Background: COVID-19, which originated in China, became a pandemic affecting more than 180 countries. By April 2020, India had announced lockdown in an attempt to control the spread of the virus. Lack of social interaction and apprehension about the studies had created emotional disturbances among medical students. Methods: The study was done in a medical college situated in Central Travancore, Kerala, between 2020 April 20 to May 31. Depression Anxiety Stress Scale (DASS) and Impact Event Scale-Revised (IES-R) were administered in Google forms to the MBBS batch WhatsApp groups. Results: Out of 320 responses from medical students, 239 were females, and 82 were male students. 56% of male students and 54% of female students have mild to severe depressive symptoms, 58% of male students and 54% of female students have symptoms of anxiety, and 63% of male students and 50% of female students experienced mild to severe stress.68% of males and 62% of females have higher Impact events scale. Conclusion: There is a high prevalence of anxiety and depression among medical students during the COVID lockdown period. There is a significant difference between genders in scores of anxiety, stress and impact of events. This shows the need for resilience training among medical students.

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Background: Consultation -liaison psychiatry (CLP) provides expert advice and act as a liaison. There is a high prevalence of psychiatric comorbidities among patients of other specialities. Yet, the referral rates are low, probably due to inadequate psychiatric awareness which can be assessed from the diagnostic concordance. Objective: To assess diagnostic concordance between the psychiatrist and referring doctor. Materials and Methods: This is a cross-sectional record-based study of all inpatients referred to CLP. Data was collected from CLP registry. Results: Most of the referrals were from General Medicine. The most common reason for referral was alcohol use disorders and common diagnoses made by referring physicians were alcohol use disorders, delirium and mood disorders, similar to the psychiatrist's diagnoses; however, deliberate self harm (DSH), a common diagnosis made by the referring doctor, constituted only 4.2% of psychiatrist's diagnoses. There was complete diagnostic concordance for 40.9%; perfect agreement was found for DSH and alcohol use disorders, substantial agreement for delirium and moderate agreement for mood disorders. The agreement was low for DSH with comorbid depression, other substance use disorders and organic mental disorders. Conclusion: The diagnostic concordance for common mental health problems is low, according to the present study. CLP needs to extend its educational function towards other specialities, and it should be an active component of undergraduate psychiatric training.

Background: The lifetime prevalence of major depressive disorders is 10-25% for women and 5-12% for men. Women are more prone to develop depressive episode from the period of menarche to the perimenopausal period. Relatively little research has been done on this. Materials and methods: Female patients between the ages of 12 years to 55 years presenting in the outpatient department with first episode depressive symptoms are selected (ICD 10), and the number of patients presenting in different stages of the reproductive cycle-peri menarche, pregnancy, post-partum, post-abortion and perimenopausal are noted. Age at onset, severity of the illness, positive family history, presence of somatic and hypochondriac symptoms, and suicidal intent (Beck suicidal intent scale, Hamilton rating scale for depression) were noted. Results and Discussion: Out of the total 120 patients, 53 were in the perimenopause state, 23 in the peri menarche, 5 in pregnancy, 14 in the post-partum, and 7 as post-abortion. The mean age of onset of depressive disorders was 36.7 years (SD-13.67).The severity of the depressive episode is significantly higher towards the younger age group (<30years) (2 − 24.315, p-value.002) and the number of patients presenting with somatic symptoms are much higher towards the older age group (41-55years) (2-13.760 p value-.008). There is no significant difference in the presence of positive family history, hypochondriasis and suicidal intent among various age groups. Perimenopausal and peri menarche periods show a higher prevalence of depressive disorders during the female reproductive cycle. Conclusion: There is a high prevalence of depression during female reproductive phases. More studies based on female reproductive hormonal changes and mood disorders are needed to prove the association.

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