ABSTRACT Parenting is both an art and science of nurturing a child that comes very naturally to some. In today’s world, the fundamentals of parenting are getting challenged but it has been even more magnified during the coronavirus 2019 (COVID-19) pandemic. The mental health of children is bound to be affected by the stress related to COVID-19 owing to loss of usual routine, unpredictability, uncertainty. Various other social, economic, and environmental factors also threaten their mental well-being. Parents are the child’s first and longest-lasting context for development. Positive parenting that involves sensitivity, responsivity, caring, communicating, and empowering would ensure positive developmental outcomes in children and adolescents. Positive parenting and self-care of parents would serve as a promotive and preventative intervention for child and adolescent mental health, especially during this crisis. ________________________________________________________________________________________ Keywords: COVID- 19; parenting; pandemic
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Abstract Introduction: Training, practice and continuing professional development in neuropsychiatry and clinical neuroscience vary across different countries. However, little is known about the opinions of the Nepalese psychiatrists about the provision of neuropsychiatry training. This study evaluates the current training in neuropsychiatry and clinical neurosciences during the postgraduate psychiatry training and reflect on current practice. Material And Method: The participants were psychiatrists (qualified and psychiatry residents). An online questionnaire using Survey Monkey electronic Platform was emailed with a uniform resource locator (URL). Results: Sixty-four out of ninety-five participants responded with response rate of 65.3%. Two-third of the respondents were qualified psychiatrists. The duration of neurology rotation ranged from 1 to 3 months and it was reported to be mandatory. Two-thirds reported that there is no clinical neuropsychiatry training during psychiatry residency. On a ten-point Likert scale (with 10 being the highest possible score), the participants rated their neuropsychiatry training as 5.16±1.84 while they rated the necessity for further training in neuropsychiatry as 7.92±1.96. Two-thirds identified a lack of interest by the specialty society as an obstacle for the implementation of neuropsychiatry training for psychiatrists. More than half viewed that neuropsychiatry training to be incorporated into the existing psychiatry training scheme whereas three-fifths favoured a one-year specific training program in neuropsychiatry after completion of psychiatry training. Conclusion: The current psychiatry training is inadequate to meet substantial neuropsychiatry training opportunities for a high proportion of psychiatrists in Nepal. This finding may be used to improve and standardize neuropsychiatry training in postgraduate psychiatry training
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Abstract Masturbatory behaviors occur as a part of psychosexual development in young children, but if such behaviors exceed resulting in discomfort and disability, it is known as gratification disorder. Children with such genital self-stimulatory behaviors are infrequently seen and diagnosed in Asian outpatient settings, possibly due to prevalent stigma. We report the cases of 3 children of 3, 4, and 8 - year-old with the diagnosis of gratification disorder based on comprehensive history-taking, general physical examination, and neurological examination along with videotape recording of the event. Investigations such as electroencephalogram (EEG), urinary microscopic examination, and culture were also conducted in each case. Clinical history, examination, and investigations such as EEG and urinary examination were reviewed. Behavior therapy and psychoeducation were successful in alleviating the disorder and allaying parental fears of taboo in all these cases. There was significant improvement in self-genital stimulatory behavior in all 3 cases at 3 months follow-up. Keywords Behavior therapy, gratification disorder, masturbatory behaviors, self-genital stimulatory behavior ©Clinical Pearls
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In recent years, children are immersed in both traditional and new forms of digital media around the globe. Screen time is now embedded in the daily lives of young children beginning from infancy. Pre-schoolers exposed to screen and interactive media may benefit in many ways but excessive and inappropriate screen exposure could potentially lead to several health and developmental risks. Excess screen time in early childhood has found to negatively impact cognitive, language, literacy and socio-emotional development. Despite challenges of screen media parenting practices and those posed by lockdown (work from home, online schooling) during COVID-19 pandemic, parents hold the key to navigate these challenges by serving as role models to ensure positive developmental outcomes in their children.
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In Nepal, three years post-graduate psychiatry training started in 1997. There has been significant growth in psychiatry training opportunities over the past two decades and currently available in 16 institutes. There are five different post-graduate training programs, and the training curriculum and evaluation process is not uniform. Hence, there are some variations in available training opportunities. There are about 45 residents (trainees) currently training in psychiatry. The term ‘early career psychiatrists’ (ECPs) includes trainees in psychiatry and psychiatrists within seven years of graduation.1
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Nepal is a low and medium-income country (LMIC), situated in South-east Asia, with a population of 29 million, of which, 40–50% are children and adolescents. The Coronavirus Disease 2019 (COVID-19) pandemic has affected the lives of people around the world, including Nepal. The child and adolescent mental health (CAMH) needs and services in Nepal have a significant gap. CAMH in Nepal suffers from lack of specialized training in this field as well as scarcity of human resources and services. There is only one full-time child and adolescent psychiatry (CAP) out-patient clinic in the country. Some recent activities have focused on CAMH in Nepal but the COVID-19 pandemic has produced new challenges. Access to mental health services for children and adolescents (C&A) across Nepal has been adversely affected. Factors such as closure of schools, confinement at home, lockdown, transportation problems, uncertainty, loss of usual routine and fear of infection have affected the mental health of C&A. This has highlighted a need to build capacity of available local human resources, enhance community support, teach measures of coping with stress and improve CAMH service delivery by strengthening the referral system, but these have to be addressed overcoming problems of travel restrictions and limited resources.
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