Indian Journal of Psychiatry最新文献

{"title":"Effectiveness of fluoxetine and mindfulness therapy in improving depression in people with Type 2 Diabetes Mellitus in Primary Care Settings (DIAMAND)-A single-blind, parallel-group, randomized controlled trial from Bengaluru.","authors":"Dhanya Raveendranathan, Johnson-Pradeep Ruben, B Ramakrishna Goud, Anupama Nataraj, Ilene Babu, Nikitha K Padmanabha, Sumithra Selvam, Smita N Deshpande","doi":"10.4103/indianjpsychiatry_803_24","DOIUrl":"10.4103/indianjpsychiatry_803_24","url":null,"abstract":"<p><strong>Background: </strong>Depression and type 2 diabetes mellitus (T2DM) share a bidirectional relationship. This comorbidity is associated with poor glycemic control, reduced medication adherence, and impaired quality of life. Evidence comparing pharmacological and psychological interventions for mild depression in T2DM within primary care settings remains limited.</p><p><strong>Objectives: </strong>To compare the effectiveness of Fluoxetine, Mindfulness therapy, combination Fluoxetine + Mindfulness, and treatment as usual (TAU) in reducing depressive symptoms among individuals with T2DM and mild depression.</p><p><strong>Methods: </strong>This single-blind randomized controlled trial (RCT) was conducted among individuals (<i>n</i> = 200) with T2DM and mild depression recruited from the Bengaluru site of the multi-center diabetes mellitus and depression (DIAMAND) study. Participants were randomized to Fluoxetine, Mindfulness therapy, combination treatment, or TAU. Depression severity, medication adherence, diabetes self-management, quality of life, HbA1c, and random blood sugar (RBS) were tested over 4 months. Repeated Measures ANOVA (RMANOVA) and effect size estimates were used for analysis.</p><p><strong>Results: </strong>Depressive symptoms improved significantly over time across all study arms; and no significant between-group differences were observed in depression outcomes. No significant differences were found between groups for glycemic control, medication adherence, diabetes self-management, or quality of life. Effect sizes for reduction in depressive symptoms compared with TAU were 0.48 for Mindfulness, 0.45 for fluoxetine, and 0.31 for combination treatment.</p><p><strong>Conclusions: </strong>In this RCT, depressive symptoms and medication adherence improved across all study arms; however, none demonstrated superiority over TAU. Mindfulness-based interventions may represent feasible, scalable, low-intensity approaches for mild depression in primary care settings. Future adequately powered studies with longer follow-up are needed to evaluate long-term effectiveness of psychological and pharmacological interventions.</p>","PeriodicalId":13345,"journal":{"name":"Indian Journal of Psychiatry","volume":"68 Suppl 2","pages":"S426-S435"},"PeriodicalIF":2.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13553100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148911698","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":"Psychometric properties of MERIT: A concise tool for community health workers to screen priority mental disorders.","authors":"P Lakshmi Nirisha, Satish Suhas, Barikar C Malathesh, Nitesh Kulal, Nisha R Harshitha, Gajanan Sabahit, Narayana Manjunatha, Jagadisha Thirthalli, Chennaveerachari Naveen Kumar, Adarsha Alur Manjappa, Rajani Parthasarathy, Prabhat K Chand, Sanjeev Arora, Suresh Bada Math","doi":"10.4103/indianjpsychiatry_326_24","DOIUrl":"10.4103/indianjpsychiatry_326_24","url":null,"abstract":"<p><strong>Background: </strong>Task shifting is an accepted way to address the treatment gap for mental health disorders. Community Health Workers (CHWs) can play vital roles through screening, referral, and providing basic counseling. To address the dearth of a concise screening instrument for CHWs, the \"Mental HEalth ScReenIng Tool for Community Health Workers in India [MERIT]\" was designed and developed. In this paper, we have examined the psychometric properties of MERIT.