Industrial Psychiatry Journal最新文献

Background: Prolonged QTc intervals, psychiatric medications, and associated risks such as sudden cardiac deaths and their cardiovascular safety profile are still being studied globally, given the revolution brought by them in the field of psychiatry.

Aim: To study the cardiac safety profile of psychotropics in terms of QTc prolongation and establish the safety of psychotropics as a group.

Materials and methods: In this study, 121 subjects receiving psychotropic medications were included. ECG of all the patients was performed and followed up to 4 weeks.

Results: The control group showed no difference at any of the three-time intervals, with the mean QTc interval at baseline being 391.3 + 49.70, at one week being 391.3 + 49.70 and at four weeks being 391.3 + 49.70. In contrast, the mean QTc interval for the patients' group was 352.9 + 64.68 at baseline, 353.3 + 649.70 at one week, and 354.4 + 64.82 after four weeks. The difference was found to be substantial (P < 0.001) but negligible (P = 0.078) when the baseline QTc interval was examined for one week. The point that needs to be highlighted here is that significant QTc changes after 4 weeks of starting some psychotropics were noted. However, the number of patients leading to QTc prolongation, i.e. QTc >470 mm/sec in females and >440 mm/sec in males, were, in fact, negligible (3 in number).

Conclusion: Based on the prescribed doses of the medications and any Torsade de pointes (TdP) risk factors, those taking psychiatric medications should have a personalized cardiac monitoring routine. Overall, psychotropics have emerged as a safe option for treating psychiatric illnesses. They do impact the QTc interval, but the number of cases presenting with arrhythmia and other life-threatening cardiac side effects are very few that too if monitored, these risks can be avoided.

Datura stramonium poisoning, triggered by the plant's tropane alkaloids, including atropine, hyoscyamine, and scopolamine, can pose substantial public health concerns. Historically used in traditional and ceremonial contexts in India, Datura ingestion leads to acute and potentially fatal central nervous system and gastrointestinal symptoms. The psychiatric manifestations of toxicity, such as vivid hallucinations, agitation, and delirium, can lead to self-harming behavior and complicate clinical diagnosis by mimicking other neurological and mental disorders like psychosis. In India, these dangers are amplified by the plant's deep roots in cultural and religious practices, often resulting in accidental overdoses and chronic misuse, particularly among vulnerable populations like children. There is a need for a multi-pronged approach to address this issue, including enhanced clinical awareness, widespread public education, and regulatory policies to prevent both accidental and deliberate exposure. There is a need for collaborative efforts among healthcare professionals, policymakers, and communities to ensure prompt treatment and effective prevention strategies. Future research should focus on potential pharmaceutical treatments to help chronic users recover and prevent long-term cognitive effects.

Background: Borderline Personality Disorder (BPD) in adolescents is a complex, often under-recognized psychiatric condition characterized by the emotional dysregulation, impulsivity, unstable self-image, and difficulties in relationships.

Aim: To explore the clinical and sociodemographic characteristics of BPD in adolescents, as well as associated factors and management strategies.

Materials and methods: A cross-sectional study was conducted at the outpatient department of a tertiary care Institute of Mental Health and Neurosciences from November 2024 to January 2025. A total of 71 adolescents aged 9 to 18 years were assessed using the Borderline Personality Features Scale for Children-11 Self-Report (BPFSC) and the DSM-5 criteria for BPD.

Results: Results revealed a predominance of female participants (95.77%), with an average age of symptom onset at 14.97 years and an average age of presentation at 16.87 years. The most common presenting symptoms, included impulsivity (90.14%), affective instability (80.28%), and intense anger (78.87%), while identity disturbance was the less frequently observed (8.45%). Familial conflict was the most common predisposing factor (36.61%), with Major Depressive Disorder (MDD) as the most frequent comorbidity (11.26%). Psychotherapy was universally prescribed, with low-dose quetiapine (28.16%) and sertraline (26.76%) being the most used pharmacotherapies.

Conclusion: The findings highlight the importance of recognizing the early manifestation of BPD traits, particularly in those at high risk for developing the full disorder. Recognizing BPD as a significant, but often overlooked condition in adolescents is essential to mitigate its impact and improving the quality of life for affected individuals making early identification and intervention a necessity.

More than 40 years after the approval of Law 180, Italy remains the only country to have entirely replaced psychiatric hospitals with a comprehensive, community-based mental health system. Driven by the vision of Franco Basaglia, this transformative reform moved psychiatric care away from institutionalization toward a model rooted in human rights, autonomy, and social inclusion. Although pioneering, the implementation was uneven, constrained by limited financial and human resources, and initially hindered by the absence of systems to evaluate care outcomes. Recent nationwide studies have revealed significant shortcomings in continuity of care, limited access to psychosocial interventions, and variability in treatment quality for conditions including personality, bipolar, depressive, and psychotic disorders. Internationally, the Italian model has significantly influenced mental health reforms in Latin America. In Brazil, the development of the Centros de Atenção Psicossocial reflected Basaglia's principles but is now challenged by service overload and a lack of inpatient alternatives. Paraguay has recently adopted progressive legislation promoting community care and deinstitutionalization, while Peru has implemented legal frameworks to integrate mental health into the general health system, although progress remains gradual. These diverse experiences underscore the Italian reform's global relevance and the complexities of translating its principles into practice.

Background: Burnout and psychological distress are prevalent among medical professionals, particularly in resource-limited settings like India, where systemic stressors exacerbate workplace strain.

Aim: To assess the effectiveness of a culturally adapted emotional wellness training program in reducing burnout and enhancing well-being among Indian doctors.

Materials and methods: A quasi-experimental one-group pretest-posttest study was conducted with 30 doctors at a Government Medical College in South India. A 10-week intervention included mindfulness, cognitive-behavioral strategies, and peer support. Outcomes were measured using the Brief Symptom Inventory (BSI), Utrecht Work Engagement Scale (UWES-9), and WHO-5 Well-Being Index, analyzed with paired t-tests and correlation analyses.

Results: Post-intervention, psychological distress decreased (Global Severity Index: 0.40 to 0.10, P < 0.001), work engagement improved (vigor: d = 0.45; dedication: d = 0.82), and well-being increased (WHO-5: 57.53 to 73.67, P < 0.001). Negative affect moderated outcomes, with no role-based differences (P > 0.05).

Conclusion: The program effectively reduced distress and enhanced engagement, showing feasibility in low-resource contexts, though sustainability requires systemic support.