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   Table of Contents - Current issue
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January-June 2020
Volume 25 | Issue 1
Page Nos. 1-70

Online since Wednesday, October 7, 2020

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EDITORIAL  

COVID-19 pandemic: A crisis for health-care workers Highly accessed article p. 1
Sandeep Grover, Seema Rani, Aseem Mehra, Swapnajeet Sahoo
DOI:10.4103/jmhhb.jmhhb_96_20  
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DR. A. K. KALA AWARD PAPER Top

A study of cardiovascular risk among depressed obese patients p. 5
Chitra Singh, Mohd Wasim, RK Solanki
DOI:10.4103/jmhhb.jmhhb_19_18  
Background: Both depression and obesity are widespread problems with major public health implications. Depression and obesity are both associated with an increased risk of cardiovascular disease (CVD) and with marked impairments in the quality of life. Aim and Objective: The aim of the study is to assess the CVD risk and cardiovascular risk factors among depressed obese individuals. Materials and Methods: Fifty patients of depression whose body mass index (BMI) >30 kg/m2 and diagnosed with ICD-10 criteria of depression were selected as study group and 30 healthy obese of BMI >30 kg/m2 without depression were selected as the control group for the study. The participants were divided into two groups: obese patients with depression and healthy obese individuals without depression. Fasting venous blood sample was collected under aseptic condition to estimate fasting blood sugar, total cholesterol, and high - density lipoprotein cholesterol. Using standard mercury manometer at least two readings at 5 - min intervals, were taken to measure the blood pressure (BP) in the supine position. Both the groups were subjected to specially designed pro forma which included personal and sociodemographic details and Framingham risk assessment tool for assessing cardiovascular risk. The cardiovascular risk was assessed and compared using Framingham risk score assessment tool. Results and Conclusion: Mean age of depressed obese was 46.44 ± 10.44 years and healthy obese had 47.33 ± 10.53. Mean BMI of study group was 32.82 ± 2.53 and healthy obese had 31.76 ± 1.66. BMI was significantly associated with depression. Presence of depression in obese patients increases the chances of CVD risk. Presence of smoking, hypertension, and high cholesterol in patients with depression, increase the risk of CVD, which can be modified by healthy diet, regular exercise, and BP management with periodic blood investigation and regular medication.
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ORIGINAL ARTICLES Top

