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A Monograph Series Devoted To The Understanding Of Medicine, Mental Health, Man, Mind, Music And Their Matrix
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   Table of Contents - Current issue
January-December 2016
Volume 14 | Issue 1
Page Nos. -

Online since Thursday, October 27, 2016

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Late Prof. P. C. Shastri: A Role Model and Teacher Par Excellence p. 1
KP Dave
DOI:10.4103/0973-1229.193072  PMID:28031620
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Preface: Positive Psychiatry, Neuroscience, End of Life, and Other Essays p. 3
Ajai R Singh
DOI:10.4103/0973-1229.193073  PMID:28031621
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Neuromodulation, Emotional Feelings and Affective Disorders Highly accessed article p. 5
Fushun Wang, Alfredo Pereira
DOI:10.4103/0973-1229.154533  PMID:28031622
Affective disorders such as anxiety, phobia and depression are a leading cause of disabilities worldwide. Monoamine neuromodulators are used to treat most of them, with variable degrees of efficacy. Here, we review and interpret experimental findings about the relation of neuromodulation and emotional feelings, in pursuit of two goals: (a) to improve the conceptualisation of affective/emotional states, and (b) to develop a descriptive model of basic emotional feelings related to the actions of neuromodulators. In this model, we hypothesize that specific neuromodulators are effective for basic emotions. The model can be helpful for mental health professionals to better understand the affective dynamics of persons and the actions of neuromodulators - and respective psychoactive drugs - on this dynamics.
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Neural Implications of Psychotherapy, Pharmacotherapy, and Combined Treatment in Major Depressive Disorder p. 30
Thomas L Schwartz, Daniel Santarsieri
DOI:10.4103/0973-1229.193079  PMID:28031623
Numerous clinical trials have been conducted to determine the utility of antidepressant treatment (ADT), psychotherapy, and combined psycho-pharmaco-psychotherapy (PPPT) in treating major depressive disorder (MDD). While all approaches have shown benefit over placebo to varying degrees, the parallel neurophysiological mechanisms that underlie their efficacy have received little attention. The authors will review and discuss a growing body of literature that relates the factors of treatment selection and response to the principles of neuromodulation, with emphasis regarding how neuroimaging and other experimental data reinforce the need for personalized MDD treatment. This manuscript and its theoretical approaches were supported by conducting relevant literature searches of MEDLINE and PubMed electronic databases, prioritizing systemic reviews, and randomized clinical trials using selected MeSH terms. The authors conclude that ADT, psychotherapy, and PPPT all create potentially observable neurofunctional changes and argue that additive and synergistic potentiation of these effects in PPPT may produce more sustained symptom relief than with monotherapy alone.
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Bioethical and Other Philosophical Considerations in Positive Psychiatry Highly accessed article p. 46
Ajai R Singh, Shakuntala A Singh
DOI:10.4103/0973-1229.193075  PMID:28031624
The paper begins by asserting the need for bioethical and related philosophical considerations in the emerging subspecialty Positive Psychiatry. Further discussion proceeds after offering operational definitions of the concepts fundamental to the field – Bioethics, Positive Psychology, Positive Psychiatry and Positive Mental Health - with their conceptual analysis to show their areas of connect and disconnect. It then studies the implications of positive and negative findings in the field, and presents the Positive Psychosocial Factors (PPSFs) like Resilience, Optimism, Personal Mastery, Wisdom, Religion/Spirituality, Social relationships and support, Engagement in pleasant events etc. It then evaluates them on the basis of the 4-principled bioethical model of Beneficence, Non-malfeasance, Autonomy and Justice (Beauchamp and Childress, 2009[5], 2013[6]), first offering a brief clarification of these principles and then their bioethical analysis based on the concepts of 'Common Morality', 'Specific Morality', 'Specification', 'Balancing' and 'Double Effects'. The paper then looks into the further development of the branch by studying the connectivity, synergy and possible antagonism of the various Positive Psychosocial Factors, and presents technical terms in place of common terms so that they carry least baggage. It also takes note of the salient points of caution and alarm that many incisive analysts have presented about further development in the related field of Positive Mental Health. Finally, the paper looks at where, and how, the field is headed, and why, if at all, it is proper it is headed there, based on Aristotle's concept of the four causes - Material, Efficient, Formal and Final. Suitable case vignettes are presented all through the write-up to clarify concepts.
