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  Most popular articles (Since May 29, 2017)

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Depot preparation in schizophrenia: Indian outlook
Mohit Shah, Disha Parikh, Sagar Karia
July-December 2018, 2(2):152-157
Schizophrenia is a mostly chronic mental disorder, and symptomatic relapse is frequently observed. It is often associated with social and/or occupational decline that can be difficult to reverse. Most patients with the illness need long-term pharmacological treatment and antipsychotic drugs represent the mainstay of clinical care. Long-acting injectable antipsychotics are an important alternative to oral medication, particularly advantageous in the context of compliance management.
  3,404 273 -
Specific learning disability in Maharashtra: Current scenario and road ahead
Henal R Shah, Surbhi C Trivedi
January-June 2017, 1(1):11-16
Specific learning disability (SLD) is a common and invisible yet highly impactful disability. There have been many changes in the field of SLD. These range from changing concepts, introduction of newer diagnostic systems, presentation of the Rights of Persons with Disability Act, of 2016, an increasing awareness in parents, teachers, and public, filing of legal case, and the Honorable High Court issuing orders regarding this disability. All these happenings require reflecting and implementing new strategies. This will not only to benefit all the concerned people but also make the process of diagnosis and intervention streamlined. In the past, Maharashtra has been a forerunner in granting help to these children. Keeping this in mind, it seemed necessary to look at the current scenario of SLD in our state and suggest a way forward.
  3,203 367 -
Adolescent mental health: Issues, challenges, and solutions
Naresh Nebhinani, Shreyance Jain
January-June 2019, 3(1):4-7
  3,103 400 -
Clozapine-induced massive hematemesis: A rare case report
Javed Ather Siddiqui, Shazia Farheen Qureshi, Yousef Bin Ahmed Shawosh
July-December 2019, 3(2):171-172
Clozapine (CLZ) is a drug of choice for the treatment of resistant schizophrenia. It is always blamed probably due to its life-threatening side effects, such as agranulocytosis, constipation, cardiomyopathies, and rarely hematemesis. We report the case of a 65-year-old patient diagnosed with resistant schizophrenia and treated with CLZ later he developed sudden massive hematemesis. The aim of our case report is to describe the rarely seen and potentially life-threatening side effect related to CLZ. Physician, particularly psychiatrists and medical specialists, should not ignore, be aware, and alert or always need to be watchful to the fatality of CLZ-induced hematemesis in the management of psychiatric disorders and should take appropriate therapeutic measures in such a case.
  2,605 595 -
Transgender: Status in India
Neena S Sawant
July-December 2017, 1(2):59-61
  2,410 403 1
School mental health programme in Maharashtra - Today and way ahead
Kishor Gujar, Varsha Pingale
January-June 2017, 1(1):4-7
Positive mental health is, and should continue to be the basis of all the mental health policies of any country. The scarcity of well-documented school mental health (SMH) activities and the data for the region of Maharashtra is the main rationale behind this review article. After reviewing some important studies related to SMH in India, the SMH data at Child Guidance Centre of Yashwantrao Chavan Memorial Hospital in Maharashtra, will be used to discuss and propose a guideline for further SMH activities in Maharashtra. SMH program is the best way to cater to the current and future demand of mental health services and to improve overall child and adolescent mental health.
  2,324 350 -
Family therapy in India
Anuradha Vishwas Sovani
July-December 2018, 2(2):88-92
Origins of family therapy are traced, acknowledging that this is in fact a group of therapeutic approaches. An overview of work done at major mental health centers in India is followed by an attempt at outlining key differences in Indian vis-a-vis Western approaches to family therapy, addressing some of the unique problems that are encountered in our country. Traditional systems of arranged marriage and a joint family, in vitro fertilization interventions and the family pressures to have a baby, the impact of work on family life and the onslaught of social media and family migrations across the globe are some of the issues outlined. Major approaches to family therapy are selected, and their key features are highlighted. Specifically, Minuchin's structural family therapy and Virginia Satir's conjoint family therapy are described. Touching very briefly on Milton Erickson's strategic family therapy, the article moves on to White and Epston's narrative family therapy; and each approach is described vis-a-vis its strengths when applied to an Indian family setup. The article ends on preventive, promotive, and rehabilitative approaches espoused by the author as also by many therapists in India. Behavioral family interventions by Sanders are outlined as is the positive parenting program and its Indian avatar in Palakshaala. Preventive approaches such as functional family therapy by Sexton and Alexander are described. Rehabilitative work with patients and caregivers is outlined, citing examples. The article ends by highlighting some recent changes in the social fabric that seem to be deeply affecting family structures.