Prevalence of depression and anxiety in college students Highly accessed article p. 10
Tanvi Deepak Shah, Titiksha Pol
DOI:10.4103/jmhhb.jmhhb_16_20  
Context: Depression and anxiety are the most common mental disorders existing today among the youngsters owing to academic excellence pressure and societal living expectations. They are overlooked most of the times and can have a grave impact on a student's personal, academic, and social life. Aim: The aim of the study was to find the prevalence of depression and anxiety in college students. Methods: A prospective study was done in 400 college students in the age group of 18–25 years. A self-made questionnaire, along with the Beck's Depression and Anxiety Inventory, was administered. Results: We found that depression was prevalent in about 48.30% of the students, whereas anxiety was prevalent in 50% of these students. Conclusion: Hence, moderate-to-severe levels of depression and anxiety exist in college students, which need to be confirmed and diagnosed clinically and treated at the earliest.
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Knowledge overload versus actual practices: Knowledge and awareness about COVID-19 infection among patients attending the emergency services of a tertiary care hospital during the COVID “lockdown” period p. 14
Swapnajeet Sahoo, Aseem Mehra, Gopika Jagota, Aarzoo Suman, Shivanee Kumari, Deba Prasad Dhibar, Navneet Sharma, Savita Kumari, Sandeep Grover
DOI:10.4103/jmhhb.jmhhb_57_20  
Background: It is essential to assess the knowledge and awareness about COVID-19 infection among people utilizing the emergency health-care services. Aim: This study aimed to evaluate the knowledge and awareness about COVID-19 infection and the practices followed by the patients and their caregivers with respect to prevention of spread of COVID-19. Methodology: A cross-sectional exploratory study was conducted in the emergency outpatient services of a tertiary care center using a brief self-designed questionnaire. Results: More than half of the participants considered that touch and coming in contact with a person with cough/cold were the most common mode of spread of the infection, but many others had several misinformations regarding the exact mode of transmission. Three-fourth of the participants thought that wearing a mask is required to protect oneself from getting infected, while handwashing and social distancing as important precautionary measures were reported by only half and one-fourth of the participants respectively. Only half of the participants used masks during traveling to the hospital and one-third reported of sanitizing hands during travel and only half of the participants reported of having knowledge about using surgical masks and sanitizers in emergency premises, and only two-fifths thought social distancing to be a precautionary measure to follow in the emergency setting. Conclusions: The study findings highlight the need to improve awareness programs so as to improve the knowledge and practices of medically ill patients and their caregivers attending the emergency services.
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The association between identity status, perceived parenting strategies, and mental health of in-school adolescents in South-West Nigeria: A descriptive survey p. 21
Abimbola Margaret Obimakinde, Olayinka Omigbodun
DOI:10.4103/jmhhb.jmhhb_1_20  
Aim: This study was aimed to determine the level of identity development, its associations with perceived parenting strategies, and the mental health of in-school adolescents. Background: Adolescence is marked with the struggle for a balance between subjective psychological differentiation and connection to others, which drives identity formation and guides the path to mental health. Concerning, the developmental processes that incite or escalate adolescents' mental health problems, theories have postulated that social interactions with parents have consequences for the identity status and mental health of adolescents. Methods: A study on 286 in-school adolescents was conducted in Ibadan, between February and April 2016. Data were collected using the Assessment of Identity Development in Adolescents, Scale of Parenting Style, and the Strength and Difficulties Questionnaires. The analysis was done with the Statistical Package for Social Sciences version 21, using Student's t-test, ANOVA, and correlation statistics. Results: The males and younger adolescents, had higher scores for identity discontinuity and incoherence. The scores for perceived mothers' responsiveness correlates positively with the adolescents' score for identity discontinuity (rs= 0.173; P = 0.03), while perceived mothers' demandingness correlates positively with adolescents' identity discontinuity (rs= 0.211; P < 0.001) and incoherence (rs= 0.180; P = 0.01). Identity discontinuity (rs= 0.209; P = 0.00) and incoherence (rs= 0.294; P = 0.00) correlated positively with emotional problems while identity incoherence correlated with conduct problems (rs= 0.211; P = 0.03). Conclusion: During the process of the adolescents' self-actualization, there is a tendency for “conflict” with the parents as the primary authority figure. Hence, the adolescents' perception of parenting strategies can affect their identity development and mental health.
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Internet addiction and psychological well-being among high school students of Mangaluru city, Karnataka, India p. 27
Neha Shresta, Mackwin Kenwood D'mello
DOI:10.4103/jmhhb.jmhhb_26_20  
Background: Despite the controversies on the effects of Internet usage, the habit of Internet usage is increasing in all ages and rampant among the young ages making it critical to understand its relationship with psychological well-being (PWB). Objectives: The study was conducted to determine the relation of Internet addiction with PWB among school students aged 12–16 years. Materials and Methods: A cross-sectional study was conducted among high school students in Mangaluru city. A total of 654 students participated in the study. Data on Internet usage and PWB were obtained using Young's Internet Addiction Scale and Ryff's Psychological Well-being Scale, respectively. The relation between Internet addictions with PWB was analyzed using correlation statistics. Results: The mean age of the respondents was 14.3 ± 1.007 years, and 62.7% were males. There was a weak negative correlation between PWB of the high school students and Internet addiction scores (r = −0.255, P < 0.001). Students with a higher level of Internet addiction were more likely to be low in PWB. Linear regression showed that Internet addiction was a significant negative predictor of PWB (β = −0.272, P < 0.001). Conclusion: PWB of high school students is negatively affected by Internet addiction. Hence, it is crucial to develop strategies addressing young adolescents for effective prevention of problematic Internet use.
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Social cognition in first-degree relatives of patients with schizophrenia and mania with psychotic symptoms: A comparative study p. 31
Vikas Kumar, Deyashini Lahari Tikka, Basudeb Das
DOI:10.4103/jmhhb.jmhhb_6_20  
Background: Non-affective psychosis refers to psychosis unrelated to mood or affect. Affective psychosis is a psychological disorder where people experience a loss of contact with reality and experience mood disturbances working as a primary cause. The focus has been shifted to the first-degree relatives of these populations to prevent the disorder at the earliest. So, the first-degree relatives are known to be a high-risk population with genetic vulnerability. These two disorders (schizophrenia and mania with psychotic symptoms) show various impairments in various field but these impairments are present to define these disorders, unaffected relatives of these two disorders for different areas like social, cognitive, neurocognitive and social functioning. Cognitive dysfunction and social cognition dysfunction as a trait marker nearly established in affective and non- affective populations. Aims and Objectives: Purpose of this study to assess social cognition, neurocognition and social functioning in FDRs of patients with schizophrenia and mania with psychotic symptoms. Methodology: The sample consisted of 30 FDRs of patients with schizophrenia and mania with psychotic symptoms and 15 normal healthy control. After the initial screening by the clinical assessments, based on their amenability for the interview, Social Cognition Rating Tools in Indian Setting (SOCRATIS) was applied to all three groups. Result and Conclusion: The study found that first degree relatives of patients with schizophrenia group found to be lower in externalized attribution bias on a measure of social cognition compared to FDRs of patients with mania with psychotic symptoms group and healthy controls. And the FDRs of patients with schizophrenia and mania with psychotic symptoms groups were found higher in reaction time in trail making on a measure of neurocognition compared to healthy controls.
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Mobile dependency: Factors influencing it and its association with depression among adolescents p. 39
Narayana Murthy Mysore Ramaiah, AB Fatma, Preetha Susan George, MC Smitha
DOI:10.4103/jmhhb.jmhhb_46_20  
Introduction: In the present era due to the usefulness and availability of apps, games, information, and entertainment, mobile usage has become habitual. Studies have found that mobile phone dependency is associated with an unhealthy lifestyle, extrovert or neurotic personality traits, and maternal affectionate constraints in childhood. Objectives: The objective of this study is to estimate the prevalence of mobile phone dependence among adolescents and assess the relationship between mobile phone dependence and depression among them. Materials and Methods: It is a cross-sectional study conducted among late adolescents and early adults. Data regarding the sociodemographic details, mobile phone dependence, and the factors influencing it were collected using the standardized pretested semi-structured questionnaire. Results: Among 701, majority of the participants (99.7%) were using mobile phones, and among them, about 43.4% of the study participants had mild, 29.1% had moderate, and 4.4% had severe mobile dependence. It was observed that 56% of them had normal, whereas 4% of them had extreme and 2% had severe depression, but no significant association was found between mobile dependency and depression. Conclusion: Three-fourth of the adolescents and young adults had mobile dependency, but there was no significant statistical association seen between mobile dependency and depression.
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Intravenous buprenorphine does not impair psychomotor and cognitive functioning in opioid-dependent patients using oral dextropropoxyphene: A randomized, double-blind, crossover study p. 45
Shri Gopal Goyal, Atul Ambekar, Raka Jain, Manju Mehta, Ashwani Kumar Mishra
DOI:10.4103/jmhhb.jmhhb_24_20  
Background and Objectives: Some opioid-dependent injecting buprenorphine (BPN) users can continue to inject BPN even while using dextropropoxyphene as a treatment or as a drug of abuse. With this rationale, this study was aimed to assess the effect of injection BPN on psychomotor and cognitive functioning in opioid-dependent patients receiving oral dextropropoxyphene. Methods: This was a randomized, placebo-controlled, double-blind, crossover study, carried out in the inpatient unit of the tertiary level de-addiction facility. Twenty opioid-dependent male, current injecting drug users were given a single dose of injection of BPN (1.2 mg) or placebo, in a crossover design, 2 h after the routine morning dose of oral dextropropoxyphene at day 4 and day 6 of admission. Psychomotor and cognitive functioning was assessed with the help of standard tools (trail making – Parts A and B, digit symbol substitution test, delayed recall test, and digit span) at baseline and after 10 min, 3 h, and 6 h of injection BPN/placebo. Results: There was no significant difference in the scores on any of the tests for psychomotor and cognitive functioning at any time period after receiving either injection BPN or placebo. Conclusions: A single dose of intravenous BPN in opioid-dependent patients on oral dextropropoxyphene did not produce any significant change in psychomotor and cognitive functioning as compared to placebo.
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A cross-sectional study on prevalence of eating disorder and body image disturbance among female undergraduate medical students p. 53
Siva Ilango Thangaraju, R Karpagalakshmi, S Arumuganathan, S Usaid, S Sumithra Devi, V Sethumadhavan
DOI:10.4103/jmhhb.jmhhb_13_20  
Background: Eating disorders describe illnesses that are characterized by irregular eating habits and severe distress or concern about bodyweight or shape. Female college students have been reported to be more keen to have a thinner figure than their male counterparts in both Western and Asian settings. This study aims to find the prevalence of eating disorders and body shape concerns among female undergraduate medical students in South India. Materials and Methods: A cross-sectional study design was used to collect data from female undergraduate medical students of a private medical college in south India. Study instruments include a semi-structured pro forma, Eating Disorder Examination Questionnaire (EDE-Q 6.0), and Body Shape Questionnaire (BSQ 34). Descriptive analyses of sociodemographic variables and scores in the questionnaires were carried out. Results: One hundred and ninety-nine female students participated in the study were included for analysis. The mean age of the students was 20.4 years. Mean body mass index (BMI) score was found to be 23.78. On EDE-Q, 13.6% of students scored more than 5 suggesting presence of eating disorder. 61.9% had mild-to-moderate concerns on their body shape while 9% had severe concerns. BMI and body shape concerns positively correlated with subscales of eating disorder. Conclusion: This study showed significant presence of eating disorder symptoms and body image dissatisfaction among female college students. Addressing this subset of population with regards to these concerns may help prevent onset of mental health and behavioral problems in future.
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CASE REPORTS Top

