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Introduction: To mitigate the spread of the pandemic coronavirus infection (COVID-19), governments across the world have adopted \"lockdowns\" which have confined many individuals to their homes. This disrupts normal life routines, elements of which are important circadian cues. The pandemic is also associated with new stressors, altered roles, and uncertainties about health and economic security, which are also likely to affect sleep. The current study is an online survey of sleep experience, routines, physical activity, and symptoms of anxiety and depression, to study the alterations associated with the lockdown. Materials and Methods: The survey was conducted in early May 2020 using a questionnaire circulated through social media platforms. Questions related to demographic characteristics, current and previous sleep schedules, routine, and working patterns. Insomnia (Insomnia Severity Index - 4), Stress (Perceived Stress Scale - 4), anxiety and depressive symptoms (Patient Health Questionnaire - 4) and physical activity (International Physical Activities Questionnaire) were assessed using standardized instruments. Results: A total of 958 valid responses were received. Compared to the prelockdown period, there was a shift to a later bedtime and waking time, with a reduction in night-time sleep and an increase in day-time napping. These effects were visible across occupational groups, but mostly affected working individuals except health professionals. Sleep quality deteriorated across groups. Reductions in sleep duration were associated with depressive symptoms. Conclusions: The COVID-19 lockdown is associated with changes in sleep schedule and in the quantity and quality of night-time sleep. Although these changes are associated with elevated rates of emotional symptoms, it is unclear from these cross-sectional results, whether sleep deterioration produces psychological distress, or vice versa.

Background: The COVID-19 pandemic has led to a complete shut-down of the entire world and almost all the countries are presently in a \"lockdown\" mode. While the lockdown strategy is an essential step to curb the exponential rise of COVID-19 cases, the impact of the same on mental health is not well known. Aim: This study aimed to evaluate the psychological impact of lockdown due to COVID-19 pandemic on the general public with an objective to assess the prevalence of depression, anxiety, perceived stress, well-being, and other psychological issues. Materials and Methods: It was an online survey conducted under the aegis of the Indian Psychiatry Society. Using the Survey Monkey platform, a survey link was circulated using the Whatsapp. The survey questionnaire included perceived stress scale, Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Warwick-Edinburgh Mental Well-being Scale to assess perceived stress, anxiety, depression, and mental well-being, respectively. The survey link was circulated starting from April 6, 2020 and was closed on April 24, 2020. Results: During the survey, a total of 1871 responses were collected, of which 1685 (90.05%) responses were analyzed. About two-fifth (38.2%) had anxiety and 10.5% of the participants had depression. Overall, 40.5% of the participants had either anxiety or depression. Moderate level of stress was reported by about three-fourth (74.1%) of the participants and 71.7% reported poor well-being. Conclusions: The present survey suggests that more than two-fifths of the people are experiencing common mental disorders, due to lockdown and the prevailing COVID-19 pandemic. This finding suggests that there is a need for expanding mental health services to everyone in the society during this pandemic situation.

