India stands second in the world with approximately 500 million Internet users. Fast technological improvements have increased the accessibility and uses of internet in all age group tremendously since past decade arising threats that many individuals especially adolescents, will be affected by internet addiction. Purpose of this paper is to present comprehensive overview of the current literature on Internet addiction. Though internet addiction is not officially recognized as a distinct behavioral disorder yet but in context of rapidly growing internet use, the internet addiction (IA) is been recognized as a global concern. It seems necessary to have some effective measures for prevention and management of internet addiction. Multi-model treatment of internet addiction looks promising but focus should also be on prevention. People should be made aware about the negative consequences of irresponsible internet use. Achieving a balance between provision of adequate internet facilities and protection of public from hazards of Internet use poses a challenge for policymakers. Mental health professionals should be aware about IA and work towards implementation of preventive, diagnostic and treatment strategies. World Mental Health Day 2018 will focus on “young people and mental health in a changing world” with an emphasis on the needs of this population on which our future depends. Young people are spending most of their time in online activities including pornography, gambling, online video games, excessive chatting, cyber bullying and cyber crimes etc. India has the youngest population in the world but it’s our responsibility to inculcate the right habits among next generation so we don’t lose the power of our young just in surfing online and they are available in real world instead of a virtual one only.

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Attention-deficit hyperactivity disorder (ADHD) is one of the popular neurological developmental disorders among children, adolescents, and even in adults. It is manifested by difficulty in attention, hyperactivity, and impulsiveness. ADHD and impulsivity can hinder in the school life, attaining goals, different abilities, and competitions of the student. There is ample literature reporting the prevalence of ADHD in the most part of the world. However, the prevalence of ADHD is not clearly understood in India. Many studies have been conducted in India to estimate the prevalence of ADHD in different parts of the country, but no attempt has yet been done to draw a conclusion on the pooled prevalence of ADHD in India. The goal of this study is to review all the available observational studies on the estimation of prevalence of ADHD among children and adolescents from different parts of the country to calculate the pooled prevalence of ADHD in India (among children and adolescents). The search also was limited to studies conducted from 2009 to 2019. All the epidemiological survey related to ADHD prevalence was included in the study after considering the inclusion criteria. Articles were reviewed using Preferred Reporting Items for Systematic Reviews and Meta-Analysis. Each individual study was assessed for risk bias using the “Quality assessment checklist for prevalence studies” extracted from Hoy et al. Pooled Prevalence estimates was calculated with random effect model. The point prevalence of ADHD among children and adolescents in the included studies ranges from 1.30% to 28.9%. The pooled prevalence of ADHD among children and adolescents is 7.1% (95% confidence interval [CI]: 5.1%–9.8%). The summarized prevalence of ADHD is 9.40% (95% CI 6.50%–13.30%; I² = 96.07% P < 0.001) among male children and 5.20% (95% CI 3.40%–7.70%; I² = 94.17% P < 0.001) among female children with a range of 7.6%–15% in 8–15 years of children. The prevalence of ADHD among children in India is consistent with the worldwide prevalence. According to the ADHD Institute, Japan the world prevalence of ADHD ranges from 0.1% to 8.1%. This explains that ADHD affects quite a large number of children in India. As India is known for stigma related to mental disorders understanding the prevalence of ADHD in Indian Population helps to gain an insight into morbidity burden of the country and helps the parents and teachers to take care of the persons suffering from ADHD.

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Adolescence is a time in which adolescents give way to intense emotional relationships and find self concept and build self esteem. Literature reports that 55%-63% of adolescents are at low level of emotional intelligence which results in low self esteem. The present survey was conducted to assess the relationship between emotional intelligence and self esteem among 200 randomly selected (lottery method) students from six conveniently selected schools of dist. Faridkot, Punjab by using the emotional intelligence scale (EIS), Rosernberg self- esteem rating scale and socio demographic data sheet. Emotional intelligence scores were compared with self esteem scores. The Pearson's product moment correlation, t-test and ANOVA were used for statistical analysis. The results showed that emotional intelligence and self esteem had significant positive correlation at the level of 0.01. Study concluded that emotionally intelligent adolescents have high self esteem. Adolescents should be early identified early for emotionally immaturity and can be managed with help of school health nurse in school setting by providing different strategies for emotional intelligence and thus enhancing the self esteem.

