Indian Journal of Psychiatry最新文献

Background: Dhat syndrome, an entity mostly recognized in men, has also been observed in women wherein distress is a result of non-pathological Vaginal Discharge (VD).

Aim: To synthesize evidence on the sociodemographic profile, clinical presentation, comorbidities, diagnostic approaches, and treatment outcomes of female Dhat syndrome, to clarify its nosologically status and inform clinical management.

Methods: The current paper followed PRISMA guidelines and used five databases (Scopus, MEDLINE, PubMed, CINAHL, and EMBASE) to select studies published up to January 31, 2025. Quantitative, mixed-method studies, case series, and case reports focusing on FDS were included and narratively synthesized. The risk of bias was assessed using the Joanna Briggs Institute (JBI) critical appraisal tools.

Results: A total of 21 studies with 4,375 women affected by female dhat syndrome (FDS) were included. Primarily married and from low-to-middle-income backgrounds, these women commonly reported weakness, fatigue, and body pain, which they attributed to VD. According to them, VD was a result of excessive body heat, infections, and sexual anxieties. Psychiatric comorbidities, particularly depression, anxiety, and somatoform disorders, were prevalent. Psychoeducation, antidepressants, and anxiolytics were the primary intervention strategies used by medical professionals.

Conclusion: The presentation of FDS is influenced by psychological and cultural factors. Evidently women having lesser access to health and sexual education present more frequently with FDS. Greater awareness, standardized diagnostic criteria, and standardized management strategies are needed to address the distress and improve clinical outcomes for affected women.

Background: Specialty-focused reporting guidelines can help cater to the nuances of manuscripts pertaining to a medical field.

Aim: The present work describes the development of reporting guidelines for case reports and case series in mental health and psychiatry.

Methods: A set of mental health and psychiatry experts followed a step-wise process of examining the existing reporting guidelines for case reports, generating items for reporting guidelines specific to mental health and psychiatry, refinement, and developing consensus.

Results: The Case Reports In Mental health and Psychiatry (CRIMP) reporting guidelines have 8 items, with two having sub-items. The CRIMP can be used for reporting a single case or case series of up to 10 cases, but is not applicable for case reports with detailed review of literature and long-format case studies. The items include: identification as case report/case series in the title, introduction mentioning the novelty or reasons for reporting, case demographics and setting, case description and assessment, case diagnosis, discussion of the key issue(s), pertinent references, and ethical aspects.

Conclusion: The CRIMP reporting guidelines have potential utility for authors, reviewers, and editors in the field of mental health and psychiatry, while drafting or appraising case reports and case series.

Background: Dementia is a major cause of disability among older adults. The global burden of dementia is expected to triple by 2050, with developing countries, witnessing a sharp increase. Early detection and management through screening programs can mitigate the progression of cognitive decline.

Objectives: This study aimed to determine the prevalence and predictors of cognitive impairment among older adults residing in rural areas.

Methods: An analytical cross-sectional study was conducted among older individuals residing in rural communities. A three-stage cluster sampling method was employed to select 350 participants. Cognitive screening was performed using the Hindi Mental State Examination, with a score ≤23 indicating cognitive impairment. Data on socio-demographics, clinical parameters, and functional abilities were collected and analyzed using SPSS version 26.

Results: The prevalence of cognitive impairment (CI) was 24.9% (n = 87), with the majority presenting with mild CI (87.4%). CI was significantly higher among females (33.9%) (AOR: 3.2, 1.7-6.01). Key predictors of CI included advanced age (AOR: 3.4, 1.8-6.7), widowhood (AOR: 2.2, 1.5-4.1), and functional limitations [activities of daily living and instrumental ADL (ADL and IALD)] (AOR: 9.71 and 11.22, respectively). A significant positive correlation was found between overall Hindi mental state examination (HMSE) score and anthropometric measures, with the strongest association observed with height (r = 0.47, P < 0.001), followed by weight (r = 0.37, P < 0.001).

