Indian Journal of Psychiatry最新文献

Background: Intellectual Disability poses the significant public health challenge and stigma. Notably, there has been a steady increase over the past few years in the issuance of Unique Disability Identity (UDID) cards, which are specifically designated for individuals with disabilities.

Aim: To examine socio-demographic patterns and clinical profiles of individuals certified with intellectual disability (ID) for UDID.

Methods: This is a hospital-based cross-sectional study observed over 2 years at a tertiary care government hospital. Data from 960 applicants assessed for ID certification were chart reviewed. Diagnoses followed ICD-10 criteria, and standardized intelligence tests determined the level of ID.

Results: Mean age was 17.5 years. Of the applicants, 2.3% had borderline intelligence, 37.2% mild ID, 36.04% moderate, 15.8% severe, and 8.4% profound. Males comprised 63.2%, females 36.7%. Only 1.77% were employed.

Conclusion: The UDID initiative improves access to welfare and support services for individuals with ID, highlighting the need for ongoing policy and rehabilitation efforts.

Background: Mental health is a global priority concern. The vast majority of people lack the ability to recognize mental illness and tend to have poor knowledge and attitude toward them. Help-seeking preferences even for common mental disorders remain unsatisfactory.

Objectives: To assess the mental health literacy level and health-seeking preferences for common mental disorders among adults above 18 years residing in rural and urban Puducherry.

Method: A cross-sectional explanatory mixed-method study was conducted, incorporating both quantitative and qualitative approaches. The quantitative component utilized a structured questionnaire administered through a multistage cluster random sampling technique. The Mental Health Literacy Scale (MHLS), comprising 35 items across six attributes, along with seven case vignettes, was employed to assess participants' ability to recognize common mental disorders and their preferences for health-seeking. The qualitative component involved two focus group discussions-one in a rural setting and one in an urban setting conducted using a mini-ethnographic approach.

Results: A total of 230 participants were surveyed. Responses to the survey indicated an average to poor level of mental health literacy (89.6%). There is adequate knowledge of professional help availability (73%) and where to seek information through resources such as general practitioners, friends, and Internet. However, most participants were inclined to hide (80%) their mental illness due to stigma. Only 14.3% and 9.4% could recognize generalized anxiety disorder and depression as mental illnesses, respectively. In the qualitative part, personal, family, social, and health system factors were identified as barriers to seek professional help for mental illness. The major barriers noted were trust in traditional/faith healers, stigma, low awareness, lack of trust, and confidentiality in the government sector.

Conclusion: Mental health literacy among adults was inadequate, and they were unable to recognize common mental health disorders. Professional health-seeking behavior was low due to misconceptions, stigma, and lack of trust in the health system.

Background: Coercive interventions may be required during psychiatric in-patient care, but require careful monitoring to minimize inappropriate use.

Aim: In this article, we aimed to systematically review published literature on the frequency and patterns of selected coercive methods in mental health establishments (MHEs) in India.

Methods: From a systematic screening of four databases (MEDLINE, EMBASE, CINAHL and PSYCINFO) supplemented by searching relevant citations and selected journals, we retrieved studies of frequency and patterns of mechanical restraint, chemical restraint and seclusion at Indian MHEs.

Results: Nine studies reported 1595 restraint events over 62699.86 in-patient days, i.e between 1.64 to 175.71 events per 1000 in-patient days or 16.38 to 195.22 events per 100 admissions. Chemical restraints using combinations of haloperidol with promethazine or lorazepam were preferred over physical restraints or combined physical/chemical restraint in most (8/9) studies. No clear patterns of acuity, setting or diagnostic break-up could be ascertained. No studies reported on the use of seclusion. From these results, we estimate that in a 30 bedded fully occupied psychiatric unit in India, a median of 43 admissions, 7 restrained patients and 26 monthly restraint events occur per month.

Conclusion: The varied rates suggest differences in clinical practice including practice culture (eg the involvement of caregivers), but might also reflect incomplete or inconsistent reporting. Determinants of restraint, which may operate at the level of the patient characteristics, staffing, or ward culture; needs further delineation. Finally, restraint reports are rare, and uniform reporting guidelines will help policy makers understand the phenomenon better.

Background: Effective coping is indispensable for negotiating the challenges of medical college. Numerous factors affect the choice and usefulness of coping strategies, and personality holds considerable significance among these.

Aim: We planned the present study to investigate coping-personality relationships in medical students, identify common coping strategies used, and study the influence of demographic factors on coping.

Methods: Students completed questionnaires with demographic details and two self-report scales: Big-Five Inventory (personality) and Brief COPE (coping).

Results: Out of the 300 forms distributed, 256 responses met the inclusion criteria. Brief COPE scores were higher for engagement/adaptive coping. Significant correlations were found between various coping strategies and personality traits. Conscientiousness correlated the most with adaptive strategies and neuroticism with maladaptive ones. We conclude that engagement coping is used more commonly by medical students.

Conclusion: Those with high conscientiousness and low neuroticism are more likely to use effective coping strategies.

Perinatal opioid use is the major public health concern worldwide due to its hazardous effect on the mother and the developing fetus. Opioid agonist maintenance treatment with buprenorphine or methadone has been the recommended treatment for opioid dependence during pregnancy for various reasons. There is scarcity of literature in this regard. This is first report from India presenting cases of pregnancy with opioid dependence with buprenorphine maintenance treatment and its outcomes.

Supratherapeutic dosing of selective serotonin reuptake inhibitors (SSRIs) in obsessive-compulsive disorder (OCD) is an area of clinical interest, particularly for treatment-resistant cases. Standard SSRI doses often provide insufficient symptom relief, prompting clinicians to explore higher-than-recommended doses. Evidence suggests that supratherapeutic dosing can enhance serotonergic activity, potentially improving treatment response. However, the risk-benefit profile must be carefully considered due to side effects. While some studies support its efficacy, individual response varies, necessitating close monitoring. Further research is needed to establish optimal dosing strategies and long-term safety in OCD patients requiring intensified SSRI therapy.