Indian Journal of Psychological Medicine最新文献

{"title":"Mental Health Challenges Among Doctors in India: A Scoping Review of Existing Research.","authors":"Dushad Ram, Akash Mathew","doi":"10.1177/02537176251349766","DOIUrl":"10.1177/02537176251349766","url":null,"abstract":"<p><strong>Purpose of the review: </strong>The mental health of doctors in India is a growing public health concern due to its impact on healthcare delivery, patient outcomes, and professional fulfillment. There is a lack of comprehensive synthesis of the existing literature; hence, this scoping review was conducted. The objective of this review was to map and synthesize the literature on the mental health challenges doctors face in India and to provide a comprehensive overview of key issues.</p><p><strong>Collection and analysis of data: </strong>A detailed literature search was conducted across PubMed, EBSCO, Web of Science, and Google Scholar databases, covering studies from 2000 to 2024. Data extraction included the sample size, population characteristics, mental health issues investigated, study focus, and key findings. A descriptive synthesis and thematic analysis were performed. This review included 122 studies predominantly conducted across India. More than half of the surveyed doctors exhibited significant levels of depression and anxiety, often linked to long working hours, inadequate rest, and high occupational demands. Lifestyle disorders, including inadequate sleep, poor physical activity, and unhealthy diets, were prevalent and exacerbated stress. Work-life balance was achieved by only 25% of doctors, with gender disparities placing additional burdens on females. Higher emotional intelligence correlated with better professional and life satisfaction. Organizational stressors, including resource shortages and workplace conflicts, contributed to burnout, with rates varying across specialties.</p><p><strong>Conclusions: </strong>Indian doctors face mental health challenges due to professional pressures, work-life imbalance, gender disparities, and resilience issues. Systemic interventions are urgently needed, including mental health support systems and emotional intelligence training.</p>","PeriodicalId":13476,"journal":{"name":"Indian Journal of Psychological Medicine","volume":" ","pages":"02537176251349766"},"PeriodicalIF":1.9,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12267212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144674671","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":"Beyond the Bet: Exploring Gambling Disorder and Its Comorbidities: Case Series.","authors":"R Selvameenatchi, Sylviah Immanuel, Sivabackiya Chithiravelu, R Arul Saravanan","doi":"10.1177/02537176251350591","DOIUrl":"10.1177/02537176251350591","url":null,"abstract":"","PeriodicalId":13476,"journal":{"name":"Indian Journal of Psychological Medicine","volume":" ","pages":"02537176251350591"},"PeriodicalIF":1.9,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12237993/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144608246","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":"Inhibitory Learning-based Exposure Response Prevention Therapy in Obsessive-compulsive Disorder: A Development and Efficacy Trial Protocol.","authors":"Mareena Thampy, Paulomi M Sudhir, Ajay Kumar, Himani Kashyap, Srinivas Balachander, Janardhanan C Narayanaswamy, Y C Janardhan Reddy","doi":"10.1177/02537176251347929","DOIUrl":"10.1177/02537176251347929","url":null,"abstract":"<p><strong>Background: </strong>Serotonin reuptake inhibitors (SSRIS) and cognitive behavior therapy (CBT), comprising exposure and response prevention (ERP), are the first line of treatment for obsessive compulsive disorders (OCD). However, many patients fail to achieve clinically significant symptom relief from traditional exposure-based therapies. This has led to research on strategies that can optimize the effects of ERP. Inhibitory learning theory (ILT) provides a novel foundation for understanding how exposure therapy reduces fear and has been mainly studied in the context of anxiety and phobia.</p><p><strong>Novelty: </strong>There is limited empirical data on applying the principles of IL, such as expectancy violation, variability, deepened extinction, labelling of affect, and removal of safety signals as mechanisms of extinction that can aid the achievement of favorable outcomes in OCD. In the absence of an existing manual, we describe the development of a novel IL-based ERP therapy intervention and the trial protocol to test its efficacy in patients with OCD.</p><p><strong>Methods: </strong>A quasi-experimental study design with baseline, post-treatment, and follow-up assessments will be adopted. The first phase of this study includes developing and validating an IL-based ERP intervention. A sample of 24 patients diagnosed with OCD will be recruited to receive IL-based ERP as part of the study. Measures of OCD symptom severity will be used to test efficacy.