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Background: Family is the only institution which provides security and support without any rewards in return. The family environment influences adolescence psychological adjustment and problem-solving strategies as well as self-confidence and abilities to set clear goals. The healthy functioning of these interaction patterns enhances the mental well-being of an individual. Aim: This study is aimed to assess the impact of family environment on the mental well-being of adolescent girls in selected villages of Western Punjab, India. Materials and Methods: Quantitative, descriptive, cross-sectional survey approach was used to assess the family environment and mental well-being of conveniently selected 900 adolescent girls (age of 11–19 years) in selected villages of Punjab using sociodemographic data sheet, Family Environment Scale and Warwick Edinburgh mental well-being scale. Results: Approximately two-third (36.7%) of the adolescent's girls have below-average mental well-being, whereas the majority (62.2%) of adolescent girls have average, and only 1.1% have above-average mental well-being. Mental well-being was positively correlated with cohesion, acceptance, and caring at P < 0.01 level, and expressiveness, independence, active recreational orientation, and organization were positively correlated at P < 0.05 level. Conflict and control were not significantly correlated with mental well-being. Conclusion: It can be concluded that there was a significant positive relationship between various domains of family environment with mental well-being among adolescent girls. Mental health professionals and community health nurses should take the early initiative to identify any malfunction in families to avoid possible deterioration in mental well-being and psychological problems among adolescent girls.

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Background: Assertiveness is one of the essential skills in the modern working environment, there are many benefits of being assertive such as; better time management, increased self-esteem and the ability to negotiate more effectively. Nurses are confronted with the daily responsibility of assessing, intervening and evaluating client responses to stress and client interactions. Some nurses may have learned to express their needs honestly, to use anger constructively, to improve personal and work relationships and to build self-confidence through assertive behaviour. So the aim of this study was to assess the effect of assertiveness training program on nurses’ self-esteem. Methods: The study was conducted at selected Hospitals of the Pune city on 60 nurses (30 in control groups and 30 in experimental groups), tools were used for data collection, namely: Socio-demographic data structured interview schedules, self-esteem inventory, assertive communication skills checklist (ACs-list). Results: Highly statistically significant difference was noticed between before and after training program regarding practice about communication skills and assertiveness. Also s a significant change was found in self-esteem of nurses after the training program. Conclusion: Implementation of assertiveness training program had positive effect on their self-esteem.There is need to implementassertiveness training program for nurse.

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Children and adolescents lack adequate skills to recognize and cope with the feelings of anger, which is often displayed in the school setting in the form of disruptive behaviors. Training adolescents with anger management skills reduces the negative outcomes related to anger issues. The objective of review is to provide comprehensive overview of anger management interventions for adolescents. Search was done using electronic databases such as Cochrane Library, OVID Medline, PubMed, CINAHL, EBSCOhost Springer, Wiley Online Library, ProQuest, ScienceDirect, and PsycINFO. Total 212 studies were found on anger management; twelve studies (five meta-analysis, one randomized controlled trial, one mixed methods, and five experimental) fulfilled the inclusion criteria of the study and these studies were included in the systematic review. Majority of the studies used cognitive behavioural therapy (CBT) as predominant therapeutic strategy for anger management for adolescents. Only few studies included rational emotive behavior therapy, social skill training, and education on anger. CBT with problem-solving skill training, communication skill training, and self-instruction was found to be effective in reducing anger problems in adolescents.

