Industrial Psychiatry Journal最新文献

Background: Alcohol use disorders (AUDs) are among the most common comorbid psychiatric disorders in patients with adult attention deficit hyperactivity disorder (ADHD), and adult ADHD is an independent risk factor for developing AUD.

Aim: To study the prevalence of adult ADHD in patients with Alcohol dependence syndrome (ADS).

Materials and methods: In total, 177 cases of ADS diagnosed as per International Classification of Diseases-10, Diagnostic Criteria for Research (ICD-10, DCR) were included. The severity of alcohol dependence was estimated by the Severity of Alcohol Dependence Questionnaire (SADQ). The included patients were screened for adult ADHD by the Adult ADHD Self-Report Scale (ASRS-v1.1) symptom checklist, and statistical tests were applied.

Results: Out of 177 patients with ADS, 21 patients screened positive for adult ADHD (11.9%). Greater severity of alcohol dependence among those screened positive for adult ADHD was noted compared to the adult ADHD negative group (P = 0.013). Adult ADHD-positive patients had an earlier age of onset of alcohol consumption (P = 0.020), higher mean duration of alcohol consumption (P < 0.001), and early onset of ADS (P = 0.038). ICD-10 criteria of loss of control, salience, and use despite harmful effects were significantly higher among the adult ADHD-positive group.

Conclusion: The study findings suggest a significant prevalence of adult ADHD among patients with ADS.

Background: Antipsychotic drugs have the potential to cause QT-interval prolongation (QTIP), which may lead to Torsades de Pointes and sudden cardiac death. Thus, it is important to know about the incidence and risk factors for QTIP.

Aim: The primary objective of the study was to find out the incidence of QTIP due to the use of antipsychotic drugs in patients with schizophrenia and acute psychosis after two weeks of drug use. The secondary objective was to find the risk factors for QTIP.

Materials and methods: The study included 160 consenting patients, aged ≥18 years, either sex, diagnosed with schizophrenia or acute psychosis, who had not taken oral/water-based injectable antipsychotics during the last 15 days or any long-acting antipsychotic injectable during the previous 6 months. Patients with other psychiatric disorders, substance use other than nicotine/caffeine, low serum levels of potassium/calcium/magnesium, congenital long QT syndrome, history of cardiac conditions, or those taking drugs with high risk to cause QTIP were excluded. ECG was recorded before starting treatment and after at least 2 weeks of treatment with antipsychotic drugs. Corrected QT interval (QTc) was calculated using Fridericia's and Bazett's formulae. QTc >450 ms in males and >460 ms in females was considered prolonged.

Results: The mean age of study participants was 35.88 years (SD: 13.32), and 88 (55%) were males; 138 (86.3%) suffered from schizophrenia. Seventy-one (44.4%) and 74 (46.3%) received risperidone and olanzapine, respectively. Twelve (7.5%) developed QTIP (QTc calculated using Fridericia's formula). Twenty-five (15.6%) were seen to develop QTIP (QTc calculated using Bazett's formula). Additional risk factors for QTIP could not be identified in the study sample.

Conclusion: QTIP is present in a reasonable number of participants. Careful screening and assessment for risk factors that could increase the chances of QTIP must be done regularly in patients getting antipsychotic drugs.

Background: Today, people are living in a digital world where they spend most of their time with electronic devices such as smartphones and computers and are not aware of the influence of the digital world in their life.

Aim: The aim of this study was to explore digital detox experience of people when they were asked to shut off the digital devices from their life for one day.

Materials and methods: The study's findings were based on semistructured interviews with participants who were willing for "a data off" experience. This study included a thematic analysis of the content of interviews from participants.

Results: Data gathered on the basis of these interviews were personal experiences shared by individuals who were abstinent from using digital devices for one day. A total of 2 major themes, discomforts, and benefits were emerged from the primary themes. The primary themes such as psychological difficulties, physical Vicissitudes, and social disquiets together produced the major theme of discomfort. Sense of belonging, mood enhancers, organized life, and health promoting activities contributed to the major theme benefits.

