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   Table of Contents - Current issue
Coverpage
March-April 2021
Volume 63 | Issue 2
Page Nos. 119-210

Online since Wednesday, April 14, 2021

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EDITORIAL  

The National Commission for Allied and Healthcare Professions Act, 2020 and its implication for mental health Highly accessed article p. 119
Om Prakash Singh
DOI:10.4103/indianjpsychiatry.indianjpsychiatry_268_21  
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REVIEW ARTICLES Top

High-dose thiamine strategy in Wernicke–Korsakoff syndrome and related thiamine deficiency conditions associated with alcohol use disorder p. 121
Samir Kumar Praharaj, Ravindra N Munoli, Sonia Shenoy, Suma T Udupa, Linda Susan Thomas
DOI:10.4103/psychiatry.IndianJPsychiatry_440_20  
Thiamine is essential for the activity of several enzymes associated with energy metabolism in humans. Chronic alcohol use is associated with deficiency of thiamine along with other vitamins through several mechanisms. Several neuropsychiatric syndromes have been associated with thiamine deficiency in the context of alcohol use disorder including Wernicke–Korsakoff syndrome, alcoholic cerebellar syndrome, alcoholic peripheral neuropathy, and possibly, Marchiafava–Bignami syndrome. High-dose thiamine replacement is suggested for these neuropsychiatric syndromes.
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Relationship between alexithymia and depression: A narrative review p. 127
Rajesh Sagar, Shivangi Talwar, Geetha Desai, Santosh K Chaturvedi
DOI:10.4103/psychiatry.IndianJPsychiatry_738_19  
Alexithymia has been described as difficulty in expressing as well as experiencing feelings. It has been studied in relation with medical as well as psychological conditions and has been seen to impact treatment outcomes. The current review focuses on the relationship of alexithymia with depression and the role of culture in this relationship. The keywords for literature included terms such as depression, alexithymia, depression and alexithymia, Toronto Alexithymia Scale, assessing alexithymia and depression, and alexithymia as a trait. The main findings of the review were that alexithymia and depression are highly correlated, and severity of depression and gender are independently associated with alexithymia and may interfere with treatment outcomes.
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ORIGINAL ARTICLES Top

