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Volume 61, Number 6 November-December 2019
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Recovery in schizophrenia: Nihilism must give way to optimism
Om Prakash Singh 547
Media Matters in suicide – Indian guidelines on suicide reporting
Lakshmi Vijayakumar 549
B. Vinay, H. N. Shashidhara, Rajani Parthasarathy, Girish N. Rao,
Suresh Bada Math, Jagadisha Thirthalli 635
Does the Lancet Medical Journal Legitimize Terrorism?
Bevinahalli Nanjegowda Raveesh, Mudraje Prasad Ganesh,
Bhat Satish 640
Case presentation in academic psychiatry: The clinical applications, purposes, and structure of formulationand summary
Narayana Manjunatha 644
LETTERS TO EDITOR
Postpartum psychosis in Sturge–Weber syndrome: A case report
Anantprakash Siddharthkumar Saraf, Sneh S. Babhulkar, Vivek P. Joge 649
Commentary on “Gulati P, Chavan BS, Sidana A. Comparative efficacy of baclofen and lorazepam in the treatment of alcohol withdrawal syndrome. Indian J Psychiatry. 2019;61:60-4”
Parvesh Batra, Anirudh Bhushan, Neha Dhiman 650
Authors’ reply to commentary on “Gulati P, Chavan BS, Sidana A. Comparative efficacy of baclofen and lorazepam in the treatment of alcohol withdrawal syndrome”
Prannay Gulati, Bir Singh Chavan, Ajeet Sidana 652
Successful administration of electroconvulsive therapy in a patient with treatment-resistant schizophrenia and coexisting myasthenia gravis
Vanteemar S. Sreeraj, Sudhir Venkataramaiah, Aditya Sunka,
Sriganesh Kamath, Naren P. Rao 653
Tramadol withdrawal psychosis
Ajeet Sidana, Ira Domun, Prinka Arora 655
Quetiapine-induced behavioral disorder during sleep
N. A. Uvais, Naseem Palakkuzhiyil, T. P. Mohammed 656
Commentary on “high-risk behavior in patients with alcohol dependence”
Samir Kumar Praharaj 657
Factors influencing treatment outcome in bipolar disorder
Karthick Subramanian, Natasha Celia Saldanha 658
Delirium associated with discontinuation of sertraline in an elderly
Subhash Das, Mitesh Kumar, Alisha Sahotra 660
Commentary on: Parental care seeking pathway and challenges for autistic spectrum disorder
Avni Gupta, Sujata Sethi, Hitesh Khurana, Ashish Kumar Malik 661
Authors’ response to commentary on: Parental care seeking pathway and challenges for autistic spectrum disorder
Pranab Mahapatra, Abhimanyu Singh Chauhan, Sanghamitra Pati 662
Successful application of add-on high-definition transcranial direct current stimulation in a schizophrenic patient with comorbid alopecia universalis
Rujuta Parlikar, Sowmya Selvaraj, Lakshmi Shiva,
Vanteemar S. Sreeraj, Ganesan Venkatasubramanian,
Prabha S. Chandra 663
A rare case of Huntington’s disease presenting with treatment-resistant psychosis
Kartik Singhai, Pooja Patnaik Kuppili, Pratibha Gehlawat 665
Sex, love, and relationships: My journey of 40 years
Mrugesh Vaishnav 552
Clinical profile of obsessive-compulsive disorder in children and adolescents: A multicentric study from India
Eesha Sharma, Adarsh Tripathi, Sandeep Grover, Ajit Avasthi,
Amitava Dan, Chhitij Srivastava, Nishant Goyal, S. M. Manohari,
Janardhan Reddy 564
Factor structure and validity of Type D personality scale among Indian (Tamil-speaking) patients with acute myocardial infarction
Vikas Menon, Anoop G. Pillai, Santhosh Satheesh,
Charanya Kaliamoorthy, Siddharth Sarkar 572
Prevalence and pattern of problematic internet use among engineering students from different colleges in India
Saurabh Kumar, Swarndeep Singh, Krishnamurti Singh,
Srinivas Rajkumar, Yatan Pal Singh Balhara 578
Relationships of attention-deficit hyperactivity disorder with defense styles and harm avoidance among male inpatients with alcohol use disorder
Cuneyt Evren, Elvan Cicikci, Gokhan Umut, Bilge Evren,
Kubra Durmus 584
Effect of adjunct yoga therapy in depressive disorders: Findings from a randomized controlled study
Suriya Kumar, Eswaran Subramaniam, Ananda Balayogi Bhavanani, Sukanto Sarkar, Sivaprakash Balasundaram 592
Chronotypes and its association with psychological morbidity and childhood parasomnias
Ng Syiao Wei, Samir Kumar Praharaj 598 Characteristics and correlates of poststroke depression: An Indian study Amlan Kusum Jana, Suddhendu Chakraborty, Samir Kumar Praharaj 605
Evaluation of clinical and suicidal behavior characteristics among urban, Turkish middle-age depressive patients with comorbid attention deficit hyperactivity disorder
Dursun Hakan Delibas, Esin Erdogan, Seref Gulseren 612
A comparative study of temperamental, behavioral, and cognitive changes in thalassemia major, thalassemia minor, and normal population
Ranjan Bhattacharyya, Kaustav Chakraborty, Arya Sen,
Rajarshi Neogi, Sumita Bhattacharyya 618
Insomnia and depression: How much is the overlap?
