ABSTRACTS FOR FREE PAPERS

Adverse childhood experiences and substance use disorder in adult life in patients attending a tertiary care institute in north-eastern India

Aahel Bandyopadhyay

King George Medical University, Lucknow, Uttar Pradesh, India

Background: Substance use disorder (SUD) is a widely prevalent condition worldwide. Studies have found that childhood adversities are one of the key factors leading to the changes in neural networks, impaired endocrine and immune system development resulting in chronic physiological dysfunction. There are only a few studies reporting relationship between adverse childhood experiences (ACEs) and SUD in India.

Aim: To assess the impact (if any) of adverse childhood experiences on substance use disorder in adult life.

Methods: Observational and descriptive study with sample size 150 was conducted among patients having SUD of age group 18-60 years attending Department of Psychiatry, Regional Institute of Medical Sciences, Imphal, Manipur during May 2022 to June 2024. Study tools were semi structured questionnaire for socio demographic profile, DSM-5 diagnostic criteria for diagnosis and severity of SUD, semi-structured proforma for type and pattern of substance use, Adverse Childhood Experiences International Questionnaire for assessing childhood trauma of subjects.

Results: Among the subjects with alcohol and opioid use disorder, significant difference existed between those who had experienced ACEs and who had not in the domains of community violence, contact sexual abuse, history of alcohol &/or drug abuser in household etc. along with significant difference in mean total ACE score showing that severity of alcohol and opioid dependence increases with increase in total ACE score.

Conclusion: This study emphasises need for life-course approach to mental health and substance use prevention, integrating early childhood interventions with adult treatment programs to break the cycle of childhood adversity and addiction.

Effectiveness of neuro-cognitive plasticity therapy on cognitive distortions in major depressive disorder

Aakriti Varshney, Anand Pratap Singh

Department of Psychology and Mental Health, Gautam Buddha University, Greater Noida, Uttar Pradesh, India

Background: Cognitive distortions are automatic, maladaptive thought patterns that contribute to the onset and persistence of Major Depressive Disorder. These distortions are not only psychological constructs, but are also rooted in dysfunctional neural connectivity within specific brain networks.

Aim: The present study evaluated the effectiveness of neuro-cognitive plasticity therapy in reducing cognitive distortions and negative automatic thoughts in adults with MDD using a pre-post experimental design as part of a preliminary pilot investigation.

Method: Twenty-four participants diagnosed with MDD administered the Cognitive Distortion Scale (CDS) and Automatic Thoughts Questionnaire-Negative (ATQ-N) before and after a 6-week intervention of NCPT.

Results: The results indicated a significant reduction in CDS total scores (t = 7.84, p < .001, Cohen’s d = 1.60) and ATQ-N total scores (t = 6.92, p < .001, Cohen’s d = 1.41).

Conclusion: NCPT was found to be effective in carrying a significant reduction in maladaptive thinking patterns and negative automatic thoughts in patients with MDD, supporting its potential as an integrative therapeutic approach.

Assessing quality of life in patients with idiopathic generalized epilepsy: A cross sectional study from a tertiary care hospital in Jabalpur

Aanchal Gupta, Namrata Khandelwal, Aftab Ahmed Khan

NSCB Medical College and Hospital, Jabalpur, Madhya Pradesh, India

Background: Idiopathic Generalized Epilepsies (IGEs) represent a major subset of genetic epilepsies, predominantly affecting adolescents and young adults. Quality of life (QOL) in individuals with epilepsy is significantly influenced by psychiatric comorbidities, medication side effects, and seizure-related factors, but remains understudied in Indian populations.

Methods: Ethical clearance was obtained from the Instituional Ethics Committee, No. IEC/2023/7335-69. A cross-sectional observational study was conducted on 69 individuals aged 10-65 years diagnosed with IGE at a tertiary care centre in Central India. Sociodemographic and clinical details were recorded. The Quality of Life in Epilepsy Inventory-31 (QOLIE-31) was administered to assess health-related QOL. Statistical analyses included t-tests, ANOVA, and correlation tests to explore associations between QOL and clinical variables.

Results: Over half of the participants (52.2%) had moderate QOLIE-31 scores (40-59), while 15.9% had poor scores (<40). Seizure worry and emotional wellbeing were key factors influencing overall QOL. Females reported significantly higher seizure worry than males (p=0.004). Participants aged 20-29 had significantly higher seizure worry and better social functioning than those aged 10-19 (p<0.05). Significant correlations were observed between QOLIE-31 scores and medication effects (r=0.326, p=0.011), seizure worry and social function (r=-0.266, p=0.040), and emotional wellbeing and social function (r=-0.299, p=0.020).

Conclusion: Psychiatric symptoms and antiepileptic drug side effects significantly affect QOL in IGE patients. Addressing these factors through integrated psychiatric care may improve seizure outcomes and patient well-being. Future longitudinal and intervention-based research is warranted to build on these findings.

Assessing attitude and stigma towards mental illness among healthcare professionals

Aashi Bhalla^1,2, Karthigai Priya¹, Rama Rao Mannam¹

¹Meenakshi Medical College Hospital and Research Institute, Kanchipuram, Tamil Nadu, ²All India Institute of Medical Sciences, Gorakhpur, Uttar Pradesh, India

Background: Stigma surrounding mental health limits the growth, hinders opportunities to live a meaningful and fruitful life of patients with psychiatric disorders. Furthermore, stigma existing among health care professionals, hinders the treatment provision and options, empathy, care and mental and physical well-being promotion. Globally, patients suffering from mental illness face prejudice, discrimination not just by general population but also by doctors. The present study is attempted to explore the stigma attached towards mental illness among medical interns and non-psychiatry doctors.

Aim: The study aims to assess the attitude and level of stigma attached towards patients with mental illness among medical interns and non-psychiatry doctors from various specialities.

Methodology: The research was observational and cross- sectional in design carried out on doctors in a medical college. Socio-demographic data including field of specialization, experience, and academic post were recorded. Attribution Questionnaire (AQ-27) and Opening Mind Scale for Health Care Providers (OMS-HC-15) were administered and SPSS software version 16 was used for data analysis. Sample Size -200 Duration of study- 3 months

Result: In AQ-27, Overall Help (21.6%; 22.04%), Pity (18.97%; 19.03% ), Coercion (17.66%, 17.90% ) dimensions scored the highest scores. Anger (7.43%) was the item with lowest score. In Mann-Whitnney scale it indicated that the variable segregation is trending to be positive (p=0.058). The interpretation of OMS-HC 15 via Independent-t-test in which attitude was found to be significant, trending towards positive (p=0.011).

Conclusion: Though the level of stigma among healthcare professionals was found to low, there is room for improvement in various aspects.

Sexual dysfunction in females of mental illnesses and its impact on quality of life: A cross-sectional analytical study

Aastha Priyadarshi, Pankaj Kumar, Rajeev Ranjan

AIIMS, Patna, Bihar, India

Background: Sexual health is a crucial but often neglected aspect of women’s mental well-being. Female sexual dysfunction is highly prevalent among women with mental illness and negatively affects quality of life marital satisfaction, and treatment adherence. In India, stigma and limited communication around sexuality further contribute to underreporting. There is a lack of and common mental illness.

Aim: To compare sexual function and its impact on QoL among remitted married females with SMI (schizophrenia, severe depression with psychosis) and CMI (mild-moderate depression, severe depression without psychosis, and obsessive-compulsive disorder).

Methods: This cross-sectional analytical study will include 278 remitted married females (139 in each group) attending the Psychiatry OPD at AIIMS Patna, diagnosed as per ICD-11 CDDR. After informed consent, socio-demographic and clinical data will be collected using a semi-structured proforma. Sexual function will be assessed using the Female Sexual Function Index (FSFI), and QoL using WHOQOL-BREF. Statistical analysis will be done using SPSS v22. Group differences will be assessed using independent t-test and associations using logistic regression.

Expected Results: Both groups are expected to show a high prevalence of sexual dysfunction, with the SMI group likely to have significantly lower FSFI scores and greater impairment in QoL domains. Sexual dysfunction is anticipated to correlate negatively with overall QoL. Result to be discussed.

Conclusion: The study aims to highlight the substantial burden of sexual dysfunction among remitted women with mental illness and reinforce the need for routine sexual health assessment and gender-sensitive interventions within psychiatric settings in India.

Comparison of serum brain-derived neurotrophic factor levels in alcohol dependence and healthy controls

Aayushi Malik, Shruti Srivasatva, Sanjay Agrawal

University College of Medical Sciences, New Delhi, India

Background: Alcohol dependence is a chronic relapsing disorder associated with neurobiological alterations, impaired neuroplasticity, and increased psychiatric vulnerability. Brain-Derived Neurotrophic Factor (BDNF), a key regulator of neuronal survival and synaptic plasticity, has been implicated in substance use disorders. Chronic alcohol exposure is known to alter BDNF expression; however, data from Indian clinical settings comparing serum BDNF levels in alcohol-dependent individuals and healthy controls remain limited.

Aims: To compare serum BDNF levels in patients with Alcohol Dependence Syndrome and healthy controls.

Methods: This case-control study was conducted at a tertiary-care general hospital. Forty male patients diagnosed with Alcohol Dependence Syndrome as per ICD-10 criteria and 40 age-matched apparently healthy male controls were recruited. Sociodemographic and clinical variables were recorded. Serum BDNF levels were estimated using a sandwich enzyme-linked immunosorbent assay, and comparisons were made between the two groups.

Results: The mean serum BDNF level among alcohol-dependent cases was 2.589 ± 1.15 ng/mL (median 2.62; range 1.7-3.05), which was markedly lower than that observed in healthy controls, who had a mean serum BDNF level of 5.3175 ± 3.48 ng/mL (median 3.6; range 2.4-8.82). This difference was statistically significant, indicating substantially reduced peripheral BDNF availability in the alcohol dependence group.

Conclusion: Patients with alcohol dependence exhibited significantly lower serum BDNF levels compared to healthy controls, supporting the role of impaired neuroplasticity in the patients.

Efficacy and safety of dapoxetine hydrochloride in treatment of premature ejeculationin Indian patients

Abhay Paliwal, Rachana Sharma Paliwal¹

M.G.M. Medical College, ¹Sparsh Clinic, Indore, Madhya Pradesh, India

Methods: This was a multi centric double blind randomised clinical trial in subjects diagnosed as PME based on a brief multi-dimensional psychometrically validated questionnaire with PE score more than 11 were enrolled to receive dapoxetine or placebo in 3:1 randomization plan. Patients were evaluated at baseline, after 4 weeks of therapy and after 8 weeks up therapy for PE score, patient reported outcome measure for premature ejaculation profile, clinical global impression for change in PE and adverse event if any routine laboratory investigations were done at baseline and after therapy.

Results: Total 201 patients were enrolled. The responder rate (i.e. proportion of patient with PE < 9) was significantly more in Daproxite in group (35.33% versus 13.95% p = 0.008) compared to placebo at 4 weeks. Similarly at 8 weeks is responder rate was 62.96% Dapoxetine group and 25% in placebo group (p= 0.068). In Dapoxetine group PEscore is decreased significantly compare to placebo at 4 and 8 weeks of therapy (p=0.0001 and p=0.0033). According to patient reported outcome major for PE there were significant improvement in Dapoxetine group. According to clinical global impression for change significantly p < 0.0001 and p =0.0001) more proportion of patients reported significantly better / better / much better change at 4 and 8 weeks compared to baseline status there was no serious adverse event reported. most commonly reported adverse event in Dapoxetine group was headache, dizziness and gastric comfort.

Conclusion: Efficacy of Dapoxetine in PE was significantly evident in terms of responder rate.

Gender and stress in healthcare students: A cross-sectional analysis

B. R. Abhijna

KVG Medical College and Hospital, Sullia, Karnataka, India

Background: Healthcare education is emotionally taxing, academically demanding, and frequently linked to high levels of stress. Stress perception, coping, internet use, and lifestyle behaviours are all impacted by gender-related differences; however, there is little Indian research that examines these aspects collectively.

Aims:

1. To compare perceived stress levels between male and female undergraduate healthcare students.

2. To explore gender differences in coping strategies, internet use patterns, and physical activity, and examine their association with perceived stress.

Methods: A cross-sectional analytical study was conducted among 487 students. Tools included Perceived Stress Scale (PSS-10), Brief COPE Inventory, Young’s Internet Addiction Test (IAT), and International Physical Activity Questionnaire-Short Form (IPAQ-SF). Data were analyzed using Mann-Whitney U, Chi-square, and Spearman correlation (p<0.05).

Results: Of the 487 students participated (63.4% female, 36.6% male), female students reported significantly higher perceived stress (19.67 ± 4.78) than males (17.96 ± 5.16; p = 0.001). Overall, 52% reported moderate stress and 35.7% high stress. Male students scored higher internet addiction scores (p = 0.001), while females more frequently used emotion-focused coping (p = 0.045). Perceived stress showed a positive correlation with avoidant coping (r > 0, p < 0.05) and internet addiction (r > 0, p < 0.05), and a weak negative correlation with physical activity.

Conclusion: Stress patterns and behavioural reactions are strongly influenced by gender. These results show significant gender-linked variations and behavioural correlates of stress among healthcare students, highlighting the need for gender-responsive mental health practices and stress-reduction strategies in medical education.

Effectiveness of brief family based intervention in obsessive compulsive disorder

Abhishek, Rahul Saha

VMMC and Safdarjung Hospital, New Delhi, India

Background: The effectiveness of psychotherapeutic family-based approach when used alongside medication to treat obsessive compulsive disorder (OCD), aiming to address the challenges posed by the therapist-intensive, time-consuming, and costly nature of Cognitive Behavioural Therapy (CBT), which can limit accessibility for patients, especially in resource-limited settings.

Method: We conducted a randomized trial with 42 OCD patients who were drug naive at Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, dividing them into two groups. One group received brief family based intervention involving psychoeducation, family intervention, and exposure and response prevention techniques. Other group received routine counselling alongside pharmacotherapy in both groups. Participants were assessed using Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Family Accommodation Scale-Interviewer Rated (FAS-IR), and Burden Assessment Schedule (BAS) before and after the intervention. Statistical analysis was performed using SPSS v26, with paired t-tests, independent t-tests, and chi-square tests for categorical variables.

Result: The mean YBOCS scores for both the BFBI group and the routine counselling group showed decrease in severity after 3 months, but this difference was not statistically significant (p=0.16).

Limitations: Small sample size. Pharmacotherapy administrated not recorded. Absence of assessment on counselling done in control group. Exclusion of patients with other comorbid illnesses.

Conclusion: study highlights the potential benefits of a condensed, family-oriented therapy for OCD, suggesting it as a valuable adjunct to pharmacotherapy. Findings support existing literature on reducing family accommodation and caregiver burden to enhance treatment efficacy. Research underscores the importance of holistic treatment approaches that include caregiver support, potentially improving outcomes for patients and families.

Prevalence of body dysmorphic disorder in college going students and it’s impact on quality of life: A quantitative study

Abhishek Mohanty, Vivek Vajaratkar

Department of Orthopedic Surgery, Goa Medical College, Goa, India

Background: Body Dysmorphic Disorder (BDD) is a psychiatric disorder characterized by preoccupation with perceived defects in physical appearance, leading to emotional distress and impairment in social, academic, and occupational functioning.

Aim and Objectives: This study aimed to determine the prevalence of BDD among undergraduate students in Medical and Allied Health courses and to assess its impact on quality of life. Assessment was conducted in two stages using the 9-item Cosmetic Procedure Screening (COPS) questionnaire for BDD screening, followed by the Mental Health Quality of Life-7D (MHQoL-7D) scale.

Methods: A cross-sectional, two-stage quantitative study was conducted among 542 undergraduate students of MBBS and Allied Health Sciences at Goa Medical College and Hospital. In Stage 1, students were screened using the COPS questionnaire. In Stage 2, those who screened positive were assessed using the MHQoL-7D. Data were analyzed using SPSS version 24.0 with descriptive statistics, Chi-square tests, and multivariate analysis.

Results: The prevalence of BDD was 13.3%. No significant association was found between BDD and gender, academic discipline, or age group. Quality of life assessment showed satisfactory independence and relationships in several students, but marked disturbances in self-image, appearance-related concerns, and social participation.

Conclusion: This study provides significant Indian prevalence-based evidence of BDD among medical and allied health students, highlighting its negative impact on quality of life and occupational functioning and the need for early identification and multidisciplinary intervention.

Key words: Body dysmorphic disorder, occupational functioning, prevalence, quality of life, undergraduate students

Sexual dysfunctions in alcohol use disorders on baclofen versus nonbaclofen alcohol deaddiction treatmenta randomized clinical trial

Aditya Aithal, Santosh Ramdurg

Shri B.M. Patil Medical College Hospital and Research Centre, BLDE University, Vijayapura, Karnataka, India

Background: Alcohol use disorder (AUD) is often accompanied by sexual dysfunction, worsening psychosocial outcomes and relapse risk. Baclofen is an established anti-craving agent, but its effect on sexual functioning remains uncertain.

Aim: Assess the Sexual Dysfunction in men with alcohol dependence, currently abstaining and receiving baclofen vs patients receiving regular treatment for alcohol deaddiction.

Methods: In this randomised clinical trial, 110 men were allocated equally to baclofen (n=55) and non-baclofen (n=55). Ninety-seven completed follow-up (13 lost; baclofen=7, non-baclofen=6), giving final samples of 48 and 49. Assessments at baseline and 1 month used the Severity of Alcohol Dependence Questionnaire (SADQ), Changes in Sexual Functioning Questionnaire (CSFQ) and International Index of Erectile Function (IIEF). Mann-Whitney U tests compared groups; Wilcoxon signed-rank tests assessed within-group change.

Results: Baseline characteristics were comparable, including age (37.22±6.66 vs 36.02±6.98) and dependence severity (SADQ 25.29±10.59 vs 22.96±8.34; p=0.314). Baseline sexual function was similarly impaired (IIEF 47.33±12.30 vs 46.55±11.80; p=0.843). After one month, both groups showed significant improvement in CSFQ and IIEF scores (within-group p<0.001). Post-treatment IIEF increased to 57.94±9.85 (baclofen) and 59.12±9.17 (non-baclofen), with no significant between-group difference (p=0.606).

Conclusion: Both regimens produced marked improvement in sexual functioning during early abstinence. Baclofen did not confer additional benefit, suggesting that recovery of sexual function in AUD is driven primarily by abstinence rather than treatment-specific pharmacological effects.

Stigma experience in patients with vitiligo: A narrative review Aditya Dubey, Deepak Krishna Ghormode, Bhuvaneshwari Dewangan

Shri Shankaracharya Institute of Medical Science Hospital, Bhilai, Chhattisgarh, India

Background: Vitiligo is a chronic, acquired depigmenting disorder that leads to visible changes in appearance. Although benign, it is widely associated with psychosocial burden. Patients frequently experience social withdrawal, and emotional distress, which may further increase perceived stigma.

Aim: To assess the extent of perceived Stigma In Patients With Vitiligo.

Method: A narrative review of qualitative and quantitative studies published in peer-reviewed journals was conducted. Articles examining perceived, internalized, and enacted stigma among individuals with vitiligo were included and thematic findings were summarized.

Result: Across studies, patients with vitiligo consistently reported high levels of stigma arising from public misconceptions. Stigma was associated with poorer quality of life. Younger individuals, women, those with darker skin phototypes, and patients with facial or widespread involvement were particularly vulnerable.

Cognitive impairment in patients with alchol use disorder

Aditya Guru, Ram Ghulam Razdan, Rajvardhan Bhanwar

Index Medical College Hospital and Research Centre, Indore, Madhya Pradesh, India

Background: Alcohol use disorder (AUD) accounts for 5.9% of global deaths, with 16% of individuals aged >15 engaging in heavy episodic drinking; Indian male prevalence reaches 9.1%, driven by rural country liquor consumption. Chronic AUD induces deficits in cognitive flexibility, problem-solving, decision-making, and executive functions, influenced by demographics (age, gender, genetics), misuse patterns (onset, bingeing, alcohol type), and comorbidities, yet Central India lacks region-specific data on these impairments.

Objectives: Primary: Evaluate prevalence and patterns of cognitive impairment in AUD patients per ICD-11 criteria. Secondary: Examine sociodemographic correlates (age, education, family history, socioeconomic status) and clinical factors (duration, daily/maximum doses, severity of alcohol/nicotine use) with cognitive domains including attention/orientation, memory, verbal fluency, language, and visuospatial ability.

Methods: Prospective, cross-sectional study over one year at Index Medical College Hospital, Indore, recruiting 90 males aged 18-60 via convenience sampling: Group A (AUD + nicotine dependence, n=30), Group B (nicotine dependence only, n=30), Group C (controls, n=30). Assessments include semi-structured proforma, PHQ-9 (<10), GHQ-12, AUDIT, FTND, CIWA-Ar (‰¤10), ACE-III, and MMSE; exclusions for major disorders, cognitive-altering medications. SPSS v26 analysis: chi-square for categorical, t-tests/ANOVA for continuous (p<0.05).

Results: Pending; literature indicates 83% experience alcohol-related harms, 44% of young AUD patients (>10 years use) show MMSE deficits, and 70.7% early-detox patients impair in executive/memory/visuospatial domains, worsened by short abstinence or low education.

Conclusion: Study will delineate AUD-specific cognitive risks, informing rehabilitation, psychopharmacology, and policies for India’s high-burden regions.

From telepsychiatry to artificial intelligence – Harnessing technology for transformative elder care in India

Adivya Srivastava

ABVIMS and Dr RML Hospital, New Delhi, India

Background: India’s older-adult population is projected to exceed 194 million by 2031, with parallel increases in cognitive disorders, depression, multimorbidity and social isolation. Conventional geriatric psychiatry services remain tertiary-centric and inadequate to meet population needs.

Aims: To synthesize evidence on technology-driven innovations telepsychiatry, artificial intelligence (AI), wearables/Internet of Things (IoT), and robotics that can transform elder care in India, and to analyze recent national initiatives (Tele-MANAS, eSanjeevani, Ayushman Bharat Digital Mission) in comparison with global advances.²

Methods: An integrative review of publications (2018-2025), government white papers, and institutional reports was conducted. Data were collated on intervention models, outcomes, and implementation barriers across the four domains. Sources included MoHFW dashboards, NDHM/ABDM policy papers, and AIIMS-IIT collaborative studies.³

Results: Telepsychiatry expansion through eSanjeevani and Tele-MANAS has improved access and adherence for older adults, showing positive satisfaction and cost-utility outcomes.³

AI-based innovations, speech and neuroimaging biomarkers, predictive EMR analytics, and conversational agentsenable early dementia detection and risk prediction but require large-scale validation. Wearables and IoT devices enhance safety via remote vitals, fall detection, and GPS monitoring, though affordability and connectivity remain barriers. Robotics and assistive technologies demonstrate efficacy for companionship, ADL support, and caregiver relief, with low-cost Indian prototypes under development.¹¹

Conclusions: India’s digital-health infrastructure and cost-sensitive innovation provide a pathway toward an ethically governed human-technology symbiosis in geriatric psychiatry. Addressing digital literacy, data governance, and workforce training will be crucial for nationwide implementation.¹²

Key words: Artificial intelligence, geriatric psychiatry, India, IoT, robotics, telepsychiatry, Tele-MANAS

Prevalence and pattern of sexual dysfunction among male patients with alcohol dependence: A cross-sectional study at SIMS, Hapur, Western Uttar Pradesh

Aishani Gupta, Prakash Chandra, Akhil Dhanda

Saraswathi Institute of Medical Sciences, Hapur, Uttar Pradesh, India

Background: Chronic alcohol consumption leads to neurochemical, hormonal, and vascular alterations that adversely affect male sexual functioning. Despite its high prevalence, sexual dysfunction among alcohol-dependent men is often under-recognized in routine psychiatric practice in India.

Aims: To determine the prevalence and pattern of sexual dysfunction among male patients diagnosed with alcohol dependence.

Methods: A cross-sectional analytical study was conducted among 50 male patients with alcohol dependence attending the Psychiatry OPD at SIMS, Hapur. The Severity of Alcohol Dependence Questionnaire (SADQ) was used to assess dependence severity. Sexual functioning was evaluated using the Arizona Sexual Experiences Scale (ASEX) along with the Arackal & Benegal Sexual Dysfunction Checklist based on ICD-10 criteria.

Results: Sexual dysfunction was identified in 56% of participants based on ASEX total scores. The most frequently reported problems were difficulty in achieving erection (32%) and maintaining erection (30%). Premature ejaculation occurred in 28%, delayed ejaculation in 10%, and reduced sexual desire in 22%. Satisfaction-related concerns such as dissatisfaction with sexual performance (12%) and reduced frequency of intercourse (8%) were also reported. Higher SADQ scores showed a statistically significant association with presence of sexual dysfunction (p < 0.05). Men with alcohol use duration exceeding five years demonstrated higher prevalence of dysfunction compared to those with shorter duration.

Conclusion: More than half of alcohol-dependent male patients experienced sexual dysfunction, with erectile difficulty and premature ejaculation being the predominant complaints. Increased dependence severity (higher SADQ scores) and longer duration of alcohol consumption were strongly associated with sexual impairment.

Proportion of depression and anxiety in antenatal and postnatal women: A cross sectional study in tertiary care hospital in Mandya

Aiswarya Renil, K. S. Ashok Kumar

Mandya Institute of Medical Sciences, Mandya, Karnataka, India

Background and Aims: Perinatal mental health problems are among the most common complications of pregnancy and childbirth. Depression and anxiety significantly affect maternal wellbeing and infant outcomes, yet often go undetected. Understanding differences in prevalence between antenatal and postnatal women helps guide screening and intervention. This study aimed to assess and compare depression and anxiety among antenatal and postnatal mothers attending a tertiary care centre.

Methods: A cross-sectional study was conducted in the Department of Psychiatry, MIMS, Mandya, from 2024 to 2025. A total of 406 participants were recruited through consecutive sampling, including 203 antenatal and 203 postnatal mothers. Sociodemographic and clinical details were collected using a structured proforma. Depression and anxiety were assessed using the HAM-D and HAM-A, and psychological distress using the GHQ-12. Data analysis was performed using SPSS, with chi-square tests applied and p < 0.05 considered statistically significant.

Results: Depression was present in 24.6% of antenatal mothers and 34.9% of postnatal mothers, showing a statistically significant difference (X² = 4.71, p = 0.03). Anxiety was reported in 29.6% of antenatal women and 25.1% of postnatal women, with no significant difference (X² = 0.79, p = 0.37). GHQ-12 scores suggested comparable levels of psychological distress across the groups.

Conclusion: Postnatal mothers exhibited significantly higher rates of depression, indicating increased vulnerability after childbirth. Anxiety levels were similar in both groups. The findings underscore the need for routine perinatal mental health screening and timely interventions across pregnancy and the postpartum period.

Cortical plasticity measures as potential endophenotypes in young-onset mania: A TMS based endophenotypic study

Akanksha Parial, Srijan Das, Sanjay Kumar Munda, Nishant Goyal

Central Institute of Psychiatry, Ranchi, Jharkhand, India

Background: Cortical inhibition and plasticity abnormalities are increasingly recognised in bipolar disorder. Transcranial magnetic stimulation (TMS) studies demonstrate reduced short-interval intracortical inhibition, shorter cortical silent period, altered long-interval intracortical inhibition, and diminished long-term potentiation-like plasticity, suggesting disturbances in the balance between inhibitory and excitatory neurotransmission. Paired-pulse TMS is a non-invasive method to probe GABAergic and glutamatergic circuitry, yet consistent endophenotypic patterns remain unclear.

Aim: To compare cortical inhibition and plasticity measures in healthy first-degree relatives of young-onset mania (FDR), remitted young-onset mania patients (RP), and healthy controls (HC).

Methods: 30 right-handed participants (FDR n = 10, RP n = 10, HC n = 10) underwent single- and paired-pulse TMS over the motor cortex. Measures included cortical silent period, short-interval intracortical inhibition (SICI%), long-interval intracortical inhibition (LICI%), and percentage change in the stimulus intensity required to elicit a one-millivolt motor-evoked potential (SI1mV) after a plasticity-inducing protocol. Normality was tested using Shapiro-Wilk. Between-group comparisons used the Kruskal-Wallis test, and within-group pre-post changes were analysed using the Wilcoxon signed-rank test.

Results: SICI% was lowest in FDRs (89.92%), intermediate in RPs (93.37%), and highest in HCs (95.81%). LICI% was greatest in remitted patients (99.29%). Remitted patients showed the largest change in SI1mV (26.45%). No parameter demonstrated statistically significant between-group differences.

Conclusion: Although no significant differences were detected, subtle shifts in inhibitory and plasticity measures across groups may reflect familial liability, illness progression, and medication effects. Larger, longitudinal studies are needed to clarify their endophenotypic potential

Benzodiazepine requirements and clinical course in alcohol-induced delirium: A one-year retrospective chart review from a tertiary centre in Central India

Akash Parial, Manoj Kumar Sahu

Pt. JNM Medical College, Raipur, Chhattisgarh, India

Background: Alcohol-induced delirium is the most severe form of alcohol withdrawal and causes significant morbidity if undertreated. Benzodiazepines remain the standard therapy, but real-world dosing data from Indian general-hospital psychiatry settings are limited.

Aim: To estimate the lorazepam doses required for managing alcohol-induced delirium and identify factors associated with higher benzodiazepine needs.

Methods: A retrospective chart review was conducted at Pt. JNM Medical College Hospital, Raipur. Twenty-five patients admitted over one year and diagnosed with alcohol-induced delirium per ICD-11 were included. Delirium onset and resolution were confirmed with the Confusion Assessment Method (CAM). Sociodemographic details, duration of alcohol use, past withdrawal complications, day-wise lorazepam dosing, delirium duration, and hospital stay were extracted and analyzed descriptively.

Results: The mean age was 39.3 ± 9.4 years; 92% were male. The mean duration of alcohol use (n = 22) was 14.4 ± 5.1 years. Median delirium duration was 3 days (IQR 2-4). Median cumulative lorazepam requirement was 36 mg (IQR 24-48), averaging ~12 mg/day. Past delirium tremens (36%) and withdrawal seizures (12.5%) were linked to higher lorazepam needs (median 52 mg and 64 mg respectively), consistent with kindling. Median hospital stay was 9 days (IQR 7-11). Medical complicationsfever, arrhythmia, aspiration pneumoniawere more common in patients needing higher doses. No deaths occurred.

Conclusion: Patients with alcohol-induced delirium required moderate lorazepam doses (~12 mg/day for 3 days). A history of severe withdrawal and concurrent medical complications predicted higher benzodiazepine requirements, underscoring the importance of early risk assessment and timely, adequate dosing.

Intermittent theta-burst stimulation in facial emotion recognition and negative symptoms in schizophrenia: A randomised trial

I. Akhila, Lokesh Kumar Singh, Ajay Kumar

All India Institute of Medical Sciences, Raipur, Chhattisgarh, India

Background: Facial emotion recognition (FER) deficits are a core impairment in schizophrenia and contribute significantly to poor social functioning. Intermittent theta-burst stimulation (iTBS), a patterned form of repetitive transcranial magnetic stimulation targeting the dorsolateral prefrontal cortex (DLPFC), has shown potential in modulating cognitive and emotional processing. This study examined the effects of iTBS on FER and negative symptoms in schizophrenia, and the influence of baseline illness severity on FER outcomes.

Aims: To assess the effect of iTBS over the left DLPFC on facial emotion recognition in patients with schizophrenia, and to evaluate its impact on negative symptoms and the relationship between baseline illness severity and improvement in FER.

Methods: In this randomized, double-blind, sham-controlled trial, 59 patients with schizophrenia (29 active; 30 sham) received 20 sessions of iTBS over 10 days. FER was assessed using the Facial Emotion Recognition Task, and negative symptoms using the PANSS Negative Subscale at baseline, post-intervention, and 2-week follow-up. Data were analyzed using repeated measures ANOVA and correlational analysis.

Results: No significant between-group differences were observed in FER improvement across time points (p > 0.05). Similarly, there was no significant group × time interaction for negative symptoms (p > 0.05). Illness severity did not significantly correlate with FER changes.

Conclusion: Although active iTBS did not demonstrate significant superiority over sham, within-group improvements and overall symptom reduction support its safety and potential as an adjunctive intervention. Larger, longer-term studies with neurobiological markers are warranted.

Expressed emotions and its association with medication adherence and quality of life in individuals with psychotic disorders: A cross-sectional analytical study

Akhila Prabhakaran, Sandesh Venu, Pradeep Thilakan

Pondicherry Institute of Medical Sciences, Kalapet, Puducherry, India

Background: Expressed emotion (EE) is an important psychosocial factor in psychotic disorders and may affect medication adherence and quality of life (QOL). However, studies exploring this link are limited.

Aim: To assess the association of expressed emotions with medication adherence and quality of life in persons with psychotic disorders.

Method: This two-year cross-sectional study was conducted in the psychiatry outpatient department of a tertiary care hospital in South India. We recruited 120 individuals diagnosed with psychotic disorders as per ICD-10. We used the Family Emotional Involvement and Criticism Scale (FEICS), Brief Adherence Rating Scale (BARS), WHO Quality of Life-BREF (WHOQOL-BREF), and the Brief Psychiatric Rating Scale (BPRS) for assessment. Multivariable linear regression was used to analyse the relationship between EE, medication adherence, and QOL.

Results: The mean age of the sample (N = 120) was 37.8 (±11.7) years. The FEICS subscale scores for Perceived Criticism (PC) and Emotional Involvement (EI) were 11.4 ± 5.8 and 15.2 ± 5.5. Medication adherence was negatively correlated with PC (r = -0.46, p < 0.001) and BPRS score (r = -0.50, p < 0.001). Regression analysis showed higher PC (β = -0.33, p < 0.001) and higher BPRS score (β = -0.37, p < 0.001) predicted poorer adherence. Additionally, higher PC predicted lower scores in the physical domain of QOL (β = ˆ’0.28, p = 0.008).

Conclusion: Higher perceived criticism was associated with poorer medication adherence and lower physical QOL, highlighting the need to address family criticism as part of routine clinical care.

A study of attitude towards psychotropic medications and medication adherence among patients and caregivers of acute psychosis patients

V. Akshai, Sabari Sridhar, Nileena Namboodiripad Kakkatu Mana

Department of Psychiatry, Sri Ramachandra Medical College, Chennai, Tamil Nadu, India

Background: Early medication adherence is critical for stabilization, relapse prevention and long term outcomes in acute psychosis. Caregivers play a significant role in supervising treatment especially in early phase of illness. Caregiver attitudes are particularly important in Indian context, since family is involved in many aspects of the patient’s care.

Aim: To assess the attitude towards psychotropic medications and medication adherence among patients and caregivers of acute psychosis.

Methods: Cross sectional study design involving 60 consecutive patient-caregiver dyads of acute psychosis after 1 month of treatment initiation presenting to the OPD were recruited based on the inclusion and exclusion criteria (those with organic and substance use causes and those with neurodevelopmental disorders were excluded). The knowledge and attitude towards psychotropic medications was assessed using €œSelf report attitude towards psychotropic medications questionnaire among caregivers. The medication adherence was assessed using MARS 5 (Medication Adherence Report scale). The patient’s symptoms were assessed using PANSS scale.

Results: Statistically significant positive correlation between attitude towards psychotropic medications and medication adherence was observed.

Conclusion: Higher Positive caregiver attitudes toward psychotropic medications were associated with higher medication adherence. These findings highlight the importance of psychoeducation regarding psychotropics and nature of illness for patients and caregivers.

A cross sectional study to assess knowledge and attitude towards mental health illnesses among young adults in India

Amit Kumar

Air Force Central Medical Establishment, Delhi, India

Background: Some studies have shown that patients with mental health illnesses have lower levels of knowledge regarding these issues from the beginning, suggesting that increased knowledge at younger age may reduce delay in first presentation of patients to mental health professionals. However, no major study has been done among current generation young adults in Indian population in the recent past regarding such knowledge, misconceptions and attitude which is needed for specific prevention methods to reduce stigma and delay in presentation in future.

Aim: The aim of this study is to evaluate baseline knowledge and attitude towards mental health illnesses among young adults in Indian population.

Methods: In a cross-sectional study design; 600 young adults aged 18-25 years were included. Previously diagnosed patients of psychiatric disorders were excluded. After informed consent, all participants were given structured questionnaire that included questions about their socio demographic characteristics, knowledge concerning mental health illnesses and scale for the measurement of attitudes towards alcohol.

Result: It was found that poor educational and socioeconomic status had statistical significance with poor knowledge and attitude towards mental health illnesses and related issues in young adults.

Conclusion: There is poor knowledge and attitude as well as misconceptions in young adults about mental health illnesses who have poor educational level and socio-economic status. Specific brief intervention programs for increasing awareness about mental health illnesses in young adults may be beneficial in reducing stigma and delay in presentation in future. A prospective study with control group can be planned to understand this.

Diagnostic stability of cannabis-induced psychosis – A retrospective study

Amit Kumar, Diptadhi Mukherjee¹, Pankaj Verma

VMMC and Safadrjung Hospital, New Delhi, ¹LGB, Regional Institute of Mental Health, Tezpur, Assam, India

The estimated prevalence of cannabis use in India is 2.8 % in the general population and 11% among patients seeking treatment in the major centres across India. The primary psychoactive constituent in cannabis is THC.

Aim: To study the Diagnostic Stability of cannabis-induced psychosis.

Objectives: 1. To describe sociodemographic and clinical correlates of cannabis-induced psychosis 2) To assess the diagnostic stability of CIP Inclusion criteria-1) Having a diagnosis Cannabis induced psychotic disorder (F12.5, ICD-10) during the study period. 2) The diagnosis has been made on or before December 2022 (to ensure an adequate follow-up period of six months.) 3) Age 18 years or above.

Methodology: Study design: Retrospective design. Study site: LGBRIMH. Study population: Individuals diagnosed with CIP in LGBRIMH OPD/IPD. Study participants: We have traced and reviewed the case record files of the study population only. Sampling: we have taken 400 samples. we have randomly selected 400 cases from the list of 649 cases. Data collection-The medical records of patients diagnosed with Cannabis-induced Psychotic Disorder have been recruited from January 2018 to December 2022.

Results and Conclusion: majority of the patients were young adult The median age of onset of psychosis and the median age of treatment-seeking was 24 years. Among the patients following up, 89 cases had stable diagnoses, 77 cases were diagnosed with schizophrenia, and 20 cases were diagnosed with mood disorders and other psychiatric disorders. The study was conducted after the approval of the Scientific and Ethical Committee of LGBRIMH. Patients was not contacted at any point in study.

Effects of subthalamic nucleus deep brain stimulation on psychiatric manifestations of Parkinson’s disease: A prospective study

Amrita Mandal

National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India

Background: Subthalamic nucleus deep brain stimulation (STN-DBS) is an effective intervention for advanced Parkinson’s disease (PD), with well-established motor benefits. Stimulation of the limbic/associative parts of the STN may have an effect on behaviour and mood.

Aim: To prospectively evaluate changes in depression, anxiety, psychotic symptoms, impulsivity, and apathy following STN-DBS; to examine their relationship with postoperative reductions in dopaminergic medications.

Methods: 21 patients with PD undergoing STN-DBS were assessed at baseline and at 3 months post-DBS. Psychiatric measures included the Hospital Anxiety and Depression Scale (HADS), Scale for Assessment of Positive SymptomsParkinson’s Disease (SAPS-PD), Starkstein Apathy Scale, QUIP-RS for impulse-control disorders and short UPPS-P Impulsive Behaviour Scale (SUPPS-P). Motor severity and dopaminergic medication load were indexed using the Unified Parkinson’s Disease Rating Scale (UPDRS) and Levodopa Equivalent Daily Dose (LEDD). Statistical analyses included Wilcoxon signed-rank tests for paired non- parametric comparisons, McNemar tests for categorical variables (Bonferroni correction where applicable). Within-subject design meant each participant served as their own control.

Results: STN-DBS resulted in significant reductions in LEDD and UPDRS scores (p<0.001). Significant decreases were observed in psychotic symptoms (p<0.001), anxiety (p = 0.028), depression (p<0.001), impulsivity-compulsivity (p = 0.007), and also in negative urgency, lack of perseverance. A significant increase in apathy was noted post-DBS (p<0.001). Frequencies of depression and Impulse Control Disorders declined,, apathy remained unchanged. None of these findings were significant after adjusting for LEDD.

Conclusion: STN-DBS is associated with improvement in motor symptoms and psychiatric symptoms, although apathy worsened significantly. These changes are likely related to reduced dopaminergic medication load.

Dermatologic burden of injection drug use: A systematic assessment

Anaf Kololichalil

AIIMS, New Delhi, India

Background: Cutaneous complications are among the earliest and most visible harms associated with injecting drug use, yet remain under-recognised in clinical addiction settings in India. Limited systematic data exist on the morphology, distribution, and burden of skin lesions among persons who inject drugs (PWID).

Aims: To document the prevalence and patterns of injection-related dermatologic lesions among PWID and to examine associations between lesion severity, injection behaviours, and duration of injecting.

Methods: This cross-sectional study included 198 adults with a history of injecting drug use recruited from a tertiary addiction centre. Trained clinicians performed structured dermatologic examinations using standard operational definitions. Sociodemographic data, substance use patterns, injection practices, and lesion characteristics were recorded. Associations between injection frequency, advanced site use, and lesion severity were analysed.

Results: Track marks (91.9%), puncture marks (64.6%), and scarring (37.9%) were the most frequent lesions, predominantly involving the cubital fossa (>90%). Severe lesions occurred in 41.4% and were significantly associated with higher injection frequency (p=0.005). Advanced site involvement was associated with longer injecting duration (p=0.028). Time since last injection was not significantly related to lesion severity. Only 1.5% of participants had ever sought medical care for skin complications.

Conclusion: PWID in India exhibit a substantial dermatologic burden with characteristic chronic pigmentary and scarring patterns, particularly in high-use sites. Lesion severity correlates with behavioural risk markers, underscoring the value of cutaneous assessment in addiction care. Integration of dermatologic screening within harm-reduction and treatment services is warranted.

Correlation between suicidal ideation, impulsivity, perceived stress, and salivary cortisol in suicide attempters: A cross-sectional study in a tertiary healthcare center

Anantprakash S. Saraf

BRLSABVM Government Medical College, Rajnandgaon, Chhattisgarh, India

Background: Suicide is a major public health concern, and impulsivity and perceived stress play crucial roles in suicidal behaviors. Dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, reflected by altered salivary cortisol levels, has been implicated in suicidality. Understanding the relationship between suicidal ideation, impulsivity, perceived stress, and cortisol dysregulation may help to identify potential biomarkers for suicide risk assessment.

Objective: To estimate the prevalence of impulsivity and perceived stress among patients admitted after a recent suicide attempt and explore their correlation with suicidal ideation and salivary cortisol levels.

Methods: A descriptive, cross-sectional study was conducted among 86 patients admitted after a recent suicide attempt at a tertiary healthcare center in Rajnandgaon, Chhattisgarh. The Modified Scale for Suicidal Ideation (MSSI), the Barratt Impulsiveness Scale (BIS-11), and the Perceived Stress Scale (PSS) were used to assess suicidal ideation, impulsivity, and stress levels, respectively. Morning salivary cortisol levels were measured using an ELISA method. Statistical analyses included independent t-tests, Pearson’s correlation, and multiple linear regression.

Results: A significant positive correlation was observed between suicidal ideation and impulsivity (r = 0.97, p < 0.001), between suicidal ideation and perceived stress (r = 0.89, p < 0.001), and between impulsivity and perceived stress (r = 0.87, p < 0.001). Salivary cortisol levels also significantly correlated with suicidal ideation (r = 0.94, p < 0.001), impulsivity (r = 0.94, p < 0.001), and perceived stress (r = 0.88, p < 0.001).

Conclusion: This study highlighted a strong association between suicidal ideation, impulsivity, perceived stress, and cortisol dysregulation.

Impact of psychiatric comorbidities on quality of life in patients with dermatological conditions: A cross-sectional study

Anantprakash S. Saraf

BRLSABVM Government Medical College, Rajnandgaon, Chhattisgarh, India

Background and Objectives: Dermatological conditions impact quality of life and are often linked to psychiatric comorbidities like anxiety and depression. Understanding the interaction between skin disorders, mental health, and demographic factors is vital for holistic care. This study aims to assess patient profiles, identify psychiatric comorbidities, and explore the relationship between psychiatric factors and quality of life in dermatology outpatients.

Methods: This cross-sectional study included 114 patients with dermatological disease. Data were collected using validated tools including the Dermatology Life Quality Index (DLQI), Patient Health Questionnaire-9 (PHQ-9), Hamilton Depression Rating Scale (HAM-D), Generalized Anxiety Disorder-7 (GAD-7), and Patient Health Questionnaire-15 (PHQ-15). Descriptive statistics were used to summarize the data, and associations were analyzed using chi-squared tests, logistic regression, and correlation analysis. Receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive utility of PHQ-9 for high DLQI scores.

Results: The majority of the patients were young, unmarried, and urban residents, with acne (36.0%) and fungal infections (27.2%) being the most common dermatological conditions. Psychiatric comorbidities were prevalent, with 60.5% of participants experiencing depression and 44.7% reporting anxiety. Higher DLQI scores were significantly associated with the PHQ-9 (p < 0.05), HAM-D (p < 0.05), and GAD-7 (p < 0.05) scores. Logistic regression identified the PHQ-9 and HAM-D as independent predictors of high DLQI scores (p < 0.05). ROC analysis of the PHQ-9 yielded an AUC of 0.72, suggesting moderate accuracy in predicting an impaired quality of life.

Conclusion: Dermatological conditions often coexist with psychiatric comorbidities, notably depression and anxiety.

Quality of life of brown sugar (Heroin) addicts in an urban community of Indore

Ankit Raghuwanshi, Rajvardhan Bhanwar, Ramghulam Razdan

Department of Psychiatry, Index Medical College, Hospital & Research Centre, Indore, Madhya Pradesh, India

Background: Opioid dependence is a major public health concern associated with significant physical, psychological, and social morbidity. Beyond mortality and medical complications, opioid use markedly impairs quality of life (QoL), which is an important indicator of treatment outcomes and long-term recovery. Community-based data on QoL among opioid-dependent individuals in India are limited.

Aim and Objectives: To assess the quality of life of opioid-dependent individuals residing in an urban locality of Indore and to study their socio-demographic profile and patterns of substance use.

Methodology: This cross-sectional, community-based study was conducted in Azad Nagar, Indore. Forty participants aged 18-60 years, diagnosed with opioid dependence syndrome as per ICD-10 criteria, were included after informed consent. Individuals with acute intoxication, severe withdrawal, or major medical or psychiatric illness were excluded. Quality of life was assessed using the WHOQOL-BREF questionnaire, which evaluates physical health, psychological health, social relationships, and environmental domains.

Results: The majority of participants were young adults, with a marked male predominance. Most belonged to lower socio-economic strata, had low educational attainment, and were engaged in daily wage labor or were unemployed. Polysubstance use was common, particularly tobacco, alcohol, and cannabis. WHOQOL-BREF scores revealed significant impairment across all four domains, indicating poor physical health, psychological well-being, social functioning, and environmental satisfaction.

Conclusion: Brown sugar addiction is associated with substantial deterioration in quality of life across multiple domains. Comprehensive de-addiction treatment, psychosocial interventions, and community-based rehabilitation are essential to improve overall well-being and support sustained recovery in this vulnerable population.

A cross-sectional study of nonpsychiatry junior resident doctors’ knowledge, beliefs, attitudes and practices in care of individuals experiencing psychosis

Ankita Upadhyay, Kanaka Mahalakshmi

Andhra Medical College and Government Hospital for Mental Care, Visakhapatnam, Andhra Pradesh, India

Background: Trainee doctors in non-psychiatric specialties frequently encounter individuals with psychiatric symptoms during medical care. Despite the high prevalence of acute/chronic psychotic conditions in general medical and surgical settings, training in proactively identifying and effectively managing them often remains minimal across institutions. Data regarding this gap in training is currently unavailable and could help improve the standard of care and quality of consultation liaison.

Aims: To study the knowledge, beliefs, attitudes and practices of non-psychiatry junior doctors towards individuals experiencing psychosis and to find any emerging trends among the sub-specialties.

Methods: Following institutional scientific and ethical clearance, a structured digital questionnaire on knowledge, beliefs, attitudes and practices was circulated amongst junior resident doctors (1st-3rd year MD/MS/DNB) across all broad specialties among multiple government and private medical colleges and affiliated teaching hospitals. Data collected is represented in terms of percentages and means.

Results: Data collection and analysis are currently ongoing. However, we anticipate a high prevalence of inadequate knowledge and training in dealing with individuals with psychotic disorders and lacunae in practices at point of care medical/surgical units.

Prescription patterns and naturalistic treatment outcomes in paediatric bipolar disorder

Anmol Sharma, Srinivas Balachander, Y. C. Janardhan Reddy, K. John Vijay Sagar¹

Departments of Psychiatry and ¹Child and Adolescent Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India

Background: Management of paediatric bipolar disorder is largely guided by data from adult studies, with limited evidence from child and adolescent populations. Understanding real-world prescribing practices and outcomes is therefore essential.

Objectives: To describe prescription patterns and evaluate short- and long-term outcomes among children and adolescents admitted with bipolar disorder at a tertiary care centre.

Methods: A retrospective chart review was conducted for patients below 18 years admitted between 2014 and 2023 with a diagnosis of bipolar disorder or mania. Clinical records were examined for demographic details, clinical characteristics, medications prescribed, and outcomes at discharge and follow-up. Data were analysed using descriptive statistics.

Results: The study included 224 patients with a mean age of 14.8 ± 2.4 years; 61.6% were male. Most admissions were for manic (59.8%) or mixed episodes (28.1%), and psychotic symptoms were documented in 26.8%. Lithium was the most frequently prescribed mood stabiliser (70.1%), followed by valproate (27.6%). Risperidone (45.5%) and olanzapine (29.5%) were the most commonly used antipsychotics. Combination pharmacotherapy was employed in 68.7% of cases. The mean duration of hospital stay was 27.1 ± 22.1 days. At discharge, 84.9% of patients were rated as much or very much improved. Follow-up data were available for 71% of the cohort over a mean duration of 33.2 ± 29.3 months, with 28.6% experiencing rehospitalisation. Patients receiving lithium demonstrated a longer time to rehospitalisation compared to those not treated with lithium.

Conclusion: Combination therapy is widely used in the inpatient treatment of paediatric bipolar disorder.

Neuroleptic malignant syndrome in a 17-year-old female following prokinetic and psychotropic drug exposure: A case report

Anna Sehgal, Sreya Banerjee

Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India

This case report presents a 17-year-old female who manifested Neuroleptic Malignant Syndrome (NMS), a rare but life-threatening neurologic complication following extended use of prokinetic and psychotropic medications. The primary aim was to elucidate the clinical presentations, diagnostic procedures, management strategies, and outcomes in an atypical context, where drugs primarily prescribed for gastrointestinal symptoms led to severe neuropsychiatric consequences. The patient developed fever, rigidity, tremors, and significantly elevated creatine phosphokinase (CPK), necessitating intensive care. A systematic workup excluded infectious and autoimmune origins, and detailed drug history revealed prolonged use of levosulpiride 75 mg/day and itopride 150 mg/day for two months for persistent nausea and gastric discomfort, alongside domperidone, ondansetron, and gabapentin. The temporal association between these agents and NMS onset, combined with resolution after withdrawal and administration of amantadine and anticholinergic agent trihexyphenidyl, established causality. This case emphasizes the imperative for gastroenterologists to exercise judiciousness when considering long-term prokinetic therapy and, ultimately, underscores that meticulous drug history-taking is needed in the evaluation of such atypical neuropsychiatric presentations, thereby improving diagnostic accuracy and patient safety.

To study of effect of length of proceeding of divorce cases on petitioners and respondents

Anshu Sharma, Anshu Devi

Department of Psychiatry, Muzaffarnagar Medical College and Hospital, Muzaffarnagar, Uttar Pradesh, India

11.4 lakhs cases of divorce are pending at different level in courts in India July 2022. Mostly are in utter Pradesh .the taken time for judgment where both parties are agreed is usually 6 to 9 months but in other disputed and complicate d cases may vary from months to years. It has certainly effect on mental health of petitioners and respondents.

Aim and Objectives: study is to find and establishment relationship between length of proceeding on mental health of both parties petitioners and respondents.

Tools: general mental health questionnaires, perceived stress scale,, Oldenburg burn out inventory, becks inventory, Brief psychotic rating scale, formulated questionnaires for length of proceeding.

Method: 50 both cases of petitioners and respondents are assessed on scale on general mental health questionnaire, perceive stress scale Oldenburg burn out inventory, BPRS, Becks inventory and formulated questionnaires for length of proceeding and obtained data were finally analyzed.

Result and Conclusion: results had showed significant effect on mental health. The length of proceeding is more burnout. The immediate effect is anger and the long term has increased suicidiality and depressive effect.

Prevalence of psychotic symptoms in patients with delirium: A cross-sectional study

Anuja Rudingwa, Subho Chakrabarti, Sandeep Grover, Swapnajeet Sahoo, Nikhil Kamal

Postgraduate Institute of Medical Education and Research, Chandigarh, India

Introduction: Although common, little is understood about the psychotic symptoms in patients with delirium. Aims and objectives: To evaluate the prevalence of psychotic symptoms in patients diagnosed with delirium.

Materials and Methods: 335 patients diagnosed with delirium seen in consultation liaison setting were prospectively evaluated for the presence of delusions, perceptual disturbance and thought disorder.

Results: The mean age of the study sample was 52 years and three-fourth (73%) of the study sample was comprised of males and the mean duration of delirium was 4 days at the time of assessment. In terms of psychotic symptoms, about one sixth 16% (n=52) of the participants had delusions, two-fifth (39%; n=131) had hallucinations, and half (51%; n=172) of the participants had thought disorder. Overall more than two third (70%; n=236) had at least one psychotic symptom.

Conclusions: Majority of the patients with delirium have psychotic symptoms.

Impact of social media use on mental health among medical undergraduates from a tertiary care centre

Anupam Sood, Gaurav Kumar, Abbas Mehdi, Parul Prasad

Career Institute of Medical Sciences and Hospital, Lucknow, Uttar Pradesh, India

Background: Social media has become deeply ingrained into the daily routine of medical students. While it offers educational and social benefits, excessive and unregulated use may adversely affect mental health and academic outcomes. Understanding this relationship is essential in a high-stress group such as medical undergraduates.

Aim: To assess the prevalence and patterns of social media use among undergraduate medical students, along with its impact on mental health.

Methods: A cross-sectional study was conducted among 380 MBBS students from a tertiary-care centre at Lucknow. Participants were selected using systematic randomized sampling method. Data were collected using semi-structured questionnaire and standardized tools Social Media Addiction Scale-Students Form (SMAS-SF), Social Networking Addiction Scale (SNAS), and MINI-Plus. Data were analysed using SPSS; correlations were tested using Pearson’s coefficient.

Results: All students reported active social media use with a mean duration of 3.77 hours per day. WhatsApp was the most frequently used platform. More than half (53.6%) reported negative effects on mental health, chiefly sleep disturbance, stress, and anxiety. A strong positive correlation was found between time spent on social media and mental health (r = -0.85, p < 0.001).

Conclusion: Social media use is universal among medical undergraduates. Excessive engagement is significantly linked to impaired mental health in terms of disturbed sleep, anxiety and eating patterns. Promoting digital balance, time management, and mental-health awareness among students is vital to minimize these adverse effects.

Key words: Medical students, mental health, social media

Demographic and clinical profile of PMI admitted in a GHPU under the preview of MHCA 2017

Anurag Solanki, Namita Dekka, Dinesh Tyagi

Department of Psychiatry, Dr BSA Hospital, Rohini, Delhi, India

Study comprised of 100 patients which are given indoor admission according to various sections of MHCA 2017, description of various sections and clinical demographic data under which they are admitted are discussed.

Sleep parameters in antipsychotic-naive schizophrenia-spectrum patients

Anuragini Suresh, W. J. Alexander Gnanadurai, A. Balaji

Department of Psychiatry, Government Kilpauk Medical College Hospital, Chennai, Tamil Nadu, India

Introduction: Sleep disturbances are a frequent, significant feature of early psychosis, potentially contributing to greater symptom severity and functional impairment. Studying drug-naive patients is crucial to understand the primary association without medication effects, informing targeted early interventions.

Aims and Objective: To assess the prevalence and severity of sleep disturbances in antipsychotic-naive first-episode schizophrenia-spectrum (FES) patients using PSQI and ISI. Secondary aims include examining the association between sleep disturbances and psychotic symptom severity through PANSS and it’s subscales, as well as the association with sociodemographic variables.

Materials and Methods: This is a six-month, cross-sectional study done at the Department of Psychiatry, Government Kilpauk Medical College Hospital. The sample includes adults who are antipsychotic-naive first-episode schizophrenia-spectrum disorder patients, who provide consent. Exclusion criteria include prior antipsychotic exposure, primary substance-use disorder, or patients with primary sleep disorders.

