Indian Journal of Psychiatry最新文献

Background: Type 2 diabetes affects 10.5% of adults globally, with sexual dysfunction being one of the complications, of which erectile dysfunction is the most commonly reported one with the prevalence ranging from 35% to 90%. There are a few studies exploring links between sexual dysfunction, depressive symptoms, and marital satisfaction, which is the reason we undertook the study.

Aim: To study the prevalence of sexual dysfunction, depressive symptoms, and marital satisfaction in male patients with diabetes and correlation between the three parameters.

Methods: A total of 120 male patients with type 2 diabetes were assessed for sexual dysfunction using ICD-10 criteria and International Index of Erectile Function, depressive symptoms using Beck Depression Inventory, and marital satisfaction using Dyadic Adjustment Scale (DAS).

Results: The mean age of patients at diagnosis of diabetes was 42.32 ± 7.48 years, and the mean duration of diabetes was 7.35 ± 3.76 years. Mean HbA1c was 9.05 ± 2.25% with only 22 patients having good glycemic control. Eight-eight patients reported sexual dysfunction with lack of genital response, premature ejaculation, and orgasmic dysfunction being common. Thirty-two patients had depressive symptoms, with borderline clinical depressive symptoms and moderate depressive symptoms in 14 patients each. Marital satisfaction was affected with the total mean DAS score being 93.95 ± 18.34. There was a negative correlation seen between sexual function and depressive symptoms and also between sexual function and increasing age, with a positive correlation seen between sexual function and marital satisfaction. Poor glycemic control was significantly associated with clinically diagnosed erectile and orgasmic dysfunction.

Conclusions: Sexual dysfunctions, depressive symptoms, and marital distress are highly prevalent in patients with type 2 diabetes, warranting timely detection and management. The three parameters are significantly correlated with each other, and poor glycemic control is significantly associated with sexual dysfunction. Psychiatric liaison would improve outcomes.

This viewpoint advocates for significant reforms in the disability certification guidelines for mental illnesses in India. Currently, two years duration of illness is required before certification, which delays essential support. The proposed model emphasizes assessing the functional impact of conditions, aligns with global standards, and suggests regular reassessments to improve accessibility and inclusivity in mental health services.

Background: Involving parents in mental health treatment services can empower parents to manage their child's illness. We conducted this study to develop a tool to assess parental care for children with mental illness.

Materials and methods: The present study was conducted in five phases that included in-depth interviews with parents in the outpatient department (OPD), focus group discussions (FGDs) with parents in an in-patient setting, and with a multidisciplinary team, item development, and the assessment of psychometric properties of the tool.

Results: Parental care for children with mental illness (PCCMI) has 50 items derived from a thematic analysis of in-depth interviews of 31 parents and 2 FGDs with eight parents admitted at CPC and eight mental health professionals experienced in child and adolescent psychiatry. It is a 5-point Likert scale. The tool showed a high item-level Content Validity Index (I-CVI range: 0.8-1.0) and a high Scale Content Validity Index (S-CVI = 0.91). The test-retest method was used to calculate reliability. A total of 38 parents were included in the test-retest method. The mother and father's mean age and standard deviation (SD) scores were 39.7 ± 5.8 and 45.1 ± 4.9, respectively. Most parents' education level is above graduation (mothers: 86.8% and fathers: 86%). Around 63% of mothers were housewives and had normal pregnancies. The single measure two-way mixed absolute agreement intraclass correlation coefficient (ICC) value for 38 subjects was 0.96 with a 95% confidence interval (CI: 0.90-0.95), indicating high reliability.

Conclusion: PCCMI has high I-CVI and S-CVI and good ICC test-retest reliability. This tool will help mental health professionals in the formal assessment of parental care for children with mental illness and provide the intervention to address issues related to the same.

Background: Medical interns have 2 weeks compulsory internship in psychiatry.

Aim: We tried to explore their learning and views about psychiatry during these 2 weeks. To document verbatim their account about the knowledge gained and their experiences during the psychiatry internship posting and derive prominent themes.

Methods: Focus group discussion was conducted at the end of the posting using a semistructured questionnaire for seven consecutive batches of interns posted in psychiatry. To enhance trustworthiness, we utilized member checking, data triangulation, and peer debriefing. Their routine during posting, competencies, expectations from the posting, and frustrations were the main points discussed. The interns willingly participated and discussed their views about psychiatry posting.

Results: They were aware of psychiatry as an important medical discipline and had a fair degree of knowledge about it. Most of them found the posting useful. The interns had not attained the required competencies in handling emergencies and use of psychiatric drugs.

Conclusion: Involvement of senior faculty and formative assessments will be necessary in the training of medical interns. This can ensure that they gain the required competencies.

