The impact of gut microbiota in mental health has been one of the most exciting and probably one of the most discussed topics of psychiatric research in the last decade. The gut microbiota may play an important role in the development of neuropsychiatric diseases, according to a growing body of research. Gut microbiota is a key regulator of gut-brain axis and may shape our brain physiology; thus, any change in its composition may change our behaviour due to altered psychiatric conditions. Relationship of gut microbiota with different mental illnesses is discussed in this article.
Background: Family is the key resource for providing care to patients, including those with alcohol dependence in India. Person with alcohol dependence affects almost every (personal, social, and psychological) aspects of family life. This leads to troubles, difficulty or undesirable procedures which impact on family members and causes gigantic burden on family caregivers. Aim: Aim of the study was to assess the level of family burden among the primary caregivers of alcohol dependent patients. Methods: A hospital-based study was conducted at a drug de-addiction treatment and training centre in north India. On the basis of purposive sampling technique, 30 alcohol dependent patients were recruited from the outpatient department (OPD) with the availability of primary caregivers. With informed consent from patient and caregiver, 30 caregivers (one for each patient) were included in the study. Assessment for pattern of burden faced by the family caregivers of persons with alcohol dependence was done by using the Family Burden Interview Schedule (FBIS). Results: Results showed that 93% caregivers were spouses and most (86.7%) of them were housewives. Every domain of care indicated moderate to severe level of burden. Alcohol dependence was associated with burden in family members. It showed high burden in rural location with low-income families. Conclusion: Alcohol dependence adversely affects the patients as well as his caregivers.
The coronavirus disease 2019 (COVID-19) pandemic has raised alarm all over the world, whereby the mental health crisis is on the rise and people are in quest for resolution. So, the present review paper is an attempt to evaluate the previous work on mindfulness, and, its impact during the COVID-19 pandemic. Mindfulness as a multidimensional construct teaches us to regulate our awareness of the present moment followed by an attitude of non-judgemental acceptance. This paradigm shift in the field of psychology has created wonders in psychotherapeutic practice. The current review aims to highlight the ‘why’ and ‘how’ of mindfulness as intervention that could reach every person, be it the COVID-19 sufferers or the COVID-19 warriors. It also provides an insight into the efficacy of mindfulness as an intervention itself or in adjunct to other psychotherapeutic treatments. Therefore, it calls forth the need to put mindfulness-based interventions during this pandemic situation.
Background: The coronavirus disease 2019 (COVID-19) pandemic has emerged as a public health emergency and has affected people in several domains including physical, financial, and psychological. Resident doctors have also suffered from psychological issues while working at the frontline to help the community. Aim: To screen for anxiety and depression among resident doctors of various departments involved/not involved in COVID-19 duty. Methods: This was a cross-sectional study conducted on 175 resident doctors of various departments at a tertiary care hospital. They were screened for depression using the Public Health Questionnaire (PHQ)-9 and for anxiety using a seven-item generalized anxiety disorder scale (GAD-7). The study was conducted through an online survey using Google forms. Results: Out of 175 resident doctors, 15.42% were screened positive for depression requiring treatment and 15.42% for anxiety requiring further evaluation. Significant association was found between depression and presence of any kind of symptoms and psychiatric comorbidity, between anxiety and gender, presence of psychiatric comorbidity, and any kind of symptoms. Conclusion: Our study suggested elevated levels of anxiety and depression due to COVID-19 pandemic. This alarmed the need of early psychiatric intervention to help them cope with the issue.
Behavioural presentations can vary in psychiatric disorders. Entomophagy, i.e. insect eating and coprophagy, i.e. eating of faeces are not only socially inept but also uncommon. These are also considered a variant of pica. The variations in psychopathology, especially the uncommon presentations are worth exploring. Here, we discussed a case with presentation of entomophagia and coprophagia along with alcohol dependence. Possible aetiological hypotheses were considered like pica, oral fixation, thiamine deficiency, and role of amygdala. This case report highlights the need to pursue and explore the aetiological reasons, so as to improve management strategies.
Introduction: In this era of technology we cannot imagine our lives without internet. However, excessive internet use may bring curse in The present study was an attempt to examine the pattern and prevalence of internet use among medical and engineering students. It was also aimed at comparing pattern of internet use, anxiety, and depression of professional students. Further, it was also intended to study the level of anxiety and depression across the subgroups of internet users. The study was carried out among 1100 professional students, use of the study
Mental health professionals across the globe foresaw the mental health impact of the coronavirus disease 2019 (COVID-19) pandemic. They have faced scarcity of trained professionals, rising morbidities, lack of protective gear, shortage of psychotropic drugs, and poor rapport building due to masking and social distancing. Amidst all, they have responded with approaches that focus on continuing mental health services to the patients already in care, education of the vulnerable people to help them cope with these stressors, and provide counselling services to patients and families affected by the pandemic.