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New psychoactive substances: An emerging epidemic
Kranti Kadam
July-December 2019, 3(2):86-91
New psychoactive substances (NPSs) are growing at an alarming rate causing a threat to the public health. They are available online or in head shops and come with variety of street names across the cities, states, and countries. NPSs are prepared in the laboratories either by tweaking or altering the chemical structure of existing substances such as cannabis and ecstasy. They are cheap, easy to obtain, and difficult to be detected by traditional drug screening methods. It has become very challenging to detect them within the clinical settings because of the fast rate of their availability and their constant changing structure. Their purity as well as pharmacology and toxic effects are still not known. These drugs cause major life-threatening complications, which is worrisome. The legal status of these drugs is ambiguous. The laws are complex, changing, are not well defined to control or regulate their use which is a major setback. As many clinicians are unaware of the existence of such drugs, the identification and management of withdrawal syndrome and overdose become difficult. There is a need to create awareness regarding the risks and the health hazards caused by these novel substances as well as to develop and design new prevention approaches that are able to attract the attention of the young population.
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Prevention of dementia in elderly population: A comprehensive review of literature
Jamaan M Al-Zahrani
January-June 2019, 3(1):14-18
Background and Aims: Dementia is the loss of cognitive functioning – remembering, thinking, and reasoning – and behavioral capabilities to such a degree that it interferes with an individual's daily living activities. The objective of this paper is to summarize current knowledge on the most promising interventions for preventing cognitive decline. Methods: Electronic databases were searched using PubMed/Medline and Google Scholar to retrieve relevant research papers conducted in Saudi Arabia and internationally. Keywords included “dementia,” “prevention strategies,” “aging,” “aged,” “Elderly population.” Articles published in the English language and published between 2000 and 2018 were included in the study. Analysis: Overall, limited evidence exists to support the cause-effect association between the progression/development of dementia and preventative strategies. Studies to date provide the most promising strategies for dementia prevention that includes healthy diet, social engagement, physical activity, cognitive activity, and vascular risk factor control. Conclusion: Dementia is a disease more commonly observed in old people. Studies in the future will determine the risk factor modification and its implications in controlled trials with specific emphasis on whether some simultaneous interventions may either have a multiplicative or additive effect.
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A profile of occupational stress in nurses
Aditi Prasad Chaudhari, Kaustubh Mazumdar, Yogesh Mohanlal Motwani, Divya Ramadas
July-December 2018, 2(2):109-114
Background: Occupational stress is common in nurses. Stress can impact the health of the nurses leading to somatic complaints. Aims and Objectives: (1) To determine the extent and causes of occupational stress among nurses at Bhabha Atomic Research Centre Hospital. (2) To compare the stress levels among nurses depending on their years of experience. (3) To study any correlation between stress levels and the extent of somatic complaints. Materials and Methods: Ninety-seven staff nurses without any preexisting psychiatric illness were evaluated for occupational stress using the Expanded Nursing Stress Scale. The extent of somatization was measured using the Patient Health Questionnaire – 15, in a cross-sectional study. Cronbach's alpha, analysis of variance, and Spearman's correlation co-efficient test were applied to the data. Results: An internal consistency of 0.945 was noted using Cronbach's alpha. 51.5% nurses experienced mild, 34% experienced moderate, and 2.10% experienced severe stress. Conflicts with supervisors, patients, and their families and workload were the main causes of occupational stress while discrimination was the least affected domain. Nurses with 6–10 years of experience had maximum stress. The stress levels correlated with the extent of somatic complaints. Conclusions: Occupational stress is prevalent in nurses. It may be higher in nurses with lesser experience and it can be associated with somatic complaints.
  1,701 196 1
Research progress in the understanding and implications of stigma related to mental health
Amresh Shrivastava, Avinash De Sousa, Pragya Lodha
July-December 2018, 2(2):93-100
Stigma is neither new nor an isolated condition for people suffering from mental as well as physical disorders. It is regrettable that scientists, researcher, philosophers, and community leaders have been silent for a long time in recognizing and dealing with it. However, during the past 20–30 years, significant progress has taken place in stigma research, the world over including India. From research done in India, there is clear evidence that: stigma is not merely a social condition. Convergence of social, mental, and physical disorders around stigma has far-reaching consequences on risk and health outcomes. The present paper looks at the position of stigma in mental health from an Indian perspective. The research done on stigma in India is reviewed, and certain recommendation for the management and eradication of stigma are elucidated. Stigma in specific conditions such as schizophrenia, substance abuse, and child sexual abuse are also addressed. The WHO guidelines and Mayo clinic guidelines to eradicate are used as a basis to be applicable to the Indian scenario. We examine how a life of an individual is affected with stigma, how mental health advancement has changed or not changed negative impact of stigma on patients and finally how stigma is measured and minimized, mainly for work done in India.