</p><p><strong>Methods: </strong>MERIT consists of nine stems (consisting of 11 questions) covering the following five domains: (a) Substance Abuse (alcohol, tobacco), (b) Anxiety, (c) Depression and Somatoform symptoms, (d) Severe Mental Illnesses, and (e) Suicidal risk. MERIT can be applied to one key informant of the household to screen for all its adult members. Mental health professionals (MHPs) with community psychiatry expertise undertook the face and content validity exercise (for both English and Kannada versions; 17 and 11, respectively) and rated the 'adequacy' (ability to pick up a mental health issue) of each of the questions on a Likert scale ranging from 0 (strongly disagree) to 4 (strongly agree). For each of the domains, the item-content validity index (I-CVI) of more than 0.8 was considered adequate. Concurrent validity was examined through concordance between the screened status as per Accredited Social Health Activists (ASHAs; quintessential CHWs; n = 16; n = 116 households) and the independent clinical impression derived by seven MHPs. Inter-rater reliability (IRR) was examined by measuring the concordance between the two groups of ASHAs (first group; n = 7, second group; n = 9), who independently screened the same 116 households.</p><p><strong>Results: </strong>All experts (for both English and Kannada versions) gave a rating of 3 or more for each of the MERIT domains. I-CVI of each domain was > 0.8 (0.86 for English and 0.80 for Kannada). Concurrent validity [n = 116; k = 0.792 indicating substantial agreement between ASHAs and MHPs; <i>P</i> < 0.001] and IRR [n = 115, k = 0.744; <i>P</i> < 0.001] were excellent. The specificity (97.50%), positive predictive value (92.4%), and negative predictive value (86%) were high. The sensitivity was 62.5%. On average, 5 minutes were required to administer MERIT.</p><p><strong>Conclusion: </strong>MERIT is concise, valid, and reliable for CHWs to screen for priority psychiatric disorders among adults. While its sensitivity is comparatively lower, it can be easily integrated into public health programs as it offers the advantage of covering the entire household by interviewing one of its key informants.</p>","PeriodicalId":13345,"journal":{"name":"Indian Journal of Psychiatry","volume":"68 Suppl 2","pages":"S415-S425"},"PeriodicalIF":2.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13553093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148911809","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":"Psychological, agricultural, and socioeconomic risk factors in farmers with and without completed suicide.","authors":"Raghavendra B Nayak, Bheemappa Anjinappa, Triptish Bhatia, Mahesh Mahadevaiah","doi":"10.4103/indianjpsychiatry_392_24","DOIUrl":"10.4103/indianjpsychiatry_392_24","url":null,"abstract":"<p><strong>Background: </strong>Farming is an occupation with higher risk for suicide compared to other occupations, and Indians are no exception. Karnataka state is only second after Maharashtra in the frequency/prevalence of farmers' suicide in India. Suicide among farmers is multidimensional in nature.</p><p><strong>Aim: </strong>To study the psychological, agricultural, and socioeconomic risk factors in farmers who had completed suicide and farmers in the same locality who had not/never attempted suicide.</p><p><strong>Methods: </strong>Families of farmers, aged between 18 and 60 years, who had died by suicide, were recruited as cases. Age- and gender-matched farmers from the same locality with similar financial risk factors were recruited as controls by the convenient sampling method after obtaining informed consent. Psychological autopsy was done in cases, and similar risk factors were assessed in controls. GHQ-12 and Mini Plus scale were used. Statistical analysis was done using SPSS software.</p><p><strong>Results: </strong>The study included 295 cases and 254 controls. Sociodemographic parameters except educational status (<i>P</i> = 0.003) were comparable among groups. Social and financial support was higher in cases than in the control group of farmers. Both groups had similar agricultural practices except crop insurance, which was low among cases (<i>P</i> < 0.001). Cases suffered from a greater number of health issues compared to controls. Substance use was significantly higher in cases (<i>P</i> < 0.001) (mostly alcohol and tobacco). Hanging was the most common method of committing suicide, followed by poisoning with pesticides.</p><p><strong>Conclusion: </strong>Farmer suicide is a complex phenomenon with underlying multiple risk factors. Farmers with suicidal attempt had underlying depression, socioeconomic, and agricultural risk factors and also substance abuse.</p>","PeriodicalId":13345,"journal":{"name":"Indian Journal of Psychiatry","volume":"68 Suppl 2","pages":"S333-S339"},"PeriodicalIF":2.