Industrial Psychiatry Journal最新文献

Psychotropic medications, particularly antipsychotics, are known to elicit various adverse effects, with ocular complications being underreported yet significant. This case series presents three instances where atypical antipsychotics, namely Risperidone, Cariprazine, and Olanzapine, led to ocular dystonias and nystagmus. These adverse effects occurred at relatively low doses, highlighting the need for vigilant monitoring even with second-generation antipsychotics. Case descriptions delineate patients experiencing acute dystonic reactions and nystagmus following initiation or dose adjustment of atypical antipsychotics, leading to upward deviation of the eyes, involuntary movements, and nystagmus. Prompt recognition and management were crucial, with cessation of the offending medication resulting in symptom remission and subsequent stabilization with alternative treatments. Factors contributing to these adverse effects, such as dopamine receptor blockade and individual susceptibility, are explored, emphasizing the importance of comprehensive evaluation and open patient-physician communication. The present case series underscores the necessity of vigilant monitoring for ocular adverse effects, even with atypical antipsychotics, given their potential to induce acute dystonias and nystagmus. The presented cases advocate for heightened awareness among clinicians to promptly recognize and manage such rare complications, ensuring optimal patient care and treatment outcomes.

Background: The Tele-Medicine Center at the National Institute of Mental Health and Neurosciences, Bengaluru, organized module-based capacity-building training courses for in-service primary care doctors (PCDs) with MBBS degree. The objective was to bolster the coverage of the National Mental Health Program services and diminish the treatment gap in the region. As part of this training, an instant collaborative video consultation (i-CVC) module allowed PCDs to engage in live, real-time video consultations with tele-psychiatrists at NIMHANS to discuss their patients' cases. Approximately 7% of the i-CVC cases focused on child and adolescent psychiatric disorders.

Aim: Aim of this study is understand the profiles of child and adolescent patients and usefulness of instant collaborative video consultations of tele-psychiatrists with primary care doctors.

Materials and methods: This study delved into data from 41 children and adolescents' (aged 10-17 years) i-CVC module case proformas. It examined six predefined learning themes highlighted by PCDs and evaluated patientprofiles, along with diagnostic agreement between PCDs and tele-psychiatrists.

Results: Among the 41 patients, there were 19 males (46.3%) and 22 females (53.7%), aged between 10 and 17 years. The study identified six key learning themes: clinical assessment, identification and diagnosis, counseling for children and parents, pharmacotherapy, and legal aspects. Emotional disorders were noted in 12 patients (29.3%), developmental disorders in eight patients (19.5%), psychotic disorders in eight patients (19.5%), and behavioral disorders in three patients (7.3%). Pharmacotherapy was initiated for five patients (12.2%), while 23 patients (56.1%) received counseling, and 13 patients (31.7%) received both treatments.

Conclusion: Diagnostic agreement between PCDs and tele-psychiatrists was observed in 25 cases (61%). This study represents the first evaluation of the collaborative i-CVC module aimed at training PCDs in child and adolescent psychiatry in India. The 61% diagnostic agreement suggests the feasibility of PCD training. These findings underscore the pressing need for an Indianized, point-of-care manual in child and adolescent psychiatry to train PCDs throughout India.

Background: Cognitive impairments in individuals with psychotic disorders impact day-to-day activities and social and occupational functioning (Bowie CR, 2006). Most of the cognitive interventions were developed in the west focusing mainly on clinical research and were not available in routine care. Adaptability and accessibility of these techniques in low-resource settings like India had major challenges. Keeping this in mind, Compensatory Cognitive Training (CCT), being an economical and noncomputerized intervention, was adapted to be used for an urban English-speaking population in India.

Aim: The study aimed to determine the acceptability and feasibility of delivering CCT to persons with schizophrenia through virtual one-on-one sessions.

Materials and methods: Patients with a diagnosis of schizophrenia were assessed for their subjective and objective cognitive deficits. CCT was delivered for 13 participants as a virtual one - one session. Three participants dropped out midway. Semistructured interview was conducted with all ten participants who completed the intervention to understand their acceptability of Virtual CCT. Feasibility was assessed using a visual analog scale on their attendance, involvement, and comprehending ability. The mean percentile scores on cognitive domains at baseline and end of intervention were analyzed.

