Industrial Psychiatry Journal最新文献

Mental health is crucial for child and adolescent development, but lack of resources often leads to silent suffering and missed opportunities. Establishing child guidance clinics (CGCs) is a step toward holistic care. During COVID, children faced disruptions to schooling, isolation, family stress, and increased digital exposure, leading to a rise in mental health issues. The stressors have left a long-term psychological impact on our lives even after years post-COVID. The study examines the 10-year journey of a CGC that which navigated the changes brought about by COVID-19, highlighting the importance of mental health for child and adolescent development. The CGC's register, which has systematic documentation of patient details, was used to retrospectively analyze patient records for the last 10 years. Data were extracted and organized to identify trends and patterns across diagnoses. Post-COVID-19, cases of autism spectrum disorder, intellectual disability, global developmental delay, Attention deficit hyperactivity disorders (ADHD), and behavioral disorders have increased. There are fluctuations in cases of Obsessive compulsive disorder (OCD), phobia, depression, and anxiety. Emotional disorders, though initially had fluctuating numbers, have also increased after the pandemic. However, expressive speech disorders, psychosis, and learning disabilities were found to be stable without many shifts. Conclusion: CGCs in India are vital in addressing the mental health needs of children and adolescents. Post-COVID, the increase in mental health concerns of children and adolescents demands more focused care and a multi-disciplinary team approach.

Background: Workplace violence (WPV) among healthcare workers (HCWs) poses a significant burden globally. Various studies have estimated the prevalence and characteristics of WPV, but few have assessed the impact in terms of the mental health of HCWs in the aftermath.

Aim: To study the prevalence of WPV and its psychological impact on HCWs. In addition, we aimed to suggest strategies that can be implemented to prevent the overpowering burden of WPV.

Materials and methods: We used a standardized questionnaire developed by the International Labor Office to assess WPV, General Health Questionnaire (GHQ-12) to assess psychological distress, and a self-reported sleep quality scoring.

Results: The study included 268 participants among which 43.7% reported having experienced WPV in the last 12 months, with 42.5% reporting verbal violence and 3.4% reporting physical violence incidents. Working in emergency services showed a significant association with experiencing verbal violence. There is also an underreporting of incidents of WPV. Among the psychological parameters, distress is significantly higher for both verbal and physical violence, and participants who faced physical violence had significantly lower sleep quality. Prevention strategies including adequate patient counseling, better communication, improved security, and stricter laws can be implemented to reduce violence.

Conclusion: WPV in healthcare is very common in India with not only high prevalence rates but also a significant psychological burden. There is a need to develop better laws and implement policies to ensure a safe and healthy workplace for HCWs.

Background: Group intervention is highly effective for survivors of IPV. There are fewer interventions available for intimate partner violence in addiction treatment settings in India.

Aim: To develop and validate the group intervention module for women survivors of IPV.

Materials and methods: The group intervention manual was developed by assessing the psychosocial needs of survivors (n = 20) of intimate partner violence and subject experts' opinions (n = 7). The manual was validated using the content validation index and kappa value.

Results: The components of the group intervention manual were developed for women survivors of IPV who were seeking treatment for their spouse's alcohol dependence. The group intervention components include sharing the experience of intimate partner violence, understanding the impact of IPV, psychoeducation regarding alcohol dependence and the treatment process for alcohol dependence, imparting social skills, safety plans, and self-care for the IPV survivors and their children, crisis intervention, and resource mapping. The content validation score of the group manual (I-CVI) is 0.79. The kappa value of 0.0078 indicates that the manual's content validity is excellent.

Conclusion: The group intervention module was validated by the mental health professionals working in the area of partner violence, and final manual has a good content validation score (0.79). The group work manual results indicate that it is feasible to apply in the de-addiction setting in India. Future studies should focus on the large number of population and should look in to address the perpetrated and couple-based intervention for the survivors of IPV.

Background: Schizophrenia (SCZ) is a severe psychiatric disorder characterized by cognitive dysfunction and persistent psychotic symptoms. Treatment refractory schizophrenia (TRS), resistant to conventional antipsychotics, presents significant challenges. Electroconvulsive therapy (ECT) is effective for TRS, but its biological mechanisms remain unclear. Biomarkers such as brain-derived neurotrophic factor (BDNF), interleukin-6 (IL-6), and cortisol, linked to neuroplasticity, immune modulation, and stress regulation, may help elucidate ECT's therapeutic effects.

Aim: This study evaluated the impact of ECT on serum levels of BDNF, IL-6, and cortisol in TRS patients and explored the relationship between these biomarkers and symptom improvement.

Materials and methods: A prospective study was conducted at a tertiary care hospital from 2018 to 2020. Thirty-five TRS patients (aged 18-60 years) underwent symptom severity assessments using the positive and negative syndrome scale (PANSS) pre- and post-ECT. Serum levels of BDNF, IL-6, and cortisol were measured using enzyme-linked immunosorbent assays (ELISA). ECT was administered bilaterally in 4-7 sessions per patient. Paired t-tests and Spearman's correlation were used for statistical analysis.