Sexual functioning during the lockdown period in India: An online survey Highly accessed article p. 134
Sandeep Grover, Mrugesh Vaishnav, Adarsh Tripathi, T S S. Rao, Ajit Avasthi, PK Dalal, Aseem Mehra, Swapnajeet Sahoo, Shivanand Manohar, Suhas Chandran, Ajay Kumar, Pratheek Sharma, Suman S Rao
DOI:10.4103/psychiatry.IndianJPsychiatry_860_20  
Aim: This study aimed to evaluate the impact of lockdown on sexual functioning in India. In addition, impact of lockdown on relationship with the partner and mental health was evaluated. Materials and Methods: An online survey was conducted using changes in sexual functioning questionnaire, Patient Health Questionnaire-4, and a self-designed questionnaire. Results: The mean age of the participants was 41.5 (standard deviation: 11.2; range: 22–77; median: 39.5) years, with the majority being males 385 (85.6%). The participants reported that lockdown led to reduction in the frequency of sexual intercourse and also touching the partner (fondling, caressing, touching, or kissing) when not indulging in sexual intercourse. Majority of the participants reported improvement in the overall relationship, communication with the partner, and interpersonal conflicts. About two-fifths of the participants reported engaging in sexual intercourse more than twice a week or more. About one-fifth screened positive for psychiatric morbidity, with 14.2% screened positive for anxiety, 14.8% screened positive for depression and 8.7% screened positive for both. In both genders, presence of depression and anxiety were associated with lower sexual functioning in all the domains. Conclusion: Lockdown led to a reduction in the frequency of sexual intercourse, and reduction in the frequency of intimacy in the form of fondling, caressing, touching, or kissing partner when not doing sexual intercourse. However, lockdown led to the improvement in overall relationship and communication with the partners and a reduction in interpersonal conflicts.
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Pain threshold and pain tolerance as a predictor of deliberate self-harm among adolescents and young adults p. 142
Mitthat Miglani, Bir Singh Chavan, Nitin Gupta
DOI:10.4103/psychiatry.IndianJPsychiatry_348_19  
Background: Recently, the assessment of pain has been used as a parameter to differentiate adolescents who indulge in deliberate self-harm from healthy individuals. Aims and objectives: The present study was conducted to compare pain sensitivity between three groups, i.e., nonsuicidal self-injury/nonsuicidal self-harm (NSSI), suicide attempters (SA), and matched healthy control (NSSI, SA, and healthy controls). Materials and Methods: Ninety participants (30-NSSI, 30-SA, and 30 matched control) between the age of 10 and 25 years were inducted from the individuals who came for help at the outdoor and emergency services for recent self-harm. Pain sensitivity was assessed by cold pain stimulation test through a cold pressor task. Results: Pain threshold, pain tolerance, total pain index as well as pain experience intensity were significantly different in the three groups. Conclusion: Participants who indulge in NSSI and SA have significantly higher pain threshold, pain tolerance, total pain index, and pain experience intensity as compared to healthy control. Although all the pain parameters were higher in the NSSI group as compared to SA group, the difference did not reach to significant level.
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A comparative diffusion tensor imaging study of patients with and without treatment-resistant schizophrenia p. 146
Anisha Aggarwal, Sandeep Grover, Chirag Ahuja, Subho Chakrabarti, Niranjan Khandelwal, Ajit Avasthi
DOI:10.4103/psychiatry.IndianJPsychiatry_147_20  
Aim: The aim was to study the brain connectivity using diffusion tensor imaging (DTI) among patients with treatment-resistant schizophrenia (TRS) and compare the same with a group of patients without TRS. Methods: Twenty-three patients with TRS and 15 patients without TRS underwent DTI using a 3T magnetic resonance imaging machine. DTI data were processed with the calculation of fractional anisotropy (FA) and apparent diffusion coefficient. Patients were also assessed on Brief Psychiatric Rating Scale, Positive and Negative Symptom Scale, Global Assessment of Functioning Scale, and Clinical Global Impression severity scale. Results: Patients with TRS and non-TRS differed significantly in the FA values in the region of right superior longitudinal fasciculus and right uncinate fasciculus, with more integrity of tracts in the non-TRS group. However, these differences disappeared when Bonferroni correction was used for multiple comparisons. Conclusion: The present study suggests lack of significant difference in DTI findings between patients with TRS and non-TRS.
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Early-onset bipolar disorder, stress, and coping responses of mothers: A comparative study p. 152
M Sam Paul, Dipanjan Bhattacharjee, Roshan Vitthalrao Khanande, Shamsul Haque Nizamie
DOI:10.4103/psychiatry.IndianJPsychiatry_865_20  
Background: Providing care and nurturance to a child with bipolar disorder (BPAD) is a challenging task for parents, especially mothers. In Indian contexts, mothers are the primary caregivers of ailing children and they have to keep intrafamily situation stable, which makes their role more stressful. Objectives: The objective of the study was to assess maternal stress and coping in mothers of adolescents with BPAD. Materials and Methods: This study was a comparative one and carried out on sixty mothers of adolescents; of which thirty were adolescents with BPAD, and the remaining thirty were the mothers of normal adolescents. The participants were selected purposively as per the mothers' age and education level, and the socioeconomic status of the families they belong to. Sociodemographic and clinical data sheet, Parenting Stress Index/Short Form (PSI/SF), and Brief COPE were applied on the mothers for data collection. Results: Mothers' of the BPAD adolescents reported higher scores in the both PSI/SF and Brief COPE. Conclusion: Mothers of the adolescents with BPAD tend to perceive high level of stress and they also use maladaptive coping more in dealing with stressful situations.
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Religiosity and Spirituality of patients with severe mental disorders p. 162
Sandeep Grover, Devakshi Dua, Subho Chakrabarti, Ajit Avasthi
DOI:10.4103/psychiatry.IndianJPsychiatry_87_20  
Background: Religion and spirituality form an integral part of life, yet have been poorly studied in patients with mental illness. Aim: This study evaluated the religious and spiritual practices, a sense of purpose/connection, religious/spiritual belief and sense of hope/control among clinically stable patients diagnosed with schizophrenia, bipolar disorder, and depression and compared the same with healthy controls. It also aimed to evaluate the association of residual psychopathology with various dimensions of religiosity and spirituality. Materials and Methods: Patients diagnosed with schizophrenia, bipolar disorder, and major depressive disorder, in a state of clinical remission were assessed on the Spiritual Attitude Inventory and compared with a healthy control group. Results: A total of 284 participants were recruited, which included patients with major depressive disorder (n = 72), bipolar disorder (n = 75), schizophrenia (n = 63), and healthy controls (n = 74). The groups were matched for age and gender. As compared to healthy controls, participants with any severe mental disorder had significantly lower participation in organized religious activities. In terms of existential well-being, all patient groups had significantly lower scores than the healthy control group. Patients with severe mental disorders significantly more frequently used negative religious coping than the healthy controls and also had lower scores on the sense of purpose. No significant difference was observed between the three patient groups on various dimensions of religiosity and spirituality as assessed in the present study. In patients with schizophrenia, higher use of negative religious coping was associated with greater residual psychopathology. Conclusion: Considering the association of negative religious coping with residual psychopathology, there is a need to incorporate psychological interventions to address religious and spiritual issues for patients with various severe mental disorders.
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BRIEF RESEARCH COMMUNICATIONS Top

