Indian Journal of Psychiatry最新文献

{"title":"Evaluating psychiatric conference posters: Benchmarking a custom generative pre-trained transformer against human inter-rater variability using a structured assessment framework.","authors":"Anusa Arunachalam Mohandoss, Rooban Thavarajah, Raj Kiran Donthu, Swapnajeet Sahoo, Sai Krishna Tikka, Shahul Ameen","doi":"10.4103/indianjpsychiatry_426_26","DOIUrl":"10.4103/indianjpsychiatry_426_26","url":null,"abstract":"<p><strong>Background: </strong>Scientific poster assessment lacks standardized and discipline-neutral rubrics. Assessment by human reviewers (HRs) is subject to inter-rater variability.</p><p><strong>Aim: </strong>To assess PA²IRS (Poster Assessment via AI-Integrated Rubric System) framework for AI-assisted psychiatric poster evaluation, and conducted a reliability study comparing AI and HR agreement.</p><p><strong>Methods: </strong>PA²IRS was developed through an AI-assisted iterative criterion refinement process modelled on Delphi principles. Sixty posters (30-case reports/series [CR], 20 original research [OR], 10-systematic review-Meta-analysis [SRMA]) were randomly sampled. Three qualified mental health professionals served as independent reviewers. A custom-GPT (GPT-5.2, GO-subscription) provided AI assessments across three domains: Domain-A (content quality, poster-type specific), Domain-B (visual), and Domain-C (impact). PA²IRS is a 100-point instrument combining an AI-assessable poster component and an in-person interview component. This study concerns only the poster component. Intraclass correlation coefficients (ICCs), Passing-Bablok regression, Bland-Altman analysis, and variance component analysis were performed using appropriate statistical tools.</p><p><strong>Results: </strong>AI-human single-measure ICCs [Overall (0.62), Domain-A (0.63), Domain-B (0.44), Domain-C (0.55)] met or exceeded human-human ICCs (0.42, 0.40, 0.27, 0.48) across all domains. Four-rater ICC (with AI) reached 0.75. Variance ratios (AI-human vs inter-human spread) were ≤1.0 across all domains for all posters combined. The SRMA subgroup showed variance ratios of 0.09-0.13 for Domains A and B (Bartlett <i>P</i> ≤ 0.002). Overall score bias was 0.11 percentage points (pp); Domain-A showed a consistent maximum positive bias of 5.5 pp across subgroups.</p><p><strong>Conclusion: </strong>AI-human agreement was within or exceeded the inter-human reliability range across three domains. The domain-dependent agreement pattern is consistent with dual-process cognitive theory. PA²IRS supports use as a scalable, standardized, and cross-disciplinarily competent formative biomedical poster assessment tool.</p>","PeriodicalId":13345,"journal":{"name":"Indian Journal of Psychiatry","volume":"68 9","pages":"805-814"},"PeriodicalIF":2.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13623258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149080772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adverse effect MonoPoly: Antipsychotic monopharmacy vs antipsychotic polypharmacy in the treatment of schizophrenia.","authors":"Shaurya Singh, Sonia Shenoy, Samir Kumar Praharaj","doi":"10.4103/indianjpsychiatry_8_26","DOIUrl":"10.4103/indianjpsychiatry_8_26","url":null,"abstract":"<p><strong>Background: </strong>Although antipsychotic polypharmacy (APP) is not recommended for the treatment of schizophrenia, it remains a common clinical practice. While APP is generally presumed to be associated with a higher burden of adverse effects, the current evidence remains inconclusive.</p><p><strong>Aims: </strong>This study compared the adverse effects experienced by patients with schizophrenia (excluding those receiving clozapine) treated with antipsychotic monopharmacy (APM) or APP using both subjective and objective assessments.</p><p><strong>Methods: </strong>This cross-sectional study included 114 patients with schizophrenia (56 receiving APM and 58 receiving APP). Spontaneously reported adverse effects, including their number and type, were recorded. Objective adverse effects were assessed using the Liverpool University Neuroleptic Side Effect Rating Scale (LUNSERS), Simpson-Angus Scale (SAS), Barnes Akathisia Rating Scale (BARS), and Abnormal Involuntary Movement Scale (AIMS).