</p><p><strong>Expected outcome: </strong>This study describes the development of an OCD-specific IL-based ERP intervention and an open-label trial to generate preliminary evidence for its utility in persons with OCD. The use of IL principles in ERP may potentially improve treatment outcomes for OCD.</p>","PeriodicalId":13476,"journal":{"name":"Indian Journal of Psychological Medicine","volume":" ","pages":"02537176251347929"},"PeriodicalIF":1.9,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12237942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144608247","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":"Mental Healthcare Act, 2017: A Framework for Ensuring Psychosocial Interventions.","authors":"Suresh Bada Math","doi":"10.1177/02537176251350947","DOIUrl":"10.1177/02537176251350947","url":null,"abstract":"","PeriodicalId":13476,"journal":{"name":"Indian Journal of Psychological Medicine","volume":" ","pages":"427-429"},"PeriodicalIF":2.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12237985/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144608248","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":"A Study of Neuropsychological Functions in Young Adults Diagnosed with Dissociative Disorder.","authors":"Sonal Agarwal, Shahzadi Malhotra, Vibha Sharma, Siddarth Maheshwari","doi":"10.1177/02537176251348667","DOIUrl":"10.1177/02537176251348667","url":null,"abstract":"<p><strong>Background: </strong>Dissociative disorders, characterized by disruptions in consciousness, memory, and identity, pose significant challenges in understanding their neuropsychological domains-particularly within the Indian context-due to limited research. This study aims to compare the neuropsychological functions of young adults diagnosed with dissociative disorder to those of a healthy control group.</p><p><strong>Method: </strong>A comparative cross-sectional study was employed using a between-group design. The sample consisted of 30 individuals diagnosed with dissociative disorder and 30 healthy controls (aged 18-30), selected through purposive sampling from a government neuropsychiatric hospital in North India. Standardized assessments, including the Dissociative Experiences Scale (DES) and selected subtests from the National Institute of Mental Health and Neurosciences neuropsychological battery (Auditory Verbal Learning Test and Triads Test [AVLT]), along with the Stroop Color and Word Test (SCWT) and the Trail Making Test (TMT), were administered. Statistical analyses, including <i>t</i>-tests, Mann-Whitney <i>U</i>-tests, chi-square tests, and correlational analyses, were conducted using the Statistical Package for the Social Sciences (SPSS) Version 27.0.</p><p><strong>Results: </strong>Participants with dissociative disorder demonstrated significantly higher DES scores than controls, indicating more significant dissociative experiences. While some neuropsychological domains did not show significant differences, individuals with dissociative disorder exhibited poorer performance on the SCWT, TMR Parts A and B (TMT-A and TMT-B), and the recognition commission component of Rey's AVLT. Correlation analyses revealed moderate associations between executive functioning, verbal memory, inhibitory control, and dissociative experiences.</p><p><strong>Conclusion: </strong>The findings highlight the association between neuropsychological factors and dissociative disorders, particularly within the Indian population. These insights may contribute to improved clinical assessments and interventions.</p>","PeriodicalId":13476,"journal":{"name":"Indian Journal of Psychological Medicine","volume":" ","pages":"02537176251348667"},"PeriodicalIF":1.9,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12222099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575403","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":"Noninvasive Brain Stimulation as a Novel Treatment Approach for Anorexia Nervosa: A Meta-analysis and Systematic Review of Literature.","authors":"Barath Ramanathan, Souganya Vijayan, Arun Selvaraj, Velprashant Venkatesan, Perarul Sivakumar","doi":"10.1177/02537176251351253","DOIUrl":"10.1177/02537176251351253","url":null,"abstract":"<p><strong>Purpose of the review: </strong>Pharmacological and psychological therapies are the main approaches for managing anorexia nervosa (AN). Recent advances in etiology and functional pathways in the brain have opened the gateway for assessing brain-focused treatment. Noninvasive techniques such as repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) have been researched for potential benefits. This systematic review and meta-analysis explored the effects of rTMS and tDCS on AN with respect to eating behavior, body mass index (BMI), and comorbid symptoms.