Indian Journal of Psychiatry最新文献

Background: First responders are at high risk for adverse mental health outcomes following trauma exposure during disaster response. This mixed methods study aimed to quantify psychological impacts and explore personal experiences among first responders after the Bahanaga train accident that killed 294 passengers in the month of June 2023.

Methods: For qualitative data, in-depth interviews (IDIs) were conducted, and quantitative data was collected using the PTSD checklist for DSM-5 (PCL-5), generalized anxiety disorder scale (GAD-7), and patient health questionnaire (PHQ-9) for symptoms of post-traumatic stress disorder (PTSD), depression, and anxiety. The study was conducted over one month during July 2023.

Results: Among 225 responders, alarming rates of symptoms of probable PTSD (10.2%), anxiety (11.6%), and depression (24.9%) were noted. Those with no prior exposure to disasters and those with no formal training in disaster response scored higher in measures for PTSD. IDIs were conducted with 22 first responders, including various stakeholders. Qualitative analysis identified themes of preoccupation with witnessing trauma, feeling overwhelmed, scary and terrible emotions, avoidance, guilt, hypervigilance, intrusive memories, emotional numbing, unmet needs for mental health support, worsening physical health, re-emergence of past traumas, compounding impact of graphic images in the media, certain positive impact, including increased empathy, resilience and finding purpose, and the beneficial role of peer support.

Conclusion: Significant psychological impacts are noted with elevated rates of probable PTSD, anxiety, and depressive symptoms among first responders one month after the Bahanaga train tragedy. These results underscore the vulnerability of first responders to mental health challenges following disaster response in India.

Background: Premenstrual dysphoric disorder is a mood disorder that has been recognized in the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition (DSM-5) as a subcategory of depressive disorders. The disorder has a high prevalence rate, and yet no uniform measure is standardized on the Indian population.

Aim: This study aimed to develop a scale to assess premenstrual dysphoric disorder that can be used for screening and for clinical use and that is standardized on the Indian population.

Methods: This study used cross-sectional research design and collected data through social media platforms from a sample of 300 females, out of which 38 were excluded for pregnancy, mental health conditions, substance use, and oral contraceptive use.

Results: The scale was analyzed using SPSS 21.0 for descriptive statistics, internal consistency, and convergent, content (factor analysis), and divergent validity. Results showed a high reliability of 0.90 and a concurrent validity of 0.76 and 0.64 against PSTT and BDI. Factor analysis revealed four factors, namely, affective and cognitive functioning, daily life and occupational functioning, somatic symptoms, and interpersonal anger. The sensitivity and specificity of the scale were found to be 86 (86%) and 66 (66%), respectively.

Conclusion: The scale developed in this study was found reliable and valid for use on the Indian population. It has high sensitivity and can be used as a screening measure for premenstrual dysphoric disorder.

Background: Little information is available on response to electroconvulsive therapy (ECT) in patients with bipolar disorder (BD) from India.

Aim: This exploratory study aims to evaluate and compare the sociodemographic and clinical profiles, treatment outcomes of BD patients with depression and mania/mixed episode who received ECT and to evaluate the predictors of response to ECT.

Results: Data of 278 BD patients who received 325 ECT courses were extracted from the ECT register. The number courses of ECT for bipolar depression (n = 202) exceeded those for mania/mixed episodes (n = 123). In terms of response to ECT, >75% response was achieved in 63.3% cases and >50% response was seen in about 90% of the patients. No significant difference was seen in response to ECTs between bipolar depression and mania/mixed episodes.

Conclusion: The present study suggests that about two-thirds of the BD patients show more than 75% response to ECT, and more than 90% of the BD patients show more than 50% response to ECT.

Background: Premenstrual dysphoric disorder (PMDD) is a condition that affects nearly 3-9% of the women in the reproductive age during the luteal phase of each menstrual cycle characterized by symptoms varying in severity and affecting the quality of life. Earlier research studies conducted have reported independent relationships between PvuII-ESR1-polymorphism and psychological traits in PMDD and risk for cognitive, behavioral, and affective symptoms. However, as the studies are few in number and the results are not consistent, there is a need for our study to link between the PvuII-ESR1gene and PMDD.

Methodology: All nonpregnant women aged between 18 and 45 years and attending the OBG or Medicine or Psychiatry OPD for a routine health checkup were recruited into the study. The cross-sectional study recruited 35 samples each in the control and PMDD groups using a validated screening PMDD Assessment Scale Questionnaire (PMDDASQ). Mann-Whitney's U test and Chi-square test were used to calculate P values for the continuous and categorical variables. Tetra-primer-amplification refractory mutation system-polymerase chain reaction was used to identify the PvuII-ESR1gene polymorphism after isolation of genomic DNA from the whole blood.

Results: Data-Analysis Pak tool and Med-Calc software were used for data analysis. The PvuII-ESR1 genotype distribution was in Hardy-Weinberg equilibrium in both PMDD and controls. The PMDDASQ scoring showed a significance with P ≤ 0.05. Pearson's Chi-Squared test performed for genotypes and alleles did not show any significant association with the phenotype.

Conclusion: PvuII-ESR1 SNP (T/C rs2234693) does not show any association with phenotype between the control and PMDD. However, PMDDAS questionnaire can be used to differentiate the women who are controls from PMDD.

India faces a significant challenge with alcohol misuse, as evidenced by the national survey revealing that 57 million out of 160 million persons with alcohol use exhibit harmful or dependent patterns, necessitating professional assistance. The Global Status Report on Alcohol and Health (2018) indicates a rising per capita alcohol consumption in the Southeast Asian Region, with India contributing substantially. To address this, implementing policies and programs to curb hazardous alcohol use is crucial. Despite a shortage of mental health professionals in India, they remain the primary caregivers for those with alcohol-related issues. Only one in five individuals with problematic alcohol use can access professional help. I argue for adopting Screening and Brief Intervention (SBI) to bridge this healthcare gap. SBI is a concise, structured counseling approach that proves effective and scalable. It can be delivered by various healthcare providers, including doctors, nurses, counselors, and paramedics. Hence, it can be seamlessly integrated into primary care, emergency, and nonclinical settings. The efficacy of SBI extends to electronic formats, providing a scope of expansion through telehealth. The WHO advocates SBI by its SAFER initiative aimed at reducing negative alcohol-associated health and social consequences. SBI is effective across age groups, including adolescents and young adults, constituting most of India's population. Emerging evidence suggests that SBI is acceptable, feasible, and effective in the Indian context. Universal or targeted SBI can be a pivotal tool in achieving the Sustainable Development Goals (2030) and global commitments for noncommunicable diseases, fortifying efforts to prevent and treat alcohol misuse.