Industrial Psychiatry Journal最新文献

Background: There are multiple barriers for psychotic patients to access mental health services, resulting in delays in treatment. Fewer studies are there exploring these barriers in the country. Identifying these barriers will contribute to management strategies.

Aims: To explore barriers to accessing mental health care in first-episode psychotic (FEP) patients and their association with clinical and demographic factors and duration of untreated psychosis (DUP).

Setting and design: This was a cross-sectional, descriptive study conducted in the Department of Psychiatry in a tertiary hospital in Eastern Nepal.

Materials and methods: Eighty-six FEP patients were enrolled. International Classification of Mental and Behavioral Disorders - Research Diagnostic criteria (10^th Revision) was used for making the diagnosis. The Barriers to Access to Care Evaluation (BACE) Nepali version assessed barriers to seeking help. DUP was determined using the Nottingham Onset Schedule-DUP version (NOS-DUP). Chi-square, parametric, and nonparametric tests were applied wherever appropriate.

Results: Attitudinal-related barriers (preference for traditional/religious treatment) were the most common major barrier. Unemployed patients from nuclear families and insidious modes of onset of psychosis had more barriers to the treatment. DUP was significantly correlated (P value < 0.001) with attitudinal barriers (r_s = 0.606), instrumental barriers (r_s = 0.476), and total BACE score (r_s = 0.632).

Conclusion: People's preferences for alternative treatment methods should be acknowledged, and multidimensional approaches for bringing the patient into standard care should be emphasized.

Background: India faces a severe mental health workforce shortage, with Madhya Pradesh (MP) having only 0.05 psychiatrists per 100,000 population-far below the World Health Organization (WHO) benchmark of 3. Granular data on psychiatrist distribution are needed to address inequities in care.

Aim: To map psychiatrist distribution across the seven districts of Indore division, MP, to assess geographic inequalities and estimate resource requirements for achieving WHO staffing norms.

Materials and methods: A cross-sectional geospatial survey (Jan-Mar 2025) identified actively practicing psychiatrists via snowball sampling, global positioning system (GPS)mapping, and inequality indices (Gini, Theil). Spatial clustering was analyzed using the nearest-neighbor index (NNI). Regression models assessed infrastructure-psychiatrist associations.

Results: Among 71 psychiatrists, 88% clustered in Indore city, yielding a regional density of 0.54 per 100,000. Three districts had no psychiatrists. High inequality (Gini = 0.78) and urban clustering (NNI = 0.38) were observed. Infrastructure availability strongly predicted psychiatrist presence (β =0.98). Meeting WHO targets requires 429 additional psychiatrists (annual investment: INR 514.8 million).

Conclusion: Severe urban-rural disparities exist in psychiatrist distribution. Targeted investments in workforce expansion, telepsychiatry (e.g. Tele-MANAS), and rural infrastructure are urgently needed to bridge the treatment gap.

Background: Suicide is a major cause of death among young adults, but few biological markers have been linked to suicidality. Interleukin-6 (IL-6) may play a role in elevating the risk of depression and suicidal tendencies. However, limited research has explored the connections between IL-6 and suicidal thoughts or actions.

Aim: This study was conducted to investigate the association between IL-6 levels and suicide attempts.

Materials and methods: In this observational study, 31 patients undergoing clinical follow-up after a suicide attempt were enrolled. The Columbia Suicide Severity Rating Scale (C-SSRS) was used for assessment of suicidal behavior. IL-6 levels in patients were measured using the ELISA technique with the IL-6 Human ELISA Kit (Invitrogen, Cat. No-BMS213-2) following the manufacturer's protocols.

Results: The mean level of IL-6 in the patients was 2.75 ± 6.50 (range: 0-36.6) pg/mL. Women exhibited higher IL-6 levels than men (women = 4.04 ± 8.97; men = 1.54 ± 1.86) pg/mL. IL-6 levels significantly increased with higher severity levels of suicidal ideation, with a P value of 0.0001, indicating a positive association. A significant positive correlation was observed between IL-6 levels and the intensity of suicidal ideation, with higher intensity associated with elevated IL-6 levels (P value = 0.0113). A significant positive correlation was observed between IL-6 levels and the lethality of suicidal ideation, with higher levels of lethality associated with elevated IL-6 levels (P value = 0.0129).

