Indian Journal of Psychiatry最新文献

{"title":"Tapentadol as a drug of abuse - A preliminary report.","authors":"Prakrithi Shivaprakash, Lekhansh Shukla, Sourabh Joshi, Jayant Mahadevan, Arun Kandasamy, Prabhat K Chand, Vivek Benegal, Pratima Murthy","doi":"10.4103/indianjpsychiatry.indianjpsychiatry_794_24","DOIUrl":"10.4103/indianjpsychiatry.indianjpsychiatry_794_24","url":null,"abstract":"<p><strong>Background: </strong>Tapentadol is a dual action opioid analgesic with emerging data on abuse and diversion.</p><p><strong>Aim: </strong>This study describes tapentadol abuse, clinical presentation, and treatment patterns.</p><p><strong>Methods: </strong>We reviewed patients seeking help for tapentadol use (2017-2023) at a South Indian tertiary hospital. We collected data on sociodemographics, clinical profiles, and treatment, including buprenorphine dose and dose limiting side effects.</p><p><strong>Results: </strong>Of 933 opioid use disorder cases, 228 involved tapentadol. Most (89%) initiated opioid use with tapentadol, and 93% injected dissolved tablets. 80% were diagnosed with opioid dependence. Over half required inpatient treatment. 75% received buprenorphine, but tolerability was poor. The median first day dose was 0.8 mg (IQR = 0.4-2), and the maintenance dose was 4 mg (IQR = 2-8), with nausea being the main side effect.</p><p><strong>Conclusion: </strong>We can conclude that Tapentadol is prone to abuse and dependence. These patients have poor buprenorphine tolerability and receive low maintenance doses. Further research is needed on effective opioid agonist treatment for tapentadol dependence.</p>","PeriodicalId":13345,"journal":{"name":"Indian Journal of Psychiatry","volume":"67 2","pages":"256-259"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11964174/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779800","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":"Understanding the active ingredients, barriers, and facilitators to implement brief psychological interventions for substance misuse in Indian prisons: A qualitative study.","authors":"Abhishek Ghosh, Renjith R Pillai, Jatina Vij, Pallab K Maulik, Blessy B George, Debasish Basu","doi":"10.4103/indianjpsychiatry.indianjpsychiatry_634_24","DOIUrl":"10.4103/indianjpsychiatry.indianjpsychiatry_634_24","url":null,"abstract":"<p><strong>Background: </strong>Substance misuse is prevalent in criminal justice populations. Addressing it in the criminal justice system (CJS) is vital for improving public health and reducing crime.</p><p><strong>Aim: </strong>This study explores the mechanisms, barriers, and facilitators of a brief psychosocial intervention for reducing substance misuse among inmates in a North Indian prison.</p><p><strong>Methods: </strong>A multidisciplinary team evaluated qualitatively using the Framework Method, guided by the Behavior Change Wheel (BCW) framework. Participants were purposively selected from those enrolled in a clinical trial and included inmates aged 18-60 who completed three sessions of the intervention. Data were collected through in-depth interviews (IDIs) and focus group discussions (FGDs) between November and December 2023. Thematic analysis identified key themes related to behavior change, implementation barriers, and facilitators.</p><p><strong>Results: </strong>The study identified ten main themes encompassing facilitators and barriers to behavior change. Key facilitators included peer influence, supportive relationships, intervention strategies, and self-reflection. Major barriers were access to drugs, prison dynamics, psychological stressors, stigmatization, and withdrawal symptoms. The BCW framework highlighted the importance of addressing both individual and contextual factors, such as capability, opportunity, and motivation, to support behavior change. The intervention's emphasis on stress management, acceptance, and building supportive peer networks was critical for its success.</p><p><strong>Conclusion: </strong>Individual interventions must be supplemented by systemic and structural changes to address prison-specific challenges. Comprehensive staff training, integrated treatment models, peer support systems, and policy advocacy are recommended to enhance the effectiveness and scalability of psychosocial interventions in the CJS.</p>","PeriodicalId":13345,"journal":{"name":"Indian Journal of Psychiatry","volume":"67 2","pages":"236-244"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11964173/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779875","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":"Gender and personal safety sensitization in schools: A qualitative inquiry into response practices to children's disclosures of sexual abuse.","authors":"Sathish K Ramakrishna, Eesha Sharma, Kavitha V Jangam, K M Rajendra","doi":"10.4103/indianjpsychiatry.indianjpsychiatry_543_24","DOIUrl":"10.4103/indianjpsychiatry.indianjpsychiatry_543_24","url":null,"abstract":"<p><strong>Background: </strong>Schools provide opportunities to educate children on health and safety and encourage disclosures of difficult experiences. Policies and response mechanisms for disclosures are critical in the impact of preventive programs.