Results: The primary hypothesis was confirmed, with a high proportion of patients demonstrating poor global sleep quality (PSQI >5). Consistent with the secondary hypothesis, a substantial prevalence of clinically significant insomnia (ISI >15) was found. Furthermore, higher PSQI and ISI scores were positively and significantly correlated with PANSS total score and subscale scores.

Conclusion: This study confirms that sleep disruption is a core, untreated feature of first episode psychosis. The findings provide empirical evidence essential for developing and implementing sleep-focused treatments as part of a comprehensive early psychosis treatment model.

A cross-sectional study to assess serum uric acid levels as a biomarker for evaluation of cognitive functions among patients with schizophrenia

C. H. Anusha, S. Madhusudhan

Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India

Background: Studies have found an association between cognitive functions and serum uric acid levels in schizophrenia. Purine metabolites are related to improved cognitive functions in schizophrenia. The current study aims to find an association between purine metabolites and cognitive functions in patients with schizophrenia.

Aim:

a) To assess serum uric acid levels and cognitive functions in schizophrenia patients.

b) To assess any association between cognitive functions and serum uric acid levels.

Methods: Data from 30 schizophrenic patients who visit psychiatry OPD are included in the study. Demographic data was collected. PANSS (positive and negative symptoms scale) was applied and Neurocognition was evaluated across seven domains using the Indian Standardized NIMHANS neuropsychological battery (MCCB-equivalent). Serum uric acid levels were assessed.

Results: Out of 30 participants, most are aged 45-50 (36.7%), male (63.3%), SSLC educated (43.3%), unemployed (63.3%), and urban residents (83.3%). Typical onset of symptoms was seen between 18-24 years (53.3%). No significant correlations with serum uric acid levels were found (p value > 0.05, not statistically significant).

Adult attention-deficit/hyperactivity disorder (ADHD), anxiety, and depression among medical students: A cross-sectional study

Anusha Chitti, SaiKiran

Guntur Medical College, Guntur, Andhra Pradesh, India

Background: Medical education is associated with high psychological stress. While anxiety and depression among medical students are well documented, Adult Attention-Deficit/Hyperactivity Disorder (ADHD) remains under-recognized despite its overlap with affective symptoms. This study assessed the prevalence of Adult ADHD, anxiety, and depression and examined their interrelationship among medical students.

Aims and Objectives: To estimate the proportion of students screening positive for Adult ADHD, anxiety, and depression using standardized tools and to evaluate correlations between ADHD scores and comorbid anxiety and depression.

Materials and Methods: A cross-sectional online survey was conducted among 391 medical students (MBBS students, interns, and postgraduates) from tertiary care institutions in Andhra Pradesh. Participants completed an online semi-structured questionnaire with sociodemographic details and the Adult ADHD Self-Report Scale (ASRS v1.1), Generalized Anxiety Disorder Scale (GAD-7), and Patient Health Questionnaire (PHQ-9). Data were analyzed using SPSS 26 with descriptive statistics and Pearson’s correlation; significance was set at p<0.05.

Results: The mean participant age was 20.7 ± 3.6 years; 63.7% were females. All respondents had low ASRS scores, suggesting no significant Adult ADHD. Anxiety levels were high, with 39.4% mild, 21.2% moderate, and 9.5% severe anxiety. Depression scores showed 30.7% mild, 19.9% moderate, and 7.7% severe depression. ADHD total scores demonstrated significant positive correlations with PHQ-9 (r=0.434, p<0.001) and GAD-7 (r=0.456, p<0.001).

Conclusion: Although significant Adult ADHD symptoms were not observed, anxiety and depression were highly prevalent and correlated with ADHD scores. Early screening, timely counseling, and stress-management interventions are recommended for medical students.

Correlation between perceived stress and coping strategies among medical and nursing with masked Autism traits students – A cross sectional tertiary hospital study

H. V. Anusha

Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, Karnataka, India

Background: Medical and nursing students experience substantial academic pressure and emotionally demanding clinical exposure. These stressors contribute to elevated perceived stress and shape the coping strategies students use. Recent research also highlights that some students engage in camouflaging autistic traitsstrategies such as masking, compensation, or assimilation to appear neurotypical. While sometimes adaptive, camouflaging is linked to increased psychological distress and reduced well-being, making it essential to examine in student populations.

Aim: To assess and compare perceived stress levels, coping strategies, and camouflaging autistic traits among first- and second-year medical and nursing students in a tertiary hospital setting.

Methods: A cross-sectional study will be conducted among 120 students (60 medical, 60 nursing) aged 18-20 years. Perceived stress will be measured using the Perceived Stress Scale (PSS), and coping strategies using the Brief COPE inventory. Camouflaging behaviours will be assessed using the Camouflaging Autistic Traits Questionnaire (CAT-Q), a validated tool evaluating masking, compensation, and assimilation. Data will be analysed descriptively and comparatively between groups.

Expected Results: Perceived stress levels are expected to be moderate to high across both groups. Medical students may demonstrate greater use of problem-focused coping, while nursing students may rely more on emotion-focused or avoidant strategies. A subset of students is anticipated to show elevated CAT-Q scores, suggesting camouflaging behaviours that may correlate with increased stress.

Conclusion: By evaluating stress, coping patterns, and camouflaging behaviours, this study aims to generate a clearer psychological profile of early-year medical and nursing students. The findings may help inform interventions that enhance adaptive coping.

The interplay of attachment styles and family dynamics in shaping aspirations: A study of young adults in an interdependent culture

Anushka Naithani

Christ University, Bengaluru, Karnataka, India

This study explores how attachment styles and family dynamics influence the personal and career aspirations of young adults in India. A total of 253 individuals between the ages of 18 and 25 filled out an online survey with standardized scales for measuring attachment, family relationships, aspirations, and personal growth. Research findings indicated that openness in communication and family expressiveness were two factors that positively correlated with secure attachment while on the other hand, family conflict and anxiety were negatively correlated with the security of attachment. Although individuals with a securely attached pattern exhibited slightly higher career ambitions than those with an insecure attachment pattern, the differences did not reach statistical significance. Family cohesion was the most prominent factor that contributed to the prediction of goal-directed behavior, indicating that the presence of supportive and communicative family environments facilitates the development of focused and sustained aspiration-related efforts. Attachment anxiety, as opposed to what was hypothesized, did not indicate less planfulness but it was significantly associated with decreased perceptions of family cohesion. In addition, the moderation analysis revealed that family cohesion was not a mediator that buffered the relationship between insecure attachment and goal-directed behaviour. Rather, family cohesion exerted a positive effect directly across different attachment groups. This study enriches culturally informed viewpoints of vocational development and emphasizes that taking into consideration the family background is of utmost importance in psychological and career counselling offered to young adults from collectivistic societies.

Key words: Attachment styles, career aspirations, family dynamics, interdependent culture, young adults

Neurocognitive assessment of memory, attention, concentration and emotional processing in patients with somatoform disorder and obsessive compulsive disorder – A comparative study

Apoorv Shah, Manish Borasi

Department of Psychiatry, Chirayu Medical College and Hospital, Bhopal, Madhya Pradesh, India

Background: This study emphasized the role of neuro-cognitive and emotional-processing assessment for Obsessive compulsive disorder (OCD) and Somatoform disorder and underscore the necessity for differentiated therapeutic approaches for both the disorders.

Objective: This study aims to assess and compare memory, attention, concentration and emotional processing in patients with somatoform disorder and Obsessive compulsive disorder.

Methodology: This cross- sectional analytical study was carried out with 60 participants,30 each in 2 groups diagnosed with somatoform disorder and OCD respectively. Sampling was done by clinical interview and application of PGI- Memory Scale (PGMIS) to assess memory, Weschler Adult Intelligence Scale (WAIS-4) to assess attention and concentration and Toronto Alexithymia Scale-20 (TAS- 20) to assess emotional processing. SPSS was used for data analysis and appropriate statistical tests were applied for level of significance.

Results: When compared for PGIMS, OCD group was more affected in domains of recent memory and visual retention. OCD group had lesser mean scores in digit forward and backward span on WAIS-4. TAS-20 results highlight higher severity of alexithymia in domain of externally oriented thinking’ in OCD group.

Conclusion: This study concluded that group of patients with OCD exhibit higher degree and severity of cognitive dysfunctions and alexithymia levels as compared to patients with somatoform disorders. These cognitive deficits are indicative of broader Frontostriatal Dysfunction’ in OCD.

Key words: Alexithymia, memory, obsessive compulsive disorder, somatoform

Neuropsychiatric outcomes following chronic alcohol use – A case series

V. Archana Mohan, Mounika Tejaswini, D. Vijayalekshmi

Andhra Medical College, Visakhapatnam, Andhra Pradesh, India

Aim: To describe the diverse cognitive and neuropsychiatric manifestations associated with chronic alcohol use through four clinically distinct cases.

Methods: This case series was compiled from patients presenting to the Psychiatry Department of Andhra Medical College over one year. Four adults with a history of chronic alcohol use were evaluated through clinical assessment, neuroimaging, neuropsychological testing, and relevant neurological investigations as indicated. Diagnoses were made according to ICD-11 criteria.

Results: Four different alcohol-related neuropsychiatric outcomes were identified:

Case 1: Alcohol-induced axonal polyneuropathy, presenting with distal weakness, paresthesias, and electrophysiological evidence of axonal degeneration.

Case 2: Alcohol-induced bilateral sensorineural hearing loss confirmed by pure-tone audiometry, with additional mild cognitive complaints.

Case 3: Alcohol-induced seizure disorder, presenting with recurrent generalized tonic-clonic seizures in the absence of structural brain lesions.

Case 4: Alcohol-induced young-onset dementia, characterized by progressive memory loss, executive dysfunction, personality changes, and neuroimaging suggestive of cortical atrophy.

Across all cases, prolonged alcohol use (over 10 years), nutritional deficiencies, and poor follow-up were common contributing factors.

Partial improvement was seen with sustained abstinence and targeted interventions.

Conclusion: These findings highlight the wide spectrum of cognitive and neuropsychiatric complications associated with chronic alcohol use, ranging from peripheral nerve damage and sensory impairment to seizure disorders and early-onset dementia. Early screening, nutritional supplementation, and consistent follow-up are essential to reduce long-term morbidity. Further research with larger samples is warranted to better understand the heterogeneity and progression of alcohol-related neurological and psychiatric disorders.

Rapid reduction in suicidality and depressive symptoms with ketamine infusion therapy: A 100-patient observational study evaluating safety, efficacy, and short-term outcomes in severe depression, active suicidal ideation, and treatment-resistant depression

B. K. Arpitha, Satish Ramaiah

Sukoon Psychiatry Centre, Bengaluru, Karnataka, India

Background: Severe depression, active suicidal ideation, and treatment-resistant depression require interventions that can provide rapid symptom relief to ensure safety and stabilization. Ketamine infusion therapy has emerged as a fast-acting option with the potential to significantly reduce suicidality and depressive symptoms within hours, yet real-world evidence from acute psychiatric settings in India remains limited.

Aim: To evaluate the rapidity, effectiveness, and safety of ketamine infusion therapy in reducing suicidal ideation and depressive symptoms in patients presenting with severe depression, acute suicidality, and treatment-resistant depression.

Methods: This observational study included 100 adults admitted to an acute psychiatry centre between June2024- June2025. Participants fulfilled diagnostic criteria for severe Major Depressive Disorder, active suicidal ideation, or treatment-resistant depression. All received intravenous ketamine at 0.5 mg/kg infused over 40 minutes, with the number of infusions determined clinically. Symptom severity was measured using the Columbia Suicide Severity Rating Scale (C-SSRS) and HAMD at baseline, 24 hours, 72 hours, and one week post-treatment. Tolerability and adverse effects were documented across all sessions.

Results: Patients demonstrated rapid and meaningful clinical improvement. Suicidal ideation reduced by 60-80% within the first 72 hours. Depressive symptoms decreased by 40-50% by Day 3, with a substantial proportion experiencing relief within hours of the initial infusion. Among individuals with treatment-resistant depression, 62% achieved a 50% reduction in depressive scores within the first week. Side effects were mild and transient, primarily brief dissociation and nausea, with no serious adverse events.

Conclusion: Ketamine infusion therapy produced rapid, significant improvements in suicidality and depressive symptoms.

Relationship between expressed emotions of caregivers and their burden in patients with somatoform disorders: A pilot study

Arvind Mishra, Snehanshu Dey

IMS and SUM Hospital, Bhubaneswar, Odisha, India

Somatoform disorders are complex psychiatric conditions characterized by physical symptoms lacking adequate medical explanation, often leading to significant caregiver distress. Expressed emotion (EE) encompassing criticism, hostility, emotional overinvolvement, and warmth plays a crucial role in shaping caregiver-patient dynamics. However, the association between EE and caregiver burden in somatoform disorders has been inadequately explored, particularly in the Indian context.

This cross-sectional, observational study was conducted among 60 patients diagnosed with somatoform disorders and their primary caregivers at the Department of Psychiatry, IMS and SUM Hospital, Bhubaneswar. Participants aged 18-65 years were recruited through convenience sampling. Assessment tools included the Patient Health Questionnaire-15 (PHQ-15) for somatic symptom severity, the Family Emotional Involvement and Criticism Scale (FEICS) for EE, and the Family Burden Interview Schedule (FBIS) for caregiver burden. Statistical analyses involved chi-square, t-tests, correlation, and regression analyses.

Results indicated that higher levels of EE particularly critical comments and emotional overinvolvement were significantly associated with greater caregiver burden. Caregivers of patients with more severe somatic symptoms experienced increased emotional and financial strain.

The study emphasizes the importance of psychoeducational and family-based interventions to reduce negative EE components and alleviate caregiver burden. Understanding this relationship can aid in developing holistic management strategies and improving outcomes for patients with somatoform disorders.

Clinical audit of the use of zuclopenthixol acetate (Clopixol Acuphase) within the psychiatric intensive care unit (PICU) of a regional public teaching hospital

Ashish Rana, Vishal Sharma¹, Sarah Ridd¹

Mackay Private Hospital, Queensland, Australia, ¹RANZCP, New Zealand

Introduction: Zuclopenthixol acetate (ZA) is commonly used in psychiatric intensive care units (PICUs) to manage acute behavioural disturbance (ABD). Despite its clinical utility, monitoring practices remain inconsistent, creating issues such as oversedation and cardiac risk. Current Queensland Health ABD guidelines do not mandate ECG or blood tests prior to or following ZA, contrasting with more rigorous interstate guidance.

Aims: This study aimed to evaluate compliance with existing Queensland ABD guidelines, benchmark standards, and develop and pilot a proposed revision to the Queensland state guideline to strengthen monitoring and improve patient safety.

Methods: A single-centre retrospective audit of all patients prescribed ZA in a regional PICU (January 2019-December 2021) was undertaken using a plan-do-study-act (PDSA) framework. Baseline practice was compared with a proposed ABD management guideline, synthesised from the Western Australian WACHS and the RANSCP guidelines. Following staff education and guideline implementation, pre/post outcomes were evaluated.

Results: Eighty-eight patients were included. Compliance improved significantly for pre-ZA blood tests (49.3% to 84.2%, p<0.01) and ECGs (43.5% to 83.3%, p<0.01), and at discharge (ECG 33.3% to 83.3%, p<0.01). Baseline documentation improved from 30.9% to 83.3% (p<0.01). Improvements were consistent across patient demographics, except for higher discharge ECG completion in non-Indigenous patients (p=0.04).

Conclusions: Implementation of the proposed ABDM guideline markedly improved monitoring and documentation of ZA use. These findings provide an evidence base for state-wide adoption through revision of the Queensland Health ABD guideline, supporting safer and more consistent care across mental health services.

Impact of binge-watching OTT platforms on academic procrastination among MBBS students: A cross-sectional study

Ashish Yadav, Deepti M Bhatt, Vishal Damani, Parnavi Singh¹

Gujarat Institute of Mental Health, ¹ESIC Medical College and Hospital, Ahmedabad, Gujarat, India

Background: Over-the-Top (OTT) streaming platforms have dramatically transformed media consumption patterns, particularly among undergraduate medical students. Binge-watching behavior, characterized by watching multiple episodes or extended content continuously, has emerged as a potential factor contributing to academic procrastination.

Aim: This study aimed to examine the correlation between binge-watching behavior on OTT platforms and academic procrastination among undergraduate medical students.

Methods: A cross-sectional observational study was conducted among 506 undergraduate MBBS students across medical colleges in Ahmedabad, Gujarat, from October to December 2024. Data were collected using validated questionnaires including the Binge-Watching Questionnaire (BWQ), Academic Procrastination Scale (APS), and socio-demographic profiles. Statistical analysis was performed using IBM SPSS version 22.1.

Results: Among 506 participants, 332 (65.6%) reported engaging in binge-watching behavior. A significant positive correlation was found between binge-watching and academic procrastination (r = 0.457, p < 0.001). Binge-watchers had significantly higher mean APS scores (76.71± 15.12) compared to non-binge-watchers (66.01 ± 17.34), p < 0.001. First-year students and higher-income groups showed significantly higher binge-watching behavior (p = 0.001). Moderate binge-watching severity was most prevalent (76.2%), with mobile devices being the primary platform for content consumption (41.0%).

Conclusion: This study demonstrates a strong positive correlation between binge-watching behavior and academic procrastination among undergraduate medical students. The findings highlight the need and pathway of future studies for awareness campaigns, time management interventions, and behavioral strategies to mitigate the negative impact of excessive OTT platform usage on academic performance.

Key words: Academic procrastination, binge-watching, medical students, OTT platforms, screen time

The synergistic triad: Evening chronotype amplifies the association of craving and impulsivity with relapse in alcohol use disorder

Ashvin Chouhan, Simran Sandhu, Prashant Gaurav, Pali Rastogi, Vijay Niranjan

MGM Medical College, Indore, Madhya Pradesh, India

Background: Relapse in Alcohol Use Disorder (AUD) is multifactorial. While impulsivity and craving are established risk factors, the predisposing role of evening chronotype and its potential interaction with other vulnerabilities remain poorly understood. This study investigated the combined predictive power of this triad on relapse risk.

Methods: In a prospective cohort study, 81 adults with AUD from a tertiary care center were assessed at baseline using the Barratt Impulsiveness Scale (BIS-11), Penn Alcohol Craving Scale (PACS), and Composite Scale of Morningness (CSM). Relapse status (Relapsed vs. Not Relapsed) was determined at a 3-month follow-up using the Timeline Followback method. Data analysis employed ANOVA, Games-Howell post-hoc tests, and binary logistic regression with interaction terms to test for synergistic effects.

Results: The relapse rate was 40.7%. The relapsed group demonstrated significantly higher motor impulsivity (p=0.008), non-planning impulsivity (p=0.014), craving (p<0.001), and eveningness (p<0.001) compared to non-relapsers. Crucially, logistic regression revealed a significant interaction between craving and chronotype (p=0.012), indicating that the effect of craving on relapse risk was substantially stronger among individuals with an evening chronotype.

Discussion: Evening chronotype is a significant and under-recognized risk marker for relapse in AUD. Its effect is not merely additive but synergistic, as it potently amplifies the risk posed by craving. These findings advocate for a paradigm shift towards “chrono-personalized” treatment, where assessing chronotype can identify high-risk patients who may benefit from evening-focused relapse prevention strategies.

Key words: Alcohol use disorder, chronotype, craving, impulsivity, relapse, synergistic effect

Integrative pharmacologic strategies for managing posthysterectomy mood disorders in India: A meta-analysis of hormonal and psychotropic drug efficacy and utilization trends

Ashwani Saini, Himanshi Gupta¹, Ved Pal Mahla

Faculty of Medicine and Health Sciences, SGT University, ¹Faculty of Pharmacy, SGT University, Gurugram, Haryana, India

Background: Hysterectomy, often accompanied by oophorectomy, is among the most common gynecological surgeries in India. The sudden decline in estrogen levels frequently precipitates mood disturbances such as depression, anxiety, and emotional instability. Despite growing awareness of these psychiatric sequelae, integrated pharmacologic management remains underutilized and inadequately documented in the Indian context.

Aims: This meta-analysis aimed to evaluate the prevalence of post-hysterectomy mood disorders and analyze the utilization of psychotropic and hormonal medications among Indian women from 2015 to 2025.

Methods: A systematic literature search across PubMed, Scopus, Google Scholar, and Research Gate identified 24 eligible studies following PRISMA guidelines. Data were pooled to derive prevalence estimates, drug utilization patterns, and heterogeneity (I²) values.

Results: The pooled prevalence of depression and anxiety following hysterectomy was 34.2% and 31.8%, respectively. SSRIs, particularly sertraline and escitalopram, were most frequently prescribed (54.5%), followed by benzodiazepines (36.4%). Hormone replacement therapy (HRT) was reported in only 18.2% of studies. Combined SSRI and HRT therapy demonstrated the highest improvement in mood scores (65-75%). Common adverse effects included drowsiness (27.2%), nausea (18.1%), and emotional blunting (9%).

Conclusion: Post-hysterectomy mood disorders remain prevalent yet underrecognized in India. While SSRIs constitute the mainstay of treatment, limited HRT use and weak gynecology-psychiatry collaboration hinders optimal recovery. Integrated pharmacologic and hormonal approaches with culturally sensitive counseling yield superior outcomes and should guide future practice.

Key words: Anxiety, depression, hormone replacement therapy, hysterectomy, SSRIs

Behind every suicide attempt: The invisible weight on caregiver’s minds

Athira M. Anil, S. V. Santosh

Hassan Institute of Medical Sciences, Hassan, Karnataka, India

Background: Caregivers of suicide attempters often experience significant emotional strain, yet their psychological burden remains under-assessed in routine clinical care. Understanding caregiver distress and its relationship with the suicidal intent of the attempter is essential for planning effective support measures.

Aims: To assess psychological distress among caregivers of suicide attempters and to evaluate its association with the severity of suicidal intent in the attempters.

Methods: This descriptive cross-sectional study included 320 suicide attempters and their primary caregivers attending the Psychiatry Department of Hassan Institute of Medical Sciences. Sociodemographic details were collected using a semi-structured questionnaire. Suicidal intent was assessed using the Beck Suicide Intent Scale and caregiver distress using the Kingston Caregiver Stress Scale. Data were analysed using descriptive statistics, correlation analysis, t-tests, and ANOVA.

Results: Suicide attempters had a mean age of 31.1 years and their caregivers was 47.2 years. The mean suicidal intent score was 10.74. A strong positive correlation was observed between suicidal intent and caregiver distress. Attempter age showed a weak positive correlation with suicidal intent, and caregiver age showed a weak positive correlation with caregiver distress. No significant associations were found between most sociodemographic factors and either outcome.

Conclusion: Higher suicidal intent in attempters is strongly associated with greater psychological distress among caregivers. Routine screening and early supportive interventions for caregivers are recommended to improve overall suicide-related care. Behind every suicide attempt lies caregiver stress;addressing it early turns invisible stress into meaningful support, enhancing recovery for both patient and family.

A study of burden of care on caregivers of patients of OCD in a tertiary care hospital in U.P.

Avanish Verma, Tarun Pal, Rashi Agarwal, Rameez Ul Islam

LLRM Medical College, Meerut, Uttar Pradesh, India

Background: Obsessive-Compulsive Disorder (OCD) is a chronic and disabling condition that affects not only patients but also their caregivers. Caregivers frequently experience emotional stress, social isolation, financial strain, and reduced quality of life.

Aim: To assess the burden of care among caregivers of OCD patients and aimed at studying various socio-demographic variables.

Method: A cross-sectional study was conducted with 30 primary caregivers of OCD patients attending a psychiatric outpatient clinic. Caregivers were divided into different age groups. R. Thara’s FBIS was administered to measure burden in various domains such as routine disruption, financial strain, family interaction, and mental health of caregivers. Data were analyzed descriptively.

Results: The majority of patients are Female belonging to age groups 31-50 years with most cases of severe OCD (according to Y-BOCS) with highest burden in 31-50 years (according to FBIS=26) with marked financial strain and role overload.

Conclusion: Caregiver burden varies significantly with age. Most cases are of severe OCD with duration of illness upto 5-6 years and burden of care on caregivers is proportional to duration of illness. Targeted psychoeducation, stress-management training, and family support interventions are recommended to reduce caregiver distress.

Hidden suicidality in alcohol users: A clinical study of deliberate self-harm

Yushi Goyal, Kunal Kumar, Abhinit Kumar, Nikhil Nayar, Purvi Vats

School of Medical Sciences and Research, Sharda University, Greater Noida, Uttar Pradesh, India

Hidden suicidality suicidal thoughts, impulses, or intentions that are not openly expressedis a significant yet under-recognized phenomenon among individuals with alcohol use. Chronic alcohol consumption increases impulsivity, emotional dysregulation, and vulnerability to deliberate self-harm (DSH). Many patients presenting with DSH may conceal the intensity of their suicidal intent, making clinical assessment challenging.

Can art touch your heart? Role of various art forms in removing mental health stigma – A narrative review

B. Shuaib Hassan, K. V. Vibha

St Johns Medical College Hospital, Bengaluru, Karnataka, India

Background: Various studies have identified mental illness as a strongly stigmatizing characteristic. It brings about negative stereotypes as well as many negative impacts to the person suffering from mental illness both at an individual and societal level. Governments and NGOs worldwide have used various art forms to address mental health related stigma.

Objective: In this paper we have made an attempt to explore the role of various art forms including visual arts, literature, performing arts etc. in reducing mental health related stigma.

Methods: A narrative review methodology was used. Data bases searched included Pubmed’, Google scholar’, APA PsycNet’ using relevant keywords. Literature focusing on art as a therapeutic intervention were excluded

Results: Cinema and theater through empathy-building narratives appeared to be highly effective for reducing mental health related stigma . Multimodal and community-driven art programs showed significant attitude improvements, particularly among youth.

Conclusion: Using various art forms under the guidance of mental health expertise is one of the efficient ways to address the mental health related stigma prevalent in the society . A community based approach which is culturally sensitive should be targeted. Governments across the world along with promoting such art forms in their mental health programs, should make policies regulating art forms which contribute in creating stigma about mental health and spread misconceptions about mental health conditions.

Assessing sexual dysfunction in women with schizophrenia: A mixed-methods study informing PLISSIT model based intervention adaptation

Bhagyashree Acharya, Jigyansa Ipsita Pattnaik, Jayaprakash Russell Ravan

Kalinga Institute of Medical Sciences, KIIT, Bhubaneswar, Odisha, India

Background: Sexual dysfunction is prevalent yet under-addressed among women with schizophrenia. Understanding its nature and correlates is essential for developing targeted interventions.

Objective: To comprehensively assess sexual dysfunction among women with schizophrenia in remission using quantitative and qualitative measures, informing brief PLISSIT model-based intervention development.

Methods: Thirty-five women with schizophrenia in remission (mean age 42.4±6.8 years) completed the Female Sexual Function Index (FSFI), Arizona Sexual Experience Scale (ASEX), and semi-structured qualitative interviews exploring subjective experiences, attributions, psychosocial impact, and help-seeking barriers.

Results: Sexual dysfunction (FSFI>26.55) was present in 91.4% of participants (mean score 19.8±5.6), with highest impairment in desire (88.6%), arousal (85.7%), and orgasm (80.0%). ASEX indicated medication-related dysfunction in 77.1% (mean 21.4±4.8). Dysfunction correlated significantly with antipsychotic dose (r=0.58, p<0.001), prolactin-elevating medications (p=0.012), and reduced quality of life (r=-0.61, p<0.001). Qualitative analysis revealed five themes: pervasive silence and stigma; attribution confusion and self-blame; cascading relational impact; healthcare system silence (only 5.7% ever asked about sexual function); and maladaptive coping including medication non-adherence (31.4%). These findings directly informed intervention development: Session 1 addressed permission-giving and psychoeducation targeting identified stigma and knowledge gaps; Session 2 provided domain-specific behavioral strategies and communication skills addressing prevalent impairments.

Conclusion: Women with schizophrenia in remission experience multidimensional sexual dysfunction significantly impacting relationships and quality of life, yet it remains systematically unaddressed. Mixed-methods assessment proved essential for developing culturally appropriate, evidence-informed PLISSIT interventions targeting identified biopsychosocial needs within feasible two-session formats suitable for routine psychiatric care.

Factors associated with severity of alcohol dependence: Evidence from a hospital-based study in South India

Bharat M. Mohan, M. Poonam¹

Shridevi Institute of Medical Science and Research Institute, Tumakuru, ¹KVG Medical College and Hospital, Sullia, Karnataka, India

Background: Alcohol Dependence Syndrome (ADS) is a growing public health problem in India, with increasing severity, especially in southern states. Identifying clinico-sociodemographic correlates of severity can guide targeted interventions.

Aims: To assess the clinico-sociodemographic profile of ADS patients and its association with severity.

Methods: A hospital-based cross-sectional study was conducted in the Psychiatry Department of KVG Medical College and Hospital, Karnataka. One hundred patients (16 years) meeting ICD-10 criteria for ADS were included by universal sampling. Clinical and sociodemographic data were collected using a semi-structured proforma. Severity was assessed using SAD-Q, psychiatric comorbidities using MINI-PLUS, and withdrawal severity using CIWA-Ar. Data were analyzed using SPSS-21.

Results: Most patients were middle-aged males (mean age 43.1 years), married, from nuclear families, and rural backgrounds. Moderate dependence was most common. Tobacco dependence was the commonest comorbidity, while generalized anxiety disorder was associated with severe dependence. Withdrawal symptoms were the primary reason for treatment seeking. Severity showed significant associations with multiple sociodemographic variables, clinical factors, and laboratory parameters.

Conclusion: ADS predominantly affected middle-aged rural males. Severity was influenced by distinct sociodemographic, clinical, and biochemical factors, underscoring the importance of comprehensive assessment and individualized management.

Biochemical characteristics among patients with suicide attempt survivors and parasuicide patients

Bharti Manjhi, Sunil K. Ahuja

Department of Psychiatry, Sham Shah Medical College, Rewa, Madhya Pradesh, India

Background: Suicide is a major public health challenge, causing immense emotional and economic burden. While numerous studies explore the link between biochemical markers and suicidal behavior, limited research differentiates between suicide attempt survivors and parasuicide patients-those engaging in non-fatal self-harm without clear suicidal intent. Understanding these differences is crucial for targeted intervention.

Aims and Objectives: 1. To analyze the biochemical correlation among suicide attempt survivors and parasuicide patients. 2. To compare the clinical profiles of both groups.

Materials and Methods: This was a hospital-based, cross-sectional study conducted at the Department of Psychiatry, Shyam Shah Medical College, Rewa (M.P.), over 6 months. A total of 65 patients who survived a suicide attempt or exhibited parasuicidal behavior and met inclusion criteria were enrolled from OPD, IPD, and casualty services. Patients requiring urgent critical care were excluded. After obtaining ethical clearance and informed consent, demographic and clinical data were collected using a semistructured proforma. Comprehensive clinical examination and psychiatric assessments were performed. Blood samples were analyzed for biochemical parameters including thyroid hormones (FT3, FT4, TSH), triglycerides, cortisol, and total cholesterol.

Results: Parasuicide is often linked to impulsivity, acute stress, and occurs more frequently in young females. It is associated with low HDL and total cholesterol, reduced thyroid hormones (FT3, TT4), and elevated cortisol, especially in repeat attempters. Completed suicide is more common in males, often premeditated, and tied to psychiatric disorders like depression. Similar biological changes-low cholesterol, thyroid dysfunction, and HPA-axis overactivity-are also seen in completed suicide cases.

Impulsivity, stressful life events, and sexual dysfunction in male patients alcohol dependence syndrome: Associations with severity and implications for relapse prevention

Bhaswati Pathak, Pooja V. Jadhav, J. Rajat, Dhanashree Akshatha, M. T. Sathyanarayana

Sri Siddhartha Medical College, Tumkur, Karnataka, India

Background: ADS severity is influenced by psychological and psychosocial factors related to relapse. Impulsivity, stressful life events, and sexual dysfunction are important relapse-related domains, but their combined association with ADS severity in rural Indian settings is less studied.

Aim: To assess impulsivity, stressful life events, and sexual dysfunction in married male patients with ADS and examine their association with ADS severity and relapse vulnerability.

Methodology: This cross-sectional study included 70 married males (21-60 years) diagnosed with ADS at a rural tertiary care hospital. ADS severity was assessed using SADQ, impulsivity using BIS-11, stress using PSLES, and sexual functioning using ASEX. Pearson’s correlation analysis was performed.

Results: The mean SADQ score was 25.88 ± 7.72, indicating moderate dependence. Sexual dysfunction was common (ASEX 18.91 ± 3.22), with 54.3% meeting dysfunction criteria. ADS severity showed significant positive correlations with impulsivity (r = 0.644, p < 0.0001), stressful life events (r = 0.515, p < 0.0001), and sexual dysfunction (r = 0.479, p < 0.0001). Duration of ADS was not significantly associated with severity with severity emerging as a more relevant indicator than duration (p>0.05).

Conclusion: Impulsivity, stress, and sexual dysfunction are significantly associated with greater ADS severity and represent key relapse-related vulnerabilities. Their combined presence may amplify dependence severity. Addressing these factors in treatment may reduce severity and support relapse prevention. with severity emerging as a more relevant indicator than duration.

A comparative study on efficacy of add-on flupirtine versus add-on ketorolac in the management of heroin withdrawal with tramadol

Bhavneesh Saini, Jivitesh Singh, Sumit Saini, Pir Dutt Bansal, Shaminder Singh

Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab, India

Introduction: Heroin withdrawal is frequently accompanied by significant musculo-skeletal pain, complicating detoxification. Tramadol-based regimens are widely used, but ceiling effect necessitate add-on agents. Ketorolac is effective but causes gastrointestinal (GI) side effects. Flupirtine provides analgesia without typical NSAID-related adverse effects, but evidence in opioid withdrawal is limited.

Aims: To compare the efficacy and tolerability of add-on Flupirtine versus add-on Ketorolac in managing heroin withdrawal with Tramadol.

Methods: This interventional comparative study included three inpatient groups of 60 each (Heroin dependence F11.2) receiving standard tramadol detoxification (300-400 mg till day 3, then tapered till day 10-12): Group 1- Flupirtine 100 mg TDS (days 2-7, then tapered); Group 2- Ketorolac 10 mg TDS (days 2-7, then tapered); Group 3- Control without NSAIDs/flupirtine. VAS and COWS were assessed at days 3,7,10, and discharge (day14). Tolerability, adverse effects, and patient satisfaction (0-10) were recorded.

Results: Baseline variables were comparable. Both Flupirtine and Ketorolac groups showed significantly greater reductions in VAS and COWS versus control at days 3,7 and 10 (p<0.05), with all groups comparable at day 14. In severe withdrawal (COWS>36), Ketorolac produced greater early reductions (days 3,7; p<0.05). The control group required higher rescue tramadol doses (p<0.05). Flupirtine had better tolerability (fewer GI side effects). Patient satisfaction was higher in both intervention groups (p=0.038, 0.041). More patients continued tramadol at discharge in the control group (p=0.010).

Conclusion: Flupirtine is an effective, better-tolerated add-on analgesic than Ketorolac for Heroin withdrawal, with comparable efficacy and superior GI safety. For severe withdrawal, Ketorolac offers greater early benefit.

Clinical correlates of thyroid dysfunction among female inpatients with bipolar disorder: A case-control study

C. Anushree

Institute of Mental Health, Madras Medical College, Chennai, Tamil Nadu, India

Background: Thyroid dysfunction, which is a common comorbidity in bipolar disorder (BD), with higher prevalence among women, is known to influence mood regulation, neurotransmission, and the course of the illness. However, there is limited research focusing on female bipolar disorder patients, which this study aims to address.

Aim: To compare sociodemographic, clinical, and treatment characteristics between female BD patients with and without thyroid dysfunction.

Methods: This case-control study will retrospectively review case records and laboratory data of female BD inpatients admitted between October 2024 and October 2025 at a tertiary care hospital. Approximately 30 cases (abnormal Thyroid Stimulating Hormone (TSH) levels) and an equal number of controls (normal TSH) will be included. Data on demographic, clinical, and treatment variables will be extracted using a structured proforma. Groups will be compared using t-tests and chi-square tests. Correlations between TSH values and illness duration, as well as lithium exposure, will be examined.

Results: On comparing the two groups, thyroid dysfunction is anticipated to be associated with a higher frequency of depressive polarity, longer duration of illness, and longer duration of lithium exposure.

Conclusion: By comparing clinical and treatment characteristics between female BD inpatients with and without thyroid dysfunction, this study aims to clarify clinical risk factors and reinforce the need for routine thyroid screening.

Technoference and its role in disrupting parent-child bonding

Chhtrajit Singh Juneja, Saurabh, Prerana Priyadarshini

Venkateshwara Institute of Medical Sciences and Hospital, Gajraula, Uttar Pradesh, India

Introduction: Technoference, the disruption of parent-child interactions due to smartphone use, has become a significant concern in modern parenting. This study examines the impact of technoference on parent-child bonding within Indian families, focusing on the frequency and context of smartphone use during caregiving tasks.

Objectives: The study aimed to assess the effect of technoference on parent-child bonding quality, using the Parent-Child Bonding Instrument (PCBI), and to analyze the correlation between technoference levels and bonding outcomes.

Methodology: A cross-sectional observational study was conducted with 100 parent-child dyads from outpatient services and community settings. Participants were parents aged 25-40 years with children aged 3 years and more. Data were collected using a semi-structured questionnaire and validated tools. Statistical analysis was done using Pearson’s correlation and chi-square tests.

Results and Observations: 41% of parents showed low bonding, 37% moderate bonding, and 22% high bonding. High technoference (85% using smartphones >3 hours daily) correlated with poor bonding (X² = 12.87, p = 0.001). Moderate technoference also negatively impacted bonding. 52% of parents felt distracted during interactions.

Conclusion: The study found that high and even moderate technoference negatively affects parent-child bonding. Findings will underscore the need for interventions to reduce digital distractions and promote healthier parent-child interactions.

Hospital-based versus domiciliary detoxification in alcohol use disorder: Which is better? A retrospective follow-up study

Chinar Sandesh Kharangate, Anil Rane

Institute of Psychiatry and Human Behaviour, Bambolim, Goa, India

Background: Detoxification of patients with alcohol use disorder during their index visit for de-addiction forms a crucial part of treatment often deciding the future course of the illness.

Aim: To study the socio-demographic and clinical correlates, and compare clinical outcomes of patients with alcohol use disorder receiving hospital-based versus domiciliary detoxification.

Methods: This was a hospital records-based retrospective follow-up study looking at historical and 1 year follow-up data of alcohol use disorder patients presenting for their first visit to a tertiary care psychiatry hospital and receiving detoxification. Two groups were identified, those receiving detoxification at home versus those receiving inpatient treatment for the same and their socio-demographic and clinical correlates were compared. A comparative analysis of their clinical outcomes was also done.

Results: The domiciliary group had higher non-follow-up rates compared to the inpatient group with over 90% of patients receiving domiciliary detoxification being lost to follow-up in less than 2 weeks. Patients with a more severe degree of withdrawal, irrespective of the setting of detoxification, had better follow-up rates however with higher relapse rates, while those presenting in milder withdrawal that did follow-up, the domiciliary group had better long-term outcomes.

Conclusion: The setting of detoxification does not play as important a part in the long-term outcomes of patients with alcohol use disorder when presenting with severe withdrawal as compared to those presenting with milder forms.

From desks to distress: Case series on school-based trauma leading to mental health crises in children

Chinar Sharma, Aparna Goyal

Institute of Human Behaviour and Allied Sciences, New Delhi, India

Background: Adverse childhood experiences in school including bullying, academic pressure, and peer exclusion, significantly contribute to psychiatric disorders. 20-30% of school children face such adversities, doubling mental health vulnerabilities. This case series highlights how these factors trigger acute crises, emphasizing early school-based interventions.

Aim: The aim is to demonstrate links between school traumas and psychiatric disorders in children. Objectives include detailing clinical presentations, diagnoses, and outcomes to guide preventive strategies in educational settings.

Methods: 3 cases from child & adolescent psychiatry ward IHBAS. Patients with school-related trauma as primary trigger, diagnosed per ICD-10 via multidisciplinary assessments (clinical interviews, psychological tests, and neuroimaging where indicated). Case 1: 14-year-old female with Emotionally Unstable Personality Disorder and Dissociative Disorder, triggered by bullying and isolation, presenting with dysregulation and dissociation. Case 2: 15-year-old female with Acute and Transient Psychotic Disorder, induced by harassment, featuring hallucinations and paranoia. Case 3: 16-year-old male with Dissociative Disorder, linked to bullying, manifesting as dissociative convulsions and somatic symptoms.

Results: Case 1: CBT and mood stabilizers reduced self-harm and improved regulation after 6 months. Case 2: Antipsychotics and supportive therapy achieved full remission in 4 weeks. Case 3: Trauma-focused CBT & SSRI resolved convulsions and somatic symptoms in 8 months. Early detection of school traumas correlated with better prognoses.

Conclusion: School-based traumas precipitate diverse psychiatric crises, underscoring the need for trauma-informed policies and integrated mental health support in schools to prevent escalation.

To determine the proportion of use of BATHE interview technique and its impact on patient satisfaction in the out-patient departments of a tertiary hospital

Chinmayi Chitale

Rajarajeswari Medical College and Hospital, Bengaluru, Karnataka, India

Background: BATHE (Background, Affect, Trouble, Handling, Empathy) is a brief psychosocial interviewing technique that supports patient-centred communication. Existing evidence shows BATHE improves patient satisfaction, but data from Indian tertiary OPDs are limited. Understanding its frequency of use and its association with satisfaction can inform communication-skills training and early psychiatric diagnosis in general medical settings.

Aim: To determine the proportion of outpatient consultations using BATHE in a tertiary hospital, and compare patient satisfaction between BATHE and non-BATHE consultations.

Methods: A cross-sectional study was conducted in the OPDs of RajaRajeswari Medical College and Hospital. Seventy-nine patients aged 18-65 years who consented were included using convenient sampling. BATHE usage was assessed using the BATHE Questionnaire, and patient satisfaction using the Consultation Satisfaction Questionnaire (CSQ). Patients were classified into BATHE vs non-BATHE groups based on their responses. Data analysis was done using SPSS.

Results: Of the 79 participants, BATHE technique was reported in 38 consultations (48%). Mean CSQ scores were higher in the BATHE group (64.76 ± 12) compared to the non-BATHE group (55.09 ± 25). This difference was statistically significant (p = 0.0002), indicating superior satisfaction when BATHE elements were used.

Conclusion: Less than half of routine OPD consultations incorporated BATHE, yet its use was associated with significantly higher patient satisfaction. Incorporating structured psychosocial interviewing techniques like BATHE into routine consultations may enhance communication and perceived quality of care. Expanding clinician training and encouraging routine implementation could help improve overall OPD patient experience in tertiary care settings with early diagnosis of psychiatric comorbidities.

Faces, figures, and feelings: Preoccupation with appearance, self-esteem, and body satisfaction in women diagnosed with polycystic ovarian syndrome – A cross-sectional study in a tertiary health care center

Chinmayie Vishwanath, Divya Kumari Sherigar, B. M. Krupa¹

Departments of Psychiatry and ¹Obstetrics and Gynaecology, Sapthagiri Institute of Medical Sciences and Research Center, Bengaluru, Karnataka, India

Background: Polycystic ovary syndrome (PCOS) is a common endocrine disorder in reproductive-age women, marked by obesity, hirsutism, acne, and menstrual irregularities, contributing to body dissatisfaction and low self-esteem. Psychosocial consequences, including negative body image and diminished self-worth, are under-recognized in routine care.

Aims: To evaluate preoccupation with perceived physical appearance, distress due to body dissatisfaction, and self-esteem, as well as to determine the associations between polycystic ovary syndrome (PCOS) clinical features and these measures.

Methods: This cross-sectional observational study recruited 60 women aged 18-40 years diagnosed with PCOS according to Rotterdam criteria from the obstetrics and gynecology services of a tertiary care center over three months. Participants completed sociodemographic and clinical profiles, the Body Image Concern Inventory (BICI), and Rosenberg Self-Esteem Scale (RSES) using structured questionnaire. Data were analyzed using descriptive statistics and appropriate inferential tests, with p<0.05 considered significant.

Results: More than half of the participants reported moderate to high levels of body image concern, and over one-third had low self-esteem scores. Women with higher BMI, clinically significant hirsutism, prominent acne, and menstrual irregularities had lower RSES scores. Greater symptom severity showed positive correlation with BICI scores and negative correlation with RSES scores, independent of sociodemographic variables.

Conclusion: PCOS represents a gender-specific mental health issue by uniquely affecting women’s physical appearance and reproductive function, domains shaped by sociocultural expectations, impacting psychosocial well-being, self-worth, and social functioning. These gendered mental health impacts are often under-recognized clinically, underscoring the need for routine psychological screening and body image interventions in PCOS management.

Behavioral and psychological symptoms in Alzheimer’s disease: Findings from a nationwide multicentre study in India

Ct Sudhir Kumar

Mental Health Action Trust, Kozhikode, Kerala, India

Background: Behavioral and psychological symptoms of dementia (BPSD) are common in Alzheimer’s disease (AD), increasing caregiver burden and complicating management. Nationwide data on BPSD in Indian patients with Alzheimer’s disease are limited.

Aim: To describe demographics, clinical characteristics, prevalence of BPSD in AD and the prescribing patterns in patients across multiple centres in India.

Methods: A retrospective case file study was conducted across 16 centres as part of a larger study. Data of 349 patients with Alzheimer’s disease were extracted and reviewed, including demographics, psychiatric and physical comorbidities, dementia severity, BPSD presence, and psychotropic prescriptions.

Results: Mean age of patients with AD was 71.57 years (SD = 9.44), with most aged 65-74 years (40.4%). Gender distribution was nearly equal; 46.7% were urban residents. Most were married (72.2%) and from the middle socioeconomic group (54.7%). Dementia severity was mild in 27.8%, moderate in 49.3%, and severe in 22.9%. BPSD were present in 270 patients (77.4%), including 66% of mild, 82% of moderate, and 81% of severe degree; 134 were female. Common symptoms were agitation/aggression (43.3%), night-time disturbed behaviours (39.8%), and irritability/lability (35.2%). Other BPSD included depression/dysphoria (17.8%), hallucinations (14.9%), anxiety (15.5%), motor disturbances (16.3%), delusions (13.7%), apathy (13.2%), appetite disturbances (14.3%), and disinhibition (9.7%). Among those with BPSD, 90.7% received dementia medications, 72.6% antipsychotics, 24.1% antidepressants, 15.6% sedatives, and 3.0% mood stabilizers. 53% of patients with BPSD and 64% of their relatives were receiving psychosocial interventions

Discussion: BPSD are highly prevalent across all dementia severities in India, highlighting the need for directed interventions.

Emotional and behavioral challenges of adolescent girls: A school-based study

Dasari Ashalatha, M. Manasa

Alluri Sitarama Raju Academy of Medical Sciences, Eluru, Andhra Pradesh, India

Introduction: Adolescence is a developmental stage marked by significant emotional, psychological, and behavioural changes, often expressed through emotional difficulties, conduct issues, hyperactivity, and problems in peer relationships. In India, the prevalence of emotional and behavioural problems among school-going adolescents ranges from 13.7 to 50%. As middle adolescence (14-17 years) is a vulnerable developmental period marked by emotional sensitivity, identity formation, and increased academic and social pressures, especially girls are particularly prone to unnoticed internalising problems such as anxiety, depression, and peer difficulties.

Aim: To assess the proportion of adolescents experiencing social and behavioural difficulties and analyse their relationship with key sociodemographic factors.

Methods: A cross-sectional study was conducted among 100 school-going female adolescents aged 14-17 years. Participants were selected using a purposive sampling technique. After taking institutional ethical committee approval and informed consent from all participants and their parents, socio-demographic data and self-administered Strengths and Difficulties Questionnaire (SDQ) were collected. Statistical significance was set at p<0.05.

Results: Majority were 15 years old girls (47%), belonged to Grade 10 (60%) and were of the Hindu religion (81%). Based on SDQ scores, 16% of participants had a high likelihood of clinically relevant emotional or behavioural problems and 25% were at risk. Significant correlations were observed among emotional symptoms, conduct problems, peer problems with hyperactivity and also peer problems with conduct problems.

Conclusion: These findings underscore the need for early school-based screening and targeted mental-health interventions to address emerging problems in this vulnerable group.

Challenges in admissions and discharges in relation to mental health care act at a neuropsychiatric institute: A retrospective chart review

Deepa Gupta, Shipra Singh, Jay

Institute of Human Behaviour and Allied Sciences, New Delhi, India

Background: The Mental Healthcare Act (MHCA) 2017 emphasizes autonomy, rights, and least-restrictive care, but its practical implementation presents challenges. Difficulties commonly arise during admissions under Sections 85/86 when individuals seek shelter rather than clinical care, and during police-initiated admissions under Sections 100/102 involving homeless or unidentified persons. Discharge processes are further complicated by family refusal, lack of a Nominated Representative, unclear accountability, and inadequate community support, leading to unnecessary prolonged hospitalization.

Aim: To examine challenges in admission and discharge procedures under the MHCA among patients admitted over six months and to understand strategies used to navigate these issues.

Methods: A retrospective chart review was conducted for adult patients admitted to male and female psychiatric wards of IHBAS over six months. Records with documented legal or procedural challenges in admission or discharge were included. Data on sociodemographics, clinical profiles, legal sections used, referral sources, admission barriers, discharge difficulties, and resolutions were extracted.

Results: Recurrent issues such as absent NR, incomplete identity verification, consent-related difficulties, family abandonment, and delayed legal decisions. Discharge delays frequently stemmed from caregiver refusal and lack of rehabilitation pathways. Resolutions commonly involved social work intervention, legal aid, and shelter-home referral.

Conclusion: Significant systemic and procedural hurdles persist in implementing the MHCA during admissions and discharges, particularly for homeless and unsupported patients. Identifying these barriers through chart review can inform administrative reforms, strengthen interagency coordination, and improve patient-centred, rights-based mental healthcare delivery.

Anti-inflammatory agents as treatment for depression: A network meta-analysis

Dev Himanshubhai Desai, Himanshu Desai¹, Archana Javadekar

Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pune, Maharashtra, ¹GIPS Psychaitric Clinic and Deaddiction Centre, Ahmedabad, Gujarat, India

Background: Neuroinflammation has a significant role in depression. Anti-inflammatory agents can be a potential new therapy for depressive disorders.

Aim: To evaluate different anti-inflammatory agents to compare their efficacy, acceptability and remission rates.

Method: A comprehensive search was conducted across multiple databases, and eligible RCTs were identified. The primary outcome measured efficacy, while the secondary outcome measured acceptability and remission. Anti-inflammatory agents were used as stand-alone and compared against a placebo or they were used adjunctively to a standard of care and compared against that standard of care and placebo. Odds ratios with 95% CI were used for the results. CiNEMA and REVMAN 5.4 were used.

Results: A total of 58 studies were included in this network meta-analysis. Agents like Omega-3 Fatty acids, NSAIDs, Corticosteroids, Minocycline, Monoclonal antibodies, N-Acetyl Cysteine, Statins, & Pioglitazones were compared. In terms of efficacy, anti-inflammatory agents demonstrated a significant antidepressant effect compared to placebo (OR=1.58 (1.29-1.94)). All cause drug dropout rates were similar between the treatment and placebo groups (OR=1.00 (0.83-1.19)). Remission rates were significantly improved in the treatment group (OR=1.71 (1.27-2.29)). Indirect comparison was conducted using SUCRA values to create a league rank table.

Conclusion: This network meta-analysis shows a significant antidepressant effect of anti-inflammatory agents as well as their tolerability. Adjunctive therapy with anti-inflammatory agents can be effective in treating MDD. When more than 3 RCTs are available, Statins show the best efficacy, followed by NSAIDs, while NSAIDs exhibited the highest acceptability and best Remission rate.

Effectiveness of add-on atomoxetine in improving negative symptoms and cognitive function in schizophrenia: An interventional comparative study

Devendra Sikhwal, Jai Singh Yadav

Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India

Background: Negative symptoms and cognitive deficits are core features of schizophrenia and are major predictors of poor functional outcome. Current antipsychotics show limited efficacy in treating these domains. Atomoxetine, a selective norepinephrine reuptake inhibitor, enhances cortical norepinephrine and indirectly prefrontal dopamine levels, suggesting potential benefit in improving negative and cognitive symptoms. Evidence from limited trials indicates mixed but promising effects.

Aim: To evaluate the effectiveness of add-on atomoxetine with second-generation antipsychotics compared to antipsychotic monotherapy on negative symptoms and cognitive functioning in schizophrenia.

Methods: This interventional study was conducted at the Department of Psychiatry, Institute of Medical Sciences, Banaras Hindu University from May 2024 to November 2025. Fifty-seven patients (18-50 years) diagnosed with schizophrenia (ICD-11) with prominent negative symptoms were consecutively recruited and assigned to:

Group A: Second-generation antipsychotic monotherapy (chlorpromazine equivalent 400 mg/day)

Group B: Same regimen plus atomoxetine 40 mg/day

Assessments using PANSS and the Hindi MoCA were performed at baseline, 3 weeks, and 6 weeks. Statistical analysis is in progress, which includes Chi-square and t-test/ANOVA with p<0.05 considered significant.

Expected Results: Add-on atomoxetine is expected to result in greater improvement in negative symptoms and cognitive functioning than antipsychotic monotherapy.

Conclusion: Atomoxetine augmentation may represent a promising therapeutic strategy to improve negative and cognitive symptoms in schizophrenia and enhance long-term functional outcomes.

Nomophobia and its association with anxiety and sleep quality in medical interns: A cross-sectional study

Devika, S. V. Santosh

Hassan Institute of Medical Sciences, Hassan, Karnataka, India

Background: Smartphone dependence is a growing behavioral concern among medical trainees. Nomophobia, the fear of being without a mobile phone may influence anxiety, concentration, and sleep quality, potentially affecting clinical performance.

Aims: To determine the prevalence and severity of nomophobia among medical interns and examine its association with anxiety, smartphone use, and sleep quality.

Methods: A cross-sectional study was conducted among 100 medical interns using the Nomophobia Questionnaire (NMP-Q), GAD-7, and the Pittsburgh Sleep Quality Index (PSQI). Participants reported daily smartphone use, non-academic screen time, and perceived clinical distraction. Descriptive statistics, cross-tabulations, and Pearson correlations assessed relationships between nomophobia, anxiety, smartphone use, and sleep quality.

Results: The mean nomophobia score was 72.44, with most interns showing moderate nomophobia. The mean GAD-7 score was 12.57, indicating moderate anxiety. The mean global PSQI score was 6.82, reflecting poor sleep quality. Nomophobia correlated positively with total smartphone use (r = 0.29, p = 0.013) and PSQI scores (r = 0.28, p = 0.015), indicating that higher nomophobia was associated with poorer sleep quality. Its correlation with anxiety was weak and non-significant (r = 0.08, p = 0.49). Many interns reported distraction during clinical duties due to frequent phone checking.

Conclusion: Nomophobia is highly prevalent among medical interns. Higher nomophobia is significantly associated with increased smartphone use and poorer sleep quality, though not with anxiety. These findings highlight the need for digital well-being interventions and institutional policies promoting responsible smartphone use to safeguard interns’ sleep and clinical performance.

Patterns of psychiatric referrals from the emergency department: A retrospective study

Devika, S. V. Santosh

Hassan Institute of Medical Sciences, Hassan, Karnataka, India

Background: Psychiatric emergencies in the emergency department (ED) include a range of acute mental health presentations. Understanding their distribution and outcomes is vital for resource planning and timely intervention.

Aim: To examine the pattern, demographic profile, psychiatric diagnoses, and inpatient admission rates among patients referred from the ED to psychiatry over a 3 month period.

Methodology: This retrospective analysis included 155 consecutive psychiatric referrals from the ED, using data from the psychiatry department referral register. Extracted information comprised demographics, psychiatric diagnosis (per institutional diagnostic criteria), and admission status. Descriptive statistics summarized referral patterns and clinical outcomes.

Results: The most frequent referrals were for alcohol use disorders (n = 88) and panic disorder/acute anxiety presentations (n = 21). Panic disorder referrals predominated among females aged 18-25 years, while alcohol use referrals were more common in males aged 30-50 years. Of the 155 referrals, 43 (27.7%) required inpatient admission: 20 with alcohol use disorders, 12 with psychotic disorders, 4 with bipolar disorder, 3 with panic disorder, 3 with depressive disorder, and 1 with a dissociative disorder.

Conclusion: Alcohol use disorders and panic/anxiety presentations are the leading psychiatric referrals from the ED in this sample, exhibiting clear age and gender trends. Over one quarter of referrals required inpatient care, highlighting the burden on ED and inpatient psychiatric services. These findings support the need for strengthened emergency psychiatry protocols, targeted training for ED staff, and efficient triage systems to manage mental health crises promptly.

