Indian Journal of Psychological Medicine最新文献

Background and aims: Medical students around the world have been found to have high rates of depression and anxiety as compared to the general population. This study aimed to assess these in medical students immediately after they joined medical school and six months later. This study also aimed to assess if there was any association with stress, anxiety, and depression scores at six months follow-up with coping styles, self-esteem, personality, family functioning, and academic performance.

Methods and materials: We enrolled 154 first-year undergraduate medical students in this study with a baseline assessment including sociodemographic factors and Depression, Anxiety, Stress Scale 21 (DASS 21). They were followed up at six months with assessments of DASS 21, family functioning using the Family Adaptability, Partnership, Growth, Affection, and Resolve Scale (APGAR), coping styles using the Brief Coping Orientation to Problems Experienced (Brief COPE) scale, personality factors using the Big Five Inventory (BFI-10) and self-esteem using Rosenberg Self-Esteem Inventory (RSES). Change in scores in DASS 21 was measured. The DASS 21 scores at six months were correlated with other scale scores using appropriate statistical tools. Logistic regression analysis was done to study the effect of different variables on the outcomes.

Results: Mean DASS scores at baseline fell within the normal range. There was a significant increase in mean DASS scores six months after joining. Despite this, only three students reported receiving treatment for mental health problems. DASS scores showed positive correlations with neuroticism and emotion-focused coping styles. About 36.6% of students reported failing in at least one subject. Academic performance did not show any association with levels of psychological distress.

Conclusion: Students showed a striking rise in psychological distress six months after joining medical school. This suggests that the medical school environment could play a role. To meet students' needs, a change in medical school culture and the provision of accessible and flexible mental health services are required.

Background: Management of opioid dependence requires titrating medication doses based on withdrawal symptoms, but its clinical assessment presents challenges when it comes to subjective reporting. This study aimed to find out the relationship between heart rate variability (HRV) and opioid withdrawal in patients with opioid dependence.

Methods: Three groups of adult males were recruited: (a) patients with opioid dependence undergoing inpatient detoxification, (b) patients with opioid dependence stabilized on buprenorphine-based opioid substitution treatment, and (c) healthy controls. Frequency and time-domain parameters of HRV were used in the analysis. The opioid withdrawal was assessed using the Subjective Opiate Withdrawal Scale (SOWS).

Results: Resting heart rate was found to be significantly different across the three groups (higher in patients stabilized on buprenorphine than the other two groups). In time-domain parameters, the detoxification group had the highest beat-to-beat variability. In frequency-domain parameters, the total power was highest for the detoxification group and lowest for the opioid substitution treatment group. In contrast, the relative power of frequency bands (very low, low, and high) did not vary across the groups at baseline. The SOWS had a weak negative correlation with root mean square of successive differences (RMSSD) in the opioid substitution group and did not have any relationship with HRV parameters in the detoxification group.

Conclusions: This exploratory study did not find HRV parameters to be robustly associated with subjective withdrawal, except for a negative association with the beat-to-beat variability among patients on opioid substitution treatment. This study adds to information on HRV in patients with opioid dependence.

Background: Although personality disorders (PD) are known risk factors for suicide attempts, studies on personality dimension are scarce, which may provide further insights for interventions.

Methods: The relationship between personality dimension, lethality, intent, and quality of life (QOL) was studied in suicide attempters with or without PD. We used the international personality disorder examination (IPDE) dimensional score, the scale for assessment of lethality of suicide attempt (SALSA), suicide intent scale (SIS), and WHOQOL-BREF QOL scale, to assess a sample of suicide attempters admitted to a general hospital.

Results: PD was present in 43.2% and 57.9% of them had more than one PD. Comparison of attempters with or without PD suggested that the lethality of attempts and QOL were comparable, whereas self-reported suicide intent was significantly low in patients with PD. A higher proportion of PD patients reported relational problems as the reason for the attempt. The personality dimensional score was significantly higher for female attempters from urban backgrounds than for those with previous attempt histories. It was negatively correlated with the lethality of attempts and suicide intent.

Conclusion: It is important to explore the personality dimension of the suicide attempters, along with PD, that may highlight additional risks and suggest the need for specific support.

Background: Guilt, a complex emotional experience pervading many lives, takes on an intricate form when intertwined with psychiatric conditions. As a multifaceted concept, guilt represents a key diagnostic feature in depression and is an integral part of obsessive compulsive disorder (OCD).

Methods: This systematic review aimed to synthesize empirical research on the varied dimensions of guilt across these two mental illnesses, where guilt is emphasized as a pathognomonic factor. A systematic computer-based literature search was conducted, using a rigorous set of eligibility criteria and specific keyword combinations to ensure relevant and exhaustive coverage of the topic. Following Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, a comprehensive literature search spanning multiple databases identified 12 eligible studies on guilt in OCD and 8 in depression.

Findings: The findings revealed 20 distinct guilt constructs measured across the two disorders. Notably, 5 unique guilt subtypes and 15 themes for OCD and 6 exclusively studied guilt for depression emerged, reflecting potential disorder-specific manifestations of guilt.

Conclusion and implication: Delineating such guilt profiles holds the potential to untangle the role of guilt in the onset, perpetuation, and clinical course of OCD and depression. This comprehensive mapping of guilt constructs provides an empirical foundation for elucidating disorder-specific pathways influenced by guilt, thereby informing the development of targeted psychological interventions tailored to the distinct guilt patterns underpinning these debilitating conditions.

Background: In the field of psychiatry and mental health, Internet gaming disorder (IGD) is a relatively new concept. In the past few decades, as online gaming and internet usage became increasingly prevalent, this became a topic of concern and research. Therefore, this study aims to estimate the prevalence of IGD and its association with personality traits among students.

