Study of marital adjustment, mechanisms of coping and psychopathology in couples seeking divorce in India

Clinicians' Perspectives on Self-Harm in Pakistan: A Qualitative Study

Background: Suicide is a serious public health problem, ranked amongst the leading causes of death worldwide. There are no official data on self-harm and suicide in Pakistan; both are illegal acts, and are socially and religiously condemned. This study explored the views of clinicians, including general practitioners (GPs) and hospital physicians (HPs) on self-harm, about their management of people who self-harm and what interventions might be appropriate in Pakistan. Methods: This qualitative study, generating data using semi-structured interviews, was nested within a Randomized Controlled Trial (RCT) of a psychosocial intervention for people following self-harm. Clinicians (n = 18) with experience of treating people who self-harm were recruited from public hospitals and general practices. Results: Face-to-face interviews were conducted in Urdu and digitally recorded with consent, transcribed and translated into English. Transcripts were checked for cultural and interpretive interpretations by the research team, then analyzed thematically using the principles of constant comparison. The following themes will be presented: encountering people with self-harming behaviors; challenges encountered in managing people who self-harm; barriers to accessing care, and what ideal care might look like. Participants identified their lack of training and expertise in the management of people with self-harm behavior. Conclusions: This is the first study to explore clinicians' perspectives on self-harm in Pakistan. The study highlighted the need for training for doctors in the identification and management of mental health problems, including the management of people who self-harm.

Remarriage in India: Online Presentation Strategies of Men and Women on an Indian Remarriage Website

Traditionally, attitudes towards remarriage in India have been characterised by scepticism and suspicion, especially in the case of women. Online remarriage sites promised to open up new possibilities for Indians seeking remarriage. A study of self-presentation strategies adopted by men and women in their online profiles posted on a popular remarriage site shows that while the new technology may have made it easier for divorced and widowed individuals to search for partners, profiles presented emphasise caste and community affiliations, and reinforce gendered roles and expectations. Those seeking remarriage, especially women, engaged in substantial efforts to allay fears and concerns associated with divorce and remarriage in India by adhering to normative standards characteristic of a deeply patriarchal society. While many profiles of men highlighted a sense of male entitlement and privilege, an account of the circumstances of divorce was missing from the profiles of both men and women even as the Indian family as a site of harmony and respectability was emphasised by both. Furthermore, while men made consumerist promises in their statements, women used their online profiles to express their consumerist dreams, simultaneously adhering to gendered expectations. Finally, both men and women engaged in selective self-presentation emphasising socially desirable traits such as a light skin tone or a desirable body type in a neoliberal context marked by consumerist modernity.

Psychopathology and coping mechanisms in parents of children with intellectual disability

BACKGROUND

Raising a child with intellectual disability (ID) can add to parenting stress significantly. This stress can manifest into psychopathologies such as anxiety and depression. The aims of the study were to assess psychopathology and coping mechanisms in parents of children with ID.

MATERIALS AND METHODS

A total of 100 consecutive consenting parents of children with ID were interviewed from child psychiatry outpatient department of a municipal-run tertiary care teaching hospital. A semi-structured pro forma, symptom checklist 90 revised (SCL90R) and Mechanism of Coping Scale (MOCS) were used for assessment.

RESULTS

Mean age for the parents was 37.02 (±7.35) years, and for the children, it was 8.29 (±3.11) years. There were 60 mothers and 61 parents of a male child among sample. Eighty-five of parents considered their child's ID to be a major concern in their life. Depression had highest mean among psychopathologies. Mothers had higher score for depression and Interpersonal-sensitivity. Parental psychopathology did not differ significantly with severity of ID of child. Global severity index of SCL90R correlated negatively with age of parents (P = 0.015) and positively with fatalism (P = 0.004), expressive-action (P < 0.000) and passivity (P = 0.001) coping mechanisms.

CONCLUSION

Depression is the most common psychopathology especially among mothers of child with ID. Psychopathology is independent of severity of ID and worsens with coping mechanisms like fatalism, expressive-action, and escape-avoidance. A child with ID should be seen and treated as a family unit giving enough attention to parent's psychological needs as well.

A comparative study of quality of life and marital satisfaction in patients with depression and their spouses

Spouses of patients suffering from depression experience various forms of burden. Present study assesses and compares the marital satisfaction and quality of life (QOL) of the patients and their spouses. Further it assesses these variables in terms of illness severity, duration of untreated illness (DUI) and other demographic parameters especially gender. In this cross sectional study, 50 patients diagnosed with Depressive Disorder along with their spouses were recruited. Both groups were assessed separately for marital satisfaction and QOL along with demographic details followed by appropriate statistical analysis. A high level of marital distress found amongst both patients and their spouses whereas only patients reported poor QOL. Increasing DUI worsens both marital satisfaction and QOL in spouses with no effects on patients. Illness severity worsens QOL in both groups with no effect on marital satisfaction. Gender was not found to have any impact on either of the groups. Small sample size and cross sectional study design were main limitations. Early and faster intervention will be helpful in patient's prognosis, and also the perception and QOL of spouses. A better treatment response may be expected if focus is at improvement in QOL rather than only symptom control. Further work will be needed with a larger population and in a longitudinal study design. Future research also needs to focus upon establishment of better norms for the DUI for depressive disorder.