Background COVID-19 has inundated the entire world disrupting the lives of millions of people. The pandemic has stressed the healthcare system of India impacting the psychological status and functioning of health care workers. The aim of this study is to determine the burnout levels and factors associated with the risk of psychological distress among healthcare workers (HCW) engaged in the management of COVID 19 in India. Methods A cross-sectional study was conducted from 1 September 2020 to 30 November 2020 by telephonic interviews using a web-based Google form. Health facilities and community centres from 12 cities located in 10 states were selected for data collection. Data on socio-demographic and occupation-related variables like age, sex, type of family, income, type of occupation, hours of work and income were obtained was obtained from 967 participants, including doctors, nurses, ambulance drivers, emergency response teams, lab personnel, and others directly involved in COVID 19 patient care. Levels of psychological distress was assessed by the General health Questionnaire -GHQ-5 and levels of burnout was assessed using the ICMR-NIOH Burnout questionnaire. Multivariable logistic regression analysis was performed to identify factors associated with the risk of psychological distress. The third quartile values of the three subscales of burnout viz EE, DP and PA were used to identify burnout profiles of the healthcare workers. Results Overall, 52.9% of the participants had the risk of psychological distress that needed further evaluation. Risk of psychological distress was significantly associated with longer hours of work (≥ 8 hours a day) (AOR = 2.38, 95% CI(1.66–3.41), income≥20000(AOR = 1.74, 95% CI, (1.16–2.6); screening of COVID-19 patients (AOR = 1.63 95% CI (1.09–2.46), contact tracing (AOR = 2.05, 95% CI (1.1–3.81), High Emotional exhaustion score (EE ≥16) (AOR = 4.41 95% CI (3.14–6.28) and High Depersonalisation score (DP≥7) (AOR = 1.79, 95% CI (1.28–2.51)). About 4.7% of the HCWs were overextended (EE>18); 6.5% were disengaged (DP>8) and 9.7% HCWs were showing signs of burnout (high on all three dimensions). Conclusion The study has identified key factors that could have been likely triggers for psychological distress among healthcare workers who were engaged in management of COVID cases in India. The study also demonstrates the use of GHQ-5 and ICMR-NIOH Burnout questionnaire as important tools to identify persons at risk of psychological distress and occurrence of burnout symptoms respectively. The findings provide useful guide to planning interventions to mitigate mental health problems among HCW in future epidemic/pandemic scenarios in the country.

Background The risk of suicide among persons with schizophrenia (SZ) is higher than in general population, with multiple contributory factors. We assessed the prevalence of risk of deliberate self-harm and suicide attempts, along with associated socio-demographic and clinical factors in a group of SZ outpatients (n=61) as part of a larger study on overall schizophrenia-associated risks. Aims To investigate factors associated with risk of deliberate self-harm and suicide among persons with schizophrenia. Method Out of 270 SZ participants evaluated for various risks using Ram Manohar Lohia Risk Assessment Interview (RML-RAI), 61 reported risk of self-harm including suicide attempt/s. The factors associated with this risk were further evaluated on clinical details and Diagnostic Interview for Genetic Studies. Results Risk of reported self-harm was 22.59%. Among them, 10% had attempted suicide at least once. Current age and past month Global Assessment of Functioning score from DIGS (GAF) were significantly correlated with suicide attempt. Attempters had significantly lower current GAF score, indicating poorer functioning. Among 27 attempters, 9 attempted at the onset of illness while 6 others attempted suicide within one year. Most common method of attempt was ingestion of insecticides or overdose of medication, followed by hanging or jumping from height. Conclusion In our hospital-based sample of suicide attempters, 10% had attempted suicide, among them over 55% within first year of illness. Attempters were significantly older than non-attempters and suffered from significantly more severe illness than non-attempters. Positive symptoms were significantly associated with attempt, irrespective of time at which suicide was attempted.

Background The growing burden of chronic often untreated mental illness has increased the importance of risk assessment in people suffering from major mental disorders. Aims The present study was undertaken to obtain prevalence of various risks and predictive factors for self-harm, violence and various other risks among randomly recruited Schizophrenia subjects (n=270) on the basis of past history of their disorder. Method Using a rigorous translation, back translation and acceptability process, a specially constructed semi-structured assessment interview, based on a prior NHS Trust risk assessment interview along with the Diagnostic Interview for Genetic Studies, detailed information was obtained for various risks. Results Risk of violence (historical) was reported among 65.55%, and risk of self-neglect among 53.33%, risk to others (47.41%), risk of coming to harm (24.07%), self-harm (22.59%), risk from others (11.85%), fire risk (2.96%) Risk of violence (historical) and risk to others was related to ‘ever’ having emotions related to harm and self-harm, ‘current’ emotions related to violence and poor compliance to treatment. Conclusion Regular risk assessment is essential to assess emotions related to violence and non-adherence to treatment. Assessment of risk helps clinicians predict the risks involved in management and in timely intervention.

BACKGROUND: Amidst corona virus disease-2019 (COVID-19) pandemic, disruption to the usual ways of life can lead to anxiety and feeling of being unsafe, which may be associated with self-medication. The study was planned to investigate the prevalence of anxiety and self-medication during COVID-19 pandemic. MATERIALS AND METHODS: In this cross-sectional study, data were collected through an anonymous online survey with questionnaire consisting of four sections: demographic data of the participants, validated COVID-19 Anxiety Inventory Items, Self-rating Anxiety Scale, and self-medication practices during COVID-19 pandemic. The data were organized and analyzed using Windows Microsoft excel and SPSS software (Version 21). Descriptive statistics were calculated for all patient characteristics and survey responses. Analytical analysis included relationship between various parameters using Chi-square test. RESULTS: A total of 1100 responses were received. Approximately half of the participants were worried about getting severely ill. Majority reported reduced social contact (71.3%, n = 784) and also communicated that the pandemic has influenced their use of safety measures (86.5%, n = 951). The prevalence of mild-to-moderate, moderate-to severe, and extremely severe anxiety cases were 23.1%, 4.7%, and 0.54%, respectively. One-fourth of the responders reported self-medication, out of which 60% were found to be anxious. Nonsteroidal anti-inflammatory drugs were most commonly used. CONCLUSIONS: Rising to the present challenge will require integration across different sectors with the immediate aim of getting people safely through the pandemic. As the world focuses on containing and delaying the spread of the COVID-19, with burdened health-care systems, we should not miss out on people with anxiety disorders and self-medication problem, which may worsen with the pandemic.

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