Internet use: A boon or a bane during COVID-19 p. 57
Pranjali Chakraborty Thakur, Manoj Kumar Sharma, Nitin Anand, Ishita Mondal, Priya Singh, SJ Ajith, Jayesh Suresh Kande, Sangeetha Venkateshan
DOI:10.4103/jmhhb.jmhhb_42_20  
The lockdown has seen an increase in the use of Internet among the public. It has also emphasized the need to look into the factors related to excessive use as well as its management. The clinical interview was carried out to understand the pattern of Internet use among cases presented to tertiary specialty clinic for the management of technology use. The clinical interview revealed an increased use of Internet immediately after the lockdown. The increased use was attributed to the modality of passing time with limited options of entertainment as well as to cope up with negative emotions. It implicates the need for building awareness about excessive use of Internet during lockdown as well as strategies to promote healthy use of technology.
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Catatonia in a young woman with intellectual disability and vitamin D deficiency managed with electroconvulsive therapy p. 60
Aarzoo Suman, Anish Shouan, Sandeep Grover
DOI:10.4103/jmhhb.jmhhb_22_20  
Catatonia as a syndrome is known to be associated with multiple psychiatric and medical conditions. Although catatonia has been reported in patients with neurodevelopmental disorders such as autism, there is lack of literature on catatonia in subjects with intellectual disability, especially among the adults. In terms of nutritional deficiencies, catatonia has rarely been reported to be associated with Vitamin D deficiency. In this report, we report a 20-year-old female who presented with catatonia in the absence of evidence of any other psychiatric disorders. Physical examination and investigations did not reveal evidence of any other abnormality, except for Vitamin D deficiency. However, the patient required treatment with electroconvulsive therapy for the management of catatonic symptoms followed by olanzapine up to 7.5 mg for managing psychotic symptoms on follow-up.
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Cyberchondria: Technology-mediated expression of hypochondriasis p. 63
Pranjali Chakraborty Thakur, Manoj Kumar Sharma, Santosh K Chaturvedi, Sundarnag Ganjekar, Nitin Anand, Aishwariya Jha, Ishita Mondal, Priya Singh, SJ Ajith
DOI:10.4103/jmhhb.jmhhb_35_20  
Cyberchondria involves excessive indulgence in online health-related platforms for information. This trend becomes more due to the presence of easy access to Internet and availability of health portals. A 34-year-old male presented with the complaints of pricking and spasm-like sensation in his throat and fear of developing cancer of the mouth or throat for the past year and excessive use of Internet. The case was assessed using clinical interview and Cyberchondria Severity Scale. It revealed the presence of excessiveness, distress, and reassurance related to online health research. These characteristics are being seen in cases with hypochondriasis. The case implies for screening and evolving psychoeducational approach to manage cyberchondria.
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SHORT COMMUNICATIONS Top

