Indian Journal of Psychological Medicine最新文献

Background: Opioid use disorder (OUD) is associated with structural brain alterations. Buprenorphine maintenance treatment (BMT)'s impact on brain morphology remains underexplored. We examined the effect of BMT on surface-based morphometry (SBM) metrics- cortical thickness, sulcal depth, gyrification, and fractal dimension, in a longitudinal controlled design.

Methods: Twenty-five men with OUD and age- and education-matched participants in the control group were recruited. Participants underwent T1-weighted MRI scans immediately after starting BMT and after six months of treatment. SBM metrics were analyzed using the Computational Anatomy Toolbox 12 (CAT12), employing threshold-free cluster enhancement (TFCE) and family-wise error correction.

Results: At baseline, individuals with OUD had greater cortical thickness in superior parietal and occipital regions and reduced thickness in the inferior temporal gyrus versus participants in the control group. After six months, significant cortical thickness reductions were observed in the occipital pole, cuneus, and occipito-temporal gyri, and calcarine sulcus in both hemispheres; sulcal depth, gyrification, and fractal dimension remained unchanged. We observed negative correlations between buprenorphine dosage and change in cortical depth in the parahippocampal region (r = -0.53, p = .007) and temporal pole (r = -0.55, p = .005), and positive correlations with fractal dimension in the medial orbitofrontal cortex (r = 0.53, p = .006) and gyrification in the lateral orbital region (r = 0.56, p = .004).

Conclusion: BMT is associated with a generalized cortical thinning in sensory regions, while dose-dependent changes are observed in memory, emotional regulation, and cognitive control regions, highlighting neuroadaptive processes in overall treatment and medication-specific effects.

Background: Parenting styles shape behavioral outcomes in children with autism spectrum disorder (ASD), yet their influence in low-resource settings, such as India, remains underexplored. This study investigates how parenting styles (authoritative, authoritarian, and permissive) correlate with behavioral outcomes in children with ASD in India, and examines demographic influences.

Methods: A cross-sectional study was conducted with 82 parents of children with ASD (aged 3-17 years) at a tertiary care hospital. Parenting styles (authoritative, authoritarian, and permissive) were assessed using the Parenting Styles and Dimensions Questionnaire (PSDQ), and behavioral problems were measured with the Strengths and Difficulties Questionnaire (SDQ). Descriptive statistics, Pearson correlation, analysis of variance (ANOVA), and t-tests were applied.

Results: Authoritative parenting predominated (mean score: 57.33 ± 9.55), linked to fewer behavioral challenges, while authoritarian (r = 0.37, p < .001) and permissive (r = 0.34, p = .002) styles were associated with increased difficulties, notably hyperactivity (6.66 ± 1.67) and peer problems (5.09 ± 1.83). Higher parental education favored authoritative practices (p = .007), whereas prolonged treatment duration worsened behaviors (p = .003).

Conclusion: Authoritative parenting mitigates behavioral challenges in children with ASD, unlike authoritarian and permissive styles, which exacerbate difficulties. These findings underscore the need for culturally tailored interventions such as workshops addressing stigma, resource scarcity, and language barriers to promote adaptive caregiving in India. Policymakers should integrate parental education into ASD care to enhance family well-being.

Background: Opioids can adversely affect sexual function by impacting the endocrine system, particularly the pituitary gland and sex hormones. While synthetic opioids have been well studied, little data exists on natural opium's impact on sexual functioning, especially in India, where it is considered an aphrodisiac. This study aims to evaluate sexual dysfunction and related factors among men who are dependent on natural opium.

Methods: In this cross-sectional study, we recruited 107 participants with a dependency on natural opium. The assessment included the Arizona sexual experience scale (ASEX), the International Index of Erectile Function (IIEF), the severity of opiate dependence questionnaire (SODQ), and the sex knowledge and attitude questionnaire (SKAQ-II). Additionally, assays were conducted for serum total testosterone, follicle-stimulating hormone (FSH), luteinizing hormone (LH), and prolactin.

Results: The rate of sexual dysfunction was 47% for ASEX and 91% for IIEF. Low serum testosterone and LH levels were found in 22% and 16% of cases, respectively. Hyperprolactinemia and low FSH levels were observed in 11% and 3% of cases, respectively. Older patients had a significantly higher prevalence of sexual dysfunction and displayed more severe opioid dependence. Hormonal assessment revealed significantly low testosterone levels among those with sexual dysfunction on ASEX. Logistic regression analysis indicated that only the severity of opioid dependence was a significant predictor of sexual dysfunction.

