Introduction

Before I did my MD in Psychiatry I had worked as a general physician for around 13 years. As a general physician I saw patients with complaints ranging from acute problems like enteric fever to chronic ones like diabetes mellitus. There was one thing that I noticed that of the 60 odd patients coming to my opd on an average at least 35-40 were coming with vague complains like some chronic pain that would shift its site, or dyspepsia, non specific weakness, fatigue. The sex ratio was heavily tilted with a female preponderance. As a young physician I would often rack my brain to go to the physiological or medical reason behind these complains. At times the people would respond to the treatment given only to have a fresh set of vague complains a few days later.

I had the luxury of following up this group of patients for 13 years and a majority never really found any organic basis for these complaints and almost 50 percent of them indulged in extensive 'doctor shopping', tried different indigenous therapies and kept coming to the hospital intermittently. 

Now of course we know that these patients have what is known as a 'somatoform disorder'. A somatoform disorder is essentially a physical manifestation of a problem in the mind. It is a kind of unconscious defense mechanism that our ego uses to defend the mind against a chronic stressor, say for example the loss of a loved one.

These experiences awakened an interest in the mental health problem being faced by the majority today and that prompted me to go for a post graduation in Psychiatry.
now when i treat people with mental health problems i feel an acute desire to discuss these cases at length and have an opinion of fellow mental health professionals and every body out there who would care to read and offer an opinion. I sincerely hope that this endeavor will help us all in managing mental health issues in the community better.