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13553090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148911889","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 a life skills intervention to forestall alcohol use among tribal adolescents in Gujarat, Meghalaya and Tamil Nadu, India: A Non-randomized study.","authors":"Jennifer R War, Vaibhav V Gharat, Wa E D Shylla, Melissa D Kyndiah, Sunil N Nayak, Smita N Deshpande, Veena Sunil, Smitha Mohanraj, Divya M Devi, Glenn C Kharkongor, Shylaja Devi","doi":"10.4103/indianjpsychiatry_778_24","DOIUrl":"10.4103/indianjpsychiatry_778_24","url":null,"abstract":"<p><strong>Background: </strong>Among youth aged 10-24 years, the main risk factor for Disability Adjusted Life Years is alcohol use (7%) (WHO Global of Disease), especially in developing countries. Tribal adolescents in India need proactive interventions to prevent them from initiating alcohol use.</p><p><strong>Aim: </strong>To assess the experiences and effectiveness of a life skills intervention to prevent alcohol initiation among tribal adolescents.</p><p><strong>Methods: </strong>Tribal adolescents aged 15-19 years were recruited to participate in a nonrandomized life skills intervention study at three sites at Gujarat, Meghalaya, and Tamil Nadu. Both control and intervention groups (assessed on WHO ASSIST V3) were screened at baseline and after 6 and 12 months. At the 12-month follow-up, the adolescents were interviewed to assess their intervention experience.</p><p><strong>Results: </strong>Fewer tribal adolescents were using alcohol in the intervention as compared to the control group (not statistically significant). Life skills intervention appeared to provide several positive skills such as knowledge transfer and better decision-making and problem-solving.</p><p><strong>Conclusions: </strong>Overall, the life skills intervention appeared to help forestall alcohol intake among tribal youth, who reported their intention to practice assertive behavior to refuse alcohol. Additional intangible benefits were reported. Youth wanted the workshops to be regular and to be expanded to other youth groups.</p>","PeriodicalId":13345,"journal":{"name":"Indian Journal of Psychiatry","volume":"68 Suppl 2","pages":"S340-S348"},"PeriodicalIF":2.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13553092/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148911596","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":"Behavioral and psychological symptoms of dementia and its relationship with caregiver burden: A cross-sectional study of inpatients with dementia in a tertiary center.","authors":"V Meghana, Preeti Sinha, P T Sivakumar, Vijaykumar Harbishettar","doi":"10.4103/indianjpsychiatry_361_26","DOIUrl":"10.4103/indianjpsychiatry_361_26","url":null,"abstract":"<p><strong>Background: </strong>Behavioral and psychological symptoms of dementia (BPSD) is commonly associated with caregiver distress, and often a reason for short-term or long-term care. Very few studies have examined the pattern of the BPSD and caregiver burden in an Indian tertiary care inpatient setting.</p><p><strong>Aims: </strong>Our study aimed to understand the pattern of BPSD, particularly its individual domains, in different types of dementia, and its relationship with caregiver distress and burden in a geriatric inpatient setting.</p><p><strong>Methods: </strong>One hundred inpatients with dementia and their informal primary caregivers participated in a cross-sectional, semi-structured interview using validated tools to assess the types and severity of BPSD and the relationship with caregiver burden.</p><p><strong>Results: </strong>All inpatients had one or more BPSD, as expected, with a median of 7 (1QR 5-8). Night-time behavioral disturbances (79%), irritability (78%), and apathy (74%) were the most common ones. In Alzheimer's dementia (AD), night-time behavioral disturbances (80%), irritability/lability (74.3%), and agitation/aggression (68.6%) were the most observed. Apathy (84.4%) was the most common BPSD in frontotemporal dementia (FTD), followed by irritability (80%), aberrant motor behavior (71.2%), and night-time behavioral disturbances (71.2%). Caregiver distress varied across different BPSD, with irritability (10%), agitation (8%), and aberrant motor behavior (7%) associated with the highest levels of distress in our study. Worsening cognitive impairment was not associated with increased burden.