Abstract The present case study describes a 36-year-old male patient presenting with symptoms of recurrent depressive disorder and obsessive–compulsive disorder (OCD) characterized by persistent sadness, negative cognitions, diminished interest, disrupted sleep and appetite, fears related to harm and death, intrusive perverse religious imagery, and compulsive handwashing, alongside pronounced cyberchondria behaviors characterized by excessive and repetitive online searches concerning OCD symptoms, physical health concerns, treatment modalities, and unsupervised medication alterations based on online information. Both the depressive and OCD symptomatology, alongside cyberchondria behaviors, significantly contribute to his psychological distress and functional impairment. A comprehensive clinical assessment was conducted, including case history, mental status examination, and administration of psychological tests. The findings indicated severe obsessional thoughts with compulsive behaviors, alongside significant depressive symptoms. Psychological assessments revealed pervasive negative self-perception, emotional avoidance, and cognitive impairments driven by intrusive thoughts, as well as dysfunctional interpersonal patterns. The patient also had maladaptive coping strategies characterized by avoidance, ritualistic compulsions, and cyberchondria, the latter manifesting through repetitive online health information seeking and unsupervised adjustments in treatment. The case formulation highlights an overlapping symptomatology of recurrent depressive disorder, OCD, and cyberchondria, all sustained by common transdiagnostic processes. The present case shows the complex interplay between OCD, depression, and cyberchondria where compulsive rituals and metacognitive beliefs perpetuate distress. The findings underscore the need for greater understanding of the transdiagnostic processes involved.
Abstract Background: Postpartum depression (PPD) is a common, underrecognized complication of childbirth, with adverse effects on maternal well-being, mother–infant bonding, and child development. Population-based data on PPD from India remain scarce despite established screening in high-income countries. Objectives: To estimate the prevalence of PPD among women availing maternal health services in a tertiary care hospital and identify associated sociodemographic and clinical risk factors. Materials and Methods: A hospital-based, cross-sectional study was conducted over 6 months among 100 postnatal women (within 4 weeks of delivery, aged >18 years) recruited by convenience sampling from a government tertiary care hospital in Chennai. Depressive symptoms were screened using the Edinburgh Postnatal Depression Scale; a score ≥13 indicated probable PPD. Sociodemographic and obstetric data were collected using a pretested questionnaire. Categorical variables were compared using the Chi-square or Fisher’s exact test, and odds ratios (OR) with 95% confidence interval (CI) were computed for significant associations ( P < 0.05). Results: The prevalence of PPD was 12% (95% CI: 6.4–20.5). A poor marital relationship (OR: 103.2; P < 0.001), a personal history of a suicide attempt (OR: 92.6; P < 0.001), and a family history of suicide death (OR: 5.0; P = 0.025) were significantly associated with PPD; age, religion, education, socioeconomic status, family type, parity, mode of delivery, past illness, obstetric history, and neonatal complications were not. Conclusion: One in eight postnatal women screened positive for PPD. Marital discord and a personal or family history of suicidal behavior were the strongest correlates, supporting routine depression and suicide risk screening in antenatal and postnatal care.
Abstract Background: Supreme Court of India (SCI) mandated 15-point guidelines to address the systemic gaps for mental health support in educational institutions. In our experience, the implementation of these guidelines is difficult due to the absence of an audit checklist, which is essential for systematically verifying compliance with predefined standards and criteria/requirements through objective evidence. To address this real-world challenge, this study was aimed to develop a structured and objective audit checklist to assess the mental health systems in educational institutions. Methodology: A multi-step approach was adopted to develop the audit checklist, including (i) a review of national/international guidelines including SCI, (ii) identification of key domains, and (iii) development of measurable indicators based on objective criteria and document-based verification, in consultation with stakeholders (e.g., principals, program officers, and mental health professionals). Then, checklist was pretested using cognitive interviewing with educational institutions ( n = 10) to assess clarity, interpretability, and feasibility of items. Results: Thirteen core domains and two context-specific domains were identified through a review of SCI, national, and international guidelines. Following stakeholder consultation and iterative refinement, the final audit checklist was developed based on these domains, with measurable indicators, objective scoring criteria, and document-based verification methods. Pretesting with educational institutions ( n = 10) demonstrated that the items were generally well understood by intended users and also indicated that the checklist was feasible to administer, acceptable to users, and appropriate for real-world settings. Conclusion: The developed audit checklist provides a practical and scalable approach for assessing institutional mental health systems aligned with SCI guidelines. It has the potential to support standardization, strengthen monitoring, and improve mental health systems in educational institutes. However, the checklist requires further validation as the part of a large multicentric study.
Abstract Substance use disorder is a complex and multifaceted condition that can manifest in many forms beyond commonly recognized substances such as alcohol, nicotine, and drugs. We present an unusual case of “low-density polyethylene” use in a 15-year-old adolescent female along with the use of other inhalants “eraser fluid,” “nail paint remover,” “petrol,” and “paint thinner” for 8 years before seeking treatment. The patient specifically chewed black plastic bags daily and experienced a sense of satisfaction and calmness with an increase in frequency and amount during examinations and stressful conditions. This is the first case report of the use of “Polyethylene” for its psychoactive effects. It remains to be seen whether the perceived mind-altering effects are due to the placebo effect or if there is an actual psychoactive potential, especially when combined with other inhalants. The pharmacodynamic properties of polyethylene need to be further studied.