  1,694 173 -
A study on prevalence of postpartum depression and correlation with risk factors
Vidhi Prakash Modi, Minakshi Nimesh Parikh, Srinivasa Kartik Valipay
January-June 2018, 2(1):27-32
Background: Postpartum depression (PPD) is a depressive disorder, also known as postnatal depression. Despite responsiveness to treatment and serious consequences if untreated, PPD often remains unrecognized. This study aims to study the prevalence of PPD and to correlate risk factors associated with it. Materials and Methods: It was a cross-sectional study in Departments of OBGY, Pediatrics, and Psychiatry in a tertiary care hospital. Two hundred and fifty consecutive women, 1–6 weeks postpartum attending the above departments, were included after written informed consent. A specially designed semi-structured pro forma was used for correlation of various risk factors. Edinburgh Postnatal Depression Scale was used for diagnosing PPD. Results: In our study, we found that 20.4% of the women evaluated suffered from PPD. Significant risk factors for PPD included age below 30 years, financial dependence, positive family history of psychiatric illness and PPD, previous girl child, unwanted pregnancy, pressure to have a male child, and complications during pregnancy and delivery. Domestic violence, substance abuse in husband, and relationship issues also increased the risk. Conclusion: Considerable prevalence of PPD is found across various cultures. Prevention of risk factors is useful in primary prevention of PPD. In the future, our study can be used for screening females with high risk for developing PPD so that more intense interventions can be applied.
  1,597 235 -
Cinema: A multimodal and integrative medium for education and therapy
Ajish G Mangot, Vasantmeghna S Murthy
January-June 2017, 1(1):51-53
Art is a creative form of expressing personal thoughts, opinions, feelings, and often a reflection of prevailing ethos and has been around for almost as long as man's existence. Today motion pictures (movies) are the most popular forms of artistic expression. They touch upon various issues of human interest like our society, fantasy, sci-fi, and in recent times, emotions. Every artwork induces unique emotional and cognitive experiences within the creator, participant and observer through novel techniques like therapeutic film making, participatory arts therapy and cinema therapy, respectively. Movies are also engaging instruments of education for medical and psychology students. Cinema allows for active learning through fantasy, expressing emotions, exploring one's own feelings and those of others, providing a safe environment for problem-solving strategies and dealing with unresolved emotions. Indian mental health professionals must now begin using this multimodal and integrative medium of cinema to its full potential.
  1,547 237 -
Testosterone and schizophrenia: A clinical review
Pragya Lodha, Sagar Karia
July-December 2019, 3(2):92-96
The relationship between testosterone and psychiatric disorders has been a long-standing one. The sex difference in schizophrenia has triggered to better understand the role that testosterone plays in the unfolding and clinical presentation of this psychotic disorder. DHEA and testosterone are found to influence dopaminergic, glutamatergic and GABAergic neurotransmission systems that are believed to play a role in the pathophysiology of schizophrenia. The onset of schizophrenia in males, most frequently encountered during adolescence, is also characterized by an increase in testosterone levels. Some studies have also observed lower testosterone levels in adult males with schizophrenia (or psychosis) compared to healthy controls.
  1,648 124 -
Depression and anxiety in patients with chronic kidney disease undergoing hemodialysis
Vinod Kumar, Vikash Khandelia, Ankita Garg
July-December 2018, 2(2):115-119
Introduction: Chronic kidney disease (CKD) is a global health problem with a high economic burden on the health-care system. Considering the chronic nature of disease patients undergoing hemodialysis are at risk of developing psychiatric disorders. In this study, we aimed to evaluate the incidence of depression and anxiety in CKD patients undergoing hemodialysis. Methods: This was a prospective, cross-sectional, observational study conducted between June 2016 and September 2017. Patients of either sex having CKD and undergoing hemodialysis were included in the study. Sociodemographic and depression and anxiety related details were collected. Results: A total 150 patients were enrolled in this study, of which 92 (61.3%) patients had depression and 42 (28%) had anxiety. Overall, depression was higher in males, but the difference was not significant; similarly, the anxiety was higher in males, but the difference was statistically significant (P = 0.050). Majority of patients with depression were aged more than 80 years; however, anxiety was more common in patients aged between 40 and 60 years. A total of 59.4% of depressive patients were Hindus, and 27.3% of anxiety patients were Hindus. The correlation between depression and marriage was significant; however, the relationship was not significant between anxiety and marriage. Among patients with depression 55.9% of patients were illiterate, and among patients with anxiety, 25.4% were illiterate. Conclusions: This study provides extensive information on the relationship between depression or anxiety and sociodemographics features among patients with CKD undergoing hemodialysis.
