Disordered time perception has been reported in schizophrenia. We investigated time perception dysfunction and its neuropsychological correlates in patients with schizophrenia. Thirty-eight patients and thirty-eight age and sex matched healthy volunteers were compared in an auditory temporal bisection paradigm using two interval ranges (a 400/800ms condition and a 1000/2000ms condition). In the temporal bisection, subjects were required to categorise a probe duration as short or long, based upon the similarity with two reference durations. All subjects also completed a battery of neuropsychological tests measuring sustained attention, shortand long-term memory and executive function. In the 400/800ms condition, patients judged durations significantly shorter than did control subjects. Patients also exhibited decreased temporal sensitivity in both conditions. We found in both groups a negative association between temporal sensitivity and sustained attention for the 400/800ms condition, and between temporal sensitivity and long-term memory for the 1000/200ms condition. In patients, short-term memory performance was negatively associated with duration judgement in both conditions, while executive dysfunction was correlated to a general performance deficit in the 400/800ms condition. These findings suggest the possibility that time perception abnormalities in schizophrenia are part of neuropsychological dysfunction and are likely to adversely impact upon activity of daily living.

This study examined the differences of heart rate variability measures between children of parents with panic disorder and children of healthy controls using linear as well as nonlinear techniques. Supine and standing heart rate variability indices were measured in all children using power spectral analysis and a measure of chaos, the largest Lyapunov exponent (LLE) of heart rate time series. No significant differences emerged between the children of panic disorder parents and children of normal controls on any of the spectral heart rate variability measures. However, children of patients with panic disorder had significantly lower LLE of heart rate time series in supine posture, suggesting a relative decrease of cardiac vagal function in this group of children. This suggests a possible heritable effect of certain measures of heart rate variability, as previous studies showed decreased heart rate variability in patients with panic disorder using spectral as well as nonlinear techniques. Recent evidence also suggests that some of these nonlinear measures are superior or of additional value to the traditional time and frequency domain measures of heart rate variability to predict serious ventricular arrhythmias and sudden death.

Background:Family History of Alcoholism and earlier Age of Onset are found to predict Severity of alcoholism. Previous Indian studies in this regard have methodological issues related to the definition of alcoholism and reliability of information obtained.Aims:To study the relationship between the Age of onset/Family History and Severity of alcoholism.Settings and Design:Consecutively admitted, 20 to 50 year old men, with alcohol-related problems at an urban teaching hospital, were recruited.Materials and Methods:After detoxification, alcohol use detection inventory test, severity of alcohol dependence questionnaire, schedule for clinical assessment in neuropsychiatry, and family interview for genetic studies were administered. Family history density was computed.Statistics:Pearson’s correlations, linear regression, and ANOVA tests were used.Results:Family history density and severity of alcoholism were positively correlated. Age of onset of initiation had a significant negative correlation with severity. The effect of family history on the rapidity of development of Problem-drinking did not reach statistical significance among those with early age of onset. The variance explained by the ‘family history status’ and ‘age of onset’ for the severity of alcoholism was similar to that reported in earlier western studies.Conclusion:This study, with enhanced methodology, using a general hospital sample of problem drinkers concludes that the age of onset of initiation is a better predictor of severity of alcoholism, than family history of alcoholism alone. Postponing the use of alcohol till the age of 25 years could be explored as a primary prevention strategy in genetically vulnerable adolescents.

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Background: In India, there is a large gap between the mental health morbidity in society and the availability of psychiatrists. However, the latest Indian undergraduate medical curriculum does not require any competency in psychiatry to be fulfilled for certification of medical graduates as doctors. Thus, the role of Indian psychiatry teachers is quite challenging. Interestingly, there has been hardly any effort to understand the felt needs of psychiatry teachers that may further improve the quality of undergraduate training. Methods: We used a survey questionnaire that was both qualitative and quantitative, with questions on topics such as years of psychiatry training and experience as a psychiatry teacher. Do they feel the need for training in undergraduate psychiatry teaching? Do they require training in teaching psychiatry theory or clinics or both? What are the specific areas where they want training? What more should be planned for psychiatry teachers? Based on an online survey further steps in the direction of psychiatry teachers felt needs were initiated. Results: Around 55 responses with a response rate of 37% were received. More than 50% were working in medical colleges for the last 5 years. About 80% felt the need for further training to teach medical students while 97% felt that additional training is required for handling theory as well as bedside clinic. More than 60% were keen to attend a 1-day workshop to upgrade their teaching skills. A majority wanted to have a forum to share their experiences and to learn from others. Based on the felt needs of psychiatry teachers from the survey, a 1-day workshop was carried out and a forum for psychiatry teachers was inaugurated. Conclusion: Training of psychiatry teachers is an important felt need for the challenges that are unique to Indian medical education. The outcome from the Karnataka survey is a progressive step in addressing this challenge.

We investigated the effects of treatment with the tricyclic antidepressant (TCA) imipramine in eight children in supine and standing postures. We used 256 seconds of real-time data for the analyses. Spectral analysis showed a significant decrease of high-frequency (HF) power (0.15-0.5 Hz), especially in the standing posture. Low frequency (LF) HF ratios were significantly higher in the standing posture after treatment, suggesting increased sympathovagal interaction. We also obtained the nonlinear measures of fractal dimension (FD), and approximate entropy (APEN). Although the FD of heart rate was significantly lower in the standing posture, APEN was significantly decreased after treatment in either posture and was the most sensitive measure in this study. These findings suggest a decreased cardiac vagal function with a relative increase in sympathetic responsiveness, which may in part be related to the cardiotoxicity of these drugs. These findings are discussed in relation to the cardiovascular side effects of TCAs.

People with schizophrenia have been categorised into three groups: those with full insight (aware, correct attributers); those aware of being unwell, but who misattributed their symptoms (aware, incorrect attributers); and those unaware of being ill (unaware). Cluster analysis of 'awareness of illness'and 'relabelling of symptoms'scores on the Schedule for the Assessment of Insight confirmed three distinct subgroups. The unaware group were impaired on executive and memory tests, whereas those in the aware, misattributing group were cognitively intact. Findings support an association between unawareness of illness and executive dysfunction, and highlight the separation of symptom misattribution from unawareness of illness.

The COVID19 pandemic is an unprecedented disaster. In India, the spread of COVID19 infection and the subsequent lockdown coincided with a crucial period of the annual examination in almost all educational institutions. The pandemic has created hurdles in the conduct of examination due to many reasons, some of which are spread of infection and associated safety issues, lack of public transport for patients as well as the postgraduates in outstation and examiners, and lack of workforce due to round-the-clock service for rendering health services leading to difficulty in arranging logistics at the examination center. Currently, there are no guidelines or policies on how examinations need to be carried out during such a pandemic. Hence, there is an urgent need to look at solutions within the profession for the completion of examination. Teachers of psychiatry play an important role in the national mental health services. Their expertise can be valuable for finding solutions that work. This article has compiled suggestions from Indian teachers of psychiatry.