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Introduction: Old age is the closing period in the life span, and it is characterized by certain physical and psychological changes in human being, including anxiety and depression. These changes often determine personal and social adjustments of the elderly. Aim: This study aimed to assess the effectiveness of progressive muscle relaxation therapy on anxiety and depression among elderly people residing in selected old age homes of Rajasthan. Materials and Methods: Pre-experimental research approach with one group pretest–posttest design was used to conduct the study. Nonprobability convenience sampling technique was adopted to select 50 elderly of selected old age homes of Rajasthan. Hamilton Anxiety Rating Scale and the Geriatric Depression Scale were used to assess anxiety and depression, respectively. Progressive muscle relaxation technique (PMRT) was implemented and continued once a day for 10 days for 20–30 min. Results: The study found that 28.0% elderly had moderate anxiety and 100% had depressive symptoms at baseline. After PMRT, anxiety and depression reduced significantly at P < 0.05.Conclusions: The study concluded that progressive muscle relaxation is effective in reducing level of anxiety and depression among the elderly but need to conduct same study on large sample. Elderly should be taught about progressive muscle relaxation so that they can use to reduce their anxiety and depression.

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Background: Mobile phones have become an important part of everyone's lives. In recent times, there seems to have been a transformation of the mobile phone from a status symbol to a necessity because of the countless advantages it provides. Excessive and addicting use of mobile phone, especially smart phone results in physical and psychological symptoms such as loneliness, interpersonal anxiety, poor self-control, and low self-esteem. Aim: The aim of the study was to assess the prevalence of nomophobia among smart phone using collegegoing undergraduate and post graduate students. Methodology: Quantitative, exploratory research approach with cross-sectional survey design was used to assess the degree of nomophobia in 300 conveniently selected college students of Faridkot, Punjab using sociodemographic datasheet and Nomophobia Questionnaire. Results: This study found that 99.7% of the collegegoing students had nomophobia. One-third (32.7%) of the college students had severe level, 59.9% had moderate level, and 7.1% of the individuals had mild level of nomophobia. Conclusion: It is concluded that 99.7% of the participants were suffering from nomophobia. People with excessive smartphone use are at high risk of developing nomophobia. Further, more attention should be given for the early detection and intervention for treat nomophobia.

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Background: Psychoactive substance abuse in India continues to be a substantive problem for the individual as well as for the society. However, its consumption trends are liable to change from time to time which seems challenging to traditional treatment interventions. It has negative impact on physical and mental health, interpersonal relationship, financial status and occupation of substance users and their family.Aim: The aim of the study is to assess the recent trends of drug abuse by drug users in Punjab. Methods: Quantitative, descriptive research approach with cross-sectional survey design was used to assess the pattern of drug abuse in 200 conveniently selected drug users visiting tertiary care level hospital of Punjab by using socio-demographic sheet and pattern of substance use sheet. Results: Majority (54.5%) of drug users were using opioids. Mean age of initiation of all drug use was 20 years. More than half (62.5%) of subjects were indulged in drug use due to suggestion of friends. Heroin was reported most expensive drug by users. Majority (86.5%) of subjects were using drugs at agricultural fields, river banks, old buildings and lonely places etc. Maximum (42.5%) of subjects were admitted to de-addiction ward due to financial problems. Conclusion: Study concluded that pattern of drug use changed from natural to synthetic/medical substances. Appropriate interventional strategies need to be used to address with changed drug use pattern during the care of patients.

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In India, National Mental Health Programme (NMHP) was started in 1982 with the primary objectives of ensuring availability and accessibility of minimum mental healthcare for all. In 1985, National Institute of Mental Health and Neuro Sciences, Bengaluru, had developed Bellary model of District Mental Health Programme (DMHP), to achieve the objectives of National Mental Health Programme (NHMP). The current DMHP has more scope for the nurses to deliver mental health services as psychiatric nurse and community nurse. Hardly, one-third of districts in India are covered under DMHP and the service utilization is also to be strengthened. Psychiatric nurses have greater scope to transform all these existing challenges into opportunities.

