Srinivasa Murthy

National Institute of Mental Health and Neuro Sciences | NIMHANS · Department of Psychiatry

Living with cancer is a challenge to the individuals and their families. This is a personal perspective of a person living with a diagnosis of cancer for over a decade and as psychiatrist supporting others in a similar situation and their caregivers. The challenges are medical, psychological, social, and spiritual. In the care of persons living wit...

The existence of spirituality throughout human history and in all the communities calls for serious examination of its value for the mental health of the population in general and social work practice in particular. There is a major rethink in the broad area of mental health towards the need to think of mental health and not only mental illnesses;...

Significant advances in the understanding of mental disorders, mental health and well-being have occurred in recent decades. Tracing the trajectory of diverse discourses on mental health over the previous five decades, author, through his personal and professional experiences, covers the growth of multiple frameworks in the broad context of mental...

The current Russian war against Ukraine is of global concern. It builds on the annexation of Crimea in 2014 and subsequently the war in the Donbas region of Ukraine, and has become a large-scale Russian invasion of Ukraine from three directions, Crimea in the south, Russia in the east, and Belarus in the north. Despite the geopolitical background t...

p class="abstract">The diagnosis and management of hair loss needs an organized and systematic approach for recognizing pattern of hair loss and identification of hair loss etiology. Early and specific diagnosis is essential to initiate appropriate treatment in the early phases of hair loss. Topical minoxidil and oral finasteride are the only appro...

The whole world including India is experiencing the ‘#MeToo movement’ to address the issues of patriarchy, gender violence and related issues. To a large extent, the current course is one of confrontation and not cooperation to address the issues of long—standing disparities in gender roles and relationships. There is a mental health aspect to the...

Purpose of review: Psycho-oncology has completed 25 years. There is growing recognition of the psychosocial needs of persons living with cancer and the role of sociocultural factors in addressing the needs. This review addresses the research in developing countries relating to distress associated with living with cancer and psychosocial care. Rec...

This chapter investigates how mental health services have changed over the past two decades in a selection of 11 major cities from four different continents. Overall, deinstitutionalization has moved patient care away from hospitals and into community settings where mental health centers are now developing outpatient services. The cities presented...

Purpose of review: Understand recent developments in psychosocial and behavioral aspects of populations affected by humanitarian emergencies. The review covers the prevalence, longitudinal course, risk factors, posttraumatic growth, biological basis and interventions to address the needs. Recent findings: Populations living in humanitarian emerg...

Background/Objectives: Research on stigma interventions focuses on general public attitudes and overlooks patients' subjective experiences of everyday stigma arising from significant others. Mental health advocacy has rapidly progressed in western countries, but still continues to be in its early stages in low- and middle-income countries. With thi...

This chapter introduces a 3-year study that explored through case studies on Guatemala, East Jerusalem, Indian Kashmir, Mozambique, Northern Ireland, South Africa and Sri Lanka how best to intervene from a psychosocial perspective following armed conflict so as to maximise the potential to contribute to constructive social change. The chapter explo...

Community psychiatry, is an important approach to the organisation of mental health care in both economically rich and in low and middle income (LAMI) countries. The development of this community psychiatry movement all over the world, is a part of series of phases of development of mental health care during the last two to three hundred years, sta...

The adoption of the National Mental Health Programme (NMHP) in August 1982 was a milestone in the history of Indian psychiatry. Such an ambitious program was formulated at a time where there were <1000 psychiatrists is a triumph of need for mental health care in the country. The story of the NMHP, both in terms of the technical forces and the perso...

The developments in the location of mental health care from mental hospitals to the general hospital psychiatric units and to the community are a revolution in the thinking of professionals and people. This change has resulted in a completely different view of persons with mental disorders, the rights of ill persons, the role of the professionals a...

Psycho-oncology is a well-established field in the developed countries and 'distress' is recognised as the sixth vital sign in the care of persons diagnosed with cancer. However, centres in India caring for cancer do not make psycho-social aspects an essential part of their care programmes. The present narrative presents the personal journey of the...

