Published Research

Abstract:

Background: Lithium remains a cornerstone of prophylaxis in bipolar disorder (BD), but adherence continues to be a major clinical challenge and merits a closer attention. There is scant literature available in Indian as well as Asian context.

Methods: This study was conducted at Department of Psychiatry, AIIMS, New Delhi with an aim to assess the self-reported medication adherence and its correlates among a naturalistic, lithium-maintained cohort (n = 76) with bipolar disorder. Subjects were included if they were on lithium therapy ≥1 year, met DSM-5 diagnosis of bipolar disorder and were in clinical remission (≥1 month). Besides sociodemographic and clinical performa, participants were assessed on medication adherence rating scale (MARS), lithium questionnaire for knowledge and lithium attitude questionnaire (LAQ).

Results: Mean age was 35.7 ± 10.6 years (males: 59.2%); median duration of illness and lithium therapy was 84 months and 24.5 months, respectively. Mean MARS score was 6.95 ± 2.81. Regression analysis (with MARS total as dependent variable) found LAQ score to be the single most significant predictor variable (β=-0.681, p < 0.0001), explaining over 75% of the total variance. In regression model with MARS factor-1 score as dependent variable, the 'LAQ score' (β=-0.601, p < 0.0001) and 'being accompanied by family during psychiatric visits (always/mostly) in the past year' (β = 0.193, p = 0.010) emerged as significant predictor variables.

Conclusion: Adherence in lithium-maintained treatment-seeking cohort of patients with BD remains far from ideal as observed in this naturalistic setting. Lithium-related attitudes and being accompanied by family during psychiatric visits were found to be significant predictors for adherence.

Background: India has a large youth population whose mental health needs must be addressed. This includes promotion of positive mental health, with early detection and effective intervention for mental health disorders. Understanding the perspectives of community stakeholders working with youth is pivotal to this effort. Current study aimed to bring together a group of community stakeholders (eg, parents, teachers, policy makers) to understand their perspectives on youth mental health problems, challenges in provision of care, and to provide recommendations to address these concerns at national level.

Materials and Methods: The study was conducted across two sites in India: Chennai and New Delhi. Three group meetings were conducted involving 52 participants, including governmental, non-governmental and community representatives working with youth. The proceedings were manually recorded, transcribed, and analyzed using thematic analysis method.

Results: Many youth mental health problems were similar across the two sites. The commonest drivers of mental health problems were reported to be academic pressure, substance use and problematic internet/social media use. Stigma and lack of awareness were identified as the most important challenges acting as barriers to seeking mental health help by youth. Prioritizing youth mental health as a national programmes along with strong political will were the major recommendations suggested by the stakeholders.

Conclusion: Initial findings suggest that prioritizing youth mental health programmes in India would be advantageous. Inclusive and collaborative approach, involving community stakeholders working with youth in providing services that promote mental health and early access to care will help in developing healthy young citizens.

Objectives: To describe the clinical profile and pattern of pediatric psychiatry emergency referrals at a tertiary-care center in India.

Methods: Retrospective chart review of emergency psychiatry records over a 13-month period (January 2015 - January 2016).

Results: Pediatric psychiatric emergencies (n=65) (mean (SD) age, 14.2 (2.39) y) constituted 10% of all-age psychiatric emergencies. Risk of harm to self and/or others was seen in a third of patients (aggression, 18.5%; self-harm, 16.9%). Common psychiatric diagnoses were dissociative disorder (27.7%), mood disorders (9.3%) and psychotic disorders (7.7%). Compared to adult emergencies attended during same time period, pediatric group had more females (63.1% vs 47.4%; P=0.02), more patients with dissociative disorders (28.7% vs 8.2%; P<0.01) and absence of psychotropic medication prescriptions (36.9% vs 20.6%; P=0.003), while frequency of self-harm and aggression as a reason for presentation was similar to adults.

Conclusion: The report helps to understand the service needs of younger age group presenting with psychiatric emergencies.

Introduction: The college students are prone to use internet in a manner that could negatively aect several aspects of their life. The present study is one of the largest studies to be undertaken in India, aimed at understanding the existing pattern of internet use and estimating the prevalence of problematic internet use (PIU) among college students.

Materials and Methods: The Generalized Problematic Internet Use Scale 2 (GPIUS-2) was used to assess the PIU. Multiple linear regression analysis was conducted to ascertain the relationship between GPIUS-2 total score and demographic and internet use-related variables.

Results: Of 3973 respondents from 23 engineering colleges located in the dierent parts of the country, about one-fourth (25.4%) had GPIUS-2 scores suggestive of PIU. Among the variables studied, older age, greater time spent online per day, and use of internet mainly for social networking were associated with greater GPIUS-2 scores, indicating higher risk for PIU. Students who used internet mainly for academic activities and during evening hours of the day were less likely to have PIU.

Conclusion: This study suggests PIU among engineering college students in India is an important public health concern. There is a need to create awareness among students, emerging adults, parents, and concerned authorities about the harms associated with PIU. Furthermore, there is a need to implement preventive strategies for inculcating pattern of safe and healthy internet usage among them. In addition, there is a need to develop public health policies for prevention and treatment of PIU and conduct further research to enhance our understanding about the same.

Key Words: Adolescents, behavioral addiction, college students, emerging adults, internet addiction, problematic internet use