Conclusion: This study provides evidence that elevated IL-6 levels are associated with suicide attempts, supporting its potential role as a biomarker for suicidal behavior.

Datura is a poisonous plant, leading to the anticholinergic toxicity of the plant. After attending a marriage celebration, fifty individuals were hospitalized with acute onset of giddiness, blurred vision, excessive sweating, headaches, feeling hot, fearfulness, and dry mouth. Physical examination revealed a flushed appearance, tachycardia, conjunctival congestion, mydriasis, and urinary retention. Anticholinergic poisoning was suspected, and psychiatric consultations revealed that most patients were anxious and fearful with slightly increased psychomotor activity, with 64% exhibiting ataxia, 52% disoriented, and 20% experiencing visual hallucinations. Symptomatic treatment included hydration, short-acting benzodiazepines, and bedside psychiatric counseling, with which all recovered within 2 days. Various psychiatric aspects of diagnosis and management are discussed.

Background: Pregnancy impacts women's physical and emotional well-being, with cesarean births potentially causing stress, anxiety, and depression. Previous childbirth experiences significantly shape views on subsequent pregnancies.

Aim: To Study the Prevalence of Depression, Anxiety, and Stress In Women Who Underwent Their First CS As Compared To those with repeated CS.

Materials and methods: It is a cross-sectional descriptive study conducted in a Tertiary Care Hospital of Ahmedabad. Obstetric-Gynaecological Department. It included 130 women, 65 who had their first CS and another 65 who had subsequent sections. After taking informed consent, Participants' sociodemographic and clinical information was acquired using a Performa, and their anxiety, depression, and stress levels were measured using three scales: GAD-7, EPDS, and PSS. Statistical analysis was performed using Excel and the statistical software SPSS.

Results: Anxiety was significantly higher in rCS women (38.46%) than in fCS women (21.53%) (P = 0.03), while depression (26.15% vs. 16.92%) and stress (38.46% vs. 26.15%) were more common in rCS but not statistically significant. Depression correlated with maternal age (P = 0.0002) and education (P = 0.044), anxiety with emergency cesarean (P = 0.01), and stress with unplanned pregnancy (P = 0.04).

Conclusion: The findings of this study emphasize the need for interventions like mental health support programs, stress management strategies, educational initiatives and early detection of mental health issues during prenatal care to improve maternal well-being.

Background: Nursing is a stressful profession that can damage one's physical and mental health and affect professional outcomes. There is sufficient evidence to suggest that occupational (work-related) stress decreases the quality of nursing care and increases the chances of making errors while working.

Aim: To assess the occupational stress among the nurses working in a Medical College Hospital in Nepal.

Materials and methods: This was a descriptive cross-sectional study conducted among the 311 nurses working in a Medical College Hospital in Nepal. Data were collected using a self-designed questionnaire which also incorporated the Expanded Nursing Stress Scale (ENSS). Chi-square test and independent sample t-test were used for statistical analysis.

Results: The mean (SD) age was 26.2 (4.3) years, more than half (52.4%) were below 25 years and almost three-fifths (58.2%) were single. Occupational stress was found among two-fifths (41.2%) of the nurses. The mean (SD) ENSS score was highest in the area of problems related to supervisors [2.3 (0.5)], workload [2.3 (0.4)], and uncertainty concerning treatment [2.3 (0.5)], and least in the area of discrimination [1.4 (0.6)].

Conclusion: Above two-fifths of Nepalese nurses experienced occupational stress. Nurses often felt stressed by unnecessary demands of patients and their families, and their stress was also related to their problems with the supervisors, uncertainty concerning treatment, and excess workload. There was a significant level of stress among the nurses working in highly demanding stations like intensive care units. Institutional interventions may be necessary to reduce occupational stress among nurses.

Compulsive sexual behavior disorder (CSBD), trichotillomania (TTM), binge eating disorder (BED), and non-suicidal self-injury (NSSI) are classified in separate categories in the International Classification of Diseases, 11^th Revision (ICD-11). This case series aims to explore these disorders' overlapping impulsive and compulsive features despite their shared phenomenology and comorbidity. It also discusses the insight, reward mechanisms, and associated neurobiological understanding of repetitive behaviors. In the end, it also highlights the potential role of glutamatergic medications in their treatment. Further research is warranted to explore the glutamatergic system's involvement and assess the efficacy of glutamate modulators across the impulsive-compulsive spectrum.