Background: Electroconvulsive therapy (ECT) is a highly effective treatment for severe and treatment-resistant depression, yet concerns remain regarding its cognitive side effects. The study aimed to assess changes in cognitive performance in patients with depression undergoing ECT and to evaluate the trajectory of recovery after treatment. Materials and Methods: A total of 95 patients diagnosed with depression were assessed over a three-year period. Cognitive performance was measured at four time points: before treatment, prior to the fourth session, within three days after ECT completion, and for a subgroup of 31 patients also six weeks post-treatment. The Montreal Cognitive Assessment (MoCA) was used for initial screening, and the MATRICS Consensus Cognitive Battery (MCCB) was applied for detailed evaluation. Depressive symptoms were monitored using the Montgomery-Åsberg Depression Rating Scale (MADRS). Results: ECT led to significant improvement in depressive symptoms, with remission rates ranging from 60–80%. Initial cognitive decline was observed early in the treatment course, particularly in memory and new learning, but cognitive functioning improved as treatment progressed. At six weeks post-treatment, further recovery was evident, although cognitive scores remained below average baseline levels. Most short-term cognitive side effects resolved within weeks after ECT. Conclusion: ECT is a safe and effective intervention for severe depression, providing substantial symptomatic relief. While transient cognitive side effects occur, they are generally reversible, underscoring the importance of monitoring cognitive outcomes throughout treatment and follow-up.
Background: Caregiving for individuals with schizophrenia is often associated with high levels of emotional, financial, and social stress, especially in rural and resource-limited settings. Expressed emotions (EE), particularly criticism, are known contributors to caregiver burden (CB), but the buffering roles of self-compassion and life satisfaction remain underexplored in such contexts. Methodology: This descriptive, cross-sectional study included 115 caregivers of patients of Schizophrenia from a rural tertiary care centre in India. Structured interviews were conducted using validated tools: the Family Emotional Involvement and Criticism Scale, WHO Burden Assessment Schedule, Self-Compassion Scale–Short Form, and Life Satisfaction Scale. Non-parametric statistical analyses, mediation models, and multiple linear regression were used to assess associations and predictors of CB. Results: Higher levels of EE, particularly criticism, were significantly associated with increased CB (ρ = 0.54, P = 0.001). Self-compassion was negatively correlated with burden (ρ = –0.5). Unadjusted models showed a small but significant indirect effect, but this mediation was not found significant after adjusting for family type. Life satisfaction did not significantly mediate this relationship (P = 0.211). Regression analysis indicated that psychological variables, especially self-compassion, explained a substantial portion of the variance in CB (adjusted R² = 0.367, P < 0.001). Conclusions: EEs, particularly criticism, contribute significantly to CB among caregivers of patients of Schizophrenia. Self-compassion acts as a protective mediator, underscoring the need for interventions aimed at reducing family criticism and enhancing caregiver self-compassion.
Dementia, particularly Alzheimer’s disease (AD), is a major global health challenge with limited treatment options. Growing evidence suggests that glucagon-like peptide-1 receptor agonists (GLP-1 RAs), originally developed for type 2 diabetes mellitus (T2DM), may offer neuroprotective benefits by improving insulin signalling, reducing amyloid-beta accumulation, and lowering neuroinflammation. Following PRISMA guidelines, a systematic literature search (2015–2025) was conducted using PubMed and Google Scholar. Eligible studies included randomized controlled trials (RCTs), longitudinal cohort studies, and systematic reviews assessing GLP-1 RAs’ effects on cognitive outcomes. Studies focusing solely on metabolic markers or non-human models were excluded. Fifteen studies met the inclusion criteria. Clinical evidence suggests that Liraglutide and Semaglutide significantly slow cognitive decline and reduce dementia risk in T2DM patients compared to metformin and dipeptidyl peptidase-4 (DPP-4) inhibitors. Mechanistic studies highlight the role of GLP-1 RAs in enhancing insulin sensitivity, reducing oxidative stress, and modulating neuroinflammation. While GLP-1 RAs demonstrate promise in dementia prevention, further long-term RCTs are necessary to confirm their efficacy, establish optimal treatment protocols, and explore their use in non-diabetic populations. If validated, these findings could lead to a new class of neuroprotective therapies, transforming dementia prevention strategies.