  1,489 260 -
Pimavanserin – drug review
Nithya Gogtay
January-June 2017, 1(1):8-10
Pimavanserin is a drug with a novel mechanism of action that has recently received approval management of patients with Parkinson's disease psychoses [PDP]. It is a 5HT2A inverse agonist that has been shown in a randomized controlled trial to be superior to placebo and also reasonably safe and effective. It significantly reduces positive symptoms seen in Parkinson's disease patients with psychosis with no evident impairment of motor function. It offers hope for patients and caregivers with this otherwise distressing and difficult to manage condition and has also paved the way for the use of 5HT2A inverse agonists in this condition.
  1,467 269 -
The divine madness: Ahistory of schizophrenia
Amey Yeshwant Angane
July-December 2017, 1(2):133-135
The nonspecific concept of “madness” has been there for thousands of years. In antiquity, people thought of “madness” in terms of divine punishment or demonic possession. It was only during early Renaissance that people took this phenomenon seriously and termed it as an illness. It is due to the efforts of a cluster of scientists and psychiatrists that has led to unraveling of schizophrenia as a mental illness characterised by delusions and hallucinations. As postgraduates, it is important to know how the mystery unfolded and how it has overcome infinite obstacles. This article throws light on how we can learn from history and not deceive ourselves when we selectively take evidence from the past to justify our beliefs. The knowledge of history helps us to understand the disease itself as well as help us understand the chronology of the events leading to the evolution of the enigmatic disorder and its elusive treatment strategies.
  1,405 279 -
Psychological issues in pediatric organ transplantation
Dinesh Saroj, Sagar Karia, Avinash De Sousa
January-June 2019, 3(1):8-13
Pediatric organ transplantation (POT) has shown enormous development in the past few decades, and the number of POT has increased exponentially. While the various medical issues in pediatric transplantation have been discussed, there is a dearth of literature on the psychological issues surrounding POT. The present review aims at providing an overview on various psychological issues that surround POT. Literature search using search engines was carried out, and review papers and original research articles were analyzed. The overall role of the psychiatrist in the POT setup is discussed and issues such as depression and anxiety that may occur in children and their parents is elaborated. The neurocognitive changes that may occur in POT are also discussed and the need for regular monitoring is stressed. Special population such as developmental disabilities and human immunodeficiency virus infection in the organ transplant setting and specific issues related to them are discussed. The role of a child and adolescent psychiatrist as an invaluable asset to any POT team is discussed and deliberated. Multiple psychological facets that may be encountered while dealing with children and adolescents undergoing organ transplantation are discussed.
  1,410 183 -
Snakes and their relevance to psychiatry
Anil Kakunje, Ramesh Ammati, Prakash Tolar, Sowmya Puthran, Mohammad Swaroop
January-June 2019, 3(1):63-66
  1,473 112 -
Self-reported suicidality behavior and attitudes toward suicide among medical and paramedical students
Ashish H Patel, Ritambhara Y Mehta, Nilanjan Chandra, Pradhyuman Chaudhary, Ravi H Shah
January-June 2017, 1(1):34-39
Aims and Objectives: The aim of this study was to evaluate knowledge and attitudes toward suicide and suicidality behavior among medical and paramedical students. Materials and Methods: A cross-sectional study was conducted in a medical college of western India where undergraduate medical (238), physiotherapy (25), and nursing (137) students were enrolled. After taking informed consent, detailed assessment of knowledge, attitude towards suicide using Suicide Opinion Questionnaire and suicidality behavior using mini-international neuropsychiatric interview were done. Data were analyzed using appropriate statistical tests. Results: Ninety-three percent students agreed “people who are at risk can't be easily identified.” Eighty percent students believed “potentially anyone can be a suicide victim.” Acceptability of suicide was highest in nursing students; B.P.T students had highest knowledge regarding suicide. None had active suicidal ideation or planning. Only at a thought level, one-third of total population reported feeling of hopelessness sometime in their life. Sixteen percent, nearly double females (n = 299) thought sometimes in their life that “it would be better off dead” compared to 8% males (n = 101). Among three groups, nursing students showed highest suicidality behavior. Conclusions: Attitudes toward suicide and suicidality behavior differ among the groups with significant gender differences. Although acceptability is the highest among nursing students, the group is at higher risk with higher suicidal ideation. Students believe, “people who are at risk can't be easily identified;” hence, further exploration, awareness, and interventions are suggested.
