Type One Diabetes Mellitus (T1DM) is one of the most significantly impacting health conditions around the world and requires daily insulin administration to manage. Research has highlighted the impact on mental health but in particular there are elevated levels of eating disorders (ED) within T1DM. The current review aimed to systematically draw together the existing research that has explored the impact of psychological treatment within this population specifically focusing on adaptations made and the impact on insulin omission. A total of 95 papers were found and 10 were included in review. The papers ranged in methodology and rigour making comparisons difficult. The review concludes that an individualised intervention addressing both ED and T1DM difficulties appears to be the most effective. There is a lack of reporting on insulin omission within the literature and more research on the function of this behaviour is needed.

Klinefelter syndrome is a disorder of variation of sex chromosome, the most common karyotype being 47XXY. Multiple case reports and articles have been published linking the increased prevalence of psychiatric disorders like Schizophrenia, Schizophreniform psychosis, Attention deficit hyperkinetic disorder, Learning disorder, etc. and seizure disorder in Klinefelter syndrome than in general population, attributing to the extra X chromosome. Here is a case of a 45-year-old gentleman with Klinefelter syndrome with schizophrenia-like psychosis and seizure disorder. He was diagnosed as Klinefelter syndrome 15 years back by genetic testing (47XXY) when he was investigated for infertility. His luteinizing hormone (LH) (32.04 mIU/ml) and follicle-stimulating hormone (FSH) (50.70 mIU/ml) levels were high and his testosterone level was low (1.76 ng/ml). He had four episodes of seizures in 2004 for which he was started on phenytoin and sodium valproate, and was seizure-free for past 10 years. He was brought to our hospital in July 2014 with complaints of talking and laughing to self, suspicion, hearing voices and aggressive behaviour, which were persistent mildly for past 15 years and aggravated for past 6 months. He was not going for work for past 15 years, does not mingle with relatives or friends.

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Introduction: Suicide is closely linked to substance abuse and it is one of the main component of premature death. Aim: To assess the factors that affect the possibility of suicidal behaviour among persons who abuse substance. Materials and Methods: The present study was a retrospective study which was conducted on 101 substance abuse patients who attempted suicide, and 101 substance abusers who have not attempted suicide. Data were collected regarding sociodemographic variables, legal problems (drunken driving/ stealing/perpetrator in domestic violence or physical abuse or sexual abuse or homicide), hereditary and addiction data. The patient was diagnosed with substance dependence syndrome, Anxiety disorders, Depression disorder and Substance-induced psychosis based on The International Classification of Diseases (ICD) 10 criteria. The socio-economic status was assessed using Modified Kuppuswamy Scale. Results: The mean age of the participants who had attempted suicide was 39 years, and those in the other was 43 years. In both the groups all subjects were males. The common abused substance was alcohol. There was a positive association between various demographic variables and attempted suicide, such as socio-economic status, education and place of residence. Early age of onset of substance abuse, abusing more than two substances, co-morbidity of psychiatry illness such as anxiety disorder, depression, and family history of psychiatry illness were the risk factors. In the ‘attempted suicide’ group, 74.2% of the participants abused drugs since more than 10 years, while it was 59.4% in the other group. There was also a positive association between the duration of abuse and attempted suicide. Conclusion: An early age of onset of drug initiation, abusing more than two substances, family history of psychiatry disorders, and co-morbid psychiatric illness increase the risk of suicide. Suicides are preventable, the need to early identification of the risk factors, assess manage and follow-up is the utmost importance of mental health professionals.

Background: Schizophrenia, a chronic psychiatric disorder affecting all major domains of a patient’s life, leads to significant disability. Since the deinstitutionalization policy, the onus of care is on families especially the primary caregiver who experiences physical and emotional burden. Depression among caregivers has been estimated to be higher than the general population. This cross-sectional study aimed to assess burden of care and depression in primary caregivers and associated caregiver variables. Methods: 75 consenting primary caregivers of patients with ICD-10 diagnosis of schizophrenia were assessed for burden of care and depression using the Burden Assessment Schedule and the Patient Health Questionnaire - 9 after collecting socio-demographic and caregiving details. Results: All the caregivers, 49 females and 26 males, had moderate to high levels of burden with a majority having moderate to severe levels of depression. Spouses (p=0.0038), older caregivers (p=0.01) and those with lower educational levels (p=0.01) experienced more burden. There was a significant positive correlation between burden of care and depression (p=0.000). Conclusion: In one of India’s largest metropolitan cities, though psychiatric services are easily available, caregivers continue to feel burdened and depressed. This can impact not just the caregiver but also care being provided to the patient and illness outcome.