Psychiatry In India Research Articles

The Bharatiya Nyaya Sanhita Act (BNSA) 2023: Implications for Forensic Psychiatry in India

The Bharatiya Nyaya Sanhita Act (BNSA) 2023: Implications for Forensic Psychiatry in India

Navigating mental health: A review of Dr. James T Antony’s vision for Indian Psychiatry

Navigating mental health: A review of Dr. James T Antony’s vision for Indian Psychiatry

A Survey Among Psychiatrists to Assess the Need for Psychiatry Sub/Super-specialization Courses in India.

India's landscape of sub/super-specialization courses is expanding rapidly. Numerous courses spanning various domains of psychiatry exist, and this trend is poised to continue its upward trajectory. We aimed to assess the need for sub/super-specialization courses in psychiatry in India and explore the structural components of the courses. This was a cross-sectional study. A total of 142 psychiatrists/psychiatry residents from India were surveyed using an online questionnaire after approval from the Institutional Ethics Committee. "Good" and "intense" need for specialization courses was reported to be highest for child and adolescent psychiatry (68.3%), followed by addiction psychiatry (56.4%) and psychotherapy (55.6%). A 1-year post-doctoral fellowship was reported to be the most preferred course format. Practical examination was suggested to be the preferred summative assessment method for different course formats. The availability of sub/super-specialization courses presents an opportunity to enhance psychiatrists' training in specific areas of interest. Offering a variety of course options enables psychiatrists to select the most suitable program based on their individual requirements and career goals.

Bridging the mental health gap: The scope, challenges, and future of digital psychiatry in India

The mental health burden in India is increasing at unprecedented rates. The increased demand for mental health care and the undersupply of services has widened the treatment gap. Due to several factors, such as increasing service costs and the circumstances surrounding the COVID-19 pandemic, India has witnessed an inclination toward using digital mental health solutions to overcome the treatment gap. Drawing from the collective evidence and experience in implementing mental health solutions using digital phenotyping and smartphone app-based care delivery in India, we define the scope, potential, and challenges of implementing synchronous and asynchronous digital mental health solutions that can serve as a template for improving global mental health.

So Why Do They Not Engage? Grounded Theory Research to Understand and Explain Why Medical Students Disengage from Undergraduate Psychiatry Education in India.

For almost 60 years, Indian psychiatry literature has called for all medical students to learn psychiatry so that millions of mentally unwell people across India might receive appropriate treatment. Yet for almost 60 years, medical students have disengaged from psychiatry education, resulting in limited learning. The literature has repeatedly cited the solution as one that involves longer exposure on posting and more exam questions, with little impact. This research sought to understand why medical students disengage from psychiatry education so that meaningful change might occur. The research utilized constructivist grounded theory, initially in one medical college in Mumbai, followed by a quantitative survey to test the findings with a wider group of interns across 10 states of India. An iterative process of data gathering and analysis was undertaken using the constant comparison method and theoretical integration. Findings identified that 98% of interns believe all MBBS (doctors) should "know" psychiatry, with "know" meaning practical skills-how to assess and treat people with mental illness. The majority of students attend psychiatry to learn those skills, but on finding faculty too overworked to teach, they disengage, saying: "there's nothing in it for me." The findings indicate that more exam questions would not increase engagement. Medical students want to learn skills to help those in mental distress. Faculty do not have time and, arguably, the training to teach them. To address the nation's mental health needs, the government needs to prioritize teaching of psychiatry skills by releasing and enabling psychiatry faculty, alongside the certification of psychiatry skills.

Legal aspects of proxy practices in clinical psychiatry in India

Proxy procedures in psychiatry include proxy consultations, proxy prescriptions, covert and refill medications. Before Mental Healthcare Act (MHCA) 2017, there was minimal emphasis on the rights of individuals with Severe Mental Illness (SMI), leading family members to use proxy practices. With the new legislation, these practices have to be seen in a new light. Proxy consultations may be allowed for information, advice, etc. but not for giving medications or making a diagnosis. Proxy prescriptions can be given if the patient gives prior authorization or through nominated representative in advanced directive. Psychiatrists may consider covert medications if the patient lacks capacity, but not in emergencies. Medication refills can be given with physicians’ recommendation for a specific duration.

Research on psychotherapy in India: A systematic review.

We systematically reviewed empirical studies of psychotherapy with Indian clients. We defined psychotherapy as an intervention aimed at treating mental disorders using "talk," which, in a professional medical setting, along with the therapeutic relationship, acquires medicinal value. Besides manual searches in three leading Indian psychiatry journals, we conducted digital searches in PubMed, Google Scholar, and Scopus databases. We found that the commonly practiced evidence-based psychotherapy in India follows the cognitive-behavioral model. Our findings suggest several replication studies which claimed to have used the well-established western models of cognitive behavioural paradigm but have mostly focused on basic behavioural techniques in their protocol. A few innovations were observed, and several essential errors were noted. Innovations include contextual modifications to address the difficulties and challenges faced in service delivery, while errors include deviations from protocol without adequate rationale.

