Letters to Editor
detect ongoing psychotic illness. Hence, the possibility of unidentified psychotic illness and unreliable response for scales and questionnaires among a number of individuals in the control group is not ruled out. Either obtaining a detail clinical history (medical and psychiatric) and mental state examination by mental health professionals or by using screening instrument like mini-international neuropsychiatric interview.[3] Would have served the purpose adequately. 3. Using these scales and questionnaire 1 week immediately after an attempted suicide increases the possibility of colored responses particularly in the Social Support Questionnaire, psychological, social relationship domain of WHO-QOL Bref scale,[4] hence leading to possible false low score among suicide attempters. The possibility of false score remains high among those with adjustment disorder, depression. 4. The possibility of unreliable responses among subjects with ongoing psychotic illnesses like schizophrenia in all the scales cannot be ruled out completely. 5. These scales could have picked up reliable responses if used among those suicide attempters currently in remission for any psychiatric illness. This could be ascertained by validated instruments with cut-off scores, mental state examination and also obtaining or confirming history from a defined key informant. 6. History of medical comorbidity among both groups, which might produce low score on WHO-QOL Bref, also has not been ruled out. 7. Albert Einstein College of Medicine (AECOM) coping
styles questionnaire[5] having 87 items has been wrongly quoted as “AECOM coping style scale” having 95 items.
Piyali Mandal, Sathya Prakash
Department of Psychiatry, AIIMS, New Delhi, India E‑mail: [email protected] REFERENCES 1.
Kumar PN, George B. Life events, social support, coping strategies, and quality of life in attempted suicide: A case-control study. Indian J Psychiatry 2013;55:46-51. 2. Goldberg D, Williams P. A User’s Guide to the General Health Questionnaire. Windsor: NFER-Nelson; 1998. 3. Sheehan DV, Lecrubier Y, Sheehan KH, Amorim P, Janavs J, Weiller E, et al. The Mini-International Neuropsychiatric Interview (M.I.N.I.): The development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry 1998;59 Suppl 20:22-33. 4. Murphy B, Herrman H, Hawthorne G, Pinzone T, Evert H. Australian WHOQoL Instruments: User’s Manual and Interpretation Guide. Melbourne, Australia: Australian WHOQoL Field Study Centre; 2000. 5. Plutchick R, Conte HR. Measuring emotions and the derivatives of the emotions: Personality traits, ego defenses and coping styles. In: Wetzler S, Kats MN, editors. Contemporary Approaches to Psychological Assessment. New York: Brunner Maze; 1989. p. 239-69. Access this article online Quick Response Code Website: www.indianjpsychiatry.org
DOI: 10.4103/0019-5545.130518
A fresh look at homosexuality Sir, The recent Supreme Court Judgment criminalizing homosexuality, overruling the 2009 Judgment of the High Court, has been a shock to everyone. It has emotionally disturbed those with homosexual orientation and their families. Recently, two articles were published in IJP on homosexuality.[1,2] I am writing in response to the above, to have a fresh look on homosexuality.
homosexuality is a normal psychosexual development. A normal variant cannot be considered completely normal. It is, in fact, an aberration in the psychosexual development, caused by genetic and psychosocial factors for which the person is not responsible. There are research findings, which suggest that there are structural differences in the brains of people with homosexual orientation.
The official position of the medical and psychiatric classificatory systems on homosexuality is that it is a normal variant in the psychosexual development. This is a positive approach in the understanding of homosexuality. In the past, it was associated with sin and crime and hence those people with homosexual orientation were ostracized in society. With this new approach, they will have a healthy space in society.
Homosexuality is not normal statistically and biologically. Statistically, it is not normal since it forms a minority and skewed in the normal distribution. Every biological function has a physiological goal and purpose. Sexual activity has two goals. One is procreation to safeguard the continuation of the species. The second one is the experience of pleasure, which in fact, is to facilitate the sexual activity and to strengthen the bond between husband and wife. Homosexuality negates one of the goals of sexual activity procreation.
