Indian Journal of Psychological Medicine最新文献

{"title":"Recognizing Identity, Respecting Autonomy: The Role of Psychiatrists in Legal Gender Recognition.","authors":"Anitha Rayirala","doi":"10.1177/02537176251347928","DOIUrl":"10.1177/02537176251347928","url":null,"abstract":"","PeriodicalId":13476,"journal":{"name":"Indian Journal of Psychological Medicine","volume":" ","pages":"02537176251347928"},"PeriodicalIF":1.9,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12181176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Typology of Self-injurious Behaviors Admitted to a Tertiary Care Hospital.","authors":"Ajith P Jayan, Sumesh T P, Diya P Albert, Nisha Radhakrishna Pillai, Vidhukumar Karunakaran","doi":"10.1177/02537176251346895","DOIUrl":"10.1177/02537176251346895","url":null,"abstract":"<p><strong>Background: </strong>If we can classify self-injurious behaviors without a priori assumptions about related variables, it could contribute to the nosology of self-injurious behaviors with etiological and management underpinnings.</p><p><strong>Methods: </strong>A cross-sectional study was conducted among 90 adult subjects consecutively admitted to the medical and surgical wards of a tertiary care center. In addition to socio-demographic and relevant clinical variables, intent, lethality, impulsivity, social support, and stressful life events were measured. <i>K</i>-means cluster analysis was used to delineate groups.</p><p><strong>Results: </strong>Hierarchical cluster analysis followed by <i>K</i>-means cluster analysis yielded three groups and their characteristics. The first group consisted of older individuals with high lethality and intent, and low impulsivity. Mental illnesses such as depressive disorder and delusional disorder were more common in this group compared to the others. The second group showed some impulsivity and poor perceived social support. Their attempts were characterized by lower lethality and intent. The third group included the youngest individuals, with high impulsivity and high mean stress scores despite having high perceived social support. Both the second and third groups had a fair representation of borderline personality disorder.</p><p><strong>Conclusions: </strong>Adults with self-injurious behaviors could be divided into three distinct clusters, which has implications for nosology, etiological models, and management.</p>","PeriodicalId":13476,"journal":{"name":"Indian Journal of Psychological Medicine","volume":" ","pages":"02537176251346895"},"PeriodicalIF":1.9,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12176789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Haloperidol in the Prevention and Management of Delirium in Medical Inpatients: An Umbrella Review of Systematic Reviews.","authors":"Vijaykumar Harbishettar, Vijayakumar Heggeri, Saraswathi Tenagi, Aparna S Harbishettar, Krishna Prasad Muliyala, Sivakumar Pt, Geetha Desai, Muralidharan Kesavan","doi":"10.1177/02537176251345129","DOIUrl":"10.1177/02537176251345129","url":null,"abstract":"<p><strong>Objective: </strong>Delirium occurs in up to 31% of general hospital patients in the medical, surgical, or critical care wards. Agitation is common during hyperactive delirium, which poses a risk to themselves, other patients, or staff. Evidence for using oral or parenteral haloperidol from randomized controlled trials and published systematic reviews shows divergent findings, ranging from good response to no difference compared to placebo, despite its popularity in routine clinical use. We decided to perform an umbrella review of systematic reviews on the efficacy and safety of haloperidol in delirium.</p><p><strong>Collection and analysis of data: </strong>This protocol was registered with PROSPERO CRD42024502020. We searched PubMed, Ovid MEDLINE, and PsychINFO for systematic reviews with meta-analyses published in English only over the previous 20 years. These were searched under title, abstract, and Medical Subject Headings (MeSH) terms as applicable. We used Assessing the Methodological Quality of Systematic Reviews 2 to assess the quality of the articles. Ten systematic reviews were finally selected for review that focused on either preventing or treating delirium. The summary of results did not find that haloperidol is effective in preventing or treating delirium, though all included reviews found it a safe drug to use. Heterogeneity from <i>I</i> ² statistics varied from a moderate to a high degree and may be attributable to population, outcomes, and setting variations.