</p><p><strong>Collection and analysis of data: </strong>Electronic database searches were conducted based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines using the following keywords: eating disorders, anorexia nervosa, neurostimulation, repetitive transcranial magnetic stimulation, rTMS, and transcranial direct current stimulation, tDCS. The study included articles published in English until December 2024. The data extracted from the studies included author details, year of publication, type of study design, type of stimulation, stimulation methods, sessions, outcomes, and comorbid symptoms. A total of 20 studies were included in the review; 16 used rTMS, and four used tDCS. Five studies were included in the meta-analysis. The dorsolateral prefrontal cortex (DlPFC) was the main target area for neurostimulation. One study targeted the bilateral dorsomedial prefrontal cortex, right inferior parietal lobe, and insula. The meta-analysis revealed increased BMI following rTMS (standardized mean difference [SMD] = 0.174, 95% confidence interval [CI]: -0.201 to 0.548, <i>p</i> = .363). The Eating Disorder Examination Questionnaire score decreased (SMD = 0.231, 95% CI: -0.204 to 0.671, <i>p</i> = .304), and there was a significant reduction in comorbid depression (SMD = -0.501, 95% CI: -0.941 to -0.053, <i>p</i> = .030) and anxiety (SMD = -0.461, 95% CI: -0.892 to -0.025, <i>p</i> = .040). Studies involving tDCS showed potential improvement in BMI, core symptoms of AN, and its associated symptoms.</p><p><strong>Conclusion: </strong>Noninvasive neurostimulation has shown improvement in the symptoms of AN and BMI, although meta-analyses have not yet demonstrated robust effects. In contrast, more substantial evidence supports its efficacy in alleviating mood symptoms. Further research is needed to understand the underlying mechanisms, optimize targets, and refine stimulation parameters, which are crucial for developing effective brain-targeted interventions.</p>","PeriodicalId":13476,"journal":{"name":"Indian Journal of Psychological Medicine","volume":" ","pages":"02537176251351253"},"PeriodicalIF":1.9,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12226522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575405","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":"Evaluation of Behavioral Patterns and Impulsivity in Individuals Who Have Attempted Suicide Presenting to the General Hospital Emergency Department.","authors":"Lavanya Shivaprakash Pujar, Sanjay H C, Shubrata K S, Dayananda Sagar L, Harisha Delanthabettu, Tintu Mathew","doi":"10.1177/02537176251348189","DOIUrl":"10.1177/02537176251348189","url":null,"abstract":"<p><strong>Background: </strong>Suicide attempts are one of the important causes of end of life in middle- and low-socioeconomic countries. A considerable number of suicide attempts are due to impulsive behavior. Non-planning, decreased attention, decreased cognition, and risky behavior constitute important reasons for suicide attempts. The study aimed to understand the proportion and patterns of attempts at suicide and the assessment of impulsivity in individuals with suicide attempts.</p><p><strong>Methods: </strong>In this cross-sectional study, the proportion of suicide attempts among the total number of cases admitted to the emergency department was calculated. The sample size of this study was 104. Informed consent was obtained from the individuals who risked their lives. Sociodemographic details were collected using a semi-structured pro forma. Later, information related to the method used for suicide, age groups, and gender indicating the pattern of suicide was collected using a semi-structured pro forma, and levels of impulsivity in individuals attempting to end their lives were assessed using the Barratt Impulsiveness Scale 11.</p><p><strong>Results: </strong>Of total patients admitted to the emergency department, 8.8% had a history of suicide attempts. Most individuals were young (50%); males and females constituted an equal proportion, and the most common method used was insecticide poisoning (35.6%). Impulsivity was seen in 47% of individuals who presented with a suicide attempt. High impulsivity was seen in individuals using insecticide poisoning and other poisons.</p><p><strong>Conclusion: </strong>A person's intention to end life even once increases the risk of multiple suicide attempts and even loss of life. The role of impulsivity in suicide attempts, especially in youth, is significantly high. Hence, one has to be vigilant enough to identify and provide necessary psychiatric help to individuals who come with suicide attempts.</p>","PeriodicalId":13476,"journal":{"name":"Indian Journal of Psychological Medicine","volume":" ","pages":"02537176251348189"},"PeriodicalIF":1.9,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12222093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575404","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":"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":"311-313"},"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}