</p><p><strong>Aim: </strong>To understand school policies and practices for disclosures of child sexual abuse (CSA).</p><p><strong>Method: </strong>A school-based program on gender, sexuality, and personal safety was implemented in 162 schools between June 2022 and February 2024. The program addressed health, safety, boundaries, help-seeking, gender, sex, love and attraction, and decision-making. It encouraged children to discuss difficult experiences. A standard operating procedure was followed for responding to health or psychosocial issues, focusing on emotional support, avoiding retraumatization, and activating child protection mechanisms. School response practices were observed through extensive field notes maintained during the program implementation.</p><p><strong>Results: </strong>The program reached 21,234 students. There were 44 instances of CSA disclosure. Fifteen were high-risk disclosures (recent/proximity to alleged perpetrators/poor psychosocial support). A report was shared with the school/child protection system for further action. There were challenges noted in organizing appropriate responses to children's health and psychosocial needs at all levels. Schools lacked uniform policy and were unfamiliar with the state and national level provisions for child protection. Schoolteachers conveyed invalidating, disbelieving, and evasive attitudes toward children's disclosures, and there was no existing coordination between schools and the child protection system.</p><p><strong>Conclusion: </strong>Despite national and state level child protection policies, ground realities of response to CSA are highly deficient. Implementation of sexuality education programs, planned in several national endeavors, would be contingent upon school readiness and intersectoral collaborations.</p>","PeriodicalId":13345,"journal":{"name":"Indian Journal of Psychiatry","volume":"67 2","pages":"245-251"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11964166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780029","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":"Rethinking and reclaiming psychiatry.","authors":"Savita Malhotra","doi":"10.4103/indianjpsychiatry.indianjpsychiatry_107_25","DOIUrl":"10.4103/indianjpsychiatry.indianjpsychiatry_107_25","url":null,"abstract":"","PeriodicalId":13345,"journal":{"name":"Indian Journal of Psychiatry","volume":"67 2","pages":"181-191"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11964170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779436","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":"Psychiatry research and prevalence of psychiatric disorders among tribal populations of India: A systematic review and meta-analysis.","authors":"Ajay Kumar Bakhla, Arvind Nongpiur, Babli Kumari, Puja Pallavi, Anit Kujur, Dhanpati Sahu","doi":"10.4103/indianjpsychiatry.indianjpsychiatry_869_24","DOIUrl":"10.4103/indianjpsychiatry.indianjpsychiatry_869_24","url":null,"abstract":"<p><strong>Background: </strong>The tribal population in India is characterized by low socioeconomic status and facing issues like marginalization, discrimination, cultural disruption, and displacement. These challenges have significant effects on their mental health, but research on psychiatric conditions among them is limited.</p><p><strong>Aim: </strong>We aim to find existing psychiatry literature and to estimate the prevalence of depression and anxiety among them.</p><p><strong>Methods: </strong>We carried out systematic searches across several databases like PubMed, Scopus, Web of Science, Cochrane, EBSCOhost, ProQuest (Health research collections), PsycNet, Ovid, and Google Scholar, without limiting the publication period.</p><p><strong>Results: </strong>Our search yielded 107 relevant articles, which included systematic reviews, prevalence studies, review articles, scale development studies, intervention studies, qualitative and miscellaneous studies. The prevalence of mental health disorders varied across the studies with depression ranging from 3% to 43%, anxiety upto 8%, mania from 0.04% to 0.39%, schizophrenia from 0.07% to 0.52%, intellectual disability from 0.1% to 0.6%, epilepsy from 0.2% to 1.03%, and dementia or cognitive impairment from 0% to 42.92%. Meta-analysis, of studies on depression, 15 studies were included, and the pooled prevalence was found to be 14% (with a confidence interval of 8% to 22%). For anxiety disorders, 8 studies showed a pooled prevalence of 3% (confidence interval 0% to 7%). In conclusion, this systematic review found 107 relevant studies.