Background Research on the distribution and association of depression with tobacco consumption among young population is commonly prioritised in India, while studies on tobacco use among middle-aged (45–59 years) and elderly (≥ 60 years) adults are noticeably lacking. Thus, we conducted this study with the objectives of estimating the prevalence, distribution and determining the association of depression and tobacco consumption among middle-aged and elderly Indian population; overall and stratified into age group, gender, and geographical location. Methods Using dataset from Longitudinal Aging Study in India (LASI), a bivariate analysis was conducted among middle-aged (45–59 years) and elderly (≥ 60 years) Indians to estimate the prevalence of depression and tobacco consumption. States and Union Territories were categorised as low, medium, and high as per prevalence of depression and tobacco consumption, and spatial distribution maps were created. To reduce the confounding effects of demographic & socioeconomic and health-related & behavioural covariates; propensity score matching (PSM) was conducted. Nested multilevel regression modelling was employed to explore the association between depression (outcome variable) and tobacco consumption (explanatory variable) using STATA version 17. The p value < 0.05 was considered statistically significant. Results Overall, 36.78% (36.03–37.55%) participants documented using any form of tobacco; with higher consumption of smokeless tobacco (SLT) (19.88%) than smoking (SM) (13.92%). The overall prevalence of depression was 7.62% irrespective of tobacco consumption, and 8.51% among participants consuming any form of tobacco. Mizoram had the highest consumption of tobacco in any form (78.21%), whereas Madhya Pradesh recorded the highest (14.62%) depression prevalence. Bihar, Uttar Pradesh, West Bengal, and Uttarakhand had both high prevalence of depression and any form of tobacco consumption. The average estimated treatment effect (ATE) indicated a positive association both between depression and any form of tobacco consumption ( p value = 0.001) and with smokeless tobacco ( p value = 0.001) consumption. Participants ever consuming any form of tobacco had 28% higher odds (aOR-1.28 (1.18–1.38). The odds of having depression were higher among females (aOR = 1.28 (1.17–1.41); richest (aOR-1.48 (1.32–1.65); living alone (aOR = 1.14 (1.01–1.33). Participants with comorbidity (aOR = 1.20 (1.10–1.30) and multimorbidity (aOR = 1.24 (1.13–1.36)) had higher odds of depression. Conclusion The study has established significant positive association between depression and tobacco consumption stratified into gender and age group. Prioritisation of mental health disorders like depression and tobacco prevention and cessation programmes must be implemented with focusing on females and the middle-aged population with community awareness and intersectoral collaborative effort irrespective of subnational-variations.

Background: While telepsychiatry became a prominent and widely used service in the COVID-19 pandemic-related lockdown, data regarding the patient's experience of telepsychiatry consultations is lacking. Materials and Methods: In this study, we attempted to understand the experience and level of satisfaction of 129 patients receiving psychiatry consultations over video consultations from April 2021 to December 2021. We also tried to understand the factors that might be associated with the satisfaction of the patients. Results: About three-fourths (77.5%) of the respondents were very satisfied with the quality of care provided and the overall experience of the consultation. The majority (92.2%) of the respondents reported that they would \"definitely\" recommend the telepsychiatry service to a friend or relative in need of a psychiatric consultation. The majority of the patients expressed high levels of satisfaction with the amount of time spent, the amount of freedom in expressing themselves, the amount of freedom in choosing the treatment option, the prescription provided, and the number of medications prescribed. The clarity of voice and the quality of connectivity throughout the consultation were found to be associated with the level of satisfaction. Conclusions: The present study suggests that overall satisfaction with teleconsultations was high among patients and/or caregivers for telepsychiatry consultations.

Anxiety disorder during pregnancy has an adverse effect on the fetal, Obst, and neonatal outcomes. There is controversy about the use of psychotropic during pregnancy. The effective, safest, and easy to administer, nonpharmacological intervention is the unmet need. Biofeedback therapy is an acceptable and effective therapy for anxiety symptoms during pregnancy. We report a case of a young pregnant presented with anxiety symptoms in the first trimester along with recurrent panic attacks. The patient was managed with Biofeedback therapy, without any prenatal or postnatal complication. Future studies are required to understand the efficacy and effectiveness of biofeedback therapy.

Aim: To evaluate the factors associated with treatment dropout among patients attending the psychiatric outpatient services. Materials and Methods: Seventy-two patients who dropped out from treatment were contacted and they were compared with 200 regular attendees for sociodemographic and clinical variables, medication adherence, treatment satisfaction, attitude toward medication, insight, and therapeutic alliance. Results: Compared to \"regular attendees,\" those who dropped out from treatment were significantly older, were more likely to be married, had higher age of onset, had longer duration of illness, received less supervision for medication at home, higher proportion of them continued to remain symptomatic, had more negative attitude toward medications, had poorer insight, were poorly complaint with medication, were less satisfied with the treatment provided, and had poor quality of therapeutic alliance. Conclusion: This study suggests that dropout from treatment can be avoided by addressing issues of negative attitude toward medications, improving satisfaction with the treatment contact and enhancing therapeutic alliance.