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Field of Psychiatry: Current Trends and Future Directions: An Indian Perspective p. 108
Kishore P Dave
DOI:10.4103/0973-1229.193069  PMID:28031625
Attempting to predict future is dangerous. This is particularly true in medical science where change is a result of chance discoveries. Currently, practicing psychiatrists are aware of deficiencies in psychiatric practice. However, we have a number of genuine reasons for optimism and excitement. Genetics, novel treatment approaches, new investigative techniques, large-scale treatment trials, and research in general medicine and neurology will give better insights in psychiatric disorders and its management. Psychiatric services in rural India can be reached by telemedicine. There are some threat perceptions which require solving and remedying. Subspecialties in psychiatry are the need of the hour. There is also a requirement for common practice guidelines. Mental Health Care Bill, 2013, requires suitable amendments before it is passed in the Indian Parliament. Research in psychiatry is yet to be developed as adequate resources are not available.
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Task before Indian Psychiatry Today: Commentary p. 118
Avinash De Sousa
DOI:10.4103/0973-1229.193080  PMID:28031626
In this commentary on the article, “The Task Before Psychiatry Today Redux: STSPIR,” (Singh, 2014)[20], the author, while agreeing with most of the paper's findings, proposes a rather parallel judgment that intersects at the same paths ahead. There is a need for widespread and easily available essential mental health services in India. Health agenda must focus on spreading and scaling up psychiatric services. There is also a need to spread awareness of psychiatry and mental health and, as a psychiatrist, one must focus on making psychiatry available to a wider audience. Psychiatrists need to maintain a holistic view of psychiatric disorders while viewing them from both a neurobiological and psychosocial perspective. There is a need to revamp psychiatric training in departments with an increase in the thrust toward fostering translational research excellence in various spheres. Psychiatrists must continue to be trained in psychotherapy and practice it regularly. Psychiatric departments need to promote research excellence and focus on reducing brain drain. The practical applications of the tasks set out for psychiatry are more difficult than one can imagine, and a conscientious effort in that direction shall serve for its betterment. The future is bright and psychiatry must work toward making it brighter.
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Out of Flatland: The Role of the Notion of a Worldview in the Science of Well-being p. 133
Danilo Garcia, Patricia Rosenberg
DOI:10.4103/0973-1229.193082  PMID:28031627
This paper discusses the suggestion of the notion of a worldview as part of the Science of Well-Being. We present, at first, an allegoric comparison as to why the view of a ternary unity of being (i.e. a coherence of the three parts of the being, body, mind, and psyche to maximize well-being) is difficult to grasp. We also discuss that humans do have unique experiences and memories, but that we are also connected to both all living things and to our environment. Finally, we point to a ternary model of personality to increase our understanding of a person's well-being: Temperament, character, and identity.
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The Problem of Dualism in Modern Western Medicine p. 141
Mathew H Gendle
DOI:10.4103/0973-1229.193074  PMID:28031628
Dualism is historically important in that it allowed the medical practice to be divorced from church oversight. The reductionist approaches of modern Western medicine facilitate a dispassionate and mechanistic approach to patient care, and dualist views promoted by complementary and alternative medicine are also problematic. Behavioural disorders are multifactorally realizable and emerge apparently chaotically from interactions between internal physiological systems and the patient's environment and experiential history. Conceptualizations of behavioural disorders that are based on dualism deny the primacy of individual physiology in the generation of pathology and distract from therapies that are most likely to produce positive outcomes. Behavioural health professionals should adopt holistic models of patient care, but these models must be based on methodologies that emphasize radical emergence over the artificial separation of the “physical” and “mental.” This will allow for the humanistic practice of medicine while simultaneously maximizing the likelihood of treatment success.