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Higher secondary school stage is a stage of human development of the students that occurs between childhood and adulthood. Some sensitive factors like physical, mental, family, school, relationship and social factors influence on the students while learning. All people have minimum stress but excessive stress may cause anxiety and it’s harmful for health. A co relational Study on Academic Stress and Self-Esteem among Higher Secondary Students in selected Schools of Guwahati City, Assam, India was conducted. Descriptive Co relational research design was used for the study and it was conducted on 250 students selected by using ‘multi-stage random sampling technique’ from five randomly selected Government Higher Secondary Schools of Guwahati city, Assam. Data were collected by using ‘Educational Stress Scale for Adolescents’ (ESSA) and ‘Rosenberg Self-Esteem Scale’. Results: Findings of the study revealed that out of 250 students, 169 students (67.6%) had moderate level of stress, 41 students (16.4%) had low level of stress and 40 students (16.0%) had high level of stress. Also that 177 students (70.8%) had moderate level of self-esteem, 37 students (14.8%) had low level of self-esteem and 36 students (14.4%) had high level of self-esteem. It was found that the level of academic stress and the level of self-esteem were negatively correlated with one another with r = -0.165 (P=0.004, <0.05) at .05 level of significance. Conclusion: Therefore, appropriate strategies for ‘stress management’ are highly recommended.

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Introduction: The period of transition from school to medical education is critical and students faced many challenges and have a stressful life. Coping and resilience level of a student determine psychological well-being for higher professional competence and learning. The study aims to determine impacts of coping, and resilience on psychological well-being among medical students. Materials and Methods: A cross-sectional descriptive survey was conducted by randomly enrolling 151 MBBS students at All India Institute of Medical Sciences, Rishikesh, Uttarakhand. The information on personal and professional domains, coping, resilience and psychological well-being was sought by using sociodemographic profile sheet, resiliency scale for adult, BREF-COPE (Coping Orientation to Problems Experienced), and Ryff's psychological well-being scale. Appropriate descriptive and inferential statistics was applied to formulate results. Results: Resilience did not show significant relationship with psychological well-being in medical students. However, it was found that high level of resilience enables to predict more autonomy (P < 0.05), personal growth (P < 0.05), help in findings meaning in life (P < 0.05) and develop strong structural aspects (P < 0.05) in physical structure. Further, higher resilience enables to more use of self-distraction (P < 0.05). Likewise, it was also evident that better level of psychological well-being enables students to use more active coping (P < 0.05), positive reframing (P < 0.05), and acceptance coping strategies (P < 0.05). Conclusion: Higher level of resilience will help the medical graduates to buffer day to day stressors and enalbles to use more positive coping strategies. Discussion and Recommendation: Improvement in social and personal life of the health sciences students should be kept in mind along with clinical competency. Development of resilience to tolerate day to day life hassles is a healthy practice to have a positive augmentation of psychological well-being. The study recommended to implicit educational training centered on resilience and positive coping strategies in future.

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The Mental Healthcare Act (MHCA) 2017 has come up with some major changes in the mental healthcare by introducing the concept of advance directives and nominated representatives and aims at strengthening the human rights of person with mental illness (PMI) and clearly emphasized the responsibility of the government. The objective of this article is to give a brief overview of the MHCA-2017 and specify the role of mental health nurses in enabling PMI and protects their rights, as they are also included in the mental health professionals.

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In India, the prevalence of mental disorders is in increasing over the year, at the same time the mental healthcare professionals shortage also in the rising trend. Smart technologies such as Artificial Intelligence (AI) play an important role in filling this Mental Health delivery gap. In this paper let us know about how the chatbot is one such technology used in mental healthcare delivery. Interestingly, chatbots are initially used mainly to deliver the mental health services such as psychotherapy, later is used in other industries also. The reviews show that Chatbots are widely used to manage anxiety, depression, stress and also to provide psychoeducation. However, it has its own limitation such as, it cannot think like a human with wisdom and empathy; and also the confidentiality of the data is very much serious concern. At the same time, these Chatbots will become an integral part of our lives in the coming years. And we need Chatbots that match our culture. In order, to benefit from this technological advancement, we should have a regulatory and assessment process in place.