  1,271 233 -
Cognitive rehabilitation in psychiatry
Urvashi Rupin Shah
July-December 2017, 1(2):68-75
Cognitive impairments in mental disorders are common, poorly recognized, and largely unaddressed despite their significant impact on daily life functioning. Today, the treatment of psychiatric disorders goes beyond only symptom management and emphasizes optimizing functional abilities. Cognitive Rehabilitation or Cognitive Remediation(CR)is the nonpharmacological intervention that has received attention over the last few decades and is steadily emerging as a potentially strong tool to manage cognitive issues that impact functional outcomes. Alarge body of research has studied role of CR in schizophrenia populations, and the role in other disorders is now being explored. This review looks at the various studies from across the globe and in India to understand the types of programs, their theoretical underpinnings, imaging data, and efficacy of CR. There is considerable heterogeneity across studies in terms of methods, materials, and approaches, and it is challenging to identify the key active ingredients that ensure success. Overall, the meta-analysis studies have identified strategy coaching by an expert therapist and use of CR in conjunction with psychosocial and vocational programs as important factors to ensure best results. Despite promising results in enhancing cognition across most studies, generalization and transfer of this improvement to real-life functioning still remains elusive. Other moderators that can possibly influence outcomes such as motivation factors, therapist-patient relationship, personal goals of the patient and families, and the socioeconomic milieu of the patient need to be studied more extensively in the future studies to develop a comprehensive model of cognitive rehabilitation.
  1,171 227 -
The development of herbert rosenfeld's views on narcissism
Anuradha Menon
July-December 2017, 1(2):76-83
This review tracks the development of Herbert Rosenfeld's(1910–1986) work on the psychoanalytic concept, narcissism. The author conceptualizes the scope of this work in Darwinian terms to emphasize the extraordinarily fertile theoretical and clinical material produced by Rosenfeld, which is linked in the text to several other contemporary Kleinian psychoanalysts. The beginning of his lifelong work is examined as “Origins,” the development itself as “Evolution” and at the end of his life, the shifts in his theoretical stance is looked at as “Metamorphosis.” Clinical material is used to illustrate the core concept of narcissism as a defence against separateness.
  1,186 200 -
Attitude toward mental illnesses among paramedical professionals and junior doctors
Chintan K Solanki, Hemang M Shah, Ganpat K Vankar, Minakshi N Parikh
July-December 2017, 1(2):102-108
Context: Attitudes of paramedical and medical professionals to psychiatric illnesses are important for referral and use of mental health facilities by general people. Knowledge of psychiatric disorders and experience of working with psychiatric patients may be responsible for positive attitudes. Aims: The aim was to assess attitude toward different mental illnesses among different paramedical professionals and to know the impact of education and work experience on attitudes toward mental illnesses. Subjects and Methods: Study sample was nursing staff, nursing students, and junior doctors from tertiary care hospital and students of clinical psychology from a private deaddiction center. The study design was cross-sectional. Attitude to Mental Illness Questionnaire was used with modifications and addition of demographic details. Experience of working with psychiatric patients and attending mental health primary care(MHPC) program also were included for the evaluation of attitudes. Results: Attitudes toward drug abuse, depression, alcohol abuse, and schizophrenia were more negative while toward anxiety spectrum disorders, conversion, and dissociative disorders were more positive. Subjects with experience of working with psychiatric patients and experience of MHPC program showed more positive attitudes. Conclusions: There is need of, developing program containing knowledge of mental health, implementing practical experience of working with psychiatric patients in the curriculum of paramedical and medical profession and restructuring present curriculum to develop positive attitudes to mental illnesses for benefit of community.
  1,164 187 1
Lead and its association with mental illness
Sandeep Grover, Soumya Jhanda
July-December 2017, 1(2):62-64
  1,173 169 1
Delusional parasitosis revisited
Neena S Sawant
January-June 2019, 3(1):1-3
  1,112 226 -