Karnataka telemedicine mentoring and monitoring program for complete integration of psychiatry in the general health care p. 171
Narayana Manjunatha, Rajani Parthasarathy, Daniel Ritish Paul, Vinay Basavaraju, Harihara Nagabhushana Shashidhara, Bhaskarapillai Binukumar, Channaveerachari Naveen Kumar, Suresh Bada Math, Jagadisha Thirthalli
DOI:10.4103/psychiatry.IndianJPsychiatry_134_20  
The National Mental Health Survey of India reported a higher prevalence and treatment gap of psychiatric disorders among the general population. Task shifting is one of the important solutions to meet this requirement. The prevalence of psychiatric disorders among primary care is about 30%–50%. Digitally driven primary care psychiatry program (PCPP) designed to innovate different module to upscale the skills of primary care doctors (PCDs) in live consultation of PCDs in their general patients. To exponential coverage of PCDs, Karnataka Telemedicine Mentoring and Monitoring (KTM) Program is been implemented across all districts of Karnataka. It is the training of trainer version of PCPP where psychiatrists serving in District Mental Health Program of all districts of Karnataka become trainers to implement of two digital modules (Telepsychiatric On-Consultation Training and Collaborative Video Consultations) of PCPP with the target to train all PCDs of Karnataka. This paper aims to provide a glimpse of this innovative KTM program and current progress with a preliminary analysis of translational quotient indicating skill transfer and retention.
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Psychosocial intervention model for migrant workers during extended lockdown: The Chandigarh model p. 175
BS Chavan, Priti Arun, Gurvinder Pal Singh
DOI:10.4103/psychiatry.IndianJPsychiatry_542_20  
Background: Human suffering and future uncertainty due to extended lockdown is enormous and this is much more among migrant workers. Aim: The aim of this study was to design and utilize a model for psychosocial intervention for migrant workers during the extended lockdown. Materials and Methods: In Chandigarh, due to lockdown, 61 migrant workers from various states were lodged in a shelter home at village Maloya, located in the outskirt of Chandigarh. Since no specific model was available to handle the psychosocial issues of this specific population, hence, an attempt was made to prepare a model for psychosocial intervention using Maslow's hierarchy of needs. Results: Changes in infrastructure and facilities provided to migrant workers due to implementation of this model for psychosocial intervention helped the participants seeing beyond their problems. Conclusion: Psychosocial intervention model based on Maslow's theory was found suitable for migrant workers in shelter home in Chandigarh.
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Suicidal ideation in schizophrenia: A cross-sectional study in a tertiary mental hospital in North-East India p. 179
Santanu Nath, Kamal Narayan Kalita, Aparajeeta Baruah, Anantprakash Siddharthkumar Saraf, Diptadhi Mukherjee, Pankaj Kumar Singh
DOI:10.4103/psychiatry.IndianJPsychiatry_130_19  
Introduction: Suicide is a leading cause of mortality in schizophrenia. The study attempts to find an association of suicidal ideation, a less studied entity than suicide attempt, with various sociodemographic and clinical profiles in patients with schizophrenia. Materials and Methods: It is a cross-sectional study involving 140 patients diagnosed as schizophrenia. Sociodemographic and clinical profiles were collected using a semi-structured proforma. Positive and Negative Syndrome Scale, Calgary Depression Scale for Schizophrenia, InterSePT Scale for Suicidal Thinking, and Drug Attitude Inventory-10 were applied to assess psychopathology, depressive symptoms, suicidal ideas, and attitude toward psychotropics, respectively. The analysis was done using appropriate statistics. Results: Majority of the study sample were Hindus, male, unmarried, literate, unemployed, and belonging from lower socioeconomic class. About 25.7% attempted suicide earlier and 29.3% currently have suicidal ideation. A previous suicide attempt, family history of psychiatric illness and that of suicide and comorbid substance use, significantly predicted (p < 0.05) a current suicidal ideation. Ideation has also been found to be significantly correlated to comorbid depression and the positive, negative, emotional, and excitement domains of schizophrenic psychopathology. Conclusion: The current study shows suicidal ideations in schizophrenia patients to be significantly related to schizophrenic psychopathology and comorbid depression, thus calling for a holistic management in preventing a fatal outcome.
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MISCELLANY Top