Conclusions: This research indicates that natural opium users frequently experience sexual dysfunction, which correlates with the intensity of opioid dependence. Consequently, clinicians must assess and address this issue to consistently improve treatment outcomes.

This article presents a simple explanation of fixed-effect and random-effects models in meta-analysis. In summary, we use a fixed effect model when the studies to be pooled are largely similar in design, methods, and sample characteristics, and when we can consequently assume that the values of an outcome in these studies represent sample-related variations of a single true value in the population. We use a random effects model when studies are meaningfully dissimilar in their design, methods, and/or samples, and when we can consequently assume that the values of the outcome in these studies represent sample-related variations of true values in different populations; that is, there are many true values. These conceptual issues should guide an a priori decision to favor one model or the other; the choice should not be made after eyeballing the results of analysis. This article also explains when a fixed effect model should be chosen, how the choice of model affects study weights in a forest plot, and how the choice of model affects the pooled estimate, its precision, and its chance of being statistically significant. Other practical notes are also provided.

Background: Transcranial electrical stimulation (tES) is a non-invasive neuromodulation technique increasingly recognized for its therapeutic potential in psychiatric disorders. Recent advances have enabled its administration in home settings, potentially increasing accessibility, reducing costs, and overcoming logistical barriers to in-clinic care. This scoping review systematically maps the preliminary evidence on home-based tES interventions for psychiatric disorders, while also assessing their feasibility, safety, and methodological trends.

Collection and analysis of data: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR), we conducted a comprehensive literature search in PubMed and Scopus, covering publications from 2000 to 2024. Eligible studies examined the use of home-based tES (transcranial direct current stimulation [tDCS], transcranial alternating current stimulation [tACS]) for the treatment of psychiatric disorders. Extracted data included study characteristics, stimulation protocols, monitoring approaches, outcomes, and reported challenges. Forty-three studies met the inclusion criteria, comprising 19 randomized controlled trials (RCTs), 12 open-label studies, and 12 case series or case reports. These studies encompass various psychiatric conditions, with depressive disorder and mild cognitive impairment/dementia being the most frequently investigated. The majority of the studies utilized tDCS, often with remote supervision or digital support.

Conclusions: Our review suggests high feasibility, good adherence, and minimal adverse effects, with potential symptom improvement across various disorders. However, small sample sizes, heterogeneity in protocols, and limited long-term data restrict the generalizability of results. Larger, methodologically rigorous trials are needed to establish efficacy, optimize stimulation parameters, and inform standardized guidelines for safe at-home tES use. Integration with telehealth systems and digital therapeutics may further enhance its scalability.

Background: Pornography addiction is a growing public health concern worldwide, with increasing recognition of its prevalence and consequences in India. This study explores the onset, manifestation, and impact of pornography addiction within the Indian context, addressing the need for culturally relevant research.

Method: A retrospective, observational, cross-sectional study was conducted using data from 589 individuals who sought treatment for pornography addiction through online and offline healthcare platforms. Patients aged 18 and older were included based on the International Classification of Diseases, 11th Revision (ICD-11) diagnostic criteria for Compulsive Sexual Behavior Disorder (CSBD) (6C72). Data on demographic factors, clinical diagnoses, and treatment outcomes were analyzed using International Business Machines Statistical Package for the Social Sciences (IBM SPSS). Participants received either pharmacological treatment, psychotherapy, or a combination of both.

Results: The sample included 589 participants, predominantly male (n = 583; 98.98%), with a mean age of 28.98 years; 374 (63.5%) were under 30, and 287 (48.7%) were single. Most identified as heterosexual (n = 568; 96.4%) and had no prior treatment history (n = 465; 78.9%). Common co-morbid sexual dysfunctions included erectile dysfunction (n = 232; 39.4%), premature ejaculation (n = 198; 33.6%), and low sexual desire (n = 109; 18.5%). Pharmacological treatment was most common (n = 338; 57.4%), followed by psychotherapy (n = 207; 35.2%) and combined treatment (n = 44; 7.4%). Age showed significant associations with addiction severity (χ² = 17.07, p = .01), relationship status (χ² = 190.11, p < .01), and treatment modality (χ² = 12.25, p = .01), with younger individuals more often receiving psychotherapy. Severity was weakly but significantly correlated with both age (r = 0.149, p < .01) and number of psychiatric diagnoses (r = 0.098, p < .05).

Conclusions: Pornography addiction in India is shaped by age, relationship status, and cultural context. These findings underscore the need for age-targeted, culturally informed interventions. Future research should examine longitudinal trends and psychiatric comorbidities to guide comprehensive treatment planning.