Cannabis use and benzodiazepine dependence: Clinical implications from a mixed-methods study

Dheerendra Kumar Mishra

Government Medical College, Satna, Nimi, Madhya Pradesh, India

Introduction: Benzodiazepine (BZD) dependence is an emerging challenge in addiction psychiatry, characterized by withdrawal morbidity and risk of chronic use (1,2). Cannabis, a commonly co-used psychoactive substance, is often perceived as anxiolytic or sleep-promoting, but its role in shaping the clinical course of BZD dependence remains unclear (3,4). This study examined the influence of cannabis use on BZD withdrawal severity, illness duration, and treatment engagement.

Methods: A cross-sectional mixed-methods design was employed among individuals diagnosed with BZD dependence at a tertiary-care psychiatric service. Participants were grouped into BZD-only and BZD + Cannabis categories. Withdrawal severity was rated using the Clinical Institute Withdrawal Assessment Scale-Benzodiazepines (CIWA-B), and cannabis involvement was assessed with the Cannabis Use Disorders Identification Test-Revised (CUDIT-R). Semi-structured interviews explored perceived benefits and consequences of cannabis use. Quantitative comparisons and thematic analysis were conducted.

Results: Among 108 participants, 52 reported BZD dependence alone, while 56 also had cannabis abuse. Mean duration of dependence was longer in the BZD + Cannabis group (234 ± 38 days) than in the BZD-only group (112 ± 32 days). Withdrawal scores were higher in the BZD-only group (18 ± 3) compared with the BZD + Cannabis group (10 ± 4). Qualitative findings indicated that cannabis was often viewed as a coping aid for insomnia and anxiety, but also contributed to reduced urgency in seeking professional care.

Conclusion: The findings suggest that cannabis co-use may blunt the expression of BZD withdrawal while simultaneously prolonging dependence and delaying treatment entry.

Assessment of sociodemographic profile and psychiatric manifestations in patients with human immunodeficiency virus infection – A hospital based cross-sectional study

Dhivyarakshna Thamodhar, Sumati Arikera, T. R. Chandrashekhar

Belagavi Institute of Medical Sciences, Belagavi, Karnataka, India

Background: People with HIV face a high burden of mental-health problems, worsened by stigma and limited mental-health resources in India. Although psychiatric disorders are common in PLHIV, they often remain under-recognized, highlighting the need for further research.

Aim and Objectives:

1. To assess the sociodemographic factor in patients with HIV infection.

2. To assess the psychiatric manifestations in patients with HIV infection.

3. To associate the sociodemographic profile with psychiatric manifestations.

Materials and Methods: This hospital-based cross-sectional study included 70 HIV-positive patients attending the ART Centre, Belagavi Institute of Medical Sciences, after IEC approval. After consent, socio-demographic details were collected, and psychiatric morbidity was assessed through a semi-structured interview following ICD-10 guidelines. Data analysis was performed using SPSS 20.0.

Results: Among 70 participants, most were male (61.4%), Hindu (67.1%), married (47.1%), from nuclear families (60%), lower socioeconomic groups (58.6%), and urban areas (55.7%). Overall psychiatric morbidity was 41.4%, with depression (11.4%) and substance-use disorder (8.6%) being most common. Higher psychiatric morbidity was observed among those from nuclear families and with a positive family history.

Conclusion: Psychiatric disorders, especially depression and substance-use disorders, are frequent in PLHIV and negatively influence ART adherence and clinical outcomes. Early identification and integration of mental-health services into HIV care are essential to improve treatment success and overall quality of life.

A comparative study of impulsivity and suicidality in early versus late opioid users

Dipanjana Hazra, Suresh Chakravarti

Gauhati Medical College and Hospital, Guwahati, Assam, India

Background: Early initiation of opioid use is associated with higher impulsivity and greater vulnerability to suicidal thoughts and behaviours. Understanding how age of onset and impulsivity interact can guide targeted interventions.

Aims: To compare suicidality and impulsivity between early and late opioid users, and to examine the strength of association between impulsivity levels and suicidality within each group.

Methods: A cross-sectional study was conducted among 100 opioid-dependent individuals classified as early users (n = 53) and late users (n = 47). Suicidality was assessed using the Columbia Suicide Severity Rating Scale, and impulsivity using the Barratt Impulsiveness Scale. Group differences were examined using chi-square tests, t-tests, and ordinal logistic regression.

Results: Early users showed significantly higher suicidality (X² = 6.242, p = 0.023; t = 2.171, p = 0.016) and greater impulsivity. Logistic regression indicated that low and moderate impulsivity substantially reduced suicidality risk compared with high impulsivity. Among early users, low impulsivity reduced suicidality odds by about 99.5%, and moderate impulsivity by 98%. In late users, low impulsivity showed a near-zero odds ratio, while moderate impulsivity reduced odds by about 95%. The association between impulsivity and suicidality remained stronger in early users.

Conclusion: Early opioid use is associated with elevated impulsivity and suicidality. Impulsivity strongly predicts suicidality, with the highest risk in individuals with high impulsivity. These findings emphasize the need for early identification and focused interventions targeting impulsivity to reduce suicide risk.

Predictors of Adherence in Bipolar Disorder

Diptanu Pandey, Swapanjit Sarma

Department of Psychiatry, IIMSAR & DR. B. C. Roy Hospital, Haldia, West Bengal, India

Outline of Proposed Research Topic

Introduction: A high proportion of patients with bipolar disorder as well as patients with schizophrenia do not fully comply with treatment. Non-adherence is strongly associated with an increased risk of relapse, greater likelihood of hospital admission, and a longer duration of hospitalization once admitted. In the past three decades, a number of studies have sought to identify predictive factors for medication adherence in schizophrenia patients. Very few studies, however, have specifically explored this issue among patients with bipolar disorder.

Objective of Research: To examine how insight, side-effects, and drug attitude are related to medication adherence of number of Schizophrenia and Bipolar Disorder patients.

Materials and Methods:

i. Materials:

a. Demographic/Clinical Proforma: Age, gender, education, hospitalizations, etc

b. Medication Adherence Rating Scale (MARS-10)

c. Insight in Psychosis Questionnaire (VAGUS Model)

d. Drug Attitude Inventory (DAI-10)

e. UKU Side-Effect Rating Scale

ii. Methodology:

a) Study design / Experiment design:

A hospital based cross-sectional study.

b) Study population:

Patients with diagnosed Schizophrenia and Bipolar Disorder

c) Sample Size: 101

Result: Appropriate statistical prevalence and group comparisons will be done. Medication adherence, insight, attitude and impacts of side effects on medication adherence will be assessed with logistic regression models. The final result will be tabulated by December 2025. As per the priliminary analysis of the collected data so far, results are expected to be in line with the study of Ghosh P et el (2022).

Innovative teaching-learning methods in postgraduate academics: A perspective

Divya Hegde

St John’s Medical College, Bengaluru, Karnataka, India

Introduction: Traditional didactic teaching focuses primarily on knowledge transmission, while innovative methods uniquely strengthen communication and soft skills areas often under-emphasised in conventional postgraduate teaching. These strategies allow learners to practice communication in context, rather than merely understand it theoretically. This perspective explores the integration of innovative teaching-learning approachesmock courts, mock press conferences, and audiovisual series reviewsas tools to strengthen communication and interpersonal competencies in postgraduate medical training.

Methods: Three interactive pedagogical strategies were introduced to postgraduate learners in a structured academic setting. These methods incorporated reflection, peer and faculty feedback, and mapped outcomes.

1. Mock Court: Learners participated in medico-legal case hearings requiring evidence-based justification, respectful argumentation, and demonstration of professionalism under scrutiny.

2.. Mock Press Conference: Trainees addressed a simulated media panel and public health stakeholders, practicing clear messaging, avoidance of jargon, crisis communication, and responsible handling of sensitive information.

3.. Series Review: Selected clinical films and documentaries were reviewed and discussed to explore complex themes such as interprofessional dynamics, empathy, stigma, and sociocultural determinants of health.

Results: Postgraduates reported high engagement, reduced monotony, and increased motivation compared to traditional lecture formats. They demonstrated improved confidence in communicating complex clinical information in stressful or high-stakes environments. Postgraduates expressed that these activities helped them practice real-life scenarios safely, allowing trial & error, and guided correctionelements rarely available in conventional teaching. Overall feedback was strongly positive, with participants requesting more frequent inclusion of such simulation-based learning in academics as teaching-learning methods.

Gabapentin for alcohol use disorder: Reduction in heavy drinking and increase in abstinence: A case series from a tertiary care center

Divyam Goswami, Kenil Jagani

Pandit Deendayal Upadhyay Medical College, Rajkot, Gujarat, India

Background: Alcohol Use Disorder (AUD) is a chronic relapsing condition with limited pharmacotherapeutic options beyond standard anticraving agents. Gabapentin, a Gamma-aminobutyric acid (GABA) analogue, attenuates central nervous system hyperexcitability and craving. Although international trials support its efficacy, real-world data from India remain limited.

Aim: To evaluate the effect of Gabapentin on heavy drinking days (HDD) and abstinent days (AD) among patients with AUD.

Method: A retrospective case series was conducted involving five patients diagnosed with DSM-5 AUD who were initiated on Gabapentin 600 mg/day alongside routine psychosocial management. The number of HDD ( 5 drinks/day) and AD (0 drinks/day) during the 28 days before and after Gabapentin initiation were compared.

Results: All patients demonstrated substantial clinical improvement. Mean HDD decreased from 23.8 ± 9.4 (pre-treatment) to 1.2 ± 1.7 (post-treatment), and mean AD increased from 0.0 ± 0.0 to 23.2 ± 5.0 within four weeks. Individual case changes were as follows: Case 1 (28 †’ 0 HDD; 0 †’ 27 AD), Case 2 (28 †’ 3 HDD; 0 †’ 15 AD), Case 3 (28 †’ 0 HDD; 0 †’ 26 AD), Case 4 (7 †’ 0 HDD; 0 †’ 28 AD), and Case 5 (28 †’ 3 HDD; 0 †’ 20 AD). No adverse effects were reported.

Conclusion: Gabapentin was associated with marked reductions in heavy drinking and a parallel increase in abstinent days across all five cases. These findings highlight Gabapentin’s potential as an effective and well-tolerated adjunct in the management of AUD. Further prospective controlled studies are warranted.

Profile of neuroimaging and EEG in patients with psychiatric disorders: A neuropsychiatry clinic based study from India

Drishtant Sachan, Darpan Kaur, Rakesh Ghildiyal

Department of Psychiatry, Mahatma Gandhi Mission Medical College and Hospital, Kamothe, Navi Mumbai, Maharashtra, India

Background: Neuropsychiatry is an interesting interface of Psychiatry and Neurology.

Aims: To study profile of Neuroimaging and EEG in patients with psychiatric disorders.

Methods: This was a retrospective record based study where MRI, CT and EEG reports of patients with psychiatric disorders were analysed over the past 6 months. The records of patients with psychiatric disorders where Neuroimaging and EEG were advised as per clinical care across OPD, IPD and CLP setting, referred to neuropsychiatry clinic were included. Data collection form was pre designed comprising variables such as age, sex, profile of MRI, CT & EEG, Neurological and Psychiatric diagnosis. Institutional Ethical Committee clearance was obtained. Results were analysed using descriptive statistics and SPSS.

Result: We found that Neuroimaging and EEG studies were done in N=50. The mean age of the sample was 43.9 years. Gender profile of the sample comprised 44% male and 56% female. MRI reports comprised 52%, CT reports comprised 22% and EEG reports comprised 26% of the sample. Abnormal MRI Brain reports were found in 38 %, abnormal CT Brain reports were found in 14 % and abnormal EEG reports were found in 8 % reports. The most common MRI abnormality was Mild cerebral and cerebellar atrophy. The most common CT abnormality was chronic ischemic changes. The most common EEG abnormality was Bifrontal slowing of theta range. The most common Neurological condition was Dementia and the most common Psychiatric diagnosis was Schizophrenia.

Conclusion: Our study expands horizons in Neuropsychiatry and has relevant clinical and research implications.

Instagram use and its association with body image dissatisfaction, self-esteem, and depression among medical students – A cross-sectional study

B. Farheena Thasneem, P. Swathi

Andhra Medical College, Visakhapatnam, Andhra Pradesh, India

Background: Instagram, a highly visual social media platform, is widely used among young adults and may influence appearance perception. Frequent exposure to image-based content can lead to body image dissatisfaction, lower self-esteem and depression, making it important to study these associations among medical students.

Aims and Objectives: To assess Instagram usage patterns and the prevalence of body image dissatisfaction among undergraduate medical students using Instagram, and to examine its association with body image dissatisfaction, self-esteem, and depressive symptoms.

Methods: A cross-sectional study involving 334 undergraduate medical students was conducted. Data on Instagram usage patterns, body image dissatisfaction (Body Shape Questionnaire-16B), self-esteem (Rosenberg Self-Esteem Scale), and depressive symptoms (PHQ-9) were collected.

Results: Instagram was the primary image-based platform for most participants. Body image dissatisfaction was predominantly mild to moderate, with low self esteem and mild depressive symptoms. Instagram use showed a significant association with higher body image dissatisfaction, which correlated positively with depressive symptoms and negatively with self-esteem.

Conclusion: Body image dissatisfaction, self-esteem, and depressive symptoms were interrelated among Instagram users, reflecting the psychological impact of social media. These findings highlight the need for awareness and interventions that promote healthier online engagement and support positive body image and mental well-being in medical students.

Key words: Body image dissatisfaction, Instagram, medical students, self-esteem, social media

Knowledge, attitude and practice (KAP) about people with psychiatric illness and psychiatry referrals among non-psychiatric specialist doctors in a medical college hospital

V. S. Gaurav, Virupakshi Jalihal, Asmita Mukund Toro, S. Sai Nikhil

Ramaiah Medical College and Hospital, Bengaluru, Karnataka, India

Background: Morbidity due to psychiatric illnesses in patients with physical illnesses has been found to be 31-34.5 %. Psychiatry referral rates are 0.01- 3.6% for inpatients, 1.42-5.4% in emergency set-ups and 0.06-7.17% in outpatients indicating significantly low referral rates compared to those having psychiatric comorbidities. KAP are known to influence referrals.

Aims: To assess KAP about psychiatric illness and psychiatry referrals among non-psychiatric specialist doctors.

Methods: Cross-sectional online survey (Google Form) was sent to all (N=289) specialist doctors. It contained Informed consent, Sociodemographic details, Mental Health Knowledge Schedule (MAKS), Mental Illness Clinician’s Attitude Scale (MICA-4) and Reported and Intended Behaviour Scale (RIBS), and thirteen face validated questions regarding referrals to Psychiatry. The survey was open until atleast 25% of participants responded.

Results: The survey response rate was 28% (n=81). The mean MAKS, MICA-4 and RIBS scores were 48.98+/-2.95, 44.06+/-9 and 15.4+/-2.97 respectively indicating higher knowledge yet negative attitudes and stigmatizing behaviors toward psychiatry. Negative correlation between MAKS and MICA-4 indicating those with more knowledge had lesser stigmatizing attitudes, positive correlation between MICA and RIBS indicating negative attitude resulting in stigmatizing behaviors was observed. Unwillingness of the patient (76.5%), Stigma towards psychiatry (53.1%), Insurance coverage (29.6%) were common reasons for non- referral.

Conclusion: Most specialists had greater knowledge about psychiatric illness yet stigmatizing attitudes and behaviors which are barriers to treatment, strategies to overcome these barriers will improve patient outcomes.

Parenting 2.0: An adaptive framework for responsive and resilient child development in the Kerala context

Gayathri Rajan

Aster MIMS, Kozhikode, Kerala, India

Background: Kerala, India, presents a critical paradox of high socioeconomic development coexisting with elevated youth psychopathology, including one of India’s highest suicide rates (26.9 per 100,000). Developmental risk factors stem from intense academic pressure/parental expectations, fragmented caregiving due to transnational migration (“Gulf Syndrome”), and pervasive digital immersion. These interwoven stressors contribute significantly to adolescent anxiety and depression.

Aims: To construct and validate a Culturally Attuned Adaptive Parenting 2.0 (CAAP 2.0) framework. This framework is designed to move family dynamics beyond a transactional achievement orientation towards responsive, resilience-building interactions, explicitly addressing the unique cultural, academic, and digital demands of the Keralite context.

Methods: The framework validation proposes a rigorous mixed-methods study (Concurrent Nested Design: QUAN/QUAL). Implementation fidelity and cultural acceptability will be guided by the RE-AIM framework, utilizing qualitative data from Focus Group Discussions (FGDs) with community stakeholders. Clinical efficacy will be measured quantitatively using established tools such as the Child and Youth Resilience Measure (CYRM) and the Strengths and Difficulties Questionnaire (SDQ).

Results: The CAAP 2.0 is structured around three pillars: Adaptive Emotional Scaffolding, Resilient Skill Cultivation, and Critical Digital Stewardship (P2.0). The core mechanism is Strategic Autonomy Granting within collectivist norms, facilitating the internalisation of values and psychological flexibility over external, coerced obedience, thereby directly mitigating toxic stress.

Conclusion: CAAP 2.0 offers a scalable, evidence-based intervention for preventive mental health in transitional, high-stress societies. It provides a crucial pathway for policymakers and clinicians to cultivate psychological resilience in South Asian youth proactively.

The role of childhood neglect in patients with functional neurological symptoms disorder: A case series

Gayatri Deepak Gaikwad, Suhani Desai

Vedantaa Institute of Medical Sciences, Palghar, Maharashtra, India

Introduction: Conversion disorder/Functional neurological symptom disorder (FNSD) is diagnosed when a person has one or more symptoms of altered voluntary motor or sensory function, which are inconsistent with a recognized neurological disease, involuntary and produce significant impairment in daily activities, not otherwise explained as a result of substance use. The gain from these episodes is primarily psychological and not social, monetary or legal. Studies have found that psychological stressors as well as coping mechanisms play an important role in the etiology of FNSD.

Aim: This research study aims to achieve a better understanding of the role of upbringing and childhood neglect in the development of FNSD.

Methodology: Qualitative interviews were conducted for the patients (> 18 years of age) fulfilling the diagnostic criteria according to DSM-5 for Conversion disorder with emphasis on their childhood and interpersonal relationships. The data was analysed by the principal investigator in the form of multiple case studies. Sample size – 10.

Conclusion: It was observed that patients who had to take up responsibilities of caregivers for their family members early in their adolescence or childhood and experienced neglect from family developed to be hyper-independent or did not know how to express their needs and desires as adults which led to unfulfilled physical and emotional needs. It also led to development of unhealthy coping mechanisms. It was also observed that the majority of these cases had lower educational backgrounds and a few reported emotionally unavailable significant others.

Key words: Childhood neglect, conversion disorder, coping mechanisms

Relapse frequency and defense mechanism patterns in alcohol dependendence – A cross sectional study from a tertiary care centre

K. Geethanjali, Riswana Fathima

Tirunelveli Medical College, Tirunelveli, Tamil Nadu, India

Background: Alcohol Dependence Syndrome remains one of the most prevalent substance-use disorders in India, with high relapse rates despite available treatment modalities. Psychological factors particularly defense mechanisms may play a crucial role in vulnerability to relapse, yet limited Indian data exist examining their relationship.

Aim: To assess relapse frequency among individuals with ADS and to explore the association between predominant defense mechanisms and relapse patterns in a tertiary care setting.

Methods: This cross-sectional study was conducted in the De-addiction Clinic of a tertiary care psychiatric centre. A total of 40 participants diagnosed with Alcohol Dependence Syndrome (ICD-11/DSM-5 criteria) were recruited through consecutive sampling. Sociodemographic and clinical details, including duration of dependence and treatment history, were collected using a semi-structured proforma. Relapse frequency in the past was recorded. Defense mechanisms were assessed using the Defense Style Questionnaire-40 . Participants were categorized into low, moderate, and high relapse-frequency groups. Statistical analyses included chi-square tests, ANOVA, and correlation methods to examine associations between defense styles and relapse.

Results: It is anticipated that individuals with higher relapse frequency will show significantly greater use of maladaptive defense, whereas those with fewer relapses will show higher use of mature defenses Sociodemographic and clinical correlates influencing relapse patterns will be identified.

Conclusion: Understanding the relationship between defense mechanism, patterns and relapse frequency can help clinicians tailor psychological interventions for ADS. Strengthening mature defenses through psychotherapy may reduce relapse risk and improve long-term outcomes. The findings provide insight for enhanced relapse-prevention strategies in tertiary care settings.

Study of EEG patterns in children and adolescents with ADHD and their controls in different brain regions

Gopal Krishna Swain^1,2, Jaisingh Yadav¹

¹IMS, BHU, Varanasi, ²AIIMS, Gorakhpur, Uttar Pradesh, India

Background: ADHD is a neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity. Objective biomarkers for diagnosis remain limited.

Aim: To compare EEG patterns in children and adolescents with ADHD with healthy controls across different brain regions.

Methods: EEG recordings were obtained from clinically diagnosed ADHD patients and age-matched controls. Frequency bands (delta, theta, alpha, beta) were analyzed and compared across brain regions.

Results: The ADHD group demonstrated increased theta and delta activity and reduced alpha and beta power, predominantly in frontal regions.

Conclusion: EEG patterns in ADHD show distinct neurophysiological abnormalities. EEG may serve as a useful investigative tool for understanding and supporting the diagnosis of ADHD.

A multidimensional assessment of socio-demographic, lifestyle, BMI, and family history factors associated with antipsychotic-induced weight gain in a tertiary care hospital

K. G. Gopika

Basaveshwara Medical College & Hospital, Chitradurga, Karnataka, India

Background: Antipsychotic-induced weight gain (AIWG) is a common and clinically significant adverse effect that increases cardiometabolic risk and negatively impacts treatment adherence. Identifying socio-demographic predictors helps guide early preventive strategies.

Aim: To assess socio-demographic, lifestyle, BMI and family history factors associated with antipsychotic-induced weight gain in a tertiary-care hospital.

Methods: A prospective observational study was conducted among 100 adults newly initiated on antipsychotic drugs and followed for 6 months. Socio-demographic variables, baseline BMI, lifestyle habits, occupation, socioeconomic status, and family history of medical comorbidities were recorded. Weight was assessed at baseline and at follow-up. Statistical analysis were done.

Results: Weight gain was higher in the middle aged group (80%) compared to younger individuals and older adults. Females showed greater weight gain than males (75% vs. 60%). Urban and rural participants, and religion wise had nearly similar prevalence. Weight gain was highest among those with lower education (66.7%) and among unemployed/homemakers (92%). Lower socioeconomic status had a stronger association, with the lowest SES showing 80% weight gain. Married individuals had higher prevalence (60%) compared to single or divorcee/widower groups. Participants with a positive family history of metabolic or cardiovascular illness had more weight gain (75%) than those without. Baseline BMI showed a graded pattern, with overweight (76.9%) and obese individuals (100%) gaining more weight. Smoking and alcohol intake showed no significant differences.

Conclusion: Weight gain was substantial during the first 6 months of antipsychotic therapy, especially among socio-demographically vulnerable groups. Early monitoring and lifestyle interventions are essential to prevent long-term metabolic complications.

A cross-sectional study of self-esteem, psychopathology and quality of life among patients suffering from vitiligo

Gunjan Miniyar, Utkarsh Mestri, Shilpa Adarkar

Department of Psychiatry, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India

Introduction: Vitiligo is a chronic depigmenting skin disorder that significantly affects physical appearance and psychosocial well-being. Beyond cutaneous manifestations, vitiligo is associated with low self-esteem, psychological distress, and impaired quality of life due to social stigma and altered body image. The unpredictable course and visible nature of lesions often contribute to anxiety, depression, and social withdrawal. Given these psychosocial consequences, it is important to evaluate the psychological impact of the condition alongside its clinical features. This study was conducted to assess self-esteem, psychopathology, and quality of life among patients suffering from vitiligo.

Methods: After obtaining IEC approval total of 80 adult patients aged 18-65 years diagnosed with vitiligo were included. Patients with psychiatric or medical comorbidities that could interfere with assessment were excluded. Sociodemographic details were collected using a semi-structured proforma. Self-esteem was assessed using the Rosenberg Self-Esteem Scale, and health-related quality of life was evaluated using the Dermatology Life Quality Index. Depression, anxiety, and stress were assessed using the DASS-21.

Results: Most patients experienced measurable impairment in quality of life, with a substantial proportion reporting moderate to severe impact. Depression, anxiety, and stress symptoms were prevalent among participants, and nearly one-fifth exhibited low self-esteem. A significant association was observed between the type of vitiligo and the degree of quality-of-life impairment.

Conclusion: These findings demonstrate that vitiligo imposes a considerable psychological burden and adversely affects quality of life. Incorporating routine psychosocial screening and appropriate mental health interventions into standard dermatological care may help improve overall patient outcomes.

Assessment of insomnia and self-esteem among sub-jail prisoners: A cross-sectional study

Guttakada Vishnu Vardhan, O. Sindhuja, Kishore Kumar Rokkam

Santhiram Medical College and General Hospital, Udumalpuram, Andhra Pradesh, India

Background: Sleep disturbances and low self-esteem are common but often overlooked among incarcerated individuals. Overcrowding, restricted autonomy, psychological stress, and inadequate sleep environments increase vulnerability to insomnia and negatively influence self-worth. Despite global evidence, data from Indian sub-jails, particularly in Andhra Pradesh, remain limited. Understanding these concerns is essential to guide targeted interventions in correctional settings.

Aim: To assess the severity of insomnia and levels of self-esteem among sub-jail prisoners in Andhra Pradesh and to examine the association between them.

Methods: A cross-sectional study was conducted among 60 prisoners aged 18-65 years. Sociodemographic and prison-related details were collected using a structured proforma. Insomnia severity and self-esteem were assessed using the Insomnia Severity Index (ISI) and Rosenberg Self-Esteem Scale (RSES), respectively. Data were analyzed using descriptive statistics and chi-square tests, with significance set at p < 0.05.

Results: Subthreshold insomnia (41.7%) and moderate insomnia (28.3%) were most common, while 11.7% reported severe insomnia. Low self-esteem was observed in 36.7% of participants. A significant association was found between insomnia severity and self-esteem (X² = 13.11, p = 0.041), indicating that higher insomnia scores were linked with lower self-esteem. Gender (p = 0.041) and family income (p = 0.042) were significantly associated with insomnia, while type of offense (p = 0.029) showed a significant association with self-esteem.

Conclusion: Insomnia and low self-esteem are prevalent among sub-jail prisoners, and their association highlights unmet mental health needs. Routine screening, sleep-focused interventions, and structured rehabilitation programs may improve psychological well-being.

A comparative study of emotional intelligence among alcohol dependent patients and normal adults

Harini Kurapati, B. Sai Ram

Andhra Medical College, Government Hospital for Mental Care, Vishakapatnam, Andhra Pradesh, India

Background: Emotional intelligence refers to the ability to perceive, understand, and manage one’s own emotions and relationships. It involves being aware of emotions in oneself and others and using this awareness to guide thinking and behaviour. Emotional intelligence Plays a key role in emotional regulation, interpersonal functioning and coping . Individuals with alcohol use disorder often show impairments in emotional processing, yet comparative data of EI deficits relative to healthy controls remain limited.

Aim: To assess emotional intelligence in individuals with alcohol dependence and compare it with EI in healthy controls.

Methods: This comparative cross sectional study includes individuals diagnosed with Alcohol dependence attending a tertiary care centre and healthy controls . participants were assessed using a standardised emotional intelligence scale i.e Schutte self report emotional intelligence test (SSEIT). Participants were analysed using a sociodemographic proforma, clinical evaluation, and a standardised emotional intelligence scale . Emotional intelligence was assessed using an independent t -test .

Results: Individuals with Alcohol dependence demonstrated significantly lower Emotional intelligence scores compared to healthy controls

Conclusion: Emotional intelligence is markedly reduced in individuals with alcohol use disorder. These findings highlight the importance of integrating Emotional intelligence focused interventions in the assessment and rehabilitation of Alcohol use disorder patients.

Disparities in mental health services utilisation across gender: A retrospective study from tertiary care facility of Eastern India

Hariom Pachori, Avinash Sharma

Central Institute of Psychiatry, Ranchi, Jharkhand, India

Introduction: In India mental health service utilisation is still not symmetrical to all sections of the people. Despite significant progress in the field of public health as well as mental health still many people tend to refrain from availing scientific mental health service and treatment modes. There are observable differences in using of tertiary mental health services among people of different gender.

Aims and Objectives: This study is an endeavor to see the Disparities in Mental Health Services Utilisation Across Gender in a tertiary mental health facility located in the Eastern Region of the Republic of India.

Methodology: This study is retrospective in nature. This study is based on a retrospective analysis of routinely recorded patients’ related clinical data collected during 2012 and 2025.

Results: In the present study, it was noted that, within the span of 14 years, there is more than 70% increase in patients’ registration at OPD level. In the present study, it was noted that, in case of new as well as follow-up cases males have always constituted an overwhelming majority than females.

Conclusions: In the context of new cases (patients coming to the Institute for the first time), the number of male patients almost doubled during 2012 to 2025 and at the time of follow-up, this difference was seen to further increase to nearly 2½ times.

Key words: Gender difference, mental health, services utilisation

Severity and suicidal ideation in patients with depressive disorder visiting at a tertiary hospital – A cross-sectional study

Haritkumar Dhavalkumar Joshi, Saurav Kumar

G S Medical College and Hospital, Pilkhuwa, Uttar Pradesh, India

Introduction: Depression is a mood disorder that causes a persistent and pervasive feeling of sadness and loss of interest and can affect anyone. People who had stressful life events, severe loss or trauma, family history of depression are very likely to undergo depression. Suicidal ideation for suicidal attempts is common among people with mental health problems, particularly depression.

Aim: To study severity and suicidal Ideation in Patients with Depressive Disorder visiting at a tertiary hospital.

Objectives:

1. To find out the severity of depression in patients with depressive disorder

2. To assess suicidal ideation in patient with depressive disorder.

Methods: This is a cross-sectional observational study of 40 Depressive Disorder patients who visited the psychiatry department in a tertiary care hospital from May to October, 2024. After the diagnosis was made by two consultant psychiatrists using ICD-10-DCR, consent was taken, their sociodemographic details were collected. Severity of Depressive Disorder was assessed using Beck’s Depression Inventory (BDI), suicidal ideation was assessed by Becks Scale for Suicidal Ideation (BSS).

Result: Most patients scored high on BDI, significant correlation was found between the severity of Depressive Disorder and suicidal ideation.

Discussion: Our study correlated with previous studies . In our data, most of our patients that presented to us had higher severity of depression and had more suicidal ideation. Thus we conclude that suicidal ideation is associated with severity of depression.

Key words: Beck’s Depression Inventory (BDI), Becks Scale for Suicidal Ideation (BSS), depressive disorder

Effect of perceived stigma and interpersonal support on helpseeking behavior among suicide attempters – A cross sectional study

S. Harshitha, S. Karthick, C. Vigneshvar, P. Vimalanathane

Department of Psychiatry, Mahatma Gandhi Medical College and Research Institute, Puducherry, India

Background and Aims: Suicidal behavior remains a major health concern, with stigma such as judgment, blame, and social rejection -hindering help-seeking among suicide attempters. Interpersonal support plays a protective role by influencing individuals’ willingness to disclose distress and access care. This study examines the effect of perceived stigma and social support on help-seeking behavior which would help develop targeted interventions and prevent future attempts.

Methods: A cross-sectional study was conducted over one year. Patients were recruited from emergency-medical services and cross-referrals to psychiatry. Socio-demographic details and clinical history were obtained from patients and caregivers. Perceived stigma, social support, help-seeking behavior, anxiety, depression, and suicide intent were assessed using HADS, STOSA, ISEL-12, IASMHS, and Beck’s Suicide Intent Scale.

Results: A total of 98 participants with a mean age of 33.6 years, comprising (56.1 %) female and (43.9%) male with Parent being the most common care giver (36.7%). Most common mode of suicide attempt was agrochemical poisoning (38.8%) followed by drug or tablet overdose (29.6%). Participants demonstrated moderate help-seeking behavior (IASMHS=49.06±8.02) which did not differ significantly by gender (M=49.26±7.87 Vs F=49.91±8.51; p=0.838) and mode of suicide attempt (agrochemical poisoning =47.40 ±8.735; drug or tablet overdose =49.66±7.032; p=0.240). There was no significant correlation observed between perceived social support and help-seeking attitudes (ISEL-IASMHS : P=0.118), similarly stigma was also not significantly associated with help seeking (IASMHS-STOSA: p=0.902).

Conclusion: Perceived stigma and interpersonal support were not associated with help-seeking attitudes, suggesting that help-seeking behavior is multifactorial, highlighting the need for comprehensive and individualized suicide suicide prevention approaches.

Study of impulsivity, aggression and hostility among patients with current suicide attempt

Hemendra Singh, C. Swati, Ashwin Kulkarni

Department of General Medicine, MS Ramaiah Medical College, Bengaluru, Karnataka, India

Introduction: Suicide claims over 720,000 lives globally and about 73% occur in low-and-middle income countries. In the presence of impulsivity, aggression and hostility traits, a suicide thought may proceed to attempt.

Methodology: A total of 100 consecutive suicide attempters aged 18-60 presenting to tertiary hospital over a period of 1-year were recruited for this cross-sectional study. Demographic details were collected using structured proforma and validated tools were used to measure depression, hopelessness, suicide ideation, intent, impulsivity and aggression. Data was analysed using median and interquartile range, Bivariate Spearman’s correlation and Kruskal-Wallis test on SPSS 19 software.

Results: Most patients were from urban community (79%), aged below 30 years or less (62%), married (48%), unemployed (58%), and female (66%). There was significant correlation between aggression and depression (Þ=0.232, p=0.20) and between impulsivity and aggression (Þ =0.237, p=0.021); aggression and impulsivity were not correlated to suicide intent or ideation. The substrates of aggression - anger and hostility (Þ =0.277, p=0.005 and Þ =0.296, p=0.003) were significantly correlated to number of suicide attempts and hostility was significantly correlated (Þ =0.198, p=0.048) with suicide intent. The substrate of impulsivity - attention (Þ =0.214, p=0.039) was significantly correlated with total number of suicide attempts. There was significant difference in mean scores of anger (p=0.018) and hostility (p=0.048) across different methods of self-harm.

Conclusion: Patients with suicidal thoughts may require thorough evaluation of impulsivity, aggression and hostility as a part of risk assessment. Longitudinal studies are required to confirm the findings.

Key words: Aggression, hostility, impulsivity, suicide

Assessment of stress, depression and anxiety during pre-menstrual phase in females pursuing medical graduation

Himanshu Sareen, Garvit Shivran

PIMS Medical College & Hospital, Jalandhar, Punjab, India

Objectives: To assess stress, depression, and anxiety during the premenstrual phase among female medical students, to compare these parameters across different years of study, and to evaluate changes across the academic year and menstrual phases.

Methodology: This longitudinal observational study included all consenting female medical students across different years of medical graduation. Participants in the premenstrual phase (one week prior to menstruation) were assessed at three time points: retrospectively before the start of the academic year, during the course (six months after commencement), and one month prior to final examinations. A semi-structured proforma, Depression Anxiety Stress Scale-21 (DASS-21), and Menstrual Distress Questionnaire were administered. The same participants were reassessed during the post-menstrual phase up to one week after onset of menses to assess symptom relief. Data collection occurred in both pre- and post-menstrual phases at six months and before examinations. Statistical analysis was conducted to assess temporal, phase-wise, and year-wise differences.

Results: Higher mean scores of stress, anxiety, and depression were observed during the premenstrual phase compared to the post-menstrual phase across all years of study. Final-year students demonstrated significantly higher stress and anxiety scores, particularly prior to examinations, compared to 3rd and 2nd year students. First-year students showed relatively higher anxiety levels during the initial months of the course. Menstrual distress scores positively correlated with academic stress and year of study. Post-menstrual assessments showed partial to complete symptom relief in most participants. Premenstrual psychological distress varies significantly across different years of medical training and is exacerbated by academic stress.

A comparative study to assess occurrence of relapses in patients with schizophrenia on: Long acting injectables versus oral antipsychotic medications

Ilonika Raj, Deepanjali Medhi

Department of Psychiatry, Gauhati Medical College and Hospital, Guwahati, Assam, India

Background: Schizophrenia is a chronic psychiatric disorder marked by recurrent relapses, functional impairment, and high healthcare utilization. Medication adherence is a major determinant of relapse prevention, and long-acting injectable (LAI) antipsychotics are increasingly recognized as superior to oral antipsychotics for maintaining symptom stability and reducing hospitalization rates. This study aimed to compare relapse occurrence in schizophrenia patients receiving LAIs versus oral antipsychotics.

Methods: A hospital-based cross-sectional study was conducted in the Department of Psychiatry, Gauhati Medical College and Hospital, from September 2024 to August 2025. One hundred schizophrenia patients, diagnosed according to ICD-10 criteria and with a minimum illness duration of two years, were enrolled. Fifty received LAI antipsychotics (Group A) and fifty received oral antipsychotics (Group B). Data on socio-demographics, illness history, PANSS scores, treatment adherence, relapses, and hospitalizations were collected using standardized tools, including the PANSS scale and Modified Kuppuswami Scale. Statistical analysis included descriptive and inferential methods.

Results: Patients receiving LAIs demonstrated higher adherence (80% vs. 36%), lower relapse rates (24% vs. 60%), fewer hospitalizations (0.3 ± 0.6 vs. 1.1 ± 0.9), and lower mean PANSS scores (88.4 ± 18.2 vs. 95.6 ± 21.1) compared to those on oral antipsychotics. These results are consistent with previous studies showing improved clinical stability and reduced relapse risk with LAI therapy.

Conclusion: Long-acting injectable antipsychotics are associated with improved adherence, reduced relapse frequency, and lower hospitalization in schizophrenia patients, supporting their use as an effective maintenance strategy in chronic schizophrenia management.

Key words: Long-acting injectables, oral antipsychotics, PANSS, relapse, schizophrenia

The responsive brain: Functional near infrared spectroscopy reveals prefrontal hemodynamic differences in obsessive compulsive disorder patients

Isha Kanwal, Pankaj Kumar, Sambhu Prasad, Kamlesh Jha

AIIMS, Patna, Bihar, India

Background: Treatment outcomes are variable and to predict treatment response using clinical variables still comes across as a challeng in patinets with Obsessive Compulsive Disorder. Recent studies suggest that functional neuroimaging holds promise in personalized pharmacotherapy selection at treatment onset.

Novelty: Neuropsychological task based functional neuroimaging (functional Near Infrared Spectroscopy) is being used as a tool for understanding treatment outcome.

Aims and Objectives: To estimate the association of changes in oxy-Hb concentration in pre-frontal cortex in response to neuropsychological tasks (Trail Making Test and Verbal Fluency Test) using functional Near Infrared Spectroscopy with the treatment outcome at 12 weeks measured by Yale- Brown Obsessive Compulsive Scale (YBOCS) in patients of Obsessive Compulsive Disorder.

Methodology: A longitudinal pre-post study done at Psychiatry department of AIIMS Patna, with 40 patients of OCD, diagnosed according to ICD-10 DCR recruited. Hemodynamic parameters in pre-frontal cortex evaluated using functional Near Infrared Spectroscopy during cognitive paradigm at baseline and clinical assessment by YBOCS both at baseline and 12 weeks.

Result: The participants in the responders group showed significantly higher oxy-hemoglobin concentration in the pre-frontal cortex during the performance of Verbal fluency Task and Trail Making Task-A as compared to nonresponders group.

Conclusion: This suggests a possibility of better cortical activation in the responder group at baseline compared to non-responder group.

Bipolar disorder in an adolescent with SPINK-1 (Serine peptidase inhibitor, kazal type 1) gene mutation

Ishita Malik, Nishant Goyal

Central Institute of Psychiatry, Ranchi, Jharkhand, India

Background: Genetics seem to play a significant role in mood disorders. Studies have found various genes associated with risk of bipolar disorder- Dopamine Receptor D2 (DRD2), Phospholipase C Gamma 1 (PLCG1), Toll-Like Receptor 4 (TLR4) and few others. 17 year old boy presented with a 3 year illness characterised by episodes of increased talk, tall claims, increased energy, decreased need for sleep, overspending, associated with significant bio socio occupational dysfunction. Presented with the complaints for last 1 month. Past history of 10 seizure attacks in a day on two occasions in 2022 along with complaints of pain in abdomen, vomiting, nausea, increased blood pressure (210/160mm Hg. On mental status examination, had overfamiliar manner of relating, increased speech productivity, irritable affect and delusion of grandiose ability.

Aim: We report the first case of SPINK-1 ( Serine peptidase inhibitor, kazal type 1) gene mutation with bipolar disorder.

Method: EEG data were recorded in EDF format and preprocessed using MNE-Python. Channels were renamed to match the standard 20-20 system, non- EEG channels were removed, and data were bandpass filtered between 1-40 Hz. Source localisation was performed using the FreeSurfer fsaverage template for subjects without individual MRI.

Results: His qEEG was done which showed activations over fusiform gyrus. Study has shown higher theta activity of the right anterior cingulate and low-alpha activity of the left parahippocampal gyrus at the source level.

Conclusion: First case of SPINK-1 gene mutation with bipolar disorder. Comorbidities as seen have never been reported in such phenotype clusters.

Spirituality, quality of life and global functioning in schizophrenia

B. Janarthanan

JIPMER, Puducherry, India

Introduction: Spiritual & religious dimensions of life are among the most important cultural factors shaping illness behaviors. Spirituality plays a vital role in lives of people with schizophrenia as it offers valuable benefits in illness recovery.

Aims and Objective: To identify the relationship of spirituality to Quality of Life and Global Functioning in patients with Schizophrenia.

Materials and Methods: A cross- sectional design with systematic random sampling method was used to recruit 100 subjects. PANSS, Global Assessment of Functioning (GAF) and Royal Free Interview for Spiritual and Religious belief & WHO-QOL-BREF Scale were used.

Results: Findings revealed that majority of subjects (73.3 %) were highly spiritual with maximum of 59% and 96% had fair quality of life and functioning too well respectively. Spirituality was significantly associated with physical domain of quality of life, global functioning and with occupation of subjects (P< 0.05). Quality of life was associated with duration of illness and visit to traditional healer (p<0.05).

Conclusion: The study results concluded that recommendations shall be made to include spiritual assessment as a routine part of psychiatric care and further researches in this area would yield a crystal clear idea of this complex area in the field of psychiatry.

Key words: Global functioning, quality of life, schizophrenia, spirituality

Relationship of social cognition deficit with disability in patients with schizophrenia on clozapine

Jasmeen, Sandeep Grover, Subho Chakrabarti

Post Graduate Institute of Medical Education and Research, Chandigarh, India

Aim: To evaluate the association between social cognition deficits and disability in patients with treatment resistant schizophrenia receiving long term clozapine therapy.

Methodology: A total of 436 patients who had been receiving clozapine for at least six months and were on regular followup were assessed. Social cognition was evaluated using the Observable Social Cognition: A Rating Scale (OSCARS) and disability was assessed using the IDEAS scale. Current illness severity was measured using the CGI. Sociodemographic variables such as age and gender were recorded.

Results: The mean OSCARS score for the study sample was 24.7 (SD: 7.25), and most patients had moderate disability. Higher social cognition deficits were strongly correlated with greater disability across all IDEAS domains (r = 0.39-0.65, p < 0.01).

Conclusion: The presence of social cognition deficits adversely affects disability in patients with. These findings highlight the need to develop targeted interventions to address social cognitive impairments to improve functional outcomes.

A cross-sectional study to assess internet addiction and its impact on quality of sleep and social anxiety among health sciences students in Mangalore

B. Jayachandra, Jayanth Kumar

Kanachur Institute of Medical Sciences, Mangalore, Karnataka, India

Background: Internet addiction among health sciences students is associated with various psychological problems including poor sleep quality and social anxiety. This study aimed to assess the prevalence of internet addiction and its impact on sleep quality and social anxiety among health sciences students in Mangalore.

Aims: To assess prevelance of internet addiction, social anxiety and sleep quality.

Materials and Methods: A cross-sectional study was conducted among 383 undergraduate students from medicine (n=179), nursing (n=124), and physiotherapy (n=80) programs at Kanachur Educational Trust, Mangalore. Stratified random sampling was employed. Data collection utilized Young’s Internet Addiction Test (IAT), Pittsburgh Sleep Quality Index (PSQI), and Liebowitz Social Anxiety Scale (LSAS) along with sociodemographic questionnaires. Chi-square tests performed to assess associations, with p<0.05 considered statistically significant.

Results: The prevalence of internet addiction was 54.8% (210/383), with 42.3% showing occasional/frequent problems (IAT scores 50-79) and 12.5% showing significant problems (IAT scores 80-100). Poor sleep quality (PSQI >5) was found in 68.4% (262/383) of participants. Social anxiety (LSAS total score 55) was present in 47.5% (182/383) of students. Internet addiction showed significant association with poor sleep quality (X²=38.42, p<0.001) and social anxiety (X²=45.67, p<0.001). Among internet-addicted students, 81.4% had poor sleep quality compared to 52.6% in non-addicted students. Similarly, 68.1% of internet-addicted students had social anxiety versus 23.1% without addiction.

Conclusion: Internet addiction demonstrated high prevalence among health sciences students with significant associations with poor sleep quality and social anxiety, warranting targeted interventions and mental health support programs.

Key words: Health sciences, internet addiction, sleep quality, social anxiety

Awareness, experiences, and perspectives on the Mental Healthcare Act (2017) among patients and caregivers: A multi-centric cross-sectional study

Jhilmil Dua, Ritvik Gupta¹, Bhuma Ben Desai, Avnish Kumar

All India Institute of Medical Sciences, Rishikesh, Uttarakhand, ¹PGIMS, Rohtak, Haryana, India

Aim: To assess awareness, experiences, and perspectives regarding MHCA 2017 among patients with mental illness and their primary caregivers across multiple centres in India.

Methods: This multi-centric cross-sectional analytical study included 800 participants from four centres (including patients & caregivers) recruited from tertiary-care psychiatry services using purposive sampling. Data were collected using a socio-demographic and clinical sheet along with a semi-structured questionnaire assessing awareness, experiential encounters, perceived rights, and attitudinal perspectives, supplemented with one open-ended qualitative response. Quantitative data were analysed using descriptive statistics, chi-square tests, t-tests, and ANOVA, while qualitative responses underwent thematic analysis. Ethical principles were adhered to throughout.

Results: Findings from the interim analysis have indicated poor overall awareness and limited knowledge regarding MHCA 2017, with a majority of both patients and caregivers unaware of key provisions such as advance directives, nominated representatives, right to access mental healthcare, and safeguards against coercion. Awareness was significantly associated with education level, urban residence, and prior mental-health service engagement (p < 0.05). Qualitative themes highlighted confusion about rights, dependence on clinicians for decision-making, and perceived absence of information dissemination. Participants expressed a desire for clearer communication, community sensitisation, and structured awareness programs.

Conclusion: An interim analysis of this study suggests substantial gaps in awareness and understanding of MHCA 2017 among primary stakeholders, underscoring the need for targeted education initiatives, institutional training, and policy-level strategies to enhance the rights-based implementation of MHCA 2017.

Understanding stress and burnout among postgraduate medical residents to inform intervention design: A qualitative study

Jigyansa Ipsita Pattnaik, Shiva Mittal

Kalinga Institute of Medical Sciences, KIIT, Bhubaneswar, Odisha, India

Background: Medical postgraduate residents experience high rates of occupational stress and burnout, yet evidence-based interventions tailored to their contextual needs remain limited. A qualitative needs assessment was conducted to inform development of a culturally appropriate brief psychological intervention module.

Objective: To explore lived experiences of stress, burnout, and coping mechanisms among medical postgraduate residents, thereby informing evidence-based intervention design.

Methods: An exploratory qualitative study employed semi-structured in-depth interviews (IDIs) with 24 medical postgraduate residents across various specialties at a tertiary care teaching hospital in India. Purposive sampling ensured representation across training years and departments. Interview guides explored stress sources, manifestations, coping strategies, barriers to seeking support, and intervention preferences. IDIs lasting 45-60 minutes were audio-recorded, transcribed verbatim, and analyzed using Braun and Clarke’s thematic analysis framework.

Results: Key themes identified: (1) unique occupational stressors including duty hours, academic pressures, and hierarchical dynamics; (2) challenges in maintaining work-life balance, highlighting need for communication and interpersonal effectiveness skills; (3) maladaptive coping and help-seeking barriers including stigma and time constraints; (4) preference for brief, skills-based interventions using medical frameworks; (5) need for systematic stress assessment and psychoeducation. Residents conceptualized stress warranting assessments similar to physical illnesses, preferring brief formats compatible with demanding schedules.

Conclusions: Findings informed a four-session intervention module incorporating stress recognition frameworks, adaptive coping strategies, distress tolerance skills, and wellness practices including interpersonal effectiveness skills. Medical analogies and conversational language emerged as critical design elements, demonstrating value of participatory approaches in developing contextually relevant mental health interventions for healthcare professionals.

Serum creatine phosphokinase level in patient of alcohol withdrawal and its association with delirium

Jinti Das, Dhrubajyoti Bhuyan, Kavery Bora

Department of Psychiatry, Assam Medical College and Hospital, Dibrugarh, Assam, India

Background: Alcohol Withdrawal (AW) and Alcohol Delirium (AD/Delirium Tremens) represent a severity spectrum of alcohol-related disorders. Elevated serum creatine phosphokinase (CPK), reflecting muscle injury and autonomic hyperactivity, may help differentiate these clinical states and predict severity.

Aims: To compare serum CPK levels between patients with Alcohol Withdrawal and Alcohol Delirium, and to examine the association between withdrawal severity and CPK elevation.

Methods: This comparative cross-sectional study included 86 patients: 43 with Alcohol Withdrawal and 43 with Alcohol Delirium, aged 18 to 56 years. Patients with medical or neurological conditions that could elevate CPK were excluded. Withdrawal severity in the AW group was assessed using the CIWA-Ar scale. serum CPK levels were measured at baseline prior to treatment. Statistical analyses included Chi-square test, independent t-test, Kruskal-Wallis test, and correlation analysis.

Results: Among AW patients, 27.9% had mild, 53.4% moderate, and 18.6% severe withdrawal. Mean CPK levels increased significantly with severity: Mild: ~124 IU/L, Moderate: ~300 IU/L, Severe: ~760 IU/L, A statistically significant difference in CPK levels was observed across the three severity groups (p < 0.001). The Alcohol Delirium group showed markedly elevated CPK levels (~980 IU/L), which were significantly higher than the overall AW group (p < 0.001) as well as each severity subgroup

Conclusion: Serum CPK levels increase significantly with the clinical severity of alcohol-related states, with the highest values in Alcohol Delirium. CPK may serve as a useful supportive biomarker to differentiate AW from AD and to anticipate severe

Impact of climate change on psychiatric illnesses: Anxiety, PTSD, and depression

Jishnu Bhattacharya

Birbhum Medical College, Birbhum, West Bengal, India

Climate change poses not only environmental and physical health risks but also significant threats to mental health. This presentation explores the growing body of evidence linking climate change to the increased prevalence and severity of psychiatric disorders, particularly anxiety, post-traumatic stress disorder (PTSD), and depression. We examine how extreme weather events, rising temperatures, displacement, and chronic stressors associated with environmental degradation contribute to psychological distress and mental illness. The presentation also highlights vulnerable populations, mechanisms of impact, and emerging strategies for mental health adaptation and resilience. By understanding the psychiatric dimensions of climate change, we can better prepare for and mitigate its full spectrum of consequences.

Design and pilot validation of an offline browser-based disability assessment support tool (Kalyan v1.0) for childhood neurodevelopmental disorders

M. Jithin Raj

INHS Kalyani, Visakhapatnam, Andhra Pradesh, India

Background: Manual Gazette-based disability assessment for children with neurodevelopmental disorders requires multiple cross-references and is prone to error. Gazette Notification No. 1272 (12 March 2024) mandates standardized methods using VSMS, ISAA, and SLD guidelines. This study developed an offline, browser-based tool (Kalyan v1.0) to automate Gazette-compliant disability percentage calculations for pediatric populations.

Aim: To design and pilot-validate a mobile-compatible, offline digital tool for supporting accurate and standardized disability assessment in childhood neurodevelopmental disorders.

Methods: Gazette and ISAA data were encoded using HTML5, CSS3, and JavaScript to create a fully offline disability assessment support tool. Thirty dummy child profiles (ages 3-18 years) covering Intellectual Disability, Autism Spectrum Disorder, Specific Learning Disability, and Global Developmental Delay were used. Outcomes measured included accuracy, computation time, and usability (System Usability ScaleSUS, rated by two clinicians).

Results: The tool matched manual Gazette-derived disability percentages in 30/30 cases (100% concordance). Mean computation time decreased from 10.4 to 2.1 minutes (‰ˆ80% reduction). Usability was rated excellent (SUS = 91/100).

Conclusion: The Disability Assessment Support Tool (Kalyan v1.0) accurately replicates Gazette 2024 calculations for childhood neurodevelopmental disorders, reduces final disability computation time, operates fully offline, ensuring privacy and accessibility.

A study of psychiatric comorbidities in patients with chronic kidney disease undergoing haemodialysis and its impact on quality of life

Jivitesh Singh Chahal, P. D. Bansal, Aman Bharti

Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab, India

Background: Chronic kidney disease (CKD) represents a major public health concern, particularly in India, where haemodialysis remains the most accessible form of renal replacement therapy. Patients with end-stage renal disease frequently experience psychological distress, especially depression and anxiety, which adversely affects treatment adherence and overall quality of life (QOL).

Aim: To assess the prevalence of psychiatric comorbidities among patients with CKD undergoing haemodialysis and to evaluate their impact on QOL.

Methods: This descriptive cross-sectional study included 96 patients receiving haemodialysis for 3 months at Guru Gobind Singh Medical College & Hospital, Faridkot. Sociodemographic and clinical details were recorded. Psychiatric assessment was performed using the Hamilton Depression Rating Scale (HAM-D) and Hamilton Anxiety Rating Scale (HAM-A). QOL was evaluated using the WHOQOL-BREF. Data analysis was conducted using SPSS v26, with p < 0.05 considered statistically significant.

Results: Psychiatric comorbidities were present in 64.4% of patients. Depression was identified in 45.8% and anxiety in 49.0%, with co-occurrence in 30.02%. WHOQOL-BREF scores indicated moderate impairment, with mean domain scores of 50.10 (physical), 53.21 (psychological), 60.60 (social), and 45.10 (environmental). Only 35.4% of participants reported good overall QOL, while 31.3% rated their QOL as poor. Higher levels of depression and anxiety were significantly associated with poorer QOL across all domains.

Conclusion: Depression and anxiety are highly prevalent in patients undergoing haemodialysis and markedly impair their QOL. Routine psychiatric screening and integrated mental-health care should be incorporated into nephrology services, particularly in resource-limited settings.

Adult ADHD in substance use disorders: Prevalence and correlates among males in Eastern India

Kailash Ranwa, Pankaj Kumar, Shinjini Choudhary, Sambhu Prasad

AIIMS, Patna, Bihar, India

Background: Attention-Deficit/Hyperactivity Disorder (ADHD) is an underdiagnosed comorbidity in individuals with substance use disorders (SUD), often contributing to earlier initiation of use, greater addiction severity, and poorer treatment outcomes. Evidence from India on this association remains limited. This study aimed to estimate the prevalence and clinical correlates of adult ADHD in treatment-seeking male patients with SUD.

Methods: This cross-sectional study included 209 male patients aged 18-45 years with DSM5 diagnosed substance use disorders. ADHD was screened using the Adult ADHD Self-Report Scale (ASRS-5, Hindi version) and confirmed with the Diagnostic Interview for ADHD in Adults (DIVA-5). The Addiction Severity Index (ASI) was applied to assess the severity. Data were analyzed using chi-square and non-parametric tests.

Results: Mean participant age was 27.4 ± 6.9 years. Opioids (78%) were the predominant primary substance, followed by alcohol (15.3%) and cannabis (4.3%); polysubstance use was highly prevalent (94%). On screening, 14 (6.7%) were ASRS-5 positive; 13 (6.2%) were confirmed on DIVA-5. Adult ADHD was significantly associated with being unmarried (p=0.021) and residing in urban area (p=0.019). ADHD patients initiated substance use earlier (median 19 vs. 23 years; p = 0.029) and developed SUD sooner (20 vs. 24 years; p = 0.019). ASI revealed greater alcohol-related problems in the ADHD group (p = 0.039).

Conclusion: Adult ADHD was identified in 6.2% of male SUD patients, although lower than both Indian and international estimates, its link with earlier onset and higher severity underscores the need for routine ADHD screening and integrated management of deaddiction.