Objectives: This study investigates the moderating role of resilience in the relationship between bullying and mental well-being among Nigerian secondary school students. Given the well-documented negative impact of bullying on psychological health, the research aims to determine whether resilience acts as a protective factor that buffers students against the adverse effects of bullying. Methods: A cross-sectional survey design was utilized, involving 439 secondary school students (223 males, 216 females) aged 11–16 years, selected through convenience sampling from three secondary schools. Standardized self-report instruments were administered: the victim scale of the revised Olweus Bully/Victim Questionnaire to assess bullying experiences, the 10-item Connor–Davidson Resilience Scale to measure resilience, and the Warwick-Edinburgh Mental Well-being Scale to evaluate mental well-being. Data analysis included Pearson correlation and moderation analysis using Hayes’ PROCESS macro (Model 1). Results: Bullying was negatively correlated with mental well-being (r = −0.03, P < 0.01), while resilience showed a strong positive correlation with mental well-being (r = 0.96, P < 0.01). Regression results indicated that bullying significantly predicted reduced mental well-being (B = −0.13, P < 0.001), whereas resilience significantly predicted improved mental well-being (B = 0.77, P < 0.001). A significant interaction effect between bullying and resilience (B = 0.01, P < 0.001) revealed that resilience moderated the relationship between bullying and mental well-being. Simple slope analysis demonstrated that at high levels of resilience, the negative impact of bullying on mental well-being was nonsignificant. Conclusions: The findings underscore the protective function of resilience in counteracting the psychological harm associated with bullying. Enhancing resilience in students may serve as a critical intervention strategy to preserve their mental well-being. Schools are encouraged to incorporate resilience-building programs alongside anti-bullying initiatives to create a more supportive and mentally healthy learning environment.
Background: Dementia, including Alzheimer's disease and vascular dementia, is a growing global health concern. Type 2 diabetes mellitus (T2DM) increases the risk of dementia, yet the mechanisms linking these conditions remain unclear. This study evaluates metabolic, cardiovascular, cognitive, and radiological differences in dementia patients with and without T2DM. Methods: A cross-sectional study was conducted at a tertiary care hospital, involving 60 dementia patients (30 with T2DM and 30 without T2DM). Metabolic markers (blood glucose, glycated hemoglobin, lipid profile, and C-reactive protein [CRP]), cardiovascular parameters (blood pressure and electrocardiogram findings), cognitive performance (Mini-Mental State Examination [MMSE] and Montreal Cognitive Assessment [MoCA]), and brain structure changes (magnetic resonance imaging [MRI]-based atrophy scales) were assessed. Results: Dementia patients with T2DM exhibited significantly higher body mass index, waist-to-hip ratio, low-density lipoprotein, triglycerides, and CRP levels compared to non-T2DM patients (P < 0.001). Cognitive impairment was more severe in the T2DM group, with lower MMSE (P = 0.004) and MoCA scores (P < 0.001). MRI findings revealed greater medial temporal atrophy (P = 0.002) and parietal atrophy (P = 0.008) in T2DM dementia patients, while non-T2DM dementia patients exhibited more severe white matter lesions (P = 0.008). Regression analysis identified CRP as the strongest predictor of cognitive function (beta = -0.4783, P < 0.001), with glycated hemoglobin showing a near-significant association with MMSE (P = 0.052).Conclusion: T2DM in dementia is linked to greater metabolic dysfunction, inflammation, and cortical atrophy, leading to greater impairment in cognitive function. CRP was the strongest predictor, highlighting inflammation as a key therapeutic target.
