Lithium carbonate in the treatment of manic depressive psychosis in children

The authors present their experience of prophylactic lithium therapy in seven children diagnosed as manic depressive psychosis, bipolar type, according to International Classification of Diseases, 9th revision. The authors demonstrate the effectiveness of lithium as a therapeutic and prophylactic agent for manic depressive illness in children. Side-effects are not a problem if serum lithium levels are maintained between 0.6-1.2 mEq/L. Renal functions have remained un-impaired even after three years of lithium therapy in four children.

The WHO collaborative study on strategies for extending mental health care, IV: A training approach to enhancing the availability of mental health manpower in a developing country

Part of the WHO collaborative study is the training of general health workers to provide mental health services. The authors describe the training program used in Raipur Rani, chandigarh, India, to train medical ancillaries (called peripheral health workers). Training methods used were based on evaluation of 1) Workers' existing knowledge of and attitudes toward mental health problems, 2) existing training materials, 3) the need for new training materials, and 4) the support and supervision workers needed to carry out their duties. Use of the workers has greatly increased the availability of mental health services.

The WHO collaborative study on strategies for extending mental health care, II: The development of new research methods

Teams in seven developing countries under sponsorship of the World Health Organization have been carrying out collaborative operational research on providing mental health care through primary health care services. New techniques of identifying mental disorders in children and adults have been developed and tested. Methods of assessing the skills and attitudes of health workers toward mental health work and of gauging community attitudes toward mental illness have also been developed. Results have been directly applied in planning better mental health care. The authors conclude that cross-cultural collaborative research is effective in improving mental health care for those in greatest need.

Knowledge and attitudes of primary health care personnel concerning mental health problems in developing countries

A semi-structured interview for assessing the knowledge and attitude of health workers concerning mental health problems was applied in seven developing country areas within the context of a World Health Organization coordinated collaborative study. The results indicate a lack of basic mental health training associated with a failure to recognize mental health problems, restricted knowledge concerning psychotropic drug therapy, and an inability to visualize practical forms of mental health care which could be introduced at primary care level. The results were used to design appropriate training programs, and the observations will be repeated to assess the effectiveness of training.

The burden of mental illness on the family. Results of observations in four developing countries. A report from the WHO Collaborative Study on Strategies for Extending Mental Health Care

As part of the WHO Collaborative Study on Strategies for Extending Mental Health Care 259 families in four developing countries (Colombia, India, Sudan and the Philippines) were screened with regard to the social burden caused by mental illness of one of its members. Levels of subsistence, previous illness, financial burden, personal relations and social acceptance were studied. The social burden was greatest in the urban areas.

Dermatolglyphic studies in schizophrenia : a review

Dermatoglyphic studies Carried out in Schizophrenia have been evaluated and critically examined. Methodological errors existing in the previous studies have been pointed out and some guidelines for methodological refinements suggested and a dermatoglyphic corsensus index for diagnosis has been evolved. The heterogeneous nature of schizophrenia, being a group of syndromes, has been unanimously accepted, therefore, each category should be studied separately. Further scope of this potentially fruitful area has been discussed.

A follow up study of hysteria

The present study undertook to examine the outcome of a group of cases who were diagnosed as hysteria, six or more years ago in a general hospital psychiatric unit and correlate various clinical factors with good or bad outcome. Of the 81 cases selected for the study, 57 (67%) could be located and followed up after a gap of 6-8 years. Majority of the cases (74%) had either no symptoms or symptoms less than before at the time of the follow up. In only 3 cases, there was evidence of an underlying organic illness which seemed to have been missed at the initial assessment. A new sub-classification of hysteria with glossary of terms used for this study is presented for future research work.

Childhood mental disorders in primary health care: results of observations in four developing countries. A report from the WHO collaborative Study on Strategies for Extending Mental Health Care

To ascertain the frequency of mental disorders in Sudan, Philippines, India, and Columbia, 925 children attending primary health care facilities were studied. Rates of between 12% and 29% were found in the four study areas. The range of mental disorders diagnosed was similar to the encountered in industrialized countries. The research procedure involved a two-stage screening in which a ten-item "reporting questionnaire" constituted the first stage. The study has shown that mental disorders are common among children attending primary health care facilities in four developing countries and that accompanying adults (usually the mothers) readily recognize and report common psychologic and behavioral symptoms when these are solicited by means of a simple set of questions. Despite this, the primary health workers themselves recognized only between 10% and 22% of the cases of mental disorder. The result have been used to design appropriate brief training courses in childhood mental disorders for primary health workers in the countries participating in the study.

A model for rural psychiatric services-raipur rani experience

During the last five years efforts have been directed to understand the needs of the mentally ill persons residing in the rural areas. An outcome of our work involving 60,000 people living in a geographically defined area in Ambala District of Haryana has resulted in a realistic model for wider application in the country. The project work has led to the development of a number of research instruments and data regarding the prevalence of mental illness in the rural areas. A method for identifying mentally ill and to study the community attitudes has also been developed. The preparation of the Manual and simple training programmes has been a significant contribution. Knowledge regarding the practical problems of supervision and support of peripheral health workers in carrying out mental health work has been gained. The formation of the Mental Health Association by the village leaders has enhanced the community awareness and involvement in the ongoing programme of care.It is hoped that the experiences and the results of the above research work would act as a stimulant for similar experiments and further refining of the needed expertise and data for making mental health care a reality at the primary health care in the near future.

Stability of serum lithium levels-usefulness and relevance in Indian conditions

Two groups of patients on regular lithium therapy were studied to find out the stability in values of serum lithium over a period of time. Serum samples of one group was stored at -4°C while that of other group at room temperature. These samples were subsequently analysed over a period of eight days and subjected to statistical analysis. It was seen that values on the first day did not differ significantly from values of subsequent days. Implications of this findings are discussed in Indian conditions as lithium estimation facilities are available only at a few centres.

Manic-depressive psychosis and schizophrenia: a dermatoglyphic study

The study analysed qualitative and quantitative dermatoglyphic features in schizophrenia and manic-depressive psychosis. Differences were found which support the view that these two psychoses are genetically distinct. A possible field for further study is discussed.

Mental disorders in primary health care: a study of their frequency and diagnosis in four developing countries

1624 patients who were attending primary health facilities in 4 developing countries were examined to determine how many were suffering from mental disorder. Using stringent criteria to establish the presence of psychiatric morbidity, 225 cases were found, indicating an overall frequency of 13.9%. The great majority of cases were suffering from neurotic illnesses and for most the presenting complaint was of a physical symptom, such as headache, abdominal pain, cough or weakness. The health workers following their normal procedure correctly detected one third of the psychiatric cases.