A cross sectional analysis of mental health knowledge and attitudes in relatives of depressed patients

Kalindi Kamble, Swara Kulkarni, Ajita Nayak

Department of Psychiatry, Seth G.S. Medical College and K.E.M Hospital, Mumbai, Maharashtra, India

Background: Globally, Depression imposes major health burdens, amplified by inadequate mental health knowledge among patients and their families.

Introduction: Depression imposes significant social and economic burdens, yet treatment access remains limited. Mental health literacy of relatives defined as the knowledge and beliefs about mental disorders which aid their recognition, management or prevention determines treatment gap. Hence this study was conducted to assess the mental health literacy in relatives of patients suffering from depression.

Method: 100 consecutive patients who satisfied the DSM 5 criteria for depression were recruited. Their close relatives were interviewed. Those with any other psychiatric or medical comorbidity that interfered with the process were excluded. The relatives were interviewed with a semi structured proforma for the sociodemographic details. Mental Health Literacy Scale (MHLS) was used to understand the mental health awareness among relatives.

Results: The majority of patients were male (66%), married (81%), and under 40 years old (56%). Patients had a mean illness duration of 6.41 years. Mental health literacy was found to be low (mean MHLS = 86) falling below the 10th percentile. Only 7 relatives fell in the average range. None of the patients scored above average or high on MHLS . MHLS Scores were found to be higher in males and relatives with secondary education and above.

Conclusion: The relatives of patients of depression were found to have poor knowledge and beliefs of mental illnesses. Targetted interventions to increase mental health literacy are needed to enhance their well-being and result in better patient outcomes.

Severity and caregiver burden in patients with dissociative disorder visiting a tertiary hospital – A cross-sectional study

Karman Mahajan

GS Medcial College, Pilkhuwa, Uttar Pradesh, India

Dissociative disorders involve the mechanism of dissociation so that there is a disruption in one or more mental functions such as memory, identity, perception, consciousness or motor behaviour. The disturbance may be generally sudden or gradual, transient or chronic and the signs and symptoms of the disorder often caused by psychological trauma. It poses a huge caregiver burden Research has demonstrated that caregiver burden can lead to a variety of negative outcomes, including family dysfunction, social isolation, access to healthcare, use of services, and financial difficulties. It can also cause mental health issues, such as depression, anxiety, stress, and burnout syndrome, as well as physical health problems.

N-acetylcysteine as adjunctive treatment for protracted alcohol withdrawal syndrome: A randomized controlled pilot study

Kartik Chaudhary, Sudipta Kumar Das, Udit Kumar Panda, Pallavi Preetinanda

Kalinga Institute of Medical Sciences, KIIT, Bhubaneswar, Odisha, India

Background: Protracted alcohol withdrawal syndrome (PAWS) is characterized by persistent neuropsychiatric symptoms that contribute to relapse. N-acetylcysteine (NAC), through glutamate modulation and antioxidant properties, may alleviate these symptoms, though evidence of use of NAC in PAWS is limited.

Aims: To compare clinical outcomes of treatment-as-usual (TAU) plus N-acetylcysteine (NAC) versus TAU alone in patients with PAWS.

Methods: This single-blind pilot RCT enrolled 30 patients with alcohol dependence who completed detoxification and met PAWS criteria (persistent symptoms 2 weeks post-detoxification with AWSC 25). Patients were randomized to TAU+NAC (1200-2400 mg/day) or TAU alone for 8 weeks. Primary outcome: Alcohol Withdrawal Symptom Checklist (AWSC) score change. Secondary outcomes: Penn Alcohol Craving Scale (PACS), VASC, HAM-A, HAM-D, and Pittsburgh Sleep Quality Index (PSQI). 26 patients (87%) completed assessment (2 dropouts per arm).

Results: Mean age 42.8±8.3 years; 23 males. At 8 weeks, TAU+NAC showed greater AWSC reduction (baseline 41.2±9.1 to 22.4±7.8) versus TAU (39.8±8.6 to 28.1±9.2; mean difference -5.7, 95% CI: -11.2 to -0.2, p=0.042). PACS scores decreased 47% (TAU+NAC) versus 31% (TAU; p=0.08). VASC reduced from 7.1±1.6 to 3.4±1.9 (TAU+NAC) versus 6.9±1.8 to 4.8±2.1 (TAU; p=0.12). HAM-A improved 52% versus 36% (p=0.09); HAM-D 48% versus 33% (p=0.11); PSQI 44% versus 29% (p=0.15). Relapse to heavy drinking: 2/13 NAC patients (15.4%) versus 5/13 TAU patients (38.5%, p=0.38). Medication adherence was 84.6% (NAC) and 92.3% (TAU). Mild gastrointestinal symptoms occurred in 3 NAC patients (23%).

Conclusion: Adjunctive NAC showed significant benefit in reducing PAWS symptoms and improvements in craving and neuropsychiatric symptoms.

Psychiatric morbidity in patients with Type-II diabetes mellitus attending a tertiary care hospital

Kashish, Tanu Kundal

Adesh Medical College and Hospital, Shahabad, Haryana, India

Background: Type-II Diabetes Mellitus (DM) is a chronic metabolic disorder associated with significant physical and psychological burden. Individuals with DM frequently experience depression, anxiety, and emotional distress, which can negatively affect glycemic control, treatment adherence, and overall quality of life.

Aim: To determine the prevalence of psychiatric morbidity among patients with Type-II DM attending a tertiary care hospital.

Methods: A cross-sectional study was conducted among 25 patients attending the diabetic clinic at Adesh Medical College and Hospital, Shahabad. Socio-demographic details were recorded using the Modified Kuppuswamy Scale (2025). Psychiatric morbidity was assessed using the ICD-10 Symptom Checklist for Mental Disorders. Data were analyzed using SPSS v27.0, and chi-square tests evaluated associations between psychiatric morbidity, gender, HbA1c levels, and medication adherence.

Results: Psychiatric morbidity was present in 52% of participants. Depression was the most prevalent disorder, followed by anxiety and substance use disorders. No significant association was found between gender and psychiatric morbidity (p = 0.27). A significant association was seen between poor glycemic control (HbA1c > 7) and psychiatric morbidity (p < 0.001). Additionally, 76.9% of patients with psychiatric morbidity were non-adherent to diabetic medications.

Conclusion: Psychiatric morbidity is common among patients with Type-II DM and is strongly linked to poor glycemic control and non-adherence. Integrating routine mental health screening into diabetic care is crucial to improve treatment outcomes and overall patient well-being.

Prevalence of cognitive deficit in schizophrenia patients

Kashish Garg, Abdul Sajid¹

American International Institute of Medical Sciences, GBH American Hospital, ¹AIIMS Udaipur, Rajasthan, India

Background: Anxiety, depression, and impaired quality of life are common in patients with psychiatric and chronic medical conditions.

Aim: To assess the levels of anxiety, depression, and quality of life in the study participants and to evaluate the relationship between affective symptom severity and quality-of-life domains.

Methods: Participants were assessed using the Hamilton Anxiety Rating Scale (HAM-A), Hamilton Depression Rating Scale (HAM-D), and the WHO Quality of Life - BREF (WHOQOL-BREF) questionnaire.

Results: Among 120 participants, the mean HAM-A score was 19.8 ± 6.2, indicating moderate anxiety. The mean HAM-D score was 17.3 ± 5.8, suggesting moderate depression. WHOQOL-BREF domain scores were lowest in the psychological (mean 41.2 ± 12.5) and social (mean 39.5 ± 10.7) domains, while physical (mean 52.6 ± 11.9) and environmental (mean 55.8 ± 10.3) domains were relatively higher. A significant negative correlation was observed between HAM-A/HAM-D scores and WHOQOL-BREF scores (p < 0.01), suggesting that higher symptom severity was associated with poorer quality of life.

Conclusion: Participants showed moderate levels of anxiety and depression, which were associated with reduced quality of life. Addressing affective symptoms may improve overall functioning and well-being.

Impulsivity, emotional dysregulation, aggression, and hopelessness in suicide attempts among bipolar disorder patients in India: A cross sectional study

Kaustubh R. Bagul, Simran Sandhu, Muskan Gulani

Mahatma Gandhi Memorial, Indore, Madhya Pradesh, India

Background: Suicide attempts are prevalent in bipolar disorder, yet the trait-level factors that differentiate individuals with a history of attempts from those without remain insufficiently understood. Impulsivity, aggression, hopelessness, and emotional dysregulation have been proposed as potential vulnerability markers, but limited research has examined these constructs together in remitted bipolar patients.

Aim: To compare levels of impulsivity, aggression, hopelessness, and emotional dysregulation between remitted bipolar disorder patients with and without a lifetime history of suicide attempts, and to determine whether these traits independently predict suicide-attempt status.

Methods: This cross-sectional study will include 150 adults with DSM-5 bipolar disorder in remission, recruited from a tertiary-care centre. Participants will be grouped based on presence or absence of past suicide attempts. Trait measures will include the Barratt Impulsiveness Scale (BIS-11), Buss-Perry Aggression Questionnaire, Beck Hopelessness Scale (BHS), and Difficulties in Emotion Regulation Scale (DERS). Sociodemographic and clinical variables will also be assessed. Group differences will be analysed using appropriate statistical tests, and logistic regression will examine whether trait variables independently predict suicide-attempt history after adjusting for confounders.

Expected Results: Individuals with a history of suicide attempts are expected to show significantly higher impulsivity, aggression, hopelessness, and emotional dysregulation. Regression analyses may identify one or more traits as independent predictors of suicide-attempt status.

Conclusion: Findings are expected to deepen understanding of trait-based vulnerabilities contributing to suicidal behaviour in bipolar disorder. Identifying stable psychological predictors could enhance risk assessment and inform targeted preventive strategies for remitted bipolar patients.

A retrospective study on presenting complaints and co-morbidities in children with ADHD in a tertiary care hospital

Khaleel Mohammed, N. Prasanna Kumar

Department of Child and Adolescent Psychiatry, Andhra Medical College, Visakhapatnam, Andhra Pradesh, India

Background: Attention-Deficit/Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder in childhood, frequently associated with multiple psychiatric and medical co-morbidities. Hospital-based data on presenting complaints and co-morbidities from tertiary care settings can inform early detection and comprehensive assessment strategies.

Aims: To know the presenting complaints and also the prevalence of psychiatric and medical co-morbidities among children with ADHD attending a tertiary care hospital.

Methods: This retrospective chart review included case records of children aged 5-17 years diagnosed with ADHD, as per DSM-5 criteria, in the child and adolescent psychiatry OPD of Andhra Medical College. Socio-demographic details, presenting complaints, and co-morbid psychiatric or medical diagnoses were noted and analysed using appropriate statistics.

Results: The results will be presented with the appropriate statistics.

Conclusion: The conclusion will be drawn from the results achieved by appropriate statistics.

Exploring the psychological impact of dating app usage on emerging adults

Khushi Panwar, S. Deepakkumar

Christ University, Bengaluru, Karnataka, India

This study explores the psychological impact of dating app usage among emerging adults (aged 18-30). A qualitative design employing semi-structured interviews was used with 15 participants, selected via purposive sampling to ensure diversity across gender, sexual orientation, and background. Data were analyzed using reflexive thematic analysis. Findings reveal a dualistic impact: dating apps offer opportunities for social connection, validation, and confidence building, while also presenting significant challenges including emotional exhaustion, anxiety, ghosting, and compulsive usage. Participants adopted coping mechanisms such as app withdrawal, peer support, and journaling, contributing to greater emotional maturity and self-awareness. The study concludes that while dating apps pose notable psychological risks, they also function as platforms for social exploration and personal growth. These insights highlight the importance of digital literacy and emotional awareness in promoting healthier online dating experiences among emerging adults.

Key words: Emotional well being, individual differences, interaction and engagement patterns, mental health, motivation, negative outcomes, positive outcomes, psychological well-being

Stressful life events, hopelessness, and suicidal intent in patients admitted with attempted suicide in a tertiary care hospital

Killivazhavan

Tirunelveli Medical College, Tirunelveli, Tamil Nadu, India

Background: Suicide attempts are a leading cause of emergency admissions, with stressful life events and hopelessness recognized as proximal risk factors for elevated suicidal intent.

Aim: To examine the relationship between stressful life events, hopelessness, and severity of suicidal intent among patients admitted following a suicide attempt.

Methods: This hospital-based cross-sectional study included adult patients admitted with suicide attempts in a tertiary care centre. Within 72 hours of admission, participants were assessed using the Presumptive Stressful Life Events Scale (PSLES), Beck Hopelessness Scale (BHS), and Beck Suicide Intent Scale (SIS). Correlations and multiple linear regression were performed using SPSS 26.

Results: Preliminary results showed that majority of the participants were middle aged females and most of the participants had mild to moderate degree of hopelessness. Majority of the study population had a medium suicidal intent.

Conclusion: Hopelessness is the strongest predictor of suicidal intent, amplified by cumulative stressful events. Routine screening for hopelessness and acute stressor management are vital in post-attempt care to prevent reattempts.

Association between adult sensory processing and behavior characteristics in alcohol use disorder: A quantitative study

Kiran Vivekanand Talkhande, Vivek Vajaratkar

Department of Orthopedic Surgery, Goa Medical College and Hospital, Bambolim, Goa, India

Background: Alcohol use disorder (AUD) is characterized by a persistent pattern of alcohol consumption. Occupational therapists focus on improving daily functioning and quality of life, are uniquely positioned to address sensory challenges and maladaptive behaviours.

Aims: The aim of the study was to determine association between sensory processing and behavior characteristics in alcohol use disorder.

Method: A cross-sectional quantitative study recruited 350 males and females with ICD-10 (F10) alcohol use disorder, aged 18-59, over six months through convenience sampling at the Institute of Psychiatry and Human Behavior. Participants, accompanied by caregivers and able to respond to questionnaires, were assessed using the Adolescent Sensory Profile for sensory processing and Adult Behavior Checklist for behavior characteristics in AUD. Data were analyzed with JAMOVI 0.9.6.

Results: Participants were analyzed using chi- square test and was found that there is a strong association between sensory processing and behavior characteristics (X²=73.25, p<0.0001), but it was found that there exists strong association between anger and sensory sensitivity (X²=416, p<0.0001) and sensory seeking (X²=419.8, p<0.0001). Also, it was found that there is no association between anger and sensory avoiding (X²=0.6992, p= 0.4031) and low registration (X²= 0.01567, p=0.9004). Anger behavior (89.71%) was the predominating behavior observed.

Conclusions: This study concludes that there is strong association between sensory processing and behavior characteristics. This research also provides valuable insights for developing tailored intervention strategies that enhance the quality of life and functional independence of affected individuals.

Cyberchondria and smartphone addiction among students of professional and humanities colleges in semi urban area – A cross sectional study

G. R. Kishore Kumar

Sri Muthukumaran Medical College Hospital and Research Institute, Chennai, Tamil Nadu, India

The increase in smartphone usage and easy access to health information online has led to emerging behavioral concerns among young adults, particularly cyberchondria, an excessive online health-related searches leading to heightened anxiety and smartphone addiction. Students in professional and humanities colleges represent a vulnerable population given their heavy reliance on digital devices for academic and personal purposes. This cross-sectional study aimed to assess the prevalence of cyberchondria and smartphone addiction among students in professional and humanities colleges in a semi-urban area and to explore the relationship between these two phenomena. A structured questionnaire incorporating validated scales for cyberchondria and smartphone addiction was administered to students from professional and humanities colleges. Data on demographic characteristics, smartphone usage patterns, health-seeking behaviors, and psychological parameters were collected and analyzed using appropriate statistical methods.

The study revealed a significant prevalence of both cyberchondria and smartphone addiction among the student population. A strong positive correlation was observed between smartphone addiction severity and cyberchondria levels. Students from professional colleges demonstrated distinct patterns compared to humanities students in terms of online health information-seeking behavior and device dependency. The findings underscore the need for targeted interventions including digital literacy programs, mental health support services, and awareness campaigns to promote healthy technology use patterns. Educational institutions should consider implementing comprehensive policies addressing digital wellbeing as an integral component of student health initiatives.

Comparison of affective temperament profiles in mood disorders: A cross-sectional study

Kranti Sonawane, Dibyendu Mohanty¹

Seth G.S. Medical College and K.E.M Hospital, Mumbai, Maharashtra, ¹AIIMS, Bhubaneshwar, Odisha, India

Introduction: Affective temperaments are stable, biologically based traits influencing emotional reactivity, mood regulation. Past studies linked it to mood disorders, but comparative data in India are limited. This study compared affective temperament profiles in Bipolar Affective Disorder (BPAD) and Recurrent Depressive Disorder (RDD) with clinical associations.

Methods: A cross-sectional 18-month study was conducted at a tertiary care hospital, including 42 BPAD, 42 RDD, and 60 healthy controls following ethics approval and informed consent. Participants were assessed using TEMPS-A (Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Auto-questionnaire), HAM-D (Hamilton Depression Rating Scale), YMRS (Young Mania Rating Scale), and ICD-10. Chi-square, Kruskal-Wallis, and Mann-Whitney U tests were used to compare temperament scores and their association with clinical variables.

Results: Temperament Profiles: Proportion of cyclothymic temperament was significantly higher in BPAD (71.4%), depressive temperament was predominant in RDD (100%), and hyperthymic temperament was most common in controls (80.6%) (p < 0.001).

Clinical Characteristics: Anxious temperament was significantly associated with substance use (p = 0.003). Deliberate self-harm attempts were more frequent in individuals with irritable (100%) and anxious (70%) temperaments (p = 0.028, p = 0.003).

Conclusion: Affective temperaments associated with specific mood disorders, e.g., cyclothymic with bipolar and depressive with recurrent depression, align with past studies. Hyperthymic temperament in healthy individuals may have a protective role, while anxious and irritable temperaments contribute to substance use and self-harm. Thus, affective temperaments are associated with clinical characteristics in mood disorders, with implications for diagnosis, detection, and personalized treatment.

Prevalence of impulsivity trait in adults who have committed deliberate self-harm

Kratika Bhoyar, Pawan Khot, Neil Pawar

Rajashree Chhatrapati Shahu Maharaj Medical College, Kolhapur, Maharashtra, India

Background: Deliberate self-harm (DSH) is a growing public health concern and a known predictor of future suicidal behavior. Among various psychological correlates, impulsivity has emerged as an important personality trait influencing self-harming actions. Identifying the prevalence and pattern of impulsivity in individuals with DSH can enhance understanding and inform preventive strategies.

Objective: To study prevalence of impulsivity trait in adults who committed deliberate self-harm

Methodology: A cross-sectional observational study was conducted among adults aged more than 18 years admitted following DSH at a tertiary care hospital. After informed consent, participants were assessed using a socio-demographic proforma and the Barratt Impulsiveness Scale (BIS-11). Data were analyzed to estimate prevalence and correlation between impulsivity scores.

Results: A total of individuals who had committed deliberate self-harm were included in this cross-sectional study. The Study had a mean age of 23.1 years. The sample comprised 48 males and 32 females. Poisoning was the predominant method of self-harm. High levels of impulsivity as measured by the BIS-11 Scale.

Conclusion: In this study of adults who engaged in deliberate self-harm, more than half (56.2%) exhibited high levels of impulsivity as measured by the BIS-11 scale, highlighting impulsivity as a significant psychological factor in self-harm behavior.

Study assessing depression and anxiety in patients of supra ventricular tachycardia pre and post radio-frequency ablation

Kush Goyal, Fiona Mahapatro

Dr. D.Y. Patil Medical College, Navi Mumbai, Maharashtra, India

Background: Supra ventricular tachycardia refers to a group of rapid heart rhythm disorders originating at or above the atrioventricular node, characterised by a narrow QRS complex of less than 120 ms and an elevated heart rate. The prevalence of SVT is approximately 25/100,000. SVT often presents with features that closely resemble to those with anxiety. Literature states that anxiety is present in 20% of patients of SVT. There are hardly any studies in India evaluating SVT with anxiety.

Aim: To determine depression and anxiety in patients of supra ventricular tachycardia pre and post radio frequency ablation.

Materials and Methods: This study is cross sectional and observational study in a tertiary care hospital. Patients of SVT referred to psychiatry department over 2 months were assessed. Detailed psychiatric evaluation including MSE was done. Patients were evaluated twice pre and post radio frequency ablation and diagnosis (if any) was made as per DSM 5. We had about 50 patients.

Results: Interesting finding emerged. The most common symptoms were palpitations, followed by dizziness, and shortness of breath. 1/6 of assessed patients were suffering from Anxiety disorder whose symptoms did not subside post radio frequency ablation.

Conclusion: Since palpitation is the most common symptom organic causes should be ruled out, as cardiac and psychiatric illness coexist, this overlap can lead to frequent misdiagnosis. Further research is needed to better assess the relationship between the overlapping clinical presentations of SVTs and anxiety disorder.

Excessive daytime sleepiness and poor sleep quality in medical undergraduate students: The role of smartphone use, screen time, and internet addiction – A cross-sectional study

Macharla Nischal Krishna, J. Ramya Rachel, T. Madhusudan

SRM Medical College Hospital and Research Centre, Kattankulathur, Chengalpattu, Tamil Nadu, India

Background: Sleep problems and excessive daytime sleepiness (EDS) are common among medical undergraduates, often linked to heavy academic schedules and digital overuse. Smartphone dependence, increased screen time, and internet addiction have emerged as key contributors to sleep disruption.

Aim: To examine the relationship between smartphone use, screen time, and internet addiction with poor sleep quality and EDS among medical students.

Methods: A cross-sectional study was conducted among 255 medical undergraduates aged 18-30 years at SRM Medical College Hospital and Research Centre, Kattankulathur. Participants completed the Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), Smartphone Addiction Scale (SAS), and Internet Addiction Test (IAT). Screen time was obtained from device data. Data were analyzed using descriptive statistics and Pearson correlation, with p < 0.05 considered significant.

Results: Poor sleep quality (PSQI > 5) was found in 58.4%, and 31.2% reported EDS (ESS > 10). Mean daily screen time was 5.7 ± 1.6 hours. Smartphone addiction correlated with ESS (r = 0.34, p < 0.01) and PSQI (r = 0.41, p < 0.01). Internet addiction also correlated with PSQI (r = 0.33, p < 0.01).

Conclusion: Smartphone overuse, prolonged screen exposure, and internet addiction are significantly associated with poor sleep quality and EDS among medical students. Awareness on digital wellbeing and sleep hygiene may enhance overall health and academic performance.

Key words: Daytime sleepiness, internet addiction, medical students, screen time, sleep quality, smartphone addiction

Beyond the patient: Assessing caregiver burden and quality of life in families of individuals with psychiatric disorders K. Madhumitha, Seenivasan

Tirunelveli Medical College, Tirunelveli, Tamil Nadu, India

Background: Family caregivers of persons with psychiatric disorders often experience substantial burden, which may adversely affect their quality of life. Understanding this impact is essential for planning caregiver-focused interventions in routine mental health services.

Aim: To assess caregiver burden and quality of life, and explore their association among primary family caregivers of individuals with psychiatric disorders.

Methods: This cross-sectional hospital-based study will be conducted in the psychiatry department of a tertiary care centre. A total of 79 primary family caregivers of patients with psychiatric disorders will be recruited by consecutive sampling from outpatient and inpatient services. Sociodemographic and clinical data of caregivers and patients will be recorded using a structured proforma. Caregiver burden will be assessed using the Zarit Burden Interview and quality of life using the WHOQOL-BREF. Descriptive statistics will summarise burden levels and QoL scores. Group comparisons (t-test/ANOVA or non-parametric equivalents) and correlation analyses will examine associations between ZBI scores, WHOQOL-BREF domains, and relevant caregiver/patient variables. Multiple linear regression may be performed to identify independent predictors of higher burden and poorer QoL.

Results: It is anticipated that a substantial proportion of caregivers will report moderate to severe burden, with corresponding reductions in QoL across domains, particularly psychological and social. Higher burden is expected to correlate with lower QoL scores and factors such as longer duration of caregiving and greater patient illness severity.

Conclusion: The study is expected to highlight the significant toll of psychiatric illness on family caregivers and underscorethe need for integrating caregiver assessment and support into routine psychiatric care.

Suicidal intent and its psychosocial correlates among patients with alcohol dependence syndrome: A cross-sectional study

Manasa Sudhir Paluru, Gazzali Kassim M. Yahiya, M. T. Sathyanarayana, G. S. Harshitha

Sri Siddhartha Medical College and Hospital, Tumakuru, Karnataka, India

Background: Suicidal intent is a critical clinical concern in Alcohol Dependence Syndrome (ADS), arising from complex psychosocial disruptions. Psychosocial factors like family criticism, emotional involvement and life dissatisfaction, may influence this vulnerability. However, the contribution of these psychosocial factors to suicidal intent in ADS remains insufficiently examined in Indian clinical settings.

Aim: To assess suicidal intent and examine its association with psychosocial variables among patients with ADS.

Methods: A cross-sectional study was conducted among 110 diagnosed ADS patients using purposive sampling. Suicidal intent was assessed using Beck’s Suicidal Intent Scale. Psychosocial parameters including perceived criticism, emotional involvement, and life satisfaction were assessed using family emotional involvement & criticism scale &satisfaction with life scale. Statistical analysis included descriptive statistics, Pearson correlations and Chi-square tests, with p<0.05 considered significant.

Results: Suicidal intent was identified in 42.7% of participants. Suicidal intent correlated positively with perceived criticism (r = 0.21) and negatively with emotional involvement (r = -0.27). Life dissatisfaction (60.9%) was significantly associated with higher suicidal intent (p = 0.018). Individuals with higher intent showed greater psychosocial strain.

Conclusion: Suicidal intent is common in ADS and closely linked to psychosocial vulnerabilities, including perceived criticism, reduced emotional involvement and life dissatisfaction. Early identification of these factors and targeted psychosocial interventions may help mitigate suicidal risk and improve clinical outcomes in ADS.

Key words: Alcohol dependence, psychosocial Correlates, suicidal intent

Prevalence of anxiety and depressive disorder and the role of body image and self-esteem in women of the menopausal age group

Manisha Mandloi, Ram Ghulam Razdan

Index Medical College Hospital & Research Centre, Indore, Madhya Pradesh, India

Menopause can lead to significant physical and psychological effects1. These changes can profoundly impact a woman’s body image and self-esteem, increasing her vulnerability to psychiatric conditions like anxiety and depressive disorders2,3. In the sociocultural context of Central India, these experiences may be further intensified by unique social pressures and expectations regarding aging4. This study was designed to quantify the prevalence of these disorders and investigate their relationship with psychosocial factors in this specific demographic.

Aim: This study aims to determine the prevalence of anxiety and depressive disorders and to explore the role of body image and self-esteem as contributing factors to mental well-being in women of menopausal age in Central India.

Objectives: To clinically assess the prevalence and severity of anxiety and depressive symptoms. To examine how post-menopausal women in Central India perceive and experience changes in their bodies and self-esteem. To analyze the correlation between body image, self-esteem, and the severity of anxiety and depressive symptoms. To identify coping mechanisms women employ to navigate these experiences.

Methodology: This study employed a cross-sectional design, incorporating both quantitative and qualitative methods. The study population comprised post-menopausal women residing in Indore, Central India. Psychiatric assessment was conducted through clinical interviews using the Hamilton Anxiety Rating Scale (HAM-A) and the Hamilton Depression Rating Scale (HAM-D). Positive body image was quantitatively measured using the self-reported Body Appreciation Scale-2 (BAS-2). In-depth qualitative data on lived experiences and self-esteem were gathered through one-on-one, semi-structured interviews. Sample Size and Inclusion/Exclusion Criteria the Sample Size and Sampling.

Hippocampal changes in metabolites among patients of schizophrenia compared to healthy controls: A proton MRS study

Manishit Singh, S. Umesh¹

Institute of Medical Sciences, Varanasi, Uttar Pradesh, ¹Central Institute of Psychiatry, Ranchi, Jharkhand, India

Introduction: Schizophrenia is a severe mental disorder characterized by delusions, hallucinations, and cognitive deficits such as working memory and executive dysfunction. The hippocampus, a critical component of the Default Mode Network, may hold insights into the disorder’s neurobiology and serve as a potential biomarker.

Aim: This study aimed to measure the levels of N-Acetyl Aspartate, N-Acetyl Aspartyl glutamate, Myoinositol, creatine in hippocampus to determine any difference among patients of schizophrenia when compared with controls using proton magnetic resonance spectroscopy.

Materials and Methods: The study, conducted at the Central Institute of Psychiatry, Ranchi, included 22 drug-naïve or medication-free schizophrenia patients and 21 age-, sex-, and education-matched healthy controls. All participants underwent Proton Magnetic Resonance Spectroscopic Imaging of the left and right hippocampus, and patients were rated using PANSS, MOCA, and Sidedness Bias Schedule.

Results: The study showed that there was significant decrease in the baseline N acetyl aspartate levels in the right hippocampus of Schizophrenic group compared with healthy controls.

Conclusion: The reduced NAA levels in right hippocampal region might explain neuronal damage occurring in the region, which in turn might be related to positive symptoms of schizophrenia, offering potential biomarkers for its neurobiology.

Prevalence of ADHD and its association with clinical parameters of OCD

Manita Kumari, Lokesh Shekhawat, Chhavi Bharti

Dr RML Hospital and ABVIMS, New Delhi, India

Introduction: Obsessive-Compulsive Disorder (OCD) is a debilitating psychiatric condition characterized by intrusive obsessions and repetitive compulsions. Recent literature has indicated significant associations between OCD severity and Attention Deficit Hyperactivity Disorder (ADHD). However, data from the Indian context remains limited, necessitating further investigation.

Research Question: Is there an association between ADHD symptomatology with the severity of OCD?

Methods: A cross-sectional observational study was conducted at the Department of Psychiatry, ABVIMS & Dr. Ram Manohar Lohia Hospital, New Delhi, from February 2024 to June 2025. Participants diagnosed with OCD (based on DSM-5 criteria) were assessed for ADHD symptomatology, using validated psychometric instruments including Y-BOCS and Adult ADHD Self-Report Scale. Statistical analyses involved correlation matrices and ROC analyses to evaluate associations and predictive accuracy.

Results: The study included 92 participants (54% males, 98% urban residents). Significant associations were identified between OCD severity and ADHD symptomatology (Ï = 0.456, p < 0.001). ROC analyses demonstrated strong predictive values of ADHD symptoms (AUC = 0.738) for severe OCD.

Discussion: The study highlights and ADHD symptoms as critical predictor of OCD severity, supporting a multidimensional approach to understanding OCD.

To study of anxiety, depression and quality of life in stable chronic obstructive pulmonary disease patients

Manoj Kumar Yadav, B. S. Shekhawat

Department of Psychiatry, Government Medical College, Kota, Rajasthan, India

Background: Chronic Obstructive Pulmonary Disease (COPD) is a prevalent chronic respiratory disorder associated with significant morbidity and impaired quality of life. Along with physical limitations, COPD patients commonly experience psychological comorbidities such as anxiety and depression, which may further deteriorate health-related quality of life. Despite their high prevalence, these conditions often remain underdiagnosed, particularly in stable COPD patients.

Aim: To assess the presence of anxiety and depression in stable COPD patients and to evaluate their correlation with quality of life.

Materials and Methods: This observational cross-sectional study was conducted among 100 stable COPD patients aged 40-75 years attending the outpatient department of Respiratory Medicine. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS), and quality of life was evaluated using the Chronic Respiratory Questionnaire (CRQ). Data analysis was performed using IBM SPSS version 23.0.

Result: A high proportion of stable COPD patients exhibited clinically significant anxiety and/or depression. Anxiety was independently associated with poorer scores across multiple CRQ domains, including dyspnoea and emotional function, while depression was predominantly related to impaired emotional and mastery domains. Psychological factors showed a stronger association with quality of life than spirometric measures of disease severity.

Conclusion: Anxiety and depression significantly reduce quality of life in stable COPD patients. Early screening and management are essential for better outcomes.

Key words: Anxiety, chronic obstructive pulmonary disease, depression, quality of life, psychological comorbidity

Perceived parental media usage as a predictor of adolescent mental health and self-esteem

Mansi Sanghvi Bhayani

Marga: A Mind Wellness Studio, Kolkata, West Bengal, India

Background: Parents play a central role in supporting children’s emotional development. However, increasing engagement with mediaincluding television, newspapers, social networking sites and mobile devicesmay reduce the quality of parent-child interactions. Prior research has largely focused on children’s own media use; limited work has examined how parents’ media usage influences children’s self-esteem and mental health. The present study explores adolescents’ perception of their parents’ media usage and its relationship with their psychological wellbeing.

Aims: The study aimed to examine: (1) the correlation between perceived parental media usage and adolescents’ self-esteem; (2) the correlation between perceived parental media usage and adolescents’ mental health; and (3) the influence of age and standard on these variables.

Methods: A survey research design was used. The sample consisted of 300 adolescents, aged 13-17, from English-medium schools in Vadodara. Tools included: a researcher-developed Parental Media Usage Scale (α = .79), the Mental Health Inventory (MHI-38), and the Rosenberg Self-Esteem Scale, Data were analysed using Pearson correlation, independent t-tests, and Structural Equation Modelling (SEM).

Results: Perceived parental media usage demonstrated a significant negative correlation with adolescents’ mental health and self-esteem. Adolescents who perceived higher parental media involvement reported increased distress and lower self-worth. SEM confirmed that parental media usage significantly predicted both outcomes. Age and standard showed minimal impact, with no significant differences across groups.

Conclusion: Excessive parental media engagement may reduce meaningful parent-child interaction, negatively affecting adolescents’ mental health and self-esteem. Findings highlight the need for parental awareness and school-based psychoeducation to promote healthier family communication

Study of factors responsible for non-adherence among psychiatric patients: A cross-sectional study

Mansi Saxena, Tamanna Hooda, Sheetal Tripathi

Institute of Mental Health and Hospital, Agra, Uttar Pradesh, India

Background: A major problem in healthcare is non-adherence to recommended medical treatments, which has an impact on clinical results for patients and drives up expenditures.

Poor health outcomes, a rise in morbidity and death, and higher healthcare costs can result from non-adherence.

It is especially noticeable in those with mental health issues, since greater rates of non-adherence are sometimes caused by the intricacy of treatment plans and the nature of psychiatric conditions.

Addressing non-adherence is critical for assessment of treatment gap in community and improving individual health outcomes and reducing the overall burden on healthcare system.

Aim: To evaluate factors responsible for non-adherence among psychiatric patients.

Methodology: This was a. 3-month cross-sectional study at IMHH Agra OPD/IPD will include 150 randomly selected psychiatric patients (18-65 years) diagnosed by ICD-10. Using a semi-structured pro-forma, MARS, and a validated self-made questionnaire, data on sociodemographic, illness, substance use, and medication adherence was collected. Exclusions include chronic medical, neurological, or intellectual disabilities

Result: will be discussed later.

Religious scrupulosity and menstruation-linked contamination obsessions: A culture-bound variant of OCD

Manvi Hira, Akhilesh Sharma

PGIMER, Chandigarh, India

Background: Obsessive-compulsive disorder (OCD) may present with culturally shaped symptom content, particularly in societies where concepts of ritual purity hold strong religious significance. Menstruation-related impurity beliefs, though prevalent in some cultures, rarely manifest as the core driver of contamination obsessions. Distinguishing culturally sanctioned purity practices from pathological scrupulosity is diagnostically challenging and requires culturally sensitive evaluation.

Aim: To describe the clinical features, diagnostic considerations, and treatment response in a patient with combined religious and menstruation-linked contamination OCD, and to highlight the effectiveness of culturally adapted Exposure and Response Prevention (ERP).

Methods: A 40-year-old woman presented with a three-year history of intrusive thoughts related to ritual impurity, fear of divine displeasure, and contamination concerns triggered by menstruation. Compulsions included prolonged ritualistic bathing (3-4 hours/day), excessive laundering, and avoidance of menstruating women or objects perceived as impure. Assessment included mental status examinations, Yale-Brown Obsessive Compulsive Scale (Y-BOCS), a cultural formulation interview, and evaluation of family accommodation. Management involved fluoxetine (60 mg/day), aripiprazole augmentation, structured psychoeducation addressing religious misinterpretations, and culturally adapted ERP integrating menstrual-related exposures and culturally congruent cognitive reframing.

Results: The patient demonstrated extreme baseline severity (Y-BOCS: 36) with high family accommodation. With systematic reduction of accommodating behaviours and graded ERP, she showed progressive improvement, achieving complete remission (Y-BOCS: 0) within eight weeks. No adverse effects were observed.

Conclusion: This case demonstrates the complex interplay between religious scrupulosity, cultural purity norms, and contamination fears. Culturally informed assessment and tailored ERP can be highly effective in treating culture-bound manifestations of OCD.

Drug compliance and factors affecting it in Psychiatry – A cross sectional study

Mayur Mayank, G. Prasad Rao, Vainika Rao Akkinepally

Asha Hospital, Hyderabad, Telangana, India

Background: Medication nonadherence represents the most significant obstacle to achieving positive therapeutic outcomes across psychiatric populations. With global noncompliance rates for maintenance treatment estimated at 40% to 60%, it is a major factor contributing to relapse and increased morbidity. Identifying the specific patient- and environment-related factors influencing adherence is essential for optimizing clinical care delivery.

Aim: To comprehensively identify and analyze the demographic, clinical, and psychological factors associated with medication compliance among patients receiving care for a psychiatric illness.

Methods: A sample of 100 psychiatric patients (aged >18 years, prescribed medication for more than 6 months) was recruited from the inpatient and outpatient departments of Asha Hospital in July 2025. Data collection involved a systematic approach comprising sociodemographic assessment, a semi-structured clinical interview, and the application of the standardized Rating of Medication Influences Scale to quantify adherence determinants.

Results: Overall medication compliance was observed in 56% of the cohort. The strongest predictors of adherence were internal motivation, specifically Perceived Personal Daily Benefit (20%), and strong external support, evidenced by a Positive Family Belief (20%) towards treatment. In contrast, the main barriers to compliance were the subjective burden of treatment, particularly being Distressed by Side Effects (9%), and the psychological defense of Denial of Illness (7%).

Conclusion: The primary opportunities for intervention lie in reducing the impact of side-effect distress and addressing denial of illness. Implementing targeted psychoeducation focused on anticipating and managing side effects, is critical for improving clinical outcomes in this population.

IPV among wives of individuals with alcohol use disorder

Merene Elza Biji, T. V. Pavan Kumar, D. Rajkiran

NRI Academy of Medical Sciences, Guntur, Andhra Pradesh, India

Background: Intimate partner violence includes physical, sexual, psychological, and economic abuse. While alcohol does not cause violence, it impairs judgment and self-control, increasing the risk of partner abuse. In India, alcoholism is a major stressor that heightens violence against women, particularly within families.

Aim: To assess the severity of IPV among wives of alcohol use patients and to find its association with severity of partner’s alcohol use.

Method: This cross-sectional study involved wives of alcohol-use patients. Partners’ alcohol severity was assessed using the AUDIT, while wives’ psychological symptoms were evaluated with PHQ-9 and GAD-7. Experiences of abuse were measured using CASR-SF, and data were summarized using mean values.

Results: The mean participant age was 35.8 years. Mean scores were 16.3 for AUDIT, 11.2 for PHQ-9, 8.3 for GAD-7, and 14.8 for CASR-SF. As AUDIT scores were non-normally distributed, the Mann-Whitney U test was used. AUDIT scores showed significant associations with PHQ-9 [p=0.046, hedges’g 0.86, CI : 0.20 to 1.50] and GAD-7 [p<0.001, hedges’ g 1.34, CI: 0.64 to 2.03], both with large effect sizes, but no significant association with CASR-SF [p=0.183, hedges’ g 0.15, CI: -0.48 to 0.77]

Conclusion: The results suggest that husbands alcohol use can be one of the factors that increase psychological distress in wives even without reported abuse, highlighting the need to screen partners for mental health issues beyond physical or sexual violence.

Comparison of sexual dysfunction and quality of life between alcohol use disorder and opioid use disorder patients

Minal Jain, Ruchi Soni, J. P. Agrawal, Samiksha Sahu

Gandhi Medical College, Bhopal, Madhya Pradesh, India

Background: Substance use disorders are frequently associated with sexual dysfunction and impaired quality of life. Alcohol Use Disorder (AUD) and Opioid Use Disorder (OUD) adversely affect sexual functioning and overall well-being through distinct neurobiological and psychosocial mechanisms, yet comparative evidence remains limited.

Aims: To compare sexual dysfunction and quality of life among patients with Alcohol Use Disorder and Opioid Use Disorder.

Methods: A cross-sectional comparative study was conducted among 100 patients attending a tertiary care de-addiction center, including 50 patients with AUD and 50 with OUD, diagnosed as per ICD-10 criteria. Sexual dysfunction was assessed using a standardized sexual dysfunction scale, and quality of life was evaluated using the WHOQOL-BREF questionnaire. Sociodemographic and relevant clinical variables were recorded. Statistical analyses were performed to compare outcomes between the two groups.

Results: Sexual dysfunction was common in both groups, with significantly greater severity observed in patients with OUD. Quality of life was impaired across physical, psychological, social, and environmental domains in both disorders, with lower scores among patients with OUD. Greater sexual dysfunction was associated with poorer quality of life in both groups.

Conclusion: AUD and OUD are associated with significant sexual dysfunction and reduced quality of life, with a greater burden among patients with Opioid Use Disorder. Routine assessment of sexual health and quality of life may enhance holistic de-addiction care.

Late-onset alcohol dependence in elderly patients: A case series from a Delhi tertiary care center

Mohan Dabas, Abhishek Kumar

VMMC and Safdarjung Hospital, New Delhi, India

Background: Late-onset alcohol dependencecommencing after the age of 50-60 yearsis increasingly recognised but remains underreported in India. Older adults are physiologically more sensitive to alcohol and may develop dependence rapidly even with relatively short periods of heavy drinking. Psychosocial stressors such as bereavement, interpersonal conflict, declining health, or sexual dysfunction often precipitate new-onset alcohol use in this population. Early identification is essential, as older adults frequently respond well to structured treatment.

Case Presentation: This case series describes three male patients aged 57, 58, and 62 years who developed alcohol dependence within the past 2-3 years without prior substance-use history or family history of alcoholism. Each case had distinct psychosocial triggers: performance anxiety secondary to erectile dysfunction, family/property-related stress and marital conflict, and bereavement after spousal loss. All patients progressed from occasional drinking to daily use (180-375 mL/day), with characteristic withdrawal symptoms (tremors, sweating, irritability, anxiety, sleep disturbance) and mild hepatomegaly with elevated transaminases. Diagnoses were made using ICD-10 criteria for Alcohol Dependence Syndrome. Management included inpatient or outpatient benzodiazepine-assisted detoxification, thiamine supplementation, motivational interviewing, relapse-prevention strategies, and targeted psychosocial interventions (marital counselling, stress management, grief counselling). All three patients-maintained abstinence and demonstrated functional improvement at three-month follow-up.

Conclusion: Late-onset alcohol dependence can emerge rapidly in older adults following significant life stressors, even in the absence of prior risk factors. Routine screening for new-onset drinking in elderly patients is crucial. Timely medical detoxification combined with age-sensitive psychosocial interventions can lead to favourable short-term outcomes.

Taming trauma and tremors: The psychiatric versatility of propranolol

M. Mohan Reddy

Sri Devaraj Urs Medical College, Kolar, Karnataka, India

Background: Propranolol, a non-selective beta-adrenergic blocker traditionally used in cardiovascular medicine, has gained significant relevance in psychiatric practice. Its ability to cross the blood-brain barrier and modulate adrenergic hyperarousal has led to its use in performance anxiety, aggression, trauma-related symptoms and psychotropic-induced movement disorders. Growing off-label use, including unsupervised use among students, highlights the need for an updated appraisal.

Aims: To review the pharmacology, psychiatric indications, evidence base, safety profile and limitations of propranolol in contemporary psychiatric practice, with emphasis on its relevance in the Indian setting.

Methods: A narrative review of English-language literature was conducted using PubMed and other databases, focusing on clinical trials, systematic reviews and observational studies evaluating propranolol in anxiety disorders, post-traumatic stress disorder (PTSD), antipsychotic-induced akathisia, aggression, behavioural disturbances in dementia and psychotropic-induced tremors.

Results: Propranolol reduces peripheral autonomic arousal and influences central noradrenergic circuits implicated in fear learning and emotional memory. Strong evidence supports its efficacy in performance anxiety and antipsychotic-induced akathisia. It demonstrates benefit in aggression associated with neurodevelopmental and neurocognitive disorders and in tremor secondary to mood stabilisers. Its role in PTSD, particularly in memory-reconsolidation-based protocols, shows promise but remains inconsistent. Concerns include cardiopulmonary contraindications, potential misuse and limited evidence for chronic anxiety disorders.

Conclusion: Propranolol serves as a versatile adjunctive agent in psychiatry, particularly for performance anxiety, akathisia, aggression and medication-induced tremors. Its use requires careful individualisation due to safety considerations and limited long-term evidence.

Prevalence and patterns of psychiatric emergencies and its risk of aggressive behavior in a tertiary care hospital: A cross-sectional study

P. Monisha, Ramakrishnan

SRM Medical College Hospital and Research Center, Chennai, Tamil Nadu, India

Introduction: The aim of this study is to evaluate the prevalence, understand the pattern of psychiatric emergencies and to assess the risk of violent behavior associated with emergencies using standardized psychiatric assessment tools presenting to a tertiary care hospital in Chengalpattu, Tamil Nadu, South India.

Materials and Methods: This cross-sectional descriptive study was conducted over six months ( Feb 2025-July 2025) in the Emergency Department of SRM Medical College Hospital, Chengalpattu, Tamil Nadu. A total of 193 patients aged above 18 years who required psychiatric evaluation were included using convenience sampling. Data were collected through structured interviews after obtaining informed consent. The Mini International Neuropsychiatric Interview (MINI-Plus) was used for diagnosis, while the Columbia Suicide Severity Rating Scale (C-SSRS) and Modified Overt Aggression Scale (MOAS) were applied to assess suicidality and aggression respectively. Ethical approval was obtained from the Institutional Ethics Committee, and confidentiality was strictly maintained.

Results: Among the 193 participants, most were aged 26-35 years, with females (58%) predominating. The majority were married (66.8%), belonged to middle socioeconomic status (58.5%), and resided in urban areas (52.8%). Alcohol dependence and anxiety disorders were the most common diagnoses, while deliberate self-harm and suicidal behavior constituted 34.2% of all referrals. The C-SSRS was positive in 40.9% of participants, and the MOAS indicated aggressive behavior in 28.5%. Substance use was present in 39.9%, and 13.5% reported prior suicide attempts.

Conclusion: Psychiatric emergencies were predominantly related to suicidality, alcohol use, and anxiety. This poses a need for triaging of psychiatric emergencies.

A cross sectional study to assess the prevalence of internet addiction and its association with social avoidance and sleep quality in adults

V. Mugilarasi, W. J. Alexander Gnanadurai, C. Jayakrishnaveni

Department of Psychiatry, Government Kilpauk Medical College Hospital, Chennai, Tamil Nadu, India

Background: Internet use is integral to daily life, but problematic or excessive internet usage is linked to various psychological symptoms. There is a high prevalence of internet addiction among adults, where non-productive activities like gaming and social media consume their lives and negatively affect their education and career. Poor sleep quality and excessive sleepiness are also common correlates of internet addiction.

Aims: This study aims to assess the prevalence of internet addiction in adults, and to assess social avoidance and sleep quality in adults with internet addiction. A further objective is to assess the association between the severity of internet addiction with sleep quality and social avoidance.

Methods: A cross-sectional design was employed using convenience sampling. Participants completed the Internet Addiction Test along with validated scales for social avoidance and sleep quality. Descriptive statistics, Pearson correlations, and regression analyses were conducted.

Results: The primary hypothesis was supported, with a high proportion of participants showing moderate-to-severe internet addiction. Poor sleep quality was common, with many participants scoring above the PSQI > 5. Higher internet addiction scores were significantly correlated with greater social avoidance and poorer sleep quality, including sleep disturbances and daytime dysfunction.

Conclusion: The study shows that problematic internet use is strongly linked with both higher social avoidance and poorer sleep quality. Individuals with greater internet addiction experience more social avoidance, and disrupted sleep patterns. These findings emphasize the need for early identification and combined interventions that address internet-use habits, social avoidance symptoms, and sleep hygiene to improve overall functioning.

A cross sectional study to assess stress level and disability in patients with anxiety disorders attending psychiatry OPD in KMCRI Hubballi Mukesh Chand^1,2, Mahesh Desai¹

¹Karnataka Medical College and Research Institute, Hubballi, Karnataka, ²AIIMS, Gorakhpur, Uttar Pradesh, India

Background: Anxiety disorders are among the most common mental health conditions worldwide, characterized by excessive fear, worry, and behavioral disturbances. They significantly impact the quality of life, leading to substantial functional impairments. In India, the prevalence of anxiety disorders is notable, with urban areas showing higher rates.

Objective: This study aims to assess the levels of stress and disability among patients with anxiety disorders attending the psychiatry outpatient department at KMCRI, Hubballi, Karnataka. The study also seeks to explore the associations between anxiety severity, perceived stress, and functional disability.

Methods: A cross-sectional study was conducted on 70 patients diagnosed with anxiety disorders based on DSM-5 criteria. Data collection involved structured interviews using the Hamilton Anxiety Rating Scale (HAM-A), Perceived Stress Scale (PSS), and WHO Disability Assessment Schedule 2.0 (WHODAS 2.0). Statistical analyses were performed using SPSS version 26, with significance set at p<0.05.

Results: The majority of participants were aged 31-45 years (55.7%), with a slight predominance of females (52.9%). A significant proportion of patients (61.4%) belonged to the upper lower socio-economic class. The results indicated that higher levels of perceived stress were associated with more severe anxiety symptoms and greater disability. A significant correlation was found between anxiety severity and stress (p<0.0001), and between stress and disability (p<0.0001).

Conclusion: The findings highlight the significant impact of stress on anxiety and disability in patients with anxiety disorders. There is a need for integrated treatment approaches that address both anxiety and associated stress to improve functional outcomes in these patients.

Early life malnutrition and severe mental illness: A study using anthropometry

Mustafa Ali, Sanjeev Jain¹, Biju Viswanatha²

IHBAS, New Delhi, ¹Rohini Nilekani Centre for Brain and Mind, National Institute of Mental Health and Neurosciences (NIMHANS), ²Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India

Insufficient intake of both micro- and macronutrients in early life has an impact on both physical and mental health in adulthood and may contribute to the risk of severe mental illness. Patients with severe mental illness (SMI) had significantly reduced sitting height and a lower sitting height/standing height ratio, suggestive of inadequate nutrition in early, pre-adolescent life. The sitting height and the sitting height/standing height ratio correlated significantly with an earlier age at onset (AAO) in male patients and modestly with AAO in females. Growth stunting is a major public health concern in the Indian population. As a result of chronic malnutrition, growth stunting may impact cognitive and physical development, have epigenetic consequences, contribute to de novo mutations, both somatic and germline, and interfere with DNA stability. These factors could also contribute to the risk and recovery from mental illness in later life.

Key words: Bipolar disorder, growth stunting, malnutrition, schizophrenia

Correlation of severity of alcoholism with age of onset and family history of alcoholism; A study on Indian males

G. S. V. Nagarjun Yadav, Sumati Arikera, T. R. Chandrashekhar

Belagavi Institute of Medical Sciences, Belagavi, Karnataka, India

Background: In a developing country like India, with its markedly different socio-cultural milieu, would have alcohol dependent persons who may be subtyped with the age-of-onset criterion, with respect to at least some of the biological, clinical, psychological, behavioural and social variables.

Aims and Objectives:

1. To study the relationship between the age of onset and severity of alcoholism.

2. To study the relationship between family history and severity of alcoholism.

Materials and Methods: A Retrospective Cohort Study on 74 males who were diagnosed with Alcohol Dependence Syndrome at Belagavi Institute of Medical Sciences was conducted. Demographic details were collected; the severity of alcoholism was assessed using Severity of Alcohol Dependence Questionnaire (SADQ).

Results: The mean SADQ severity score showed that subjects with early onset and a positive family history had the highest severity (40.4±4.8), whereas those with late onset and no family history had the lowest (30.3±11.7).

A linear regression model confirmed that both early onset and positive family history significantly predicted higher severity (R²= 0.20).

Pearson correlation showed severity was positively associated with family history and with early onset.

Conclusion: Severity of alcohol dependence was significantly greater in individuals with early drinking onset and those with a positive family history, suggesting that delayed initiation of drinking and addressing familial risk could be important for reducing dependence severity.

Metabolic side effects of amisulpride in psychiatric patients – A retrospective study

N. Navitha

KVG Medical College and Hospital, Sullia, Karnataka, India

Background: Amisulpride is a second-generation antipsychotic with lower risk of extrapyramidal side effects compared with first-generation antipsychotics. However, concerns persist regarding its metabolic side effects and hyperprolactinemia, especially in Indian populations with rising rates of metabolic syndrome.

Aim: To evaluate the prevalence and severity of metabolic side effects associated with amisulpride in psychiatric patients.

Methods: A retrospective cross-sectional study was conducted at the Department of Psychiatry, KVG Medical College, Sullia, India, between January and December 2024. Sixty patients aged 18-65 years receiving amisulpride monotherapy (~600 mg/day) for 6 months were included. Patients with pre-existing metabolic or endocrine disorders, concurrent psychotropics, or incomplete records were excluded. Baseline and follow-up (6 months) parametersweight, BMI, fasting glucose, HbA1c, fasting lipid profile, and prolactinwere analysed using paired t-tests, subgroup comparisons, and multivariate regression.

Results: The mean age was 32.1±8.0 years; 58.3% were male. Mean treatment duration was 14.4±5.2 months. Significant increases were observed in weight (mean 1.2 kg, P<0.001), BMI (P<0.001), total cholesterol (170.1-186.8 mg/dl, P<0.001), and LDL cholesterol (110.6-116.7 mg/dl, P=0.006). Fasting glucose, HbA1c, HDL, and triglycerides showed no significant change. Prolactin levels increased markedly (17.5-112.4 ng/ml, P<0.001), with higher elevations in females (21.1-189.2 ng/ml) than males (14.9-57.6 ng/ml; P<0.001). Hyperprolactinemia occurred in 95% of patients, though only 10% developed clinical symptoms.

Conclusion: Amisulpride causes minimal weight gain and no glycaemic alterations but significantly elevates cholesterol and prolactin, especially in females. Regular lipid and prolactin monitoring is essential to reduce long-term risks.

Key words: Amisulpride, hyperprolactinemia, metabolic syndrome

Decoding personality in psychogenic nonepileptic seizures

D. S. Navya Shree, A. Sharanabasappa

Sapthagiri Institute of Medical Sciences and Research Center, Bengaluru, Karnataka, India

Background: Psychogenic non epileptic seizures (PNES) are functional neurological episodes driven by psychological factors rather than epilepsy. Patients often face distress, interpersonal difficulties, and stress sensitivity. Personality traits may shape symptom expression, coping, and treatment engagement. This study examines the personality profile of PNES patients using a brief self report measure.

Aims: To describe personality traits among patients with PNES using the TIPI and to identify prominent trait patterns within this population.

Methodology: Design: Cross-sectional descriptive study conducted. Inclusion: Adults 18-60 years with PNES diagnosis and able to complete questionnaires. Exclusion: Major neurological illness, intellectual disability, or acute psychiatric instability. Tools: Sociodemographic proforma and a self-report personality inventory – TIPI. Analysis: Data analyzed using descriptive statistics (mean ± SD; frequencies and percentages).

Results: Thirty PNES patients were assessed (mean age 29.8 ± 7.6 years; 63% female). Personality scores showed higher agreeableness (5.1 ± 1.0) and openness (4.8 ± 1.0), moderate conscientiousness (4.2 ± 1.1), and lower emotional stability (3.1 ± 1.3). This profile reflects a combination of emotional vulnerability with generally cooperative and receptive interpersonal tendencies.

Conclusion: PNES patients in this study displayed a personality profile marked by low emotional stability alongside higher agreeableness and openness. These traits may shape symptom expression, stress sensitivity, and therapeutic engagement. Recognizing such patterns can support more tailored communication and enhance the effectiveness of psychological interventions for PNES.

Prevalence of nomophobia and its correlation with internet addiction among medical graduates: A cross sectional study Neerupreet Kaur Dhillon, Bhagwat N. Rajput, Harish Kumar

World College of Medical Sciences and Research and Hospital, Rohtak, Haryana, India

Background: With the rapid expansion of digital technology, the fear of being without one’s mobile phone or internet has emerged as a growing concern among all including the students. Given the increasing use of smartphones for both academic and recreational purposes, many medical undergraduates are at risk of developing problematic dependence that may influence their mental health and academic life.

Objective: This study aimed to determine the prevalence of nomophobia among undergraduates in India and to examine its correlation with internet addiction.

