Indian Journal of Psychological Medicine最新文献

Purpose of the review: Magnetic seizure therapy (MST) is a novel neurostimulation method that merges the benefits of controlled seizure induction with the targeted application and enhances the safety of magnetic stimulation. This article reviews current research and assesses the potential role of MST in the management of mood disorders.

Collection and analysis of data: We searched PubMed and Google Scholar for English-language articles on MST in mood disorders. We also searched for articles comparing MST with electroconvulsive therapy. Early clinical studies and preclinical studies suggest that MST may be effective in alleviating both manic and depressive symptoms, with a more favorable cognitive profile. However, evidence remains preliminary, with limited randomized controlled trials and comprehensive long-term follow-up data.

Conclusion: Although MST appears promising as an innovative treatment option, additional large-scale, rigorously controlled studies are needed to confirm its safety, effectiveness, and ideal therapeutic approaches for individuals with mood disorders.

Purpose of the review: Metacognition is the ability to reflect on and regulate one's own cognitive processes. It is increasingly recognized as a critical factor in schizophrenia, influencing insight, treatment adherence, and functional outcomes. Self-report tools are widely used to assess metacognition, but their reliability, validity, and clinical applicability remain debated.

Collection and analysis of data: This systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was registered with International Prospective Register of Systematic Reviews (PROSPERO). A total of five electronic databases (PubMed, PsycINFO, Embase, Web of Science, and Scopus) were searched for studies published between 2014 and 2024. Eligibility was defined by the Population, Intervention, Comparison, Design (PICO-D) framework, focusing on adults with schizophrenia or schizoaffective disorder assessed with self-report metacognition measures. Study quality was appraised using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) Risk of Bias checklist. Of 2,437 records screened, 36 studies were included. Data were narratively synthesized, with statistical properties such as internal consistency (Cronbach's α), test-retest reliability, and factor structures summarized. Most tools, including the Beck Cognitive Insight Scale (BCIS), Metacognition Assessment Scale (MAS), and Metacognitions Questionnaire (MCQ-30), demonstrated high internal consistency (α = 0.70-0.95) and satisfactory construct validity. Findings consistently linked metacognitive deficits to greater symptom severity, poor social functioning, and reduced treatment response, while higher self-reflection and cognitive flexibility predicted improved clinical and vocational outcomes. However, limitations included reliance on self-report accuracy, limited longitudinal validation, and inadequate cross-cultural adaptation.

Conclusions: Self-report measures of metacognition in schizophrenia exhibit strong psychometric support and clear clinical utility for diagnosis, symptom monitoring, and rehabilitation planning.

Background: Patients with serious mental illness experiencing psychosis go through many challenges in their daily life activities. Despite the relevance of this issue, qualitative studies on this area from the Global South are scarce. This qualitative study aims to explore the impact of psychosis on functioning in patients with serious mental illness.

Methods: Nine patients clinically diagnosed with serious mental illness, aged 18-60, identified through maximum variability sampling, were approached for written informed consent. Subsequently, they were invited for an in-person interview regarding the impact of psychosis on their daily activities and everyday functioning. Interviews were also conducted with seven primary caregivers and four healthcare professionals working in the field of mental health. The interviews were audio-recorded, transcribed, and thematically coded in Microsoft Word and Microsoft Excel. The data analysis was done using the Systematic Text Condensation (STC) strategy. Interviews were conducted until thematic saturation was achieved.

Results: The key themes are presented as: Influence of psychosis on functioning, personal narratives of living with psychosis, and personal anecdotes from mental health professionals on psychosis and functioning. The results highlight the multidimensional nature of psychotic experiences, which reach beyond clinical manifestations and lead to significant emotional distress, reduced self-worth, and a diminished sense of personal identity.

Conclusions: This study brings out the need for holistic, patient-centered approaches that recognize the complex lived experiences of individuals experiencing psychosis, emphasizing the importance of comprehensive support systems that address functional, social, and psychological dimensions of mental illness.

Purpose of the review: The mental health of students is an increasing concern in school settings, with teachers often acting as the first line of support. As a result, there is growing interest in improving teachers' mental health literacy (MHL) through structured training programs. This systematic review aims to synthesize available evidence on MHL interventions targeting school teachers and to evaluate their effectiveness in enhancing knowledge, attitudes, and the ability to identify and address students' mental health issues.