Bhopal disaster is an important milestone in Indian Industrial Psychiatry. The disaster was not only the biggest industrial disaster but also one in which complex forces have joined hands to demy the mental health needs of the population. Though the biggest general population epidemiological study over 5 years was carried out to understand the ment...

Child neglect and abuse is a public health priority. Adverse conditions in early life are associated with higher risk of mental disorders. Family conditions and quality of parenting have a significant impact on risk of mental and physical health. Children's exposure to neglect, direct physical and psychological abuse, and growing up in families wit...

Mental health interventions in low and middle income countries, with limited resources of human and other resources, requires that they be viewed from multiple viewpoints. This applies to the issue of covert medication, which on the face should not be practiced at all, in an ideal care situation. In India, it would be better to consider the use of...

This study explores gender issues from a sociocultural perspective related to stigma among people suffering from schizophrenia in India. Stigma experiences were assessed by conducting semistructured interviews with 200 patients attending urban or rural psychiatry clinics. The resulting narratives were examined by thematic content analysis. Men with...

Assess psycho-social outcomes in a rural cohort of patients with bipolar-I disorder (BD). Detailed evaluations were performed using the Longitudinal Interval Follow-up Evaluation (LIFE) assessments of community-based BD patients in southern India. Several subjective and objective outcome measures were examined. Only half the cohort could be describ...

Indian psychiatrists have actively engaged with world psychiatry by contributing to understanding and care of persons with mental disorders based on the religious, cultural and social aspects of Indian life. The contributions are significant in the areas of outlining the scope of mental health, classification of mental disorders, understanding the...

IntroductionHinduism as a ReligionConcept of Mental HealthTherapySuicideDeath and End of LifePreventive PsychiatryClassification of Mental DisordersResearch Studies of YogaOther AspectsImplications for Mental HealthAcknowledgmentsReferences

The concept of the burden of disease, introduced and estimated for a broad range of diseases in the World Bank report of 1993 illustrated that mental and neurological disorders not only entail a higher burden than cancer, but are responsible, in developed and developing countries, for more than 15% of the total burden of all diseases. As a conseque...

This article describes the construction and use of a systematic structured method of mental health country situation appraisal, in order to help meet the need for conceptual tools to assist planners and policy makers develop and audit policy and implementation strategies. The tool encompasses the key domains of context, needs, resources, provisions...

Data on the prevalence and correlates of anxiety, mood, behavioral, and substance disorders are presented from a 2007-8 national survey of the Iraq population, the Iraq Mental Health Survey (IMHS). The IMHS was carried out by the Iraq Ministry of Health in collaboration with the Iraq Ministry of Planning and the World Health Organization (WHO) Worl...

In the Middle East mental health and psychosocial support systems are underdeveloped. Seven critical factors are identified that hinder the initiation of well functioning mental health and psychosocial intervention programmes: 1) shortage of national professional leadership; 2) absence of infrastructure to support mental health and psychosocial pro...

IntroductionSuicide in Different ReligionsDifferences Across CountriesInternational Developments Relevant to Asia and the Far EastFuture Areas of ActionConclusions References

It is important to understand stigma in India, given its varied culture and mixture of rural and urban populations. Information from western literature cannot be applied without considering the sociocultural differences. The research aimed to study the subjective experiences of stigma and discrimination undergone by people suffering from schizophre...

There is growing recognition of importance of including psychosocial care as part of the total response to meet the needs of survivors of disasters, conflicts and postconflict situations. Developing countries have extremely limited mental health resources to meet the normal needs of the population and find it beyond their capacity to meet the psych...

INTERNATIONAL SITUATIONIn the USA, Behavioral Sciences are taught in the first year of undergraduate studies. During the first two years, there are about 60 hours of teaching in various psychosocial areas. In the third year, 30 hours are devoted to practical teaching of Psychiatry. In the fourth year, there is a full-time posting of 8 weeks of Psyc...

There is growing awareness of the mental health impact of all types of mass violence. The exposure of large population groups, mostly having no mental health problems prior to the exposure, and the subsequent development, in a significant proportion of the population, of a variety of psychiatric symptoms and disorders represent both a challenge and...