</p><p><strong>Conclusions: </strong>The authors conclude that there is limited evidence for haloperidol in preventing or treating delirium. Future studies must not aim to assess the resolution of delirium; instead, they must modify outcome measures, to mainly behavioral and psychiatric symptoms such as agitation, hallucinations, and persecutory delusions in delirium.</p>","PeriodicalId":13476,"journal":{"name":"Indian Journal of Psychological Medicine","volume":" ","pages":"02537176251345129"},"PeriodicalIF":1.9,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12176798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Double Burden of Financial Constraints and Stigma with Isolation of Families of Bipolar Mood Disorder Patients: A Constructivist Grounded Theory Analysis from Tamil Nadu, India.","authors":"Vrinda Sankar Kala, Arul Saravanan R, Manesh Muraleedharan, Sammita Jadhav, Tanay Trivedi","doi":"10.1177/02537176251346955","DOIUrl":"10.1177/02537176251346955","url":null,"abstract":"<p><strong>Background: </strong>The family members of the bipolar patients are subjected to stigma and mental and physical abuse by the bipolar patient. This can reflect as expressed emotion and ultimately affect the financial and physical well-being of the patient and family members.</p><p><strong>Objective: </strong>The aim of this study was to understand various challenges faced by caregivers of bipolar disorder patients and their families, including emotional well-being, and financial challenges, as well as community and health system support.</p><p><strong>Methods: </strong>A constructivist grounded theory approach is used to understand the issue and develop themes.</p><p><strong>Results: </strong>Caregiving for individuals with bipolar disorder often presents gender-related differences, as women experiencing greater emotional burden and stress compared to men, who may focus more on financial and emotional support. These responsibilities are further complicated by financial constraints related to treatment, as the high costs of medication, therapy, and hospitalizations can be overwhelming, especially for families with limited resources or inadequate insurance coverage. Additionally, stigma and isolation significantly impact both patients and caregivers, as societal misconceptions, workplace discrimination, and excessive concern from the community can lead to withdrawal and reluctance to seek help, worsening mental health outcomes.</p><p><strong>Conclusions: </strong>Gender-based disparity in the well-being of caregivers of mental disorders is a neglected issue, which needs further research and support. Also, health system strengthening and community education are essential to improve the well-being of family members and caregivers of bipolar disorder patients.</p>","PeriodicalId":13476,"journal":{"name":"Indian Journal of Psychological Medicine","volume":" ","pages":"02537176251346955"},"PeriodicalIF":1.9,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12176796/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reflections of Symposium on Responsible Media Reporting in Suicide Prevention.","authors":"Latha K, Sharmitha Krishnamurthy, Guru S Gowda, Deepika Reddy S, Staicey Mathai, K S Meena, Venkata Senthil Kumar Reddi","doi":"10.1177/02537176251347107","DOIUrl":"10.1177/02537176251347107","url":null,"abstract":"","PeriodicalId":13476,"journal":{"name":"Indian Journal of Psychological Medicine","volume":" ","pages":"02537176251347107"},"PeriodicalIF":1.9,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12176775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interpersonal Psychotherapy for Suicidal Risk: A Narrative Review of Randomized Controlled Trials.","authors":"Dhanpati Sahu, Ajay Kumar Bakhla, Varun S Mehta","doi":"10.1177/02537176251347066","DOIUrl":"10.1177/02537176251347066","url":null,"abstract":"<p><strong>Purpose of the review: </strong>This narrative review evaluates the effectiveness of interpersonal psychotherapy (IPT) among individuals at risk of suicide, with a focus on the quality of randomized controlled studies.