Robin Victor, Sherry Garg, Ravi Gupta 623
Investigating spontaneous brain activity in bipolar disorder: A resting-state functional magnetic resonance imaging study
Rashmin Mansukh Achalia, Arpitha Jacob, Garimaa Achalia,
Abhijit Sable, Ganesan Venkatasubramanian, Naren P. Rao 630
BRIEF RESEARCH COMMUNICATION
Taluk Mental Health Program: The new kid on the block?
Narayana Manjunatha, Channaveerachari Naveen Kumar, Kalaivanan Rakesh Chander, Kamaldeep Sadh, Guru S. Gowda,
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Does the Lancet Medical Journal Legitimize Terrorism?
Bevinahalli Nanjegowda Raveesh, Mudraje Prasad Ganesh1, Bhat Satish2
Department of Psychiatry, Mysore Medical College and Research Institute, Mysore, 1President, Indian Medical Association, Puttur, 2Chairperson, Medicolegal Cell, AMC, Mangalore, Karnataka, India
Last month, Indian Doctors were outraged to read an Editorial in “The Lancet,” a highly reputed international medical journal, on a political situation in the Indian state of Jammu and Kashmir (J&K) under the garb of concern for mental health. All this amounts to blatant interference in the internal affairs of a sovereign nation, that too with a distorted narrative in a journal meant for ethical scientific deliberation of medical and health-care issues. To its credit, the editorial made no effort to hide the political nature of the message as conveyed in the title, despite the mention of mental health issues within. All this by selective references to the UN Human Rights report (OHCHR) already rejected by the Indian Government and biased reports on mental health issues in Kashmir.
While the editorial shows concern for health, safety, and freedom of “Kashmiris” in the Kashmir province, Lancet admits “Autonomous status revoked” applies to the entire state of J&K including the provinces of Jammu & Ladakh. In that case, why has the concern been shown only for Kashmiris? Does it mean that the editorial found it inconvenient to include the other two provinces which do not have any such bloody conflict on the lines of Kashmir, and rather have welcomed the revoking? The editorial next refers to the Human Rights report by the UN Commissioner of July 2019 and mentions both state security forces and armed groups (collectively) as having caused various acts of violence, including terrorism.
The editorial has conveniently ignored the history of Kashmir, lest it expose their tall claims. What has been grossly ignored is that the same armed groups are
Address for correspondence: Dr. Bevinahalli Nanjegowda Raveesh,
Department of Psychiatry, Mysore Medical College and Research Institute, Mysore, Karnataka, India.
responsible for the biggest incident of ethnic cleansing in recent times of Kashmiri Pandits, a native peace-loving community. There can be nothing more inhuman than to legitimize perpetrators of this barbaric act by mentioning them as “armed groups” rather than “terrorists.” On the same lines, the editorial quite naturally avoids any mention of support to these terrorists and infiltration from Pakistan, thanks to their policy of state sponsored terror. This is reflected in the same UN report that mentions the Financial Action Task Force, an inter-governmental organization to monitor money laundering and terrorist financing. However, Lancet chooses to ignore all this. The Government of India has rightly rejected this UN report, and said “It is a matter of deep concern that this UN report accords legitimacy to terrorism that is in complete variance with UN Security Council positions.” The UNSC had, in February 2019, strongly condemned the dastardly Pulwama terror attack and subsequently proscribed Masood Azhar, the self-styled leader of terrorist entity Jaish-e-Mohammed. However, in the update, terrorist leaders and organizations sanctioned by the UN are deliberately underplayed as “armed groups.”