Stevens–Johnson syndrome (SJS) is a rare, life-threatening adverse drug reaction characterized by extensive epidermal detachment and mucosal necrosis. While commonly linked to oxicam analgesics, antiepileptics, sulfonamides, allopurinol, and antiretrovirals, its association with quetiapine and other antipsychotics is rare. This case report describes a 60-year-old female who developed SJS following exposure to a low dose of quetiapine. She exhibited severe oral mucosal erosions and per rectal bleeding without cutaneous involvement. Psychiatric assessment confirmed recent initiation of quetiapine for behavioral symptoms. This case highlights the complexities of diagnosing and treating rare drug-induced reactions. Early detection, timely withdrawal of the offending drug, and cautious dose adjustments are crucial in preventing severe complications like SJS and improving patient outcomes.
Background:Mental health disorders, especially depression and anxiety, are prevalent among cancer patients due to the significant psychosocial impacts of the disease. Despite high morbidity, psychiatric disorders in cancer patients are often underdiagnosed and undertreated.Aim:This study aims to identify the sociodemographic, clinical, and psychosocial factors associated with psychiatric morbidity in cancer patients.Materials and Methods:A cross-sectional, observational study was conducted in the psychiatry and radiation oncology departments of a North Indian tertiary care hospital. One hundred and forty-four cancer patients aged 18-75 years undergoing chemotherapy and/or radiotherapy were assessed for the presence of psychiatric comorbidity using semistructured interview. Standardized instruments, including the Patient Health Questionnaire, Coping Behavior Assessment Scale, Brief Religious Coping Scale, Multidimensional Scale of Perceived Social Support, and Presumptive Stressful Life Events Scale, were then applied to assess for psychosocial correlates.Results:Out of 144 patients, 77 (53.5%) were female and 67 (46.5%) were male, with a mean age of participants being 52 years. 63.89% of participants were diagnosed with psychiatric disorders, most common being depressive illness (19.44%), followed by adjustment disorder (18.05%), anxiety disorders (14.58%), sleep disorders (5.55%), substance use disorders (3.47%), and bipolar affective disorder/psychotic disorders (2.77%). Significant associations were found between psychiatric morbidity and older age, advanced cancer stages, stressful life events, low social support, and coping strategies. No significant associations were found with gender, marital status, education, or occupation, and other clinical correlates such as cancer type, location, and treatment modality.Conclusion:The study highlights the high prevalence of psychiatric morbidity in cancer patients and reveals the critical role of certain psychosocial factors, with adaptive coping strategies, positive religious coping, and robust social support linked to better mental health outcomes. This emphasizes the importance of early identification and effective psychosocial interventions to improve patient outcomes.
Genital Self-Mutilation (GSM) is the most extreme manifestation of major deliberate self-harm, with nearly 70%–80% of cases found to have an underlying psychiatric disorder, including schizophrenia, depressive disorder, bodily distress disorder, obsessive–compulsive disorder, and borderline personality disorder. The case series presents four male patients with GSM evaluated at a tertiary care center using detailed clinical evaluation and International Classification of Diseases-10 diagnostic criteria. The first case represents Van Gogh syndrome, while the second one represents Klingsor syndrome, the third one presents GSM as a means of suicide, and the fourth one highlights the interphase between GSM and substance use, namely alcohol intoxication. Most of the existing literature exists in Western contexts, reflecting the need for greater awareness and systematic reporting of such cases from the developing nations, to better understand the underlying causes and to develop effective prevention and intervention strategies.
Background: Perspectives of young adults with mild intellectual disability toward their acceptance in society have not been taken into account. However, in the recent years due to policy enactments, there have been a positive change, but still, it is miles to go. Objective: To find out the perspectives of individuals with mild intellectual disability about their acceptance in the society using qualitative methods. Materials and Methods: Ten persons with mild intellectual disability (five male and five female) with Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition diagnosis (intelligence quotient [IQ] between 50 and 69) aged 18–35 were selected using a convenient sampling method. Results: Persons with mild intellectual disability expressed that they must be accepted as such and not as victims of charity, pity, sympathy, etc. These participants also shared that their acceptance in the society must be accepted with existing potentials. Conclusion: Findings suggest that persons with intellectual disabilities have a good understanding of their acceptance. It also highlights that people with intellectual disabilities find themselves more comfortable, safe, and secure when they are with their peers with intellectual disabilities and not with peers without disability (having average IQ).