</p><p><strong>Collection and analysis of data: </strong>The available literature was systematically searched on PubMed, the Cochrane Library, Hinari-Research4Life, and ResearchGate to identify RCTs in which participants at risk of suicide received IPT compared to other forms of treatment. Extracted study data were organized into a table of evidence using Microsoft Excel and Word. The Risk of Bias 2 Excel tool was used to evaluate the possibility of bias. Out of 158 identified studies, six met the inclusion criteria for review and analysis, encompassing 1,275 participants, of whom 53.1% were randomized to IPT conditions. Among these studies, two demonstrated that IPT was effective in significantly reducing suicidal ideation and behaviors over time compared to treatment-as-usual or waitlist conditions. However, most studies did not report clinically significant outcomes, such as risk ratios, effect sizes, and confidence intervals (CIs) with <i>p</i> values. A significant risk of bias was observed across the majority of studies, particularly in randomization (83.30%), deviation from the intended intervention (66.70%), missing outcomes (66.70%), measurement of outcomes (66.70%), and selection of the reported results (100%), with an overall high risk of bias across all assessed domains.</p><p><strong>Conclusions: </strong>The effectiveness of IPT in reducing suicidal risk was found to be imprecise due to incomplete reporting of results, indicating the need for further conclusive and evident research.</p>","PeriodicalId":13476,"journal":{"name":"Indian Journal of Psychological Medicine","volume":" ","pages":"02537176251347066"},"PeriodicalIF":1.9,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12176788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Executive Function and Emotion Regulation in Depressive and Anxiety Disorders: A Cross-sectional Study.","authors":"Tanisha Shetty, Himani Kashyap, Urvakhsh Meherwan Mehta, Binu V S","doi":"10.1177/02537176251340586","DOIUrl":"10.1177/02537176251340586","url":null,"abstract":"<p><strong>Background: </strong>Executive function (EF) and emotion regulation (ER) deficits are prevalent in depressive and anxiety disorders, suggesting a transdiagnostic role. Given their role in treatment engagement, symptom reduction, and relapse prevention, we examine EF and ER interrelationships in these disorders.</p><p><strong>Methods: </strong>Participants (<i>n</i> = 27 depressive/anxiety disorders, <i>n</i> = 27 nonclinical group) underwent psychiatric screening and assessments of symptom severity, EF (set-shifting, response inhibition [RI], working memory [WM], verbal fluency, planning), and ER (severity, strategies, situational ER following emotion induction). Mann-Whitney <i>U</i>-test/<i>t</i>-test was used for group comparisons, and Pearson's/Spearman's test was used for correlations.</p><p><strong>Results: </strong>The clinical group showed lower WM (Cohen's <i>d</i> = 0.94, <i>p</i> = .001), verbal fluency (Cohen's <i>d</i> = 0.7, <i>p</i> = .01), and RI (Cohen's <i>d</i> = 0.35, <i>p</i> = .02); greater ER difficulties (Cohen's <i>d</i> = -1.40, <i>p</i> < .001), greater negative ER strategy use of catastrophizing (Cohen's <i>d</i> = 0.55, <i>p</i> < .001); and on the emotion-induction task-higher use of acceptance, other-blame, but no positive reappraisal. The nonclinical group showed greater positive ER strategy use of refocus on plan (Cohen's <i>d</i> = 0.53, <i>p</i> < .001) and no use of rumination on the emotion-induction task. The severity of ER difficulties correlated with poorer WM (<i>p</i> = .006); acceptance as an ER strategy correlated with poorer RI (<i>p</i> = .02). EF and ER difficulties and maladaptive strategies were significantly higher in the depression/anxiety group.</p><p><strong>Conclusions: </strong>The findings extend prior research by providing actionable insights for tailored interventions and merit testing in larger samples. With poorer WM linked to greater ER difficulties and inefficient RI to passive acceptance, interventions such as cognitive training may enhance ER.