Utilizing the opportunity of complete lockdown in COVID-19 pandemic for quitting alcohol p. 67
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava
DOI:10.4103/jmhhb.jmhhb_30_20  
The Corona Virus Disease-2019 (COVID-19) pandemic has been linked to socioeconomic disruptions and impairment in the quality of life. Alcohol-based hand rubs have been recommended for maintaining hand hygiene when the hands are visibly not dirty, but they have no role in the prevention and treatment of the disease on consumption. It is important to note that in order to reduce the risk of transmission of the infection, many nations have imposed a complete lockdown, and such compulsory restrictions have even affected the sale of alcohol in various consumable forms. From the public health perspective, it should be considered as a window of opportunity to motivate people who are planning to quit drinking or at least significantly reduce the consumption of alcohol. In conclusion, the intake of alcohol does not have any role in the prevention or treatment of the COVID-19 infection. On the contrary, it will be ideal to consider the settings of lockdown as an event which should be utilized for quitting alcohol forever without being exposed to stigma.
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Strengthening risk communication to avert stigma and discrimination in the ongoing coronavirus disease 2019 pandemic p. 69
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava
DOI:10.4103/jmhhb.jmhhb_20_20  
The Corona Virus Disease-2019 (COVID-19) outbreak continues to be a public health emergency of international concern owing to its rise in the caseload, case fatality rates and the emergence of the cases in different nations other than China. Amidst all the happenings and the global threat, it is a must to ensure that we strengthen our risk communication and community engagement activities to avert any kinds of social stigma and discrimination towards the affected individuals. The emergence of stigma will overcomplicate the already complex problem and significantly affect the efforts to prevent the ongoing transmission, contact tracing and successful containment of the infection. In order to avoid these impending consequences, the need of the hour is to formulate community-based guides, organize global campaigns, strengthen risk communication activities, and improve the trust of people on health systems and by showing empathy & compassion towards the affected individuals. In conclusion, the road to fight the COVID-19 infection is an uphill task and we cannot succeed in the same without the participation and solidarity from the community. Thus, it is of utmost important to strengthen our risk communication without giving any scope to the emergence of stigma and discrimination.
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