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Background: Technology that years ago we could only dream of or read in science fiction novels, which we then actually created with much hope in their power of connecting people, has become a tool of gratification. To many, smart phone is an eye opener, their first alarm clock, newspaper, and stress buster. The scariest part about smart phone addiction is that it can affect our physical and mental health, our relationships, and productivity. Considering the growing use of smart phone by the youth and its impact on sleep, this study was undertaken to assess the relationship between Smart phone screen time and sleep quality. Materials and Methods: A quantitative approach with cross-sectional design was adopted for the study. An application named “Quality time” was used to assess the screen time among samples. Pittsburgh sleep quality index was used to appraise the duration of sleep. Results: The study establishes that there was a significant negative correlation between smart phone screen time and sleep duration (ρ = −0.61 P < 0.001) Conclusion: Availability of diverse sort of electronic media engages the students more on screen, which adversely affects their sleeping quality and pattern. Although the development of technology is a boon, findings of the study depict that greater the screen time, poorer the quality of the sleep.

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Background: The incidence of dyslexia in Indian primary schoolchildren has been reported to be 2%–18%, dysgraphia 14%, and dyscalculia 5.5%. India is thought to have approximately 90 million people with varying degrees of learning disabilities (LDs) and an average class in school has about five students with LDs. A recent news article in Times of India states that dyslexia is the most common LD with nearly 35 million children suffering from it. Aim: The aim of the study was to assess the prevalence of selected LDs among primary school children through primary school teachers. Methodology: Quantitative, exploratory research approach with survey design was used to assess the prevalence of selected LDs among primary schoolchildren through 100 primary school teachers as samples in selected primary schools students of Delhi using sociodemographic datasheet and structured questionnaire tool. Results: Evaluation of the questionnaire from 100 teachers identified that 784 (26%) students were at risk of developing LDs among 2934 children. The study shows that out of 784 primary schoolchildren identified at risk, 54.9% were identified having dyslexia, while 23.9% were identified having dysgraphia, and 21.1% were identified having dyscalculia. Conclusion: It is concluded that 26% of the primary school students are at risk of developing selected LDs. Teachers whose class students were found to be at risk of developing LDs were asked to see further medical help.

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Background: Nurses have been called upon to lead and to be a partner in the transformation of healthcare Industry. Nurses and nurse managers must be empowered to perform their leadership roles to facilitate positive patient outcomes. Empowerment is possible when employees have access to information, support, resources, and the chance to discover and development. Aims and Objective: The aim was to investigate structural empowerment in nursing staff and to identify training needs to provide continuing education through workshop or conference. The objective of this study was to assess the level of empowerment of nurses working in hospital industry. Materials and Methods: A descriptive research design was adapted for the present study. A self-administrated questionnaire was distributed to the respondents on the basis of convenient sampling. Quantitative data were entered using SPSS version 17, and it was analyzed using descriptive statistics. Results: Majority of the respondents expressed that they empowered moderately. Conclusion: Empowerment of the nursing staff is very essential, and nursing administration must understand the importance of empowerment so that nursing professional can lead the hospitals effectively and facilitate the delivery of safe, high-quality patient care in hospitals.

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Mental health literacy can be defined as knowledge and beliefs about mental disorders which aid their recognition, management or prevention. Young generation and college going students have unique perceptions about mental illness in every section of the society. They are the future adults of this society and windows of modern India, so their opinions are important indicators of mental health literacy. Aim of the study was to assess the mental health literacy among students of university of Delhi. The study was conducted using a descriptive, exploratory, cross sectional survey design on 100 (50 males and 50 females) postgraduate students from the University of Delhi, India. A semi-structured interview, with a standardized tool, Mental Health Literacy (MHL) questionnaire was used to assess the knowledge, awareness, and attitudes of students towards patients with mental disorders like depression and psychosis. Results shows Most of the subjects had well awareness about identification of the patients with mental disorder, whereas as more than half of the subjects had exact awareness to identify depression. Most of the subjects had adequate knowledge and identified poor outcome and prognosis for patients with psychosis as compared to depression if not treated. Stigmatization of subjects towards patient with depression and psychosis was present and was higher for psychosis. Most of the subjects rated psychiatrist and immediate community members as the most reliable help for the patients with depression and psychosis. Conclusions drawn from the study were, overall mental health literacy of the university students in Delhi was found to be adequate, but not satisfactory in the area of risk factors and stigmatization.