Cognitive behavioural therapy (CBT) has been found to have strong empirical evidence for the treatment of anxiety and mood disorders. However, its applicability to schizophrenia and other psychotic disorders have posed as a challenge to clinicians and researchers for a long time. In the recent years, there has been a growing body of literature on the effectiveness of CBT on psychosis. The present study attempts to highlight the role of brief CBT in the management of a 23-year-old Bengali speaking, unmarried male, hailing from a rural extended family, with a diagnosis of schizophrenia with prominent symptoms of hallucinations and delusions for the past three years. He was treated with brief CBT approach, resulting in improvement after eight sessions.
Background: Paroxysmal psychiatric symptoms are commonly associated with pre-ictal, ictal, or post-ictal phases of seizure. Most of the studies regarding psychiatric symptoms are semiological in nature emphasising anatomical correlates of seizure in patients in pre-neurosurgical evaluation. Phenomenological studies of psychiatric symptoms in epilepsy are limited by various factors. Objective: To describe and evaluate phenomenological understanding of ictal fear and reflex epilepsy in two patients while emphasising their experiences with respect to disorder of awareness of body while also presenting electroencephalogram (EEG), imaging results, and clinical examination of the patients. Methods and results: Two case reports of patients attending Department of Psychiatry, Tezpur Medical College and Hospital (TMCH) revealed ictal fear in generalised myoclonic epilepsy in one case and reflex epilepsy in generalised epilepsy syndrome in another case. Conclusion: It was concluded that in undiagnosed cases of epilepsy as with the first case, diagnosis of ictal fear is very difficult. Ictal fear in generalised myoclonic seizure as compared to partial seizure such as temporal lobe seizures is not common. Diagnosis of reflex epilepsy in generalised epilepsy syndrome is confused with dissociative phenomenon/conversion syndromes. Phenomenological evaluation of these psychiatric symptoms revealed disorder in awareness of body.
During the Covid times, doctors of all disciplines, including psychiatry are engaged as front-line workers and this editorial is on that experience.
The 47 th CEZIPS, Kaziranga Sir, How were unexplained medical symptoms comprehended before 20th century?How were they discerned by society?How were these symptoms branded?Well, some were understood as God's wrath and others were named agnosias.With the advent of brain imaging techniques and relentless curiosity, the former found a place in psychiatric nosology and the later were reappropriated as cortical brain lesions.
Case description: A 28 years old, married Hindu male from a tea garden community, working as daily wage earner was diagnosed as a case of schizophrenia, paranoid type from psychiatry outpatient department (OPD) of Tezpur Medical College and Hospital (TMCH). He was prescribed with tablet risperidone 6 mg and tablet trihexyphenidyl 4 mg daily, and injection fluphenazine decanoate 25 mg intramuscularly (IM) every 30 days. He came for check-up after 27 days, and clinically and symptomatically he was found to be better. However, on enquiry it was found that by mistake he was given injection fluphenazine decanoate 25 mg on daily basis continuously for 27 days. But there were no signs of extrapyramidal symptoms (EPS) or any other side-effects. He was discharged with tablet trihexyphenidyl 4 mg and was asked to come after 15 days. But on follow up, it was reported that after a few days, the patient suffered from resting tremor of both upper and lower limbs. He was treated in a private hospital and the patient survived. Conclusion: Medical and paramedical staff should take care in prescribing and giving such depot injections.
Background: Electroencephalography (EEG) is a widespread test in medical setup yet there is scarcity of data of what percentage of referred EEG has abnormality that is suggestive of epileptiform discharges and what is the frequency distribution of these abnormalities.Objective: The study is used to retrospectively evaluate the frequency and pattern of EEG abnormality in various age groups and all sexes.Method: It was a retrospective cross-sectional analysis of EEG of every patient referred to EEG laboratory for finding discharges suggestive of epileptiform discharges over a one-year period.The age and sex data of patients were collected.The epileptiform discharges were classified accordingly to the International Federation of Societies of Electroencephalography and Clinical Neurophysiology definition of interictal epileptiform activities (IEA).Result: The study revealed that a higher percentage of patients in the younger age group (100/126 [79%]) displayed abnormal EEG results, compared to the adult population (58/106 [54%]).This discrepancy indicates a significant difference in the prevalence of abnormal EEG findings between these two age groups.Moreover, the study found no discernible variation in the occurrence of abnormal EEG results based on sex. Conclusion:The study found age was an important variable in predicting both frequency of abnormality and its type.
Background: Brain fag and burnout are exhaustion syndromes first described in different cultural contexts, and both occur among students.They share some similarities but have not been compared in research.Objective: This study sought to determine the relationship between brain fag and burnout among adolescent students in Calabar, Nigeria.Method: In this cross-sectional study, 810 students were recruited from ten secondary schools in Calabar.The Brain Fag Syndrome Scale and the Maslach Burnout Inventory-Student Survey were administered.Results: The mean sample age was 15.93 (±1.35) years, and the gender distribution was approximately equal.The emotional exhaustion and cynicism dimensions of burnout were significantly associated with brain fag syndrome (p<0.05).Respondents with high emotional exhaustion (Odds ratio [OR]=3.3,confidence interval [CI]=2.06-5.36)and cynicism (OR=2.7,CI=1.66-4.39)were more likely to meet the threshold for brain fag syndrome.Principal components analysis of items from both instruments yielded a four-factor structure, and one had substantial loadings from both scales.Conclusions: Both syndromes are related, probably due to an overlap in core exhaustion symptoms.More research is needed to elucidate their relationship further.
