Industrial Psychiatry Journal最新文献

The 2023 Odisha train accident in India is one of the deadliest train accidents in recent history, which is expected to have a massive psychological impact on the survivors and their families. Despite train accidents being common, there is an apparent lack of a process to support the psychosocial needs of the survivors. This narrative review highlights the catastrophic nature of the accident and possible psychological consequences of train accidents based on the literature and discusses approaches that can be taken to provide mental health support for the survivors. While there was appreciable support for the treatment of the injuries, financial compensation, and other practical help, it appeared that there were unmet needs for psychological support. With a greater understanding of trauma manifestation and effective strategies, it is feasible to set up an implementation plan that can take care of survivors from crisis support to long-term psychological intervention and rehabilitation. It would need multidisciplinary and multilevel cooperation and support. While preventing accidents should be the primary focus, providing timely and appropriate care for the survivors is of paramount importance. This review highlights the gap in psychological support for train accident survivors and provides a feasible approach that can be easily integrated into the existing health and social care system.

Background: There has been an increase in the estimated burden of alcohol use disorders (AUD) in countries like India. Treatment of AUD needs to be multi model and can be pharmacological and Psychological is their approach. Brief interventions are an effective approach to reducing drinking.

Aim: To assess if brief group intervention has any change in the motivation stage, readiness to change scores, self efficacy levels of an individual.

Materials & method: Alcohol use disorder patients were included and pre intervention scales-Severity of Alcohol Dependence Questionnaire {SADQ}, Stage of change readiness and treatment eagerness, General Self efficacy scale, University of Rhodes Island change assessment scale were applied. Three Group sessions were taken on a weekly basis and scales were re applied at the end of 12 weeks.

Results: A total of 83.33% of the participants were in early remission, the SADQ scores decreased in all participants, and 60% were in the Action phase of Motivation. Approximately 80% had a high score on the taking steps component of readiness to change scale and there was a statistically significant increase in the mean self efficacy score post intervention.

Conclusion: Brief group intervention involving psychoeducation and motivational enhancement techniques is a low cost, simple, and time saving behavioral intervention that not only increases rates of early remission but also leads to change in motivation and self efficacy levels.

Background: Comorbidity of various psychiatric conditions with migraine is common and important. A thorough analysis of mental conditions in migraine is essential to encourage the holistic care of such patients.

Aim: To assess psychiatric comorbidity in patients with migraine using a well-standardized clinical diagnostic tool.

Methods: This cross-sectional study was conducted in the outpatient department of a tertiary care hospital in North India. Persons with migraine attending the facility were enrolled as per the inclusion and exclusion criteria set for this study. The ICD-10 mental disorder symptom checklist was the principal tool to assess the psychiatric comorbidity in the patients.

Results: Total Patients recruited were 146 out of which 70.5% had a psychiatric comorbidity. Depressive disorder (17.1%) was the most common while delusional disorder (4.1%) was the least common psychiatric disorder comorbid with migraine. Other comorbid psychiatric diagnoses were recurrent depressive episodes (6.8%), dysthymia (10.3%), bipolar affective disorder (7.5%), panic disorder (5.5%), generalized anxiety disorder (8.2%), mixed and other anxiety disorders (6.2%), obsessive-compulsive disorder (6.2%), post-traumatic stress disorder (4.8%), adjustment disorders (5.5%), dissociative (conversion) disorders (6.8%), and somatoform disorders (6.2%). Lower socioeconomic status and the presence of aura with migraine are two important patient-related factors linked with the occurrence of any psychiatric comorbidity in migraine.

Conclusion: The prevalence of comorbid psychiatric disorders in migraine patients is very high. The relationship between demographic and medical information of people with migraine with individual psychiatric comorbidities is complex.

Background: School refusal behaviour is an umbrella term that often subsumes constructs such as truancy, school refusal, and school phobia. It is influenced by various psychological and psychosocial factors and can lead to significant distress to the child and the family.

Aim: To assess the clinical and functional profile of school refusal behavior in children and adolescents presenting to a tertiary care child and adolescent psychiatry center in the Indian context.

Materials and methods: Thirty-six subjects (6-17 years) presenting to a tertiary Child and Adolescent Psychiatry service with school refusal behavior (SRB) were evaluated using the MINI-KID 6.0 and School Refusal Assessment Scale-Revised (SRAS-R). The sociodemographic and clinical characteristics of the sample were studied using frequency analysis and central tendencies. The association between school refusal and these variables was examined using Cramer's V coefficient.

Results: Anxiety in social/evaluative situations associated with tangible rewards at home was the predominant primary reason for school refusal in this sample. There was a significant statistical association between functions of school refusal and scholastic performance, psychiatric diagnosis, and family stressors. The Children's Global Assessment Scale (CGAS) scores varied widely from 30 to 80 indicating an inability to function in almost all areas to no more than a slight impairment in functioning.