Methods: A cross sectional study was conducted among the medical undergraduate students at WCMSRH. Data were collected through a structured questionnaire that included the Nomophobia Questionnaire (NMP-Q) and the Internet Addiction Test (IAT). Descriptive statistics were applied to assess prevalence levels, and correlation analysis was performed to explore the relationship between nomophobia and internet addiction.

Results: A significant proportion of students exhibited moderate to severe levels of nomophobia. Similarly, a high percentage showed moderate to severe internet addiction. Correlation analysis revealed a significant positive association between nomophobia and internet addiction scores.

Conclusion: Nomopobia and internet addiction are highly prevalen among undergraduate students and strongly interrelated. Educational institutions should promote awareness, provide psychological support, and encourage balanced digital habits to reduce these issues and improve overall well-being and academic outcomes.

Association between neurocognition and retinal thickness in schizophrenia – A cross-sectional study

Neha Makkithaya, S. Madhusudan, K. Kiran Kumar

Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India

Introduction: Schizophrenia is marked by significant cognitive impairment alongside structural brain abnormalities. Recent evidence suggests that retinal changes, particularly reduced foveal thickness and peripapillary retinal nerve fiber layer (pRNFL) thickness, may serve as peripheral indicators of neurodegeneration due to shared neurodevelopmental origins with the brain. Limited Indian data exists regarding whether retinal thickness correlates with neurocognitive performance. This study aimed to evaluate retinal thickness and cognitive functioning in individuals with schizophrenia and examine the association between these variables.

Methods: A cross-sectional study was conducted among 33 clinically stable patients with schizophrenia at Victoria Hospital, BMCRI. Symptom severity was assessed using PANSS. Neurocognition across seven domains was evaluated using the Indian standardized NIMHANS neuropsychological battery. Retinal measuresfoveal thickness and pRNFL thicknesswere obtained via optical coherence tomography (OCT). Data were analyzed using SPSS v24, employing Pearson’s correlation to explore associations between retinal metrics and cognitive scores.

Results: Participants demonstrated cognitive deficits across multiple domains, and OCT findings showed mild reductions in retinal thickness. Correlation analysis revealed weak, non-significant associations between retinal thickness and cognitive performance (foveal thickness: r = 0.18-0.24; pRNFL: r = -0.05 to 0.21; p > 0.05).

Discussion: Although both cognitive impairment and subtle retinal thinning were observed, their association was weak. Small sample size, illness variability, and treatment effects may explain the negligible correlation. While retinal imaging remains a promising potential biomarker, larger studies are needed to determine its utility in assessing cognitive dysfunction in schizophrenia.

A comparative study of female sexual dysfunction among hypertensive women on telmisartan versus telmisartan and cilnidipine combination therapy at a tertiary care centre in Bengaluru

Nehal Kejriwal

Rajarajeswari Medical College and Hospital, Bengaluru, Karnataka, India

Background: Female sexual dysfunction (FSD) is a prevalent but underrecognized concern among hypertensive women, and certain antihypertensive agents may impair sexual function. Telmisartan, an angiotensin receptor blocker, may influence sexual health via vascular and hormonal mechanisms, while cilnidipine, a dual L/N-type calcium channel blocker, offers endothelial and sympathetic inhibitory effects that may help preserve sexual function.

Aims: To compare the prevalence and severity of FSD in hypertensive women receiving telmisartan monotherapy versus telmisartan with cilnidipine combination therapy.

Methods: We conducted a cross-sectional comparative study of 50 hypertensive women attending a tertiary care centre in Bengaluru. Patients were divided into two groups: Group A (telmisartan only, n = 25) and Group B (telmisartan + cilnidipine, n = 25). Sexual function was assessed using the Female Sexual Function Index (FSFI). Statistical analysis was performed using SPSS version 26, and p < 0.05 was considered significant.

Results: FSD was more common in Group A (72%) than in Group B (44%) (p = 0.04). Mean FSFI scores were significantly lower in Group A (22.18 ± 3.12) compared to Group B (26.48 ± 2.85) (p = 0.001). Domain-wise analysis showed better preservation of desire, arousal, lubrication, orgasm, and satisfaction in the combination-therapy group. A negative correlation existed between hypertension duration and FSFI score (r = -0.318, p = 0.027).

Conclusion: In hypertensive women, telmisartan with cilnidipine appears more effective than telmisartan alone in preserving sexual function, suggesting a protective role of cilnidipine.

Key words: Cilnidipine, female sexual dysfunction, FSFI, hypertension, telmisartan

Awareness and insight regarding nicotine use in nursing students: A cross-sectional study

Nidhi, B. Kavitha, Sharanabasappa Algudkar

Sapthagiri Institute of Medical Sciences and Research Center, Bengaluru, Karnataka, India

Background: Nicotine use remains a significant public health concern, with increasing prevalence among young adults, including healthcare trainees. Nursing students play an essential role in tobacco cessation and health education; however, their personal nicotine use, awareness, and insight into dependence may influence their future professional practice.

Aim: To assess nicotine dependence, awareness, and insight regarding nicotine use among nursing students.

Methods: A cross-sectional study was conducted among 90 nursing students at a tertiary care institution. Participants reporting any form of nicotine use were assessed using the Fagerstrom Test for Nicotine Dependence (FTND) and the Nicotine Awareness Scale (NAS). Sociodemographic details, patterns of use, and attitudes toward quitting were recorded. Data were analyzed using descriptive and inferential statistics.

Results: The mean age of participants was 21.4 ± 2.1 years, and 38% reported current nicotine use in smoking or smokeless forms. Among users, 62% demonstrated low to moderate dependence (mean FTND score: 3.8 ± 1.6), while 18% showed high dependence. Awareness of nicotine-related health risks was moderate (mean NAS score: 68.5 ± 12.4/100). However, only 42% recognized their nicotine use as a form of addiction. A significant negative correlation was observed between awareness and dependence scores (r = -0.41, p < 0.01).

Conclusion: The study highlights a gap between awareness and personal insight regarding nicotine dependence among nursing students. Incorporating targeted psychoeducation and tobacco cessation training into nursing curriculum may enhance self-awareness and strengthen preventive healthcare roles.

Internet overuse and its association with alexithymia in female medical students of a tertiary care hospital

Nidhi Dixit, Kiran Jakhar, M. K. Srivastava

GIMS Hospital, Greater Noida, Uttar Pradesh, India

Background: Excessive internet use is increasingly recognised as a behavioural problem affecting mental health in young adults. Medical students may be particularly vulnerable due to high academic demands and prolonged digital engagement. Alexithymiadifficulty in identifying and describing emotionshas been linked with addictive behaviours, yet its relationship with internet overuse among female medical students remains underexplored.

Aims: To determine the prevalence of internet overuse and examine its association with alexithymia in female medical students.

Methods: This cross-sectional study involved 200 female undergraduate and postgraduate medical students aged 18-40 years from a tertiary care teaching hospital in central India. Participants completed a socio-demographic proforma, Young’s Internet Addiction Test (IAT), Toronto Alexithymia Scale-20 (TAS-20) and General Health Questionnaire-12 (GHQ-12). Data were analysed using descriptive statistics and correlation tests; p < 0.05 was considered significant.

Results: Overall, 68% of participants met criteria for internet addiction: 42.5% mild, 20.5% moderate, and 5% severe. Students with moderate to severe internet overuse had significantly higher TAS-20 total scores compared with non-addicted peers. A moderate positive correlation was observed between IAT and TAS-20 scores, particularly in €œdifficulty identifying feelings and €œdifficulty describing feelings subdomains (r > 0.30, p < 0.01). Higher internet use levels were also associated with elevated psychological distress and functional impairment.

Conclusion: Internet overuse is common among female medical students and is significantly associated with alexithymic traits and psychosocial dysfunction. Screening for alexithymia may inform preventive strategies to mitigate problematic internet use in this population.

Thyroid function tests in generalized anxiety disorder and depressive disorders, and their association with symptom severity scores

Nikhita Loomba, Sanjay Agrawal, Shruti Srivastava, Rajarshi Kar, Nishant Raizada

University College of Medical Sciences and Guru Teg Bahadur Hospital, New Delhi, India

Background: Thyroid hormones influence neurodevelopmental, metabolic and affective processes, and abnormalities in them have long been associated with depressive and anxiety symptoms. However, comparative data examining thyroid function tests (TFTs) in Generalized Anxiety Disorder (GAD) and Depressive Disorders (DD), and their association with severity scores, remain limited in Indian clinical populations.

Aims: To compare TSH, fT3 and fT4 levels between patients with GAD and DD, and to examine the association of these parameters with symptom severity.

Methods: A cross-sectional comparative study was conducted on 126 adult outpatients (63 of each group) diagnosed using ICD-10 criteria at a tertiary-care hospital. Sociodemographic details, anthropometric parameters, and clinical variables were noted. Serum TSH, fT3 and fT4 were measured using immunoassay. Severity was assessed using HAM-A and DASS-21 in GAD, and HAM-D and DASS-21 in DD. Appropriate statistical tests and correlation analyses were performed.

Results: Median TFT values were within the laboratory reference ranges in both groups. Between-group comparisons showed no statistically significant differences in TSH, fT3 or fT4 levels between GAD and DD. Further, no significant correlations were found between TSH, fT3, or fT4 and symptom severity on HAM-A, HAM-D or DASS-21 in either group. Subclinical thyroid dysfunction was seen in a minority, did not differ between the groups.

Conclusion: In this study, patients with GAD and DD had comparable thyroid profiles, and TFT parameters did not demonstrate significant associations with illness severity. Thyroid indices appear to reflect background physiological variation rather than a state marker of symptom burden in these disorders.

Serum 25-hydroxyvitamin D levels in generalized anxiety disorder and depressive disorders, and their association with symptom severity

Nikhita Loomba, Sanjay Agrawal, Shruti Srivastava, Rajarshi Kar, Nishant Raizada

University College of Medical Sciences and Guru Teg Bahadur Hospital, New Delhi, India

Background: Vitamin D, with neuroimmunological and neuromodulatory roles has been implicated in the pathophysiology of common mental disorders. However, data from Indian tertiary-care settings directly comparing serum 25(OH)D levels in Generalized Anxiety Disorder (GAD) and Depressive Disorders (DD), and examining their association with standardized severity measures, remain limited.

Aims: To evaluate and compare serum 25(OH)D levels in patients with GAD and DD, and to examine the association between 25(OH)D levels and symptom severity.

Methods: In this comparative cross-sectional study, 126 adult outpatients (63 of each group) diagnosed using ICD-10 criteria were recruited from a tertiary-care general hospital. Sociodemographic and clinical variables (including daily sunlight exposure) were recorded. Serum 25(OH)D was estimated using immunoassay. Severity was assessed using HAM-A and DASS-21 in GAD, and HAM-D and DASS-21 in DD. Appropriate statistical tests and correlation analyses were applied.

Results: Patients of GAD and DD groups were broadly comparable on sociodemographic variables, illness variables, anthropometric parameters and sunlight exposure. Median serum 25(OH)D levels were in the deficient range in both groups [GAD: 16.54 (±13.57) ng/mL; DD: 15.92 (±14.29) ng/mL], with no statistically significant between-group difference. Analysis of 25(OH)D in relation to HAM-A, HAM-D and DASS-21 scores showed no overall correlation with illness severity in either diagnostic group.

Conclusion: Vitamin D deficiency was highly prevalent and comparable across GAD and DD, and 25(OH)D levels did not demonstrate a consistent association with symptom severity. In this sample, 25(OH)D appears to be a shared background factor than as a state-sensitive biomarker of GAD or DD severity.

Predictors of relapse in alcohol dependence syndrome – A hospital based case control study in rural Central India

Nitisha Pramod Shirbhate, Harshal Sathe, Sally John

MGIMS, Sewagram, Wardha, Maharashtra, India

Background: Alcohol Dependence Syndrome (ADS) imposes a substantial global burden, contributing 5.1% to disability-adjusted life years, with relapse posing a chronic challenge influenced by biopsychosocial factors. In rural Central India, where AUD prevalence reaches 1 in 12 adults, predictors of relapse remain underexplored despite high treatment dropout rates.

Aims: This case-control study compared psychological, social, and personality factors between relapsed (cases, n=69) and abstinent (controls, n=43) ADS patients to identify relapse predictors.

Methods: Adult males (18-65 years) from a rural tertiary psychiatry center underwent assessment via PHQ-9 (depression), GAD-7 (anxiety), Insomnia Severity Index, Presumptive Stressful Life Events Scale (PSLES), Multidimensional Scale of Perceived Social Support (MSPSS), and Ten-Item Personality Inventory (TIPI). Relapse defined as >3 lapses or 30g alcohol/day in prior 3 months; abstinence as none. Mann-Whitney U tests analyzed non-normally distributed scores.

Results: Cases exhibited significantly higher depression (PHQ-9, U=2506.500, p=0.001), anxiety (GAD-7, U=2367.500, p=0.001), insomnia (U=2541.000, p=0.001), and PSLES scores (U=1823.000, p=0.003), alongside lower emotional stability (U=878.500, p=0.001) and MSPSS total (U=969.000, p=0.002; family p=0.008, friends p=0.042, significant other p=0.046). No sociodemographic differences emerged.

Conclusion: Elevated psychological distress, insomnia, stress, neuroticism, and diminished social support robustly predict ADS relapse. Targeted interventions enhancing resilience and support networks hold promise for sustained abstinence in resource-limited settings.

Key words: Alcohol dependence, psychological distress, relapse predictors, rural India, social support

Clinical application and efficacy of repetitive transcranial magnetic stimulation (rTMS) in treatment-resistant obsessive-compulsive disorder: Experience from SKIMS Kashmir, India

Nizam Ud Din Dar, Abdul Majid Gania

SKIMS, Srinagar, Jammu and Kashmir, India

Background: Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive neuromodulation technique that alters cortical excitability through electromagnetic induction. Since its development in the late 20^th century, rTMS has gained regulatory approval for major depressive disorder (MDD), obsessive-compulsive disorder (OCD), migraine, and other neuropsychiatric conditions. Growing global and Indian evidence supports its role as an effective and safe option, particularly in treatment-resistant psychiatric disorders. This abstract summarizes the clinical application of rTMS, with special emphasis on experience from SKIMS.

Methods: Patients with treatment-resistant OCD were carefully selected after ruling out contraindications and obtaining informed consent. rTMS was administered using DB-80 coil.. Motor threshold was determined using standard methods, and stimulation parameters were individualized according to established protocols. Patients received 20-30 sessions targeting disorder-specific cortical regions, alongside ongoing pharmacotherapy when indicated. Clinical outcomes and follow-up evaluation were assessed using standardized rating scales (YBOCS).

Results: International and Indian studies demonstrate that rTMS produces significantly greater response and remission rates than sham stimulation in MDD and OCD, with good tolerability. At SKIMS MCH Bemina, 50 patients with OCD were treated, higher stimulation intensity (>50%) and completion of 25-30 sessions were associated with better outcomes. At two-month follow-up, a substantial proportion achieved and maintained full or partial remission with no serious complications.

Conclusion: rTMS is safe, effective, and well-tolerated. Optimal outcomes depend on appropriate patient selection, adequate stimulation intensity, and completion of the full treatment course. Integration of rTMS into routine psychiatric care can significantly improve outcomes in refractory OCD.

Association of stressful life events with different types of first episode of psychosis among patients attending tertiary care unit: A cross sectional analytical – Pilot study

Padmavathi Nagarajan, R. Rajeswari, Vikas Menon

Department of Psychiatry, JIPMER, Puducherry, India

Introduction: Psychosis, characterized by hallucinations, delusions, and social withdrawal, leads to disability and heightened suicide risk, particularly in schizophrenia. Early treatment improves outcomes, as untreated psychosis worsens prognosis. Stressful life events interacting with biological vulnerability are key triggers for first-episode psychosis.

Aims and Objectives: This study examines the association between stressful life events and types of first-episode psychosis in a tertiary care setting, and evaluates the impact of socio-demographic and clinical factors on these stress experiences.

Materials and Methods: A cross-sectional analytical study was conducted among 50 first-episode psychosis patients attending JIPMER, Puducherry, recruited through consecutive sampling. Eligible participants were aged 18 years or older, of either gender, experiencing a first episode of psychosis within the past 12 months, and had not received antipsychotic medication or psychotherapy. Stressful life events and perceived stress were measured with the Presumptive Stressful Life Events Scale and Perceived Stress Scale respectively while symptom severity was assessed using the Brief Psychiatric Rating Scale.

Results: Among 50 first-episode psychosis patients, the majority were females (56%) with a median age of 34.5 years. Schizophrenia was the most common diagnosis (28%), followed by acute transient psychotic disorder (20%) and bipolar disorder with psychotic features (16%). Overall, 68% had non-affective psychosis and 32% affective psychosis. Non-affective psychosis patients showed significantly higher stressful life event scores compared to affective psychosis patients.

Conclusion: Stressful life events are more strongly linked to non-affective first-episode psychosis, with higher stress observed in males and rural populations.

Hyponatremia in psychiatry inpatients – A retrospective study in a tertiary care hospital

Pallavi Saini, Nayana Naik, Mary Coni Dsouza

Institute of Psychiatry and Human Behaviour, Bambolim, Goa, India

Background: Hyponatremia, defined as serum sodium <136 mEq/L, is a clinically important electrolyte disturbance in psychiatric inpatients. Its nonspecific symptoms often overlap with psychiatric symptoms, leading to delayed recognition. Chronic patients, especially those with schizophrenia, psychogenic polydipsia, or on psychotropics such as SSRIs, mood stabilizers, and antipsychotics, are particularly vulnerable. Even mild hyponatremia can precipitate seizures, falls, coma, or death, especially in older adults, highlighting the importance of early detection.

Aim: This study aimed to estimate the prevalence of hyponatremia among psychiatric inpatients, describe associated clinical symptoms, and examine its relation with demographic and diagnostic variables.

Methods: A retrospective cross-sectional study was conducted at a tertiary care hospital. Records of adult inpatients (>18 years) admitted for more than one year were reviewed using convenience sampling. Patients with medical or surgical renal illnesses were excluded.

Results: Of 96 psychiatric inpatients, 37 had hyponatremia, giving a prevalence of 38.5% (95% CI: 29.4-48.5%). Among these, 64.9% were male and 35.1% female, with the highest prevalence in the 40-50-year age group (29.7%). Schizophrenia was the leading diagnosis, seen in 54.1% of cases. Clinical symptoms were observed in 54.0%, most frequently dizziness (45.0%) and polydipsia (40.0%). Mean sodium was 129.32 ± 4.17 mmol/L, and potassium 4.04 ± 0.47 mmol/L. No significant gender (Na: p=0.177; K: p=0.747) or seizure-history differences (Na: p=0.326; K: p=0.139) were noted.

Conclusion: Hyponatremia is common among psychiatric inpatients and often remains asymptomatic without reliable predictors. Routine biochemical monitoring is vital for timely identification and prevention of serious complications.

Evidence-based understanding of the transcendence-spirit-soul-mind continuum: Towards a pedagogy for training psychiatrists as healers of soul and mind

Parameshwaran Ramakrishnan^1,2

¹The AdiBhat Foundation of India, New Delhi, India, ²Tower Health Phoenixville Psychiatry, Drexel University College of Medicine, PA, USA

Background: The term psyche historically encompassed both mind and soul, yet contemporary psychiatry has largely neglected the spiritual dimension. Empathic listening (EL), a phenomenological approach, may provide an evidence-based pathway to reintegrate constructs of transcendence, spirit, and soul into psychiatric care.

Aims: To develop an evidence-based understanding of the €œSpiritual Structures of the Mind and propose a pedagogical framework for spiritually informed psychiatric training.

Methods: Twelve case studies were inductively analyzed from two series: (1) a clinical series (N=6) by a psychiatrist trained in chaplaincy, with EEG data recorded from the provider; and (2) a classroom series (N=6) within a graduate course on Clinical Evidence-Based Theology at UC Berkeley, with EEG recordings from both providers and recipients. Analyses integrated patients’ healing experiences, providers’ transcendent states, neuroscientific literature on empathy and meditation, and EEG findings.

Results and Discussion: EL encounters demonstrated two distinct healing states. The self-transcendent state, marked by gamma predominance, was described by patients in spiritual terms (God, Samadhi, Mashallah) and reflected a thought-free Divine awareness correlated with healing. Providers reported awe and nonagency, signifying parallel transcendence. The mindful-meditative state, associated with theta-delta predominance, enabled self-reflection, self-empathy, and patient identification with the soul (nafs, atman), facilitating disentanglement from passion-driven turmoil. Shifts in breathing further underscored links between breath, spirit, and recovery.

Conclusion: EL enables patients’ transition from soul-state to transcendence, fostering tranquility and healing. EL training provides psychiatrists a first-person understanding of patients’ inner world, enhancing diagnostic accuracy and offering protection against burnout through their own self-transcendent experiences.

Effect of adjunctive high-definition transcranial direct current stimulation in treatment of depression – A double blinded randomized sham-controlled study

Paramjeet Singh, Aditya Somani, Lokesh Kumar Singh

All India Institute of Medical Sciences, Raipur, Chhattisgarh, India

Background: High-definition transcranial direct current stimulation (HD-tDCS) is a neuromodulation technique proposed to enhance cortical targeting and potentially improve depressive symptoms. Its adjunctive efficacy in patients receiving standard treatment for depressive disorders remains uncertain.

Aims: To compare the effect of adjunctive active HD-tDCS with sham HD-tDCS in reducing depressive symptom severity and improving remission rates in patients with depression.

Methods: A double-blind randomized sham-controlled trial was conducted in adults (18-50 years) diagnosed with depressive disorders as per ICD-10-DCR. Fifty participants were randomized to receive either active HD-tDCS (2 mA, 20 minutes, 10 sessions) or sham stimulation (0.2 mA). All participants continued treatment as usual. Outcome assessments were performed at baseline, after 10 sessions, and at 4-week follow-up using the Hamilton Depression Rating Scale (HAM-D). Analysis was done using repeated measures ANOVA under intention-to-treat and per-protocol frameworks.

Results: Both active and sham groups showed significant improvement in depressive symptoms over time (p < 0.001). However, there was no significant group — time interaction for HAM-D scores in either intention-to-treat (p = 0.565) or per-protocol analysis (p = 0.658), indicating no differential reduction in symptom severity between active and sham HD-tDCS. Remission rates did not significantly differ between groups.

Conclusion: Adjunctive HD-tDCS did not demonstrate superior efficacy over sham stimulation in reducing depressive symptom severity or improving remission rates. Improvements observed across both groups likely reflect non-specific therapeutic factors or concurrent standard treatment effects.

Comparative study of delirium symptoms in elderly and young adults

Pariniti Khillan

PGIMER, Chandigarh, India

Background: Little information is available about similarity and differences in the symptom profile of older adults and young adult patients experiencing delirium.

Aim: To compare the symptom profile of delirium in elderly (>60 years) and young patients (18-60 years).

Methods: 335 patients referred to the Psychiatry consultation liaison service were prospectively evaluated on the Delirium Rating Scale - Revised 98 (DRS-R 98) for the symptom profile.

Results: The study consisted of 335 subjects out of which 63.2% were young adults and 37.8% were older adults, with male: female ratio of 3:1. The frequency and intensity of most delirium symptoms measured by the DRS-R-98 did not differ significantly between the two groups. However, young adults showed a significantly greater prevalence and severity of affective lability (p= 0.009).

Conclusion: Older adults and young adult patients do not differ in their symptom profile.

Mental health literacy in university students: An intervention-based study

Patel Swatiben Harishbhai, Himani Dipakkumar Parikh, G. K. Vankar

Parul Institute of Medical Science and Research, Vadodara, Gujarat, India

Background: Mental health literacy (MHL) plays a critical role in early recognition of psychiatric symptoms, timely help-seeking, and stigma reduction. Despite growing awareness, misconceptions about mental illness remain common among university students in India, contributing to delayed treatment and persistent stereotypes. Short, structured educational interventions have shown promise in improving MHL, yet comparative data across multiple faculties in Gujarat remain limited.

Aim: To evaluate baseline psychiatry knowledge among students from Medical, Psychology, Nursing, and Social Work, and to assess the effectiveness of a brief psychiatry orientation lecture in improving MHL.

Methods: A pre-post interventional design was conducted at a private university in Gujarat. Participants completed a 20-item validated questionnaire assessing true/false/don’t-know responses (score range 0-20). A one-hour interactive lecture delivered by a psychiatrist covered prevalence, aetiology, diagnosis, and treatment of common psychiatric disorders. Pre-test and post-test scores were compared to determine knowledge gains across faculties.

Results: Baseline responses revealed limited knowledge related to alcohol as an addiction, bodily symptoms of psychiatric presentation, mentally ill people as violent, yoga curing all mental illness, clinical psychologist’s role in prescribing medications and psychiatric drugs being addictive. Post-intervention scores demonstrated significant improvement across all faculties (p < 0.001), with the largest gains seen in groups with lower baseline scores. Gender differences were minimal.

Conclusion: A brief psychiatrist led orientation significantly improved MHL among university students across diverse faculties. The intervention is scalable, feasible, and suitable for integration into routine academic curricula.

Long-term sexual dysfunction among survivors of head and neck cancer: A systematic review and meta-analysis

S. Pavana, B. J. Srinivasa, U. S. Vishal Rao

HCG, Bengaluru, Karnataka, India

Background: Sexual dysfunction is a frequently overlooked consequence of head and neck cancer treatment, influenced by physical changes, psychosocial distress, and treatment-related morbidity. Despite its high prevalence, sexual health is rarely discussed in routine oncology care.

Aims: To determine the pooled prevalence of long-term sexual dysfunction in head and neck cancer survivors and to evaluate patterns of desire, intercourse difficulties, sexual satisfaction, and frequency of clinical discussions on sexual health.

Methods: A systematic search of PubMed, Embase, Scopus, Google Scholar, IndMed, and medRxiv (1994-2024) identified studies reporting post-treatment sexual dysfunction in head and neck cancer survivors. Nineteen studies (n=2,739) met eligibility criteria. Data extraction was performed independently by three reviewers, and discrepancies resolved by consensus. Random-effects meta-analysis using inverse variance weighting was conducted. Heterogeneity was assessed using I² statistics.

Results: The pooled prevalence of negative impact on sexuality was 51% (95% CI: 38%-64%). Problems with sexual desire were reported by 36% (95% CI: 31%-41%), and intercourse difficulties by 50% (95% CI: 36%-64%). Only 24% (95% CI: 5%-67%) reported sexual satisfaction at one year post-treatment. Importantly, 86% (95% CI: 69%-94%) stated that sexual health was not discussed in clinical settings. Most studies assessed outcomes one year after treatment, with nasopharyngeal carcinoma being the predominant cancer type.

Conclusion: Sexual dysfunction is highly prevalent and significantly under-addressed among head and neck cancer survivors. These findings highlight the urgent need for routine sexual health assessment, structured communication, and integrated psychosexual rehabilitation within survivorship care pathways.

High-definition transcranial direct current stimulation for reducing craving in substance use disorders: A systematic review and meta-analysis

Pinki Sevda^1,2, Priyanka Saha², Jadeer K. Muhammed², Rohit Verma¹, Siddharth Sarkar²

¹Department of Psychiatry, ²National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, India

Background and Aim: Substance use disorder is a chronic relapsing illness and craving plays an important factor in relapse. High-definition transcranial direct current stimulation is a novel non-invasive brain stimulation technique which employs focal stimulation of the brain and has minimal adverse effects. However, its efficacy across substance use disorders remains underexplored. This systematic review and meta-analysis aimed to assess the efficacy of HD-tDCS on craving in substance use disorders.

Methods: Five databases including PubMed, CENTRAL, EMBASE, Scopus and Google Scholar were searched from inception to April 2025. Review included randomised controlled trials comparing HD-tDCS vs sham intervention which reported craving as an outcome. Pooled effect size was measured by random-effect model and heterogeneity was estimated by I². Risk of bias was assessed by revised Cochrane risk-of-bias tool (RoB 2.0).

Results: Out of 3155 records, three RCTs (n=138) met the inclusion criteria. Substances studied included opioid, cannabis and methamphetamine use disorders. HD-tDCS protocols were almost similar across the studies. Pooled analysis demonstrated a moderate reduction in craving compared to sham stimulation (g = -0.596; 95% CI: -1.039 to -0.152; p = 0.008) across all the studies, with minimal heterogeneity (I² = 0%). Risk of bias ranged from low to moderate.

Conclusion: HD-tDCS intervention produced a moderate, statistically significant reduction in craving across substance use disorder, with favourable tolerability. However, the small number of studies and smaller sample size of trials limits its generalizability. Larger and more substance-specific randomised trials are warranted to confirm the efficacy and optimize stimulation parameters.

Invisible burden: Psychiatric morbidity, perceived stigma and quality of life among caregivers of children with autism and intellectual disability – A cross-sectional study

Pooja Saraf, Manisha Choudhary, Shri Gopal

Dammani Institute of Mental Health and Neuroscience, PBM Hospital, Bikaner, Rajasthan, India

Background: Autism Spectrum Disorder (ASD) and Intellectual Disability (ID) are common, often co-occurring neurodevelopmental disorders that lead to significant impairments in social and adaptive functioning. Individuals with these conditions and their families frequently face stigma, which may worsen psychological distress and lower quality of life. However, limited Indian research has examined the unknown comorbid Psychiatric Disorders, perceived stigma, and quality of life and their relation among caregivers of children with ASD and ID.

Objective: To assess the prevalence of psychiatric Morbidity, Perceived stigma and impact on the quality-of-life caregivers, among children and adolescents with autism spectrum disorder (ASD) and Intellectual Disability (ID).

Marterials and Methods: This cross-sectional observational study is undergoing at S.P. Medical College, Bikaner, Rajasthan. This study include caregivers of children and adolescents diagnosed with autism spectrum disorder (ASD) and Intellectual Disability (ID). Validated Hindi versions of the Affiliate Stigma Scale (ASS), General Health Questionnaire-12 (GHQ-12), and World Health Organization Quality of Life-BREF (WHOQOL-BREF) will be administered to assess caregiver stigma, psychiatric morbidity, and quality of life respectively. Higher scores on the ASS and GHQ-12 will indicate greater perceived stigma and psychological distress, whereas higher WHOQOL-BREF scores will denote better quality of life among caregivers.

Results and Conclusion: High levels of stigma and psychological burden among caregivers of children with ASD and ID significantly reduce their quality of life. Early screening and structured psychosocial support may improve caregiver well-being and daily functioning.

Key words: Autism spectrum disorder, intellectual disability, stigma, psychiatric comorbidity

Utility of structured risk assessment in prediction and management of aggression among psychiatric inpatients in a tertiary care hospital

Prabhjot Dhillon, B. Sivaprakash

Mahatma Ghandi Medical College and Research Institute, Puducherry, India

Background: Aggression in psychiatric inpatient settings is common, with nearly 1 in 5 patients committing at least one violent act during admission and 8-18% of inpatients in Indian studies exhibiting violence. While structured risk assessment shows promise, evidence from Indian settings remains limited.

Aims and Objectives: To examine the effect of structured risk assessment on aggression and compare predictive validity of dynamic (Dynamic Appraisal of Situational Aggression) (DASA), Clinical Global Impressions Scale (CGI-S)) versus historical (Historical Clinical Risk Management-20 (HCR-20)) measures.

Methods: This observational comparative study was conducted in the Department of Psychiatry, MGMCRI. Thirtynine inpatients (aged 18) with severe mental disorders per Diagnostic and Statistical Manual-5 were randomly assigned to two groups. Group A received structured risk assessment (DASA, HCR20) plus routine assessment (CGIS). Group B received assessmentasusual. Aggressive incidents were documented using SOASR (The Staff Observation Scale - Revised).

Results: Cases (n=21) and controls (n=18) were comparable on sociodemographic and clinical variables. Aggression frequency was similar between cases and controls (0.76 vs 0.28 episodes, p>0.05). Dynamic assessments showed superior predictive validity: DASA (AUC=0.86) and CGIS (AUC=0.89) outperformed HCR20 (AUC=0.61). Lag correlation analysis showed DASA predicted nextday aggression (p<0.001). Among cases, aggression correlated strongly with illness severity and clinical judgment (r=0.67).

Conclusion: Incorporating structured dynamic risk assessmentparticularly DASA, supported by CGIS enhances shortterm prediction beyond static measures. Routine use may facilitate earlier detection and leastrestrictive management strategies.

Ctrl+Alt+Delusion: Cyber-paranoia as an emerging clinical phenotype – A four-case series

Prachi Dixit, Ajita Nayak

Seth G.S. Medical College and K.E.M Hospital, Mumbai, Maharashtra, India

Introduction: Digital dependence has transformed the landscape of paranoid ideation. Cyber-paranoia, irrational, delusionally-held beliefs involving phone hacking, online surveillance, digital cloning, or technology-mediated controlappears increasingly in schizophrenia-spectrum disorders. Growing clinical encounters suggest an emerging phenomenological subtype shaped by contemporary digital environments.

Methods: Four patients with schizophrenia and prominent cyber-themed persecutory delusions were assessed using detailed interviews, collateral information, and longitudinal history. Cases were selected to illustrate the range of digital-centric delusional content and associated psychosocial and technological vulnerabilities.

Results: Across all four patients, cyber-specific suspiciousness formed the nucleus of psychopathology before generalizing to family, neighbours, or institutions. Shared themes included phone hacking, covert surveillance, digital clones, morphing of images, financial cyber-theft, and technology-based control. All patients displayed high conviction, behavioural disturbances, and partial response to standard antipsychotics, necessitating clozapine and in some cases ECT.

Case Highlights:

Case 1: 24Mbeliefs of digital clones via a phone app, morphing into pornographic content, and impostor-parent delusion.

Case 2: 25Ffirm beliefs of phone hacking, hidden cameras, and online surveillance by ex-fiancé; repeated legal complaints.

Case 3: 29Mperceived control through a virtual game, electrical currents, and targeted online cues.

Case 4: 24Mcyber-themed delusions involving app-based digital cloning, hacking, and financial theft.

Conclusion: Cyber-paranoia represents a clinically significant, digitally-anchored variant of paranoid psychosis. Early recognition, attention to digital-contextual triggers, and psychoeducation on cyber-literacy are essential. Further research is needed to establish its diagnostic validity.

Study of impact of age of onset on quality of life in schizophrenia

Prachi Dixit, Priyanka Bodhare, Ajita Nayak

Department of Psychiatry, Seth G.S. Medical College and K.E.M Hospital, Mumbai, Maharashtra, India

Quality of life (QOL) is recognized as an important outcome measure of treatment of Schizophrenia. The QOL is a multidimensional parameter with components such as person’s satisfaction with his/her life as a whole, general wellbeing, satisfaction with his/her social and material well-being, as well as health and functional status. There is an ambiguity regarding the determinants of QOL but major influencing role of clinical variables of Schizophrenia have been consistently reported. Hence this study was conducted to compare the quality of life of patients of Schizophrenia with early age of onset to adult age of onset.

Methods: This was a cross-sectional observational study. All patients satisfied the DSM-5 Criteria of Schizophrenia. Patients between 18 to 65 years maintained on medications and with no active symptoms were included in the study. Patients with age of onset of illness before 18 years were included in group 1. Group 2 consisted of sociodemographically matched patients with onset after 18 years. Minimum duration of illness was 2 years. The WHO-QOL scale was used to compare the 2 groups on quality of life.

Results: QOL of patients in group 1were found to have less scores on all four domains of WHOQOL scale as compared to group 2 patients. A statistical significant difference was seen on physical health (p - 0.001) and psychological health domain (p - 0.001) between the 2 groups

Conclusion: Age of onset is a significant risk factor for poor quality of life in Schizophrenia. Patients with earlier age of onset are likely to suffer from significant

Psycho-neuro-immuno-endocrinological framework in psychiatry historytaking

Prashant Chaudhari, M. Krishnapriya

Bandra Care Clinic, Mumbai, Maharashtra, India

Modern psychiatry is in crisis, anchored to a diagnostic system (the DSM) forged in political compromise, not scientific discovery. This paper, synthesizing the perspective of Dr. Bhaskar Mukherjee, is a manifesto for a new kind of specialist: the Brain Physician. It calls for a radical paradigm shift away from the prevailing “medical psychologist” model towards a rigorous, systems-based neurobiological framework. This approach reframes psychiatric illness not as a collection of discrete disorders, but as the clinical expression of a single, lifelong neurodevelopmental and neurodegenerative process involving the Psycho-Neuro-Immuno-Endocrine (PNIE) axis. This manifesto will dissect the systemic rot that created this anti-medical field, deconstruct the lethal consequences of its “diktats,” and define specific, high-functioning phenotypes like the “Industrialist Rage” syndrome to demonstrate the nuanced biological management of the “Fanatic Brain.”

Laughter without joy: A case of gelastic seizure

Prateek Jain, Natasha Patel, Varun Mehta

Central Institute of Psychiatry, Ranchi, Jharkhand, India

Background: Gelastic seizures are rare focal epilepsies marked by sudden, emotionless laughter, most often from hypothalamic hamartomas but also temporal or frontal foci. Usually appearing in early childhood, they are frequently misidentified as behavioral or psychiatric issues and often resist standard antiepileptic drugs. Surgical options may be needed in hamartoma cases. We present a 13-year-old girl with recurrent inappropriate laughter, illustrating diagnostic and management challenges.

Aims: To showcase a rare case of Gelastic seizures, to highlight its clinical features, diagnostic tools, management and to raise its awareness.

Methodology: A 13-year-old girl from rural Bihar presented with seizures since 6 months of age, showing two patterns: brief laughter spells with impaired awareness occurring daily, and rarer episodes progressing to neck turning, loss of consciousness, generalized jerks, and incontinence. MRI showed a hypothalamic hamartoma, confirming gelastic seizures. She was started on Carbamazepine, Levetiracetam, and Clobazam, and scheduled for neurosurgical hamartoma resection.

Discussion: Gelastic seizures are hard to identify because their core sign, sudden inappropriate laughter, is often mistaken for behavioral or psychiatric issues. These brief, stereotyped spells may be seen as attention-seeking, mania, psychosis, pseudobulbar affect, tics, or tantrums. Minimal motor signs and subtle autonomic changes make them easy to miss, delaying diagnosis and timely EEG, imaging, and treatment.

Conclusion: This Child OPD case highlights the need for strong suspicion when evaluating episodic laughter. A structured assessment with EEG and neuroimaging is crucial for confirming diagnosis.

This paper has been presented at JASCON 2025 (Jharkhand State CME).

A clinical study of the pattern of cannabis use among patients with schizophrenia

Prayashi Kashyap

Jorhat Medical College and Hospital, Jorhat, Assam, India

Background: Cannabis has a diverse history due to its fibre-producing and psychoactive properties. Strong epidemiological evidence links chronic cannabis use to the onset of schizophrenia, especially in vulnerable individuals, or to the worsening of symptoms in those with the illness.

Aim: To determine the patterns of cannabis use and its relationship with the severity of illness and the clinical profile of patients with schizophrenia.

Methodology: All patients aged 18 to 60 years seen by the Gauhati Medical College and Hospital’s Psychiatry Department between October 1, 2022 and September 30, 2023 and diagnosed as “Schizophrenia” and had used cannabis are included in our study. A brief history of cannabis use patterns and disease indicators was collected. Patients completed the Positive and Negative Syndrome Scale (PANSS) and the Cannabis Use Disorders Identification Test-Revised (CUDIT-R).

Results: All 50 participants smoked cannabis in the form of Ganja. Chillum was the most common method used. The beginning of cannabis use and the onset of schizophrenia were found to be statistically significantly correlated (p < 0.001) with a very strong positive correlation (r = 0.968). The CUDIT-R scores of cannabis consumption and the negative and general PANSS scores of schizophrenia respectively revealed a moderate positive and statistically significant correlation. A statistically significant (p < 0.001) and extremely strong positive (r = 0.978) association was found between the total PANSS scores of schizophrenia and the CUDIT-R scores.

Conclusion: The northeastern region of India is home to many cannabis users, hence this study was beneficial.

Prevalence of psychiatric comorbidity among children with chronic kidney disease undergoing dialysis: A cross-sectional study

Preeti Kour, Rakesh Banal

Psychiatric Disease Hospital GMC, Jammu, Jammu and Kashmir, India

Background: Children with chronic kidney disease (CKD) who require dialysis experience major medical, psychological, and social challenges. Vulnerability to psychiatric diseases is increased by treatment burden, recurrent hospitalizations, and chronic illness. Despite this, pediatric nephrology continues to place insufficient emphasis on mental health evaluation.

Aim: To determine the prevalence and pattern of psychiatric comorbidity among children with chronic kidney disease undergoing dialysis using a standardized diagnostic tool.

Methods: A cross-sectional study was conducted at a tertiary care hospital that included children aged 6-18 years diagnosed with CKD and undergoing hemodialysis and peritoneal dialysis. A systematic diagnostic tool, Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID), was used for psychiatric evaluation. Clinical and sociodemographic factors, such as the length of dialysis, the etiology, concomitant diseases, and the duration of CKD, were noted. Psychiatric disorder prevalence rates were computed, and correlations with clinical factors were investigated using suitable statistical tests.

Results: A total of 26 patients were included. There was a significant prevalence of psychiatric comorbidity. As per MINI-KID, 12 patients had depressive disorders, 5 patients had generalized anxiety disorder, and 6 patients had attention deficit hyperactivity disorder. Psychiatric symptoms were more common in children who had dialysis for longer periods of time and who were hospitalized more frequently. There were no discernible gender differences. A significant percentage had co-occurring psychiatric disorders.

Conclusion: Psychiatric comorbidity is highly prevalent in children with CKD receiving dialysis. Dialysis care should incorporate routine mental health screening that may enhance general functioning and quality of life.

A study of nursing students’ attitude toward people living with HIV/AIDS using the nurses’ attitude about HIV/AIDS Scale

Preity Yarlagadda, Md Adil Faizan

Mamata Medical College, Khammam, Telangana, India

Introduction: HIV/AIDS remains a significant global health challenge, with stigma and discrimination against people living with HIV/AIDS (PLWHA) persisting despite medical advances. Nurses play a crucial role in HIV care, but their attitudes can impact the quality of care. Assessing nursing students’ attitudes toward PLWHA is vital, as these future healthcare providers’ perceptions influence compassionate care delivery. This study evaluated nursing students’ attitudes using the Nurses’ Attitude about HIV/AIDS Scale-Version 2 and examined associations with socio-demographic factors.

Materials and Methods: A cross-sectional survey was conducted among 120 undergraduate nursing students at Mamata Nursing College from March 2025 to May 2025. Participants completed a structured questionnaire including socio-demographic data and the attitude scale. Data were analyzed using descriptive statistics and Chi-square tests to assess relationships between attitudes and demographics. Ethical approval was obtained, and participation was voluntary.

Results: The sample was predominantly female (94.2%) with a mean age of 19.37 years. Most students showed generally positive attitudes toward PLWHA, with some exhibiting moderate attitudes. Chi-square analyses found no significant associations between attitudes and socio-demographic variables, except a near-significant trend related to education level (p = 0.054), with third-year students showing slightly more moderate attitudes.

Conclusion: Nursing students generally hold positive attitudes toward PLWHA, but education level may influence perceptions. Findings suggest that demographic factors alone do not predict attitudes, highlighting the need for curriculum enhancements focusing on experiential learning, stigma reduction, and empathy training to foster compassionate care for PLWHA.

The impact of tourette syndrome on social functioning and academic performance

Prerana Priyadarshini, Chhtrajit Singh Juneja

Venkateshwara Institute of Medical Sciences and Hospital, Gajraula, Uttar Pradesh, India

Background: Tourette Syndrome (TS) is a neurodevelopmental disorder characterized by motor and vocal tics, affecting academic performance and social functioning. Comorbidities like ADHD and anxiety complicate the outcomes. This study investigates the impact of TS on these domains, focusing on tic severity and associated comorbidities.

Objectives: The study aimed to assess the academic and social functioning of children and adolescents with TS, examine the relationship between tic severity and these outcomes, and identify the most common comorbidities.

Methods: A cross-sectional observational study was conducted at Venkateshwara Institute of Medical Sciences and Hospital with 100 participants aged 8-18 years. Data on tic severity, academic performance, and social functioning were collected using YGTSS, school records, and PedsQL. Statistical analyses were performed using SPSS.

Results: Significant academic and social impairments were observed in TS children. Severe tics correlated with higher absenteeism (83.3%), grade repetition (41.7%), and lower social functioning scores (48.2). Anxiety (22%) and ADHD (8%) were the most common comorbidities.

Conclusion: TS significantly impacts academic and social outcomes, with tic severity serving as a key predictor. Comorbidities like anxiety and ADHD further affect these outcomes. Early intervention and targeted support are essential to improve academic performance and social integration in children with TS.

Association between respiratory diseases with generalized anxiety disorder and depression

Prerna Jha, Ramesh Chokhani¹

Everest and Star Hospital, ¹RB Diagnostic Centre, Kathmandu, Nepal

Background: Respiratory diseases, especially COPD is a worldwide public health issue. Depression is one of the most common complications among COPD patients. Depression in respiratory diseases, patients may contribute to lower compliance with pulmonary rehabilitation, less physical activity, more frequent acute exacerbations, poor clinical outcomes.

Aims and Objectives: To determine the association between respiratory disease with generalized anxiety disorder and Depression.

Methodology: An observational cross-sectional study was conducted. A purposive sample of 100 patients attending OPD was enrolled. Descriptive statistics, including mean, standard deviation, minimum, maximum and frequency distribution tables were generated. The chi-square test was applied to assess the association between psychiatric problems, respiratory diseases and other variables. Hamilton Depression Rating scales. HAM-D and Generalized Anxiety Disorder-7 were applied.

Results: Age ranging 60 and above had higher prevalence of depression and anxiety among respiratory ill patients. The association between age and depression was found to be statistically significant (p=0.049), indicating that age was significantly associated with severity of depression.

Conclusion: The association between age and depression was found to be statistically significant. Among participants above 60 years, 32% had severe depression, 53% had moderate depression and 14% had mild depression.

Key words: COPD, depression, generalized anxiety disorder, respiratory disease

Psychosocial rehabilitation and reintegration outcomes among destitute psychiatric patients: A retrospective observational study

Prerna Nigwal, Ashvin Chouhan

MGM Medical College, Indore, Madhya Pradesh, India

Background: Destitute individuals with untreated mental illness represent a severely marginalized population, often found wandering without social support. Psychosocial rehabilitation (PSR) has proven effective for long-stay psychiatric patients, yet its application among destitute individuals remains underexplored.

Objective: To evaluate the demographic and clinical characteristics, reintegration pathways, and short-term follow-up outcomes among destitute psychiatric patients rescued and admitted to mental hospital of central India, using PSR principles described in contemporary rehabilitation literature.

Methods: A retrospective analysis of institutional records was conducted using a dataset of over 300 destitute psychiatric patients. Variables included age, gender, provisional diagnosis, days after being found, and reintegration destination. Descriptive analyses and chi-square associations were performed. Insights from a systematic review of PSR models were used to interpret findings.

Results: The cohort exhibited high rates of psychotic disorders like schizophrenia and unspecified psychosis, prolonged wandering, and limited social support. A substantial proportion were reintegrated with families or NGOs. Follow-up records were sparse, but available data suggested mixed stability.

Conclusion: Destitute psychiatric patients demonstrate significant rehabilitation potential when provided structured care, echoing findings from PSR models. Strengthening community-based follow-up and rehabilitation pathways is essential for sustainable recovery.

Prevalence of insomnia among alcohol dependence syndrome patients in withdrawal: A cross-sectional observational study

Priya Deepak, Brig V. S. Chauhan¹

BAVMC, ¹AFMC, Pune, Maharashtra, India

Background: Alcohol Dependence Syndrome (ADS) is a chronic disorder where sleep disturbances, particularly insomnia, are common during alcohol withdrawal and can persist for a longer duration, despite maintaining abstinence leading to risk of relapse.

Aim: To assess the prevalence of insomnia in patients with ADS admitted in withdrawal and examine its sociodemographic and clinical correlates.

Methods: This cross-sectional study was conducted over 18 months at a tertiary care hospital in Maharashtra. The study population included 83 male patients aged 18-55 years, diagnosed with ADS, and admitted in withdrawal state. Insomnia was assessed using the Pittsburgh Sleep Quality Index (PSQI) on Days 1, 7, and 28 of hospitalization. Alcohol withdrawal severity was measured using the Clinical Institute Withdrawal Assessment for Alcohol-Revised (CIWA-Ar). Sociodemographic and clinical factors were also recorded. Statistical analysis was conducted using SPSS STATISTICS version 29.0, with a p-value < 0.05 considered significant.

Results: The prevalence of insomnia (PSQI > 5) was 31.3% on Day 1, 12% on Day 7, and 15.7% on Day 28. Sociodemographic factors also showed significant correlations with alcohol withdrawal severity.

Conclusion: The prevalence of insomnia was highest on Day 1 of admission and improved by Day 7. However, insomnia persisted in a significant number of patients by Day 28. Effective management of insomnia during alcohol withdrawal is crucial to improve outcome and to prevent relapse.

Key words: Alcohol dependence syndrome, alcohol withdrawal, insomnia, Pittsburgh sleep quality index (PSQI), sleep quality

Typology and prevalence of psychosis, bipolar affective disorder and depression; by study of inpatient documents of a psychiatry ward in a tertiary care hospital: A retrospective

Priyadarshee Patra

Base Hospital, Delhi Cant, New Delhi, India

Background: Worldwide prevalence rates od Psychotic disorders remain constant (1-3%). As limited literature is present on Indian population, this retrospective study aims to assess prevalence and typology of above-mentioned disorders in past one year.

Aim:

1. Typology and prevalence of Psychosis in tertiary care center

2. Typology and prevalence of Bipolar Affective disorder in tertiary care center

3. Typology and prevalence of depression in tertiary care center.

Methodology: A cross-sectional retrospective file review was carried out for all inpatient documents, freshly or previously diagnosed with Psychosis, BPAD or depression according to ICD-10 criteria, in psychiatry ward, in tertiary care hospital between Mar 2021 to Mar 2022. Socio-demographic, clinical and relevant assessments data were extracted from electronically saved opinions of Psychiatrists. Ms-Excel sheet was used to extrapolate data gathered and subsequently analyzed by SSPS. Prevalence of above-mentioned illnesses was calculated. Descriptive analysis were used for socio-demographic and clinical data.

Results: 12 month prevalence of schizophrenia 50.2%, schizophreniform disorder 0.7%, schizoaffective disorder 2.2%, delusional disorder 27.8%, acute and transient psychotic disorder 9.4%, psychotic disorder due to an organic condition 5.2% and substance induced psychotic disorder 4.1%. BP I constitute 62.5% of all bipolar cases in 12 month period whereas BP II constituted 25% of the same. About 30% of patients diagnosed with depression had severe depressive features.

Conclusions: Findings underscore the important public health significance of depression, BPAD and Psychosis among Psychiatry inpatients and the need to improve screening and treatment access in this population.

A study of burden in primary caregivers of persons with dementia and comparison between urban and rural populations: A cross-sectional study

Priyadeep Zamindar, Deepali Negi¹, Savinder Singh²

National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, ¹National Drug Dependence Treatment Centre, AIIMS, New Delhi, ²Institute of Mental Health, Amritsar, Punjab, India

Background: Caregiver burden impairs caregivers’ quality of life while simultaneously reducing the quality and length of their lives, causing greater suffering for patients. Dementia, with its chronic course and lack of a cure, is one of the most prominent causes of caregiver burden.

Aims: To compare caregiver burden among caregivers of Persons with Dementia coming from rural and urban backgrounds and find the predictors of caregiver burden.

Methods: The cross-sectional study was conducted over 12 months in 176 dyads of caregivers and patients with dementia. Patients were evaluated using the Mini-Mental State Examination, Activities of Daily Living, and Instrumental Activities of Daily Living Scales. Caregiver burden was assessed using the Zarit Burden Interview.

Results: Burden was significantly higher in the urban sample than in the rural sample. Male gender, single patient status, and more prolonged illness duration were associated with higher caregiver burden. Among caregivers, women, especially the patient’s daughters, had a higher burden.

Conclusion: Caregiver burden is lower in the rural population, even with a higher prevalence of dementia and more severe disease. Certain other socio-demographic factors also predict higher burden. These should be used as a reference for the development of adequate management of caregiver burden and the morbidities associated with it.

Clinical and demographic trends among adolescent callers to Tele MANAS Delhi: A chart review

Priyam Sharma, Shweta Kiran¹, Shipra Singh², Om Prakash², Rajinder K. Dhamija²

State Tele MANAS Cell, IHBAS, ¹Mentoring Institute, Tele MANAS, IHBAS, ²IHBAS, New Delhi, India

Introduction: India’s adolescent population (ages 10-19 years) is estimated to be 253 million, which is highest in the world. This group of population is susceptible to several mental health concerns. Tele MANAS is a digital component of the National Mental Health Programme which provides 24X7 tele-mental health service across all Indian States and UTs.

Aim: To examine the demographic profile and clinical patterns among adolescent callers who contacted Tele MANAS Delhi services.

Methods: A retrospective chart review was conducted using call-log and case-record data from Tele MANAS Centre, Delhi. Records of adolescent callers over a 6-month period (1^st May 2025 to 31^st October 2025) were screened and descriptive statistics were used to summarize the data.

Results: A total of 10593 calls were received in Tele MANAS, Delhi, of which 1756 (16.57%) were adolescent callers. 343 (19.53%) callers were females and 261 (14.86%) were males. Around 155 (8.82%) callers reported suicidal ideas or attempts and 36 (2.05%) reported violence and aggression towards others. Other common presenting concerns were sadness of mood and related symptoms (8.54%), stress related to exam/workplace/relationship (2.33%), sleep disturbances (1.87%), anxiety and related symptoms (1.42%), symptoms related to bio-socio-occupational dysfunction (0.51%), substance abuse and behavioural addiction related symptoms (0.22%), grief related symptoms (0.11%), symptoms suggestive of losing touch with reality (0.11%) and symptoms suggestive of PTSD (0.05%).

Conclusion: A substantial proportion of callers to Tele MANAS Delhi were adolescents, highlighting the growing need for accessible mental health support in this age group.

Evaluating the impact of telephonic follow-up on adherence to multi-component tobacco cessation interventions: A randomized controlled trial

Priyanka B. Kolkar, A. Vinod, Narayan R. Mutalik

Department of Psychiatry, S Nijalingappa Medical College and HSK Hospital and Research Center, Bagalkote, Karnataka, India

Background: Tobacco use is a leading preventable cause of morbidity and mortality in India. Although behavioral and pharmacological interventions exist, poor follow-up adherence significantly reduces cessation success. Telephonic reminders offer a simple and scalable method to enhance engagement, especially in resource-limited settings.

Objectives: The primary objective of this study is to assess whether telephonic reminders improve follow-up adherence among individuals with tobacco dependence. Secondary objectives include comparing early follow-up rates between intervention and non-intervention groups and identifying barriers to follow-up.

Methods: This ongoing randomized controlled trial includes adults diagnosed with tobacco dependence attending the Psychiatry Department of SNMC, Bagalkote. Baseline assessments include sociodemographic details, tobacco use pattern, Fagerstrom Nicotine Dependence score, and cotinine levels. Participants are randomized into an intervention group receiving structured telephonic reminders and a non-intervention group receiving standard care. Follow-ups are scheduled at 2 weeks, 4 weeks, 3 months, 6 months, and 12 months. Data are analyzed using SPSS 19.0, with t-tests for continuous variables and Chi-square tests for categorical variables (p < 0.05).

Results (interim): At the 4-week mark, the intervention group demonstrated better retention, with 10 dropouts compared to 13 dropouts in the non-intervention group. Baseline characteristics such as age, sex, income, and Fagerstrom scores were comparable, though significant differences were observed in occupation and type of tobacco used. Early adherence patterns favor participants receiving telephonic reminders.

Conclusion: Preliminary findings suggest that telephonic reminders may improve early follow-up adherence in individuals attempting tobacco cessation. Final results will help determine their long-term impact on adherence & abstinence.

Screening for eating disorder risk among undergraduate medical students in western Maharashtra: A cross-sectional study

Priyanka Bhau Deshmukh, Ashish Ubhale

MIMER Medical College, Talegaon, Pune, Maharashtra, India

Background: Eating disorders (Eds) are increasing among young adults, especially medical students who face academic stress and sociocultural pressures. Early screening using validated tools is important for identifying those at risk.

Aim: To estimate the prevalence of ED risk among undergraduate medical students using the Eating Attitudes Test-26 (EAT-26) and examine associations with gender, year of study, and selected high-risk behaviors.

Methods: A cross-sectional analytical study was conducted among 306 MBBS students. Data were collected via a structured Google Form containing sociodemographic details, the EAT-26, and behavioral questions. An EAT-26 score 20 indicated ED risk. Prevalence was summarized as percentages. Associations with gender and year of study were analyzed using Chi-square test and odds ratios.

