Context:Different risk factors associated with adolescent suicide attempts have been identified including those of socio-demographic and clinical variables. Relatively, little research has been done in the area of their stressors and coping patterns.Aims:To study the recent psychosocial stressors and patterns of coping associated with adolescent suicide attempts.Settings and Design:Tertiary care hospital, case-control study.Materials and Methods:One hundred consecutive cases of adolescent attempted suicide admitted to the hospital and an equal number of controls, matched individually for age and sex, from the relatives and friends of other patients in the ward, were studied. Assessment included details regarding socio-demographic data, psychiatric and physical morbidity, their recent stressors, and patterns of coping. Stressors were assessed using Presumptive Stressful Life Event Scale and coping strategies by Ways of Coping Questionnaire (revised).Statistical Analysis:Chi-square test and multivariate logistic regression analysis.Results:The number of stressful life events and mean stress scores in the preceding 1 month and certain coping strategies such as confronting, distancing, and escape-avoidance were found to be significant risk factors associated with adolescent suicide attempts. Strategies such as self-control, seeking social support, accepting responsibilities, problem solving, and positive appraisal act as protective factors.Conclusions:Recent stressors and strategies such as confronting, distancing, and escape-avoidance are significant risk factors associated with adolescent suicide attempts, whereas certain coping strategies act as protective factors. Teaching adolescents these protective coping patterns may be a promising strategy for prevention of adolescent suicide attempts.

Background: Suicides are among the leading cause of death among adolescents and young adults worldwide, including India. Suicide attempts are about 20 times more common than completed suicides. Teenagers and youth who attempt suicide belong to a heterogeneous group. Various biological and psychosocial factors, including family factors, contribute to such behavior. Quality of family functioning and relationships may act as an important contextual factor in deciding suicidal behavior. Hence, this study was done to explore the family factors contributing to suicide attempts. Methods: Qualitative exploratory study design and purposive sampling were used. Data were collected from 22 adolescents and young adults using an in-depth interview method. All audio recordings were transcribed in Malayalam, and then translated to English. Codes were developed using the qualitative data analysis software. Thematic analysis was done. Themes and relationships were identified and synthesized to a framework that represents the summary of the data. Results: Most of the participants perceived the home environment as hostile. Problems within the family included parental conflicts and separation, conflict with a sibling or other members of the family, and marital disharmony. Most of them perceived low family support. Socioeconomic factors such as financial issues, superstitious beliefs, disturbing neighborhoods, interpersonal issues, and the stigma of having a mental illness, in a family member, were also noted. Conclusion: Hostile family environment, faulty interactions between family members, and lack of perceived family support may contribute to suicidal behavior among adolescents and young adults. Hence, it is imperative to consider these factors while treating them or planning any suicide prevention program for them.

Background Palliative psychiatry is a new approach for the care of patients with severe and persistent mental illness (SPMI). To assess the attitudes of psychiatrists in India towards palliative psychiatry for patients with SPMI and to compare these to the attitudes of psychiatrists in Switzerland. Methods In an online survey, data from 206 psychiatrists in India were collected and compared with data from a previous survey among 457 psychiatrists in Switzerland. Results Psychiatrists in India generally considered it very important to prevent suicide in SPMI patients (97.6%). At the same time, they considered it very important to reduce suffering (98.1%) and to ensure functionality in everyday life (95.6%). They agreed that palliative psychiatry is important for providing optimal care to SPMI patients without life-limiting illness (79.6%) and considered palliative psychiatry as indicated for patients with SPMI (78.2%). By contrast, curing the illness was considered very important by only 39.8 % of respondents. Relative to psychiatrists in Switzerland, psychiatrists in India were significantly more concerned about preventing suicide and less willing to accept a reduction in life expectancy, even at the expense of quality of life in patients with severe and persistent schizophrenia and recurrent major depressive disorder. At the same time, they were significantly more likely to advocate palliative psychiatry. Conclusion Most of the participating psychiatrists in India agreed that palliative psychiatry can be indicated for patients with SPMI. The comparison with psychiatrists in Switzerland highlights the need to take account of cultural differences in future studies of this kind.

Background: Delirium is a complex neuropsychiatric syndrome which is common in hospital settings. It is associated with increase in the length of hospital stay, functional decline, health care costs and signicant morbidity and mortality. A signicant step for devising appropriate measures to prevent and manage delirium is to determine its occurrence and outcomes in a particular setting. The present study aims to nd the prevalence of delirium among adult inpatients of tertiary care hospital setting. Methods: Cross sectional, tertiary care hospital-based study which was conducted on adult inpatients aged 18 years and above who were referred for consultation liaison psychiatry services. The confusion assessment method was used for screening of delirium and the DSM 5 diagnostic criteria was used for diagnosis. The clinical prole, sociodemographic prole of the patient was recorded in a semi structured questionnaire. Chi-square test and Fischer's exact test were used for comparing categorical variables between groups. Multivariate analysis using binary logistic regression was used to nd the adjusted odds ratio and their condence intervals and its statistical signicance. Results: 39.2% (98 of 250) patients included in the study were found to have delirium. Patient's age, sex, Intensive Care Unit stay, comorbid physical illness, and past history of delirium were found to have signicant association (p<0.01) with delirium Conclusions: The prevalence of delirium among adult inpatients availing consultation liaison psychiatry services attending a tertiary care hospital was estimated to be 39.2%. Statistically signicant association was found between delirium and age, sex, Intensive Care Unit stay, comorbid physical illness and past history of delirium (p value<0.01).

No abstract