</p><p><strong>Conclusion: </strong>An individually tailored management approach targeting specific BPSD symptoms, with equal focus on both the patient and the caregiver, is key.</p>","PeriodicalId":13345,"journal":{"name":"Indian Journal of Psychiatry","volume":"68 8","pages":"748-755"},"PeriodicalIF":2.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13561471/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148944262","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":"Telephone-based outreach and interventions for persons with suicide attempts - A randomized controlled trial.","authors":"Ram Pratap Beniwal, Triptish Bhatia, Uttara Chari, T S Smitha, K Murugesh, Supreet Kaur Bhasin, S V Vidhya Shree, Priya Sreedaran, Smita N Deshpande","doi":"10.4103/indianjpsychiatry_366_24","DOIUrl":"10.4103/indianjpsychiatry_366_24","url":null,"abstract":"<p><strong>Background: </strong>Suicidal ideation and a history of suicide attempts (SAs) are risk factors for future suicide. Telephone outreaches as treatment augmentation strategies could address these risks.</p><p><strong>Aim: </strong>To compare the efficacy of manualized addon telephone-based psychosocial interventions (TBPIs) with telephone contacts (TCs) during follow-up on suicidal ideation in individuals with a recent SA.</p><p><strong>Methods: </strong>Using a parallel-group, rater-blind, two-arm, randomized controlled trial design at two general hospital settings, we recruited 390 individuals with recent SA. We excluded recent psychosis, substance dependence, and medically unstable conditions. The TBPI group (N = 194) received three sessions of manualized psychosocial intervention with reminders for treatment adherence. The TC group (n = 196) received three telephone reminders for treatment adherence. Both the outreaches were at weekly intervals. Primary outcomes were changes in Beck's Scale for Suicide Ideation and rates of repeat suicidal behaviors at 6 months.</p><p><strong>Results: </strong>Using intent to treat analysis at trial completion, TBPI (N = 194, χ² = 44.19, <i>W</i> = 0.14, <i>P</i> < 0.001) and TC (N = 196, χ² = 20.26, <i>W</i> = <i>0.07</i>, <i>P</i> < 0.001) significantly reduced suicidal ideation at 6 months. There were no significant differences between TBPI and TC on suicidal ideation (δ = -0.031(CI = -0.091-0.030), <i>P</i> < 0.323) nor on rates of repeat suicidal behaviors (TBPI, N = 3 [1.5%]; TC N = 5 [2.6%], χ =2.24, <i>P</i> < 0.329). Exploratory analyses revealed significantly reduced suicidal ideation in those who received TBPI irrespective of whether psychiatric disorders were present. Those who received TC and were without psychiatric disorder did not show significantly reduced suicidal ideation.</p><p><strong>Conclusions: </strong>Telephone outreaches - during follow-up - are potential treatment augmentation strategies in individuals at risk of suicide in Indian hospital settings.</p>","PeriodicalId":13345,"journal":{"name":"Indian Journal of Psychiatry","volume":"68 Suppl 2","pages":"S324-S332"},"PeriodicalIF":2.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13553102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148911846","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 qualitative exploration of the lived experiences and views of users of mental health services after self-harm.","authors":"Priya Sreedaran, T S Smitha, K Murugesh, S V Vidhya Shree, Triptish Bhatia, Smita N Deshpande","doi":"10.4103/indianjpsychiatry_791_24","DOIUrl":"10.4103/indianjpsychiatry_791_24","url":null,"abstract":"<p><strong>Background: </strong>Individuals at risk of suicide have low engagement with mental health services (MHS). Reasons for this include stigma about suicide, inadequate public awareness, and the difficulty in approaching MHS. Lived experiences of users of MHS might yield insights into this low engagement and improve the access to mental health interventions for users.</p><p><strong>Aim: </strong>To explore the lived experiences and views of individuals with self-harm who were users of specialist MHS in a tertiary general hospital setting.</p><p><strong>Methods: </strong>We used a qualitative study design with in-depth interviews. We included participants who had used inpatient or outpatient MHS for a self-harm attempt. We used a realist approach to thematic analysis and <i>ATLAS ti</i> qualitative software for coding.