Results: The prevalence of ED risk was 13.07% (40/306). Final-year students showed the highest prevalence (21.88%), followed by first-years (16.92%), though the association between academic year and ED risk was not statistically significant (p=0.3728). Gender was also not significantly associated with ED risk (p=0.3184). High-risk behaviors were common: binge eating (45.10%), purging (22.22%), excessive exercise (52.94%), and significant weight loss 9 kg (8.50%). These behaviors showed statistically significant associations with ED risk.

Conclusion: More than one in eight medical students screened positive for ED risk. Although ED risk did not significantly differ by gender or academic year, the high prevalence of risky behaviors underscores the need for early screening and mental-health support in medical colleges.

Key words: Disordered eating, eating disorders, EAT-26, medical students

Tardive dyskinesia in psychiatric inpatients of a tertiary care hospital: Prevalence, clinical correlates, and association with antipsychotic use

Purbasha Sengupta, Sibasis Roy¹, Sanchari Roy

Department of Psychiatry, Calcutta National Medical College, Kolkata, ¹Department of Psychiatry, Jhargram Government Medical College, Jhargram, West Bengal, India

Background: Tardive dyskinesia (TD) is a late-onset movement disorder resulting from prolonged dopamine-receptor blockade, characterized by involuntary, repetitive movements of face, limbs, and trunk. Understanding its prevalence and correlates in Indian tertiary-care settings remains crucial for prevention and early detection.

Aims and Objectives: This study aimed to determine the prevalence of tardive dyskinesia among psychiatric inpatients, identify clinical correlates, compare the association with typical versus atypical antipsychotic use, and evaluate the correlation between Abnormal Involuntary Movement Scale (AIMS) scores and Clinical Global Impression of Severity (CGIS) scores.

Methodology: A cross-sectional study was conducted on 268 psychiatric inpatients receiving antipsychotic medications. Tardive dyskinesia was assessed using AIMS, and clinical severity was evaluated using CGIS. Demographic and clinical data were collected. Statistical analyses included chi-square tests, independent t-tests, Pearson and Spearman correlations, and multivariate logistic regression.

Results: The prevalence of TD was 14.93% (40/268). Patients with TD were significantly older (46.2 ± 12.8 vs 39.2 ± 12.1 years, p = 0.0009), more likely to be female (67.5% vs 45.2%, p = 0.015), and had higher exposure to typical antipsychotics (47.5% vs 21.5%, p = 0.001). Among typical antipsychotics, Haloperidol significantly associated with TD (p = 0.003; OR = 3.04). Among TD patients, AIMS scores positively correlated with CGIS scores (r = 0.418, p = 0.007).

Conclusion: Tardive dyskinesia remains a clinically relevant adverse effect among inpatients, particularly in older females and those exposed to typical antipsychotics. Regular AIMS screening, rational antipsychotic use, and early intervention remain essential to minimize its burden.

Assessment of antenatal anxiety, depression, and pregnancy-specific fears in women with and without prior pregnancy loss: A cross-sectional comparative study

Raghav Singh

KVG Medical College and Hospital, Sullia, Karnataka, India

Background: Pregnancy is a period of profound physiological and emotional change, and women with a history of pregnancy loss are particularly vulnerable to psychological distress. Antenatal anxiety, depression, and pregnancy-specific fears are under-recognized determinants of maternal and foetal outcomes.

Aim: To assess antenatal anxiety, depression, and pregnancy-specific fears among women with and without prior pregnancy loss.

Methods: A hospital-based cross-sectional comparative study was conducted among 64 pregnant women attending the antenatal outpatient department of a tertiary care centre. Thirty-two women with a history of pregnancy loss (Group A) were matched by age and trimester with 32 women without such history (Group B). Standardized tools including the Generalized Anxiety Disorder-7 (GAD-7), Edinburgh Postnatal Depression Scale (EPDS), Pregnancy-Related Anxiety Questionnaire (PRAQ), and Hospital Anxiety and Depression Scale (HADS) were administered. Data were analysed using descriptive statistics, chi-square tests, t-tests, correlation, and binary logistic regression.

Results: Women with prior pregnancy loss had significantly higher mean scores on GAD-7 (10.4 vs. 6.2, p < 0.001), EPDS (11.3 vs. 7.8, p = 0.002), and PRAQ (28.7 vs. 22.5, p < 0.001). Clinically significant anxiety was observed in 53.1% of Group A versus 21.9% of Group B. Logistic regression showed prior pregnancy loss (OR 3.2, 95% CI: 1.2-8.5) and higher EPDS scores (OR 2.7, 95% CI: 1.1-6.6) as independent predictors of antenatal anxiety.

Conclusion: Women with a history of pregnancy loss experience significantly higher psychological morbidity, particularly anxiety, depression, and pregnancy-related fears. Routine screening and targeted interventions are essential to improve maternal mental health.

Workplace stress and caffeine consumption: Department-wise variations in anxiety among medical residents

Raghav Singh

KVG Medical College and Hospital, Sullia, Karnataka, India

Background: Medical residency involves long working hours, heavy clinical responsibilities, and intense workload across specialties. Caffeine is widely consumed by residents to combat fatigue, but excessive intake has been linked to increased anxiety and disturbed sleep. Few studies have examined the relationship between caffeine consumption and anxiety levels across different medical specialties.

Objective: To assess department-wise variations in caffeine consumption among medical residents and examine their relationship with anxiety levels using the Generalized Anxiety Disorder-7 (GAD-7) scale.

Methods: A cross-sectional study was conducted among postgraduate residents at a tertiary teaching hospital. Daily caffeine intake was assessed using a 7-day consumption log. Anxiety levels were measured using the GAD-7 scale and categorized as mild, moderate, or severe. Data were analysed using correlation, regression, and subgroup comparisons between high-workload (surgical, obstetrics & gynaecology) and lower-workload (psychiatry, radiology, pathology) specialties.

Results: Surgical and obstetrics-gynaecology residents reported the highest caffeine intake (>300 mg/day), compared to 200 mg/day among non-clinical residents. Anxiety severity correlated with caffeine intake, with GAD-7 scores significantly higher in high-caffeine groups (p < 0.01). A greater proportion of residents from surgical and obstetrics-gynecology departments reported moderate-to-severe anxiety compared to non-clinical specialties.

Conclusion: Caffeine consumption and anxiety levels vary across specialties, with surgical residents showing the highest burden. Targeted interventions to reduce reliance on caffeine and promote healthier coping strategies are essential to safeguard resident well-being.

Exploring alexythymia in alcohol dependence: A cross-sectional study of the influence of tobacco use

Raghav Singh

KVG Medical College and Hospital, Sullia, Karnataka, India

Background: Alexithymia, characterized by difficulty in identifying and expressing emotions, is frequently observed in individuals with alcohol dependence. Emotional dysregulation may contribute to poor coping, relapse, and treatment resistance. Tobacco use, highly prevalent among alcohol-dependent individuals, may further exacerbate alexithymia; however, this association remains underexplored in Indian populations.

Objectives: To assess the prevalence and severity of alexithymia in alcohol-dependent patients compared to healthy controls, and to examine the influence of concurrent tobacco use and alcohol withdrawal severity on alexithymia.

Methods: A comparative cross-sectional study was conducted at the Department of Psychiatry, KVG Medical College, Sullia, including 112 male participants with Alcohol Dependence Syndrome (ADS) and 56 healthy controls. Assessments included sociodemographic and clinical details, history of alcohol/tobacco use, Clinical Institute Withdrawal Assessment for Alcohol-Revised (CIWA-AR), and the Toronto Alexithymia Scale-20 (TAS-20). Data were analyzed using SPSS v21. Independent t-test/Mann-Whitney U test and Chi-square test were applied, with p < 0.05 considered significant.

Results: ADS patients had significantly higher TAS-20 scores than controls (60.3 ± 13.9 vs. 49.7 ± 9.3; p < 0.001). True alexithymia was present in 41.1% of ADS patients versus 3.6% of controls. Tobacco use was more frequent among ADS patients (83.9% vs. 26.8%; p < 0.001) but its duration or type did not influence TAS-20 scores. A history of complicated withdrawal (64.3%) correlated with greater alexithymia severity.

Conclusion: Alexithymia is highly prevalent in alcohol dependence and is aggravated by severe withdrawal, underscoring the need to address emotional regulation in de-addiction programs.

Efficacy of high-frequency repetitive transcranial magnetic stimulation on craving in patients with alcohol use disorder: A randomized sham controlled trial

Rahul Gautam, Vishal Sinha

Sarojini Naidu Medical College, Agra, Uttar Pradesh, India

Background: Alcohol use disorder (AUD) is a chronic relapsing illness with craving being a key determinant of early relapse. Existing interventions shows limited efficacy. High-frequency repetitive transcranial magnetic stimulation (HF-rTMS) targeting the right dorsolateral prefrontal cortex (DLPFC) is a promising neuromodulatory approach, although controlled evidence from Indian populations is scarce.

Aim: To determine the efficacy and safety of HF-rTMS in reducing alcohol craving following detoxification in AUD patients.

Methods: A double blind randomized controlled trial was conducted. Patients with AUD diagnosed according to DSM-5 who had completed 7-10 days of detoxification using Fixed-dose benzodiazepine reduction regimen, the Patients were randomized in two groups to receive either active or sham HF-rTMS for 10 sessions. Craving was assessed using the Alcohol Craving Questionnaire (ACQ-NOW) and the Obsessive-Compulsive Drinking Scale (OCDS) at baseline, 4, and 8 weeks. Safety was evaluated by Transcranial Adult Safety Screen (TASS).

Results: Active HF-rTMS produced a statistically significant reduction in craving compared to sham . A 2 X 3 mixed-design ANOVA revealed a significant Group X Time interaction for both OCDS (p < 0.001) and ACQ scores (p < 0.001), confirming the superior anti-craving effect of active rTMS. Active OCDS scores decreased from 44.80 ± 3.92 to 11.00 ± 6.13 at 8-week follow-up, while ACQ scores dropped from 266.30 ± 10.95 to 61.90 ± 16.29.

Conclusion: Active HF-rTMS demonstrated superior, sustained anti-craving efficacy compared to the sham condition. These results strongly support HF-rTMS as a safe and effective adjunctive neuromodulation strategy for managing craving in recently detoxified AUD.

A cross sectional study of cognitive functions assessment in alcohol dependence disorder and its implications for primary care

Rahul Mathur, Kashyap Shah

MGMMC, Indore, Madhya Pradesh, India

Alcohol Dependence Disorder (ADD) has a profound impact on public health, society, and the economy, making it a significant concern. The often-overlooked cognitive impairments are crucial in primary care settings, where timely detection and intervention can significantly influence patient outcomes. This study examines the cognitive consequences of ADD using neurocognitive assessments in hospitalized patients at a Central Indian government hospital, emphasizing implications for primary care and family medicine management. A cross-sectional analysis was conducted on 90 inpatients at a Central Indian tertiary care hospital, examining the relationship between cognitive dysfunction and alcohol dependence severity. The study included participants aged 18-65, diagnosed with alcohol dependence according to ICD-10 criteria, who underwent cognitive assessments using the Montreal Cognitive Assessment (MoCA), Frontal Assessment Battery (FAB), and Severity of Alcohol Dependence Questionnaire (SAD-Q). Result and discussion The study’s results showed that patients with severe alcohol dependence had significantly lower scores on the MoCA (72.2% below cutoff) and FAB (33.3% below cutoff) assessments. A negative correlation was found between SAD-Q scores and both MoCA (-0.509) and FAB (-0.324) scores, suggesting that increased dependence severity is linked to greater cognitive decline. These findings underscore the importance of incorporating cognitive evaluations and rehabilitation into primary care practices to effectively manage alcohol-related cognitive impairments. The study’s conclusion highlights the presence of significant cognitive impairments in individuals with Alcohol Dependence Disorder, particularly affecting frontal executive functions. Implementing routine cognitive assessments in primary care settings can facilitate early detection and comprehensive management, ultimately improving patient outcomes.

Nicotine gum-assisted tobacco cessation versus brief advice alone: A retrospective observational study of smoked and smokeless tobacco users in a government psychiatry OPD

Raj Kumar Sahu

ESIC MC&H, Basaidarapur, New Delhi, India

Background: Randomized and meta analytic data show nicotine chewing gum improves smoking cessation versus placebo or usual care, particularly in more dependent users who benefit from higher dose formulations. Brief advice or minimal counselling, although cost-effective, generally produces smaller quit rates.

Aim: To compare 3-month point prevalence abstinence from smoked and smokeless tobacco (SLT) between 140 patients receiving nicotine gum (4-30 mg/day) and 60 patients receiving advice/brief counselling alone in a retrospective observational cohort derived from psychiatry OPD records.

Methods: Psychiatry OPD registers from October-December 2024 were abstracted, including socio demographic data, comorbid psychiatric diagnoses, tobacco type, and treatment offered (nicotine gum vs advice only). Descriptive statistics summarized baseline characteristics and treatment patterns; group differences were examined using chi square tests for categorical variables and t tests for continuous variables.

Results: Among 200 eligible patients, 140 received nicotine gum (median dose 12 mg/day, range 4-30 mg) and 60 received advice only, with comparable baseline characteristics. Three-month point prevalence abstinence was 42.9% in the gum group versus 10.0% with advice alone (absolute risk difference 32.9%, p<0.001), and nicotine gum remained independently associated with higher odds of quitting (adjusted OR 5.2, 95% CI 2.3-11.6).

Conclusion: In this retrospective cohort, adjunctive nicotine gum within a 4-30 mg/day range was associated with markedly higher short term cessation rates than advice or brief counselling alone, aligning with evidence from randomized trials and meta analyses. Integrating structured NRT into routine psychiatric tobacco dependence treatment may substantially improve quit outcomes for both smoked & SLT users.

Dothiepin for benzodiazepine discontinuation: A matched comparative outpatient study

Raj Kumar Sahu

ESIC MC&H, Basaidarapur, New Delhi, India

Background: Long-term benzodiazepine use for anxiety or insomnia often leads to dependence, problems with memory, and a higher risk of falls. Current guidelines push for a structured approach to stopping these medications, using both psychological and medical support. Sedating tricyclic antidepressants like dothiepin (dosulepin), may improve benzodiazepine discontinuation outcomes.

Aim: To evaluate whether adjunctive dothiepin enhances benzodiazepine discontinuation compared with advice-only management in patients with benzodiazepine dependence.

Method: In a retrospective matched study, 24 outpatients with DSM-5 Benzodiazepine use disorder on long-term clonazepam or alprazolam received dothiepin 25-100 mg/day with gradual benzodiazepine taper over 8-12 weeks and were compared with 24 age, sex, and dose-matched patients given standard advice and supportive counselling only. The primary outcome was complete benzodiazepine discontinuation at 12 weeks; the secondary outcome was clinically significant withdrawal reactions.

Results: At 12 weeks, 70.8% of patients on dothiepin stopped benzodiazepines completely, compared to 37.5% in the advice-only group (X²=4.74, df=1, P=0.029; relative risk 1.89, 95% CI 1.05-3.41). Withdrawal reactions showed up in 16.7% of the dothiepin group and 41.7% of the advice-only group (X²=4.02, df=1, P=0.045). Dothiepin was generally well tolerated, with anticholinergic side effects seen in 20.8% of cases and no serious events.

Conclusion: Adjunctive dothiepin during benzodiazepine taper was associated with higher discontinuation rates and fewer withdrawal reactions than advice-only management in this small group of patients, warranting prospective controlled trials.

Psychosocial stressors, family loading, temperament, and gender in childhood dissociative (conversion) disorders: A 18-case hospital-based study from rural India

Raj Kumar Sahu, Akshaya B. Raj

ESIC MC&H, Basaidarapur, New Delhi, India

Background: Dissociative (conversion) disorders in children and adolescents are common in low- and middle-income countries, yet Indian data on socio-demographic and psychosocial correlates remain limited. Understanding contextual and familial factors can guide targeted assessment and intervention strategies in children and adolescents.

Aim: To describe the socio-demographic profile, dissociative subtypes, psychosocial stressors, family psychiatric history, and temperament among children and adolescents presenting with dissociative disorders at a tertiary-care hospital.

Methods: This retrospective review included all consecutive patients aged 10-18 years diagnosed with dissociative (conversion) disorders over a 2-year period presenting to psychiatry OPD. Data were extracted on age, gender, education, family income, dissociative subtype, comorbidities, area of residence, psychosocial stressors, parental education, relationship with parents, temperament, and family history of dissociative disorder, and summarized using descriptive statistics.

Results: The dataset comprised 18 patients, predominantly female and in early to mid-adolescence (13-17 years), with most studying in classes 8-12 and belonging to low-income families. Dissociative convulsions and stupor were the most frequent subtypes, constipation and headache/migraine were common somatic comorbidities, and almost all belonged to rural backgrounds. Medical/somatic crises, relationship crises, and educational stressors were the leading precipitating factors, a positive family history of dissociative disorder was present in the majority, and anxious or behaviorally inhibited/harm-avoidant temperaments predominated.

Conclusion: Paediatric dissociative presentations clustered among rural, low-income adolescents with prominent somatic stressors, strong familial loading, and anxious/inhibited temperament. These findings underscore the need for early psychosocial interventions in primary and school settings, along with family-focused psychoeducation and temperament-informed management.

Mental stress and coping strategies among spouse of alcohol dependent syndrome

K. Rajeshwari, H. D. Bhagyavathi

Mandya Institute of Medical Sciences, Mandya, Karnataka, India

Background and Aims: Alcohol Dependence Syndrome (ADS) is a chronic relapsing condition that affects not only the individual but also the family, particularly the spouse, who often experiences emotional, financial, and social strain. In India, where alcohol use is predominantly seen among men, women as spouses face cultural and socioeconomic pressures that influence their stress levels and coping responses. This study assessed perceived stress and coping strategies among spouses of ADS patients and examined their association with the severity of dependence.

Methods: A cross-sectional study was conducted in the Department of Psychiatry, Mandya Institute of Medical Sciences, from October 2024 to September 2025. Seventy-three spouses of ADS patients diagnosed using ICD-10 criteria were recruited through consecutive sampling. Sociodemographic data were collected using a semi-structured proforma. Severity of dependence was measured with the SADQ-C, perceived stress with the PSS, and coping strategies with the Brief COPE. Data were analyzed using SPSS, with p < 0.05 considered significant.

Results: The mean age of spouses was 34.9 years; 98.63% were females, mostly from rural (86.3%) and lower socioeconomic backgrounds. Among ADS patients, 60.27% had severe dependence. High stress levels were observed in 57.53% of spouses, while avoidant coping was used by 69.86%. Severity of ADS showed a strong positive correlation with perceived stress (p < 0.00001) and avoidant coping (p < 0.013). High stress was also significantly associated with avoidant coping (p < 0.012). Rural residence and low education were linked to higher stress.

Conclusion: Spouses of ADS patients experience substantial stress, especially in rural area and low education.

Bridging psychopharmacology with evidence-based spiritual care: Towards a mindfulness-based ketamine-assisted psychotherapy training curriculum

Ramakrishnan Parameshwaran^1,2, Thomas Brod³

¹The AdiBhat Foundation of India, New Delhi, India, ²Tower Health Phoenixville Psychiatry, Drexel University College of Medicine, PA, ³Psychiatry Geffen UCLA School of Medicine Office, Los Angeles, CA, USA

Background: Ketamine, a glutamatergic modulator, demonstrates rapid antidepressant, anxiolytic, and anti-suicidal effects. In addition to neurobiological mechanisms, patients often report self-transcendent or mystical experiences, including ego-dissolution and encounters with the Divine. Neuroscientific evidence links these phenomena to gamma-predominant EEG activity, paralleling contemplative states described in mindfulness and chaplaincy traditions. Psychiatry lacks structured frameworks to therapeutically integrate these experiences.

Methods: A systematic search of the PubMed database was conducted (n = 28,150 records). After screening, 487 studies were included for qualitative synthesis. Studies addressing neurobiology, dissociation, spirituality, and psychotherapeutic applications of ketamine were analyzed. Data were extracted on clinical outcomes, experiential phenomena, and integrative therapeutic approaches, with emphasis on evidence linking ketamine experiences to self-transcendence and their potential for curriculum development.

Results: Findings confirm that ketamine exerts dual effects: (1) neurobiological (e.g., glutamatergic modulation, BDNF-TrkB signaling) and (2) experiential (self-transcendence, mystical states). Evidence suggests that validating and integrating these experiences enhances therapeutic outcomes. Empathic listening (EL) emerges as an effective non-pharmacological method to elicit similar states and provides a training scaffold. The proposed Mindfulness-to-Transcendence framework aligns psychopharmacology, phenomenology, and spiritual care, offering practical tools for clinician training in ketamine-assisted psychotherapy.

Conclusions: Systematic evidence supports integrating pharmacological and spiritual dimensions of ketamine therapy. A structured MB-KAP curriculum can equip clinicians to recognize and therapeutically integrate transcendent experiences, advancing psychiatry beyond symptom relief towards holistic healing, recovery of selfhood, and human flourishing.

Medicolegal psychiatry in Canada (Ontario) with focus on motor-vehicle accident assessments, benefits, compensation, and catastrophic impairment

Ramamohan Veluri

Northern Ontario School of Medicine University, Ontario, Canada

Background: Canada, and particularly the largest province Ontario, has a highly developed medicolegal framework for assessing psychiatric and neurocognitive consequences of motor-vehicle accidents (MVAs). The system integrates insurance legislation, structured benefits, and standardized medico-legal assessments. With increasing motorization and rapidly evolving insurance markets in India, understanding this model has growing relevance.

Aims: To describe the structure and functioning of the medicolegal assessment system for MVA-related psychiatric injuries in Ontario; outline available medical and rehabilitation benefits; explain the determination of Catastrophic Impairment; and highlight the adversarial dynamics between claimants, insurers, and legal representatives. The aim is to identify lessons that may be applicable to emerging systems in India.

Methods: This presentation is based on the author’s extensive clinical and medicolegal practice for 30 years in Ontario. Legislative frameworks, clinical assessment standards, and commonly used psychiatric evaluation methods are reviewed. Case examples are used to illustrate practical challenges.

Results: Ontario’s model provides structured benefits including income replacement, medical/rehabilitation funding, attendant care, and psychological treatment. Psychiatric sequelae like PTSD, depression, anxiety, somatic symptom disorders, and neurocognitive symptoms are common. Determination of Catastrophic Impairment, which significantly increases benefits, follows strict medico-legal criteria and often becomes highly contested. Insurer-requested and claimant-requested assessments frequently diverge, creating adversarial evaluations, prolonged disputes, and variable access to care.

Conclusion: Ontario’s medicolegal MVA system offers a sophisticated but complex model for assessing psychiatric injuries. As India faces rising road-traffic accidents and increasing legal-insurance activity, a clearer framework, drawing on Canadian experience, may help ensure fairness, transparency, and clinically sound evaluations.

Understanding stigma and help-seeking barriers among medical students in India: The role of family, tradition, and culture

Ranjeet Dhabale, P. Swathi

Andhra Medical College, Visakhapatnam, Andhra Pradesh, India

Background: Medical students globally face elevated psychological distressdepression, anxiety, suicidal ideationsurpassing general population rates (Puthran et al., 2016; Rotenstein et al., 2016). In India, medical students show 50% depressive symptoms, 50% anxiety, 21% suicide ideation (Balhara et al., 2019; Sharma et al., 2020). Help-seeking is low due to stigma, confidentiality fears, academic/career risks, and cultural barriers: family honor (izzat), collectivism, gender roles, marriage prospects, religious beliefs (Mehta et al., 2018; Chong et al., 2016; Math et al., 2020). BSPH-MH scale is validated for Indian youth (Chaturvedi et al., 2023), but India-specific cultural factors in medical student help-seeking remain underexplored.

Aims: Assess stigma/barriers to mental health help-seeking among Andhra Pradesh medical students, emphasizing family honor, collectivist decision-making, marriage concerns, gender roles, supernatural/religious attributions, medical-specific professional stigma.

Methods: Cross-sectional survey with stratified sampling across government medical colleges for regional/year representation. Instrument: BSPH-MH scale (24 items), 20 culturally-adapted barrier items, 6-item help-seeking module. Anonymous online data analyzed via descriptives, reliability, gender/year subgroups, Western stigma comparisons.

Results: General barriers mild-moderate; family/cultural barriers significant. Key factors: family influence, gender expectations, professional stigma. Most aware of services but prefer informal sources (friends/family) over professionals. Questionnaire showed good psychometrics, factorial validity; culturally-sensitive items unbiased.

Conclusion: Interventions must target family dynamics, gender roles, professional stigma. Use informal networks as gateways to professional care. Highlights need for India-specific strategies bridging awareness-engagement gap.

Impaired oral glucose tolerance in drug-naive schizophrenia: A case-control study

Richa Choudhary, Prerna Nigwal

MGM Medical College, Indore, Madhya Pradesh, India

Background: Schizophrenia is associated with a 2-3 fold higher risk of type 2 diabetes compared to the general population, but it remains unclear whether the illness itself contributes to impaired glucose regulation independent of antipsychotic exposure. Identifying glucose dysregulation in drug-naive patients is crucial to guide antipsychotic selection and early metabolic monitoring.

Method: This hospital-based case-control, cross-sectional study included 60 drug-naive schizophrenia patients (ICD-10, age 18-40 years) and 60 age- and sex-matched healthy controls recruited from a psychiatry OPD and mental hospital after ethical clearance and informed consent. All participants underwent a 75 g oral glucose tolerance test (OGTT) with capillary blood glucose measured by glucometer at fasting and 2 hours; 2-hour values were used to define impaired OGTT as per standard criteria.

Results: Mean fasting and 2-hour blood glucose levels in cases were 81.2 ± 15.9 mg/dL and 116.0 ± 25.7 mg/dL, respectively, while in controls they were 83.1 ± 12.1 mg/dL and 115.7 ± 20.2 mg/dL, with no significant difference in fasting values. The prevalence of impaired OGTT was significantly higher in schizophrenia patients (9/60; 15%) than in controls (2/60; 3.3%) (chi-square = 4.90, p = 0.0268).

Conclusion: Drug-naive schizophrenia patients showed a significantly higher prevalence of impaired oral glucose tolerance compared to healthy controls, despite similar fasting glucose levels, suggesting an illness-related vulnerability to dysglycaemia. Routine OGTT-based metabolic screening should be considered early in the course of schizophrenia to inform risk-sensitive treatment planning.

Key words: Oral glucose tolerance test, schizophrenia

A clinical study of the prevalence of exposure to TORCH infections among patients of schizophrenia

Rishi Biswanath, Deepanjali Medhi¹

IHBAS, New Delhi, ¹Gauhati Medical College and Hospital, Guwahati, Assam, India

Background: Studying the prevalence of exposure to TORCH infections in patients with schizophrenia is important for several reasons, to clarify the role of prenatal infectious exposure in the development of schizophrenia, forming preventive measures, particularly in maternal and child health, new therapeutic and management strategies for those at risk or affected by the condition.

Aims and Objectives: To assess the sociodemographic profile of patients of schizophrenia.

To assess the prevalence of exposure to TORCH infections among patients of schizophrenia.

Methodology: A hospital based, cross-sectional study conducted among 100 patients at the Department of Psychiatry, GMCH, Guwahati and diagnosed with schizophrenia, according to ICD-10.

A semi-structured proforma for socio-demographic data.

Serum IgG antibodies for Toxoplasma, Rubella and CMV infections using Enzyme-Linked Fluorescence Assay. IgG antibody for Hepatitis using Enzyme-Linked Immunosorbent Assay. IgG antibody of HSV using Polymerase Chain Reaction, IgG antibody of HIV using Immunochromatography.

Results: The peak incidence of schizophrenia occurs in the late teenage years to mid-twenties, a critical developmental period that coincides with higher seropositivity rates for TORCH infectionsspecifically Toxoplasma (18%), Rubella (22%), and CMV (20%).

Conclusion: The observed associations between TORCH infectionsToxoplasma, Rubella, and CMVand schizophrenia suggest that these infections might play a role in the development or exacerbation of the disorder. Investigating the causal mechanisms behind these associations is crucial to reveal potential pathways for early intervention and prevention.

Limbic activity and connectivity to different areas of brain in Depression: A resting state fMRI, case series study in 10 BHU students diagnosed with depression

Ritika Bisht, A. K. Pandey

IMS, BHU, Varanasi, Uttar Pradesh, India

Introduction: Depression among students/youth is increasing day by day characterized by sadness of mood, lack of interest sleep and appetite disturbances. The limbic system is the critical component and may hold insight into the disorder’s neurobiology, and may serve as potential biomarker.

Aim: This study aimed to assess the activity and connectivity of limbic system to other areas of brain in resting state fMRI in 10 BHU students with depression.

Materials and Methods: the study was conducted in BHU, included 10 drugs naïve (first time diagnosed with depression) and RDD who relapsed. All participants were assessed for severity by HAM-D. They signed the consent form and then underwent resting state fMRI scans.

Results: Hippocampal volume reduction seen and consistent abnormal activity and connectivity to other areas seen. the dlPFC also showed abnormal connections with majority of regions.

Conclusion: The findings suggest that, reduced hippocampal volume and abnormal limbic system and PFC connectivity to each other and to other areas of brain.

Work-life balance and burnout in postgraduate medical trainees: A cross-sectional comparison of medical and surgical specialties

Ritvik Gupta, Nishant Goyal¹

Institute of Mental Health, PGIMS, Rohtak, Haryana, ¹Central Institute of Psychiatry, Ranchi, Jharkhand, India

Background: Work-life balance and burnout have become major concerns in postgraduate medical training, affecting residents’ mental health and the quality of patient care. Long working hours, academic pressure, and demanding clinical responsibilities increase vulnerability to stress, fatigue, and emotional exhaustion. Differences in workload and lifestyle between medical and surgical specialties may further shape how residents experience work-life balance and burnout.

Aim: To compare work-life balance and burnout among postgraduate residents in medical and allied branches versus surgical branches across India.

Methods: A cross-sectional, two-group study was conducted via an online survey using a Google Form and non-probability snowball sampling. Postgraduate residents from various institutes and specialties across India participated. The survey included a validated semi-structured questionnaire, the Work-Life Balance Scale, and the Maslach Burnout Inventory. Participants were categorized into medical/allied and surgical branches. Data were analyzed using appropriate statistical tools.

Results: A total of 509 residents participated (Medical = 274; Surgical = 235). Surgical residents reported greater interference of work with personal life, more personal life interference with work, and higher emotional exhaustion. Medical residents demonstrated better work-personal life enhancement. Responses showed that both groups experienced substantial work-related stress and perceived workplace toxicity, although these were more commonly reported by surgical residents. Despite this, most participants across both groups endorsed using effective coping strategies.

Conclusion: Surgical residents experience higher work-life conflict and burnout, while medical residents report more enrichment between work and personal life. These findings emphasize the need for targeted institutional efforts to mitigate stress and enhance resident well-being.

Clinical course and outcomes following deliberate self-harm (DSH): An ambispective cohort study from a tertiary care centre

Roli Rajeevkumar Gupta, Santosh Ramdurg, S. G. Gouthami

Shri B M Patil Medical College, Hospital and Research Centre, Bijapur, Karnataka, India

Introduction: Deliberate self-harm (DSH) is a major psychiatric emergency and an established predictor of future suicide attempts. Although acute medical stabilization is routinely provided, structured psychiatric follow-up is often lacking. Evidence suggests that consistent post-attempt contact can significantly reduce recurrence. This study examined the clinical course, diagnostic distribution, and impact of regular psychiatric follow-up on outcomes among patients admitted after DSH.

Methods: An ambispective cohort study was conducted among 78 patients admitted following DSH between September 2024 and March 2025 at a tertiary healthcare centre and they were followed up regularly for six months, both in person and telephonically. Psychiatric diagnoses were assigned using ICD-11, and suicidality was assessed with the Columbia Suicide Severity Rating Scale (C-SSRS). Data were analyzed using descriptive statistics, paired t-tests (baseline vs follow-up C-SSRS scores), and chi-square tests for gender and diagnosis comparisons.

Results: Affective disorders (Major Depressive and Adjustment Disorders) were present in 24.1%, substance-use disorders in 22.9%, psychotic disorders in 4.8%, and impulsive or unclassified acts in 48.2%. Females (61.5%) predominated in the affective and impulsive groups, whereas males (38.5%) were more represented in substance-use-related DSH. Mean C-SSRS scores decreased by 61% (p < 0.01) from baseline to final follow-up. Recurrence occurred in 4 (5.1%) and completed suicide in 2 (2.6%), both lower than reported international rates (12-25%).

Conclusion: Affective and substance-use disorders were the predominant psychiatric diagnoses among DSH patients. Structured six-month regular psychiatric follow-up significantly reduced suicidality and recurrence, underscoring its value as a practical, low-cost suicide-prevention strategy in tertiary-care psychiatry.

A cross-sectional study on impact of loneliness and medical co-morbidities on mental health in elderly individuals in old age homes in Dakshina Kannada

Roopa, Sudharani P. Naik, K. Jayanth Kumar

Kanachur Institute of Medical Sciences, Mangalore, Karnataka, India

Background: Loneliness is a significant public health concern among older adults, particularly those in institutional care, where physical, psychological, and social challenges further compromise mental well-being and quality of life.

Aims: To examine the impact of loneliness and medical co-morbidities on the mental health of elderly residents in old age homes, focusing on the prevalence and severity of loneliness, its association with psychiatric and socio-demographic factors, and its effect on overall quality of life.

Methods: A cross-sectional study was conducted over 18 months among elderly individuals (60-80 years) with medical co-morbidities residing in old age homes for at least six months, selected through multi-stage random sampling. Data were collected using the UCLA Loneliness Scale, WHOQOL-BREF. Statistical analysis was performed using chi-square tests, with p < 0.05 considered significant.

Results: Among 84 participants (mean age 68.5 ± 7.2 years; 58.3% female), 76.2% reported significant loneliness (mean UCLA score = 52.4 ± 8.9) and 69.0% had impaired quality of life (mean WHOQOL score = 45.3 ± 11.7). Psychiatric morbidity was found in 42.9%, with depression most prevalent (28.6%). Loneliness was significantly associated with female gender (p = 0.019) and longer stay duration (p = 0.033), and negatively correlated with quality of life (r = 0.72, p < 0.001). Medical co-morbidities significantly affected mental health (p = 0.027).

Conclusion: Loneliness profoundly affects the mental health and quality of life of elderly individuals in institutional care, underscoring the need for comprehensive interventions that reduce social isolation and enhance psychological well-being.

Self-compassion and cognitive flexibility as predictors of quality of life among parents of children with autism

Rushi, R. P. Beniwal¹

Department of Clinical Psychology, All India Institute of Speech & Hearing (AIISH), Mysuru, Karnataka, ¹ABVIMS & Dr. Ram Manohar Lohia Hospital, New Delhi, India

Background: Parents of children with Autism Spectrum Disorder (ASD) often experience heightened psychological stress, which may influence their cognitive and emotional functioning. Constructs such as self-compassion and cognitive flexibility are considered important protective factors and may have implications for caregivers’ quality of life.

Aims: The study aimed to examine the relationships among self-compassion, cognitive flexibility, and quality of life in parents of children diagnosed with ASD.

Methods: A total of fifty (N = 50) parents/caregivers attending the outpatient services, whose children met diagnostic criteria for ASD, were recruited through purposive sampling. Standardized measuresthe Self-Compassion Scale (SCS), Cognitive Flexibility Inventory (CFI), and WHOQOL-BREFwere administered. Data were analysed using SPSS version 21.0, and Pearson’s product-moment correlation was employed to assess associations among variables.

Results: Self-compassion demonstrated a significant positive correlation with cognitive flexibility, suggesting that higher levels of emotional self-regulation and adaptive self-attitudes are associated with increased cognitive adaptability. Self-compassion also showed a significant positive association with overall quality of life. Although cognitive flexibility was not significantly related to global quality of life scores, several significant correlations emerged between specific CFI subscales and WHOQOL-BREF domains, indicating domain-specific linkages.

Conclusion: The findings highlight the relevance of psychological resources among parents of children with ASD. Incorporating constructs such as self-compassion and cognitive flexibility into parent counselling, psychoeducation, and intervention planning may enhance caregiver well-being and promote resilience in the context of long-term caregiving demands.

Key words: Autism spectrum disorder, Caregivers/Parents, cognitive flexibility, quality of life, self-compassion

Mapping stress-related disorders (F40) in tertiary care: Demographic profile and resource planning data from a psychiatric outpatient department

Sabahuddin Ammar, Saurabh Jaiswal, Abhilash Boda

Autonomous State Medical College, Sultanpur, Uttar Pradesh, India

Introduction: Psychiatric disorders are recognized as an emerging silent pandemic in our diverse country, contributing significantly to the global burden of disease. Despite advancements in mental healthcare, substantial disparities persist concerning the accessibility and quality of services within under-resourced areas. There is currently no epidemiological data on mental health available from the Sultanpur district of UP. This study was conducted to assess the socio-demographic and diagnosis profile of patients presenting to the psychiatry OPD, thereby filling this geographical data gap.

Aims and Objectives: To assess the socio-demographic characteristics and diagnostic patterns of patients attending the Psychiatry OPD at ASMC, Sultanpur.

Methodology: A 3 year retrospective analysis of case records was conducted for all psychiatric patients who visited psychiatry OPD between November 2022 to November 2025 at ASMC, Sultanpur. Socio-demographic variables and clinical diagnosis were extracted and analysed using descriptive statistical methods.

Results: A total of 40,092 patients visited the outpatient department during the study period. The mean age of the attending patients was found to be 35.26 years with Male predominance (56.4%). Most of the patients were Hindu (89.8%) and Married (67.8%). Regarding clinical diagnosis, the most prevalent group, classified as per ICD 10, was F40: Neurotic, Stress-related, and Somatoform disorders, which accounted for 43.8% of the total cases.

Conclusions: The age-wise distribution of psychiatric disorders was consistent with existing literature. Seasonal trends indicated a surge in OPD attendance during April and September. These findings may aid policymakers and clinicians in planning, allocating resources and strengthening mental health services in underserved district.

Assessing Hikikomori, a multistage epidemiological study across Indian students

Sahil Doshi, G. Prasad Rao, Chytanya Deepak, Amit Awasthi, Neerja Gidwani

Asha Hospital, Hyderabad, Telangana, India

Aim: To assess the prevalence, socio-cultural determinants, and psychological correlates of Hikikomori among Indian students.

Background: Hikikomori refers to a pattern of severe and prolonged social withdrawal, often lasting six months or more, in which individuals confine themselves to their homes and disengage from education, employment, and social interaction. The objective was to assess Hikikomori using a self assessment tool. In recent years, the intersection of modern lifestyles, rapid technological advancement, and changing family structures has contributed to the risk factors for such withdrawal, particularly among adolescents and young adults.

Methods: A sample size of 146 students aged 15 to 25 years in urban and semi-urban educational institutions in Hyderabad were assessed using HQ-25 which is a 25-item self-report questionnaire assessing the severity and multidimensional aspects of Hikikomori. It consists of 3 factors - socialisation, isolation, emotional support.

Result: 50% of the population assessed was found to be suffering from Hikikomori. Factor 3 (emotional support) was found to be most prominently affected with about 35% population reporting withdrawal.

Conclusion: In India, research on hikikomori remains sparse, with only isolated studies hinting at its presence among student populations. However, several contextual factors like rising academic pressures, heightened parental expectations, intense competition for limited opportunities, and the expanding digital ecosystem, suggest that the risk may be higher than currently appreciated.

Dermatology patients with psychiatric comorbidity at a tertiary care hospital in Telangana

Sambaraju Vinaykanthteja

Mamata Medical College, Khammam, Telangana, India

Dermatological conditions often extend beyond physical manifestations, frequently intertwining with psychological and psychiatric factors. This presents unique challenges for both patients and clinicians. The co-occurence of dermatological and psychiatric conditions can manifest in various ways, ranging from the exacerbation of psychiatric symptoms due to skin disorders to the the development of skin manifestations secondary to psychiatric conditions or their treatments. Furthermore, the psychosocial impact of dermatological conditions like acne, psoriasis and eczema often extends beyond physical symptoms, leading to emotional distress, social stigma, and impaired quality of life. Understanding this complex interplay between dermatological and psychiatric disorders is crucial for providing holistic care and improving treatment outcomes for these patients. This study aims to determine the prevalence and association between dermatological disorders and depression, anxiety and stress disorders.

Emotional regulation strategies among patients with depressive disorders

Samiksha Agarwal, Mukesh Kumar Swami, Vijay Kumar Saini, Tanu Gupta

All India Institute of Medical Sciences, Jodhpur, Rajasthan, India

Aims: To explore emotional regulation strategies among patients with depressive disorders.

Methods: After ethics approval, a cross-sectional study was conducted over 18 months at a tertiary care centre in India. A total of 251 outpatients diagnosed with depressive disorders as per ICD-11 were recruited following written informed consent. Depression severity (Hamilton depression rating scale) and emotional regulation (Emotional regulation questionnaire) were assessed. SPSS 29 was used for analysis. The associations were examined with nonparametric tests (Mann-Whitney-U test and Spearman’s correlation). Automatic linear modelling with best subset method was used for regression.

Results: Majority of participants were female (53%), married (63.3%), from nuclear families (62.2%), with a mean age of 31.35 years & education of 12.2 years. Significant negative correlation was found between depression symptom severity & cognitive reappraisal (r=-0.44) and between depression (r=-0.45), anxiety (r=-0.25), insomnia (r=-0.21) & somatic (r=-0.30) domains of depression and cognitive reappraisal, expressive suppression & per capita family income (r=-0.14) and expressive suppression & number of family members (r=-0.13). Significant positive correlation was observed between expressive suppression & duration of current episode of depression (r=0.13). Suicide attempts were significantly lesser with higher cognitive reappraisal use (U=4846.00, p=0.001). Regression analysis revealed cognitive reappraisal (B=-1.75; 95% CI -2.27, -1.23) as a significant predictor of depressive symptom severity.

Discussion: As per previous studies, patients with depression have a greater tendency to use expressive suppression than using cognitive reappraisal.

Conclusion: Cognitive reappraisal use predicts severity of depression. Association of emotional regulation strategies may provide avenue for psychological interventions.

Impact of test anxiety on self-esteem and coping skills in children with specific learning disability with and without ADHD

Samiksha Sahu, Sarita

Gandhi Medical College, Bhopal, Madhya Pradesh, India

Background: Children with Specific Learning Disability (SLD) frequently experience heightened test anxiety (TA), which undermines self-esteem and coping skills, exacerbating academic challenges. ADHD comorbidity amplifies these issues through executive dysfunction, yet comparative data in Indian pediatric populations remains scarce. This study addresses gaps in understanding TA’s differential impact on SLD alone versus SLD+ADHD, aligning with ANCIPS 2026’s theme “Unshackling Psychiatry for Society’s Mental Health” by highlighting barriers to emotional resilience.

Aim: To evaluate the impact of test anxiety on self-esteem and coping skills in children with SLD with and without ADHD.

Methods: Comparative cross-sectional study of 164 children aged 8-16 years from Mumbai tertiary psychiatry clinic: 82 SLD alone, 82 SLD+ADHD (DSM-5 diagnosed, 2021-certified). Tools: Westside Test Anxiety Scale, Rosenberg Self-Esteem Scale (α=0.77), Kids Coping Scale (problem/emotion-focused). Analysis: t-tests, ANOVA, chi-square, Pearson correlations via SPSS v22 (p<0.05).

Results: SLD+ADHD showed higher TA (3.32±1.08 vs. 3.11±1.07, p<0.05), lower self-esteem (21.65±7.39 vs. 29.16±6.11, p=0.00), extremely high TA (30.5% vs. 17.1%). Negative TA-self-esteem correlation in SLD (r=-0.230, p=0.037), not SLD+ADHD. Problem-focused coping dominated (SLD: 2.50±0.55; SLD+ADHD: 2.28±0.66, p=0.02); SLD+ADHD females used more emotion-focused (p=0.00). No TA-coping correlations.

Conclusion: ADHD comorbidity intensifies TA and erodes self-esteem in SLD children, shackling development. Routine TA screening and primary care interventions can liberate youth, advancing recovery-oriented psychiatry.

Oral health-related quality of life in alcohol dependence patients with and without nicotine use – A cross-sectional study

M. Santhosh, P. Swathi

Andhra Medical College, Visakhapatnam, Andhra Pradesh, India

Background: Alcohol dependence is associated with poor oral health due to hygiene neglect, nutritional deficiencies, and adverse tissue effects. Concurrent nicotine use through smoking or smokeless tobacco may further compromise Oral Health-Related Quality of Life (OHRQoL). Despite frequent co-use, limited evidence compares OHRQoL among nicotine users and non-users within alcohol-dependent populations.

Aim: To assess and compare OHRQoL among alcohol-dependence patients with and without nicotine use.

Method: A hospital-based cross-sectional study included adults aged 18-65 years diagnosed with alcohol dependence (ICD-11) and admitted to a de-addiction unit. Participants were categorized as nicotine users or non-users. Sociodemographic and clinical data were collected using a semi-structured proforma. OHRQoL was assessed using the validated Oral Impact Daily Performance (OIDP) scale. Nicotine dependence was measured using the Fagerstrom Test for Nicotine Dependence (FTND) for smokers and FTND-Smokeless Tobacco (FTND-ST) for smokeless tobacco users. Alcohol dependence severity was evaluated using the Severity of Alcohol Dependence Questionnaire (SADQ). Group differences will be analyzed using appropriate statistical methods.

Result: Nicotine users are expected to demonstrate significantly higher OIDP scores than non-users, indicating poorer OHRQoL. Higher FTND/FTND-ST and SADQ scores may correlate with more severe OIDP impairment. Detailed results will be presented at the conference.

Conclusion: This study provides comparative analysis of OHRQoL between nicotine users and non-users among alcohol-dependence patients. Understanding these impacts may enable healthcare providers to identify high-risk patients early and integrate targeted oral health and cessation interventions into de-addiction care.

A study of inmates with substance use disorder admitted at deaddiction centre at Central Jail Hospital Tihar

Sashi Bhushan Kumar Gupta

Central Jail Hospital, Tihar, New Delhi, India

Background: Substance Use Disorders (SUDs) constitute an escalating public health concern and carceral settings demonstrate an even higher prevalence of substance dependence compared to community populations. Prisons often function as unintended treatment centers for individuals who may not have accessed care due to stigma, poor mental health literacy, poverty, or limited community-based services. This chapter presents a comprehensive analysis of socio-demographic and clinical characteristics of individuals treated for SUDs at the Tihar Jail de-addiction facility.

Method: We used the sociodemographic, clinical and criminal record data collected over eleven months for 3363 inmates who were admitted at deaddiction centre of central jail tihar.

Results: Records of 3,363 inmates seeking treatment for substance dependence over an eleven-month period were analyzed. Of these, 43.4% were first-time admissions and 56.6% were repeat admissions. Most inmates were young adults aged 21-30 years (63.6%), unmarried (59.1%), educated up to Class 6-10 (49.9%), and working as labourers or daily wagers (43.3%). Opioid dependence was the most common diagnosis (29.3%). Among 897 inmates assessed for offences, Arms Act violations were most frequent (33.2%). Nearly half (45.9%) reported physical assault. Many of the 293 assessed reported a positive family history of substance use.

Conclusion: These findings are consistent with national and international evidence highlighting the heightened vulnerability of young, socially marginalized males to substance dependence and criminal involvement.

The Sukoon Clinical Outcomes Project – An objective, measurable and comprehensive clinical progress mapping in acute psychiatry inpatient setting with a structured treatment protocols – The pilot study report

Satish Ramaiah, Vipul Rastogi

Sukoon Health, India

Background: Systematic measurement of clinical outcomes in acute psychiatric inpatient settings is limited in India. The absence of standardised frameworks restricts benchmarking, quality improvement, and value-based psychiatric care. The Sukoon Clinical Outcomes Project was developed to address this gap through a structured outcomes framework aligned with international standards.

Aims: To evaluate the feasibility and clinical impact of a multi-domain outcome measurement framework embedded within a structured inpatient treatment programme (Sukoon A2R+).

Method: This pilot study included over 170 consecutive inpatients admitted with acute psychosis, bipolar disorder, depression, OCD, anxiety disorders, personality disorders, and substance-use disorders, all managed under the Sukoon A2R+ structured treatment programme. Validated tools assessed symptom severity, insight, functioning (WHODAS 2.0), medication adherence, behavioural risk, therapy participation, length of stay, readmissions, and patient satisfaction (WHO Responsiveness Tool). Assessments were conducted at admission, weekly, and discharge using an integrated electronic data system, with scientific oversight and external validation.

Results: Clinical outcomes exceeded international benchmarks. Mean symptom reduction was substantial (e.g., BPRS: 23-point reduction; Y-BOCS: 74% reduction). All assessed patients showed improved insight and 50% functional improvement. Medication adherence improved in all treatment completers, behavioural risk reduced to low levels in over 90%, mean length of stay was 12-14 days, and six-month readmission was 8%. Patient satisfaction exceeded WHO standards.

Conclusion: Embedding structured outcome measurement within a defined inpatient care pathway (Sukoon A2R+) is feasible and associated with superior clinical, functional, and operational outcomes, supporting scalable, data-driven psychiatric care.

ECT without pain: Clinical evidence supporting magnesium pretreatment

Satish Ranjan

Institute of Medical Sciences and Sum Hospital, Bhubaneswar, Odisha, India

Background: Modified Electroconvulsive Therapy (MECT) is an effective treatment for severe psychiatric disorders. However, succinylcholine used during anesthesia often produces muscle fasciculations, post-ECT myalgia, and transient increases in serum potassium, which may heighten patient anxiety and reduce acceptance of repeated sessions. Magnesium sulphate, with its neuromuscular stabilizing and analgesic actions, may help reduce these adverse effects and improve the overall ECT experience.

Aim: To assess the effect of intravenous magnesium sulphate pretreatment on succinylcholine-induced fasciculations, post-ECT myalgia, serum potassium rise, and seizure duration in patients undergoing MECT.

Materials and Methods: A prospective controlled study was conducted on 20 psychiatric patients aged 20-55 years undergoing MECT. Participants were randomly allocated into two groups of ten each. Group C received standard induction with thiopentone and succinylcholine, while Group M received intravenous magnesium sulphate (30 mg/kg) before induction. Fasciculations were graded after succinylcholine administration. Myalgia was assessed at 8 and 24 hours using the Wong-Baker scale. Serum potassium levels were measured pre-induction and post-procedure. Seizure duration was recorded. Statistical analysis included Mann-Whitney U test and paired and independent t-tests.

Results: Magnesium significantly reduced fasciculation severity (p = 0.030) and decreased myalgia at 8 hours (p = 0.00037) and 24 hours (p = 0.000082). The rise in serum potassium was substantially lower in the magnesium group (p = 1.17 × 10). Seizure duration remained within therapeutic limits (p = 0.040).

Conclusion: Magnesium pretreatment enhances comfort and safety during MECT.

Knowledge of human sexuality among health science students: An intervention study

Saumya Rathi, Jugal Rathod

Parul Institute of Medical Science and Research, Waghodia, Gujarat, India

Background: Human sexuality and disorder are major area of deficit in medical curriculum. Several studies have explored knowledge about human sexuality among medical students suggestive of widespread ignorance and negative attitude towards sex. With availability of internet, the added source of knowledge can impact medical students’ knowledge about sexuality, hence periodical assessment of medical students’ knowledge is relevant to fill up the gaps in knowledge.

Aim: To find out knowledge about human sexuality among MBBS, ayurvedic, homeopathy, pharmacy and nursing students as well as the impact of intervention on their knowledge.

Method: Cross sectional interventional study involving undergraduate Health Science students (n=407 ) of Parul university was done. The survey instrument consisted of 20-item Derogatis’ Inventory of Sex Knowledge with an added question about Dhat Syndrome.. The respondent was asked to mention for each statement to rate as true or false or don’t know. Each correct response carried 1 point with score range of 0 - 20. After pre test,1 hour interactive lecture was conducted using Power point slides which was immediately followed by post test

Result: There was good knowledge regarding reproductive organs (more than 50% responded correctly) however there were myths related to sexual drive and ageing, sexual fantasies, masturbation, marital relationship and intercourse during menstruation as (only 20-40% responded correctly). Significant improvement in knowledge level was observed after the intervention

Conclusion: Although the participants were having good knowledge regarding anatomy and physiology of reproductive system, but simple brief educational intervention can improve level of sexual

Effect of antiepileptic on cognitive function in drug naive patient with seizure

Savita Patel, Abhay Paliwal¹

Government Medical College, Satna, ¹Mahatma Gandhi Medical College, Indore, Madhya Pradesh, India

Background: In context of cognitive function, we know that seizure disrupts activity leading to deterioration of cognitive function and this deterioration is also seen as a side effect of antiepileptic. Various study state differently on effects of antiepileptic on cognition.

Aim: To study effect of antiepileptic on cognitive function in drug naIve patient.

Method: Patient who have seizure disorder and are drug naIve had been started on antiepileptic and cognitive domain - executive function, visuospatial construction, speed, verbal learning and memory & attention were measured with appropriate test before starting anti-epileptic and after 4 week of it.

Results: 38 patients were recruited. We found statistically significant comparison before and after giving antiepileptic drug within:-

1) Executive function [COWA t value -2.244, p value 0.037]

2) Attention [CTT-1= t value -2.711, p value 0.014 and CTT-2=t value 2.686, p value 0.015]

3) Verbal learning and memory [t value -2.328, p value 0.031]

Conclusion: early and proper treatment with required number and dosage of drug for seizure control will lead better cognition in many of the domains.

Key words: Antiepileptic, cognitive domain, drug naive

Normal pressure hydrocephalus as a complication in a case of BPAD

Shaktipriya Surisetty, Mounica Tejaswini

Andhra Medical College, Government Hospital for Mental Care, Visakhapatnam, Andhra Pradesh, India

Introduction: Normal Pressure Hydrocephalus (NPH) is a potentially reversible cause of gait disturbance and cognitive decline. Its recognition in young psychiatric patients is challenging, as symptoms may overlap with drug induced Parkinsonism and primary mood disorder.

Aim: To describe a young woman with bipolar affective disorder (BPAD) who developed suspected NPH and to emphasise the need to evaluate organic pathology when new neurological symptoms appear during psychotropic treatment.

Methods: A 25-year-old female with BPAD- mania was treated intermittently with Olanzapine and sodium valproate. After medication non-adherence and a subsequent manic relapse in pregnancy, she was restarted on anti psychotics and valproate. Over two years she developed progressive rigidity, tremors, slowness, gait imbalance, slurred speech and was referred to neurological evaluation. Detailed history, neurological examination, cognitive screening and CT/MRI brain were performed, and psychotropics were rationalised.

Results: On examination she was conscious but partly cooperative, with MMSE 17/30, cogwheel rigidity, exaggerated reflexes and a broad based, unsteady gait requiring support. CT brain showed dilated ventricular system with prominent sulci, MRI revealed early cerebellar atrophy with ventriculomegaly. Antipsychotics were tapered, Antiparkinsonian agents including trihexiphenidyl and amantadine started, physiotherapy advised. She showed symptomatic improvement in gait, though residual rigidity and mild cognitive deficits persisted.

Conclusion: This case highlights suspected NPH complicating BPAD in a young adult, underscores the importance of timely neuroimaging and multidisciplinary management when new gait and cognitive symptoms emerge in psychiatric patients.

Effects of adjunct transcranial direct current stimulation on craving and relapse in patients of alcohol dependence syndrome

Shalini Bajpai, Col Pankaj Kumar Sharma

Base Hospital, Delhi Cantt, New Delhi, India

In summary, Alcohol dependence remains a major public health challenge with high rates of relapse despite standard treatments. Craving and executive control dysfunction are central to relapse vulnerability and are not fully addressed by existing therapies. Transcranial direct current stimulation offers a novel, mechanism-based adjunctive intervention targeting prefrontal networks underlying craving and relapse. This study aims to determine the effect of adjuvant tDCS compared with sham stimulation on craving and relapse in patients with ADS in an Indian tertiary care deaddiction centre, thereby addressing an important gap and advancing the field of addiction neuroscience, and potentially improving outcomes in Indian clinical practice. This study was conducted as a randomized, double-blind, sham-controlled, parallel-group clinical trial. The research spanned a duration of 12 months, including recruitment, intervention, and follow-up periods. The study population comprised adult male and female patients aged 18 to 60 years who were diagnosed with alcohol dependence syndrome as per the ICD-10 criteria, admitted or attending outpatient detoxification and rehabilitation services. The sample size was calculated based on an expected effect size of 0.6 for reduction in craving scores, with a power of 80% and a significance level (α) of 0.05. The minimum required sample was calculated as 30 per group. Accounting for an anticipated attrition rate of 15%, a total of 70 patients were recruited, with 35 allocated to each arm. The study demonstrated that tDCS significantly reduced craving and relapse two of the most persistent challenges in addiction psychiatry.