Editor—Disparities remain worldwide between high and low income countries in mental health services and protection of human rights for mentally ill patients.1 Substantial improvement has not been achieved in mental health since 2001, regional imbalances also remaining similar.2 When does society give importance to disadvantaged people? Can society...

To examine the naturalistic course of bipolar disorder in a rural, community-based, partially treated cohort. All patients diagnosed with bipolar disorder during an epidemiological survey (n=34) in a rural area in India were followed longitudinally using standardized instruments, and the life-chart method used to examine their course. Seven (26%) o...

Among the consequences of war, the impact on the mental health of the civilian population is one of the most significant. Studies of the general population show a definite increase in the incidence and prevalence of mental disorders. Women are more affected than men. Other vulnerable groups are children, the elderly and the disabled. Prevalence rat...

IntroductionStudies of Mental Health Consequences of the DisasterMental Health InterventionsUnresolved IssuesReferences

This review covers the epidemiological research from developing countries to identify the scope of research in the various aspects of epidemiology and the strengths of research. The period covered is June 2004 to June 2005. The literature survey used searches of Medline, key psychiatric journals and personal correspondence with leading psychiatric...

In resource-poor countries, there remains an alarming treatment gap for people with schizophrenia, particularly those living in rural areas. Decentralization of mental health services, including community-based outreach programmes, represents one obvious strategy for bringing appropriate care to these communities. This study set out to assess the c...

Human resources for mental health are a challenge in all countries. In countries rich and poor, there is a big gap between the need for mental health services and the availability of those services. In an unusual way, the barriers to mental healthcare appear to be universal, which is not true of non-psychiatric healthcare. Nonetheless, the World He...

Meeting the mental health needs of those persons in conflict and post-conflict situations in the eastern Mediterranean region (EMR) is an important goal of the World Health Organization. Of the 22 countries in the EMR, 85% of the population has been affected by conflict in the past two decades. This has resulted in a high prevalence of mental disor...

The ability to interpret collected data across international mental health communities often proves to be difficult. The following paper reports on the use and appropriateness of focus group methodology in helping to clarify issues that could help substantiate data collection and comparison across different cultures and regions. Field tests of the...

This study reviews the mental health research done in Bhopal in the wake of the gas disaster. Based on interviews with the victims themselves, as well as with professionals, it highlights the fact that despite the continuing suffering of the victims, no systematic effort has been made to tackle the mental health problems that were generated as an i...

A widely promoted model of mental health care and prevention appropriate to many low-income countries is one that is integrated into the local primary health care system. To examine the influence of health-seeking behaviours (demand-side factors) and the access to/availability of services (supply-side factors) on local service utilisation patterns...

limited healthcare budgets and a seamless demand for resources suggests that a formula for allocating resources is needed. Economic evaluation can assist in developing this formula. mental health economic studies (cost minimisation, cost-effectiveness, cost-utility, cost-benefit and cost of illness analysis) in geriatric psychiatry from developed a...

Psychiatric diagnosis and classification is an important part of psychiatric practice. The experiences from developing countries have contributed to a better understanding of mental disorders. The observation of universal nature of mental disorders with national variations in presentation emphasises the need for national adaptation of international...

Bhopal’s gas leak disaster is the worst recorded industrial disaster in human history. On the night between December 2–3, 1984, methyl isocyanate leaked at the Union Carbide India Limited (UCIL) factory at Bhopal, in central India, spreading into the surrounding environment. This leak of an “extremely hazardous chemical” covered the city of Bhopal...

Targeting resources on cost-effective care strategies is important for the global mental health burden. To demonstrate cost-outcome methods in the evaluation of mental health care programmes in low-income countries. Four rural populations were screened for psychiatric morbidity. Individuals with a diagnosed common mental disorder were invited to se...

During the last two decades several initiatives have been taken to improve psychiatric services in low-income rural areas in developing countries. They have included the formulation of national mental health programs and establishment of pilot programs for integration of mental health care with primary health care in India, Iran, and other countrie...

Psychiatry in the third world is at the early stages of understanding the nature and consequences of mental disorders.There is gradual development of organised ways of providing mental health care. The studies reviewed show both commonalities with western psychiatry and differences. Growing knowledge has the potential to enrich world psychiatry as...

