There has been a lack of studies on bullying in non-western low-income and middle-income countries. This study reported the prevalence of traditional victimization, cybervictimization, and the combination of these, in 13 European and Asian countries, and explored how psychiatric symptoms were associated with victimization. The data for this cross-sectional, school-based study of 21,688 adolescents aged 13–15 were collected from 2011 to 2017. The main outcomes were traditional and cybervictimization obtained from student self-reports. The Strengths and Difficulties Questionnaire was used to assess psychiatric symptoms. Generalized estimating equation and logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs). The mean prevalence of any victimization was 28.9%, of traditional victimization only, this was 17.7%, and for cybervictimization only this was 5.1%. Cybervictimization occurred both independently, and in combination with, traditional victimization. The mean prevalence of combined victimization was 6.1%. The mean proportion of those who were cyberbullied only among those who were either cyberbullied only or bullied both traditionally and in cyber was 45.1%. The rates of prevalence varied widely between countries. In the total sample, those who experienced combined victimization, reported the highest internalizing symptoms (girls, OR 1.25, 95% CI 1.22–1.29; boys, OR 1.29, 95% CI 1.25–1.33). The study findings suggest that anti-bullying interventions should include mental health components and target both traditional and cyberbullying. Due to the overlap between these, targeting bullying should primarily focus on how to reduce bullying behavior rather than just focusing on where bullying takes place.

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Clozapine is known to be an effective antipsychotic for schizophrenia. Cardiovascular complications associated with initiation of clozapine include tachycardia, postural hypotension, and myocarditis. Factors associated with development of cardiovascular adverse events are not clearly known, and dose titration has been described to be one among the associated risk factors. We report a case of a 45-year-old man with treatment resistant schizophrenia who developed supraventricular tachycardia during initiation of clozapine and discuss the role of verapamil in its successful management.

Poised to have the highest number of young people in the world, India will have the onus of providing adequate mental health resources to a demographic considered among the most vulnerable with regard to mental well-being. While the Mental Healthcare Act 2017 pushed for greater accountability and care in supporting individuals with mental illness, these directions were specific to services provided by the state and did not address the care required in non-hospital settings. Since many manifestations and repercussions of mental health issues in young people occur in educational institutions, it becomes vital to address ways in which we can formulate ethical mental health services at those sites. This article is a reflective case study of the ethical dilemmas and challenges around issues of confidentiality and quality of care in relation to demand, contributing to a larger mental health ecology involved in providing mental health resources at the Student Support Centre, Manipal, that caters exclusively to students in an Indian campus town.