Undergraduate Psychiatry Teaching and Learning in India: A Bumpy Ride

In India, there has been exponential growth in the number of MBBS seats and postgraduate seats over the past two decades. In the year 2021, there were 83,275 MBBS seats and 42,720 postgraduate seats in 554 medical colleges in India.1,2 As of the second week of October 2023, 706 medical colleges are collectively providing 1,08,890 MBBS seats.3 In the same period, 331 medical institutions now offer postgraduate programs in psychiatry, contributing to a total of 1,360 MD seats in psychiatry.4 The change of figures over three years gives an idea about the rapid increment in undergraduate (MBBS) and postgraduate seats in psychiatry in India.

The Psychiatrists Premier League: A Unique Opportunity for the Evolution of Sports Psychiatry in India

The field of sports psychiatry has gained recognition in recent years for its vital role in supporting the mental health and well-being of athletes. In India, where sports are becoming increasingly popular and competitive, there is a growing need for specialized mental health professionals to address the unique mental health challenges faced by athletes. This article details the origin and evolution of the psychiatrists premier league (PPL), a cricket tournament and highlights this as a unique opportunity to leverage the expertise of psychiatrists and drive the evolution of sports psychiatry in India. The PPL aims to establish a platform that brings together psychiatrists, mental health professionals, and other stakeholders in a collaborative environment. Through the PPL, psychiatrists can gain first-hand expertise in the mental health of athletes in addition to their overall well-being and performance. Furthermore, the PPL can act as a catalyst for research in sports psychiatry in India. It can encourage collaborative studies, outcome evaluations, and the development of standardized assessment tools. The league can also facilitate partnerships with sports organizations, enabling research projects to be conducted within the sporting community. The evolution of sports psychiatry in India through the PPL has the potential to positively impact the overall well-being of athletes and contribute to their success. By integrating mental health professionals into the sporting ecosystem, the PPL can help break the stigma surrounding mental health issues in sports and promote a holistic approach to athlete care. As the field of sports psychiatry continues to grow, the PPL can serve as a model to enhance mental health support systems within the realm of sports in India.

Setting the stage: A pilot analysis of reporting of study setting in two major Indian psychiatry journals.

Setting the stage: A pilot analysis of reporting of study setting in two major Indian psychiatry journals.

A journey of holistic research and training in mental health

My early exposure to mental illness in our community, the plight of mentally ill people and their families drove me to seek postgraduate training in psychiatry in India. I realized early on that only research could make an impact on the scale that was needed. My contacts with thoughtful scientists and mentors helped me understand that by training enthusiastic individuals – especially women, multi-focussed research could make a substantial impact and have a multiplier effect. I thus devoted my life not only to research, but research-based training. I outline below our training programs and their outcomes.

Trends in female authorship in two major psychiatry journals in India

Women authors are under-represented in academic medicine and academic publishing. We examined the representation of women in key authorship positions in psychiatric journals in India as well as time trends in female authorship across a decade. All articles originating from India and published in two leading Indian psychiatry journals during 2019–2020 were examined and compared with articles published in these journals during 2009–2010. Important outcomes examined were representations of women as first author, corresponding author, and last author, and the number of women in authorship lists. A total of 817 articles was analyzed; of these, 251 (30.7%) were published during 2009–2010 and 566 (69.3%) during 2019–2020. Women first-authored just over a quarter of the articles (n = 218, 26.7%). Nearly half of the articles (n = 389, 47.6%) had no woman author. Representation of women in key authorship positions and in total authorship increased significantly across time. Notably, the proportion of women first authors significantly increased for original papers (24.5% in 2009–2010 vs 38.1% in 2019–2020, p = 0.011). Gender gap in academic psychiatry publishing in India has narrowed during the past decade but is still evident. There is a need to identify and address factors that could narrow the gender gap.

Overview of practice of Consultation-Liaison Psychiatry.

Overview of practice of Consultation-Liaison Psychiatry.

Finding the Rainbow in the Deluge: Community Mental Health Perspectives on Psychosocial Impacts of COVID-19 in India.

The COVID-19 pandemic has caused significant disruptions in health care services, including mental health services. The impact of the pandemic has been especially severe in low- and middle-income countries, such as India. This Open Forum examines the challenges faced by primary care psychiatry in India and elaborates on how the pandemic has accentuated them. The "rainbow in the deluge" model is introduced as a simple model to train in usage of basic coping strategies for mental health issues that arise because of the pandemic and to provide a framework for finding meaning through the pandemic experience.

Research Design: Cohort Studies.

In a cohort study, a group of subjects (the cohort) is followed for a period of time; assessments are conducted at baseline, during follow-up, and at the end of follow-up. Cohort studies are, therefore, empirical, longitudinal studies based on data obtained from a sample; they are also observational and (usually) naturalistic. Analyses can be conducted for the cohort as a whole or for subgroups amongst which comparisons can be drawn. Because there is no randomization to the subgroups of interest, cause and effect relationships cannot be determined, and relationships between variables must be stated as associations that may or may not be influenced by confounding. The cohort that is studied can be prospectively or retrospectively defined, and each method has its advantages and disadvantages. These and other issues are explained with the help of examples. A special note is made of cohort studies in Indian psychiatry.

