Psychiatry and Society

Memory loss results from disruption at any of these processes Forgetfulness and Memory Loss  Forgetfulness or failure to remember information , is a common complaint. All of us have at some time or the other forgotten to make that important call, to pick up some items from the store, an anniversary or birthday, or a colleague’s name. Students forget what they have “learnt” during exams. We often can’t remember where we have left our car keys, our wallet or that important document. Is it normal? And more importantly; when do we need to seek help? Forgetfulness or memory loss and difficulty concentrating are common symptoms of mental health disorders. This is specially so in depression, anxiety disorders, ADHD (Attention Deficit Hyperactivity Disorder), and dementias as shown in the examples below. A young working professional seeks help for increased forgetfulness and poor ability to focus at work. Further probing reveals decreased interest in doing things at work an...

Aptitude testing for responsible work choice Aptitude testing for career guidance has existed only since the 1930s . Aptitude testing was not needed until work choice became freely available about 200 years ago. Before that a person had no choice in his field of work. People trained for whatever their parents did. If they had access to patronage or money they could take up a profession. Now, with the concept of Right to Education, governments seek to extend career choice to all socioeconomic strata. With this new privilege of work choice comes the responsibility of choosing wisely. Aptitude testing takes into account abilities, personality, intelligence and motivation for making a career choice. Work choice a brief history For 10,000 years we did the work our parents did. In the initial millennia of mankind’s existence, work was necessary for survival. Primitive man was a hunter-gatherer to fulfil the biological need for food. As the first human settlements evolved man be...

ADHD teens with appropriate life skills can live independently Does your  teenager with  ADHD have the life skills to survive in hostel? She did well in her 12th board exams and scored high in the CET. To attend the engineering college of her choice she has to move from home to a hostel in another city. Given her difficulty organising her daily schedule, would she be better off doing the same subjects at the local engineering college? The answer would depend on her personality and the life skills she has acquired. ADHD teenager personality types Teenagers with ADHD are of 3 character types: the optimistic, the terrified and the lost. They are placed into these categories depending on their productivity and anxiety (either too much or too little). The optimistic teen does not worry. He is excited about the independence that college life will bring, but may not realise that freedom comes with responsibilities (financial, social and personal). If he's still disor...

10yr window to treat mental health problems affecting academic performance Mental health & academic performance Mental health has a direct impact on academic performance in children. Neglected childhood psychiatric disorders like ADHD and Learning Disorders adversely affect the child’s academic performance and educational attainment. Poor educational outcomes affect the child’s health, employment, and status as an adult. This is especially so for psychiatric conditions that are seen at 7 years and persist beyond 16 years of age. Mental health disorders in children have a greater impact on academic performance than chronic physical illness. The presence of a single mental condition results in morel board exams failures and backlogs. This association is more than for chronic illnesses of the neurological, lung, heart, or digestive systems. Physical impairments are not associated with exam failures. More than half the teenagers who fail to complete their secondary edu...

ADHD treatment improves academic performance ADHD medication enhances academic performance when started early. ADHD drug treatment improves reading ability  in children with Attention Deficit Hyperactivity Disorder (ADHD) and Dyslexia. New research shows that drug treatment of ADHD also improves maths ability especially when started early - at least by the 4th standard. Children starting treatment a year or two later show progressively greater declines in academic performance. ADHD is characterised by inattention and hyperactive-impulsive behaviour . Parents who bring their children to the clinic are focused only on issues arising from the child's hyperactivity. Impairments due to inattention are not immediately apparent in the pre-school years. Depending on the severity of ADHD, inattention is unmasked when the child enters academic life in primary school or during the transitions to middle school, high school, and college. At each  of these...

Difficulty with reading, spelling and maths is rampant among Indian students. Two recent reports have highlighted this academic underachievement. The academic infrastructure is definitely a major contributor. However, unrecognised dyslexia  or other learning disability  also needs to be considered by every concerned parent and enlightened teacher. We have already discussed the management of dyslexia . Here we underline the urgent need for action. India ranked 72nd of 73 countries in a comparative international survey (PISA) of 15-year-old students. All students were assessed on the same test for knowledge and skills in reading, mathematical and scientific literacy. A sample of more than 5000 students from 200 Indian schools were assessed in this program. In none of these categories did more than 17% of Indian students scored above baseline levels as compared to 81% of students from OECD countries (US, UK, Australia etc). 15-year-olds scoring above baseline...

Impaired spelling and arithmetic in Standard 3 boy with Learning Disorder Learning Disorder (LD) is characterised by impaired acquisition of academic skills. This impairment in scholastic skills is not due to intellectual disability, physical disorders, emotional disturbances, or environmental, cultural, or economic disadvantage. There is a gap between ability and application. The child may know what is asked, is able to explain it verbally, but is unable to put it down in writing. Learning Disorder could affect any of the three scholastic Rs – R eading, w R iting or a R ithmetic. Types of Learning Disability Dyslexia – is the commonest learning disability (80%). It is marked by impairment of the ability to recognize and understand written words. Dyscalculia  – problems with doing math, understanding time, using money. Dysgraphia – problems with handwriting, spelling. Dyspraxia – problems with hand-eye coordination and balance, difficulties with fine motor skill...

