South Africa has a very high HIV disease burden and proper patient adherence to anti-retroviral therapy (ART) is crucial in achieving optimal treatment outcomes. Factors influencing adherence include demographic and psychosocial factors, medication-related issues and other patient-related matters. This study was carried out in order to determine factors associated with poor compliance to anti-retroviral (ARV) medications in a rural setting. This interview-based descriptive and analytical study was carried out in a health centre where 168 patients who received ARVs were interviewed with pre-structured questionnaires, which covered various important compliance-related aspects. The results showed that 37.5% of the patients were non-adherent. Amongst men, poor adherence was seen in those who were single (48.9%), with tertiary education (60%), in those who consumed alcohol regularly (47.1%) and in those who were unemployed (56.1%). Higher rates of non-adherence in women was associated with being single (36.5%) and in those who used alcohol (60.7%). Medication-related adverse effects were reported in 47% of patients, notably, neuropathy, headache, nausea, loss of memory, diarrhoea and fatigue. Common reasons for missing doses were: being away from home (57.1%), simply forgot (41.3%), side effects (50.8%) and being too busy (49.2%). Poor adherence to ART is an important concern relating to HIV management in our setting and needs to be addressed with more patient-oriented interventions.

Background:Attention deficit hyperactivity disorder (ADHD) is a common childhood mental health disorder. Treatment has shown to improve both short and long-term prognosis. Hence, study of factors leading to nonadherence is undertaken.Objective:The objective was to know the rate of nonadherence and factors affecting nonadherence.Setting and Design:Cross-sectional follow-up study at child guidance clinic in a tertiary health care facility.Materials and Methods:Forty children with a diagnosis of ADHD initiated on treatment either combined or nonpharmacological were followed-up and checked for nonadherence. Factors leading on to nonadherence were assessed.Statistics:By SPSS 16.0 and Epi info.Results:Rate of nonadherence was 62.5%. 75.7% of nonadherence contributed by social factors. Delivery by caesarean predicted nonadherence. Age of diagnosis and baseline severity did not have an effect on adherence.Conclusion:Rate of nonadherence to treatment was low compared to other Indian studies. Social factors mainly implicated for nonadherence. An effort for education and information of the society about ADHD is needed.

Background: The Geriatric Depression Scale (GDS-30) is a popular instrument that has been ratified and is being used around the world as a screening tool for over three decades. However, a validated version of the scale is not available for use among speakers of Malayalam. In this paper, we elaborate on the procedure involved in the translation and validation of the GDS-30 from the official English version into Malayalam, the hurdles encountered in the process, and how they were overcome. Methods: The steps recommended by the World Health Organization (WHO) were applied for the translation of the original questionnaire. This involved initial forward translation of the English questionnaire, discussion by an expert panel, back-translation, pre-testing, and pilot testing of the final version. The Malayalam translation thus obtained was administered to 100 elderly persons in the community. These individuals were then examined by a qualified doctor, who had received the necessary training from a consultant psychiatrist in the diagnosis of depressive disorders. This doctor evaluated the study subjects clinically using theInternational Classification of Diseases-tenth revision (ICD-10) criteria for the diagnosis of depression, which is considered as the gold standard. Sensitivity, specificity, Cronbach'salpha, and split-half reliability were calculated to determine validity. Results: The translated scale yielded a sensitivity of 87.20%, a specificity of 73.80%, an area under the Receiving Operator Curve (ROC) of 0.814, Cronbach's α of 0.920, and split-half reliability of 0.897, thereby proving to be a valid screening tool. Conclusion: The Malayalam translation of the GDS-30 is a valid instrument to screen for depression in an elderly Malayalam-speaking population.

Background: Psychiatric disorders are usually found to be associated with thyroid dysfunction. Although thyroid dysfunction's relevance to psychiatric disorders is recognised, few studies have estimated the prevalence of subclinical hypothyroidism in subjects with the premenstrual dysphoric disorder in the Indian population. Method: A hospitalbased cross-sectional study conducted in a tertiary care centre in central Kerala enrolled 70 subjects diagnosed with Premenstrual Dysphoric Disorder (PMDD) who presented to the psychiatry and gynaecology Outpatient Departments (OPD). Sociodemographic and clinical data were collected, followed by the administration of the PMDD rating scale. Mini International Psychiatric Interview was done to rule out other psychiatric disorders. TSH was done for all subjects after two months during follow up. Results: 63.33 % of subjects with PMDD were found to have thyroid dysfunction. A significant association was established between PMDD score and subclinical hypothyroidism. Conclusion: Subclinical hypothyroidism is common in premenstrual disorder and is closely associated with the same.

Background: About 70% of persons with mental illness (PWMI) live in their families, with elderly family members assuming the role of caregivers. Aims: To screen for depression and associated sociodemographic and illness-related variables, among elderly caregivers of PWMI. Materials: Caregivers above the age of 60 years of PWMI were assessed by Geriatric Depression Scale- Short Form (GDS-SF), Multiphasic Inventory for Perceived Social Support (MSPSS) and WHO – QOL Bref. Results: 64% of the caregivers were screened positive for depression. Even though 92.5% had moderate to high PSS. Low PSS was significantly related to depression(p=0.001). The mean(SD) QoL score was 52.02(11.402). These two variables predicted 41.1% of the possibility of depression and PSS was more associated with caregiver depression. Conclusion: Understanding the prevalence of depression and the various associated factors is important to plan for interventions that can have an indirect impact on the care of the PWMI.