Conclusion: From this study, it can be concluded that digital detox experience is an eye opener for people about how they behave when there is no access to the world of internet. Although they need to struggle to maintain the data off activity, it certainly helped them to understand the way they can actively engage in more fruitful and productive activities which enhances their quality of life.

This text discusses a case report of a pregnant anemic female in her second trimester with a diagnosis of bipolar depression and comorbid obsessive compulsive disorder (OCD). Managing both mood stabilization and obsessive compulsive symptoms simultaneously in a pregnant female presents a real challenge, especially considering that serotonin reuptake inhibitors (SSRI), the first-line treatment for OCD, can induce manic or mixed mood states in bipolar disorder patients. This case is unique in view of limited options left with pregnancy in place. Lamotrigine was chosen as an agent and was introduced in this patient which is rated as FDA pregnancy risk category C which amounts to risk cannot be ruled out (human data lacking, animal studies positive or not done). Patient responded well and maintained well on monotherapy of lamotrigine and showed significant improvement in both symptoms of depression and OCD. USG-level II examination shows no abnormality on repeated scans.

Background: There is a rising trend of alcohol addiction in our Indian society. Studies from high-income countries have demonstrated the effective usage of mobile phones in delivering psychosocial interventions in the treatment of substance disorders.

Aim: To assess the effectiveness of Tele-Counseling as a mode of continuing care for patients with alcohol dependence syndrome.

Materials and methods: An open-label randomized control trial was conducted with 78 male participants. Patients with severe mental disorders or cognitive impairments were excluded. Participants received standard care treatments and were randomly assigned to either the Tele-Continuing Care (TCC) group or the Treatment as Usual (TAU) group. 1) 'Telephone Continuing Care ' group (TCC) who received pro-active contact and counseling through mobile phones from the treatment team on the 1^st, 2^nd, 4^th, 8^th, 12^th, 16^th, 20^th, and 24^th week after discharge. 2) The 'Treatment-As-Usual' group (TAU) received usual outpatient follow-up care. We contacted patients and their caregivers every month over mobile phones, belonging to both groups and collected information regarding drinking status up to one year after discharge. We compared abstinence rates, drinking percentage days, and treatment adherence rates. By including all the variables, we did logistic regression to predict relapse.

Results: The mean age of participants was 41.38 ± 9.06 years, with the majority being married. A higher percentage of patients in the TAU group had higher education qualifications compared to the TCC group. Duration of treatment adherence was significantly (P = 0.017) longer in the TCC group than TAU group (159.83 (120) ±129.47 vs. 100.37 (60) ±112.95) days. Similarly, compliance with abstinence-maintaining medications was better (P = 0.027) in the TCC group than TAU group (142.85 (120) ±115.50 v/s 95.29 (52.5) ±104.42) days. Attendance to group therapy sessions also was better in the TCC group (P = 0.001) compared to the TAU group. However, there was no statistical significance between the two groups in terms of abstinence rate at the end of one year (TCC: 61.8% and TAU: 44.4%) and also the drinking percentage days at the end of one year (TCC 28.22% vs. TAU 38.76%). Logistic regression revealed that a Family History of Alcoholism and Poor Drug compliance were found to be significant predictors of relapse.

Conclusion: As Tele-Counselling Care in our study showed partial effectiveness in improving the outcome measures, research should focus on improvising further to strengthen the Tele-Counselling model, especially in resource crunch Low- and Middle-Income countries and this could be included in the armamentarium of alcohol de-addiction program.

Background: Chronic use of alcohol is usually associated with poor sexual functioning. Sexual dysfunction is often associated with disharmony in relationships, which ultimately leads to an increase in alcohol consumption.

Aim: This study aimed to find out about various aspects of sexual dysfunction related to alcohol dependence syndrome (ADS).

Material and methods: A cross-sectional observational study was conducted among married males and living with their families and admitted to a tertiary care center. The patients consuming alcohol were assessed using psychometric tools, including the alcohol use disorders identification test, the severity of alcohol dependence questionnaire, and the international index of erectile function. Data from 234 male patients were analyzed using descriptive statistics.

