been relatively that robust. Additionally, there has been lack of focus on developing standards of training and research in order to provide impetus to the development of community mental health in india. The time is now ripe for the ips (along with indian association of social psychiatry and indian association for private psychiatrists) to provide leadership to this cause and develop a˜position statement in order to guide and provide a framework to the policy makers and mental health professionals of this country.
The department of psychiatry, gmch-32 (under the aegis of the community psychiatry specialty section of the ips) organized a 2-day national workshop on 2-3 july, 2016 to focus on the issues of service delivery, innovative models of care, training aspects, research and quality assurance and relationship with the mental health care bill (2016). Experts from all parts of the country with experience and expertise in community psychiatry participated in the workshop and were divided into 5 groups; each with a chief coordinator and co-coordinator who worked ahead of the workshop and identified various resource documents, and prepare background papers.
At the planning level, by the end of the workshop, the experts identified mechanisms to develop guidelines for community psychiatry in the country, and a time bound plan of action was agreed.
As per the time line, guideline development work has been initiated and is under process. This symposium will present the various facets of the conduct of the workshop, the guideline development, the guidelines per se, and the vision for the future.
An Audit of MD thesis based research: its quality and publication.
*Shrikant Srivastava, Alka Subramanyam, Vivek Agarwal,
Mona Srivastava, Hitesh Khurana, Archana Singh, Prasad Rao, Gautam Saha, Alka Subramaniam, TS Sathyanarayana Rao, *Shrikant Srivastava
Associate Professor Geriatric PsychopharmacologyDept of Geriatric Mental Health, King George's Medical University, Lucknow, UP
E-mailHYPERLINK "mailto:email@example.com" firstname.lastname@example.org
The status of MD Theses - Dr. Shrikant Srivastava
How to do research - Dr. Alka Subramaniam
How to Publish - Dr. T S Sathyanarayana Rao
Chairmen: Prasad Rao, Gautam Saha , Ajit Avasthi
Introduction: Training in research methodology is integral part of MD programmes, as mandated by Medical Council of India. Currently there are 485 MD Psychiatry seats recognized by MCI in the country, hence as many projects are being undertaken every year. The aim of this audit was to pilot the MD thesis based research on predefined criteria, and it's contribution to the published literature.
Methods: A priori, it was decided to pilot the research work completed between years 2000 and 2010 inclusive, as it will give a space of 5 years for the publications to happen (this audit was started in late 2015). The centres - Lucknow, Mumbai and Varanasi, agreed to participate, and prided data on designated format. All information on publication was cross checked by searching on HYPERLINK "http://www.Google.com" www.Google.com, and if the information was not available there, the candidate/supervisor were contacted directly. Additionally, JCR impact factor of Web of Science and h5 index were searched for the published articles to estimate their dissemination.
Results: Ninety five analyse be records were obtained from the 3 centres. All execpt 3 studies used standard diagnostic criteria, and majority of these used ICD 10 DCR or DSM IV or DSM IV TR, and 2 studies used other criteria specific to the illness under study.
Most studies were clinical oriented (n=75), and others were related to neuroimaging (n=9), drug trial (n=4), non-pharmacological trial (n=3), and laboratory measures (metabolic syndrome n=2, thyroid functions n=1). 95% thesis were clinical studies, 96% had no funding available for research, and 67% had no collaborations - either within the institute or without.
Out of 95 completed theses, only 9% were published as abstracts/conference proceedings, and 32% were published as full papers. Amongst those with full publication, only 15% were in journals with h-index value (Range 10 - 41) and 3 with JCR impact factor (average 1.1). The average time duration between completion of the thesis and publication was 4+2.8 (range 0 - 11) years, thus signifying that in majority of cases, publication follows completion of the MD degree.
Conclusion: Only a minority of MD based research work is published , and that in journals with low alt metrics. The limitations of the present study are retrospective collection of data (i.e., the students have passed and possibly left the institution), and limited number of centres involved.
Understanding female sexuality and issues in management
T.S. Sathyanarayana Rao, Rashmi Patil.
Professor, Department of Psychiatry, JSS Medical College, JSS University, Mysore, Karnataka
E-mail: HYPERLINK "mailto:email@example.com" firstname.lastname@example.org,
Sexuality is the central aspect of one's life and encompasses sex, gender identities, sexual orientation, eroticism, pleasure, intimacy and reproduction. There are many similarities so also dissimilarities between male & female sexuality and they concern thoughts, fantasies, desires, beliefs, attitudes, values, behaviours, practices, roles and relationships. However, many myths and misconceptions galore regarding female sexuality. Starting from adolescence women can be sexually active throughout their life. Each stage in the sexual response cycle is unique to women and bio-psycho-social aspects affect the same. The studies consistently report problems in two third of the female population which can be attributed to age, relationship with the partner, psychiatric & medical disorder, psychotropic & other medications. Female sexuality is still a neglected area, particularly in the Indian context. Counseling to remove stigma, taboos and misconceptions and enhancement of awareness on sexuality and relationship are essential steps in the management. There are several effective psychosocial and pharmacological therapeutic approaches for the management of female sexual disorders. The presentation will look into the problems comprehensively and suggests the evidence based practical therapeutic management of female dysfunctions.
Keywords: Female Sexuality, Management of female sexual dysfunctions, Myths and misconceptions of female sexuality, Female sexuality and relationships.
Learning through Humour in Sex - From the archives of day to day clinical practice
T.S. Sathyanarayana Rao, Vihang N Vahia
Professor, Department of Psychiatry, JSS Medical College, JSS University, Mysuru, Karnataka
HYPERLINK "mailto:email@example.com" firstname.lastname@example.org
Day to day clinical practice brings to fore many experiences encountered in clinics which have tinge of humor. Infact, humour has a significant role in every individual's life and researchers have documented many beneficial effects of the same. However, it could be a source of learning experience. Practice of sexual medicine and mastery of art and science of sex, gender and behavior problems in clinics involves many trial-and-error experiences. Clinicians have documented success and failure in their clinical practice atleast in the initial periods which helped them mature as professionals. Understanding anatomy, physiology and psychology of sex involves utmost sensitivity. The symposium highlights the journey involved and lessons learnt through the medium of humour and anecdotal experiences.
Keywords: Humour, Sex therapy, Gender.
Source of Support: None, Conflict of Interest: None