Indian Journal of Psychological Medicine最新文献

{"title":"Referral Patterns, Pathways to Care, Symptom Profile, and Diagnoses of Children Attending a Child Psychiatry Unit in South India: A Retrospective Chart Review.","authors":"Rashmi Vishwanath, Jithin Thekkelkuthiyathottil Joseph, Avinash G Kamath, Samir Kumar Praharaj","doi":"10.1177/02537176251322092","DOIUrl":"https://doi.org/10.1177/02537176251322092","url":null,"abstract":"<p><strong>Background: </strong>Childhood mental disorders are a major global concern, particularly in India. Despite efforts to establish child psychiatry services, the treatment gap persists. This study investigates referral patterns, pathways to care, and diagnostic trends among children attending a child psychiatry unit (CPU).</p><p><strong>Methods: </strong>A retrospective chart review (2017-2022) was conducted at the CPU of Kasturba Medical College, Manipal. Two investigators analyzed 1,046 files, extracting data on demographics, pathways to care, reasons for referral, and diagnoses. Inter-rater reliability was confirmed, and associations between pathways to care, diagnosis, and demographics were examined.</p><p><strong>Results: </strong>This study included children with a mean age of 11.2 years, predominantly male (63.2%). Most children (97.5%) first sought care from a healthcare provider, with 29.3% consulting mental health professionals (MHPs) and 59.6% visiting medical specialists. Primary reasons for referral included behavioral disturbances, emotional disturbances, and academic decline. Common primary diagnoses were attention deficit hyperactivity disorder (16.5%), mental retardation (14.7%), and pervasive developmental disorder (12.6%). Significant associations were found between pathways to care and diagnosis (<i>P</i> = .001), as well as between gender and both referral reasons (<i>P</i> < .001) and diagnoses (<i>P</i> < .001).</p><p><strong>Conclusions: </strong>The study provides insights into the demographic and clinical characteristics of children with mental health problems in India. The medical model of care pathways is a positive shift, and these findings can guide gender- and culture-sensitive service planning, optimize resource allocation, and inform future research in child psychiatry.</p>","PeriodicalId":13476,"journal":{"name":"Indian Journal of Psychological Medicine","volume":" ","pages":"02537176251322092"},"PeriodicalIF":1.9,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11999983/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009153","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":"Drug-induced Acute Dyskinesia-Risperidone and Tramadol Interaction: A Case Report.","authors":"Manova Sam Shalin Vr, Maikandaan Cj, Pradeep R, Vaishali S, Kanmani Vk","doi":"10.1177/02537176251329544","DOIUrl":"https://doi.org/10.1177/02537176251329544","url":null,"abstract":"","PeriodicalId":13476,"journal":{"name":"Indian Journal of Psychological Medicine","volume":" ","pages":"02537176251329544"},"PeriodicalIF":1.9,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11999994/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012742","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":"Psychiatric Emergencies in Children and Adolescents: A Comprehensive Profile and Short-term Outcome Evaluation in a Prospective Follow-up Study.","authors":"Prasanna Kumar N, Lakshmi Sravanti, John Vijay Sagar Kommu, Rajendra Kiragasur Madegowda, Shekhar Seshadri, Satish Chandra Girimaji","doi":"10.1177/02537176251329515","DOIUrl":"https://doi.org/10.1177/02537176251329515","url":null,"abstract":"<p><strong>Background: </strong>Emergency psychiatry services play a critical role in providing essential care for children and adolescents with mental health concerns, yet research in this field, especially in India, is limited. Our study aims to address this gap by investigating the demographic and clinical characteristics and short-term outcomes of children and adolescents accessing emergency psychiatric care at our tertiary care center.</p><p><strong>Methods: </strong>This prospective study included children and adolescents aged 3-18 who presented with psychiatric disorders to emergency services. All cases were assessed using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria, the Clinical Global Impression (CGI) scale, and the Children's Global Assessment Scale (CGAS). Follow-ups were done at three weeks and three months. The Shapiro-Wilk test assessed normality, followed by parametric or nonparametric tests as appropriate.</p><p><strong>Results: </strong>The mean age of the sample was 14.8 (standard deviation [SD]: 2.5) years, with boys comprising 57.1% and girls 42.9%. Most visits to emergency services occurred between 1 PM and 6 PM. The most common diagnoses were bipolar affective disorder (23.2%) and conversion/functional neurological symptom disorder (23.2%). Lorazepam and clonazepam were the most commonly prescribed medications at first visit (baseline). At first follow-up (3 weeks), a significant proportion (41.1%) was admitted as inpatients. Olanzapine was the most common drug prescribed during follow-up visits. The CGI scores decreased, while CGAS scores increased, reflecting improved functioning.</p><p><strong>Conclusions: </strong>The significant improvement in CGI and CGAS scores over follow-ups demonstrates the effectiveness of crisis intervention and pharmacotherapy in stabilizing clinical severity and enhancing functioning in the short term.