Results: Significant change was observed in specific domains of cognition. Participant involvement, lesser dropout rates, and their feedback indicated that Virtual CCT is a feasible and acceptable intervention.

Conclusion: Virtually delivered CCT appears to be an acceptable and feasible intervention to increase access to cognitive interventions for persons with schizophrenia in LAMI countries. This needs to be tested in larger populations.

Background: Premenstrual syndrome (PMS) and premenstrual dysphoric disorders (PMDDs) both represent the most studied premenstrual disorders. Most studies have substantial prevalence of both PMS and PMDD, though the current understanding of the disorders reflects that PMDD is the more severe disorder of the two. However, there is substantial overlap in the etiopathogenesis and treatment approach of both these disorders.

Aim: The current study thus explored trends of the use of PMS and PMDD as diagnostic entities.

Materials and methods: The study was conducted using Harzing's Publish or Perish for identifying top 50 cited articles on PMS and PMDD, published between 2013 and 2023. The search and the citation metrics were obtained from Google Scholar through the mentioned software. The citation metrics of the two groups of studies were compared, and appropriate statistical maneuvers were used.

Results: The PMS studies had a higher mean number of citations than PMDD studies. The PMDD studies tended to have a higher number of authors from Psychiatry or related background. The PMDD studies also had higher representation of institutions from the United States of America.

Conclusion: Using citation analysis to study the utilization trends of diagnostic label is a novel approach. This study shows that there is a need for a unique diagnostic entity to represent the premenstrual disorders, and the coexistence of PMS and PMDD is redundant.

Background: ADHD affects 8% of children and adolescents globally, marked by significant deficits in cognitive abilities, which leads to various emotional, behavioral, and adjustment issues. Traditional methods like medication and behavior therapy fall short in managing ADHD's cognitive domains, urging the adoption of innovative approaches like cognitive training programs specifically adopting the emerging technology such as ReadON.ai. However, the precise influence of computerized cognitive retraining on ADHD remains understudied.

Aim: To study the feasibility of computerized cognitive retraining (ReadON.ai) in enhancing cognitive abilities in children diagnosed with attention deficit hyperactivity disorder.

Materials and methods: The study employs a pre- and post-intervention design including six participants (7-11 years), diagnosed with ADHD according to DSM-5 criteria. Each participant underwent 30 hours of computerized cognitive retraining (ReadON.ai) over ten weeks, targeting attention and concentration, working memory, memory and learning, perceptual abilities, and reasoning skills. Assessments before and after intervention included tools like Conners' 4^TM Parent version and ReadON.ai CSA. Statistical analysis was conducted using IBM SPSS version 28.

Results: Paired t-test results revealed a significant difference in pre-test and post-test means of attention and concentration (t = -6.873, P < 0.001), working memory (t = -5.771, P < 0.001), learning and memory (t = -12.491, P < 0.001), perception (t = 14.398, P < 0.004), reasoning (t = -3.464, P < 0.018), hyperactivity (t = 11.073, P < 0.001), impulsivity (t = 11.948, P < 0.001), emotional dysregulation (t = 8.242, P < 0.001), anxious thoughts (t = 2.67 P = 0.219), depressed mood (t = 2.924, P = 0.020), school work (t = 7.387, P = 0.001) and peer interaction (t = 4.632, P = 0.006) with medium to large effect size.

Conclusion: Computerized cognitive retraining through ReadON.ai is feasible in enhancing cognitive abilities like attention and concentration, working memory, memory and learning, perception, and reasoning among children with ADHD.

Background: Alcohol-related liver disease contributes significantly to global mortality and healthcare costs, underscoring the urgency of early detection and non-invasive diagnostic tools such as transient elastography.

Aim: This study aimed to investigate the correlation between the severity of alcohol dependence syndrome (ADS) and liver dysfunction assessed via transient elastography in newly diagnosed patients.

Materials and methods: From October 2019 to September 2021, a cross-sectional observational study was conducted on 58 inpatients diagnosed with ADS according to International Classification of Diseases-10 criteria. The severity of alcohol dependence was assessed using the Severity of Alcohol Dependence Questionnaire (SADQ), serum biochemical markers, and liver stiffness measured by transient elastography within 96 hours of admission and again after four weeks of enforced abstinence. Data were analyzed using Statistical Package for Social Sciences, with descriptive statistics applied to socio-demographic and clinical data. Paired t-tests compared biochemical markers, and Spearman rank correlation analyzed the relationship between SADQ scores and liver stiffness at admission and after abstinence.