</p><p><strong>Results: </strong>We recruited 25 participants (16 women and nine men) between 18 and 43 years. All participants had completed a randomized controlled trial on the efficacy of telephone outreach in suicide prevention. The themes generated were the participants' inherent attitudes toward self-harm and suicide, their experiences of MHS, their perspectives on treatments that helped with suicidal ideation, and the impact of their experiences with MHS on future help-seeking.</p><p><strong>Conclusions: </strong>The user perspectives of MHS appear to be influenced by their inherent pre-existing beliefs about suicide. Users find specific interventions for suicidal ideation beneficial and healthcare infrastructural problems as challenges. Individuals with persistent difficulties after self-harm were more likely to engage with healthcare services. The study limitation was the absence of perspectives from those individuals who dropped out from MHS and other settings.</p>","PeriodicalId":13345,"journal":{"name":"Indian Journal of Psychiatry","volume":"68 Suppl 2","pages":"S392-S398"},"PeriodicalIF":2.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13553089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148911878","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":"Micro-RNA signature in alcohol dependence: Circulating miRNA-92b and miRNA-382-5p levels as candidate biomarkers: A case-control study.","authors":"Prateek Yadav, M K Sibin, Sukriti Pruthi, Arun K Yadav, Kaushik Chatterjee, Vinay S Chauhan, Neha Sharma, Srikrishna P Panda","doi":"10.4103/indianjpsychiatry_1031_25","DOIUrl":"10.4103/indianjpsychiatry_1031_25","url":null,"abstract":"<p><strong>Background: </strong>Alcohol dependence syndrome (ADS) involves compulsive alcohol use despite negative consequences. Early identification significantly improves outcomes. MicroRNAs (miRNAs) that regulate gene expression, show promise as potential biomarkers for this condition through distinctive molecular signatures.</p><p><strong>Aim: </strong>To determine expression of miRNA-92b and miRNA 382-5p in serum of drug naïve patients of ADS in comparison to matched healthy controls to investigate the potential of miRNA 92b and miRNA 382-5p as diagnostic biomarkers for ADS.</p><p><strong>Methods: </strong>A case-control study examined miRNA expression patterns between ADS patients and matched healthy subjects. Statistical methods were applied to evaluate the resulting data. Through receiver operating characteristic (ROC) curve analysis, optimal threshold values were determined for the two miRNAs under investigation.</p><p><strong>Results: </strong>Findings revealed median expression levels of miRNA-382-5p: 0.001 (Q1: 0.000, Q3: 0.005) in cases and 0.008 (Q1: 0.005, Q3: 0.021) in controls. Median expression levels of miRNA 92b: 0.00 (Q1: 0.00, Q3: 0.01) in cases and 3.68 (Q1: 1.16, Q3: 6.34) in controls. Both being statistically significant. ROC for miRNA-382-5p showed area under the curve (AUC) as 0.86 and for miRNA 92b as 0.99. These results indicate that serum levels of miRNA-92b and miRNA 382-5p, can be used as potential biomarkers for the detection and diagnosis of ADS.</p><p><strong>Conclusion: </strong>The association between serum miRNA-92b and miRNA-382 with alcohol use offers a promising avenue for research in alcohol use disorders (AUD). The current findings highlight their potential as biomarkers, with a high statistical significance.</p>","PeriodicalId":13345,"journal":{"name":"Indian Journal of Psychiatry","volume":"68 8","pages":"718-723"},"PeriodicalIF":2.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13561470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148929856","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":"Linkage and alcohol use outcomes of a screening, brief intervention, and referral to treatment (SBIRT) program for alcohol-related liver disease: A retrospective cohort study from India.","authors":"Abhishek Ghosh, Nipun Verma, Harsh A Thappa, Surabhi Gupta, Renjith R Pillai, Shalini Naik, Arka De, Madhumita Premkumar, B N Subodh, Sunil Taneja, Debasish Basu, Ajay Duseja","doi":"10.4103/indianjpsychiatry_451_26","DOIUrl":"10.4103/indianjpsychiatry_451_26","url":null,"abstract":"<p><strong>Background: </strong>Alcohol-related liver disease (ArLD) and alcohol use disorder remain undertreated. Collaborative care embedding addiction services within medical settings have shown promise.