</p>","PeriodicalId":13476,"journal":{"name":"Indian Journal of Psychological Medicine","volume":" ","pages":"02537176251329515"},"PeriodicalIF":1.9,"publicationDate":"2025-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11994642/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014784","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":"Recurrent Syncope Secondary to High-dose Loperamide Dependence in a Patient with Bipolar Disorder: A Case Report.","authors":"Syna Bashir, Fazle Roub, Yasir Hassan Rather","doi":"10.1177/02537176251329405","DOIUrl":"https://doi.org/10.1177/02537176251329405","url":null,"abstract":"","PeriodicalId":13476,"journal":{"name":"Indian Journal of Psychological Medicine","volume":" ","pages":"02537176251329405"},"PeriodicalIF":1.9,"publicationDate":"2025-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11994626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003806","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":"Specific Learning Disability: Ten Challenges and Ten Recommendations in Current Indian Context.","authors":"Ashlyn Tom, Rajendra Kiragasur Madegowda, Narayana Manjunatha, Channaveerachari Naveen Kumar, Suresh Bada Math","doi":"10.1177/02537176251326108","DOIUrl":"10.1177/02537176251326108","url":null,"abstract":"","PeriodicalId":13476,"journal":{"name":"Indian Journal of Psychological Medicine","volume":" ","pages":"02537176251326108"},"PeriodicalIF":1.9,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966623/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794771","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":"Exploring the Patterns of Recreational Polysubstance Use and Executive Functions in Indian Young Adults: A Cross-Sectional Study.","authors":"Deeksha Parthsarthy, Prakat Karki, Madhavi Rangaswamy","doi":"10.1177/02537176251325280","DOIUrl":"10.1177/02537176251325280","url":null,"abstract":"<p><strong>Background: </strong>Substance use is a serious public health concern and young adults in India often use multiple substances, often together. There is a dearth of research examining this and its neuropsychological consequences. Polysubstance use (PSU) usually indicates higher chances of dependence and negative outcomes. This study aims to describe the patterns of PSU and associated executive function profiles in a sample of young adults in India.</p><p><strong>Methods: </strong>Fifty-four participants aged 18-25 years filled out a self-report questionnaire on PSU, for lifetime and current use of seven classes of substances. Thirty-four participants also performed four executive functions (Flexibility, Inhibition, Working Memory, and Planning). A descriptive analysis was used to identify patterns of PSU and one-way analysis of variance (ANOVA) was conducted to compare the executive functions between three groups of substance users with nonusers.</p><p><strong>Results: </strong>Three patterns of PSU were identified in our sample: simultaneous (16.3%), concurrent (37.2%), and mixed (46.5%) patterns of use. Simultaneous and concurrent users reported the most commonly used substance combinations (alcohol/nicotine/cannabis). Performance on executive function tasks was compared among the different groups of substance users and nonusers. Executive function assessments revealed deficits in simultaneous users for inhibition (most errors) and planning (most number of moves) compared to other groups. Concurrent users had the lowest accuracy for the two-back visual working memory.</p><p><strong>Conclusions: </strong>The findings of this small sample study suggest executive function deficits are more common in simultaneous users and underscore the need for more research to examine the synergistic effects of substances on cognition and executive functions.</p>","PeriodicalId":13476,"journal":{"name":"Indian Journal of Psychological Medicine","volume":" ","pages":"02537176251325280"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11962927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780041","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":"Identifying Clinical Subtypes of Premature Ejaculation: A Cross-sectional Study of Clinical and Socio-demographic Patterns.","authors":"Adarsh Tripathi, Suyash Dwivedi, Ankita Saroj","doi":"10.1177/02537176251326740","DOIUrl":"10.1177/02537176251326740","url":null,"abstract":"<p><strong>Background: </strong>Premature ejaculation (PE) is one of the most prevalent male sexual dysfunctions globally, with prevalence estimates ranging from 5% to 40%. Recent frameworks classify PE into clinical subtypes based on chronicity, situational factors, and clinical characteristics, including lifelong, acquired, natural variable, and premature-like ejaculatory dysfunction (PLED). Despite its psychological and relational impacts, research on these subtypes, particularly in the Indian context, remains limited, underscoring the need for further exploration to inform tailored interventions.</p><p><strong>Methods: </strong>This cross-sectional study assessed heterosexual men with PE at a tertiary center in North India. Individuals with significant psychiatric/medical comorbidities were excluded from the sample. A comprehensive evaluation of patients was done, including physical examination, hormonal/metabolic screenings, and assessments using validated tools for sexual dysfunction, psychiatric symptoms, and quality of life.