Collection and analysis of data: A comprehensive literature search was conducted across eight databases: PubMed, Scopus, Ovid Technologies (commonly referred to as Ovid, a biomedical and academic research database platform), ScienceDirect, Cochrane, PsycINFO, Education Resources Information Center (ERIC), and Google Scholar. Keywords included "MHL," "teachers," "intervention," and "effectiveness." Experimental studies published between 2012 and 2024 were considered. From the 3,459 initial records, 871 remained after duplicates were removed. Following the screening of titles and abstracts, 44 studies were examined in full, of which 13 satisfied the inclusion criteria. The final review included five randomized controlled trials (RCTs), two cohort studies, and six pre- and post-intervention studies. Compared to previous reviews, this review incorporated a greater number of high-quality studies. Overall, the interventions showed a positive impact on teachers' mental health knowledge, attitudes, and supportive behaviors, although the magnitude of effects varied.

Conclusions: The review highlights that MHL training programs can be effective in empowering teachers to better support students' mental health needs. These findings support the need for contextually relevant, evidence-based training to strengthen educators' roles in promoting student well-being.

[This corrects the article DOI: 10.1177/02537176251377594.].

Background: While stigma surrounding mental illness continues to affect management, there are hardly any studies reflecting any change following psychiatric admission. We aimed to examine how self-stigma changes during treatment in an inpatient setting and how it relates to improvements in symptoms and functioning.

Methods: We analyzed stigma, depression, anxiety, stress, insight, well-being, functioning, and disability in 100 consecutive patients at admission and discharge in a psychiatric hospital in Kerala.

Results: At admission, 34.5% (confidence interval [CI]: 24.5-45.7) of patients reported self-stigma, which decreased to 23.2% (CI: 15.1-32.9) at discharge; the stigma score decreased from 17.1 ± 6.6 to 14.9 ± 4.7 (p < .005). However, stigma levels did not change between admission and discharge for most (68.3%) patients; 87.5% had minimal stigma, with no scope for further reduction. In a minority (7.3%), stigma severity increased. Stigma correlated positively with depression, anxiety, functioning, and insight, and negatively with age and well-being at admission; and at discharge, positively with stress. Patients reporting stigma had higher depression, anxiety, insight, and poorer well-being both at admission and discharge.

Conclusions: Most patients had a lower level of stigma; average stigma severity decreased during psychiatric admission; however, in a minority, it increased. While usual care was beneficial, the effectiveness of a proactive approach to stigma reduction warrants further study.

Background: Child sexual abuse (CSA) has profound psychiatric and developmental consequences; however, the relationship between specific abuse characteristics and mental health outcomes in the Indian context remains insufficiently studied. This study examined psychiatric morbidity, developmental psychopathology, and functional impairment among children with CSA.

Methods: A cross-sectional study was conducted with 100 children aged 6-17 years whose cases were registered under the Protection of Children from Sexual Offenses (POCSO) Act and referred to a government-supported protection center. Data were collected using a semi-structured interview, the Developmental Psychopathology Checklist (DPCL), DSM-5-TR-based clinical evaluations, and the Children's Global Assessment Scale (CGAS). Associations between abuse characteristics and psychiatric outcomes were analyzed using χ ² tests and logistic regression.

Results: The mean age was 10.87 years (SD = 3.22). Perpetrators were known to the child in 66% of cases, and 55% of participants experienced vaginal or anal penetration. Overall psychiatric morbidity was 53% (95% CI: 43.2-62.6). Common diagnoses included post-traumatic stress disorder (28%, 95% CI: 20.0-37.6), conduct disorder (21%, 95% CI: 14.2-30.0), and depression (17%, 95% CI: 10.9-25.5). Suicidality was reported in 12% (95% CI: 6.8-19.8). Vaginal/anal penetration was associated with higher rates of PTSD (χ ² = 8.67, p = .003) and depression (χ ² = 4.15, p = .04). Longer duration of abuse was associated with higher suicidality (χ ² = 6.30, p = .01). More severe physical injury was associated with higher suicidality (χ ² = 6.30, p = .01). Self-blame was associated with higher rates of adjustment disorder (χ ² = 4.98, p = .02). The mean CGAS score was 69.20 (SD = 12.16), reflecting mild-to-moderate functional impairment.

Conclusions: CSA survivors exhibit substantial psychiatric and functional difficulties, with specific abuse patterns linked to distinct mental health outcomes. Early trauma-focused assessment, caregiver psychoeducation, and timely psychosocial interventions are crucial to improving recovery trajectories.