</p><p><strong>Aim: </strong>We evaluated the linkage and alcohol use outcomes of an SBIRT-based collaborative care clinic at a public sector hospital in India, examining rates of linkage to addiction treatment, alcohol use outcomes at follow-up, and factors associated with successful linkage.</p><p><strong>Methods: </strong>A retrospective cohort study of 500 consecutively enrolled patients was conducted over January 2023-July 2024. Patients with ArLD were systematically screened using the Alcohol Use Disorders Identification Test (AUDIT) and risk-stratified into brief advice, brief counselling, or referral for specialized addiction treatment.</p><p><strong>Results: </strong>All patients were male, predominantly rural (53.3%), and travelled a median of 80 km. The mean AUDIT score was 18.0 ± 9.4. The clinic enrolled a mean of 26.3 patients per month; stable throughout. Of 288 patients referred for addiction treatment, 156 (54.4%; 95% CI 48.4-59.8%) were successfully linked, with a median time to first addiction contact of 3 days. At the 3-month follow-up, retention was 26.1%; among those with a recorded alcohol use status, 35.9% were abstinent. On multivariable logistic regression, no patient-level variable was associated with linkage. The sole significant factor was therapist identity (likelihood ratio χ² = 22.75, df = 5, <i>P</i> < 0.001), with linkage rates ranging from 17.6% to 72% across counsellors.</p><p><strong>Conclusions: </strong>Collaborative care model is operationally viable within a public sector hepatology department in India. Marked intertherapist variability in linkage rates underscores the need for competency-based training.</p>","PeriodicalId":13345,"journal":{"name":"Indian Journal of Psychiatry","volume":"68 8","pages":"699-708"},"PeriodicalIF":2.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13561475/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148944538","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":"Neuromodulation therapies in the management of tardive dyskinesia: A scoping review.","authors":"Anaf Kololichalil, K Muhammed Jadeer, Ragul Ganesh, Rohit Verma, Vaibhav Patil","doi":"10.4103/indianjpsychiatry_1300_25","DOIUrl":"10.4103/indianjpsychiatry_1300_25","url":null,"abstract":"<p><strong>Background: </strong>Tardive dyskinesia (TD) comprises persistent involuntary movements that usually emerge after sustained treatment with dopamine receptor blocking agents.</p><p><strong>Objectives: </strong>Although vesicular monoamine transporter 2 (VMAT2) inhibitors have expanded treatment options, a proportion of patients continue to experience disabling symptoms, prompting interest in neuromodulator interventions.</p><p><strong>Methods: </strong>Evidence was retrieved from three databases, PubMed, Scopus, and Web of Science, with coverage limited to English-language publications dated January 2000-September 2025. Studies reporting the use of deep brain stimulation (DBS), electroconvulsive therapy (ECT), repetitive transcranial magnetic stimulation (rTMS), or transcranial direct current stimulation (tDCS) for TD were charted, and the extracted findings were grouped according to neuromodulation modality following Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidance.</p><p><strong>Results: </strong>Included studies comprised DBS, ECT, rTMS, and tDCS reports, with evidence ranging from randomized controlled trials to case reports. Globus pallidus internus deep brain stimulation (GPi-DBS) showed the most consistent and durable benefit, with prospective studies reporting approximately 56%-63% improvement on extrapyramidal symptom rating scale (ESRS) and abnormal involuntary movement scale (AIMS) outcomes. ECT was associated with AIMS improvement in one small retrospective study and three case-reports. rTMS showed preliminary benefit, although protocols were heterogeneous and TD-specific controlled outcomes were limited. tDCS showed emerging benefit, particularly for facial-oral dyskinesia.</p><p><strong>Conclusion: </strong>Neuromodulation is a promising adjunctive option for refractory TD. GPi-DBS has the strongest evidence, whereas rTMS and tDCS remain investigational and require larger controlled trials.</p>","PeriodicalId":13345,"journal":{"name":"Indian Journal of Psychiatry","volume":"68 8","pages":"683-691"},"PeriodicalIF":2.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13561489/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148944634","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}