Drug therapy 'tailored' towards an individual based on his/her genetic profile is becoming increasingly popular in the era of personalised medicine.Pre-prescription testing which enables this, exploits the link between a relevant set of genetic variants and drug metabolism profile to maximise drug efficacy and lower the risk of adverse drug reactions.Since the conception over 50 years ago that drug response might be linked to underlying genetic makeup, the science around this field has evolved rapidly across a wide range of drugs including antipsychotics.Over 80% of both typical and atypical antipsychotics are known to be metabolised by phase-I drug metabolising enzymes such as cytochrome P450 (CYP450) family of genes which harbour extensive genetic variations.This has encouraged variant testing in these genes among patients with neuropsychiatric disorders.A confluence of accelerated variant discovery and next generation sequencing offers a fast and cost-effective approach.However, genomic literacy among the end users, i.e., the psychiatrists, patients, and their primary caregivers remains low, posing a major hindrance in the realisation of this pharmacogenetic goal.A well-oiled, multi-disciplinary machinery comprising of researchers, psychiatrists, and genetic counsellors would be the key for optimal dissemination of this intervention.This review presents a broad conceptual background of pharmacogenetics/pharmacogenomics, its potential in psychiatry in particular, together with clinical evidence, and the accompanying challenges for its effective implementation in clinical settings.
Background:The explicit inclusion of mental healthcare in sustainable development goals (SDGs) seems appropriate.Accomplishing the universal health coverage (UHC) agenda promises equity in health services to everyone without financial hardship.UHC has propelled an array of initiatives taken by governments of low and middle-income countries (LMICs) around the globe in terms of public health insurance to increase the utilisation of health services.Innumerable research points out that coverage under different public health insurances has led to a substantial escalation in healthcare utilisation, nonetheless, there is a lack of clarity on these financial services bringing a transition in terms of increased mental healthcare.Following the global order, India too has formulated its own Mental Healthcare Act of 2017 that treats psychiatric troubles on par with physical ailments for financial coverage.Methods: Five databases were systematically searched, viz., Elton B. Stephens Company (EBSCO) host, Cochrane, PubMed, Scopus, and Web of Science, and the review is reported consistent with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines.Results: A total of four studies could be discovered lining with our title and the first research objective was included.Conclusion: Studies made it discernible that initiatives of public health insurance did exert plenteous influence over the health of the people.Albeit, difficult to draw judgements for its convoluted and intricate nature, one cannot say with maximal assurance if public health insurance had an unswerving impact on minimising mental disorders.Nonetheless, deductions were possible and have been made by making appurtenant connections.
Chronic psychiatric illnesses cause disability. The language of recovery is now widely used globally in mental health policy, services, and research. This concept of recovery is relatively new to Indian mental health settings. The Recovery Facilitation Services initiated at the Institute of Mental Health and Neurosciences (IMHANS), Kozhikode (Calicut), Kerala, South India, follows a framework for service delivery based on sound principles of psychosocial rehabilitation. This paper elaborates on the rationale, the design, financial aspects, challenges encountered, and general observations regarding the effectiveness of the working of this service.
Background: The coronavirus disease 2019 (COVID-19) pandemic has led to worry and panic in the minds of people all over the world. Consequently, doctors and other frontline healthcare workers have become a target of stigma in the society. In spite of the Indian government appreciating doctors and healthcare workers with gestures, such as an aerial floral salute and asking the citizens to maintain a positive attitude toward doctors, several people are looking down at doctors as probable virus carriers and treating them as a potential threat to the general public. Aims: To assess stigma and discrimination faced by doctors during the COVID-19 pandemic and their psychological wellbeing. Materials and methodology: A cross-sectional study was conducted on doctors, with convenience sampling technique used to collect data. The study tools were presented in Google forms, and the link was circulated by an exponential non-discriminative snowballing method through doctors’ WhatsApp groups across several states of the country. The study tools included participant information sheet, informed consent form, sociodemographic proforma, a self-designed questionnaire related to stigma and discrimination, and the World Health Organization (Five) Well-Being Index (WHO-5). Results: Three hundred and fifty-six (69.94%) out of 509 doctors reported that they had experienced stigma from the society and their families. 95.5% doctors reported that they are proud of their profession despite experiencing stigma. 58.2% doctors reported that they have received appreciation from the society for their work. 5.6% doctors reported that stigma had a serious impact on their wellbeing. Conclusion: The study results show that majority of doctors are facing stigma and discrimination. Addressing stigma and discrimination faced by doctors and other frontline healthcare workers is significant in fighting this pandemic.
In this free-flowing conversation with the Open Journal of Psychiatry & Allied Sciences (OJPAS®), the stalwart Dr. HR Phookun speaks about how the ongoing pandemic is changing the world we live in and the major challenges for mental health professionals arising out of this crisis. He also discusses his experience of taking online classes and predicts a larger role that technology will play in the delivery of mental health services.