Conclusion: Cognitive impairment is the highly prevalent among the elderly in rural areas, with multiple socio-demographic and behavioral factors contributing to its occurrence. Implementing routine cognitive screening and promoting physical activity, social engagement, and healthy lifestyle practices are essential for early detection and intervention.

In presentations for teaching, research, or public education purposes, well-chosen images enhance focus, reflection, and memory retention. AI tools help create images that are culturally sensitive and inclusive and depict abstract or complex psychiatric scenarios. AI images should be clear, audience-tailored, and complementary to text and verbal explanations. Clear, detailed prompts ensure alignment with the intended vision and stylistic consistency across images. Addressing variables such as style, mood, and color helps create unique, compelling images. AI images can also be helpful in psychoeducation and psychotherapy, as they can be customized to the patient's demographics and symptoms and can be quickly created during a consultation. They would especially benefit patients with low literacy. This article describes the leading AI image-generation tools, offers practical guidance on image creation and effective prompt strategies, and provides example prompts. It also discusses the limitations of current models and ethical considerations. Together, these insights support educators, researchers, and clinicians in using AI images responsibly and creatively to enrich their presentations and patient care.

The Central Institute of Psychiatry (CIP), Ranchi, has been a cornerstone of Indian psychiatry since its founding in 1918, pioneering therapies, psychopharmacology, child and community mental health services, and training generations of psychiatrists. It was central to establishing the Indian Psychiatric Society and shaping psychiatric departments nationwide. Despite its historic legacy, CIP now faces a slow decline marked by chronic underfunding, unfulfilled infrastructure promises, vacant faculty positions, bureaucratic interference, and disrupted clinical services, including irregular ECT, limited radiology, and overburdened OPDs. Bureaucratic interference and side-lining of senior faculty have further weakened leadership and morale. Patients, especially from Bihar, Jharkhand, and Bengal, bear the burden of inadequate services. Immediate actions and reforms are essential, including granting autonomy, upgrading infrastructure, filling faculty vacancies, safeguarding core therapies, and establishing super-specialty programs. Preserving CIP is crucial to sustain the legacy and future of Indian psychiatry.

Background: Vaginismus, categorized under ICD-11 as a sexual pain-penetration disorder, is often overlooked in clinical practice, particularly in culturally conservative societies where stigma, lack of awareness, and gendered misconceptions delay help-seeking. This case series examines the interdisciplinary management of vaginismus.

Cases: Five women (ages 22-35) with lifelong or acquired vaginismus, diverse comorbidities (e.g., dysthymia, childhood trauma, infertility distress), and delayed help-seeking due to the sociocultural barriers were managed through an interdisciplinary model. Gynecological assessments ruled out organic causes, followed by psychiatric evaluation, and tailored interventions: pharmacotherapy (Selective serotonin reuptake inhibitors (SSRIs), duloxetine, propranolol), psychoeducation, cognitive-behavioral techniques (Jacobson's relaxation, sensate focus), and vaginal dilator therapy. Joint sessions with spouses and graded desensitization were emphasized. Outcomes were tracked over 3-8 months. All patients achieved successful penetrative intercourse and reported improved psychological well-being. Key facilitators included spousal support, trauma-informed therapy, and combined psychiatric-gynecological care. Interventions reduced anticipatory anxiety, resolved pelvic floor dysfunction, and restored marital harmony. Two patients conceived post-treatment.

Conclusion: Interdisciplinary collaboration between mental health and gynecological teams is critical for managing vaginismus, particularly in low- and middle-income countries (LMICs) where stigma delays care. The case series highlights the need for enhanced training of gynecologists and mental health professionals to recognize and manage vaginismus as a treatable disorder rather than a taboo subject. This patient series adds to the limited literature on vaginismus from LMICs and serves as an educational resource for clinicians and trainees encountering female sexual dysfunctions in similar sociocultural settings.

Background: Following a diagnosis of Attention-deficit/hyperactivity disorder (ADHD) many children require immediate use of pharmacological agents for symptom control, while for some children a trial of non-pharmacological management may be warranted initially.

