Psychiatry and Society

Aggression is uncommon in school children and should be addressed A Pune teenager was kidnapped and murdered by his school friends a few weeks ago. The victim was deliberately selected and his parents were manipulated for a ransom. Violence, theft and destructiveness are end stage behaviours of conduct problems in children and adolescents. Trajectories of aggression in children The commonest path of violence in children is ' adolescence-limited ' . The antisocial behaviours usually occur when the adolescents are 'hanging out' in a group.  This type of aggression reflects an anti- authoritarianism . Anti-authoritarianism results from frustration over being denied the benefits of full adult independence despite reaching physical maturity. Adolescent limited aggression is less violent, relies on peer encouragement, and generally diminishes by adulthood  These adolescents are usually able to integrate into society as young adults. A ...

Psychological development is a key aspect of any ‘Healthy Baby Contest”. Pathfinder Clinic judged the psychological development of toddlers participating in one such local event. Healthy baby contests are among the most attractive activities organized by many preschools and communities. Assessment is a sensitive issue at any Healthy Baby competition. Parents of contestants are concerned regarding partiality and subjective errors. Judging a Healthy Baby Contest objectively is crucial to the credibility of the event. Can psychological development be objectively assessed in 5 minutes? Psychological assessment can be time consuming and difficult to operationalize. The child’s development is captured in speech, social interaction, and manipulation of every- day objects. Usually a child’s developmental milestones are judged ‘objectively’ based on the parents responses to available screening questionnaires. We decided to get our knees dirty and go down to toddler level to get ...

Chronic unstable mood with irritability and superimposed bouts of depression is a common form of bipolar II disorder or hypomania. Persons with this pattern of illness tend to have an unstable course and stormy interpersonal relationships. They also have more irritable and hostile hypomanic episodes. The classical Bipolar II disorder or hypomania of mild elevation of mood, sharpened and positive thinking, and increased energy and activity levels is less disruptive. Persons with this irritable type of hypomania and bipolar illness have unrealistically high expectactions of those with whom they interact; whether at the workplace, at home, or other casual day-to-day interactions. When these expectations are not met they pass on their irritation and negative mood to unsuspecting others. There is usually a grain of truth in their version of the incident, but the growing number of incidents with various people at all levels reduces their credibility. At the workplace they are fr...

Checklists and psychological screening questionnaires for mental illness are effective, easy to use and widely available. Pune was shocked into considering the need for mental health screening of its bus drivers after one of them wilfully killed eight people and injured 32 others. He hijacked a bus at the depot and mowed down victims in broad daylight. Amidst the protests, and outrage the Pune administration has decided that all its bus driver undergo psychological testing. We have already looked at screening of police personnel for mental health problems , and also screening of teenagers for alcohol and drug abuse . Here we specifically examine the feasibility of regularly screening the 8600 PMPL staff and Pune bus drivers for mental health problems. Mental illness in bus drivers Mental health problems are higher for bus drivers who suffer from back pain, are dissatisfied with their jobs or undertake long-distance driving. This is more so for employees who have worked fo...

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...

Recovery to meaningful functioning after even severe mental illness is the present standard of care in mental health treatment. Recovery is made possible by medications that are now widely available at a reasonable cost. Planning and persistence with treatment need to be ensured to achieve a quality recovery. Recovery from mental disorders is a process of change through which individuals improve their health and wellness live a self-directed life strive to reach their full potential The road to recovery from mental illness has four components that together give meaning to life. 1. Health Overcoming or managing the disease and living in a physically and emotionally healthy way. Start with the basics - medication, meals, sleep and exercise . Establishing routines for these basic health tasks are essential for recovery of function. Medication is the corner stone on which recovery is nurtured. In the absence of medication frequent relapses and recurrences disrupt basic f...

Alcohol and driving don’t mix . In a flashback to Alex’s drug influenced joyride in A Clockwork Orange , a Pune youth bumped into four people at different points on his late night drive through the city. When chased and caught he was found to be under the influence of alcohol. In this post we take a look at the effects of alcohol on driving . We have already discussed some of the long term effects that necessitate imposing legal age limits for alcohol consumption in order to mitigate its neurotoxic effects on the developing brain . 30mg% is the legal blood alcohol concentration (BAC) limit for driving. Limits are a safety requirement to counter the adverse effects of alcohol on driving ability. The 30mg% level is often panned as being too low. Most countries have settled at a 50mg% threshold, some at 20mg%, others (considered very liberal) at 80mg%. Lets take a look at the effects on driving at these various blood alcohol concentrations (CDC 2011). BAC Effect on dri...