A comparative analysis of psychiatry curriculum at undergraduate level of Bangladesh, India, Nepal, and Sri Lanka p. 184
S M Yasir Arafat, Sujita Kumar Kar, Pawan Sharma, Kedar Marahatta, A K. A B. Baminiwatta
DOI:10.4103/psychiatry.IndianJPsychiatry_615_20  
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VIEW POINTS Top

Competency-based medical education: Relevance to psychiatry p. 189
Sujata Sethi, Dinesh Kataria, Vivek Srivastava
DOI:10.4103/psychiatry.IndianJPsychiatry_639_20  
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“Screen-time” for children and adolescents in COVID-19 times: Need to have the contextually informed perspective p. 192
Swarndeep Singh, Yatan Pal Singh Balhara
DOI:10.4103/psychiatry.IndianJPsychiatry_646_20  
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BOOK REVIEW Top

Kapur, M. It's Okay: To Reach Out for Help p. 196
R Srinivasa Murthy
DOI:10.4103/indianjpsychiatry.indianjpsychiatry_32_21  
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LETTERS TO EDITOR Top

Combining intensive repetitive transcranial magnetic stimulation with neurofeedback in a case of treatment-resistant depression p. 199
Antonio Bruno, Laura Celebre, Gabriele Tagliavia, Rocco Antonio Zoccali, Maria Rosaria Anna Muscatello
DOI:10.4103/psychiatry.IndianJPsychiatry_351_20  
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Russell's sign in obsessive–compulsive disorder p. 200
Praveen Rikhari, Ashutosh Kumar
DOI:10.4103/psychiatry.IndianJPsychiatry_957_20  
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Experience of conducting MD examinations in the mid of COVID-19 crisis p. 201
Anindya Das, Vijay Krishnan, Ravi Gupta, Sandeep Grover, Rajesh Sagar
DOI:10.4103/psychiatry.IndianJPsychiatry_509_20  
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Atypical incubus syndrome: A case report p. 203
Natarajan Varadharajan, Sharmi Bascarane, Vikas Menon
DOI:10.4103/psychiatry.IndianJPsychiatry_556_20  
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Opinions about people with schizophrenia among medical students: Findings from an Italian cross-sectional study p. 204
Lucia Sideli, Laura Ferraro, Caterina La Cascia
DOI:10.4103/psychiatry.IndianJPsychiatry_197_20  
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Adverse drug reactions with naltrexone: Experience from an addiction treatment center p. 206
Siddharth Sarkar, Sahithi Sri Addagadda, Gayatri Bhatia, Rakesh Kumar Chadda
DOI:10.4103/psychiatry.IndianJPsychiatry_94_20  
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Diamond Gardner syndrome in a male: A case report p. 208
Ranveer Singh, Rachit Sharma, Vikas Pathania, Bharat Khadka
DOI:10.4103/psychiatry.IndianJPsychiatry_41_20  
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Nonparaneoplastic anti-NMDA receptor autoimmune encephalitis presenting as psychosis: A case report p. 209
Marami Das, Anil Kumar Patra, Pranjal Jyoti Chakravarty
DOI:10.4103/psychiatry.IndianJPsychiatry_63_20  
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