</p><p><strong>Conclusion: </strong>Meta-analysis showed that the prevalence of depression among India's tribal population is about 14%, and anxiety disorders are present in 3% of the population.\"</p>","PeriodicalId":13345,"journal":{"name":"Indian Journal of Psychiatry","volume":"67 2","pages":"192-208"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11964161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779497","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":"Implementation of substance use screening and brief intervention model at primary healthcare level of Uttarakhand.","authors":"Vishal Dhiman, Anindya Das, Siddharth Sarkar, Yatan Pal Singh Balhara","doi":"10.4103/indianjpsychiatry.indianjpsychiatry_1034_24","DOIUrl":"10.4103/indianjpsychiatry.indianjpsychiatry_1034_24","url":null,"abstract":"","PeriodicalId":13345,"journal":{"name":"Indian Journal of Psychiatry","volume":"67 2","pages":"278-279"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11964164/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780034","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":"Does HCV treatment completion affect the neurocognitive outcomes in patients on opioid agonist maintenance treatment: A secondary analysis.","authors":"Abhishek Ghosh, Abhishek Verma, Arka De, Madhumita Premkumar, Ajay Duseja, Ritu Nehra, Debasish Basu","doi":"10.4103/indianjpsychiatry.indianjpsychiatry_900_24","DOIUrl":"10.4103/indianjpsychiatry.indianjpsychiatry_900_24","url":null,"abstract":"<p><strong>Aim: </strong>This secondary analysis investigated whether completing Direct-Acting Antiviral (DAA) treatment affects neurocognitive outcomes in patients with opioid use disorder (OUD) undergoing opioid agonist maintenance treatment (OAMT).</p><p><strong>Methods: </strong>Data from 45 participants (22 DAA treatment completers and 23 non-completers) were analyzed. Neurocognitive function was assessed at baseline and six months using the Wisconsin Card Sorting Test (WCST), Trail Making Tests (TMT A and B), Visual and Verbal N-Back tests, and Iowa Gambling Task (IGT).</p><p><strong>Results: </strong>General Linear Model (GLM) analysis revealed significant improvements in cognitive function over time in both groups, with notable gains in WCST total correct responses (<i>P</i> < .001) and Visual Working Memory 2 Back hits and errors (<i>P</i> < .001). A significant Group × Time was found for TMT-B completion time, with non-completers showing greater improvement (<i>P</i> = .039).</p><p><strong>Conclusion: </strong>These findings highlight that even incomplete DAA treatment, alongside OAMT, yields significant cognitive benefits, underscoring the importance of integrated care.</p>","PeriodicalId":13345,"journal":{"name":"Indian Journal of Psychiatry","volume":"67 2","pages":"260-266"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11964169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779997","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":"Hindi translation and validation of perinatal grief scale (short version): Assessing grief following stillbirth in bereaved mothers.","authors":"Bharti Sharma, Gursahiba Gill, Ashok Kumar, Har Ashish Jindal, Ritu Nehra, Sandeep Grover, Vanita Suri, Neelam Aggarwal","doi":"10.4103/indianjpsychiatry.indianjpsychiatry_631_24","DOIUrl":"10.4103/indianjpsychiatry.indianjpsychiatry_631_24","url":null,"abstract":"<p><strong>Background: </strong>Perinatal grief is the experience or emotions of parents following the loss of an infant by miscarriage, stillbirth, neonatal loss, or elective termination for fetal anomalies.</p><p><strong>Aim: </strong>We aimed to translate and adapt the Perinatal Grief Scale (PGS) into Hindi and evaluate its psychometric properties in a sample of women who had recently experienced a stillbirth.</p><p><strong>Method: </strong>The PGS was translated and adapted into Hindi following the process of translation and adaptation recommended by the World Health Organization. Internal consistency reliability was assessed by calculating Cronbach's alpha. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were carried out to assess discriminant validity and composite reliability. Additionally, the participants were assessed on four other questionnaires (State-Trait Anxiety Inventory, Edinburgh Postnatal Depression Scale, Generalized Anxiety Disorder Scale, and Patient Health Questionnaire) to test the convergent validity.