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BACKGROUND: Alcohol Dependence syndrome (ADS) is one of the most common psychiatric disorders that has deleterious consequences not only on the patient with ADS but also hampers social, financial, and legal matters of his family hence could be considered as a disorder of the family. Spouses of patients with ADS, a key member of such dysfunctional family system, are most vulnerable to have significant psychiatric disorders like adjustment disorders, mood disorders, anxiety disorders and psychosocial problems. Hence we have undertaken this study in order to understand and address such issues which is largely neglected in psychiatric research. AIMS AND OBJECTIVES: To assess the severity of alcohol dependence & its adverse effect on families, the prevalence and pattern of psychiatric morbidity and marital quality in spouses of men with ADS and to explore the association between them. MATERIALS AND METHODS: 60 spouses of males with ADS according to Diagnostic and Statistical Manual of Mental Disorders-IV (DSM IV-TR) Criteria were screened for psychiatric morbidity using General Health Questionnaire and the presence of specific psychiatric disorders using Structured Clinical Interview for DSM-IV AXIS-I & AXIS-II (SCID-I & SCID-II). Severity of alcohol dependence in males and its adverse consequences was assessed using Short Alcohol Dependence Data and Drinkers Inventory of Consequences, respectively. Marital quality was assessed using the marital quality scale. Data obtained was analyzed statistically. RESULTS: High prevalence of Psychiatric morbidity (63.33%) among spouses of alcohol dependent men, with majority having Axis I diagnosis of Major Depression (35%), Anxiety and Adjustment Disorder. None of them had personality disorders on SCID II. Psychiatric morbidity, poor marital quality in spouses and high alcohol dependence in their husbands and its adverse consequences were found to be significantly correlated with each other and their association was robust particularly Impulse Control, Interpersonal and Social Responsibility were most affected. CONCLUSION: Spouses of alcohol dependent men have high Psychiatric morbidity and low Marital Quality. Addressing these issues will be beneficial as spouses are known to play an important role in the treatment of ADS.

Background The delivery of mental health services largely depends on the adequacy of human resources. In India, the deficit of psychiatrists is more than 90% and is one of the major challenges that needs to be tackled to address the huge burden of mental illness. Psychiatry trainee institutes play a vital role in reducing human resource deficit and inequality in delivering mental health care. However, the distribution pattern of psychiatry trainee seats and institutes across Indian states is unknown. Therefore, we estimated the number of psychiatry trainee seats and institutes in each Indian state and union territory (UT). Materials and Methods In this cross-sectional study, psychiatry trainee seats and institutes were searched on the official web sites of Medical Council of India and National Board of Examinations. The data available on these web sites until December 2019 were included. State-wise data were compared using proportion and percentages. The psychiatry trainee index (PTI) was calculated and compared across Indian states and UTs. Results Among 221 Indian psychiatry trainee institutes considered in the present study, 116 (52.48%) were private institutes and 105 (47.51%) were government institutes. Overall, more psychiatry trainee seats were reported in government institutes (n = 565, 65.89%) than in private institutes. National PTI was considered fair (0.06), and based on their PTIs, Indian states and UTs were classified as follows: worst (n = 9), poor (n = 8), fair (n = 9), average (n = 7), good (n = 1), and excellent (n = 2). Conclusion A huge deficit of psychiatry trainees and institutes exists in more than two-thirds of Indian states and UTs, along with a huge maldistribution of seats. PTI and its distribution across the states and UTs are a crucial indicator of the need to improve the access and equity of mental health care.

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