</p><p><strong>Results: </strong>No significant differences were observed between the APM and APP groups on the overall subjective or objective measures of adverse effects. However, headache (<i>P</i> = 0.04), difficulty concentrating (<i>P</i> = 0.01), constipation (<i>P</i> = 0.01), restlessness (<i>P</i> = 0.01), and insomnia (<i>P</i> = 0.006) were reported significantly more frequently in the APP group. Compared with the APM group, patients receiving APP had a significantly longer duration of illness (<i>P</i> = 0.004; <i>d</i> = 0.55), lower treatment adherence (<i>P</i> = 0.02; <i>d</i> = 0.25), a higher total chlorpromazine-equivalent dose (<i>P</i> < 0.001; <i>d</i> = 1.21), and a higher rate of trihexyphenidyl use (<i>P</i> = 0.01; φ = 0.23).</p><p><strong>Conclusions: </strong>Overall adverse effects were comparable between the APM and APP groups. However, APP was associated with higher antipsychotic and trihexyphenidyl use; more insomnia, restlessness, constipation, and difficulty concentrating; and poorer treatment adherence.</p>","PeriodicalId":13345,"journal":{"name":"Indian Journal of Psychiatry","volume":"68 8","pages":"692-698"},"PeriodicalIF":2.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13561490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148943994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Facilitator reflections on a one-day school mental health training for teachers in India.","authors":"Rashmi Shukla, Ritwick Tripathi","doi":"10.4103/indianjpsychiatry_328_26","DOIUrl":"10.4103/indianjpsychiatry_328_26","url":null,"abstract":"","PeriodicalId":13345,"journal":{"name":"Indian Journal of Psychiatry","volume":"68 8","pages":"767-768"},"PeriodicalIF":2.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13561491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148944277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcome of services for patients with Common Mental Disorders (CMDs): A prospective cohort study.","authors":"Varun S Mehta, D Ram, Triptish Bhatia, Mary E Hawk, James E Egan, Ferdinand Kerketta, Pc Justin Raj, Aqueel Ahamed, Smita N Deshpande","doi":"10.4103/indianjpsychiatry_850_24","DOIUrl":"10.4103/indianjpsychiatry_850_24","url":null,"abstract":"<p><strong>Background: </strong>Depressive and anxiety disorders, together contribute to over 50% of the Disability-Adjusted Life Years (DALYs). While outcomes for severe mental illnesses have been extensively studied, outcome-based research on CMDs remains limited.</p><p><strong>Aim: </strong>To evaluate the needs, barriers, caregiver involvement, recovery and service satisfaction of patients with CMDs as a measure of service outcome.</p><p><strong>Methods: </strong>This prospective cohort study included 274 patients with CMDs diagnosed per ICD-10 criteria. Participants were assessed at baseline and six months using researcher-rated and service user-rated outcome measures. Instruments included the Camberwell Assessment of Needs-Research (CAN-R), Client Satisfaction Questionnaire (CSQ), Barriers to Access to Care Evaluation (BACE v3), Involvement Evaluation Questionnaire (IEQ), and Importance of Services in Recovery (INSPIRE). Generalized Linear Mixed Models (GLMM) and negative binomial regression were employed to analyze outcomes over time.</p><p><strong>Results: </strong>At baseline, 90.9% of participants had needs, with unmet needs comprising 80.7%. Major unmet needs were psychological distress (73.4%), looking after the home (57.7%), and daytime activities (50.7%). Depression had the highest impact on unmet needs, contributing to a 32% increase per unit rise in depression severity (IRR = 1.318, <i>P</i> < 0.001). Stigma accounted for only about one-fifth of the total perceived barriers to accessing care, with worrying and urging behaviors among the caregivers. At the end of six months, the unmet needs significantly improved, but caregivers were still concerned about the well-being of the participants, associated with improvements in service satisfaction.</p><p><strong>Conclusions: </strong>CMD patients had significant unmet needs, especially for psychological distress, household, and daily activities. Depression was the largest contributor to unmet needs, while panic and somatic disorders were lower. Caregiver burden evolved, and non-stigma-related barriers to care were significant.</p>","PeriodicalId":13345,"journal":{"name":"Indian Journal of Psychiatry","volume":"68 Suppl 2","pages":"S349-S358"},"PeriodicalIF":2.