Background: Autism spectrum disorder (ASD) is a growing neurodevelopmental condition that affects communication, cognition, social behavior, and sensory processing. The presence of sensory, emotional, and motor challenges can significantly affect a child’s behavior. To address these difficulties, culturally adapted play-based intervention was introduced to manage emotional, conduct, peer problems, hyperactivity, and prosocial problems. Objectives: The objective is to evaluate the effectiveness, feasibility, and acceptability of culturally adapted play-based behavioral intervention (PPBI) compared to applied behavior analysis (ABA) in enhancing behavior among ASD children in semi-rural Tamil Nadu. To assess behavior using parent and teacher-reported strength and difficulties questionnaire (SDQ) for a comprehensive evaluation at home and school. Methods: This study utilized a double-blinded randomized controlled trial and employed a purposive sampling method to recruit 46 children with ASD and divided them into two groups: Culturally Adapted PPBI and ABA group. Behavior was assessed using SDQ at baseline, 4 th , 8 th , and 12 th Week. Results: The baseline characteristics of the children were examined to ensure comparability, and there was no significant difference in age ( P = 0.06), gender and SDQ parent ( P = 0.153), SDQ teacher ( P = 0.571), prosocial parent ( P = 0.463), prosocial teacher ( P = 0.829) baseline scores between the two groups, which showed children were similar at the beginning of the intervention. Both parent and teacher reported outcomes of SDQ score revealed a significant time effect ( P < 0.0001) with behavioral issues decreased and prosocial behavior enhanced. Group × Time Interaction was significant for teacher and parent-reported prosocial behavior ( P = 0.048), suggesting the effectiveness of both interventions. However, there was no significant difference in the SDQ scores between the parent and teacher groups ( P > 0.05). Conclusion: Both PPBI and ABA improved behavior in children with ASD. However, PPBI enhances social engagement found through teacher-reported prosocial behavior. These results support the understanding that culturally tailored interventions in resource-constrained environments.
Background: There remains a notable gap in the literature concerning the exploration of marital satisfaction among bipolar disorder patients, exclusively during the remission phase. Aim: This study aims to estimate the proportion of marital satisfaction among married adults with bipolar Type 1 disorder in remission and to explore the relationship between marital satisfaction and various sociodemographic and clinical factors. Methodology: The study was designed as a cross-sectional descriptive study, involving 60 married adult patients diagnosed with bipolar type 1 disorder in remission who were attending the outpatient clinic. Residual symptoms were assessed utilizing the Young Mania Rating Scale (YMRS) and the Hamilton Depression Rating Scale. Marital satisfaction was evaluated through the Dyadic Adjustment Scale. Data analysis was carried out using licensed versions of SPSS v25. Results: The proportion of marital satisfaction among participants was 58.3%. There were statistically significant differences observed among the relationally satisfied and distressed groups in terms of the distribution of number of children, socioeconomic status, presence of symptoms between episodes, and the total YMRS score. For other variables, no statistically significant differences were observed. Conclusion: Our findings indicate that a significant proportion of individuals with bipolar type 1 disorder report marital satisfaction during interepisodic remission periods. This positive observation highlights the importance of involving spouses in therapeutic interventions during these phases. Furthermore, comprehensive management of residual symptoms may play a critical role in enhancing relationship satisfaction.