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End-of-Life Care and Psychiatry: Current Trends and Future Directions in India p. 152
Jayita K Deodhar
DOI:10.4103/0973-1229.193077  PMID:28031629
Although 80% of the deaths worldwide occur in middle- and low-income countries such as India, there is less awareness of end-of-life care (EOLC) for people with chronic, serious, progressive, or advanced life-limiting illnesses, including dementia. EOLC involves good communication, clinical decision-making, liaison with medical teams and families, comprehensive assessment of and specialized interventions for physical, psychological, spiritual, and social needs of patients and their caregivers. The psychiatrist can play a significant role in each of the above domains in EOLC. The current trends in India are examined, including ambiguities between EOLC and euthanasia. Future directions include formulating a national EOLC policy, providing appropriate services and training. The psychiatrist should get involved in this process, with major responsibilities in providing good quality EOLC for patients with both life-limiting physical illnesses and severe mental disorders, supporting their caregivers, and ensuring dignity in death.
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Lessons of Being a Patient--Personal Thoughts about Psycho-oncology in India p. 171
Rangaswamy Srinivasa Murthy
DOI:10.4103/0973-1229.154532  PMID:28031630
Psycho-oncology is a well-established field in the developed countries and 'distress' is recognised as the sixth vital sign in the care of persons diagnosed with cancer. However, centres in India caring for cancer do not make psycho-social aspects an essential part of their care programmes. The present narrative presents the personal journey of the author, reviews the situation of psycho-oncology in India and presents a three-part agenda for action.
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In Search of Rationality in Human Longevity and Immortality p. 187
Gopal C Bhar
DOI:10.4103/0973-1229.193083  PMID:28031631
The human body is machine-like, but self-moving, self-regulating, and self-adjusting, governed by willpower and intelligence. Aging of the body is basically a maintenance problem and so it could perhaps be postponed by thorough and frequent maintenance. Aging brings on a cascade of ills and health problems leading to deterioration of physical, mental, emotional, and social dimensions of life. This paper deals with solution of the problem philosophically in the light of Indian scriptures without entering into traditional bioethical issues. With a meaningful reason for existence, life can be extended. Examining the scientific perspectives on aging, some common manipulations for its extension are discussed. These are calorie restriction, vitamin and antioxidant treatment, exercise and hormonal interventions, etc. Finally, the question of longevity is explored through pursuance of eternal value-based activity and spirituality in the tradition of Indian heritage.
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The Future of the Mind (The Scientific Quest to Understand, Enhance, and Empower the Mind) p. 214
Avinash Desousa
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Why Me? p. 221
Hitesh Sheth
DOI:10.4103/0973-1229.193076  PMID:28031632
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Happy New Year p. 223
Ajai R Singh
DOI:10.4103/0973-1229.193071  PMID:28031633
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Split Personality p. 225
Ganesh Singh Dharmshaktu
DOI:10.4103/0973-1229.193078  PMID:28031634
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My Trysts and Travails p. 227
PV Santosh Rai, Acharya Vishak
DOI:10.4103/0973-1229.193068  PMID:28031635
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What Music Means To Me p. 229
Ajai R Singh
DOI:10.4103/0973-1229.193070  PMID:28031636
The author talks about two defining influences in his musical career: his father, whom he addressed as 'Pitaji' and his guru, Shri Vinayak Kunte, fondly known as Kunte-guruji to his students. Pitaji taught him, by example and precept, what emotive singing meant and the nuances of poetry appreciation and Urdu pronunciation (talaffuz). Kunte-guruji acquainted him with the richness and profundity of Hindustani Classical Music and the perfection of musical notes or “sur”. He also showed, by example, the need to lead a simple, uncomplicated lifestyle to experience the divinity inherent in music. Finally, the author also learned from Kunte-guruji the need to pass on one's learning to others and go out of one's way to do so.
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Total Reference List MSM 2016 p. 240
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Instructions to Contributors p. 261
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Template for MSM Submissions p. 267
Ajai R Singh
DOI:10.4103/0973-1229.193107  PMID:28031638
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