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13553097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148911762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of physical illnesses and lifestyle factors among severely mentally ill in a community.","authors":"Ramanujam Govindan, Triptish Bhatia, Thara Rangaswamy, Smita N Deshpande","doi":"10.4103/indianjpsychiatry_1151_24","DOIUrl":"10.4103/indianjpsychiatry_1151_24","url":null,"abstract":"<p><p>Physical health issues are frequent and often inadequately addressed in individuals with severe mental illness (PWSMI) because of several lifestyle influences. Hence to screen and estimate the prevalence of physical disorders and lifestyle factors like physical activities among community-dwelling mentally ill (PWSMI) a door-to-door survey was conducted in the catchment area of a Primary Health Center. A total of 71 participants with SMI were screened and diagnosed with severe mental illness. They were evaluated for comorbid physical illnesses and lifestyle factors like substance use and the extent of daily physical activity (work, recreation, remaining idle). The prevalence of diabetes and hypertension was 38.5% each, while that of tobacco and alcohol use was 24.3% and 21.1% respectively. Only 22.8% reported work-related physical activity, and 7% reported recreational physical activities. Physical illnesses are common, while physical activity is restricted in people with severe mental illness.</p>","PeriodicalId":13345,"journal":{"name":"Indian Journal of Psychiatry","volume":"68 Suppl 2","pages":"S457-S461"},"PeriodicalIF":2.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13553091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148911803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case of Atypical Pantothenate Kinase-Associated Neurodegeneration Masquerading as Primary Psychiatric Illness.","authors":"Arnab Biswas, Siddhartha S Saha","doi":"10.4103/indianjpsychiatry_1179_25","DOIUrl":"10.4103/indianjpsychiatry_1179_25","url":null,"abstract":"","PeriodicalId":13345,"journal":{"name":"Indian Journal of Psychiatry","volume":"68 8","pages":"765-766"},"PeriodicalIF":2.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13561459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148929736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lumateperone-induced mania: A case series.","authors":"Varchasvi Mudgal, Prashant Gaurav, Priyash Jain, Kartikay Chaturvedi","doi":"10.4103/indianjpsychiatry_1261_25","DOIUrl":"10.4103/indianjpsychiatry_1261_25","url":null,"abstract":"<p><strong>Background: </strong>Lumateperone is an approved treatment for bipolar depression with a low reported risk of treatment-emergent mania. However, real-world evidence remains limited.</p><p><strong>Cases: </strong>We describe three adults with bipolar depression who developed manic symptoms within 10-14 days of initiating lumateperone 42 mg/day. Young Mania Rating Scale scores ranged from 26 to 29. Alternative causes were excluded, symptoms resolved after discontinuing lumateperone and optimizing mood stabilizers, and Naranjo scores (7-8) indicated a probable drug association.</p><p><strong>Conclusion: </strong>Lumateperone may precipitate mania in susceptible individuals, highlighting the need for close monitoring during the early treatment period.</p>","PeriodicalId":13345,"journal":{"name":"Indian Journal of Psychiatry","volume":"68 8","pages":"761-764"},"PeriodicalIF":2.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13561462/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148929853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Message.","authors":"Rajiv Bahl","doi":"10.4103/indianjpsychiatry_912_26","DOIUrl":"https://doi.org/10.4103/indianjpsychiatry_912_26","url":null,"abstract":"","PeriodicalId":13345,"journal":{"name":"Indian Journal of Psychiatry","volume":"68 Suppl 2","pages":"S309"},"PeriodicalIF":2.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13553103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148911792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Caregiver burden for older adults with serious mental illness and factors influencing it: A community-based exploratory survey.","authors":"Neethu Mohan, Anusha Prabakaran, C B Sooria, Jayakrishnan Thavody, C M Sujina, Priya Chandran, Shibu Kumar, Harish M Tharayil, Smita N Deshpande","doi":"10.4103/indianjpsychiatry_567_24","DOIUrl":"10.4103/indianjpsychiatry_567_24","url":null,"abstract":"<p><strong>Background: </strong>Caregivers of older adults with serious mental illness (OASMI) often experience significant burden. Determining this burden and identifying its associated factors can aid in designing better interventions. However, studies evaluating the burden on informal caregivers of OASMI in India are limited, and community-based research being especially scarce.</p><p><strong>Aim: </strong>Our aim was to determine the subjective burden on the primary informal caregivers of OASMI and identify the associated factors.