Introduction: Obsessive-compulsive disorder (OCD) is characterized by underlying obsessions and yielding/nonyielding compulsions, which often leads to significant levels of distress for the individual. Recently, obsessive-compulsive symptoms have been grouped into various symptom dimensions. The Dimensional Yale-Brown Obsessive-Compulsive Scale (DY-BOCS) gives a comprehensive picture regarding symptom severity in each individual dimension of OCD, while also providing a global severity score.

Aims and objectives: The psychometric properties of the Bengali adaptation of DY-BOCS have been assessed in this study.

Material and methods: A cross-sectional study was performed on 80 individuals suffering from OCD as per the ICD-10 DCR criteria. The Bengali version of the DY-BOCS and other scales for OCD, anxiety, and depression were administered to all of them. Inter-rater reliability was assessed for 34 individuals, and agreement between self and clinician-rated version of DY-BOCS was studied for 60 individuals. Internal consistency for items in a particular dimension of DY-BOCS, convergent validity, and divergent validity were also assessed.

Results: Internal consistency was found to be excellent (Cronbach's α > 0.90 in all domains), and inter-rater reliability was found to be good to excellent for all the six dimensions of the DY-BOCS (intraclass correlation values >0.80 for aggressive and miscellaneous domains and >0.90 in all other domains). High correlation was found between self and clinician-rated versions of DY-BOCS for the age group 18-35 years, the highest correlations being found for the Contamination (r = 0.82) and Aggressive domains (r = 0.75), while it was found to decrease in the older age group. Convergent validity and divergent validity were found to be satisfactory.

Conclusion: The psychometric attributes of the Bengali version of DY-BOCS appear to be satisfactory and thus can be reasonably administered to the population having Bengali as their mother tongue.

Background: Cultural beliefs significantly shape societal attitudes toward mental illness, and these social attitudes profoundly impact help-seeking behaviors. Therefore, it is important to focus on understanding and addressing these social behaviors.

Aim: This study aimed to evaluate the effect of chronic mental illness interpretations based on culture and religious beliefs on non-medical help-seeking behaviors among patients in Türkiye.

Methods: The study was conducted from September to October 2023 using an inductive qualitative approach. In-depth face-to-face interviews were carried out with individuals diagnosed with chronic mental illness and their relatives, registered in a state-owned Community Mental Health Center (CMHC) in Türkiye. Using purposive sampling, 13 individuals who met the criteria were interviewed. Thematic analysis was used to identify themes.

Results: Three main themes and eight sub-themes were identified, including the reasons for seeking non-medical help (psychological challenges, subjective norms, physical requirements), factors contributing to seeking non-medical help (predisposing factors, enabling factors, and myths), and reflections on the benefits of non-medical practices (perceived physical benefits, perceived psychological benefits).

Conclusions: It was concluded that individuals with chronic mental illness and their relatives living in the Eastern Anatolia Region of Türkiye engaged in non-medical help-seeking behaviors and mostly turned to traditional religious practices. Culture and religious beliefs emerged as primary factors leading patients to seek non-medical treatment approaches. Consequently, there is a perceived need to explore non-medical alternative methods across various mental health settings and with diverse samples in future research endeavors.

Background: Research on climatic parameters contributing to psychiatric disorder seasonality is limited, particularly in subtropical, arid climates like Rajasthan, necessitating investigation into seasonal variations in psychiatric disorder incidence in the region. This study investigates seasonal variations in psychiatric disorder prevalence over 2 years at a Rajasthan tertiary healthcare center, aiming to uncover links with climatic factors.

Aims: To investigate seasonal variations in the utilization of outpatient psychiatry services and elucidate potential determinants contributing to these temporal variations.

Settings and design: This is a hospital-based study. A retrospective chart review of all new patients who utilized psychiatry outpatient services from July 2021 to July 2023 was conducted.

Methods and material: Data were gathered from psychiatric outpatient records of adults (July 2021 to July 2023), diagnosed using ICD-10. Seasons were categorized: winter (November-January), spring (February-April), summer (May-July), and rainy (August-October). Meteorological data, temperature, and day length were obtained. Statistical analyses, including Pearson correlation and Chi-square fitness, assessed seasonal associations with psychiatric disorders.

Results: A total of 29,164 patient records were observed. Depression correlated with temperature and photoperiod. Mania peaked in August, linked to day length. Schizophrenia showed seasonal variation without environmental correlation. Anxiety peaked in March with no statistical significance. Obsessive compulsive disorder cases spiked in June, moderately correlated with temperature and photoperiod. Alcohol-related disorders peaked in December, while opioid dependence remained steady. Cannabis-induced psychosis peaked in summer, strongly correlated with temperature and day length. Headaches surged in August, positively correlated with temperature and day length.

Conclusions: This study reveals complex relationships between seasonality, environmental factors, and psychiatric disorders, emphasizing their importance in mental health research and practice.