Mental disorders are not only common in the general population but are also one of the most prevalent group of conditions seen in primary care populations.The growing awareness of the need to organize services at the primary care level has resulted in a large number of studies of the general population and those attending primary care. The general...

The mental health professionals of the countries of Southeast Asia have been part of the international efforts to develop national and international classificatory systems. Wig and Sing (1966) proposed a classification of psychiatric disorder for use in India at the time of the International Classification of Diseases, 8th revision (ICD-8), World H...

Finger and palmar dermatoglyphics of 120 male and 120 female schizophrenics with and without a family history of schizophrenia in first-degree relatives were studied in the northwestern part of India. Patients were selected according to specific diagnostic criteria. Significant dermatoglyphic differences were observed for fingerprint patterns, tota...

Seasonality of admissions for mania has been commonly reported. Most reports are from temperature zones. We analysed admissions for mania covering a 9 year period and looked for any seasonal trends using existing methods. No seasonal variation was found. The hospital lies in the tropical zone with a relatively constant climate. This may influence t...

Under a WHO collaborative study, the Chandigarh center monitored two geographically defined populations over a 2-year period. Using helping-agency-coverage and other methods along with a set of specified criteria, 268 first-onset potentially schizophrenic cases were actively identified. Of these, 232 cases could be assessed in detail which included...

Seasonal relapses of affective disorder are known. We report 12 patients who had season-linked relapses during a prospective follow-up period of 4 years. There were both winter and summer relapses of mania and depression. The centre is in the tropical zone, with lesser variation of sunshine and temperature than in more extreme latitudes. This may i...

A total of 3622 physicians registered in the Association of Physicians of India were contacted through mail and requested to respond to a semistructured questionnaire pertaining to different aspects of medical ethics, with particular focus on informed consent. Six hundred twenty-nine physicians (17.4%) responded to the questionnaire; 86% of the res...

This report describes the results of a multicentre collaborative study comparing the safety and efficacy of alprazolam with imipramine in patients suffering from major depressive disorder. Two hundred and eight patients diagnosed as major depression as per DSM-III criteria were randomly allocated to alprazolam (N= 105) or imipramine (N = 103) in a...

This investigation examined the nature and frequency of errors in clinical judgment that were displayed by primary health care medical officers before and after short-term training in mental health care. Thirty-nine medical officers who underwent inservice training for 2 weeks were evaluated using standardized case vignettes. Before the training, d...

This article reports the development of case vignettes as a method of assessing the short-term in-service training of primary care medical officers in mental health care. A pool of 18 case vignettes representing common psychiatric problems and a standard response sheet were written first. This was mailed to 45 psychiatrists for their comments. Base...

Mental health problems in primary care settings have received wider attention in recent years (Wilkinson, 1985). In India, the National Mental Health Programme (NMHP) was formulated with the purpose of promoting mental health care through primary health care (National Mental Health Programme, 1982). As part of the implementation of NMHP, training p...

This report aimed to evaluate the mental health knowledge of primary care medical officers following short-term training in mental health care using a multiple-choice questionnaire. Seventy-eight medical officers who underwent 2 weeks' training in mental health care were assessed using parallel forms of a standardized multiple-choice questionnaire...

Ninety-four urban and 54 rural respondents who had undergone hospitalisation in the previous three years were interviewed using a semistructured interview schedule to ascertain their experiences and opinion regarding ethical issues. The interview focussed particularly on patients' satisfaction and expectations about information provided by medical...

Reviews published research in psychiatry by Indian scientists in national and international journals for 1988. Epidemiology, phenomenology, and treatment were the focus of a number of studies. Understanding mental disorders as they are seen in India was, as always, an area of interest. In transcultural psychiatry, 1 article compared the symptomolog...

This study reports the standardisation of a multiple choice questionnaire (MCQ) for evaluating the training of primary care physicians in psychiatry. An item pool of 104 multiple-choice questions of the 'single best response' type was written. This item pool along with an 'MCQ assessment sheet' was mailed to 90 psychiatrists with a request to evalu...