Conclusions: School refusal is a complex multifactorial phenomenon with both individual and psychosocial contributing factors. Understanding the phenomenon from a functional perspective helps in devising an individualized treatment plan that may lead to better outcomes.

Background: Kidney donation is a significant procedure that can profoundly impact the emotional, psychological, and social well-being of renal donors. However, there is a lack of sufficient evidence regarding the specific effects of donation on the mental health and quality of life (QOL) of living kidney donors.

Aim: To evaluate and compare the levels of depression, anxiety, and QOL among living kidney donors before and after the donation procedure.

Materials and methods: We conducted a prospective longitudinal cohort study involving 50 consecutive living renal donors, assessing them before and 3 months after kidney donation. Depression and anxiety were evaluated using the Hamilton Anxiety Rating Scale (HAM-A) and Hamilton Depression Rating Scale (HAM-D), respectively. Furthermore, the QOL of kidney donors was compared using the World Health Organization Quality of Life Brief Version (WHOQOL-BREF).

Result: The average age of kidney donors was 40.86 ± 8.59 years. Pre-transplant HAM-D and HAM-A scores showed significant negative correlations with post-transplant QoL domains (**P < 0.001). Regression analysis highlighted pre-transplant HAM-D as a significant predictor of post-transplant depression (P = 0.013).

Conclusion: Statistically significant differences in pre- and post-donation HAM-D and HAM-A scores were found, but clinical significance is crucial for interpreting real-world implications. Renal transplantation did not worsen mental health or QOL for donors post transplant, highlighting the importance of addressing pre-transplant depression and anxiety. Further research is needed to assess clinical significance and integrate mental health considerations into transplant care.

Background: Alcohol-related cognitive deficits (ARCDs) have received little clinical recognition due to doubts regarding the etiopathogenesis and lack of consensus in the diagnostic guidelines.

Aim: The present study aimed at evaluating the pattern of cognitive deficits in patients of alcohol dependence without dementia, and assessing the relationship between these subtle cognitive deficits and alcohol use parameters.

Materials and methods: The study included randomly selected, consenting, non-delirious patients of alcohol dependence syndrome (ADS) without dementia, admitted in the de-addiction ward. Cognition was assessed by Mini Mental State Examination (MMSE) of the Diagnostic Interview for Genetic Studies at admission and after 7 days of detoxification. "T-test" was used to assess cognitive improvement and residual deficits, while correlation analysis was used to compare the relationship between alcohol use parameters and MMSE scores.

Results: We recruited 63 male patients with mean age of 38.62 (±9.61) years. Significant improvement was noted in cognition post-detoxification. However, most of the subjects had subtle cognitive deficits which may fall within the realm of ARCD, mainly in domains of attention/concentration, recall, language, and visuo-constructional skills (P < 0.05). The cognitive deficits correlated with duration and severity of alcohol dependence (P < 0.05), however, were independent of daily alcohol quantity.

Conclusion: Subtle cognitive deficits may persist in patients of ADS without dementia, even after successful detoxification. They may be easily missed despite contact with mental health professionals, as these deficits may only be evident on neuro-psychological testing.

Background: The mentalization model of borderline personality disorder (BPD) utilizes a developmental psychopathology lens, emphasizing an unstable or reduced capacity to mentalize-stemming from early attachment disruptions and relational trauma-as the core feature of BPD. While the empirical evidence for the proposed intersections between mentalizing, attachment, and trauma and the development and manifestations of borderline personality is still limited, this knowledge is essential for developing effective assessments and interventions.

Aim: To examine mentalizing, attachment, and early relational trauma as predictors of the severity of symptoms in BPD.

Materials and methods: The sample included 60 individuals diagnosed with BPD, aged 18-45 years, recruited from inpatient and outpatient services in a tertiary care mental health center. Participants completed measures of mentalizing (Reflective Functioning Questionnaire, Interpersonal Reactivity Index, and Reading the Mind in the Eyes test), attachment (Attachment Style Questionnaire), early relational trauma (Complex Trauma Questionnaire), and symptom severity (Borderline Symptom List).

Results: The majority of the participants reported experiences of polyvictimization (93.3%) with the most common traumas being psychological abuse (93.3%), neglect (91.7%), and rejection (90.0%). Regression analyses revealed that uncertain reflective functioning, anxious attachment style, and the cumulative impact of trauma together predicted 53.1% of the variance in BPD symptom severity.

Conclusion: Impaired mentalizing, characterized by inflexible understanding of mental states, is a critical target for therapeutic interventions in BPD. The significant role of anxious attachment and the necessity of assessing the perceived impact of traumatic experiences highlight the importance of trauma-informed and mentalization-based interventions for this vulnerable group.