</p>","PeriodicalId":13476,"journal":{"name":"Indian Journal of Psychological Medicine","volume":" ","pages":"02537176251340586"},"PeriodicalIF":1.9,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12162532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Sexual Dysfunction, Vitamin D, and Thyroid Levels with Suicidal Behavior Among Patients with Depressive Disorder: A Cross-sectional Study.","authors":"Pinki Sevda, Preethy Kathiresan, Naresh Nebhinani, Mithu Banerjee, Sanyam Tyagi","doi":"10.1177/02537176251339764","DOIUrl":"10.1177/02537176251339764","url":null,"abstract":"<p><strong>Background: </strong>Vitamin D levels, thyroid hormones, and sexual functioning play significant roles in the risk of suicidal behavior. Despite this, there is a paucity of literature on these within the Indian context, particularly among patients with depression and suicidal behavior. The index study aims to assess the association of sexual dysfunction, hypothyroidism, and vitamin D deficiency with suicidal behavior among patients with depressive disorders.</p><p><strong>Methods: </strong>One hundred fifty individuals with a diagnosis of moderate-to-severe depressive disorder were enrolled in the study, seventy-five in each of the two groups, with and without suicidal behaviors. The Hamilton Depression Rating Scale, Columbia-Suicide Severity Rating Scale, and Changes in Sexual Functioning Questionnaire were used to assess participants' severity of depression, suicidal behavior, and sexual functioning, respectively. Vitamin D and thyroid hormone levels were evaluated.</p><p><strong>Results: </strong>Upon comparing patients with and without suicidal behaviors, being single, employed, longer duration of illness, earlier age of onset, greater depression severity, presence of sexual dysfunction, and lower vitamin D levels had significant associations with suicidal behavior in depression. Significant predictors of suicidal behavior were greater depression severity and the presence of sexual dysfunction. Greater depression severity emerged as a significant predictor for sexual dysfunction and, additionally, prolonged duration of illness in female sexual dysfunction.</p><p><strong>Conclusion: </strong>Greater depression severity and sexual dysfunction were significant predictors of suicidal behavior in depression. Comprehensive assessment of sexual functioning and vitamin D in individuals with depression can help in timely identification and effective intervention.</p>","PeriodicalId":13476,"journal":{"name":"Indian Journal of Psychological Medicine","volume":" ","pages":"02537176251339764"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12129937/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Compulsive Bathing Associated with Cyclical Vomiting Syndrome: A Case Report.","authors":"Shalaka Anand Chatorikar, Sheena Agarwal, Abhiram Narasimhan Purohith, Sonia Shenoy, Rajeshkrishna Bhandary P, Psvn Sharma","doi":"10.1177/02537176251339409","DOIUrl":"10.1177/02537176251339409","url":null,"abstract":"","PeriodicalId":13476,"journal":{"name":"Indian Journal of Psychological Medicine","volume":" ","pages":"02537176251339409"},"PeriodicalIF":1.9,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12125003/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immortal Time Bias in Cohort Studies: A Concept Simply Explained.","authors":"Chittaranjan Andrade","doi":"10.1177/02537176251343289","DOIUrl":"10.1177/02537176251343289","url":null,"abstract":"<p><p>Immortal time bias is one of many types of bias that may flaw cohort studies. This bias occurs when formal observation of patients starts before they experience the exposure of interest, and when, by design, those who experience the outcome of interest before they experience the exposure are ineligible to be included in the exposure arm of the study. Consequently, patients in the exposure arm, by design, are immortal to the outcome between the start of observation and point of the exposure. If this period of immortality is included in analysis, the result is immortal time bias. This concept is explained with one hypothetical example, related to selective serotonin reuptake inhibitor exposure and prevention of ischemic heart disease events, and one published example, related to the use of suvorexant to prevent delirium during intensive care unit admission. Also explained is how immortal time bias can be avoided, and why an awareness of the concept is important when reading studies that employ observational designs.</p>","PeriodicalId":13476,"journal":{"name":"Indian Journal of Psychological Medicine","volume":" ","pages":"02537176251343289"},"PeriodicalIF":1.9,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12089111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}