While welcoming and agreeing with a positive perception of homosexuality, it is difficult to accept the position that
Homosexuality has therefore, to be considered as an aberration in the psychosexual development caused by
Indian Journal of Psychiatry 56(2), Apr-Jun 2014
209
Letters to Editor
genetic and psychosocial factors. Those with homosexual orientation are not responsible for this aberration. It is not a sin to be discriminated against. It is not a crime to be punished. It is not a psychiatric disorder needing treatment although those with homosexual orientation can often develop anxiety and depression needing treatment, if they are ostracized in society. Since homosexuality is neither a sin nor a crime, the freedom of those with a homosexual orientation to live a happy life should not be interfered with. While society accepts homosexuality positively, those with homosexual orientation must also accept their psychosexual status gracefully and get on with life. As a probable reaction to society’s prejudice and discrimination, there seems to be a tendency for them to aggressively claim normality of their sexual orientation. They also seem to claim too much on personal freedom and rights. Personal freedom and rights are always limited to some extent, as long as we live in a social group. There are different aspects of homosexual behavior which can come into conflict with social expectations, religious beliefs and ideas of morality. People with homosexual orientation must consider all these and should be prepared for compromises. The Alcohol Anonymous prayer should be of help: “God, give me the serenity to accept the things I cannot change; the courage
to change the things I can; and the wisdom to know the difference.” As citizens of India, we should organize public opinion and take all legal steps to see that this criminalization of homosexuality is done away with.
Abraham Verghese
Department of Psychiatry, Christian Medical College, Vellore, Tamil Nadu, India E‑mail: [email protected] REFERENCES 1. Rao TS, Jacob KS. Homosexuality and India. Indian J Psychiatry 2012;54:1‑3. 2. Sathyanarayana Rao TS, Jacob KS. The reversal on gay rights in India. Indian J Psychiatry 2014;56:1‑2. Access this article online Quick Response Code Website: www.indianjpsychiatry.org
DOI: 10.4103/0019-5545.130519
Announcement
International Conference on Schizophrenia VI (IConS VI) The 6th edition of this conference organized by the Schizophrenia Research Foundation (SCARF), a WHO Collaborating Centre for Mental Health research will be held between 21st - 23rd August, 2014 at Chennai, India. Awards will be given for the best poster and the best young researcher. A new program for Building Research Capacity is being initiated this time. The conference is Co-sponsored by the WPA, WASP and the IPS. For details contact www.iconsofscarf.org 210
Indian Journal of Psychiatry 56(2), Apr-Jun 2014
Copyright of Indian Journal of Psychiatry is the property of Medknow Publications & Media Pvt. Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
detect ongoing psychotic illness. Hence, the possibility of unidentified psychotic illness and unreliable response for scales and questionnaires among a number of individuals in the control group is not ruled out. Either obtaining a detail clinical history (medical and psychiatric) and mental state examination by mental health professionals or by using screening instrument like mini-international neuropsychiatric interview.[3] Would have served the purpose adequately. 3. Using these scales and questionnaire 1 week immediately after an attempted suicide increases the possibility of colored responses particularly in the Social Support Questionnaire, psychological, social relationship domain of WHO-QOL Bref scale,[4] hence leading to possible false low score among suicide attempters. The possibility of false score remains high among those with adjustment disorder, depression. 4. The possibility of unreliable responses among subjects with ongoing psychotic illnesses like schizophrenia in all the scales cannot be ruled out completely. 5. These scales could have picked up reliable responses if used among those suicide attempters currently in remission for any psychiatric illness. This could be ascertained by validated instruments with cut-off scores, mental state examination and also obtaining or confirming history from a defined key informant. 6. History of medical comorbidity among both groups, which might produce low score on WHO-QOL Bref, also has not been ruled out. 7. Albert Einstein College of Medicine (AECOM) coping
styles questionnaire[5] having 87 items has been wrongly quoted as “AECOM coping style scale” having 95 items.
Piyali Mandal, Sathya Prakash
Department of Psychiatry, AIIMS, New Delhi, India E‑mail: [email protected] REFERENCES 1.