The next references cited by Lancet include reports on mental health by Medecins Sans Frontieres (MSF) of 2016 and repeated again by MedAct group report of March 2019. Both go one step further and interchangeably use Kashmir and Kashmir valley. This difference is crucial to the problem, simply because the violence and unrest is maximum in the five districts comprising the Kashmir valley, a strip of land comprising just 130 × 30 km.
However, their stranglehold on the J&K politics is such that there never has been a ruler of J&K in the past 70 years from anywhere else in the entire state, thanks to gross
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How to cite this article: Raveesh BN, Ganesh MP, Satish B. Does the Lancet Medical Journal Legitimize Terrorism? Indian J Psychiatry 2019;61:640-3.
640 © 2019 Indian Journal of Psychiatry | Published by Wolters Kluwer – Medknow
Raveesh, et al.: Does Lancet Legitimize Terrorism?
Figure 1: Map above exposes the geographical and sociological fallacy of the anti‐India and pro‐Pak industry in the Kashmir Valley; (1) Ladakh, (2) Kargil, (4) Jammu, (6) Kashmir Valley and (3) Rest of Kashmir
bureaucratic and administrative misuse of the autonomy they had.
The MSF study along with the Department of Psychiatry IMHANS Srinagar of 2015, has shared the details of mental health incidents, after a study designed as a case series using data from all the ten districts of Kashmir region. Interestingly, one wonders about any difference in this incidence, within the districts of Kashmir Valley and in the rest of Kashmir. For this prospective study, it seems strange they never thought of a design using control group while analyzing results, to improve the strength of the conclusions drawn? A control group, with either the five districts of Kashmir outside the valley or districts outside Kashmir but within the state of J&K to which the entire autonomous status applied, would have only increased the strength of evidence presented by the study. Was this study designed consciously to avoid scientific evidence to a conclusion not in keeping with some political line? With data from such a heterogeneous group being considered as a single entity, one wonders how a causative association can be ascertained between the outcome of mental illness, and incidence of violence in the conflict area.
Some more historical facts need to be cleared. The special status given to the state of J&K in 1954 was arbitrary but temporary, and led to the citizens of J&K being deprived of progress taking place in rest of the country, including laws such as Prevention of Corruption Act, Right to Information
Act, Right to Education Act, benefits for marginalized and many more. Minorities, Dalits, and women were deprived of their rights, which the powers from the valley denied despite successive governments over the decades. This special status was in effect a perpetuation of the two-nation theory that led to the Partition of India in 1947 and creation of a separate Muslim state of Pakistan. Even though the ruler of J&K legally acceded to India in 1947, Pakistan took control of a major part of the state by unlawful force, just like in Baluchistan few months later in 1948. Despite this, the United Nations High Commission for Human Rights report condones the aggressors, and demonizes the Indian state by falsely equating both the regions of Kashmir as simply “administered,” just like what the Separatists do [Figure 1]. Even though the Government of India has rejected this report, the editorial has reinforced the same bias by citing it as a reference. The mental health study does not seem to have considered anywhere, this massive misgovernance lasting since decades as contributing to the poor mental health.
The Indian Army is a highly professional and ethical force, and completely under the authority of a democratic government. Despite being attacked by protesters, it uses weapons only similar to what their attackers use. The Indian forces have only supported the health, safety and freedom of local citizens. However, to mischievously call them as a matter of concern by the editorial, is pure motivated bias. Perhaps, this story of a Kashmiri girl may give you an alternative perspective.
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She was the daughter of a security officer who was tortured and killed by the “armed groups” while in Kashmir, but managed to save her life by fleeing the land of her ancestors, to eventually become a doctor and prosper in Indore. This is unlike other military forces in the neighborhood, who have even bombed their own people using military jets following terror attacks by terrorists they nurtured but went rogue. All this while we have in our neighborhood a “Military that has its own country,” and do not bother twice about invading, and attacking its own people: These are the people the Lancet editorial ends up supporting.