Results: The study found a high prevalence of sexual dysfunction among the participants. Specifically, 41.5% of patients reported decreased sexual desire, 40.6% experienced a loss of overall satisfaction, and 38.9% suffered from erectile dysfunction. Patients with ADS showed significantly higher levels of dysfunction in orgasmic function, sexual desire, erectile function, and overall satisfaction compared to those without ADS. However, there was no significant difference in terms of intercourse satisfaction between the two groups. Longer durations of alcohol use were associated with a greater degree of sexual dysfunction across all domains of sexual functioning.

Conclusion: The study highlights the significant association between alcohol dependence syndrome and sexual dysfunction. Routine assessment and intervention for sexual health issues should be integral to the management of alcohol dependence.

Background: The COVID-19 pandemic was not merely limited to physical health concerns, and after the pandemic, the mental health consequences of the pandemic are still reverberating within our societies, especially in India. The college students in India were left to grapple with unforeseen circumstances, facing abrupt uncertainties with respect to their education and careers. Although their physical health was relatively more robust, their mental health status was left unexplored.

Aim: To assess depression, anxiety, and suicidal ideation in college students in the aftermath of COVID-19 pandemic.

Materials and methods: An observational cross-sectional survey was conducted on 323 undergraduate students from June 2021 to August 2021, who were required to fill a survey form which comprised basic sociodemographic details, student's concerns about COVID-19 and the following scales: Hospital Anxiety and Depression Scale (HADS) and Positive and Negative Suicide Ideation Scale (PANSI) after obtaining written and informed consent from them. The data collected was analyzed using descriptive and inferential statistics.

Results: The study revealed that 23.52% of the participants suffered from depressive disorders, and 34.98% from anxiety disorders. Although a statistically higher number of males were depressed as compared to females (33.87% versus 17.08%), it was the opposite for anxiety disorders (47.73% females versus 14.51% males). HADS anxiety score was positively correlated with worrying about family members, COVID-19 infection in family members, fear of contracting the infection, presence of psychiatric illness in family, and history of attempted suicide. HADS depression score was positively correlated with worrying about family, COVID-19 infection in family members, a prior consultation with a mental health professional, and history of attempted suicide. Suicidal ideations as predicted by PANSI Positive score was predicted by rural place of residence, number of family members, and presence of psychiatry patient in the family.

Conclusion: In the following era of the COVID-19 pandemic, anxiety and depression were high amongst college students. Various COVID-19-related and personal correlates for anxiety and depression as well as predictors for suicidal ideations could also be delineated. Institutions need to find out at-risk students and plan active measures for them.

Background: Delirium, an acute and often fluctuating disorder of attention and cognition, poses significant challenges in clinical care due to its varied presentation and complex etiological factors. In rural healthcare settings, where resources and awareness are limited, delirium is frequently under-recognized and inadequately managed.

Aim: To investigate the factors associated with and types of delirium and their correlation with sociodemographic profiles in hospitalized patients at a tertiary care rural hospital in Central India.

Materials and methods: This cross-sectional observational study was conducted on 120 patients diagnosed with delirium and referred to the Department of Psychiatry. A comprehensive assessment was performed using the Delirium Etiology Checklist (DEC) and Richmond Agitation Sedation Scale (RASS), and data spanning various associated factors, subtypes, and demographic variables were analyzed using SPSS version 27.0.

Results: The cohort had a mean age of 48.2 ± 15.96 years, with a predominance of male patients (84.2%). Substance withdrawal (16.96%), anemia (12.5%), and renal derangement (11.6%) emerged as the major factors associated with delirium. Hyperactive delirium was observed in 88.3% of patients, while hypoactive delirium was found in 11.7%. A significant association was noted between cardiac decompensation and sepsis with hypoactive delirium, while substance withdrawal with hyperactive delirium.

Conclusion: The study highlights the need for a systematic approach to identify and manage delirium's underlying associated factors, particularly in resource-limited settings, to prevent adverse outcomes.