Research in child and adolescent psychiatry in India

Suicide research in India: An overview of four decades

BACKGROUND

Suicide is a global phenomenon and a major public health concern and 'it is possibly preventable if it is well understood'.

AIM

The article is an attempt to understand 'suicide in India' with the existing literature and the lacuna for the four decades.

METHODS

The information is collected from 270 articles on suicide research in India, published in various electronic data bases and different official sites as surprisingly the nation is with highest suicide mortality rate among all regional countries.

RESULTS

The review shows an increase in the number of articles on suicide in India over the period of time. Though the suicide mortality rate in India is significantly high, the number of intervention studies remains very minimal. India's understanding about 'the concept' remains questionable as the data from different sources for the same time period shows a huge disparity. Sex, age, socio-economic status, substance abuse, mental illness, medical illness, psychological and environmental stressors etc make individuals vulnerable to end their lives.

CONCLUSION

Appropriate official documentation and more qualitative studies would help in understanding the phenomena better. Intervention studies and policy level changes are the need of the hour to save the nation from the dangerous 'iceberg of suicide'.

Screening for common mental health problems and their determinants among school-going adolescent girls in Gujarat, India

Background

The school health program is a flagship program of Government of India with a focus on improving the physical and mental health of school children, but there is no specific strategy to screen for mental health disorders under the school health program. Also, the estimation of the prevalence of common mental disorders (CMDs) such as anxiety, depression, and psychosocial distress among school children is lacking.

Methods

The author conducted a cross-sectional study among 742 adolescent schoolgirls from one government, one government-aided, and one private school in an urban area in Gujarat. We used the pre-validated instrument, general health questionnaire-12 (GHQ-12) to screen for CMDs. We estimated adjusted odds of association between screening positive for CMDs and various determinants.

Results

48.78% adolescent girls screened positive for CMDs which is alarming. Among sociodemographic characteristics, the type of school (adjusted odds of private is 1.8 and government 1.6), mother's higher education (3.0), father's less education (3.1), and working mother (1.5) had shown significant association with positive cases of the girls. Among psychosocial factors, abnormal sleep patterns (1.9) and disturbance in studies (2.3) have been found statistically significant for the presence of mental health problems among adolescent girls as per the GHQ score.

Conclusion

CMDs such as anxiety, depression, and psychosocial distress were indeed very common among adolescent school-going girls in an urban area of Gujarat, India. There is an urgent need to focus attention on the mental health of adolescent girls.

A descriptive study of behavioral problems in schoolgoing children

BACKGROUND

Behavioral problems among schoolgoing children are of significant concern to teachers and parents. These are known to have both immediate and long-term unfavorable consequences. Despite the high prevalence, studies on psychiatric morbidity among school children are lacking in our country.

MATERIALS AND METHODS

Five hundred children aged 6-18 years were randomly selected from a government school in Kanpur, Uttar Pradesh, and assessed for cognitive, emotional, or behavioral problems using standardized tools.

RESULTS

About 22.7% of children showed behavioral, cognitive, or emotional problems. Additional screening and evaluation tools pointed toward a higher prevalence of externalizing symptoms among boys than girls.

CONCLUSION

The study highlights the importance of regular screening of school children for preventive as well as timely remedial measures.

"What is strange is that we don't have more children coming to us": A habitography of child psychiatrists and scholastic pressure in Kolkata, India

The mental health of Indian school children could be expected to be a major topic of research. More people below 15 years are living in India than in any other country in the world, and India has undergone rapid social, economic, and demographic changes that have greatly increased the pressures on children to do well in school. Yet there is a striking dearth of research in this field. In this article we present the first-ever study focused on child psychiatrists in India. Based on long-term fieldwork and interviews with psychiatrists in the Kolkata metropolitan area, we present a habitography of how psychiatrists experience young people's problems. Child psychiatrists are greatly concerned about the nexus between heightened expectations of educational success and a rise of mental problems among young people. At the same time, they wonder why not many more children are coming to them with school-related complaints. To date, there is not enough research that could either confirm or disconfirm the psychiatrists' analysis of social changes, but some conclusions on the plausibility of their views can be drawn.

Drug therapy of attention deficit hyperactivity disorder: current trends

Attention deficit hyperactivity disorder is a developmental disorder with an age onset prior to 7 years. Children with ADHD have significantly lower ability to focus and sustain attention and also score higher on impulsivity and hyperactivity. Stimulants, such as methylphenidate, have remained the mainstay of ADHD treatment for decades with evidence supporting their use. However, recent years have seen emergence of newer drugs and drug delivery systems, like osmotic release oral systems and transdermal patches, to mention a few. The use of nonstimulant drugs like atomoxetine and various other drugs, such as α-agonists, and a few antidepressants, being used in an off-label manner, have added to the pharmacotherapy of ADHD. This review discusses current trends in drug therapy of ADHD and highlights the promise pharmacogenomics may hold in the future.