Treatment with SSRI's had shown significant changes in clinical conditions. However these changes did not relate significantly with serum serotonin levels.

chaotic home environment, sudden loss (death, divorce, job, finances), recent humiliating life event, unfaithful partner, HIV and legal problems. In the young, suicides are common after declaration of the results of the board exams. The most common symptom in patients is hopelessness i.e. the belief that no action can save the patient from the trauma that he or she may be undergoing. A majority (56%) attempt suicide as an escape from an unbearable situation, 13% do so to produce a change in others or the environment and the rest have a combination of escape and manipulative motives. 50 to 80% of suicide attempters have communicated their intent to the family or to their treating psychiatrist. Management : All psychiatric patients need to be asked about suicidal ideation as a part of routine assessment. Self destructive behaviours and previous attempts are the most powerful predictors of a future suicidal attempt. It needs to be clearly understood that asking about suicidal attempt does not provoke the patient to commit suicide or instil the idea of committing suicide. Many patients feel relieved on being asked about suicidal ideation and being explained that their ideas are part of an illness. In case the patient has arrived in the emergency department with history of an attempt, then, first the medical condition of the patient needs to be assessed for risk to life and admitted to the ICU under escort until the medical condition stabilizes. At the earliest opportunity he is referred for assessment by a psychiatrist. Severely suicidal patients who are depressed need to be treated with electro-convulsive therapy (ECT). The procedure has an overall response rate of 75-85% [5]. In Schizophrenia, apart from ECT, atypical antipsychotics such as clozapine are reported to be having a specific antidepressant and anti-suicidal effect. Crisis intervention centres and helplines are available in most cities all over the world. They provide an avenue

Background:The WHO Global Burden of Disease study estimates that mental and addictive disorders are among the most burdensome in the world, and their burden will increase over the next decades. The mental and behavioral disorders account for about 12% of the global burden of disease. However, these estimates and projections are based largely on literature review rather than cross-national epidemiological surveys. In India, little is known about the extent, severity and unmet need of treatment mental disorders. Thus, there was a need to carry out rigorously implemented general population surveys that estimate the prevalence of mental disorders among urban population at Pune, Maharashtra. The study attempted to address unmet need and to form a basis for formulating the mental health need of the community.Objective:The study was undertaken to estimate the lifetime prevalence and 12 month prevalence of specific mental disorders in urban population, socio-demographic correlates of mental disorders and to assess the service utilization in individuals with mental disorders.Materials and Methods:The study was undertaken among adults aged 18 years and above living in house hold and in geographical area of Pune , Maharashtra. A minimum sample of 3000 completed interviews was planned using representative probabilities to population size (PPS) sampling method which ensured equal probability for every eligible member. Data listing was obtained from Census Office from recent census of 2001 data. The face to face interviews were undertaken in homes using fully structured interview schedule of World Mental Health Survey Initiative duly revised Version of WHO- Composite International Diagnostic Interview (CIDI 3.0) by trained investigators. Clinical reappraisal was carried out using Schedules for Clinical Assessment in Neuropsychiatry (SCAN) among ten percent of diagnosed cases selected randomly. Data were entered into DDE (Blaize Software) and analyzed using SPSS software package.Results:Overall lifetime prevalence of mental disorders was found to be 5.03%.Rates among males (5.30%) were higher as compared to females (4.73%). Among the diagnostic group , depression(3.14%) was most prevalent followed by substance use disorder (1.39%) and panic disorder (0.86%). Overall 12 month prevalence of mental disorder was found to be 3.18% which was 3.47% among males and 2.85% among females. Prevalence of depression (1.75%) was the most 12-month mental disorder, followed by substance use mental disorder (0.99%) and panic disorder (0.69%).Lifetime and twelve month prevalence of any mental disorder was the highest among employed group, followed by home makers and depression was more among married, followed by separated/divorced/widowed group and the least in unmarried group in the study. Treatment gap due to low prescription received indicated the most of the ill person did not acknowledge their need for treatment or do not received the appropriate care.Conclusion:The figure of 5.03% prevalence of diagnosable psychiatric disorders in adult pop...

Background : Training in medicine is emotionally demanding. Psychological well being of medical students is a matter of concern. There is lack of Indian studies in this area. Methods : A total of 105 medical student of one batch were assessed utilizing psychophysiological state inventory, Institute for personality and ability testing (IPAT) anxiety and depression scale, achievement motivation scale, scale for locus of control and 16 PF in three phases at one-year intervals. Result: Majority of the students had average achievement, motivation and adaptability. Anxiety and depression scores fell within normal limits. In personality profile factor 'B', 'M' and 'Q4 1 ' had changed significantly. Achievement motivation showed significant decreases and CSS1 and PO1 scores showed significant increase during the years of medical education. Conclusion : The results demonstrate that over satisfaction and relaxed attitude may have poor academic outcome. MJAFI 2007; 63 : 137-140

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