Study on health-promoting lifestyle and its impact on mental health in medical students

Shivam, Vadaparty Padma

Government Medical College, Srikakulam, Andhra Pradesh, India

Medical students often face prolonged academic stress and erratic routines that can undermine both physical and psychological wellbeing. Understanding how lifestyle behaviours relate to mental health in this population is essential for targeted intervention. This study aimed to assess health-promoting lifestyle practices and examine their association with mental health outcomes among undergraduate medical students in a government medical college. A cross-sectional design was employed, using simple random sampling to recruit participants across all academic years. Standardised tools were administered to evaluate domains of health-promoting lifestyle behaviours and levels of depression, anxiety, and perceived stress. Data were analysed to explore correlations and identify lifestyle components most strongly linked with mental health indicators. Findings preliminarily indicate suboptimal engagement in key lifestyle domains such as physical activity, nutrition, and stress-management practices. Higher scores on health-promoting behaviours were consistently associated with lower symptoms of depression, anxiety, and stress, suggesting a protective effect. The results highlight significant gaps in routine self-care among medical students and emphasize the potential of structured lifestyle-enhancement programs within medical institutions. Strengthening campus-based health promotion initiatives may mitigate psychological morbidity and foster resilience in future healthcare professionals. Further longitudinal work is recommended to clarify causal pathways and guide targeted interventions.

The silent burden: Cognitive dysfunction as an under-recognized morbidity in bipolar disorder

Shlok Agrawal, Kunal Kumar, Abhinit Kumar, Nikhil Nayar, Purvi Vats

School of Medical Sciences and Research, Sharda University, Greater Noida, Uttar Pradesh, India

Background: Bipolar disorder (BD) is a chronic psychiatric illness presented as recurrent mood episodes and significant functional impairment. Overall, approximately 40% to 60% of patients with BD show neurocognitive impairment. Impairments in attention, memory, executive functioning, fluency, and processing speed adversely affect quality of life, interpersonal functioning, and vocational outcomes.

Aim: To assess the prevalence of cognitive dysfunction in patients with bipolar disorder and examine its association with key clinical variables.

Methods: A cross-sectional observational study was done in the Department of Psychiatry, Sharda Hospital, over S4 months. 32 patients with bipolar disorder were included in the study. Cognitive functioning was assessed using the Addenbrooke’s Cognitive Examination-III (ACE-III). Sociodemographic and clinical data were analyzed using descriptive statistics, Chi-square test, Pearson’s correlation, and Student’s t-test, with p ‰¤ 0.05 considered statistically significant.

Results: The mean age of participants was 35.8 ± 8.4 years; 56.3% were male. The prevalence of cognitive dysfunction was 65.6%. Fluency (68.8%), memory (62.5%), and attention (53.1%) were the most frequently impaired domains. Cognitive dysfunction was significantly associated with age 40 years (p = 0.041) and past psychotic features (p = 0.042). Total ACE-III scores negatively correlated with age (r = -0.338, p = 0.029) and duration of illness (r = -0.312, p = 0.041).

Conclusion: Cognitive dysfunction was highly prevalent among bipolar disorder patients and was significantly related to age, illness duration, and psychotic features. Early screening and targeted cognitive interventions are needed for comprehensive management.

Key words: ACE-III, bipolar disorder, cognitive dysfunction, cross-sectional study, neurocognition

Prevalence and pattern of sexual dysfunction among male patients with alcohol dependence syndrome

Shreya Mimrot, B. S. Shekhawat

Government Medical College, Kota, Rajasthan, India

Background: Sexual dysfunction is a frequent but often under-recognized consequence of chronic alcohol use. Despite clinical relevance, limited Indian data, document the pattern of sexual dysfunction in this population.

Aim: To assess the prevalence and pattern of sexual dysfunction among male patients with Alcohol Dependence Syndrome (ADS) and its association with severity of alcohol dependence.

Materials and Methods: A cross-sectional study was conducted among 100 adult males (ages 18-50Yrs) diagnosed with ADS (ICD11), consecutively attending the Psychiatry outpatient department (OPD) of a tertiary care hospital in Rajasthan. Patients with informed consent and who fulfilled the specific criteria were included in the study by convenient sampling. Sexual dysfunction was assessed using a sexual dysfunction checklist, constructed by Arackal and Benegal at the national institute of mental health and neuroscience, Bangalore containing 12 items from the diagnostic criteria for research and ICD-10 classification of mental and behavioral disorders and severity of alcoholism was assessed using the Leeds Dependence Questionnaire.

Results: Fifty-eight percent of patients reported at least one form of sexual dysfunction; Premature ejaculation was reported by 35%, problems with attaining an erection in 30%, sustaining an erection in 28%, delayed ejaculation in 5%, Anorgasmia in 12%, ejaculation with inadequately rigid erection in 1%, pain during intercourse in 3%, 8% were dissatisfied with the frequency of sexual intercourse, 5% expressed dissatisfaction with their sexual partner, and 6% reported dissatisfaction with their overall sexual performance.

Conclusion: Sexual dysfunction is highly prevalent and positively associated with severity of Alcohol dependence.

A study to compare working memory in children with specific learning disorder and typically developing children

Shreya Rastogi, Pratibha Gehlawat, Rashmita Saha, Manisha Jha

Institute of Human Behaviour and Allied Sciences, New Delhi, India

Background: Specific Learning Disorder (SLD) is frequently associated with executive function deficits, particularly in working memory, which can adversely affect academic achievement and everyday functioning. This study focused on comparing working memory performance between children with SLD and typically developing (TD) children using the N-back test and the Digit Span test.

Aims: To compare working memory in children with SLD and typically developing children.

Methods: A cross-sectional case-control design was used, including 30 children with SLD and 30 age- and gender-matched TD children (9-15 years), all with IQ in the average range. Working memory was assessed with verbal and visual 1-back and 2-back tasks, and Digit Span forward and backward, group differences were analysed with appropriate parametric or non-parametric tests.

Results: Children with SLD committed significantly more errors on N BACK-2 Verbal and on both visual N BACK-1 and N BACK-2 conditions than TD peers, indicating marked deficits in updating and sustained attention, while N BACK-1 Verbal did not differ significantly. They also obtained significantly lower scores on Digit Span Forward and Backward, reflecting reduced capacity and manipulation of verbal working memory.

Conclusion: Children with SLD exhibit significant impairments in both verbal and visual working memory compared to typically developing children, evident on N-back and Digit Span tasks. These findings underscore the need to routinely assess and directly target working memory in interventions for SLD to improve academic and functional outcomes.

Study of pathways of care among people with psychotic disorders in a semi-urban setting

Shrinivasa Undaru Bhat, Shridhar Bhat

K. S. Hegde Medical Academy, Nitte Deemed to be University, Deralakatte, Mangalore, Karnataka, India

In our country that a majority of patients with mental disorder rarely seek professional help; and most of them utilize the help of unqualified medical practitioners, local faith healers, and so on. A larger size of Duration of Untreated Psychosis (DUP) is associated with poor prognosis, higher possibility of suicide and/or harm to others, and aggression. Persons suffering from psychotic disorders usually approach different types of care providers before reaching trained mental health professionals. Because of the delay in reaching treatment facility (longer DUP), the prognosis and recovery from psychosis become poor.

The objectives to study the pathways of care in different types of psychosis and their relationship with duration of untreated psychosis (DUP). All freshly diagnosed cases of psychosis between 18 and 65 years of age and willing to provide informed consent were included in the study. Patients with organic brain disorders and substance use disorders except nicotine abuse were excluded from the study.

Assessment was done by Case Study Form by which socio-demographic details, clinical details and DUP of the patients were collected. Details regarding pathways to care and DUP were collected using the WHO Encounter FORM.

A key finding is that a majority of patients (62.7%) approached a psychiatrist directly as their first point of contact. This is in contrast to several other Indian studies where faith healers were the most common first contact. The median DUP in our sample was 6 months. This is shorter than the DUP reported in many low- and middle-income countries.

Ketamine as an adjuvant to antidepressants in moderate to severe unipolar depression: A randomised clinical trial

Shruthi Nandakumar, Santosh Ramdurg

Shri BM Patil Medical College and Research Centre, BLDE (DU), Vijayapura, Karnataka, India

Background: Major depressive disorder (MDD) remains a major global mental health challenge, contributing substantially to personal suffering and socioeconomic burden. Conventional monoaminergic antidepressants show delayed onset of action and inadequate response in many patients, especially those with severe or treatment-resistant depression. Ketamine, a rapid-acting NMDA receptor antagonist, influences glutamatergic pathways and produces faster and more robust antidepressant and anti-suicidal effects. Its unique mechanism marks a major advancement in MDD treatment strategies.

Aims: To assess the onset of response and effectiveness of ketamine as an adjuvant to oral antidepressants in moderate to severe unipolar depression.

Methods: Seventy participants diagnosed with MDD were randomly assigned into two equal groups of 35 each. Group 1 received escitalopram alone while Group 2 received escitalopram plus IV ketamine (0.5 mg/kg) twice weekly for two weeks (four infusions). Participants were assessed at baseline, after 24 hours, 2 weeks, and 4 weeks using the Montgomery-Ãsberg Depression Rating Scale (MADRS) and the Columbia-Suicide Severity Rating Scale (C-SSRS).

Results: Both groups improved, but the ketamine group showed a significantly faster and larger reduction in depressive symptoms and suicidality within 24 hours, maintained through 4 weeks. Escitalopram alone showed gradual improvement, significant only after 2 weeks.

Conclusion: Ketamine augmentation provided rapid and greater antidepressant and anti-suicidal effects than escitalopram alone, supporting its role as a fast-acting treatment option for moderate to severe MDD, especially in patients with acute suicidality.

A cross sectional study on the correlation between adverse childhood events, impulsivity and psychiatric morbidity in suicide attempters at a tertiary care center

Shruthi Vasishta, Manju Aswath, H. G. Kshamaa

Kempegowda Institute of Medical Sciences, Bengaluru, Karnataka, India

Background: Suicide is a leading cause of death and a significant public health challenge. It results from complex interaction between bio-psycho-social factors. These are - presence of adverse childhood events (ACE), impulsivity and psychiatric morbidity. Existing literature shows significant correlation of suicidal-attempt with these factors. Effect of all three factors together has not been explored. Hence the current study.

Aim: To determine the correlation of ACE, impulsivity and psychiatric morbidity with suicide attempts.

Methods: 150 consecutive patients admitted under Department of Emergency Medicine for attempt-on-life at a tertiary care hospital referred to Psychiatry, were interviewed. Socio-demographic details were collected using semi-structured proforma. Adverse Childhood Events Questionnaire (ACEQ) was administered to assess ACE, Barrat’s Impulsivity Scale to assess impulsivity and MINI Plus to assess psychiatric morbidity.

Results: Most suicide attempters were females, belonging to 21-30 age-group with lower socioeconomic background. 33% scored high on ACEQ, 46.7% on impulsivity and 90.5% had psychiatric disorder, majorly depression. ACE scores were significantly associated with previous attempts and family history of psychiatric illness. Impulsivity was significantly associated with previous attempters and in individuals with high ACE scores.

Conclusion: This study shows that the risk of attempting suicide is shaped not only by their current emotional distress, but also by various individual factors. A combination of ACE, impulsivity and presence of psychiatric morbidity increases this risk significantly. Hence evaluating for these factors in our routine consultations may result in preventing distress from escalating into a life-threatening crisis.

Sexual dysfunction among females receiving psychotropics: A hospital based cross sectional study

Shruti, Savinder Singh¹, Esha Dhawan¹

Institute of Human Behaviour and Allied Sciences, New Delhi, ¹Institute of Mental Health, Amritsar, Punjab, India

Background: Female Sexual Dysfunction (FSD) is a multifaceted condition that significantly affects women’s quality of life, particularly those receiving psychotropic medications. Despite its clinical importance, FSD remains underreported, especially in male-dominated societies where discussing sexual health is challenging.

Objective: To investigate the prevalence and nature of sexual dysfunction among females receiving psychotropic medications at a psychiatric teaching hospital.

Methods: A cross-sectional study was conducted at the Institute of Mental Health, Amritsar, Punjab, involving 100 married females aged 18-45 years who were asymptomatic from current psychiatric illness for at least one month while on psychotropic medications. Participants were assessed using the Female Sexual Function Index (FSFI) and Clinical Global Impression (CGI) scale. Statistical analysis was performed using SPSS version 21.0.

Results: The prevalence of female sexual dysfunction was found to be 76%. The study population had a mean age of 31.65±7.00 years, with 84% being housewives and 45% educated up to 8th grade. Among participants, 51% had depression, 34% had psychosis, and 15% had Bipolar Affective Disorder (BPAD). A statistically significant association was found between FSD and psychiatric diagnosis, with higher prevalence in BPAD patients followed by those with psychosis. Additionally, longer duration of psychiatric illness was significantly associated with increased FSD prevalence.

Conclusion: The study reveals a remarkably high prevalence of FSD (76%) among females receiving psychotropic medications, emphasizing the critical need for healthcare providers to address sexual health concerns comprehensively to improve medication compliance and overall quality of life.

The distorted self: Trajectories from body image pathology to personality disorder

Shweta Banerjee, Roshan V. Khanande, Khushi Jain, Riddhi Ghosh¹

Departments of Psychiatry and ¹Clinical Psychology, Central Institute of Psychiatry, Ranchi, Jharkhand, India

This paper has been presented at JASCON, 2025 (Jharkhand state conference)

Background: Body Dysmorphic Disorder evolves to dissociation, factitious symptoms, and malingering, reflecting escalating psychopathology. Persistent dysmorphic fears and maladaptive coping may consolidate into severe personality disorder marked by emotional dysregulation and functional decline. Comorbid BPAD, in remission, complicates diagnosis and management.

Aims: To illustrate the psychopathological progression and the longitudinal trajectory from body dysmorphic symptoms to pervasive personality dysfunction, to examine psychosocial, developmental, and interpersonal factors contributing to this shift, to analyse clinical features, coping patterns, and maladaptive defences observed across the progression, to reflect on management strategies, including psychotherapeutic and multidisciplinary interventions.

Methods: The patient was well until Class XI, when bullying for his thin physique led to withdrawal, anger, truancy, and academic decline. After failing Class XII, he became intensely preoccupied with his appearance, spending hours before mirrors and reacting violently when family restricted access. Psychiatric treatment began in 1999, but dysmorphic concerns, aggression, poor hygiene, and social withdrawal persisted. Clozapine reduced symptoms but caused lethargy, hypersalivation, poor appetite, and episodes resembling catatonia. From 2015, he became housebound, ritualistic, fearful, and dependent for basic care, with somatic complaints and suicidal threats. In 2024, he was admitted to CIP for detailed evaluation and management.

Discussion: Treatment reduced aggression but caused somatic issues; family support proved essential, early detection and multidisciplinary care to prevent severe pathology

Conclusion: The case shows Body Dysmorphic Disorder evolving into severe personality dysfunction, highlighting the need for early intervention, integrated treatment, and family support.

Inpatient suicides in psychosis at a mental health care facility: A mixed methods study

Shweta Banerjee, Varun S. Mehta

Department of Psychiatry, Central Institute of Psychiatry, Ranchi, Jharkhand, India

Background: In comparison to the abundant information on inpatient suicide in the West, there is a paucity of data on inpatient suicide in India. Few studies have been done in India regarding inpatient suicides, especially in a mental health facility, none to our knowledge that have focused exclusively on psychotic disorders.

Aims: To evaluate the factors associated inpatient suicides among patients with psychosis over a period of 25 years, Explore the perspectives of nurses related to inpatient suicides.

Methods: Total number of inpatient suicide deaths occurring during the past 25 years will be determined by review of register and medical records maintained at the Institute. For Interviews, 10 nurses would be recruited through convenience sampling.

Structured Assessment Questionnaire shall be Prepared and Validated.

Data shall be collected through Chart Review.

Interview guide shall be prepared.

In-depth Interviews shall be conducted.

Results: 17 suicides were recorded in CIP, Ranchi over 25 years period, 16 of which patients had psychosis. 2 were females. The quantitative data will be analyzed using SPSS version 29.0 for windows using descriptive statistics. The recordings will be transcribed verbatim, then translated to English. Thematic analysis will be used for analyzing the qualitative data. Themes generated would be interpreted and reported.

Conclusion: Although many patients benefit from the protective and containing environment of the hospital during a suicidal crisis, hospitalization of chronically suicidal patients can turn counterproductive and may also be replaced by outpatient management if required information and expertise is available with the clinician.

IPS REFERENCE: IPS/2022/1003687

What predicts problematic internet use? A study on gaming, social media and smart-phone use among adolescents of Lucknow

Shweta Singh, Kriti Sapra, Vivek Agarwal, Abhishek Mishra¹

Department of Psychiatry, King George’s Medical University, Lucknow, Uttar Pradesh, India, ¹Virtual Classroom Producer, Canadian Red Cross, Canada

Background: Globally, Problematic Internet Use (PIU) among adolescents has become a matter of public mental health concern. Understanding smartphone use, social-media use and gaming leading to PIU, their socio-demographic correlates are essential for informing prevention and intervention strategies for adolescents. This study aimed to investigate general internet addiction, and specific PIU behaviors - smartphone use, social-media use and gaming patterns among school-going adolescents, and associations among General and Specific PIU and demographics (age, gender) using Correlational and Regression Analysis.

Methods: A cross-sectional study was conducted among school-going adolescents aged 10-19 years (N = 1813). Standardised assessment tools of general PIU (Internet Addiction Test; IAT) and specific PIU domains, Gaming Addiction Scale (GAS), Bergen Social Media Addiction Scale (BSMAS), and Smartphone Addiction Scale-Short Version (SAS-SV) were used. Analyses included descriptive statistics, Chi-square/Fisher’s Exact tests, Spearman and partial correlations, and ordinal regression.

Results: The study found 11.1% moderate level, and 0.9% severe levels of PIU in adolescents. General and specific PIU behaviours among adolescents show distinct demographic patterns. The associations were retained in partial correlations controlling for age and gender. Older adolescents displayed substantially higher PIU than younger adolescents (p < .001). Gaming and social media addiction demonstrated strong effects for age and gender. Ordinal regression indicated that higher gaming, social media and smart-phone use significantly predicted higher general PIU categories (p < .001).

Conclusion: Strong interrelationships across PIU dimensions suggest a shared underlying vulnerability. These findings underscore the need for integrated screening and multi-domain intervention frameworks tailored to adolescent subgroups.

Neurological soft signs as biomarker of schizophrenia

Shyamal Chakraborty

Kothari/Desun/HHP/Remedy/Apollo/Paripurnata/Asha Bhavan, Kolkata, West Bengal, India

NSS represent minor neurological signs that indicate non-specific cerebral dysfunction. Patients with a first episode or remitting course predominantly show a decrease of NSS over time whereas a worsening of NSS can be found in the chronically ill. NSS are present in Schizophrenia but they do not reflect hard pathology. The incidence of NSS is higher in Schizophrenia compared to other psychiatric disorder.

NSS may be considered as biomarkers because they are consistently found at higher rates in Schizophrenia compared to healthy controls. NSS are often considered as trait marker that reflects genetic liability. NSS are seen in first degree relatives of patients. NSS can help identify individuals at risk of the disease. NSS can serve as markers to track the progression of the disease.

30 patients of Schizophrenia have selected from a psychiatric hospital in Kolkata with equal male-female ratios. All are assessed for the presence of NSS.

Almost 50% of cases exhibit NSS but there is wide variation in types of the soft signs. Positive symptoms are often associated with difficulty in sensory integration and motor coordination but negative symptoms may be related to difficulties in sequencing complex motor acts. Disorganized symptoms are associated with difficulties in motor sequencing and sensory processing. NSS may be more pronounced in individuals with residual symptoms.

The persistent finding of NSS in first episode patient suggests a link to a neurodevelopmental origin of Schizophrenia. NSS are considered as endophenotype- a biomarker that may help identifying individuals at risk for Schizophrenia.

DEPTH study: A retrospective study on the demographic characteristics, clinical profile, triggering factors, quality of life and treatment patterns of depression in Indian patients

Siddharth Uttam Nikam, M. Madan¹, Aarti Patil¹, K. Niklesh¹, Nitin Kapure

Alkem Laboratories, Mumbai, Maharashtra, ¹ICS Global, India

Introduction: Depression is a significant global health concern, causing personal distress, functional impairment, and increased healthcare burden. Understanding its specific characteristics in the Indian population is vital for effective management. This study aimed to assess the demographic and clinical profile, triggering factors, quality of life, and treatment patterns among Indian patients with depression.

Methods: This retrospective, multi-centric cross-sectional study collected data from healthcare facilities across India on patients diagnosed with depression per ICD-10 criteria. Information on demographics, triggers, symptoms, quality of life impact, and treatment was analyzed using IBM SPSS Statistics

Results: The study analyzed 7,888 patients (mean age: 48 years), with a slightly higher prevalence in males (56.5%). Major triggers included stressful events, chronic illness, and social isolation. Common symptoms were fatigue, low mood, and disturbed sleep. Depression notably impacted quality of life, especially sleep, social/financial functioning, and daily tasks. CBT and pharmacotherapy were the primary treatments, with escitalopram being the most prescribed antidepressant (47.7%), followed by vortioxetine (2.6%), and minimal use of bupropion or its combination with dextromethorphan (0.05% each).

Conclusions: The study highlights the considerable clinical and psychosocial burden of depression among Indian patients, particularly middle-aged individuals. Key triggers such as stress and chronic illness demand early recognition and tailored interventions. Although CBT and pharmacotherapy remain the mainstays of treatment, the underutilization of multimodal strategies indicates a gap in optimal care. These findings underscore the need for integrated, culturally sensitive, and patient-centered approaches to improve depression management and outcomes in India.

Evaluating the efficacy of dimension-based psychotherapy in patients with suicidal risk: A targeted interventional analysis

Simar Sachdeva, Sanjay Gupta

IMS, BHU, Varanasi, Uttar Pradesh, India

Background: Suicide is a growing public health concern, particularly among individuals with mild to moderate depression. Standard treatment often prioritizes pharmacological interventions, while psychotherapeutic modalities are underutilized due to systemic, procedural, and resource-based constraints. There exists a research gap in tailored psychotherapies that address multidimensional stress domains contributing to suicidal ideation. This study proposed a novel dimension-based psychotherapy grounded in the Student Stress Dimension Questionnaire (SSDQ) to target psychosocial stressors in a domain-specific and structured manner.

Materials and Methods: A hospital-based, prospective, randomized interventional study was be conducted over 12 months in the Department of Psychiatry, IMS-BHU. Patients aged 18-35 years with DSM-5-diagnosed mild to moderate depression (HAMD 10-17) and active suicidal ideation or recent suicide attempts (within 6 months) were enrolled. Subjects were randomized into: — Group 1: Standard pharmacotherapy (Escitalopram ± Clonazepam) Group 2: Pharmacotherapy plus dimension-based psychotherapy (stress-targeted interventions + structured relaxation techniques) Assessment tools included the SSDQ, a newly developed Suicidal Risk Assessment Questionnaire, Beck’s Suicide Ideation Scale, HAMD, and Session Reaction Scale-3 Brief (SRS-3-B). Follow-ups occurred at specified intervals from Day 0 to Week 12. Data was analyzed using SPSS 25.0, with significance set at p<0.05.

Results: Group 2 showed greater reductions in suicidal ideation and overall stress load compared to Group 1, with significant improvements in subjective well-being, therapeutic alliance, and session satisfaction.

Conclusion: This study aimed to introduce and validate a comprehensive, dimension-oriented psychotherapeutic model tailored to individual stress profiles in patients at suicidal risk.

Triggers, psychiatric comorbidity, and quality of life: A comparative study of migraine and tension-type headache

Smriti Gulati, Shivananda Jena

Maulana Azad Medical College, New Delhi, India

Background: Migraine and Tension-Type Headache (TTH) are globally prevalent disorders associated with specific triggers, a high burden of psychiatric comorbidity, and significant impairment in Quality of Life (QoL).

Aims: The aims of this study were to compare the prevalence of triggers, the quality of life impairment, and the co-occurrence of anxiety and depressive symptoms in patients diagnosed with migraine and TTH.

Methods: A cross-sectional observational study was conducted at a tertiary care psychiatry OPD. The sample included 100 patients diagnosed using ICHD-3 criteria. Triggers were assessed via a checklist, QOL with the WHOQOL-BREF Hindi scale, and psychiatric symptoms using standardized screening tools. Data was analyzed using appropriate comparative statistical tests.

Results: The majority of participants (88%) reported triggers, with stress (70%) and sleep deprivation (35%) being the most common factors. Key differences included a greater association of somatic triggers (p=0.003) with TTH, while dietary factors (p=0.009) and hormonal changes (p=0.017) were significantly more common in migraine. QoL was significantly impaired in both groups. Compared to TTH, migraine patients showed significantly lower QoL scores across the physical (p=0.004), psychological (p=0.020), and social (p=0.011) domains. Anxiety and depressive symptoms were highly prevalent in both groups, with no statistical difference in mean scores between migraine and TTH.

Conclusion: Both migraine and TTH are characterized by prevalent, modifiable triggers and a substantial psychiatric burden, leading to reduced overall well-being. Migraine causes more profound impairment in functioning than TTH. A multidisciplinary approach integrating trigger management, stress reduction, sleep hygiene, and psychiatric screening is strongly recommended.

Assessment of prevalence of seasonal variation in bipolar disorder: A cross sectional study

Smruti Sindekar, Smrity Shailly Bagde, Anand Khare, Sudhir Bhave

NKPSIMS and Lata Mangeshkar Hospital, Nagpur, Maharashtra, India

Background: Bipolar disorders are chronic mental illnesses encompassing bipolar I and bipolar II disorders, characterized by the presence of acute mood episodes (manic, hypomanic, depressive, or mixed), with inter-critical periods of absent or sub-syndromic symptomatology (1). Seasonal mood changes are well documented in bipolar patients (2). The ability to effectively predict periods of vulnerability in these individuals could reduce disease burden and potentially decrease mortality, as death by suicide is significantly greater in individuals with bipolar disorder than general population (3).

Aim: To assess the prevalence of seasonal variation in bipolar disorder.

Methods: This cross-sectional observational study included 72 adult patients (18 -60 years) with bipolar disorder. Seasonal variation was assessed using the Seasonal Pattern Assessment Questionnaire (SPAQ). In SPAQ, the general seasonality score (GSS), ranging from 0 (no seasonality) to 24 (extreme seasonality) was calculated for each participant. A GSS of 11 or higher indicated a potential for seasonal affective disorder. Data was analyzed using descriptive statistics.

Results: Of 72 patients, 16 patients exhibited distinct seasonal pattern in the occurrence of mood episodes . Manic or hypomanic episodes were more frequently reported during spring and summer, while depressive episodes were predominently observed in winters.

Conclusion: This study demonstrates that seasonal variation plays a significant role in the clinical course of bipolar disorder. Recognizing these patterns can help clinicians anticipate relapse and implement preventive strategies, thereby improving patient outcomes and reducing overall disease burden.

A study to assess the self-perceived factors causing relapse in patients of alcohol dependence syndrome (ADS) treated at a structured addiction treatment (SAT) center

Sojan Baby

Department of Psychiatry, Military Hospital, Jabalpur, Madhya Pradesh, India

Introduction: Around 90% treated ADS individuals may experience at least one relapse within four years of treatment.

Aim: To identify the self-perceived factors causing relapse among ADS patients treated with SAT.

SAT: A structured Addiction Treatment (SAT) was conducted in pre-scheduled batches for 45 days duration (supervised abstinence, medical detoxification, structured awareness education sessions, group therapy, peer support/family counseling, life skills/rehabilitation training and after care and follow up services).

Materials and Methods: 120 ADS patients were treated with SAT for the first time in last one year, Every relapsed case of ADS in next 6 months were included in the study. A self-administered and semi-structured questionnaire (3-point likert scale) were used. Data was analysed with descriptive and inferential statistics.

Results: 30 patients (25%) relapsed in 6 months of follow-up. Most clients had at least 2 admissions in the past and associated disciplinary records prior to administration of SAT [tough to handle cases]. Easy availability of alcohol - 27.5%, Craving - 22.5%, Family stressors - 17.5%, Peer pressure - 5%, and Work-related stress - 5% were the major self-perceived factors for relapse.

Conclusion: 75% cases had remained improved or abstinent after treatment. At organizational level it is critical to control alcohol accessibility and ensure structured occupational roles to enhance motivation and alcohol abstinence.

From parenting to stigma: Cognitive pathways in alcohol use disorders

Soumya Jain, Kunal Kumar, Abhinit Kumar, Nikhil Nayar

School of Medical Sciences and Research, Sharda University, Greater Noida, Uttar Pradesh, India

Alcohol Use Disorder (AUD) is shaped by a combination of early familial experiences, cognitive processing patterns, and the degree to which individuals internalize stigma related to their condition. Understanding how these factors interact is essential for developing psychosocially informed interventions. This study explored perceived parental style, cognitive style, and internalized stigma among 36 treatment-seeking patients with AUD at a tertiary care centre. Standardized tools, including the Short Egna Minnen Betrffande Uppfostran (Short-EMBU), Cognitive Style Inventory, Internalized Stigma of Mental Illness Scale (ISMI-9), and Severity of Alcohol Dependence Questionnaire (SADQ), were administered alongside sociodemographic profiling. Participants commonly reported parental rejection and overprotection, and intuitive cognitive style emerged more frequently than analytical style. Internalized stigma was notably high, particularly in the domains of alienation and social withdrawal. Significant correlations were observed between parental rejection and stigma levels, parental overprotection and intuitive cognitive tendencies, and between alcohol dependence severity and overall stigma. These findings suggest that negative early parenting experiences, intuitive thinking patterns, and heightened internalized stigma often co-occur in individuals with AUD. Integrating stigma-reduction strategies, cognitive restructuring approaches, and family-focused elements may enhance the effectiveness of clinical interventions for AUD.

Mental health knowledge, belief towards mental illness and psychological well being among medical undergraduate students

Souparna Nayek

Tirunelveli Medical College, Tirunelveli, Tamil Nadu, India

Background: Medical students, as future physicians, require sound mental health knowledge and non-stigmatising beliefs, yet they often face high stress that compromises their own psychological well-being.

Aim: To assess mental health knowledge, beliefs towards mental illness, and psychological well-being among medical undergraduate students and explore interrelationships.

Methods: A cross-sectional survey was conducted among medical students in Tirunelveli Medical College using the Mental Health Knowledge Questionnaire (MHKQ), Beliefs Toward Mental Illness Scale (BMI), and Ryff’s 42-item Psychological Well-being Scale. Data were analysed with descriptive statistics, t-tests, ANOVA, and Pearson correlations using SPSS 27.

Results: Students displayed moderate knowledge and moderately negative beliefs . Clinical-year students showed significantly higher knowledge and less negative beliefs than preclinical students. Psychological well-being was below average. Higher knowledge and lower stigmatising beliefs were associated with better well-being.

Conclusion: Medical students exhibit moderate knowledge, persistent negative beliefs, and reduced psychological well-being. Strengthening psychiatric education and stigma-reduction initiatives is essential to enhance both professional competence and personal mental health.

Endocrine psychosis or schizophrenia? A case of severe hypothyroidism masquerading as paranoid schizophrenia

Sreya Banerjee, Anna Sehgal

Kalinga Institute of Medical Sciences, KIIT, Bhubaneswar, Odisha, India

Background: Hypothyroidism can manifest with psychiatric symptoms that mimic primary psychotic disorders, particularly schizophrenia. This diagnostic overlap is often unrecognized in clinical practice, especially in resource-limited settings, leading to misdiagnosis and inappropriate treatment.

Aims: This case report illustrates chronic autoimmune hypothyroidism presenting as severe psychosis with schizophrenia-like features, emphasizing the importance of excluding endocrine causes in atypical or treatment-resistant psychiatric presentations.

Methods: We present a 36-year-old homemaker with a five-year history of progressive psychotic symptoms. Clinical information was obtained through patient and family interviews, mental status examination, and laboratory investigations including thyroid function tests and anti-thyroid peroxidase antibodies.

Results: The patient developed multiple psychotic features over five years: Capgras delusion (believing family members were replaced by impostors), persecutory delusions, somatic passivity, delusions of infidelity, auditory hallucinations of multiple voices, visual hallucinations of deceased parents, and self-directed speech. Mental status examination showed guarded attitude, irritable affect, impaired concentration and judgment, and absent insight. Previous irregular medication compliance yielded minimal improvement. Laboratory findings revealed severely elevated TSH (161.6 µIU/mL), low T4 (2.76 µg/dL), and strongly positive anti-TPO antibodies (>999 IU/mL), confirming autoimmune hypothyroidism. Combined levothyroxine and antipsychotic treatment resulted in significant clinical improvement.

Conclusion: This case highlights the critical need for thyroid screening in psychiatric settings, particularly when psychotic symptoms appear atypical or treatment-resistant. Autoimmune hypothyroidism can present with features closely mimicking schizophrenia. Routine endocrine evaluation should be incorporated into psychiatric protocols to ensure appropriate diagnosis and multidisciplinary management.

Safety and side effect profile of transcranial direct current stimulation in a psychiatric setting: A prospective observational study

Srivaramangai, Sivabalan

Sri Lalithambigai Medical College and Hospital, Chennai, Tamil Nadu, India

Background: Transcranial direct current stimulation (tDCS) is a non-invasive neuromodulation technique widely used as an adjunctive treatment in psychiatric disorders such as depression, schizophrenia, and obsessive-compulsive disorder. Although existing literature suggests that tDCS is generally safe, real-world data from south asian especially in Indian clinical settings are limited.

Objectives: To evaluate the safety profile and tolerability of tDCS in patients with psychiatric disorders receiving routine clinical care, to observe associated adverse effects, and to assess patient-reported willingness to continue treatment.

Methods: This prospective observational study will be conducted in the Department of Psychiatry at Sri Lalithambigai Medical College & Hospital. Adult inpatients and outpatients aged 18-65 years with psychiatric diagnoses referred for tDCS will be included after informed consent. Patients with seizure disorders, metallic cranial implants, pregnancy, or cognitive incapacity to consent will be excluded. Over a six-month period (September 2025 to March 2026), data from approximately 130-150 tDCS sessions will be collected. Adverse effects will be assessed using the 13-item tDCS Adverse Effects Checklist, along with socio-demographic and clinical profiling and the Clinical Global Impression-Severity scale. Statistical analysis will be performed using SPSS version 29 with significance set at p < 0.05.

Expected Results: tDCS is expected to demonstrate good tolerability with predominantly mild and transient adverse effects.

Conclusion: This study aims to provide real-world Indian data supporting the safety of tDCS in routine psychiatric practice.

Prevalence and relationship of orthorexia nervosa with self-esteem and lifestyle satisfaction in medical students

Subahani Shaik, Sarath Krishna

ACSR Government Medical College, Nellore, Andhra Pradesh, India

Background: Orthorexia Nervosa (ON) is an emerging eating-related condition characterized by an obsessive preoccupation with healthy eating. Although not yet formally recognized in DSM-V or ICD-10, ON has drawn increasing attention due to its overlap with eating disorders and obsessive-compulsive traits. Self-esteem and lifestyle satisfaction are reported risk factors for disordered eating, and medical students may be particularly vulnerable due to heightened health awareness and dietary concerns.

Objectives: This study aimed to determine the prevalence of Orthorexia Nervosa among medical students, to explore its association with self-esteem and lifestyle satisfaction, and to examine the relationship between demographic variables and ORTO-15 scores.

Methodology: An institutional-based cross-sectional study was conducted among 400 undergraduate medical students (I-IV year) at ACSR Government Medical College, Nellore. Participants were selected by simple random sampling. Data were collected using a structured questionnaire including sociodemographic details, physical activity, eating habits, the ORTO-15 scale, Rosenberg’s Self-Esteem Scale, and the Satisfaction with Life Scale (SWLS). Data were analyzed using SPSS v20, applying descriptive statistics, Chi-square test, Pearson correlation, and simple linear regression.

Results: The prevalence of ON was 34.6%. Of the 400 participants, 283 (70.7%) demonstrated orthorexic tendencies (ORTO-15 score <40). Prevalence was higher among females than among males. Significant associations were found between ORTO-15 scores and both physical activity and eating habits. However, self-esteem and lifestyle satisfaction showed no significant linear relationship with ON.

Conclusion: A substantial proportion of medical students demonstrated orthorexic tendencies. Early identification and interventions are necessary to promote psychological well-being among future healthcare professionals.

Weight changes in patients receiving psychotropic medications: A retrospective cohort analysis

Subas Pradhan, Catherine Apiaka¹

Central and North West London NHS Foundation Trust –MK (CNWL), London, ¹Chadwick lodge, Elysium Healthcare, Buckinghamshire, United Kingdom

Background: Weight gain is a major metabolic complication of psychotropic medication, contributing to metabolic syndrome, cardiovascular morbidity, and treatment non-adherence. Despite widespread recognition, systematic evaluation of weight changes in routine clinical settings remains limited.

Objectives: To quantify the prevalence and magnitude of weight changes, identify specific high-risk agents, and explore demographic and clinical factors influencing these outcomes.

Methods: A retrospective analysis was conducted on 70 psychiatric patients. Data on demographics, medication regimens, and weight measurements (admission vs. current) were collected. Descriptive, correlation, and comparative analyses were performed.

Results: The cohort (n=70) showed a mean weight gain of 11.44 kg (range -20 kg to +62 kg). 80% of patients gained >0.5 kg. Highest mean gains were seen with atypical antipsychotics: Quetiapine (29.68 kg), Risperidone (19.70 kg), and Clozapine (12.53 kg). Females gained more weight (mean 13.52 kg) than males (mean 9.12 kg). Prolonged treatment duration correlated with increased gain (r=0.38).

Conclusions: This study confirms the substantial burden of medication-induced weight gain, with specific atypical antipsychotics showing high risk. Female gender and prolonged treatment are key risk factors. Findings underscore the critical need for proactive metabolic monitoring and individualized weight management strategies.

Clinical Implications: Healthcare systems should integrate routine metabolic monitoring as standard practice, particularly for patients on Clozapine, Quetiapine, or Risperidone. Comprehensive proactive interventions are strongly recommended.

Key words: Atypical antipsychotics, metabolic monitoring, polypharmacy, psychotropic medications, weight gain

Role of neuro-biofeedback in the management of migraine headache

Sudhanshu Karhana, Abbas Mehdi¹, Parul Prasad¹, Aditi Jain¹

Guru Teg Bahadur Hospital, New Delhi, ¹Career Institute of Medical Sciences and Hospital, Lucknow, Uttar Pradesh, India

Introduction: Biofeedback is an established nonpharmacological approach in treating both migraine and tensiontype headaches. Neuro-feedback is a specialty field within biofeedback. Numerous published studies indicate that biofeedback can lessen both the frequency and intensity of headaches, often enabling patients to reduce their reliance on medication.

Objective: To assess the efficacy of neuro-biofeedback in reducing severity and frequency of migraine.

Methods: This was a prospective observational study using a convenient sampling strategy. Forty patients were recruited and assigned into two groups of 20 each-A (receiving neuro-biofeedback + Tab Amitriptyline 25mg) and B (Tab Amitriptyline 25mg only). Patients underwent 12 neuro-biofeedback sessions weekly, while Tab Amitriptyline was continued for 6 months. The improvement in headache characteristics was assessed using a headache diary and VAS, HDI, HIT-6 and PHQ-15 scale taken at baseline, 6 weeks, 12 weeks and 24 weeks follow up.

Results: group A patients showed a significant decrease in HDI scores from baseline to 12 weeks (P<0.001), with Migraine biofeedback group consistently having higher HDI scores. Group A showed significant improvement in HIT-6 scores at 6 weeks (P=0.007). Both groups showed reduction in headache frequency but there was a significant difference at 6 weeks (P=0.007) and 24 weeks (P=0.027) in group A and B.

Conclusion: At the end of the 24 weeks observational period there was a significant improvement in A and B group patients. It reflects that adding neuro-biofeedback in the management of migraine can increase the quality of life and reduce the medication load.

Mother-infant dyad mental illness and without mental illness

Sudipta Rani, Prerna Kukreti

Lady Hardinge Medical College, New Delhi, India

Background: Maternal mental health during the perinatal period strongly influences mother-infant bonding and infant emotional development. Conditions such as depression, anxiety, bipolar disorder, and psychosis may impair a mother’s ability to process infant facial emotions, affecting sensitivity, attunement, and early attachment formation.

Aims: To compare infant facial emotion processing and mother-infant relationship between mothers with and without mental illness, and to assess correlations with illness severity and clinical variables.

Methods: A comparative cross-sectional study was conducted from April 2024-August 2025 at Lady Hardinge Medical College, New Delhi. Eighty mothers of infants aged 1-12 months (40 with mental illness; 40 controls) were evaluated using socio-demographic and clinical proformas, MINI Screen 5.0, the Infant Facial Emotion Recognition Tool (InFER), and the Mother-Infant Relationship section of the Revised Stafford Interview. Statistical analyses included chi-square tests, Mann-Whitney tests, t-tests, and Spearman correlations.

Results: Mothers with mental illness demonstrated significantly lower InFER scores, indicating poorer infant facial emotion recognition, especially in severe psychiatric conditions. They also showed reduced affectionate involvement, emotional responsiveness, and greater disruptions in bonding. Infant temperament and developmental status were comparable between groups. Severity and duration of maternal illness showed significant associations with impaired emotion recognition and poorer mother-infant relationship domains.

Conclusion: Maternal mental illness adversely affects infant emotion recognition and mother-infant bonding. Early screening and targeted psychosocial interventions are essential to strengthen emotional attunement and promote healthier developmental outcomes.

Counting calories, chasing perfection: A case of restrictive eating, laxative misuse and depression in adolescence

Sumi Kutariar

All India Institute of Medical Sciences, New Delhi, India

Background: Adolescence is a period of heightened vulnerability to body image disturbance, disordered eating, and affective dysregulation. There is a complex interplay between societal expectations, academic stressors, parent-child dynamics, and pervasive exposure to social media content that idealises thinness and self-discipline around food and exercise. We demonstrate the nuanced ways in which school adversity, family responses, and digital media consumption intersect in the lived experiences of adolescents presenting with severe eating pathology.

Aim: To describe the evolving psychopathology, sociocultural context, and holistic management of an adolescent girl presenting with severe restrictive eating and binge-purge behaviours, and depressive symptoms.

Methods: Patient had a 6-year history of binge episodes evolving into dietary restrictions, excessive exercise, binge-purge behaviours, diet pill, school refusal, and depressive symptoms. The history highlights cumulative experiences of emotional invalidation, bullying by teachers and peers, academic stress, and progressive internalisation of thin ideals through gaming platforms and K-pop culture content. Comprehensive psychiatric and psychosocial assessment was undertaken, followed by multidisciplinary inpatient management which included structured eating, self-monitoring of dietary intake and related emotional aspects, medical stabilization, cognitive-behavioural and supportive psychotherapy.

Results: Patient weighed 31.6 kg on admission with marked preoccupation with weight, shape, and ideal body measurements with mood symptoms linked to weight and interpersonal conflicts. After comprehensive management she demonstrated improvement in various domains with weight on discharge being 45kg and marked improvement in mood.

Conclusions: This case reinforces the need for early, developmentally informed, and culturally sensitive interventions for the management of severe eating pathology in adolescence.

Neuromodulatory effects of adjuvant iTBS on EEG MU wave suppression in response to observed biological motion in schizophrenia patients with deficits in empathy

Supratik Kundu, Sanjay Kumar Munda¹, Nishant Goyal¹

Calcutta National Medical College and Hospital, Kolkata, West Bengal, ¹Central Institute of Psychiatry, Ranchi, Jharkhand, India

Introduction: Research indicates that individuals with schizophrenia may exhibit dysfunctional empathy. These result from inadequacies in the mirror neuron system. Psychosocial and pharmacological approaches have been attempted with modest efficacy to overcome social cognition impairments. Adjunctive theta burst stimulation (TBS) has been shown to enhance cognitive functioning in both healthy individuals and in people with neuropsychiatric disorders and to ameliorate clinical symptoms across psychiatric disorders.

Aim of the Study: To study the neuromodulatory effects of iTBS on EEG mu suppression in response to observed biological motion in schizophrenia patients with deficits in empathy.

Methodology: Inpatients on stable antipsychotic treatment will randomly be assigned to blinded, active, or sham stimulation groups for a total of twenty sessions over two weeks. The active group will receive bursts containing 3 pulses at 50 Hz repeated at 200-ms intervals for 2 s (i.e., at 5 Hz) over the left VMPFC at 80% of the resting motor threshold. A 2-s train of iTBS will be repeated every 10 s for a total of 990 pulses per session. Pre- and post-assessment will be done using EEG mu-wave (8-13 Hz) suppression paradigm, Interpersonal Reactivity Index, Positive and Negative Syndrome Scale (PANSS), Clinical Global Impression-Severity scale and TMSens _ Q.

Results: The group receiving active iTBS stimulation showed significant changes for EEG mu wave suppression in the 3rd person video task. Significant correlation was found between the second-person video task and affective empathy improvement.

Conclusion: This study demonstrates that iTBS provides a viable non-invasive intervention for social-cognition impairments.

Psychological correlates of caregiver burden in stroke survivors’ caregivers

Supreet Kaur, H. S. Akshatha Gowda

Sri Siddhartha Medical College, Tumakuru, Karnataka, India

Background: Stroke-related disability frequently requires extended informal caregiving, which can place a substantial burden on caregivers, leading to anxiety, depression, and a lower quality of life (QOL). This study aimed to evaluate the level of caregiver burden among those caring for stroke survivors and investigate its relationship with psychological distress and QOL.

Methods: A cross-sectional study was conducted among 54 caregivers of stroke survivors. Caregiver burden was assessed using the Zarit Burden Interview (ZBI), anxiety using the Hamilton Anxiety Rating Scale (HAMA), depression using the Hamilton Depression Rating Scale (HAM-D), and QOL using the WHOQOL-BREF. Descriptive statistics summarised caregiver characteristics. Pearson/Spearman correlations were used to evaluate associations, and one-way ANOVA and Kruskal-Wallis tests were used to examine differences across burden levels. Multiple linear regression identified independent determinants of caregiver burden.

Results: Most caregivers were male (66.7%), adult children (50%), and from rural areas (66.7%); 74.1% lived with the patient, and 68.5% reported no additional support. The mean ZBI score was 15.22 ± 6.15. Anxiety (mean 10.57 ± 6.78) and depression (mean 11.11 ± 6.34) showed significant positive correlations with caregiver burden (r = 0.458, p < 0.001 and r = 0.606, p < 0.001, respectively). Lower QOL in the physical domain was negatively correlated with burden (r = ˆ’0.344, p = 0.011). Significant group differences across burden categories were observed for anxiety, depression, and QOL-physical. In regression analysis, depression remained the only independent predictor of caregiver burden (B = 0.815; p < 0.001).

Conclusion: Caregiver burden among stroke caregivers was present.

Role of Vitamin B12 in major psychiatric disorders – A cross-sectional comparative study in a tertiary psychiatric hospital

Supriya D Silva, D. Shivaprasad¹

Sri Ram Murthy Smarak Institute of Medical Sciences, ¹Military Hospital, Bareilly, Uttar Pradesh, India

Background: Deficiency of B vitamins can cause hyperhomocysteinemia, which is associated with increased risk of heart disease, cognitive problems and mood disorders (Almeida et al., 2008; Flickera et al., 2004). Severe deficiencies of B12, folate or B6 can lead to macrocytic or pernicious anemia, syndromes characterized by fatigue, psychomotor, cognitive and mood deficits which can be easily missed. Vitamin B12 deficiency has been linked to depression because B12 is crucial for brain function and the production of mood-regulating neurotransmitters like serotonin and dopamine.

Objectives: To compare the serum Vitamin B12 levels in drug-naIve/drug-free patients with Schizophrenia, Bipolar disorder and Depressive disorder with healthy controls.

Method: This study was a cross-sectional hospital-based study. The sample size was 160, divided into 4 groups of 40 each (Schizophrenia, Bipolar disorder, Depressive disorder and Healthy controls). Blood samples were collected, and Serum vitamin B12 were measured. Clinical assessment was done on the BPRS scale. GHQ12 was applied to healthy controls.

Results: Study findings reveals that there was significant difference between the groups with respect to Serum vitamin B12 (p value<0.01). POST HOC Bonferroni analysis reveals that the serum vitamin B12 Level of patients with depression were significantly lower than the other three groups.

Conclusion: Patients with Depressive disorder had lower levels of Vitamin B12 than patients with Schizophrenia and Bipolar disorder. Also compared to healthy controls, patients with Depressive disorder lower serum Vitamin B12, suggesting the importance of assessment of Vitamin B12 in psychiatric disorders.

Key words: Bipolar disorder, depressive disorder, schizophrenia, Vitamin B12

Cognitive-behavioural modification of maladaptive cycles in illness anxiety disorder: A case illustration

Sushan Pokharel, Shalini Naik

Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India

Background: IAD (or hypochondriasis) is underdiagnosed, with higher mortality than the general population. The most widely accepted model is cognitive-behavioural, based on misinterpretation of bodily sensations leading to safety behaviours and avoidance. Remission is low without tailored treatment.

Aim: To present a case of IAD with cognitive-behavioural modification of maladaptive cycles.

Case Presentation: A 44-year-old male presented with fear of having acquired HIV after unprotected sex. This led to repeated testing and consultations. Despite negative results, he was worried that the tests might be wrong. After his brother died of a cardiac condition, his symptoms aggravated with fear of developing the same and dying. Later, his fear shifted to tetanus, from even bloodless pricks, and to rabies, from simply seeing dogs or monkeys, fearing airborne transmission. This led to repeated vaccination, and marked avoidance. He was treated as an outpatient with paroxetine up to 37.5 mg. Safety behaviours and avoidance were mitigated through an eclectic combination of Benson’s relaxation, and videoconferencing-based imaginal and in-vivo exposure therapy. Post-exposure cognitive processing aided in cognitive restructuring.

Conclusion: IAD should be considered in patients presenting with health anxiety in medical clinics. Meanwhile, rabies usually spreads through bites, scratches or mucosal contacts, unlike our patient’s fears. As IAD is chronic and recurrent, long-term specialized treatment is necessary and may reduce the morbidity and mortality. CBT is widely accepted, including psychoeducation, cognitive restructuring, behavioural intervention, and relapse prevention and is efficacious across various settings, including tele-based, as done in our case.

Digital mental health enhancement via app-based yoga in depression: A randomized controlled trial of clinical, cognitive, and biomarker outcome

Suvarna Jyothi Kantipudi, M. A. Ayisha Siddeequa, Maheshkumar¹, Vanishree Shriraam, R. Padmavathi

SRMC & RI, Sri Ramachandra Institute of Higher Education and Research (SRIHER), ¹Government Naturopathy and Yoga Medical College, The Tamil Nadu Dr. M.G.R Medical University, Chennai, Tamil Nadu, India

Background: Depression is a leading cause of global disability with high treatment non-compliance. Yoga is an accessible adjunctive therapy, but rigorous evidence for scalable, app-based delivery models is lacking.

Objectives: To evaluate the effectiveness of a 12-week app-based yoga intervention as an add-on to treatment as usual (TAU) for mild to moderate depression. Primary objective were to assess changes in depressive symptoms (HAM-D) and quality of life (WHO-QOL BREF). Secondary outcomes included serum Brain-Derived Neurotrophic Factor (BDNF) and cognitive function (RAVLT, TMT).

Methods: Ninety (N=90) outpatients (aged 18-45) with mild to moderate depression were randomized to a control group (TAU, n=45) or an intervention group (TAU plus a 12-week app-based yoga program, n=45). Clinical (HAM-D), biomarker (BDNF), quality of life (WHO-QOL), and cognitive assessments were performed at baseline and 12 weeks.

Findings: The intervention group had significantly greater reductions in depressive symptoms (HAM-D) than the TAU group (Mean Difference = -2.20, p < 0.001). Clinically, 71.1% of the yoga group achieved treatment response (50% HAM-D reduction) versus 6.7% of controls (p < 0.001), and 40.0% achieved remission (HAM-D ‰¤7) versus 4.4% of controls (p < 0.001). The yoga group also showed significant relative improvements in quality of life, BDNF and cognitive function.

Conclusions: A 12-week, app-based yoga intervention is a highly effective and clinically significant add-on therapy for mild to moderate depression. This accessible intervention improves depressive symptoms, quality of life, and cognition, paralleled by increases in serum BDNF. App-based yoga is a scalable and feasible strategy to augment standard depression care.

Mapping evidence on structured digital interventions in mental health: A scoping review of DIALOG and DIALOG+

Suvarna Jyothi Kantipudi

SRMC & RI, Sri Ramachandra Institute of Higher Education and Research (SRIHER), Chennai, Tamil Nadu, India

Background: The global burden of mental illness, including psychosis, bipolar disorder, depression and anxiety, underscores the need for scalable and cost-effective interventions that can be embedded within routine mental-health care. Many community services lack structured communication frameworks, resulting in inconsistent patient-centred practice and limited mobilisation of personal and social resources. DIALOG and its enhanced iteration, DIALOG+, were developed as technology-supported, resource-oriented interventions designed to structure clinician-patient interaction, promote shared decision-making, and improve subjective quality of life (SQoL).

Methods: A scoping review was conducted using a curated set of intervention studies, qualitative evaluations, and conceptual papers relating to DIALOG and DIALOG+. Data were systematically charted according to intervention characteristics, delivery modalities, solution-focused therapy (SFT) components, non-specific communication factors, clinical populations, outcomes, feasibility, and acceptability.

Results: The review identified a consistent intervention architecture across sources, involving a digital satisfaction scale followed by a four-step SFT-informed therapeutic conversation. Evidence from both high-income and low- and middle-income countries indicates that DIALOG+ is feasible, acceptable, and culturally adaptable. Some studies have demonstrated improvements in SQoL and unmet needs, while ongoing studies are evaluating the effectiveness and cost-effectiveness of DIALOG+ in depression, anxiety and psychosis. Qualitative findings show that the structured, digital format supports patient empowerment and articulation of complex needs.

Conclusion: DIALOG+ represents a promising, adaptable framework for strengthening routine mental-health care globally. Its structured, resource-oriented design has potential to enhance patient engagement and clinician effectiveness, provided adequate training and contextual adaptation are in place.

A randomised control trial on the effectiveness of psychoeducation on expressed emotions, caregiver burden and treatment adherence of patients with schizophrenia attending a tertiary care hospital

Swarnali Saha, Sanchari Roy, Purbasha Sengupta, Kasturi Thakur

Calcutta National Medical College and Hospital, Kolkata, West Bengal, India

Background: Caregivers of individuals with schizophrenia frequently experience high burden and expressed emotions, which adversely affect treatment adherence and clinical outcomes in patients. Psychoeducation can help in illness understanding, coping and improve both patient and caregiver well-being.

Aims: To evaluate the effectiveness of structured caregiver psychoeducation on patient psychopathology, caregiver burden, expressed emotions, and treatment adherence.

Methods: Two hundred patient-caregiver dyads from a tertiary care hospital were randomized into case (psychoeducation + pharmacotherapy) and control (pharmacotherapy only) groups. The case group received four structured interactive sessions over three months covering illness education, importance of medication adherence, coping and communication skills. Assessments were done at baseline and post-intervention using the Positive and Negative Syndrome Scale (PANSS), Family Burden Interview Schedule (FBIS), Family Questionnaire - Critical Comments (FQ-CC) and Emotional Overinvolvement (FQ-EOI), and Morisky Medication Adherence Scale (MMAS-8). Paired and independent t-tests and ANOVA were applied for statistical analysis.

Results: At baseline, FBIS and FQ-CC showed associations with lower socioeconomic status (p < 10 » ·) and urban residence (p < 0.001). FQ-CC was also higher in parent caregivers (p = 0.0068). Post-intervention, between-group comparisons showed greater improvement in cases than controls across PANSS, FBIS (p=0.0437), FQ-CC, FQ-EOI (p=0.00066), and MMAS-8 (0.047). Within group improvements in the intervention group were significant for all outcomes (p<0.001).

Conclusion: Caregiver burden is influenced by socioeconomic and family factors. Structured psychoeducation significantly reduces burden and expressed emotions in caregivers and improves adherence and symptom severity in patients. Integrating psychoeducation into routine psychiatric care can enhance family well-being and patient recovery.

Effect of brief intervention for suicide prevention on suicide cognitions in patients with recent suicide attempt at tertiary care center

C. Swati, Hemendra Singh, Mohan Raju¹

Ramaiah Medical College, Bengaluru, Kartnataka, India, ¹Clinical Psychologist, Australia

Aims and Background: Suicide is a major public health concern but most of the patients with recent suicide attempt do not get adequate psychiatric intervention. Of the multiple risk factors for suicide, we focus on suicide related cognitions and the effect of Brief Intervention on the same.

