An anonymous postal survey on the awareness of the occurrence of nonsexual and sexual boundary violations (NSBV and SBV) in the doctor-patient relationship in India was conducted with psychiatrists and psychologists working in the state of Karnataka in India (n=51). Though this was not designed to be a prevalence study on violations, the results suggest that both NSBV and SBVdo occur and, more importantly, respondents felt that this is an area which needs urgent attention in India. There was disagreement on whether some behaviours in certain situations could be construed as NSBV in the Indian culture. Though several respondents agreed that there was a need to develop guidelines on this issue in India, there was a perception that the problem was not in the availability of guidelines but in their implementation. The ethical implications of the study are discussed.

Background:The business process outsourcing (BPO) sector is a contemporary work setting in India, with a large and relatively young workforce. There is concern that the demands of the work environment may contribute to stress levels and psychological vulnerability among employees as well as to high attrition levels.Materials and Methods:As part of a larger study, questionnaires were used to assess psychological distress, burnout, and coping strategies in a sample of 1,209 employees of a BPO organization.Results:The analysis indicated that 38% of the sample had significant psychological distress on the General Health Questionnaire (GHQ-28; Goldberg and Hillier, 1979). The vulnerable groups were women, permanent employees, data processors, and those employed for 6 months or longer. The reported levels of burnout were low and the employees reported a fairly large repertoire of coping behaviors.Conclusions:The study has implications for individual and systemic efforts at employee stress management and workplace prevention approaches. The results point to the emerging and growing role of mental health professionals in the corporate sector.

which patients will understand, and record infor mation which is useful to the patient as well as to professionals. Rather than inhibiting record keeping this would result in an enriched record and improved patient care. Teaching doctors how to write such records should become an important element in undergraduate and postgraduate education and offers a particular challenge to psychiatry. It is a challenge which should be taken up sooner rather than later. BALDRY, M., CHEAL, C., FISHER, B. et al(l986) Giving patients their own records in general practice: experience of patients and staff.

Sexual and non-sexual boundary violations occur in the health professional-patient relationship all over the world as well as in India. However, the issue is rarely, if ever, discussed here in a frank and rational manner. This paper discusses the challenges faced by all health professionals and particularly mental health professionals in handling this problem in India. Health professionals can now either let things remain as they are or try to change things for the better, despite the inherent risks in attempting the latter. Since knowledge about boundary issues is essential for effective healthcare, prevention of boundary violations by oneself and reducing harm to patients should a violation occur by another professional, it is important that all health professionals are aware of the issues involved.

Objective: To evaluate the odds of association between suicidal ideation and/or attempt with comorbid eating disorders in adolescents with major depressive disorder (MDD). Methods: We conducted a cross-sectional study and included 122,020 adolescents with a primary diagnosis of MDD from the nationwide inpatient sample (NIS, 2012–2014). They were sub-grouped by a comorbid diagnosis of eating disorders (N = 1675). We calculated the adjusted odds ratio (aOR) using a logistic regression model with demographic confounders for associations of eating disorders with suicidal ideation and attempt. Results: Suicidal ideations were seen in a higher proportion of adolescents with eating disorders (46.3% vs. 14.2% in those without eating disorders). On the contrary, a low proportion of adolescents with eating disorders had suicidal attempts (0.9% vs. 39.4% in those without eating disorders). Overall, eating disorders were associated with higher odds for suicidal ideations (aOR 5.36, 95% CI 4.82–5.97) compared to those without eating disorders, but with lower odds of suicidal attempt (aOR 0.02, 95% CI 0.01–0.03). Conclusions: Adolescents with MDD and comorbid eating disorders had five-times increased odds of suicidal ideations but lower odds of a suicide attempt. Self-harm/injurious behaviors are early signs of suicidal ideations in these patients. A collaborative care model is required for the screening, early diagnosis, and management of adolescents with eating disorders to improve their quality of life.