A camp approach of community psychiatry in India: Past, present, and the future.

Camps are a popular approach to deliver medical care in India. While it is usually a one-off event for physical ailments, it is a long-term affair in Psychiatry. One of the first camps in psychiatry was rolled out as early as in 1967 at Mandar, Ranchi, followed by Raipur Rani (Haryana) in 1976 and at Gunjur, Karnataka in 1977. This camp approach became extremely popular and got expanded across India as they were thought to be synonymous with community-based outreach for mental illnesses. In the past 5 years, however, newer models of community care have emerged, necessitating a relook at this traditional approach. In this paper, the authors trace the origin, utility and future directions of these camps, taking data from community psychiatry camps conducted by the National Institute of Mental Health and Neurosciences, Bengaluru, a premier neuropsychiatric tertiary care institute in India. Data have been collated from the annual reports of the Institute, database from the District Mental health Program, Government of Karnataka, India, and compared with published literature on the same field. While camps remain as one of the important avenues to reach the unreached, there is a need to change the approach of their functioning by incorporating training (primary care providers) aspects and collaborative care. The latter may make the initiative more meaningful and sustainable.

Medicolegal Issues with Reference to NDPS and MHCA in Management and Rehabilitation of Persons with Substance Use Disorders.

Medicolegal Issues with Reference to NDPS and MHCA in Management and Rehabilitation of Persons with Substance Use Disorders.

Medicine and the critique of war: military psychiatry, social classification and the malingering patient in colonial India

AbstractThe treatment of injured Indian soldiers in Britain during WWI deployed particular ways of recording injuries and using them to make judgments about loyalty to the Imperial Army by assessing the soldier’s ability to malinger. This was possible by using personal correspondences between soldiers and their families for ethnographic ends ie. to determine susceptibility to develop mental illness through a soldier’s ethnic background and whether he was from the so-called ‘martial races’ or not. This classificatory knowledge as well as the suspicion towards exaggerated symptoms was also inherited by Indian psychiatry after partition. However, while these psychiatrists reproduced some colonial biases about susceptibility of illness, they were much more receptive to considering the social experience of patients including their kinship relations at home and in the military. By the end of WWII, symptoms came to be regarded as signs of recovery and readjustment to social relations to make a case for the lasting impacts of war on the soldier’s mental and physical health.

Management of Psychiatric Disorders in Patients with Cardiovascular Diseases.

Management of Psychiatric Disorders in Patients with Cardiovascular Diseases.

Impact of COVID-19 pandemic on treatment seeking in opioid users: A retrospective comparative study

Background: The planet has been hit by the novel coronavirus since December 2019, which has not only affected the day-to-day activities but has also affected the health-seeking approach of the general population. The reports from the National Institute on Drug Abuse survey hint toward a rise in opioid use in the states. Even in India, the utilization of health services, especially the outpatient department (OPD) and opioid substitution clinics have been affected due to the impact of COVID-19 and subsequent national and regional lockdowns. The Indian studies reflect upon the experience and measures to continue the treatment facilities in substance users, yet none are available to reflect upon the impact of COVID-19 on the pattern of opioid use or functionality of OPD services. Objective: The objective of this study is to study the impact of COVID-19 pandemic on treatment seeking among opioid users from OPD-based opioid treatment centers: a retrospective study. Methodology: A retrospective study was done in an OPD-based opioid treatment center of a tertiary care hospital to analyze the impact of COVID-19 on treatment-seeking opioid users by comparing the data of pre-COVID-19 (April 2019–March 2020) and during COVID-19 (April 2020–March 2021) OPD visits by opioid users. The OPD visits data were collected, including the number of visits, the total number of buprenorphine tablets dispensed, and the dose of buprenorphine consumed per month. The data collected were further analyzed for the descriptive and analytic statistics using the SPSS software version 23.0. Results: During the pre-COVID-19 (April 2019–March 2020) duration, there were a total of 1104 (average 92/month) OPD visits and 4818 (Average 401/month) buprenorphine tablets were dispensed; whereas during the COVID-19 year (April 2020–March 2021), it was 980 (average 81.66/month) visits and 5174 (431/month) tablets. The results were further compared using the paired t-test, which was found to be statistically significant for the number of tablets dispensed, whereas not statistically significant for the number of OPD visits and doses. Conclusion: Although the COVID-19 pandemic has affected the feasibility to seek treatment in opioid users, it has not significantly affected OPD visits for opioid treatment at our center. Although the policy changes such as Indian Psychiatry Society (IPS) interim guidelines for opioid substitution therapy have been beneficial to facilitate the harm reduction and treatment-seeking attitude and have not affected the treatment seeking as expected due to lockdown and transportation which have been a hurdle. Further regulations on opioid treatment OPD, Tele-consultation services and mobile mental health services may be helpful to ensure continuity of treatment and harm reduction among the opioid users.