Kumar PN, George B. Life events, social support, coping strategies, and quality of life in attempted suicide: A case-control study. Indian J Psychiatry 2013;55:46-51. 2. Goldberg D, Williams P. A User’s Guide to the General Health Questionnaire. Windsor: NFER-Nelson; 1998. 3. Sheehan DV, Lecrubier Y, Sheehan KH, Amorim P, Janavs J, Weiller E, et al. The Mini-International Neuropsychiatric Interview (M.I.N.I.): The development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry 1998;59 Suppl 20:22-33. 4. Murphy B, Herrman H, Hawthorne G, Pinzone T, Evert H. Australian WHOQoL Instruments: User’s Manual and Interpretation Guide. Melbourne, Australia: Australian WHOQoL Field Study Centre; 2000. 5. Plutchick R, Conte HR. Measuring emotions and the derivatives of the emotions: Personality traits, ego defenses and coping styles. In: Wetzler S, Kats MN, editors. Contemporary Approaches to Psychological Assessment. New York: Brunner Maze; 1989. p. 239-69. Access this article online Quick Response Code Website: www.indianjpsychiatry.org
DOI: 10.4103/0019-5545.130518
A fresh look at homosexuality Sir, The recent Supreme Court Judgment criminalizing homosexuality, overruling the 2009 Judgment of the High Court, has been a shock to everyone. It has emotionally disturbed those with homosexual orientation and their families. Recently, two articles were published in IJP on homosexuality.[1,2] I am writing in response to the above, to have a fresh look on homosexuality.
homosexuality is a normal psychosexual development. A normal variant cannot be considered completely normal. It is, in fact, an aberration in the psychosexual development, caused by genetic and psychosocial factors for which the person is not responsible. There are research findings, which suggest that there are structural differences in the brains of people with homosexual orientation.
The official position of the medical and psychiatric classificatory systems on homosexuality is that it is a normal variant in the psychosexual development. This is a positive approach in the understanding of homosexuality. In the past, it was associated with sin and crime and hence those people with homosexual orientation were ostracized in society. With this new approach, they will have a healthy space in society.
Homosexuality is not normal statistically and biologically. Statistically, it is not normal since it forms a minority and skewed in the normal distribution. Every biological function has a physiological goal and purpose. Sexual activity has two goals. One is procreation to safeguard the continuation of the species. The second one is the experience of pleasure, which in fact, is to facilitate the sexual activity and to strengthen the bond between husband and wife. Homosexuality negates one of the goals of sexual activity procreation.
While welcoming and agreeing with a positive perception of homosexuality, it is difficult to accept the position that
Homosexuality has therefore, to be considered as an aberration in the psychosexual development caused by
Indian Journal of Psychiatry 56(2), Apr-Jun 2014
209
Letters to Editor
genetic and psychosocial factors. Those with homosexual orientation are not responsible for this aberration. It is not a sin to be discriminated against. It is not a crime to be punished. It is not a psychiatric disorder needing treatment although those with homosexual orientation can often develop anxiety and depression needing treatment, if they are ostracized in society. Since homosexuality is neither a sin nor a crime, the freedom of those with a homosexual orientation to live a happy life should not be interfered with. While society accepts homosexuality positively, those with homosexual orientation must also accept their psychosexual status gracefully and get on with life. As a probable reaction to society’s prejudice and discrimination, there seems to be a tendency for them to aggressively claim normality of their sexual orientation. They also seem to claim too much on personal freedom and rights. Personal freedom and rights are always limited to some extent, as long as we live in a social group. There are different aspects of homosexual behavior which can come into conflict with social expectations, religious beliefs and ideas of morality. People with homosexual orientation must consider all these and should be prepared for compromises. The Alcohol Anonymous prayer should be of help: “God, give me the serenity to accept the things I cannot change; the courage
to change the things I can; and the wisdom to know the difference.” As citizens of India, we should organize public opinion and take all legal steps to see that this criminalization of homosexuality is done away with.
Abraham Verghese
Department of Psychiatry, Christian Medical College, Vellore, Tamil Nadu, India E‑mail: [email protected] REFERENCES 1. Rao TS, Jacob KS. Homosexuality and India. Indian J Psychiatry 2012;54:1‑3. 2. Sathyanarayana Rao TS, Jacob KS. The reversal on gay rights in India. Indian J Psychiatry 2014;56:1‑2. Access this article online Quick Response Code Website: www.indianjpsychiatry.org
DOI: 10.4103/0019-5545.130519
Announcement
International Conference on Schizophrenia VI (IConS VI) The 6th edition of this conference organized by the Schizophrenia Research Foundation (SCARF), a WHO Collaborating Centre for Mental Health research will be held between 21st - 23rd August, 2014 at Chennai, India. Awards will be given for the best poster and the best young researcher. A new program for Building Research Capacity is being initiated this time. The conference is Co-sponsored by the WPA, WASP and the IPS. For details contact www.iconsofscarf.org 210
Indian Journal of Psychiatry 56(2), Apr-Jun 2014
Copyright of Indian Journal of Psychiatry is the property of Medknow Publications & Media Pvt. Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