Background: Cognitive training programs have garnered significant attention globally over the past two decades due to their potential to reduce various cognitive deficits and enhance performance not only on trained tasks but also on untrained tasks and behavioral measures (transfer effects). Objectives: The objectives of this study were to compare the far transfer effects of a structured Manualized Cognitive Training Program (MCTT), two computerized cognitive training programs, and a no-training control group on parent-rated behavioral problems. the study used a parallel group randomised controlled trial to asses the impact of the cognitive training programs on a composite behavior score, which served as the primary outcome measure for evaluating both near and far effects. Methods: A total of 128 children aged 6–11 years with attention-deficit/hyperactivity disorder were screened for an intelligence quotient ≥85 using the Seguin Form Board Test and met inclusion/exclusion criteria. They were randomly assigned to four groups: MCTT (n = 32), PSSCogRehab (n = 32), Cogmed working memory training (n = 32), and a treatment as usual (TAU) control group (n = 32) with equal allocation. Assessment tools were used in this study. The Parent-rated Child Behavior Checklist (Achenbach) was administered at baseline, immediately postintervention, and at the 3-month follow-up. Results: The findings revealed no far transfer effects of the interventions on internalized behavioral problems across the three time points. However, MCTT and PSSCogRehab showed small-to-medium effect sizes (d = 0.24–0.71) for the ADHD index and externalized problem behaviors. A large effect size (d = 3.93) was observed for externalized problem behaviors at the 3-month follow-up between groups. Conclusions: The study suggests that the far transfer effects of MCTT and PSSCogRehab on behavioral improvement, particularly at the follow-up assessment, show promise and warrant further exploration with robust methodology and larger sample sizes.
Background: Caring for individuals with mental illness poses significant challenges for caregivers. In India, where spirituality is deeply rooted, the link between religious coping, spiritual well-being, and mental health in caregivers remains underexplored. Aim: The present study investigated the mental, spiritual well-being, and religious coping methods of caregivers of mentally ill patients visiting a tertiary care hospital in Northern India. Subjects and Methods: The present cross-sectional study recruited 120 caregivers of people with mental disorders using a purposive sampling technique. The mental and spiritual well-being were assessed using the Warwick Edinburgh mental well-being scale and spiritual well-being scale, while religious coping was measured using a brief religious coping scale. Results: The mean age of the participants was 39.15 years (standard deviation (SD) =11.18) and the mean score of mental and spiritual well-being was 44.04 (SD = 7.22) and 72.16 (SD = 6.32), respectively. Individuals aged 41–60 showed the highest mean mental well-being, while those without formal education reported the highest mean scores for both mental and spiritual well-being. A statistically significant positive correlation was found between positive religious coping and both mental well-being (r = 0.24; P < 0.01) and spiritual well-being (r = 0.19; P < 0.05). Conclusion: The findings suggest that positive religious coping demonstrated a significant positive correlation with both mental and spiritual well-being, whereas negative religious coping showed no such association. These results underscore the potential role of positive religious coping strategies in enhancing the overall well-being of caregivers of individuals with mental illness.
Risperidone is a widely used antipsychotic for treating schizophrenia and other psychotic disorders. While it is generally well-tolerated, it can lead to a range of adverse effects, including extrapyramidal symptoms, metabolic side effects, and neuroleptic malignant syndrome. This case report focuses on an uncommon adverse effect: myoclonus, observed in a young male with early-onset schizophrenia treated with risperidone. The case involved a young male patient diagnosed with early-onset schizophrenia who was treated with risperidone. The patient’s symptoms were monitored closely throughout the treatment process. Upon the emergence of myoclonic episodes, a dose reduction was implemented, followed by the discontinuation of risperidone. The patient exhibited significant improvement in symptoms after the dose reduction and subsequent discontinuation of risperidone. This case illustrates that risperidone-induced myoclonus can occur in younger patients, despite it being more commonly reported in elderly individuals with neurological comorbidities. This case underscores the necessity for vigilant monitoring of potential adverse effects in younger patients when initiating or adjusting antipsychotic medications. Clinicians should remain aware of the possibility of myoclonus and other uncommon side effects, even in populations typically considered at lower risk.