Methods: Brief Intervention comprising of 3 sessions were given for the 40 recruited patients with recent suicide attempt. Telephonic follow-up was done up to 6 months post discharge to screen for suicidal ideation and reattempt. Suicide Cognition Scale (SCS) was applied pre and post-interventions and change in score analysed.

Results: In this study 22 (55%) were below 30 years of age; 27 (67.5%) were female; 21 were married (52.5%); 18 (45%) were graduates; 27 (67.5%) were employed and 32 (80%) were residing in urban areas. The most common reason for the current suicide attempt was family problems (n=17, 42.5%). The most method self-harm was consumption of poison or caustic substances (n=17, 42.5%). Suicide cognitions showed significant correlation with hopelessness and ideation, but not intent and depression. Of the 40 patients recruited, 30 (75%) completed the study and had no self-harm attempt during the 6-month follow-up. SCS scores showed significant reduction post- intervention (Z=-4.763, p=0.00).

Conclusion: Brief interventions targeting suicide cognitions may be effective in preventing future attempts.

Key words: Brief intervention, cognitions, intentional self-harm, suicide

The hidden night time struggle: Sleep disturbances in children with ADHD

Syed Karrar Hussain, Syna Bashir

Institute of Mental Health and Neurosciences, Kashmir, Jammu and Kashmir, India

Background: Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder affecting around 5% of children and teenagers throughout the world. However, there is limited data available from our region regarding sleep disturbances in patients with ADHD. Our study aimed to study the prevalence and pattern of sleep disturbances and disorders in children with ADHD.

Methods: The study was a cross-sectional study including all children diagnosed with ADHD as per DSM-5 between ages of 3-16 years whose guardians provided written informed consent. Exclusion criteria was hyperactivity-inattention symptoms due to an organic condition. Sociodemographic profile were noted and presence of sleep disturbance was evaluated using sleep disturbance scale for children (SDSC) completed by parents or guardians.

Results: The study included 51 children aged 3-16 years with mean age of 9.39+3.70 years in which male children predominated (n=37, 72.54%), most of the children had birth order 1 (n=29, 56.9%), belonged to nuclear family (n=35, 68.6%), were on nonstimulant medicines (n=34, 66.7%). Among them, sleep disorder was found in majority of children (n=35, 68.6%).

Conclusion: The study reveals an alarming prevalence of sleep disorders among children with ADHD. It emphasizes the need to evaluate children with ADHD for sleep disturbances which increase the child’s problems with attention, behavior and emotional regulation.

Perception and attitudes towards cannabis among medical students: A descriptive study

Syed Mehvish Yaver

SKIMS Medical College, Srinagar, Jammu and Kashmir, India

With the growing debate on marijuana legalization, understanding medical students’ attitudes and beliefs is crucial. This descriptive study aimed to investigate the perceptions of 100 medical students from Government Medical College (GMC), Srinagar, using the Marijuana Effect Expectancy Questionnaire-Brief (MEEQ-B). The results show a mixed outlook, with 55% of participants believing marijuana has therapeutic benefits, while 42% expressed concerns about its recreational use. The study highlights the need for comprehensive education on marijuana’s effects to inform future healthcare professionals.

Predicting MDD from hippocampal volume: A novel mathematical and circuit-based model

T. Naveen Keerthi

MIMER Medical College, Pune, Maharashtra, India

Background and Objectives: Reduced hippocampal volume is consistently associated with Major Depressive Disorder (MDD), yet its predictive value remains limited due to the absence of a mechanistic framework linking structural atrophy to functional risk. Most studies offer only statistical associations, leading to uncertainty about causality. This study aimed to address this gap by developing an integrated, mechanistically informed model that predicts MDD risk from hippocampal volume.

Methods: A synthetic dataset of 500 data points, derived from meta-analytic means and standard deviations of MDD and control cohorts, was used. The analysis involved two steps: (1) a logistic regression model estimating the probability (p) of MDD as a function of hippocampal volume (V); and (2) a novel mechanistic circuit model conceptualizing hippocampal integrity as voltage and depressive load as resistance, following the derived relation . The resulting current (I), representing functional output, was used as the predictor in the regression, modeling nonlinear vulnerability to depression.

Results: Depressed subjects showed significantly lower hippocampal volumes (2.73 ± 0.46) than controls (3.28 ± 0.37). The integrated model achieved an AUC of 0.720, indicating good discriminative power. A threshold volume of 1.1348 corresponded to a high-risk probability (p 0.8). The circuit output (I) correlated strongly with p, supporting the hypothesis that structural loss amplifies functional deficits.

Conclusion: This study introduces a transparent, interpretable framework linking hippocampal structure to MDD risk. The defined anatomical cutoff highlights hippocampal volume as a potential biomarker, warranting validation with real neuroimaging datasets.

Predicting MDD from hippocampal volume: A novel mathematical and circuit-based model

T. Naveen Keerthi

MIMER Medical College, Pune, Maharashtra, India

Background and Objectives: Reduced hippocampal volume is consistently associated with Major Depressive Disorder (MDD), yet its predictive value remains limited due to the absence of a mechanistic framework linking structural atrophy to functional risk. Most studies offer only statistical associations, leading to uncertainty about causality. This study aimed to address this gap by developing an integrated, mechanistically informed model that predicts MDD risk from hippocampal volume.

Methods: A synthetic dataset of 500 data points, derived from meta-analytic means and standard deviations of MDD and control cohorts, was used. The analysis involved two steps: (1) a logistic regression model estimating the probability (p) of MDD as a function of hippocampal volume (V); and (2) a novel mechanistic circuit model conceptualizing hippocampal integrity as voltage and depressive load as resistance, following the derived relation . The resulting current (I), representing functional output, was used as the predictor in the regression, modeling nonlinear vulnerability to depression.

Results: Depressed subjects showed significantly lower hippocampal volumes (2.73 ± 0.46) than controls (3.28 ± 0.37). The integrated model achieved an AUC of 0.720, indicating good discriminative power. A threshold volume of 1.1348 corresponded to a high-risk probability (p 0.8). The circuit output (I) correlated strongly with p, supporting the hypothesis that structural loss amplifies functional deficits.

Conclusion: This study introduces a transparent, interpretable framework linking hippocampal structure to MDD risk. The defined anatomical cutoff highlights hippocampal volume as a potential biomarker, warranting validation with real neuroimaging datasets.

Scrolling into sleeplessness – Smartphone addiction and sleep quality among nursing students

T. Lakshmi Komali, H. Rupa Lakshmi

Alluri Sitaramaraju Academy of Medical Sciences, Eluru, Andhra Pradesh, India

Background: In India, Smartphone addiction (SA) and poor sleep quality are common problems that harms students’ physical and mental health which can also reduce their academic performance. Late-night phone use disrupts circadian rhythms and increases the risk of stress, anxiety, depression, and sleep disorders. However, published research on this subject in this geographical region is limited.

Aim: To assess the impact of Smartphone addiction on sleep quality among nursing students.

Methods: A cross-sectional study was conducted among 150 nursing students. Participants were selected using a convenient sampling technique. After taking ethical committee approval and informed consent from all participants, socio-demographic and other data was collected. For assessing SA and sleep quality, instruments such as The Smartphone Addiction Scale-Short Version (SAS-SV) and The Pittsburgh Sleep Quality Index (PSQI) respectively were used. Students who reported using medication impacting sleep were excluded from this study. Statistical significance was set at p<0.05.

Results: The results show that 56.3% of students had mild SA and 43.7% had moderate SA. Poor sleep quality was reported by 58.3% of students whereas 41.7% had good sleep quality.

Conclusion: This study concludes that increased frequency of smartphone usage has an impact on quality of sleep among nursing students.

Study of determinants of time in achieving successful outcome in alcohol detoxification among in patients

Taba Yedi, Raju Sah

Silchar Medical College and Research Hospital, Silchar, Assam, India

Introduction: Alcohol use disorder (AUD) has emerged as one of the most significant and persistent public health challenges worldwide, demonstrating a complex interaction of biological vulnerability, environmental pressures, and social determinants that contribute to its onset, progression, and chronicity. AUD encompasses a spectrum of maladaptive drinking patterns marked by impaired control over alcohol intake, physiological dependence, tolerance, craving, and continued use despite adverse consequences.

Aim and Objective: To assess the various determinants of time for successful detoxification in alcohol dependence syndrome in an inpatient psychiatric ward.

Methodology: It is a hospital based cross-sectional study done over duration of one year conducted among in patients, diagnosed with alcohol dependent syndrome according to ICD 10 after obtaining informed consent. Tools used were AUDIT, MINI, SADQ, CIWA-Ar and MMSE along with socio- demographic profile and clinical data collected.

Result: The majority of the patients were male from low to middle socio-economic class. Average hospital stay was 7 days. Low CIWA-Ar on first day was significantly associated with successful outcome. Severity of withdrawal symptoms correlated with severity of dependence.

Conclusion: Severity of alcohol withdrawal at the time of presentation is a significant factor to determine the achievement of successful outcome in alcohol detoxification. Other factors such as family history, socio-economic class, education and family support also contribute in predicting time for remission of withdrawal symptoms.

Digital empathy and human care: Exploring the role of AI in emotional wellbeing

Taba Yedi, Himabrata Das

Silchar Medical College and Research Hospital, Silchar, Assam, India

Introduction: Emotional wellbeing is fundamental component of overall health, influencing cognitive functioning, interpersonal relationships and quality of life. In recent years, growing mental health demands, coupled with limited access to professional care have intensified the search for innovative support systems. Advances in artificial intelligence (AI) have led to the emergence of digital tools capable of offering emotionally responsive interactions through conversational agents and wellbeing applications. These systems aim to simulate empathetic communication, a phenomenon often described as digital empathy.

Methodology: A cross sectional study, questionnaire based survey was conducted among individuals with exposure to AI tools. Informed consent was obtained.

Results: Majority of participants were educated individuals, predominantly students. Most participants used AI tools out of curiosity. Majority used it for academic purposes and for day to day stressful situations like general decision making. A significant proportion reported engaging during periods of stress and anxiety. Many of them were also aware about AI designed to express empathy and validate emotions which contributed to repeated use.

Conclusion: AI-based emotional support tools provide immediate, anonymous, and non-judgmental spaces for emotional expression, potentially reducing barriers such as stigma and accessibility. While these tools support enhancement of emotional awareness and supporting self help behaviours, concerns persist regarding authenticity, ethical responsibility, privacy and risk of over reliance on these systems. Understanding how digital empathy complements rather than replaces human care is essential for the responsible integration of AI into emotional wellbeing frameworks.

Efficacy of add-on tDCS in patients of generalized anxiety disorder

Tayyaba Haseen

KGMU, Lucknow, Uttar Pradesh, India

Background: Anxiety disorders are the most common of all mental disorders. Generalized Anxiety Disorder (GAD) refers to persistent and excessive worry about daily activities or events. Non-invasive brain stimulation techniques such as tDCS, that uses external methods, such as electrical stimulation to alter brain activities, have shown promise and being studied worldwide for its effects in anxiety disorder.

Aims: To determine the efficacy and side effects of add on tDCS in the patients of Generalized anxiety disorder.

Methods: It is an open label, prospective study done in a tertiary care hospital setting, in patients with generalized anxiety disorder as per DSM-5 criteria. 20 patients with GAD completed the sessions and follow up. They were given 10 sessions of tDCS over a period of 2 weeks. Anode was placed over left DLPFC and cathode at right DLPFC. Results were noted at baseline, week 1, week 2 and week 4 of the intervention on measuring scales (HAM-A, WHO wellbeing index, and tDCS side effect checklist).

Results: Use of add on tDCS demonstrated improvement in anxiety symptoms of HAM-A score 26.63 ± 4.5 to 19.6 ± 2.8 along with improvement in WHO wellbeing index of the patients over time. Side effect profiles were recorded and only mild transient adverse events were reported.

Conclusion: tDCS is an effective adjunct in the management of GAD. tDCS is safe and well tolerated with minimal side effects. Add on use may offer superior clinical benefits in symptom reduction.

Spotting the relapse prone patient: Clinical predictors of early relapse in alcohol use disorder – A comparative cross-sectional study at a tertiary care hospital

Tharini Durairaj, Ramya Rachel, Madhusudan

SRM Medical College Hospital and Research Centre, Kattankulathur, Tamil Nadu, India

Background: Alcohol Use Disorder remains a major global public health concern, with relapse posing persistent challenges despite treatment. Identifying socio-demographic, clinical, and psychosocial predictors of early relapse is critical for formulating targeted relapse-prevention strategies.

Aim: To determine predictors associated with early relapse among individuals with Alcohol Use Disorder.

Methods: A comparative cross-sectional study was conducted on 120 patients with AUD, divided equally into abstinent (n = 60) and relapser (n = 60) groups. Socio-demographic, clinical, and psychosocial data were collected using validated scales: Penn Alcohol Craving Scale (PACS), Presumptive Stressful Life Events Scale, Relapse Precipitant Inventory, Coping Behaviour Inventory, Severity of Alcohol Dependence Questionnaire, Pittsburgh Sleep Quality Index. Statistical analyses included Chi-square tests, independent t-tests, and multivariate analysis.

Results: Age, marital status, education, family type, comorbidity, and treatment history showed no significant association with relapse. Significant risk factors included rural residence (p < 0.001), lower socioeconomic class (p < 0.001), unskilled occupation (p = 0.0027), first-degree family history of substance use (p < 0.001), and a higher number of previous relapses (p < 0.001). Earlier age of onset of drinking was associated with relapse (p = 0.0239). Relapsers demonstrated higher craving (p = 0.013), higher maladaptive coping (p = 0.008), and higher relapse precipitant scores (p = 0.002).

Conclusion: Early relapse in AUD is strongly influenced by socio-environmental vulnerabilities, early initiation of drinking, family history, craving severity, maladaptive coping skills. Recognising these predictors enables clinicians to plan targeted interventions and improve long-term treatment outcomes.

Substance use and its mental-health correlates among young adults: A cross-sectional study

Thuraka Prathisha, Madhumitha Budigam, K. Pavan Kumar, G. Preeti, N. Ravi Kumar

CAIMS, Bommakal, Telangana, India

Introduction: Substance use involving licit and illicit substances such as alcohol, tobacco, and prescription drugs is common among young people in India, with alcohol being the most widely used, followed by cannabis and opioids. High psychiatric comorbidity especially depression, bipolar-disorder, schizophrenia, and personality disorders is frequently observed among substance users.

Aim: To assess the prevalence, patterns, and correlates of substance-use among young people seeking mental health care, examine associated harm indicators, and identify key demographic and clinical predictors.

Methodology: Cross-sectional study was conducted over 18 months (May 2024-October 2025) in the Psychiatry OPD in Karimnagar. The sample included 178 individuals aged 18-25 years presenting with substance use/mental illness. Those clinically unstable, with organic brain disorders, or unwilling to consent were excluded. Data were collected using a semi-structured proforma that included WHO-ASSIST 3.0, DSM-5, PHQ-9, GAD-7, RRS, PSQI, CAS, and PQ-16.

Results: Overall, 60.7% reported using at least one psychoactive substance. Nicotine (54.5%) and alcohol (47.2%) were most common; polysubstance use occurred in 19.7%. WHO-ASSIST identified high-risk use among nicotine (16.5%) and alcohol users (11.9%), with opiates showing the highest severe-risk clustering (40%). Moderate-to-severe depression and anxiety were highly prevalent, especially among cannabis and opiate users. Rumination, poor sleep, anger, and psychosis risk were also elevated. Higher substance use was associated with males, urban-residence, higher SES, and postgraduate education.

Conclusion: Findings highlight the need for routine screening and integrated interventions for substance use and mental health disorders among youth.

Key words: Anxiety, depression, mental-health, substance-use, young-adults

A study of quality of life in patients with anxiety disorders and assessment of caregiver burden

Towheed Mushtaq, Anurag Agarwal, Azhar Mahmood Farooqui

Integral Institute of Medical Science and Research, Lucknow, Uttar Pradesh, India

Background: Anxiety disorders are common, frequently chronic conditions that markedly impair functioning and quality of life (QOL). Caring for affected individuals can also create emotional and practical strain on family members, resulting in caregiver burden. This study assessed patient QOL and evaluated caregiver burden in a tertiary-care setting.

Method: This cross-sectional study included 150 adults (18-60 years) diagnosed with ICD-11 anxiety disorders attending the Psychiatry Department, IIMSR, Lucknow, along with their primary caregivers. Socio-demographic and clinical details were recorded. Anxiety severity was measured using the Hamilton Anxiety Rating Scale (HAM-A). Patient QOL across physical, psychological, social, and environmental domains was assessed using the WHOQOL-BREF. Caregiver burden was evaluated using the Zarit Burden Interview (ZBI).

Results: The mean patient age was 32.97 ± 13.61 years; most were 18-30 years (54.7%) and female (57.3%). Generalized anxiety disorder (28%) and panic disorder (24%) were most common. Nearly half (49.3%) had severe anxiety (mean HAM-A 25.81 ± 9.76). Overall QOL was mostly moderate (83.3%), with greatest deficits in psychological and physical domains. Caregivers mainly had mild-moderate burden (76.7%; mean ZBI 30.46 ± 7.96). Anxiety severity showed a small but significant negative correlation with total QOL (r = -0.152, p = 0.044), while caregiver burden correlations were weak and non-significant.

Conclusion: Patients with anxiety disorders showed moderate overall QOL, with significant impairment in psychological and physical domains. Caregivers commonly experienced mild to moderate burden.

Psychiatry comorbidity, quality of life, stigma in patients with drug resistant epilepsy

Udit Singh, S. Jena¹

VIMS Hospital, Gajraula, Uttar Pradesh, ¹GB Pant Hospital, New Delhi, India

This observational analytic study evaluated psychiatric comorbidity, quality of life, and internalized stigma in adults with drugresistant epilepsy (DRE) over a oneyear period. Fifty patients aged 18-65 years fulfilling ILAE criteria for DRE were included, while those with mental illness predating epilepsy, traumatic brain injury, stroke, significant sensory or language impairment, or intellectual disability were excluded. A semistructured pro forma captured sociodemographic and clinical details, and psychiatric diagnoses were established using the Mini International Neuropsychiatric Interview 6.0. Quality of life was assessed with the Hindi QOLIE31P, while stigma was evaluated using the Internalized Stigma of Epilepsy (ISE) and Internalized Stigma of Mental Illness (ISMI) scales. Statistical analyses were conducted with SPSS version 25.0. Among the 50 participants, 54% had a comorbid psychiatric disorder, with depression comprising 46% of the psychiatric diagnoses. The mean (SD) QOLIE31 score was 51.15 (6.52), indicating a moderate impact of DRE on quality of life, while mean ISE and ISMI scores were 58.74 (12.59) and 23.06 (23.20), respectively, reflecting substantial internalized stigma related to both epilepsy and mental illness. No significant association was found between psychiatric comorbidity and factors such as social support, mesial temporal sclerosis, or PETscan hypometabolism (p = 0.998). Notably, patients with psychiatric comorbidity demonstrated higher QOLIE scores yet concurrently reported higher epilepsyrelated stigma (ISE) and poorer social support compared to those without comorbidity. These findings emphasize the complex interaction between psychiatric disorders, perceived stigma, and psychosocial context in DRE, underscoring the need for routine psychiatric screening and integrated biopsychosocial management within epilepsy

Menstrual cycle and suicidal ideation: Exploring variability in women with depression

S. Uma Maheswari, B. Swapna

The Oxford Medical College, Hospitals and Research Centre, Anekal, Karnataka, India

Need for the Study: Suicidal ideation is a significant concern among women with depression, who are influenced by hormonal fluctuations across the menstrual cycle. Research suggests that mood symptoms may fluctuate during different phases of the menstrual cycle, with a notable increase in symptoms, particularly during the luteal phase. However, there is limited data on how these hormonal changes directly impact suicidal ideation. This study aims to assess the relationship between suicidal ideation and menstrual phases in women with major depressive disorder (MDD), providing insights for clinical management and targeted interventions.

Methodology: A cross-sectional study was conducted on 100 women aged 18-45 years diagnosed with Major Depressive Disorder (DSM-5) attending the psychiatry outpatient department of TOMCH & RC. Suicidal ideation and depressive symptoms were assessed using the Columbia Suicide Severity Rating Scale (C-SSRS) and the Hamilton Depression Rating Scale (HAM-D). Data on menstrual history, cycle length, and current phase were collected and categorized into follicular (days 1-14), ovulatory (around day 14), and luteal (days 15-28) phases. Statistical analyses, including Chi-square tests, t-tests, correlation, and regression analysis, were performed to examine the relationships between menstrual phases, depressive symptoms, and suicidal ideation.

Results: The study found significant variations in suicidal ideation across different menstrual phases. Among the participants, 34 women were in the follicular phase, and 66 were in the luteal phase. A total of 33% of participants reported no suicidal ideation, while 15% experienced suicidal ideation during the follicular phase, and 52% reported suicidal ideation during the luteal phase.

A retrospective study of psychiatric referral patterns from other specialties in a rural teaching hospital

Urbi Ghosh, Anil Korade¹, Brig P. S. Bhat²

Pravara Institute of Medical Sciences, Loni, Ahmednagar, ¹Byramjee Jeejeebhoy Government Medical College, ²Armed Forces Medical College, Pune, Maharashtra, India

Background: There is high prevalence of mental disorders in specialist treatment seekers across specialties. There is a pressing need to improve the Consultation-liaison (CL) psychiatry services both in hospitals and the community.

Aim and Objectives: To assess the sociodemographic profile, reasons, and diagnostic categories of psychiatric referrals from various departments in a rural teaching hospital.

Methods: This retrospective observational study reviewed records of all inpatients referred to the Psychiatry Department between January and June 2024 in a Rural Medical College in Maharashtra. Patients with complete referral and evaluation data were included. Data were collected using a semi-structured proforma, and diagnoses were assigned using ICD-10 criteria.

Results: A total of 543 referrals were studied.. The mean age was 40.2 ± 19.06 years, and 67.2% were male. Most were married (84.8%), employed (68.7%), and from lower socioeconomic groups. Past psychiatric illness was reported in 31.3%, and 9.4% had a family history. Most referrals came from Medicine (34.1%), Orthopaedics (24.4%), and Casualty (18.7%). The leading diagnoses were substance use disorder (29.3%), intentional self-harm (18%), and requests for psychiatric evaluation (16.6%), with schizophrenia, organic disorders, and behavioural syndromes occurring less frequently.

Conclusion: Substance use disorder came to be high in referrals which are referred for excessive alcohol intake. Most suicidal attempts were diagnosed as intentional self-harm, and most referrals to the psychiatry department came from General Medicine. Findings highlight the need to strengthen consultation-liaison psychiatry, improve clinician training, and enhance integration of mental-health services in rural hospitals.

Behavioural addictions in people with substance use disorders presenting to a tertiary care hospital – A cross-sectional study

Ushasti Sinha

KMC, Manipal, Karnataka, India

Background: Behavioural addictions are gaining prominence in the recent times due to better understanding of the condition over the years. Presence of a substance use disorder often masks underlying behavioural addictions or its treatment unmasks underlying ones. Co-occurrence of these conditions can pose challenge and require intervention alongside the substance use. The current study aims to study the prevalence and patterns of co-occurrence of behavioral addiction in people with substance use disorders using a screening tool.

Methods: A cross-sectional study in a clinical population of substance dependence disorder without comorbid psychiatry disorder was conducted in a tertiary care hospital. The presence of behavioural addiction was identified through Screener for Substance and Behavioural Addictions (SSBA) scale. In addition, we explore the feasibility of the ICD-11 criteria for confirmation.

Results: Out of 232 participants screened in the study, 38 (16.3%) of them had co-occurring behavioural addiction of any type. Out of the 6 behavioural addictions screened for, work addiction was most common followed by shopping. Association statistics between age category and occurrence of any behavioural addiction was significant (X2 = 5.393, p=0.02) with higher occurrence of any behavioural addiction with age category less than 44.

Conclusion: Co-occurrence of behavioural addictions with substance use is common. The significant association of behavioural addiction with younger age and onset before substance use disorders hints at a possibility of behavioural addictions being a pre-cursor for future substance dependence needing further exploration.

Open label trial of ketamine among inpatients, who gave consent, having major depressive disorder (MDD): A case series

Vaishnavi Raj, Mona Srivastava

Institute of Medical Sciences, BHU, Varanasi, Uttar Pradesh, India

Background: MDD as already established is a psychiatric emergency often associated with suicidal ideations. And Electro Convulsive Therapy is usually the gold standard treatment for urgent care in MDD. Although due to lack of stigma, and many psychiatric settings lacking the infrastructure for ECT, Ketamine is gaining recognition for use of emergency like suicide in patients with MDD.

Aim: This case series evaluated oral ketamine in six MDD inpatients who refused ECT, assessing severity via MADRS, suicidality via Suicide Intent Scale (SIS), YBOCS for comorbidities, and BFCRS for catatonia.

Methods: IPD cases with MDD who did not give consent for ECT, were given oral ketamine therapy after proper informed consent per the protocol in Andrade C. Ketamine for Depression, 1: Clinical Summary of Issues Related to Efficacy, Adverse Effects, and Mechanism of Action. J Clin Psychiatry. 2017;78(4):e415-e419.

Result: Assessments were done from point of administration to treatment completion, alongside usual care. Patients showed an average of 2-3 point reductions on SIS and 8-10 point drops on MADRS over few days, indicating rapid improvement in depression and suicidality.

Discussion: Responses in this case series were encouraging, supporting ketamine’s role in urgencies like suicide over ECT as it doesn’t have too many prerequisites.

Conclusion: Ketamine is no longer novel and it should be encouraged for potentially improving access to urgent care. However, larger controlled studies are needed to inform standardized protocols.

Efficacy of accelerated intermittent theta burst stimulation (iTBS) on negative symptoms in schizophrenia: A randomized sham control study

Vaishnavi Raj, Pankaj Gupta

Institute of Medical Sciences, BHU, Varanasi, Uttar Pradesh, India

Background: Negative symptoms of schizophrenia, particularly apathy and avolition, profoundly impair functioning and quality of life. These symptoms lead to persistent disability despite optimal pharmacology. Accelerated intermittent theta-burst stimulation (iTBS) to the left dorsolateral prefrontal cortex (DLPFC) promises rapid cortical plasticity, outpacing standard rTMS protocols.

Aims: To assess accelerated iTBS efficacy over sham in reducing negative symptoms in schizophrenia, while evaluating safety and tolerability.

Methods: Ongoing randomized sham-controlled trial at IMS BHU, Department of Psychiatry. Eight patients till now with schizophrenia received study-specific accelerated iTBS (5 in iTBS arm, 3 in sham arm), to left DLPFC. Assessments were done using PANSS, SANS, MoCA at baseline and post-treatment; and safety and tolerability via screening tools and side-effect checklists.

Results: Both groups showed reductions, but patient in iTBS arm showed marked improvement in apathy/avolition (e.g., SANS apathy sub-score drops of 30-40%). Full analysis awaits complete recruitment in the study.

Discussion: Current treatments leave psychiatrists powerless against apathy and avolition, core drivers of schizophrenia morbidity despite the use of antipsychotics (including both first-generation and second-generation antipsychotics). Accelerated iTBS offers hope as a non-invasive, rapid intervention enhancing prefrontal plasticity, with early tolerability data reassuring despite uncharted safety in intensive regimens.

Conclusion: Accelerated iTBS holds promise for targeting refractory negative symptoms however complete analysis might change the results.

Knowledge and perception of postgraduate trainees towards the use of artificial intelligence in psychiatry education

Varchasvi Mudgal, Priyash Jain

MGM Medical College, Indore, Madhya Pradesh, India

Introduction: Artificial Intelligence (AI) is rapidly transforming healthcare, necessitating its integration into medical education. This study assesses the knowledge, perceptions, and current utilization of AI among psychiatry post-graduate (PG) trainees in India to identify curriculum gaps.

Methodology: A cross-sectional survey was conducted among psychiatry PG trainees. The questionnaire evaluated demographic details, foundational AI knowledge, exposure to formal AI education, and perceptions regarding AI’s role, ethics, and future in psychiatry using a 5-point Likert scale. Frequency of AI tool usage for academic tasks was also recorded.

Results: Analysis of 206 valid responses (Mean Age = 27.83 years) revealed that while 75.7% of trainees possess basic AI knowledge, only 23.3% have received formal training/ teaching on the subject. Trainees strongly agreed on the importance of understanding AI’s ethical implications (Mean Score = 4.37/5) and learning its basics (Mean Score = 4.05/5). Conversely, they strongly disagreed that AI would replace human teachers (Mean Score = 1.91/5). Statistical analysis showed no significant association between gender or PG year and AI knowledge or perceptions (p > 0.05).

Conclusion: Psychiatry trainees exhibit a high level of interest and a perceived need for AI education, particularly concerning ethics and foundational concepts. The significant disparity between this interest and the lack of formal training highlights an urgent need to integrate a structured AI curriculum into post-graduate psychiatry education.

Patterns of nicotine dependence and readiness to change in a tertiary care hospital in Central India

Varchasvi Mudgal, V. S. Pal, Prashant Gaurav

MGM Medical College, Indore, Madhya Pradesh, India

Nicotine dependence is a major public health concern in India, particularly among individuals with psychiatric illnesses, who are disproportionately affected compared to the general population. Dependence on nicotine worsens psychiatric outcomes alongwith posing a significant barrier to recovery. This study aimed to assess the prevalence of nicotine dependence, readiness to quit, and willingness to quit among psychiatric patients in a hospital-based setting.

Methods: A cross-sectional study was conducted over six months among 200 adults attending outpatient and inpatient psychiatric services at a government mental hospital in Central India. Nicotine dependence was assessed using the Fagerstrom Test for Nicotine Dependence, readiness to quit measured with the Readiness to Change Questionnaire, and motivation was assessed by Willingness to Quit Ruler (0-10 scale). Data were analyzed using descriptive statistics and logistic regression.

Results: Out of 200 patients, 98 (49%) had nicotine dependence. Based on FTND scoring, 34% had mild dependence, 41% moderate dependence, and 25% severe dependence. Regarding readiness to quit, 39% were in contemplation, 29% in preparation, and 32% in precontemplation. On the Willingness to Quit Ruler, the mean score was 6.1 ± 2.4, with 42% scoring 7, suggesting moderate-to-high motivation to quit. Logistic regression showed younger age, male gender, and rural residence as significant predictors of nicotine dependence (p < 0.05).

Conclusion: Nicotine dependence is highly prevalent among psychiatric patients, with nearly half expressing readiness and moderate willingness to quit. Incorporating routine screening, motivational assessment tools such as the quit ruler, and targeted interventions into psychiatric services may enhance cessation outcomes.

Exercise addiction, body dysmorphic traits, and self-esteem among gym-goers: A cross-sectional study from rural Karnataka, India

Vidya Nittur

KVG Medical College and Hospital, Sullia, Karnataka, India

Background: Exercise addiction represents a behavioural addiction characterized by excessive preoccupation with exercise despite negative consequences. Body dysmorphic traits frequently co-occur with exercise addiction, while self-esteem may serve as a protective factor against both conditions.

Aims: To assess exercise addiction risk and body dysmorphic traits among gym-goers in rural Karnataka, and evaluate the protective role of self-esteem along with sociodemographic factors, BMI, social media usage, and supplement consumption.

Methods: This cross-sectional study recruited 113 adult gym-goers from Sullia, Karnataka. Participants completed the Exercise Addiction Inventory (EAI), Appearance Anxiety Inventory (AAI), and Rosenberg Self-Esteem Scale (RSES), along with a structured questionnaire capturing demographic variables, exercise patterns, supplement use, and social media exposure.

Results: Interim analysis was done on the 61 samples collected till date. 18% of the gym goers were seen to be at risk of exercise addiction, while 78% had some symptoms. 9% of the population had BDD-level anxiety. With linear regression analysis, frequency of watching gym content on social media and monthly cost for supplements were significantly associated with EAI score with p value and co-efficient of confidence interval 0.004 (1.83), 0.024 (-4.33).

Conclusion: Prevalence of gym goers prone to exercise addiction is high in rural Karnataka, with use of supplements, money spent on it, social media use for exercise, being higher in population at risk of addiction. No significant association was found in the appearance anxiety as a predisposing factor or self- esteem as the protective factor at present.

Sociocultural attitude internalization as a predictor of body image disturbances in female medical trainees: In the shadow of ideals

Vignesh Kuppusamy, Bharat Singh Shekhawat¹

All India Institute of Medical Science, New Delhi, ¹Government Medical College, Kota, Rajasthan, India

Background: Body image reflects one’s perception and emotions about physical appearance, while disturbances involve dissatisfaction, distress, or persistent preoccupation with weight and shape. Young women in academic environments are particularly vulnerable due to sociocultural beauty ideals, peer influence, and media pressures.

Aims: To determine the prevalence of body image disturbances among female medical students and examine their association with sociocultural attitudes toward appearance.

Methods: A cross-sectional study was conducted among 150 female undergraduate, postgraduate students, and medical interns at Government Medical College, Kota, selected via simple random sampling. Body Shape Questionnaire-34 (BSQ-34) assessed body dissatisfaction, while the Sociocultural Attitudes Towards Appearance Questionnaire (SATAQ-5) evaluated internalization of appearance-related sociocultural ideals.

Results: The mean BSQ-34 score was 78.57 ± 32.1 (range 34-166; median = 74). Body image concern (BSQ >80) was present in 42.7% of participants, of which 26% had mild concern, 10% moderate, and 6.7% severe concern. A significant increase in SATAQ-5 domain scores was observed with rising severity of body image disturbance (p < 0.05). BSQ-34 scores showed significant positive correlations with all five SATAQ-5 domains: thin internalization (r = 0.407), muscular/athletic internalization (r = 0.421), family pressure (r = 0.292), peer pressure (r = 0.404), and media pressure (r = 0.563).

Conclusion: A substantial proportion of female medical students experience body image disturbances, strongly associated with sociocultural pressuresespecially media-driven ideals. Preventive interventions, awareness initiatives like media literacy education, and body image resilience programs may reduce internalization of unrealistic beauty norms.

An explorative study of patient’s missed appointments at a tertiary care psychiatric hospital

Vijay Niranjan, Lkshay K. Dhawan, V. S. Pal

MGM Medical College, Indore, Madhya Pradesh, India

Background: Missed psychiatric appointments exacerbate healthcare inefficiencies, particularly in low-resource settings. In India, where mental health infrastructure is underdeveloped, understanding predictors of non-attendance is critical.

Aim: To identify factors associated with missed follow-ups in a tertiary care center in India.

Methods: A retrospective, cross-sectional analysis of 200 outpatient records (January-June 2023) was conducted. Sociodemographic (gender, residence, education) and clinical variables (diagnosis, illness duration) were analyzed using chi-square tests and binary logistic regression.

Results: Of 200 patients, 76% (n=152) missed appointments. Rural residence (aOR=1.9, p=0.049), male gender (aOR=0.5 for females, p=0.031), lower education (graduates: aOR=0.4, p=0.008), shorter illness duration (<2 years: 87% missed), and intellectual disability (100% non-attendance) emerged as significant predictors. Employment and family structure were non-significant.

Discussion: High attrition reflects systemic inequities, including rural healthcare access barriers, stigma, and inadequate caregiver support. Early-phase patients and those with intellectual disabilities or seizure disorders faced heightened risks. Contrary to some studies, females exhibited better adherence, potentially due to familial support.

Conclusion: Targeted interventions like tele psychiatry, SMS reminders, and community health worker engagement are vital. Policy reforms, such as transportation subsidies and mental health integration into national programs, may mitigate attrition. Addressing missed appointments in India requires context-specific strategies addressing socio-demographic disparities and clinical complexities. Future research should evaluate tailored interventions in low and middle income countries (LMICs).

Key words: Dropouts, follow up rates, missed appointment, missed follow up, psychiatry follow up

Psychiatric co-morbidities in vitiligo patients attending a tertiary care centre in western Uttar Pradesh: A cross-sectional study

Vikas, Pakash Chandra, Akhil Dhanda

Saraswathi Institute of Medical Sciences, Hapur, Uttar Pradesh, India

Background: Vitiligo, a chronic autoimmune depigmenting disorder, often leads to significant psychological consequences due to social stigma, visibility of lesions, and chronic disease course. Emotional distress, anxiety, and depression are common but frequently overlooked in dermatology settings.

Aim: To assess the frequency and pattern of psychiatric co-morbidities in vitiligo patients attending a tertiary care centre in Western Uttar Pradesh.

Materials and Methods: A cross-sectional study was conducted on 50 vitiligo patients (18-65 years) diagnosed as per ICD-10 (L80) criteria. Patients with prior psychiatric illness, substance abuse, or comorbid dermatological disorders were excluded. Sociodemographic and clinical details were recorded. Psychiatric evaluation was done using the Hospital Anxiety and Depression Scale (HADS), and quality of life was assessed using the WHOQOL-BREF. Disease severity was measured using VASI. Statistical analysis included Chi-square and Student’s t-test.

Results: Psychiatric co-morbidity was identified in 38% of patients. Anxiety (32%) was slightly more common than depression (28%) on HADS. Patients with vitiligo over exposed areas and those with moderate-to-severe VASI scores had significantly higher HADS scores (p < 0.05). WHOQOL-BREF showed maximum impairment in the psychological and social relationship domains, correlating with higher anxiety and depression levels.

Conclusion: Psychiatric co-morbidities are prevalent among vitiligo patients and significantly affect their quality of life. Incorporating routine psychological screening with tools like HADS and WHOQOL-BREF in dermatology practice can facilitate early intervention, counselling, and improved treatment outcomes.

Key words: Anxiety, depression, HADS, psychiatric co-morbidity, quality of life, vitiligo, WHOQOL-BREF.

Estimating burden of care and psychological health of care-givers of schizophrenia patients and correlation with clinical condition of patient

Vikash Kumar Gupta, Col Sanjay Kumar Saini¹

Command Hospital (NC), Udhampur, Jammu and Kashmir, ¹Command Hospital (CC), Lucknow, Uttar Pradesh, India

Schizophrenia is a chronic mental disorder, with significant disability and may affect educational and occupational performance of individual adversely. It’s impact can be stratified at three levels; the patient, care-givers and the society as a whole. Usually most burdened in the family is the primary care-giver of the patient. Disease progression leads to significant surge in the care-giver’s burden. This can significantly change clinical outcome of the illness and disability experienced by patient. This study was carried out to find relation between these factors and to understand relation between effects of patient’s clinical condition on care giver’s burden and vice-a-versa. After taking ethical clearance, 100 patients of schizophrenia and their caregivers were included in study which began in 2016 and subjects were recruited till 2021. Most of the patients were females (73.00%) and most of the caregivers were males (67.00%). Mean age was 44.96 and 47.9 for patients and caregivers respectively. Significant positive correlation was seen between IDEAS scores of patients with PSS-10 scores of caregivers with correlation coefficient of 0.359. There was positive correlation between BPRS scores of patients with BAS scores of caregivers, PSS-10 scores of caregivers and GHQ-12 scores of caregivers with correlation coefficient of 0.439, 0.386 and 0.382 respectively (P value <0.0001). Hence, we concluded that there is significant care giver burden in terms of stress present in primary caregivers of schizophrenia. Secondly, severity of clinical condition of patient has better positive correlation with caregivers’ burden.

Patterns and outcomes of psychiatric referrals in a geriatric hospital: A six-month descriptive study from North India

Vipindeep Kaur Sandhu, Arnab Datta, Preethy Kathiresan

All India Institute of Medical Sciences, New Delhi, India

Aim: Patterns and Outcomes of Psychiatric Referrals in a Geriatric Hospital: A Six-Month Descriptive Study from North India.

Background: Psychiatric morbidity is common among older adults admitted to tertiary care hospitals due to the overlap of medical illness, cognitive impairment, and behavioral disturbances. However, Indian data on referral patterns, follow-up practices, and outcomes of psychiatric care in geriatric hospital settings remain limited.

Methods: This retrospective descriptive study analyzed psychiatric referrals from a geriatric hospital of a tertiary care center in North India over a six-month period. Data collected included demographic variables, referral type, reasons for referral, symptom duration, follow-up advice, clinical outcomes, and changes in diagnosis or treatment. Summary statistics were used, and one-way ANOVA examined differences in follow-up planning across symptom-duration categories.

Results: A total of 63 psychiatric referrals were recorded, including 49 new referrals and 14 follow-up visits involving 10 patients. Follow-up was advised in 67% of new referrals; however, only 12% were actually reviewed. Delirium was the most common diagnosis (30.8%), followed by dementia (13.5%, predominantly with BPSD), while no psychiatric diagnosis was found in 9.6%. Active therapeutic interventions, including medication adjustments, were required in 50% of follow-up visits. Antipsychotics were the most commonly prescribed medications, predominantly at low doses consistent with geriatric practice.

Conclusions: Psychiatric referrals in geriatric hospital settings primarily address acute neuropsychiatric disturbances. Structured follow-up mechanisms and better integration of psychiatric care into routine geriatric management are needed.

Key words: Behavioral symptoms, delirium, follow-up care, geriatric psychiatry, psychiatric referrals, tertiary care hospital

A pilot study on the psychiatric benefits of a structured 10-day motorbike expedition: Effects on anxiety, depression, resilience, and quality of life

Vishal Chopra, M. Jithin Raj, Prateek’s Golas, Neeta¹

Army Medical Corps, ¹Private Practitioner, India

Background: Adventure-based therapeutic interventions combine physical activity, sensory immersion, and peer bonding, all of which contribute to psychological recovery. However, structured motorbike expeditions remain largely unexplored within psychiatric research.

Objective: To assess the feasibility, acceptability, and preliminary mental-health outcomes of a 10-day organized motorbike expedition among riders with mild-to-moderate anxiety or depression.

Methods: This single-group longitudinal pilot study (January-September 2025) enrolled 15 experienced riders who screened positive on GAD-7 or PHQ-9 (score 5). Participants undertook the 3,000-km Ride to Resilience route (Delhi-Leh-Kargil-Srinagar-Jammu-Delhi) complemented by daily mindfulness exercises and guided reflection. Standardized measuresGAD-7, PHQ-9, PSS-10, CD-RISC-25, WHOQOL-BREFand ecological momentary mood tracking were administered at baseline, post-expedition, and at 1- and 3-month follow-ups.

Results: All participants completed the expedition, with a 93% retention rate at 3 months. Satisfaction was high (mean 9.4/10). Significant reductions were observed in anxiety (Δ = ˆ’6.6, p < .001) and depression (Δ = ˆ’7.9, p < .001), indicating large within-subject effect sizes. Secondary outcomes showed parallel improvements in perceived stress, resilience, and quality of life. Mood variability decreased by 52%. Only minor transient musculoskeletal strains were reported.

Conclusion: A structured motorbike expedition appears feasible, safe, and associated with substantial, sustained improvements in anxiety, depression, resilience, and quality of life. The findings justify larger controlled trials to evaluate this innovative adventure-therapy model.

Key words: Adventure therapy, anxiety, depression, motorbike expedition, pilot study, resilience

Neuropsychological assessment and MRI brain correlates in Alzheimer’s disease

Vivekanand Bhatt, G. Prasad Rao, Sahil Doshi, Mayur Mayank

Asha Hospital, Hyderabad, Telangana, India

Background: Alzheimer’s disease (AD) involves progressive decline in memory, language, executive, and visuospatial functions. To use neuropsychological assessments for studying the underlying disease processes contributing to AD and MRI Brain correlates to identify patients with probable Alzheimer’s disease (AD) dementia in a memory clinic.

Aim: To analyse patterns of cognitive deterioration in Alzheimer’s disease and examine their correspondence with MRI Brain.

Methods: An open-label study with a sample size of 30 healthy controls and 30 patients with subjective memory symptoms, with probable AD dementia was conducted. Neuropsychological assessments across cognitive domainsmemory, language, executive functions, and visuospatial skillswere evaluated by MMSE and ACE-III along with MRI markers including hippocampal and medial temporal lobe volumetry and cortical thickness.

Results: Neuropsychological assessments (MMSE and ACE-III) and MRI Brain demonstrated strong correlations with overall cognitive severity and domain-specific impairment.

Conclusion: Integrating Neuropsychological assessments (MMSE and ACE-III) with MRI Brain enhances early detection, staging, and monitoring of Alzheimer’s disease. The case-control design supports clearer differentiation of ADrelated changes, improving diagnostic precision.

The mind and skin interplay: Exploring the effect of anxiety, depression and sociodemographic aspects on coping and functioning of young adults with psoriasis – A cross-sectional study

Vulugundam Manasa Sri Vaishnavi, B. Kavitha

Sapthagiri Institute of Medical Sciences and Research Center, Bengaluru, Karnataka, India

Background: Psoriasis is a chronic, immune-mediated skin condition that profoundly affects patients’ physical appearance and psychological health. Growing literature supports the link between psoriasis and mental health disorders such as depression, anxiety, and suicidal ideation. Young adults with psoriasis may experience impaired daily functioning, which can be influenced by their coping mechanisms. Furthermore, gender and socioeconomic status may affect psychological outcomes and coping strategies, yet these disparities are underexplored in this population.

Aim: To assess depression, anxiety, coping styles, and daily functioning in young adults with psoriasis along with the impact of gender and socioeconomic status on the individuals.

Methodology: After taking informed consent, forms having sociodemographic questionnaire (asking for age, gender, education, employment, income, duration of psoriasis and treatment status of psoriasis), PHQ 9, GAD 7, Brief COPE inventory and WHODAS 2.0 was given to 60 individuals having clinically diagnosed psoriasis in a tertiary care center aged between 18-35 years.

Results: Individuals showed maladaptive coping strategies, having stronger link to anxiety and depression and females being more effected which significantly impacted their daily living. Individuals from lower socioeconomic backgrounds were more affected. Depression emerged as more prevalent compared to anxiety, indicating that individuals experienced a deeper and more emotional impact showing statistically significant rates that maladaptive coping plays a substantial role in worsening psychological distress.

Conclusion: There is a need for integrated dermatological and psychological care for promoting problem-focused coping and reducing maladaptive coping behaviors which might significantly improve emotional well-being and disease management in this population.

Antipsychotic-induced facial dystonias presenting to ophthalmology and psychiatry outpatient clinics: A 12-case retrospective series and management

Yashika Nathani

Sattva Mental Health, Vadodara, Gujarat, India

Background: Antipsychotic-induced facial dystonias, including blepharospasm, oculogyric crisis, and oromandibular dystonia, are frequently under-recognised in routine clinical practice. Many patients first present to ophthalmology OPDs with ocular complaints before a drug-induced movement disorder is suspected

Aim: To describe the clinical characteristics of patients with antipsychotic-induced facial dystonias presenting to the ophthalmology and psychiatry outpatient departments over a 2-year period, and to formulate a practical management approach based on clinical patterns and prior evidence.

Methods: This retrospective study reviewed records of all patients presenting with new-onset facial dystonia to the eye and psychiatry OPDs from January 2023 to December 2024. Twelve patients met inclusion criteria, all of whom had current or recent exposure to antipsychotic medication and onset of dystonic movements confined to the face or periocular region. Demographic data, antipsychotic exposure, phenotype of dystonia, latency of onset, treatment, and outcomes were analysed descriptively.

Results: Among the 12 cases, the most common presentations were blepharospasm (50%), oculogyric crisis (25%), and oromandibular dystonia (16.7%). Half of the patients first presented to ophthalmology OPD. Four cases were acute (<7 days of drug change), while eight showed tardive patterns. Acute dystonias responded promptly to parenteral anticholinergics, whereas tardive dystonias required antipsychotic modification, botulinum toxin injections. Overall, 75% showed significant clinical improvement on follow-up.

Conclusion: Facial dystonias related to antipsychotics are common and often initially misinterpreted as primary ocular disease. A structured drug history and joint ophthalmology-psychiatry management significantly improve outcomes.

Loneliness, life satisfaction and psychological distress among transgenders: A community-based cross-sectional study

Yendluri Chidvilas, Sindhuja Omkaram, Rokkam Kishore Kumar

Santhiram Medical College and General Hospital, Nandyala, Andhra Pradesh, India

Background: Transgender individuals frequently face stigma, discrimination, and inadequate social support, predisposing them to increased loneliness, reduced life satisfaction, and significant psychological distress. Evidence from semi-urban regions such as Nandyal, Andhra Pradesh is scarce, emphasizing the need for localized data to guide supportive mental-health and social interventions.

Aims: To assess levels of loneliness, life satisfaction, and psychological distress among transgender individuals and to examine their association with socio-demographic variables.

Methods: A community-based cross-sectional study was conducted among 60 transgender participants in Nandyal, Andhra Pradesh, selected through simple random sampling. Data collection included socio-demographic profiling and administration of the UCLA Loneliness Scale (Version 3), Satisfaction with Life Scale (SWLS), and Kessler Psychological Distress Scale (K10). Statistical analysis was performed using SPSS version 26.0. Descriptive and inferential statistics were applied, with significance set at p < 0.05.

Results: Moderate to severe loneliness was reported by 56% of participants. Low life satisfaction was identified in 62% based on SWLS scores, and 48% demonstrated moderate to severe psychological distress on the K10. Lack of family acceptance and low social support were significantly associated with higher loneliness (58%, p < 0.001), poorer life satisfaction (54%, p < 0.01), and greater psychological distress (52%, p < 0.01).

Conclusion: Transgender individuals experience substantial psychological vulnerability, characterized by elevated loneliness, reduced life satisfaction, and significant distress. These findings highlight the urgent need for targeted mental-health services, strengthened social support systems, and inclusive policies to enhance their well-being.

Comparative study of spirituality among depressed and nondepressed university students

Yogesh, Achyut Kumar Pandey

IMS, BHU, Varanasi, Uttar Pradesh, India

Background: Depression is a very common diagnosis in India. The comparison of spirituality in depression has not been assessed adequately in our culture. Further, the studies of depressive disorders with Spirituality are very scant.

Aim: Comparative study of Spirituality among depressed and nondepressed university students.

Methods: This study had two groups for compararison. The first group was BHU students having Depression. The second group participants were healthy controls not having psychiatric disorder. Once recruited in the study, tools of the assessment which includes Hamilton Depression Rating Scale (HAM-D), Spiritual Measurement Scale & GHQ 12 were applied.

Result: By Using group statistics and Independent sample t-test, the t(58) value = 3.41 and p value = 0..001. The p value shows a statistically significant difference.

Cohen’s d = 0.88 (large effect).

Conclusion: Spirituality can serve as a protective coping mechanism.

Prevalence of internet addiction and its impact on mental health, sleep, coping and academic performance in nursing and para-medical students of medical university in southern Rajasthan

Yosha Raghuvanshi

Pacific Institute of Medical Sciences, Udaipur, Rajasthan, India

Background: Widespread smartphone access and internet use have reshaped learning among health-science students. While online platforms support academics, excessive use may lead to Internet Addiction (IA), affecting mental health, sleep, coping ability, and academic outcomes. Nursing and para-medical students may be particularly vulnerable due to demanding coursework and clinical exposure.

Objectives: To assess the prevalence of internet addiction and examine its association with psychological distress, sleep quality, coping strategies, and academic performance among nursing and para-medical students in Southern Rajasthan.

Methods: A descriptive cross-sectional study was conducted among 85 undergraduate students from Nursing, Physiotherapy, and other allied health programmes. Data were collected using Young’s Internet Addiction Test (IAT-20), GHQ-12, subjective sleep-quality questions from the Pittsburgh Sleep Quality Index, a coping scale, and an academic performance scale. Statistical analysis was performed using SPSS version 25, applying descriptive statistics and Chi-square tests with p<0.05 considered significant.

Results: Mild-to-severe internet addiction was observed in 67.1% of students. Psychological distress (GHQ-12 12) affected 75.3%, while 32.9% reported poor sleep quality. Internet addiction showed significant associations with psychological distress (p=0.028), sleep status (p<0.001), and academic performance (p=0.003). Severe addiction was more common in nursing and other allied health students.

Conclusion: Internet addiction is prevalent among nursing and para-medical students and is strongly associated with mental-health disturbances, poor sleep, and lower academic performance. Preventive digital-wellness and mental-health strategies are essential to support student well-being.

A cross sectional study of emotional blunting among individuals with depression on antidepressant treatment

H. M. Yusra, W. J. Alexander Gnanadurai, A. Balaji

Department of Psychiatry, Government Kilpauk Medical College Hospital, Chennai, Tamil Nadu, India

Background: Emotional blunting is a frequently reported yet under-recognized effect of antidepressant therapy, with many individuals continuing to experience reduced emotional responsiveness despite remission.

Aims: Primary: Determine prevalence of emotional blunting among adults in remission from major depressive disorder (MDD). Secondary: Examine associations with antidepressant class, dose, and treatment duration.

Methods: Cross-sectional assessment using HAM-D, PHQ-9, and the Oxford Emotional Blunting Subscale. Inclusion: Adults 18-65 years with DSM-5 MDD; on antidepressants 6 weeks. Exclusion: Psychotic disorders, substance-use disorders, active suicidal ideation or recent attempt, pregnancy, lactation.

Results: A substantial proportion reported emotional blunting despite remission, with higher prevalence among SSRI users and associations with drug class and treatment duration.

Conclusion: Emotional blunting remains a significant residual symptom, highlighting the need for routine screening and individualized treatment adjustments to improve patient well-being.

Comparative efficacy of escitalopram versus sertraline in major depressive disorder among patients with chronic kidney disease on hemodialysis

Khushboo Sahni, Pratik Awake, Fiona Mahapatro

D.Y. Patil Medical College, Navi Mumbai, Maharashtra, India

Background: Depression is a common comorbidity in patients with Chronic Kidney Disease on hemodialysis, adversely affecting treatment adherence, quality of life, and overall prognosis. Evidence guiding antidepressant selection in this medically complex population is limited. This study aimed to compare the efficacy of two commonly used selective serotonin reuptake inhibitors—escitalopram and sertraline—in patients with Major Depressive Disorder (MDD) undergoing hemodialysis.

Materials and Methods: This prospective, comparative study was conducted in a tertiary hospital and included 60 patients with CKD on maintenance hemodialysis diagnosed with MDD as per DSM criteria. Participants were allocated into two groups of 30 and treated with escitalopram (5 mg/day) or sertraline (25 mg/day). Depression severity was assessed using the Hamilton Rating Scale for Depression (HAM-D) and Beck Depression Inventory (BDI) at baseline and at weekly intervals for four weeks. Sociodemographic and clinical variables were recorded. Data were analysed using SPSS version 21, employing appropriate descriptive and inferential statistics, with p < 0.05 considered statistically significant.

Discussion: Both treatment groups demonstrated a statistically significant reduction in HAM-D and BDI scores from baseline to the fourth follow-up, indicating marked improvement in depressive symptoms. The mean reduction in scores was comparable between the two groups, with no statistically significant difference in efficacy. Treatment response was independent of age, gender, duration of CKD, duration of hemodialysis, and duration of depressive illness.

Conclusion: Escitalopram and sertraline show comparable efficacy in treating MDD in patients with CKD on hemodialysis. Given their similar effectiveness at low doses, antidepressant selection in this population may be guided by individual tolerability, comorbidities, and drug–drug interactions. Early psychiatric intervention can play a crucial role in improving overall outcomes in hemodialysis patients.

A comparative study of aripiprazole, olanzapine, and l-methylfolate augmentation in treatment resistant obsessive-compulsive disorder

Rezwana Mehmood

Government Medical College, Srinagar, Jammu and Kashmir, India

Introduction: About half of the patients with Obsessive-compulsive disorder (OCD) do not respond to serotonin reuptake inhibitors (SRIs) or have a partial improvement in their symptoms.

Aim: This study aimed to compare the efficiency and safety of aripiprazole, olanzapine, and L-methyl folate in patients with resistant OCD. The study consisted of an open-label prospective phase of 12-weeks to ascertain resistance to SRIs and a second 6-week open-label addition phase for non or, partial responders of the first phase.

Results: One-hundred-fifteen patients entered the 16-week open-label phase. Fifty patients (43.47%) responded to the SRIs monotherapy, two patients developed adverse effects and another three were lost to the follow up. Sixty patients (52.2%) were considered treatment-resistant and entered the 6-week open-label aripiprazole, olanzapine, or L-methyl folate addition phase; Patients showed a significant improvement over 6-week study period in olanzapine and aripiprazole group as measured by YBOCS total score (p<0.001) while there was no change in the L-methyl folate group at the end as compared with baseline (p=0.150). Clinical Global Impression-Severity decreased from 4.90 to 2.90 in olanzapine and aripiprazole group at the end of 6 weeks while there was no change in the L-methyl folate group. The CGI-I was significant in the olanzapine and aripiprazole group (p<0.001) while it was insignificant in the L-methyl folate group (p=0.088).

Conclusion: Augmentation of SRIs with olanzapine or aripiprazole could be a promising option for resistant OCD. L-methyl folate though shown to be effective in resist-ant depression was not effective in treatment resistant OCD.

Key words: Aripiprazole, obsessive-compulsive disorder, olanzapine, serotonin reuptake inhibitors