Results: ECT significantly reduced positive (P < 0.001), general (P < 0.001), and total PANSS scores (P < 0.001), with modest reductions in negative symptoms (P < 0.001). Serum IL-6 levels decreased significantly post-ECT (P = 0.018), while changes in BDNF (P = 0.198) and cortisol (P = 0.403) were not statistically significant. Increased BDNF levels positively correlated with reduced positive symptoms (P = 0.041), while decreased IL-6 levels correlated with symptom improvement (P = 0.045).

Conclusion: ECT reduces symptom severity in TRS, with significant modulation of IL-6 and potential involvement of BDNF in positive symptom improvement. These findings highlight immune and neuroplastic pathways as mechanisms of ECT efficacy and suggest biomarkers for treatment response.

Clozapine is the drug of choice for patients with treatment-resistant schizophrenia. However, it has a variety of adverse effects. Sialorrhea is a bothersome side effect that can have an impact on both medical and psychosocial aspects. There is limited literature on the use of 1% atropine eye drops sublingually for the treatment of clozapine-induced sialorrhea (CIS). In this case series, we report three patients of CIS treated successfully with 1% atropine eye drops given sublingually.

Background: Across the Globe, including in India, significant changes have occurred in the Mental health policies, programs, and schemes for Persons With Mental Illness (PWMI). Gradually, people are becoming aware of the nature of mental illness. Many Bollywood actors are coming forward to share their mental health conditions and show how successfully they handle them. Despite all these efforts, even the recovered or recovering PWMI are still being denied their basic fundamental human rights, especially regarding selection and continuation of gainful employment along with social inclusion at the community level.

Aim: Considering the above, the present study aimed to understand the lived experiences regarding the opportunities available for employment and social inclusion among PWMI in India.

Material and methods: The present study was based on a qualitative design. Patients who maintained well on treatment and had capabilities to be included in gainful employment, but were still facing difficulties in securing and maintaining regular employment, and faced discrimination in social inclusion in society, were assessed in detail by in-depth interviews after obtaining their due consent.

Results: The main themes that emerged from the study were related to their own experience of the journey of recovery in terms of getting the opportunity for full participation in employment or to be acknowledged as a valuable person in their society rather than a patient.

Conclusion: The present study's findings would enhance the understanding among health professionals, policy-makers, and community persons to plan and develop supportive programs/ social welfare services that treat PWMI as persons and involve them as productive members of society.

Background: Although smartphones have considerable utility, they also have addiction potential. The early detection of problematic smartphone use (PSU) can have significant implications for managing its psychosocial consequences. Smartphone Addiction Scale - Short Version (SAS-SV), initially developed for South Korean adolescents, has emerged as a reliable measure for adults across countries. However, SAS-SV continues to be used unvalidated in India.

Aim: To evaluate the psychometric properties of SAS-SV for the Indian adult population.

Materials and methods: Content validation of SAS-SV was done by 10 experts, followed by data collection for validation using a cross-sectional design from 434 participants (M _age = 25.4; SD _age = 2.6; 58.8% females). The datasheet consisted of a sociodemographic questionnaire and SAS-SV. Statistical analyses comprised confirmatory factor analysis (CFA), exploratory factor analysis (EFA), reliability analyses, percentiles, and evaluation of sociodemographic variables.

Results: SAS-SV's content validity index was 0.93, and item wordings were adjusted after experts' feedback. CFA did not show good fit indices; hence, EFA was used, which explained 44% of the variance from a unifactorial model. Cronbach's alpha was 0.85, McDonald's Omega was 0.86, and test-retest reliability was 0.81. There were no significant PSU differences in gender, marital status, and occupational status. Higher PSU was associated with lower age, lower education, nuclear family, and more hours of smartphone usage.

Conclusion: The current study established the psychometric properties of SAS-SV for the Indian adult population. SAS-SV can be used for assessment and treatment monitoring of PSU.

Background: Understanding of the mechanism of action of Baclofen as anticraving inalcohol dependence syndrome (ADS) is limited.

Aim: Our study aimed to examine and compareearly changes in brain glutamate and GABA with Baclofen and Acamprosate among patients with alcohol dependence syndrome.

Material and methods: Forty patients with ADS were recruited with purposive sampling and were randomized into two groups using computer-generated randomization. At the end of detoxification (CIWA-Ar <10) brain glutamate and GABA were measured with proton magnetic resonance spectroscopy (1H-MRS) in the anterior cingulate cortex (ACC) of the brain along with a measure of craving (PACS). Either Acamprosate or Baclofen was started. After 25 days of starting Baclofen or Acamprosate brain glutamate and brain GABA using 1H-MRS and PACS measures were repeat measured.

Results: Both groups had shown comparable changes in brain glutamate (F = 0.01, P = 0.92, ηp2 = 0.00) and GABA (F = 0.29, 26 P = 0.59, ηp2 = 0.008) and craving (F = 0.08, P = 0.77, ηp2 = 0.002) over time. Baclofen and Acamprosate showed a differential relation with the clinical characteristics of participants.

Conclusion: Our study has shown comparable changes in Glutamate and GABA during the early post-detoxification period both for baclofen and acamprosate. Effects of baclofen and acamprosate might correlate differently with the clinical profile of alcohol dependence syndrome which would help in choosing a particular anticraving medication.