</p><p><strong>Results: </strong>A total of 102 patients were enrolled in the study. Pairwise comparisons indicated significant differences in age of onset between lifelong premature ejaculation (LPE) and PLED (<i>P</i> = .001), as well as between LPE and acquired premature ejaculation (APE) (<i>P</i> < .001). APE was significantly correlated with tobacco dependence (<i>P</i> = .009). Patients with LPE generally scored lower across various domains of the SF-36 Health Questionnaire, indicating more significant functional impairment.</p><p><strong>Conclusion: </strong>APE emerged as the predominant subtype in the sample, followed by LPE-associated with a younger age-and PLED.</p>","PeriodicalId":13476,"journal":{"name":"Indian Journal of Psychological Medicine","volume":" ","pages":"02537176251326740"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11962933/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780042","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":"An Experiential Account of Functioning During Remission in Individuals with Bipolar Disorder: A Grounded Theory Approach.","authors":"Mareena Susan Wesley, Manjula Munivenkatappa, Jagadish Thirtalli","doi":"10.1177/02537176251323887","DOIUrl":"10.1177/02537176251323887","url":null,"abstract":"<p><strong>Background: </strong>Individuals with bipolar disorder (BD) experience considerable difficulty in functioning during remission as well. The actual lived experience of individuals with BD with respect to their functioning is not understood in the cultural context.</p><p><strong>Methods: </strong>A qualitative approach in the form of interviews was taken from 11 participants who were diagnosed with BD in remission from a tertiary care hospital. The interviews were audio recorded and coded. Thematic analysis was carried out using a grounded theory approach to bring out relevant themes surrounding their inter-episodic functional limitations.</p><p><strong>Results: </strong>The thematic analysis resulted in nine themes associated with the functioning, namely illness issues, treatment as an antidote, impact on self, relationship issues, coping strategies, disturbed cognitive functioning, stigma, occupational consequences, and dubious future.</p><p><strong>Conclusions: </strong>The qualitative interview analysis provides a comprehensive picture of the experiences undergone by patients with BD. The themes and the sub-themes that came up in the analysis are reflective of the experiences of these individuals. The findings of the study can be utilized in planning effective interventions for remitted patients in the future so that functional limitations can be effectively addressed.</p>","PeriodicalId":13476,"journal":{"name":"Indian Journal of Psychological Medicine","volume":" ","pages":"02537176251323887"},"PeriodicalIF":1.9,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951128/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752490","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":"Neurological Conundrums: A Case Series on Brain Tumors Masquerading as Psychiatric Disorders.","authors":"Aayush Srivastav, Priyanka Renita D'Souza, Keshava Pai, Sharanya B Shetty, Shreyas Aneja, Priya Suraj Ramesh","doi":"10.1177/02537176251324471","DOIUrl":"10.1177/02537176251324471","url":null,"abstract":"","PeriodicalId":13476,"journal":{"name":"Indian Journal of Psychological Medicine","volume":" ","pages":"02537176251324471"},"PeriodicalIF":1.9,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752497","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":"Lead Time Bias in Medicine and Psychiatry: A Concept Simply Explained.","authors":"Chittaranjan Andrade","doi":"10.1177/02537176251324499","DOIUrl":"10.1177/02537176251324499","url":null,"abstract":"<p><p>Screening for a disease typically results in earlier diagnosis and hence longer life lived with the disease. Earlier diagnosis permits earlier intervention, which is good if it improves functioning and quality of life from an earlier time point, and if it improves the course and outcome of the disease. However, for diseases that are benign, those that are relentlessly progressive, and those that arise late in life, earlier diagnosis and earlier intervention may not meaningfully change course and outcome. In such situations, the early detection and longer life lived with the disease can incorrectly suggest that the screening and early intervention prolonged survival. Expressed otherwise, longer survival may merely be an artifact of starting measurement earlier. This artifact is known as lead time bias. Lead time bias has long been recognized for many medical conditions, including cancers. In psychiatry, lead time bias is clearly associated with survival in dementia, and has recently been investigated in the context of duration of untreated psychosis and outcome domains in schizophrenia. It is important to know about lead time bias because it may play an unrecognized role in shaping health policy and clinical practice.</p>","PeriodicalId":13476,"journal":{"name":"Indian Journal of Psychological Medicine","volume":" ","pages":"02537176251324499"},"PeriodicalIF":1.9,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752494","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}