Background: There is some information from different developed coutries that mental health services have been badly affected by the COVID-19 pandemic. Little information is available from India. Aim: The aim of this study was to evaluate the impact of lockdown and COVID-19 pandemic on mental health services in India's various training centers. Materials and Methods: In an online survey, information was collected from various training centers of India through E-mail or WhatsApp. Results: Responses were received from 109 institutes. The majority of the responses were received from state-funded government medical colleges and private medical colleges. Since the lockdown and COVID-19 pandemic, brain stimulation treatments have completed stopped. Other, most affected services included electroconvulsive therapy, inpatient services, outpatient services, and psychotherapy services. However, there was an expansion of teleconsultations services because of the lockdown and the COVID-19 pandemic. In three-fourth of the centers mental health services were being provided to the patients with COVID-19 infection. In most of the institutes, mental health professionals were involved at different levels in the COVID-19 responsibilities. These included providing helpline services to the general public, screening people in quarantine for mental health issues, providing clinical care to COVID-19 patients, screening health care workers (HCWs) for mental health issues, and training the HCWs. Conclusion: COVID-19 pandemic and lockdown have led to the collapse of regular mental health services. The present study also shows that mental health professionals are playing a significant role in addressing the prevailing psychiatric morbidity, specifically related to the COVID-19 related issues, and taking care of the HCWs.

Case Report A 67-year-old lady presented with signs and symptoms suggestive of Alzheimer dementia for 5 years and was on treatment with Tab. donepezil 10 mg/day for the last 4 years. Since a year prior to the presentation, she was started on Tab. quetiapine 50 mg at night time for sleep disturbances and behavioral problems. [...]hypernatremia is considered as a state of reduced body water, rather than a deficiency of sodium homeostasis. [...]correction of dehydration with saline and dextrose led to a correction of sodium as well as improvement in the catatonia.

Aim: The current study aimed to evaluate the dropout rates and the reasons for dropouts among elderly patients presenting with mental health problems to a community health centre. Methodology: This naturalistic, longitudinal, follow-up study was carried out in the Outpatient Setting of a community health centre in North India. The study included 169 patients, aged ≥ 60 years diagnosed with mental health problems. They were assessed at the baseline and then followed for a period of 1 year. Those who dropped out from the outpatient clinic were contacted over the phone to evaluate the reasons for dropout from treatment. Results: The mean age of the participants was 67.6 years and the mean number of years of education was 2.9. Most of the patients were female, married, Hindu, unemployed, from lower socioeconomic status, and non-nuclear families. The most common diagnosis was that of depression (42.6%), and this was followed by somatoform disorder (11.2%). The mean age of onset of psychiatric disorder was 62.2 years, with a mean duration of illness being 30.3 months. Nearly half (53.3%) of the patients dropped out of treatment after their first visit and 90% dropped out by 1 year. Overall the most common reason of drop out was complete relief of symptoms, and this was followed by the presence of family problems, and farming-related work. Among the very early drop out (never returned to clinic after the first visit) the most common reason for dropout was complete relief in symptoms, followed by inability to follow up due to family problems, no relief in symptoms, and farming-related work. Among those who dropped out within 6 months, the most common reason was complete relief of symptoms followed by lack of time due to personal reasons. When the reason for \"late\" dropout (dropout between 6 to 12 months) was evaluated, the most common reason was complete relief of symptoms followed by an inability to follow up due to problems in the family. Conclusion: A significant number of elderly patients with mental health-related problems drop out of treatment prematurely. Psychoeducation about the illness, outcome, and course of illness should be done at each step, and prevailing psychosocial issues need to be evaluated to reduce the rate of dropout among elderly patients with mental health-related problems attending the community health centre.