Indian Journal of Psychiatry最新文献

Background: Smartphone addiction is an emerging public health issue worldwide, affecting individuals across age groups, including undergraduate medical (MBBS) students.

Aim: This systematic review and meta-analysis aimed to estimate the pooled prevalence of smartphone addiction among MBBS students in India and to explore variations based on the demographic, regional, and methodological factors.

Methods: A comprehensive search was conducted in PubMed, Scopus, Web of Science, EBSCO, and Embase for studies published up to October 01, 2024, following a PROSPERO-registered protocol (CRD42024607941). Studies reporting the prevalence of smartphone addiction among MBBS students in India were included. Two reviewers independently screened studies, extracted data, and assessed quality using the joanna brings institute (JBI) critical appraisal checklist. Meta-analysis was performed using R version 4.4.2 (2024-10-31 ucrt). Single arcsine transformation with maximum likelihood estimator was used for pooled prevalence calculation. Subgroup analyses examined differences based on the geographic region, sampling method, academic year, and type of scale used. Meta-regression assessed the influence of potential moderators. Leave one out sensitivity analysis was conducted. Publication bias was evaluated using Doi plot and luis furuya- kanamori (LFK) index.

Results: Twenty-four studies were included in the analysis. The pooled prevalence of smartphone addiction among MBBS students was 60% (95% CI 45% to 73%; number of studies = 24), with high heterogeneity (I² = 99.4%, P < 0.001). The overall prevalence of smartphone addiction among undergraduate medical students (evaluated using screening instruments for smartphone addiction) in India is 60%. Although some subgroup differences (regarding region studied, sampling method used and batch of MBBS studied) were found to be statistically significant, it is important to interpret these findings with caution, as these differences may still be influenced by chance occurrences, random error, or underlying study-level biases.

Conclusion: The high prevalence of smartphone addiction among Indian MBBS students underscores the need for targeted awareness, preventive strategies, and support systems within medical institutions. Addressing this issue is critical to safeguard students' mental health and academic performance.

The Government of Tamil Nadu gazette the Minimum Standards of Care for Deaddiction Centres 2025, marking the significant step in regulating addiction treatment centers in the State. Issued under the Mental Healthcare Act (MHCA) 2017, this notification establishes a comprehensive framework addressing registration, admission procedures, types of treatment, infrastructure, and patient rights. The regulations emphasize the role of psychiatrists in decision-making, differentiate detoxification from rehabilitation, and mandate medical oversight in treatment facilities. They also introduce safeguards against human rights violations and prescribe minimum standards for staffing, documentation, and infrastructure. However, the provision to admit patients with severe dependence (leading to capacity impairment) with harm to self (due to excessive use), as a supported admission (under Section 89 of MHCA), remains contentious and liable to potential misuse. This is because persistent impairment of capacity, seen in severe mental illnesses such as schizophrenia, is not typically seen in patients with substance use disorders. The need for staff training and mechanisms to monitor outcomes and compliance is also not explicitly mentioned. In summary, these regulations provide a much-needed framework for the regulation of addiction treatment centers. The presence of periodic reviews, structured training programs, and robust oversight mechanisms would be critical for its appropriate implementation. This initiative also sets a precedent for other states to follow suit and optimize addiction treatment services across India.

Background: Substance use disorders (SUDs), particularly alcohol dependence, represent the significant global public health challenge. Understanding the perspectives of service users and family members regarding addiction treatment is critical for improving care. Despite growing emphasis on patient-centered approaches, their insights remain underrepresented in shaping treatment programs.

Aim: To explore the treatment goals, expectations, and experiences of service users with alcohol dependence and their family members in a tertiary care hospital's substance use treatment ward.

Methods: This qualitative study was conducted in the substance use treatment ward of a tertiary care hospital. Using purposive sampling, 54 service users diagnosed with alcohol dependence and 53 family members participated in semi-structured, in-depth interviews. Participants shared their treatment goals, expectations, and recommendations for care improvement. Data were analyzed inductively using thematic analysis, with themes iteratively refined until saturation.

Results: Participants emphasized the need for comprehensive, stigma-free care. Service users sought sustained abstinence, physical health restoration, and societal reintegration post-discharge. Positive aspects included supportive staff, psychotherapy sessions, and effective relapse prevention strategies. A majority expressed high satisfaction (e.g., 70% endorsed "satisfied" or "very satisfied"), reflecting overall positive experiences. However, stigmatization and fragmented service delivery emerged as barriers. Family members echoed these views and stressed the role of family engagement in recovery.

Conclusion: This study reveals that personal, family, and systemic factors shape treatment experiences in alcohol dependence, with stigma, fragmented services, and limited family involvement as key barriers. Targeted strategies-integrated care, stigma reduction, and stronger family engagement-can enhance treatment quality and sustain recovery.

