Introduction-Demographic, clinical and familial factors may plausibly influence the manifestation of hallucinations. It is unclear if the pattern of the effects is similar in different environmental/cultural settings.

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Objective: The treatment of bipolar disorder is challenging because of its clinical complexity and availability of multiple treatment options, none of which are ideal mood stabilizers. This survey studies prescription practices of psychiatrists in India and their adherence to guidelines. Method: In total, 500 psychiatrists randomly selected from the Indian Psychiatric Society membership directory were administered a face-to-face 22-item questionnaire pertaining to the management of bipolar disorder. Results: For acute mania, most practitioners preferred a combination of a mood stabilizer and an atypical antipsychotic to monotherapy. For acute depression, there was a preference for a combination of an antidepressant and a mood stabilizer over other alternatives. Electroconvulsive therapy was preferred in the treatment of severe episodes and to hasten the process of recovery. Approximately, 50% of psychiatrists prescribe maintenance treatment after the first bipolar episode, but maintenance therapy was rarely offered lifelong. While the majority (85%) of psychiatrists acknowledged referring to various clinical guidelines, their ultimate choice of treatment was also significantly determined by personal experience and reference to textbooks. Limitations: The study did not study actual prescriptions. Hence, the responses to queries in the survey are indirect measures from which we have tried to understand the actual practices, and of course, these are susceptible to selfreport and social-desirability biases. This was a cross-sectional study; therefore, temporal changes in responses could not be considered. Conclusion: Overall, Indian psychiatrists seemed to broadly adhere to recommendations of clinical practice guidelines, but with some notable exceptions. The preference for antidepressants in treating depression is contrary to general restraint recommended by most guidelines. Therefore, the efficacy of antidepressants in treating bipolar depression in the context of Indian psychiatrists' practice needs to be studied systematically. Not initiating maintenance treatment early in the course of illness may have serious implications on the long-term outcome of bipolar disorder.

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Background:Delusions are an important symptom for the diagnosis of schizophrenia (SZ) in both the commonly used international classificatory systems - the Diagnostic and Statistical Manual of Mental Disorders IV (DSM IV - American Psychiatric Association, 2000) and the International Classification of Diseases, X (ICD X - World Health Organization, 1992). Of special significance are “bizarre delusions” the presence of which is alone sufficient for a diagnosis of SZ in DSM IV. In an attempt to find out the frequency, criteria for classification, and other clinical aspects of bizarre delusions and justification of their importance in the diagnostic system, this retrospective study was conducted.Methodology:Records of 1952 Indian patients affected with SZ, recruited for various research projects at one center were included in this study. All had a diagnosis of DSM IV SZ; all symptoms of SZ from the Diagnostic Interview for Genetic Studies were asked regardless of the presence of specific symptoms - like bizarre delusions - sufficient for diagnosis.Results:The prevalence of bizarre delusions was 2.56%. Five themes, identified on analyzing their contents are described. Main themes were unnatural, bodily sensation, change in identity, sexual, and religious.Conclusions:These themes were culture based, but definitely out of context, excessive or extremely odd. Moreover, the rarity of bizarre delusions makes it difficult to include them as a sole criterion for diagnosis.