The editorial mischievously gives only the number of blind victims of pellet injury, while omitting the key fact that these were virtually stone-throwers paid by separatists and cross border handlers, to attack the security forces. Once an assertive federal government allowed the security forces to do their job after 2016, these incidents have dropped significantly more so in the last few months once the State Assembly was dissolved and Law and Order came directly under the Federal Government. Over the decades, development funds were massively siphoned off by the state Government, leaving the needy citizens of J&K in dire straits. Despite this, the good development indicators in J&K, as the editorial has agreed, are only because of the Federal Government as you would like to imply. The Indian Government provided almost 10% of the National GDP to the state of J&K, even though the state contributed to barely 1% of the National revenue. Difficult to imagine Lancet did not have access to such basic facts.
Revoking the Autonomy of J&K has neutralized those who made money by letting the problem perpetuate since decades and kept the state in the midst of an armed unrest. They will undoubtedly do everything to ferment trouble, including misinformation warfare to paint a picture of unrest, atrocities, and trouble. They have created a false narrative since decades, using illegal funds, at various fora across the world. However, they are now getting exposed one by one. Their influence can be gauged from the extent of work done by an ISI funded body Kashmir American Forum, that almost got registered as a consultative body with the UN ECOSOC, until the founder Mr. Ghulam Nabi Fai, a US citizen, got arrested by the FBI in 2011. And, I am not yet commenting on the integrity of the UN Human Rights Commissioner office.
It is unfortunate a medical journal carries an editorial that endorses the same argument that caused the misery to lakhs over the decades. However, firm actions by Prime Minster Narendra Modi will ensure the benefits enjoyed by the rest of the country are enjoyed even by the people of J&K. This will certainly bring lasting peace to the region, and further improve the overall health care including mental health. This is despite the best efforts of Apologists with Narratives that aim to support, sympathize, and glorify the
terrorists, and punish the victims. The editorial concludes by discreetly connecting the decision by the Prime Minister Modi to further violence and alienation in the region. Even worse, it vaguely implies the recent decision by the Indian Government is responsible for the poor mental health parameters till now. All this amounts to demonizing an elected democratic Government. The Indian Nation will stand by the position conveyed by its UN representative Mr. Syed Akbaruddin, that “any dispute with Pakistan will be solved only by dialogue, and this dialogue will happen only after Pakistan stops cross border support to terror.”
Effectively, Lancet editorial seems to justify the state-sponsored terrorist outfits in Kashmir while demeaning the Union of India, the world’s largest and vibrant democracy, as a perpetrator of terror. Indians believe in tolerance and mutual respect, letting their minorities thrive, thanks to which minorities in India have even risen to become Chief Justice of Supreme Court, Military Chiefs, and even the President of the Country over the years. On the other hand, minorities in Pakistan are abused and have dwindled since independence and continue to be oppressed by the Islamic State. It has happened before in 1971 and Baluchistan province of Pakistan is increasingly resorting to violent protests, to throw away the Pakistan government who invaded them in 1948 and have kept them subjugated since then. Until Lancet team does a rethink on the editorial, we suggest they consider another editorial on the severe crisis in the Pakistan economy, or unrest in Hong Kong, and the healthcare implications of the same, especially if the internal unrest spirals into a civil war with potential disintegration of the nation and a refugee crisis. We are deeply concerned about the credibility of the editorial team that approved this write up used distorted medical data, geopolitical issues, and socio-demographics, to justify a biased political narrative and covertly supported terrorists with a track record of ethnic cleansing of peaceful minority. All this at the risk of credibility damage to a scientific forum and subsequent loss to medical literature. We can understand political leaders taking such a risk, to appease their voters, but for a private enterprise that runs a scientific journal, such an act, leaves readers with only one reason for the bias.
The editorial team is evidently compromised, and has clearly misused a scientific platform of medical literature to endorse terrorism. All this despite a commitment to the contrary following a 2014 editorial in Lancet that “denounced aggression by Israel in Gaza.” Mr. Richard Norton conveyed regret and condemnation for the same. Going ahead, he conveyed a proposal to be followed, before submissions at the intersection of medicine and politics.
Despite all that, we now see the same in the editorial on Kashmir, and the consequent outrage by readers. What The Lancet stands for is now clear!
Raveesh, et al.: Does Lancet Legitimize Terrorism?
642 Indian Journal of Psychiatry Volume 61, Issue 6, November-December 2019
Hence the serious concern, “Does the Lancet Medical Journal Legitimize Terrorism?”
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Conflicts of interest
There are no conflicts of interest.
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Raveesh, et al.: Does Lancet Legitimize Terrorism?
Indian Journal of Psychiatry Volume 61, Issue 6, November-December 2019