</p><p><strong>Methods: </strong>We conducted a cross-sectional survey among 563 caregivers of community-dwelling OASMI identified through multistage cluster sampling across three districts in Kerala. The caregiver burden was assessed using the 20-item WHO Burden Assessment Schedule, and its association with various factors was analyzed.</p><p><strong>Results: </strong>Nearly all caregivers (97.9%) experienced some caregiver burden, with 26.3% falling into the 'high-burden' category. Caregiver burden increased with advancing age of caregivers, and spouses reported significantly higher burden than other caregivers (<i>P</i> < 0.001). The OASMI factors such as being male, married, and living in poor housing conditions were associated with greater caregiver burden. The caregiver factors associated with increased burden were being male, having lower levels of education, and the responsibility of domestic budget handling. The most striking finding was that the caregivers of currently symptomatic OASMI reported an eightfold higher burden compared to those caring for currently asymptomatic OASMI. As regular treatment is known to reduce symptoms, our finding highlights the indirect role of treatment in reducing caregiver burden through symptom management.</p><p><strong>Conclusion: </strong>Given that OASMI symptoms significantly increase caregiver burden, prioritizing strategies for symptomatic improvement should be a key focus of intervention programs aimed at supporting OASMI and their caregivers.</p>","PeriodicalId":13345,"journal":{"name":"Indian Journal of Psychiatry","volume":"68 Suppl 2","pages":"S399-S406"},"PeriodicalIF":2.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13553096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148910711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Brief Psychological Intervention for Depression in Pregnancy (BIND-P): A multi-centric randomized controlled trial (RCT).","authors":"Prerna Kukreti, Ramdas Ransing, Pracheth Raghuveer, Mahesh Mahadevaiah, Smita N Deshpande, Triptish Bhatia, Manju Puri, Harish Pemde, V Omsai Ramesh, Ishwar Patil, Kumari Padma, Satish Shetty, Ravichandra Karkal, Sumit Rana, Dinesh K Kataria, Abhay Subhashrao Nirgude","doi":"10.4103/indianjpsychiatry_712_24","DOIUrl":"10.4103/indianjpsychiatry_712_24","url":null,"abstract":"<p><strong>Background: </strong>Depression is the most prevalent psychiatric disorder among women during pregnancy but often goes undetected and untreated.</p><p><strong>Aim: </strong>This study aimed to assess whether a brief psychological intervention for depression in pregnancy (BIND-P) delivered by nurses is efficacious in the treatment of depression as compared to Treatment as Usual (TAU).</p><p><strong>Methods: </strong>A multi-centric, hospital-based open-label parallel group, randomized controlled trial was conducted at four sites across India (one each in Northern and Central India, and two in Southern India) from 2018 to 2022. A total of 1,352 participants were randomly allocated (1:1) to BIND-P and TAU groups. The primary outcome assessment was a reduction in PHQ-9 scores (from baseline to 8 weeks post recruitment). The secondary outcome was the outcome of pregnancy and infant development at 6/10/14 weeks post pregnancy.</p><p><strong>Results: </strong>Both groups demonstrated a reduction in PHQ-9 scores from baseline to follow-up. However, the between-group difference was not statistically significant (adjusted mean difference [BIND-P vs TAU]: 0.03; <i>P</i> = 0.91). The overall effect size was small (Cohen's d ≈ 0.05). Discontinuation rates were lower in the BIND-P group compared to TAU (17.34% vs 30.35%). Subgroup analyses suggested greater likelihood of remission among women who were older, had higher education, were from rural settings, had lower income, were primigravida, or had high-risk pregnancies. No significant differences were observed between groups in pregnancy or infant outcomes.</p><p><strong>Conclusion: </strong>The BIND-P intervention was not inferior to TAU in reducing depressive symptoms but demonstrated lower discontinuation rates. As a low-intensity psychosocial intervention (LIPI), BIND-P may be a feasible and acceptable option for integration into routine maternal healthcare services, with potential to help reduce the treatment gap in perinatal mental health.</p>","PeriodicalId":13345,"journal":{"name":"Indian Journal of Psychiatry","volume":"68 Suppl 2","pages":"S314-S323"},"PeriodicalIF":2.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13553101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148911677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}