Background:Several Western countries have established mother-baby psychiatric units for women with mental illness in the postpartum; similar facilities are however not available in most low and medium income countries owing to the high costs of such units and the need for specially trained personnel.Materials and Methods:The first dedicated inpatient mother-baby unit (MBU) was started in Bengaluru, India, in 2009 at the National Institute of Mental Health and Neurosciences in response to the growing needs of mothers with severe mental illness and their infants. We describe the unique challenges faced in the unit, characteristics of this patient population and clinical outcomes.Results:Two hundred and thirty-seven mother-infant pairs were admitted from July 2009 to September 2013. Bipolar disorder and acute polymorphic psychosis were the most frequent primary diagnosis (36% and 34.5%). Fifteen percent of the women had catatonic symptoms. Suicide risk was present in 36 (17%) mothers and risk to the infant by mothers in 32 (16%). Mother-infant bonding problems were seen in 98 (41%) mothers and total breastfeeding disruption in 87 (36.7%) mothers. Eighty-seven infants (37%) needed an emergency pediatric referral. Ongoing domestic violence was reported by 42 (18%). The majority of the mother infant dyads stayed for <4 weeks and were noted to have improved at discharge. However, 12 (6%) mothers had readmissions during the study period of 4 years. Disrupted breastfeeding was restituted in 75 of 87 (86%), mother infant dyads and mother infant bonding were normal in all except ten mothers at discharge.Conclusions:Starting an MBU in a low resource setting is feasible and is associated with good clinical outcomes. Addressing risks, poor infant health, breastfeeding disruption, mother infant bonding and ongoing domestic violence are the challenges during the process.

<p><strong>Background.</strong> Mental illness is an important public health issue worldwide; stigmatisation and negative attitudes towards people with mental illness are widespread among the general public. However, little is known about the attitudes of undergraduates to mental illness. </p><p><strong>Purpose.</strong> To compare the attitudes towards mental illness among undergraduates enrolled in nursing courses v. those enrolled in Bachelor of Business Management (BBM) courses. </p><p><strong>Methods.</strong> A cross-sectional descriptive design was adopted for the present study. A total of 268 undergraduates were selected to complete the<em> </em>Attitude Scale for Mental Illness (ASMI) and the Opinions about Mental Illness in the Chinese Community (OMICC) questionnaires. </p><p><span><strong>Results. </strong>We found significant differences between the number of nursing and BBM students who agreed with statements posed by the questionnaires, e.g., that they would move out of their community if a mental health facility was established there (χ²=16.503, <em>p</em>&lt;0.002), that they were not afraid of treated mentally ill people (χ²=15.279, <em>p</em>&lt;0.004), and that people with mental illness tend to be violent (χ²=14.215, <em>p</em>&lt;0.007) and dangerous (χ²=17.808, <em>p</em>&lt;0.001). Nursing students disagreed that people with mental illness are easily identified (χ²=30.094, <em>p</em>&lt;0.000), have a lower IQ (χ²=70.689, <em>p</em>&lt;0.000) and should not have children (χ²=24.531, <em>p</em>&lt;0.000). Nursing students were more benevolent than BBM students, as they agreed that people with mental illness can hold a job (χ²=49.992, <em>p</em>&lt;0.000) and can return to their former position (χ²=11.596, p&lt;0.021), that everyone faces the possibility of becoming mentally ill (χ²=38.726, <em>p</em>&lt;0.000), and that one should not laugh at the mentally ill (χ²=17.407, <em>p</em>&lt;0.002). Nursing students held less pessimistic attitudes, as they felt that the mentally ill should receive the same pay for the same job (χ²=10.669, <em>p</em>&lt;0.031) and that the public are prejudiced towards people with mental illness (χ²=17.604, <em>p</em>&lt;0.001).</span></p><p><strong>Conclusion.</strong> College students’ attitudes towards people with mental illness vary based on the course that they are enrolled in. Attitudes may be positively improved by revising curriculum design to incorporate educational sessions about mental illness. These are essential steps to combat discrimination, and potentially enhance the promotion of human rights for the mentally ill.</p>

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Aim of the studyTo study the neural substrates of insight in OCD by comparing patients with good insight, patients with poor insight and matched healthy controls using functional MRI.MethodologySubjects were recruited from among patients attending OCD clinic, adult psychiatry services and psychiatry ward inpatients of National Institute of Mental Health And Neurosciences (NIMHANS), Bangalore. They were further divided into ‘good insight’ (n = 30) and ‘poor insight’ (n = 14) using Brown's assessment of belief's scale. Control subjects (n = 30) were recruited from consenting volunteers. 3 T MRI was used, mental rotation task was paradigm used for fMRI and analysis was done by SPM 8.ResultsPoor insight patients and Ggood insight patients comparison revealed differential activation in Left superior/Medial frontal gyrus (corresponding to the DLPFC). A negative correlation between BABS score and activation of right inferior parietal lobule. Mental Rotation task behavioural data results: OCD patients as a group had significantly lower accuracy compared to healthy controls. Poor insight group had significantly decreased accuracy ratio compared to Good insight group and healthy controls. A negative correlation was noted between BABS score and accuracy ratio, indicating that poorer the insight, greater the errors during the active task.ConclusionInsight has been important prognostic factor in OCD. Poor insight patients had specific deficits in left medial frontal gyrus and right inferior parietal lobule as compared to good insight patients and healthy controls. Together, these indicate that insight has a strong neurobiological underpinning in OCD.Disclosure of interestThe authors have not supplied their declaration of competing interest.