Aim: To study and identify the clinical and socio-economic factors associated with immediate use of pharmacotherapy versus non pharmacological management in children with newly diagnosed ADHD.

Methods: A retrospective cross sectional study design using chart review was conducted in child and adolescent psychiatry services of a tertiary care hospital. The medical records between 2018 and 2020 were reviewed. The socio-demographic factors, symptom profiles and comorbidities were recorded. Descriptive statistics and Binary Logistic regression analyses were calculated for factors associated with use versus non-use of pharmacotherapy.

Results: 187 patients screened positive for ADHD at the walk-in clinic and after detailed assessments, 101 were diagnosed with ADHD. With every one-point increase in Vanderbilt ADHD Parent Rating Scale (VADPRS) severity score, there is 1.2 times [P = 0.002; Exp(B) = 1.281; 99% CI: 1.089-1.494] higher likelihood of getting a pharmacological prescription for ADHD. Combined presentation has 3.8 times [P = 0.015; Exp(B) = 3.808; 99% CI: 1.295-11.198] higher likelihood of getting a pharmacological prescription compared to only hyperactive/impulsive and inattentive presentations. Among the socio-demographic variables, no statistically significant variables were observed, although the odds ratios among all social categories displayed a meaningful trend.

Conclusion: Pharmacotherapy for ADHD at initial diagnosis is strongly predicted by the severity of ADHD and other socio-economic variable that may require equal attention in the coming years.

Background: Cognitive impairment disproportionately affects the geriatric population in India due to a combination of nutritional, socioeconomic, and environmental factors.

Aim: This study employed the culturally validated Indian Council of Medical Research (ICMR)-Multilingual Dementia Research and Assessment (MUDRA) Toolbox to investigate cognitive impairment among geriatric population in Gorakhpur, India and to assess their performance in the various cognitive domains of the MUDRA toolbox.

Methods: This cross-sectional study included 1013 participants aged over 60 years selected through multistage random sampling across seven blocks in Gorakhpur district. Participants who exhibited cognitive impairment on the Montreal Cognitive Assessment (MoCA) test underwent further assessments across multiple cognitive domains in the MUDRA Toolbox, including tests of attention and executive functions, episodic memory, language, and visuospatial functions. Data were analyzed using descriptive statistics, Chi-square test, Mann-Whitney U test, and multinomial logistic regression.

Results: Among 1013 participants, 847 screened positive on MoCA (70.4% mild, 13.2% moderate) for cognitive impairment and were assessed further for other domains of ICMR-MUDRA toolbox. Males performed significantly better than females across multiple MUDRA toolbox domains, including attention and executive functions, episodic memory, language, and visuospatial skills (P ≤ 0.05). Females showed higher error rates in Trail Making Tests and higher line bisection deviation (P < 0.001).

Conclusion: Significant cognitive impairment exists among geriatric population in Gorakhpur. It could arise from the disparities in educational attainment and occupational engagement. These findings emphasize the need for early public health interventions specific for middle-aged population to delay the onset of cognitive impairment.

Background: Internet Gaming Disorder (IGD) is a behavioral addiction emerging as public health issue. Its neuropsychological underpinnings remain underexplored in the Indian context.

Aim: To compare neuropsychological profiles and social connectedness among normal, at-risk, and disordered gamers aged 18-25 years.

Methods: Ninety video gamers were categorized using the IGD Scale and compared on impulsivity, aggression, sensation seeking, self-esteem, social connectedness, and decision-making.

Results: Disordered gamers showed significantly lower self-esteem (P = 0.01) and higher motor impulsivity (P = 0.04) and boredom susceptibility (P < 0.01). Results were non-significant for remaining variables between groups. IGD severity correlated positively with motor impulsivity (r = 0.258, P = 0.014), total impulsivity (r = 0.254, P = 0.016), and boredom susceptibility (r = 0.336, P = 0.001), and negatively with self-esteem (r = -0.361, P < 0.001).

Conclusion: Young adults with IGD display heightened impulsivity, boredom proneness, and lower self-esteem, indicating the need for early, targeted psychosocial interventions.