</p><p><strong>Results: </strong>The mean age of the participants was 27.57 years (SD = 4.42), and 7% of the mothers were of advanced age. The Cronbach's alpha of the three subscales of PGS was more than 0.85, which confirms the reliability of PGS-H. A significant positive correlation was found between PGS-H and scores of STAI, EPDS, GAD7, and PHQ9 (<i>P</i> < 0.05). EFA identified three domains of PGS. In CFA, the goodness of model fit was confirmed with a root mean square error of approximation of 0.06, a comparative fit index of 0.915, and a goodness of fit index of 0.812.</p><p><strong>Conclusion: </strong>The PGS-H has been demonstrated to be a reliable and valid instrument for assessing grief in women following pregnancy loss.</p>","PeriodicalId":13345,"journal":{"name":"Indian Journal of Psychiatry","volume":"67 2","pages":"229-235"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11964168/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780032","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":"Escitalopram-induced hypnic jerks: An overlooked side effect.","authors":"Prashant Maravi, Rahul Mathur, Richa Choudhary, Simran Sandhu, Virendra S Pal","doi":"10.4103/indianjpsychiatry.indianjpsychiatry_985_24","DOIUrl":"10.4103/indianjpsychiatry.indianjpsychiatry_985_24","url":null,"abstract":"<p><strong>Background: </strong>Hypnic jerks, also known as sleep starts, are sudden, involuntary muscle contractions that occur during the transition from wakefulness to sleep. These typically benign but sometimes distressing movements have been linked to certain medications, particularly selective serotonin reuptake inhibitors (SSRIs).</p><p><strong>Cases: </strong>This article explores three cases of escitalopram-induced hypnic jerks. A 45-year-old female with major depressive disorder experienced sudden jerks after increasing her escitalopram dose from 10 mg to 15 mg, which improved after reducing the dose and adding clonazepam. A 28-year-old male with adjustment disorder developed involuntary jerks after starting escitalopram 10 mg, with symptoms improving upon clonazepam addition without altering the SSRI dose. A 31-year-old female switched from venlafaxine to escitalopram 10 mg and developed jerky head movements during sleep, which resolved after discontinuing escitalopram and starting fluoxetine.</p><p><strong>Implications: </strong>These cases suggest that escitalopram-induced hypnic jerks, though rare, may arise due to serotonin-related motor control changes during sleep. Recognizing these movements as benign can help alleviate patient anxiety. Clinicians should monitor for such symptoms, educate patients, and consider dose modifications or adjunctive treatments like clonazepam to improve sleep quality and overall well-being.</p>","PeriodicalId":13345,"journal":{"name":"Indian Journal of Psychiatry","volume":"67 2","pages":"274-276"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11964172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779950","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":"Is it time for India to set social media age limits for adolescents?","authors":"Om Prakash","doi":"10.4103/indianjpsychiatry.indianjpsychiatry_1012_24","DOIUrl":"10.4103/indianjpsychiatry.indianjpsychiatry_1012_24","url":null,"abstract":"<p><p>The rapid integration of social media into the lives of Indian adolescents presents a complex mix of benefits and challenges, particularly in the realms of mental health, online safety, and digital literacy. While age restrictions or outright bans may offer protections against risks like cyberbullying, exposure to harmful content, and increased screen time, they also carry potential drawbacks, including digital exclusion, disruption of peer support networks, and limited access to educational and mental health resources. This viewpoint article examines the multifaceted challenges of implementing social media age restrictions in India, considering the diversity in digital literacy, sociocultural factors, and infrastructural disparities between urban and rural areas. Recognizing these complexities, the article proposes alternative approaches, including comprehensive digital literacy programs, enhanced parental involvement, age-appropriate content moderation, and flexible, phased access to social media. By advocating for a balanced, collaborative approach involving policymakers, educators, parents, and platform providers, this article emphasizes the importance of creating a safe yet empowering digital environment that nurtures responsible online engagement. Such a nuanced policy framework would allow Indian adolescents to safely benefit from the positive aspects of social media while minimizing risks, ultimately fostering a generation of resilient, informed digital citizens.</p>","PeriodicalId":13345,"journal":{"name":"Indian Journal of Psychiatry","volume":"67 2","pages":"267-273"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11964175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780036","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}