Indian Journal of Psychological Medicine最新文献

Purpose of the review: Bollywood (Hindi cinema) is a powerful global medium that shapes public attitudes toward mental healthcare. This scoping review systematically maps and characterizes the portrayal of mental health professionals (MHPs) in contemporary Bollywood films to identify dominant stereotypes, representational patterns, and potential gaps in representation.

Collection and analysis of data: A scoping review was conducted in accordance with the Arksey and O'Malley framework. A systematic search of online databases identified Hindi-language films released between 2011 and 2024. Inclusion criteria were applied to select films featuring MHP characters. Data from each portrayal were systematically charted to analyze demographics, professional competence, ethics, and narrative function. Thirty-five films featured 42 distinct MHP portrayals. The findings revealed a consistent pattern of negative representation. MHPs were presented as minor, unnamed characters with ambiguous professional status. MHPs were frequently portrayed with clinical incompetence (>70%) and major ethical violations (>73%), with these harmful stereotypes appearing persistent over the decade. A culturally specific pattern emerged where supernatural narratives frequently invalidate MHP expertise. Psychotherapy, though depicted, was often caricatured or undermined, and treatment outcomes were typically ineffective. A significant gap was identified concerning the lack of nuanced or positive MHP role models.

Conclusions: The systematic misrepresentation of MHPs in Bollywood portrayals risks reinforcing harmful stereotypes, trivializing professional care, and discouraging help-seeking in a country already facing a vast treatment gap. This review highlights an urgent need for the film industry to move beyond caricature and to create more accurate, ethical, and humanizing portrayals that can contribute positively to public mental health literacy.

Background: Depression is a significant global health issue, often accompanied by suicidality, which requires urgent and effective interventions. Oral ketamine is emerging as a potential rapid-acting treatment, but data on its efficacy and tolerability remain limited, particularly in the Indian context. Thus, this retrospective study was conducted to assess the response to oral ketamine in patients with depression and suicidality.

Methods: A retrospective cross-sectional study was conducted on 41 patients diagnosed with major depressive disorder (MDD), bipolar depression (bipolar affective disorder [BPAD] depression), or who had suicidal ideation, all of whom were administered oral ketamine therapy at a tertiary care psychiatric institute in India. Depression severity and suicidal ideation were assessed using the Hamilton Depression Rating Scale (HAMD) and the Modified Scale for Suicidal Ideation (MSSI), respectively, at baseline and after the third ketamine session. Sociodemographic and clinical variables were analyzed to explore their association with treatment outcomes.

Results: The mean reduction in HAMD and MSSI scores post-third ketamine session was 8.19 (p < .001) and 4.95 (p < .001), respectively, indicating significant improvements in both depressive symptoms and suicidal ideation. Common side effects included dizziness, nausea, and hypertension, and the least common was diarrhea.

Conclusions: Oral ketamine appears to be an effective and well-tolerated option for rapidly reducing depressive symptoms and suicidal ideation in patients with MDD and BPAD depression. It can be used in outpatient settings to provide immediate benefit to patients. Future studies with robust, prospective designs are needed to determine optimal dosing, evaluate long-term safety, and establish sustained efficacy.

Adolescents with substance use disorders often have co-morbid disruptive behaviour disorders, due to shared aetiology or bidirectional feedback. Such patients require a more nuanced assessment, as discussed in this editorial. Limited studies exist on the management of the comorbidity. Psychosocial interventions, especially those involving the family, are the most important.

Family accommodation (FA) is prevalent in obsessive-compulsive disorder (OCD). When patients refuse treatment, the impacts are more severe-with poorer clinical outcomes, greater FA, and more caregiver burden. In these cases, caregiver interventions are an essential clinical priority. However, clinical documentation of structured, culturally informed interventions for FA and caregiver burden for adults with OCD, in the absence of patient participation, remains limited. This case study describes an eight-session caregiver-focused intervention for a 26-year-old male experiencing burnout while accommodating his twin sister with OCD, who was refusing treatment. The intervention, grounded in cognitive-behavioral principles, targeted maladaptive caregiving patterns, reinforced boundary-setting, and facilitated shifts in caregiver behaviors and family routines. Post-intervention assessments indicated reductions in FA and emotional distress, with gains maintained at the one-month follow-up. This case highlights the feasibility and clinical utility of caregiver-directed approaches in adult OCD. It underscores the need for structured support for caregivers in collectivist cultures and suggests that even indirect interventions can disrupt symptom-maintaining cycles and promote systemic well-being.

Background: Pyromania is an impulse-control disorder characterized by repeated, deliberate fire-setting accompanied by increasing tension and followed by a sense of immediate gratification afterwards, as defined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR). Although rare, pyromania carries significant medicolegal consequences and occurs in the lifetime of approximately 3%-6% of psychiatric inpatients. This study evaluates socio-demographic characteristics, substance use patterns, and psychiatric comorbidities among individuals diagnosed with pyromania at a community hospital in the Bronx, New York.

Methods: This retrospective observational study included patients aged 9 years or older admitted to the psychiatric center between December 2013 and 2023. Twelve individuals met the inclusion criteria and were diagnosed with pyromania based on clinical assessment documented in the electronic medical record. Extracted data included demographic characteristics, socioeconomic variables, substance use history, and co-occurring psychiatric diagnoses.

Results: Included patients ranged in age from 9 to 59 years (mean 28.58 ± 16.21), and 75% were male. Most were US-born (83.33%), with 66.67% identifying as African American and 33.33% as Hispanic. All adults were single and unemployed. Psychotic disorders, primarily schizophrenia, were present in 58.33% of the sample, and 58.33% also had substance use disorders. Among youth, oppositional defiant disorder (ODD) and conduct disorder were common, while no adult met criteria for antisocial personality disorder.

Conclusions: Pyromania frequently co-occurred with psychiatric comorbidities, especially psychotic disorders and substance use. Although the overall prevalence is low, this disorder carries notable clinical and legal implications, underscoring the importance of targeted assessment and intervention in urban mental health settings. To the best of our knowledge, this is the first observational study to describe the socio-demographic and clinical characteristics of individuals diagnosed with pyromania in New York, USA.