Inclusive Education Inclusive education for children with autism and other developmental disabilities is now approaching reality in Pune. Nine children with autism appeared for the Maharashtra 10th standard (SSC) board exam. The accommodations and waivers granted to these students reflect an infusion of the fresh breath of inclusion into the corridors of the board of education . Sarva Shiksha Abhiyan (SSA) in Maharashtra The Education for All Movement , the central government’s flagship SSA, seeks to ensure that every child, including those with special needs, is provided an elementary education. As far as disability is concerned the SSA has adopted a zero rejection policy. It provides for universal access to infrastructure and curricula in schools. Maharashtra is at the forefront of this scheme. In all 380000 teachers from Maharashtra attended workshops on inclusive education through the SSA. 414277 children with special needs were identified and 380723 enrolled under the SSA in...

Bullying by children in schools has serious mental health effects on the victim and the bully. Up to 25% of high school students report being victimised by bullies. 13% of victims have considered suicide. In rural India 31% of middle school students report being bullied (Kshirsagar 2007). Bullying is twice more prevalent in coeducational schools than in girl schools. The prevalence of bullying increases from 13% in the 3rd grade to 46% in the 6th grade. Bullying is higher in classes with more retained students. Bullying occurs in a variety of settings that are an extension of your child's school life. Bullying can occur face to face, by texting or on the web (cyberbullying). Bullying is not a phase of growing up, it is not a joke, and it is not a sign that boys are being boys. Bullying can cause lasting harm - to the victim, the bully and the bully-victim (children who are bullied and also bully other children). Bullying takes many forms Verbal : Name calling, teasing ...

Stressed youths relaxing Academic stress is a significant aspect of youth. Youth is the developmental phase between puberty and working adulthood. It is a period of continuing student-hood. This is a distinctive feature of youth - it exists only for those who undergo post-secondary education. This is for the privileged few who do not join the workforce full-time after schooling. Youth is a valuable time for serious experimentation. The young person is not fettered by long-term commitments. In contrast to adolescence, youth is a period of independence - the peer group is no longer a dominant influence. There is greater freedom to develop as an individual. The young person evolves a personal perspective on life and develops a sense of direction before tackling the duties of adulthood. However this stage of life is by no means stress-free. By definition youth is associated with academics. Academic demands are perceived as significant stressors by youths (Rao 2000, Goff 2011). The...

Effective study skills are essential learning habits for students. Some students have a knack of learning much in a short time. Others study for hours without much progress. An important differentiating factor is the method of study. Effective study habits can be learned (Barry L. Richardson and Murray Saffran 1985, D F Alexander 1985). The good student must not rely on “study drugs” as these are associated with addiction, panic reactions, confusion, and medical complications including heart attack and stroke (Steve Sussman and colleagues, 2006). Habit No 1: Apply book learning to daily life Those who learn rapidly apply their imagination freely to their studies. They see that every subject of study deals with something vital in the affairs of the world, and probably of personal relevance. Allow the knowledge you are acquiring to become an active part of your daily life, with some bearing on normal activities. Thinking about studies in this way will help build greater interest and...

Over the last two months three teenage students from the same Pune school have died by copycat suicide. 'Copycat’ suicides are frequent among adolescents aged 15-19 years. They occur more often than expected by chance alone. There has been an increase in teenage clusters in more recent years (Gould et al1990). Patterns of ‘copycat’ suicide There are two patterns of suicide clusters: point clusters , which are localised in both space and time (spatio-temporal), and mass clusters , which are localised in time only. Point clusters A point cluster is a temporary increase in the frequency of suicides within a small community or institution like a school or hospital. This differentiation is important as even limited resources can be effectively mobilised for prevention. Mass cluster A mass cluster is a temporary increase in the frequency of suicides within an entire population. Mass clusters are typically associated with high-profile celebrity suicides that are publicised ...

Exams at St Germain's Pune students need to differentiate true exam stress or test anxiety from rational test anxiety  that occurs due to a lack of adequate preparation. Both conditions need to be addressed differently. True test anxiety is diagnosed when the student panics, "blanks out", or overreacts despite the following (Hanoski 2008): there is enough time for studying study strategies are adequate attendance is regular class material is understood Managing rational test anxiety (Morgan et al, 1986) When there is adequate time for preparation effective learning habits minimise rational test anxiety. Effective learning habits We begin at this stage if the student comes to the clinic 6-8 weeks before the exams. Acquiring effective study skills is essential for all students. Plan and stick to a study schedule . This simple yet crucial first step is often neglected. Spend at least half the study time in elaborative rehearsal,  thinking about what is being re...

A Pune school joined the ranks of those in which a punished and humiliated teenager committed suicide. A teenage life snuffed out by the psychological pain of humiliation. It was apparently over his talking with a girl student. He was thrashed by the school principal, two teachers and the girl's uncle. This was not punishment - it was physical abuse. The boy did not return home after school. His father, a labourer, went to the school to look for him. The next morning the teenager’s body was found on the railway tracks. Labourers moving to their work-site Behaviours perceived as undesirable by teachers The chain of events in this suicide apparently begins with the teenager talking to a girl student - normal adolescent behaviour. It is in the stage of adolescence that opposite-sex social interaction begins. A co-ed school would be the ideal place for this adolescent interaction. Yet this behaviour was perceived as seriously undesirable by the school authorities. Let’s loo...