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Psychoeducation is a specific form of education. It is aimed at helping persons with a mental illness or anyone with an interest in mental illness, to access the facts about a broad range of mental illnesses in a clear and concise manner.^[1] Teaching patients and families with a view to improving treatment compliance is a major goal in psychiatric nursing ^[2] and client adherence to treatment regimen increases when health education is an integral part of the client’s care ^[3]. The aim of this review was to determine whether the importance and advantages of psychoeducation is and whether it is supported by evidence of effectiveness from rigorous clinical trial researches. Database literature searches were performed in a pre-defined manner. Thirteen RCTs were located, that investigated about psychoeducation and mental disorders. The evidence are supportive of benefits of psychoeducation in combination with usual treatment except only in very few trials suffering from significant methodological flaws. There is evidence to suggest that benefit of psychoeducation is significant for patient suffering from major mental disorder such as schizophrenia and mood disorder and short term psychoeducation is beneficial in personality disorder.

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Background: Alcoholism, also known as alcohol use disorder (AUD), is a broad term for any drinking of alcohol that results in mental or physical health problems. In addition to the direct pharmacological effects of alcohol on brain function, psychosocial stressors that commonly occur in heavy-drinking alcoholic patients (e.g., legal, financial, or interpersonal problems) may indirectly contribute to on-going alcohol-related symptoms, such as sadness, despair, and anxiety; the association of alcohol consumption and associated anxiety or depression need to be studied. The objectives of the study were to assess the (1) level of anxiety among the AUD patients and (2) level of depression among the AUD patients. Methodology: A descriptive study to assess the level of anxiety and depression among AUD patients in a tertiary care hospital of Western Maharashtra was conducted on 30 AUD patients from April 03 2018, to April 17, 2018. The Hospital Anxiety Depression Scale (HADS) containing 14 questionnaires, 7 for anxiety and 7 for depression, was administered; the collected data were analyzed and interpreted. Results: The analysis of the score has shown that 60% of the patients had mild anxiety and 40% possessed normal anxiety level in the anxiety component of HADS and 70% of the patients had mild depression and 30% of the patients had moderate depression in the depression component of the HADS. Those patients who have mild anxiety also have a mild or moderate level of depression. Conclusion: Assessment of associated anxiety and depression among AUD patients and subjecting to treatment if required will benefit the treatment compliance of AUD.

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Introduction: Quality of life (QOL) is defined as the combination of an individual's functional health, feeling of competence, independence activities of daily living, and satisfaction of social circumstances. Aim: This study aimed to assess and compare the QOL among the elderly people in selected rural and urban areas of Uttar Pradesh. Materials and Methods: A quantitative nonexperimental comparative study research design was adopted for the study. The data were collected using convenience sampling technique. The total sample comprised 70 elder people, 35 each from the urban and rural areas. A standardized World Health Organization-QOL BREF questionnaire containing 26 items was used for assessing the QOL of the subjects. Data were analyzed using the Statistical Package for the Social Sciences version 25. Results: The urban elders had better QOL in the only environmental domain (P = 0.003) than the rural population, and all the other domains such as physical (P = 0.45), psychological (P = 0.33), and social relationship (P = 0.42) did not have any significant difference. There was no association found between QOL among the elderly people in rural and urban areas with their selected sociodemographic variables. Conclusion: There is a significant difference in the environmental domain QOL among the elderly living in urban areas than the rural one. A qualitative approach can be used to explore comprehensive findings in future studies.

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