Herpes simplex encephalitis (HSE) typically presents with fever, seizures, and altered sensorium, but atypical presentations with predominant psychiatric symptoms can delay diagnosis and treatment. We report a case series of three patients, who initially exhibited psychotic symptoms, including hallucinations and mood disturbances, without classic neurological signs. Diagnosis was confirmed via cerebrospinal fluid analysis and MRI findings. Early antiviral therapy led to prompt recovery. This series highlights the importance of considering HSE in acute psychiatric presentations to prevent misdiagnosis and ensure timely intervention.

Background: High-definition transcranial direct current stimulation (HD-tDCS) modifies cortical excitability and its application over dorsolateral prefrontal cortex (DLPFC) has expanded to include addictive behaviors, given its capacity to alter core processes associated with addiction.

Aim: To assess the effect of excitatory HD-tDCS over left DLPFC on impulsivity, problem solving, executive functions, and overall severity in children and adolescents having behavioral addictions.

Methods: This hospital-based, double-blind, randomized, sham-controlled trial was registered prospectively in the Clinical Trial Registry of India (registration number -CTRI/2023/08/056081). 52 subjects aged 10-20 who scored ≥ 2 on Brief Screener for Substance and Behavioral Addictions were enrolled for the study. Participants were randomized into active (G1) and sham (G2) HD-tDCS groups and 20 sessions of HD-tDCS given, that is, twice daily for 10 days. Barratt Impulsiveness Scale, Problem Solving Inventory, Behavior Rating Inventory for Executive Functions, and Clinical Global Impression were used to assess outcomes at baseline and 2 weeks. tDCS side effects checklist was administered to monitor adverse events.

Result: Significant improvement was noted in both the groups across all outcome variables over time. HD-tDCS was well tolerated and was better in reducing impulsivity, problem solving, executive functions, and illness severity in the active group than in the sham group.

Conclusion: HD-tDCS has a substantial potential in improving the core processes involved in behavioral addictions adding a promising tool to the therapeutic options for young population.

This is the fourth and last article in the series on translation, adaptation, or development of a rating scale and its psychometric testing. The focus of this article is on criterion validity, construct validity, and factor analysis. Validity refers to whether the tool measures "what it purports to measure." Content validity, criterion validity, and construct validity are the different types of validity. Content validity was previously discussed in this series. Criterion validity assesses how a new scale correlates with a criterion or "gold standard." Depending on the time of administration of the "gold standard," this can be classified as concurrent or predictive validity. Pearson's correlation coefficient is the measure used to establish criterion validity for continuous variables, while phi coefficient is used for dichotomous ones. Construct validity assesses whether the new tool performs consistently with the theoretical concepts. This can be of two types: convergent and divergent validity, and is estimated using Pearson's correlation coefficient. Factor analysis (FA) is a multivariate technique that evaluates whether several variables are linearly related to a set of factors. It is also a method to assess construct validity. There are two methods of FA: exploratory and confirmatory FA; the steps of exploratory FA are discussed in detail here.

Background: Adolescents' sleep problems are commonly assessed by parents' interview.

Aim: To translate self-reported Children's Report of Sleep Patterns (CRSP) questionnaire in Hindi language (CRSP-H) and assess sleep pattern of adolescents.

Methods: CRSP questionnaire was translated in Hindi language following standard guideline. Translated CRSP-H was used for adolescents (11-18 years) of 7^th-12^th grade to assess their sleep pattern in term of sleep duration, Sleep Hygiene Indices (Caffeine Index, Activities Hour Before Bed index, Sleep Location Index, and Electronics Use at Sleep Onset Index), Sleep Disturbance Scores (Bedtime Fear/Worries Scale, Restless Legs Scale, Parasomnias Scale, and Insomnia Scale), and Sleep Patterns.

Results: Participants included 231 children (boys 55%; age 14.1 ± 1.6 years; class VII/VIII/IX/X/XI/XII 17.8%, 20.8%, 29.4%, 13.4%, 13.8%, and 4.8%, respectively; time taken 20.8 ± 7.2 min). Sleep duration on weekdays and weekends were 7.4 ± 1.2 and 9.0 ± 1.5 hours, respectively. 138 (67.6%) participants were good sleepers. Sleep Disturbance Scores were worse in poor sleepers. Senior grade students had shorter sleep on weekdays (P = 0.04) and weekends (P = 0.04). Bedtime for 57.1% was between 9 and 11 pm on weekdays and 61% after 11 pm on weekends. Poor sleepers had higher (P < 0.01) Electronic Use at Sleep Onset, Bedtime Fears, Restless Leg Syndrome Symptoms, and Insomnia in comparison to good sleepers. Poor sleepers had significantly higher (P < 0.01) sleepiness and bed wetting scores (P = 0.02).

Conclusion: Adolescents sleep for 7.4 hours on weekdays and 9 hours on weekends respectively. Higher classes and higher Sleep Disturbance Scores are associated with reduced sleep duration.