Results: Initial SADQ scores indicated moderate alcohol dependence in 55% of participants. According to Alcohol Use Disorders Identification Test, 38% had a medium-to-severe risk of harmful alcohol consumption. Liver fibrosis assessment showed that 63.8% had no or mild fibrosis on day 1, increasing to 81.0% by day 28. Moderate to advanced fibrosis (measured above 7.5 kilopascal) decreased from 8.6%, 12.1%, and 15.5% on day 1 to 3.4%, 5.2%, and 10.3% on day 28, respectively. There was a statistically significant (P < 0.05) reduction in serum biochemical markers and mean liver stiffness after four weeks of abstinence.

Conclusions: The study underscores that the greater severity of alcohol dependence correlates with more pronounced liver function impairments and stiffness. Transient elastography indicated significant liver fibrosis in actively drinking patients, with notable improvement after one month of abstinence.

Background: Compulsive buying behavior [CBB] or pathological buying (PB) is a psychiatric disorder of growing recognition and many psychosocial factors have been proposed to predispose or precipitate this predicament.

Aim: To find out the association of compulsive buying behavior, emotional distress, self-esteem, internet addiction, and impulsiveness among nursing students.

Materials and methods: A web-based cross-sectional, online survey was conducted among nursing undergraduates to assess the association of compulsive buying behavior, emotional distress, self-esteem, internet addiction, and impulsiveness using total enumerative sampling from February 2024 to April 2024. Data were collected using self-administered PBS, IAT, Rosenberg self-esteem scale, BIS-Brief, and DASS-21 scales. Descriptive and inferential statistics were used. Frequency distribution, Bivariate correlation, and Multiple regression analysis were also used.

Results: There were 410 participants with valid responses, and 207 [50.5%] fell into the category of pathological buying. The participant group "with pathological buying" was comparable with the group "not having pathological buying" in terms of sociodemographic statistics, preferred modality of purchasing stuff, and the "duration of daily internet use". However, the DASS-21 and IAT scores were significantly higher among the participants "with pathological buying". On regression analysis, both DASS and IAT scores were predicting the PBS scores.

Conclusion: There is a significant association between pathological buying with internet addiction and psychological distress, but not with self-esteem, and impulsivity.

Background: The WHO tobacco control team established the Access Initiative for Quitting Tobacco (AIQT) in July 2020. The AIQT team developed a virtual assistant "Florence" to provide digital counseling services to people willing to quit tobacco.

Aim: To assess tobacco users' experience of using WHO digital health assistant "Florence" and to track their behavior changes.

Materials and methods: The study was conducted at a tertiary care Teaching Hospital in Delhi-NCR, India from November 2021 to March 2022. A total of 102 English-speaking tobacco users were enrolled through snowballing and online requests to use Florence (https://www.who.int/campaigns/Florence), once at baseline, and pursue as often as they wish during the next three months. A predesigned WHO questionnaire (Florence Introductory Questionnaire and Florence User Follow-up Questionnaire) was used to assess participants' experiences of using Florence and track changes in tobacco use behavior at follow-up. Statistical analysis was performed through SPSS-22 using appropriate frequency distribution parameters and nonparametric tests to assess acceptance and efficacy of Florence.

Results: Most participants at baseline, over 3-5 minutes, felt that Florence could not understand their speech (48%), and needed improvement in advice and information on quitting and tobacco use (52%) but felt comfortable interacting with Florence (42.2%). However, participants who re-visited Florence during the next 3 months (12/102) agreed that Florence helped them make a quit plan and used the recommended toll-free quit (9/12). Overall, there was a significant increase in proportion of participants who did not consume tobacco in the last 07 days after using Florence (09 versus 25 of 102, P < 0.01) and made quit plans (07 versus 15 of 102, P < 0.01) compared to baseline.

Conclusion: Considering the ease, accessibility, and amount of time spent with this virtual assistant, Florence appears a positive step forward in tobacco cessation.