Methods and material: The present cross-sectional study was conducted at an Engineering college in Nunna, Andhra Pradesh. The planned duration of the study was 12 months, from March 2020 to March 2021. However, it was extended until August 2021 due to the COVID-19 pandemic lockdown, as colleges were closed indefinitely until further instructions. In the current study, a total of 170 students (first year to final year) from an engineering college, aged between 19 and 25 years, were included. Students who provided informed consent or expressed willingness to participate in the study through a self-structured questionnaire and those who had internet access or experience with online gaming in the past 12 months were included. The demographic profile, including age, sex, academic year, accommodation status, and departmental course was studied. Also, the device used for gaming was examined.

Results: The gender distribution in the given population indicates that approximately 65.88% are males and 34.12% are females, for a total of 170 individuals studied. In that 18 participants (10.58%) were found to have IGD. Among 18 participants with IGD, 14 were males and 4 were females. The gender prevalence for male and female participants was calculated separately and found to be 12.5% for males, and 6.9% for females which is almost a ratio of 2:1. The summary explores the relation between the Big Five personality traits and IGD. The current study subjects were categorized as low, medium, or high for each trait based on their IGD status (positive or negative). Significant correlations were determined between extraversion and IGD (p = .02), conscientiousness and IGD (p = .02), and neuroticism and IGD (p = .02).

Conclusion: The current study findings suggest that the overall prevalence of IGD among college students is 10.58% with a higher prevalence among males, IGD is positively connected with neuroticism and negatively correlated with extraversion and conscientiousness. This implies that certain characteristics, either alone or in combination, may raise the likelihood of individuals developing an IGD.

Introduction: Substance-use disorders (SUDs) are a public health problem. The Global Adult Tobacco Survey (GATS) and National Family Health Survey (NFHS) provide evidence of high usage. Hence, the National Mental Health Survey (NMHS) WB data were analyzed to estimate the prevalence, pattern, disability burden, and service utilization of SUD.

Methodology: The usual NMHS methodology was used. Four districts were selected, and thereafter, a multistage random sampling was done. The validated Bengali version of the Mini International Neuropsychiatric Interview (MINI) and other instruments like the Fagerstrom Test for Nicotine Dependence (FTND), disability, and health care utilization modules were used.

Results: A total of 2,646 eligible members (age >18 years as per 2011 census) were interviewed. It was found that alcohol use as per MINI at least 3 drinks of alcohol within 3 hours on 3 or more occasions was 3.9%, and the weighted prevalence of alcohol-use disorder (AUD) and tobacco-use disorder (TUD) was 3.04% and 14%, respectively. The AUD and TUD prevalence was lower than the national prevalence, yet they were more prevalent in urban areas than in the national trend. The ratio of women to men suffering from AUD in WB (1:5) was one of the highest in the country (all India average 1:18). Also, the treatment gap of 89.2% was more than the national average.

Discussion: SUDs are an important public health problem in the state of WB, which requires further research, particularly among women, comorbid psychiatric disorders, and in urban areas.

Introduction: Diagnostic and treatment accuracy of depression can lead to a better and possibly earlier response and remission in patients. The literature, though scanty, seems to suggest that quantitative electroencephalography (QEEG) can predict the outcome of antidepressant effects.

Methodology: Articles published between January 1990 and July 2019, including those dealing with QEEG recordings before and after the initiation of antidepressant medication, were included. The pooled effect size and subgroup analysis of waveforms were calculated to predict response to antidepressants.

Result: In all, 572 results were retrieved from the searches, of which 20 studies were included. Pooled data using a random-effects model (REM) calculated an effect size of 0.80 (95% CI [0.64-0.97]). Heterogeneity of the sample was low with Tau² = 0.02; df = 18 (P = .30); I² = 12%. Moreover, subgroup analysis showed that theta band frequencies were better at predicting response than alpha band frequencies (the standard mean difference [SMD] for theta was 0.91 compared to 0.68 for alpha waves).

Conclusions: QEEG is a valuable predictor of the antidepressant response. Among the EEG frequencies, the theta band showed the most significant change with treatment.

Background: The current study aimed to develop and implement the National Assistance in Mental Health for Health Care Providers (NAMAH) module, which focused on wellness and building resilience for a cohort of physicians.

Methods: The NAMAH module is a 12-week tele-mentoring program leveraging videoconference technology that uses the ECHO (Extension of Community Healthcare Outcome) HUB and SPOKE and consists of real-life case discussions and a brief didactic. The module's content was developed after iterative feedback from experts and incorporated suggestions from healthcare providers (HCPs) following a needs assessment. A pre and post-design was used to assess the impact of the module on psychological distress using the self-reported Kessler Psychological Distress Scale (K10) and burnout using the Maslach Burnout-Inventory-Human Services Survey (MBI-HSS) among the 32 physicians who participated.

Results: There was a significant decrease in the mean scores before (19.5 ± 6.27) and after (17.38 ± 6.23) the NAMAH module (p < .05) in the psychological distress as measured by K 10 with a Cohen's d of 0.41 (95% CI: 0.05-0.77). There was also a significant decrease in the mean scores after the intervention in the emotional exhaustion and depersonalization domain of the MBI-HSS with a medium effect size (Cohen's d of 0.65) and large effect size (Cohen's d of 0.94), respectively.

Conclusion: The findings from this pilot study lay a foundational framework, encouraging further exploration, research, and scaling-up of such interventions to enhance mental health among physicians and HCPs.