Background: Studies from around the world have shown higher rates of anxiety, depression, alcohol and other drug use, and burnout in medical students. Aims: The aim of this study was to identify the socio-demographic factors and severity of difficulties Sri Lankan medical students face regarding psychological wellbeing and burnout. Method: This one-off survey used a cross-sectional design, assessing substance use, psychological wellbeing, and burnout using the CAGE, GHQ-12, and OLBI. The survey was open to all medical students in six universities in Sri Lanka. Chi-square analysis was used to assess the statistical significance related to categorical dependent variables and one-way ANOVA for continuous dependent variables. Results: A higher prevalence of diagnosed mental health conditions was found following admission to the medical course in comparison prior to admission. Sixty-two percent of students had a score of more than 2 on the GHQ-12 indicating caseness. The OLBI identified exhaustion in 79% of students. The CAGE questionnaire was positive in 4.8% of students. Conclusions: Only a small proportion of students are recognizing their mental health difficulties and seeking help. Further understanding is required as to why this is, as well as re-evaluation of the demands of the curriculum. Effective ways of regularly identifying and providing practical and evidence-based support for mental health problems in medical and other undergraduates need to be identified and introduced.

Introduction: Epidemiological surveys indicate that the prevalence of autism is rising worldwide. A study in Sri Lanka has shown 1 in 93 children to be affected. Early diagnosis is vital as early intensive behavioural interventions improve outcome in autism. It has been shown that the level of physicians' knowledge of autism influences the average age of diagnosis and provision of further information to caregivers. Objectives:To assess the knowledge of diagnostic features and comorbidities of childhood autism among doctors in a tertiary care hospital and to identify the factors affecting it.Method: A descriptive study was conducted on 176 doctors at Colombo South Teaching Hospital, using the Knowledge about Childhood Autism among Health Workers Questionnaire. Data was collected by authors and analyzed using SPSS version 21. Ethical approval was obtained from the ethical review committee of the Lady Ridgeway Hospital.Results: Majority (61.9%) considered themselves incompetent in identifying autism. Knowledge was highest regarding symptoms of impaired social interactions (75.81%) and lowest for restricted repetitive interests/behaviours (60.79%), with a significant difference between medical officers and postgraduate trainees (p=0.045). ___________________________________________

Dandy-Walker malformation, which is a congenital malformation of the cerebellum, is documented in literature to be associated with psychotic symptoms, obsessive compulsive symptoms, mood symptoms, hyperactivity, and impulsive behavior. The pathogenesis of psychiatric symptoms in Dandy-Walker malformation is thought to be due to disruption of the corticocerebellar tracts, resulting in what is known as cerebellar cognitive affective syndrome. We present a case of Dandy-Walker malformation presenting with psychiatric symptoms. This case highlights the necessity to be aware of psychiatric manifestations of cerebellar disease as it has an impact on the diagnosis and treatment.

Child sexual abuse (CSA) is a major public health problem affecting all cultures and social classes. Estimated global prevalence of CSA is 11.8% [1]. Retrospective studies in Sri Lanka have shown prevalence of sexual abuse among adolescents to be 21.9% [2]. A retrospective descriptive study was carried out of all children referred through courts or Judicial Medical Officer to a Child Guidance Clinic at Lady Ridgeway Hospital, from 2010-2014, due to alleged CSA. Psychological consequences were assessed by a Consultant Psychiatrist and diagnosis was made according to the International Classification of Diseases, 10 th edition. Approval was obtained from Ethics Review Committee of The Lady Ridgeway Hospital, Colombo. Data obtained from case records were suitably altered to maintain confidentiality.

Objective: There has been increasing interest in the physical health, mental wellbeing and burnout afflicting medical students over recent years. This paper describes the overall results from phase two of an international study including a further nine countries across the world. Methods: We sampled large groups of medical students in nine countries at the same time and with exactly the same method in order to aid direct comparison of demographics, burnout and mental wellbeing through validated instruments. Results: A total of 4,942 medical students from these countries participated in this study. Around 68% of respondents screened positive for mild psychiatric illness using the General Health Questionnaire-12. Around 81% and 78% of respondents were found to be disengaged or exhausted respectively using the Oldenburg Burnout Inventory. Around 10% were found to be CAGE positive and 14% reported cannabis use. The main source of stress reported by medical students was their academic studies, followed by relationships, financial difficulties and housing issues. Conclusion: Cultural, religious and socioeconomic factors within each country are important and understanding their effects is fundamental in developing successful local, regional and national initiatives. Further quantitative and qualitative research is required to confirm our results, clarify their causes and to develop appropriate preventative strategies.

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Introduction: Autism spectrum disorder (ASD) is a neurodevelopmental disorder, in which medical disorders are known to occur higher than in the general paediatric population. This may indicate either that the neurodevelopmental disorder is acting as a risk factor or sharing a common pathophysiological mechanism with the medical disorder. We could not access any publications focusing on medical comorbidities in autism from Sri Lanka. Objective:To compare the prevalence and types of medical comorbidities between children with ASD and outpatient controls presenting to a children's hospital in Sri Lanka. Method:This was an observational analytical study using a case control design. Seventy three consecutive new enrolments diagnosed as ASD at the child psychiatric services of Lady Ridgeway Hospital were recruited to the study group. An age and gender matched group of children presenting to the outpatient department with minor physical problems were recruited as the comparison group. The presence of a medical disorder was determined retrospectively by perusal of medical records. Results:The prevalence of febrile seizures, epilepsy, bronchial asthma, atopic dermatitis and recurrent gastrointestinal symptoms in the child were higher in the ASD group compared to the control group. The differences of the rates between groups for bronchial asthma and recurrent gastrointestinal symptoms were statistically significant. Also, pregnancy induced hypertension _________________________________________