ORCID Profile
0000-0003-1616-6403
Current Organisation
All India Institute of Medical Sciences
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Publisher: Bentham Science Publishers Ltd.
Date: 02-2014
DOI: 10.2174/1872214807666131229130540
Abstract: Thyroid dysfunction and psychiatric disorders share a bidirectional relation. Thyroid hormones have been found to affect the central nervous system both structurally and functionally. Conventional antidepressant drug therapy is characterized by a delayed and at times suboptimal response. Various strategies have been devised in order to circumvent this limitation. L- Thyroxine has been used as both acceleration therapy and augmentation therapy as adjuvant therapy with antidepressants. The hormone has also been used as monotherapy, both in prevention and management of depression. The potential use of thyroid hormone as an adjunct therapy in management of euthyroid depression and relevant patents has been discussed.
Publisher: SAGE Publications
Date: 03-2016
Publisher: Medknow
Date: 2012
Publisher: Elsevier BV
Date: 09-2020
Publisher: Medknow
Date: 2015
Publisher: Wiley
Date: 08-10-2021
DOI: 10.1111/DAR.13187
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-2012
Publisher: Elsevier BV
Date: 2020
DOI: 10.2139/SSRN.3728583
Publisher: Medknow
Date: 2012
Publisher: Informa UK Limited
Date: 07-12-2010
Publisher: SAGE Publications
Date: 10-2015
Publisher: Touch Medical Media, Ltd.
Date: 2020
Publisher: Cold Spring Harbor Laboratory
Date: 07-10-2021
DOI: 10.1101/2021.10.03.21264490
Abstract: With millions of people getting affected with COVID-19 pandemic caused by a novel severe acute respiratory syndrome corona virus 2 (SARS-CoV-2), people living with post COVID-19 Symptoms (PCS) are expected to rise in the future· The present study aimed at assessing PCS comprehensively and its associated factors among COVID-19 recovered adult population in north India. In a tertiary health centre at Delhi, an online based cross-sectional study was conducted using a semi-structured questionnaire, developed by employing a nominal group technique, in aged 18 years and above who were SARS-CoV-2 positive during the month of January to April 2021. Socio-demographic, various potential risk factors, including pre-existing morbidities, vaccination status, and severity of acute COVID-19 illness, information on acute illness for management and a spectrum of PCS were collected between June 16 to July 28, 2021. Each participant was contacted telephonically before sending the survey link. PCS were presented as relative frequency chi-square test, odds ratio, including adjusted, were calculated to rule out association between PCS and potential predictors. A total of 773 of 1801 COVID recovered participants responded to the link reaching a participation rate of 42·9%, with a median age of 34 years (IQR 27 to 44). Male respondents were 56·4%. Around 33·2% of them had PCS at four or more weeks, affecting almost all body organ systems. The most prevalent PCS were fatigue (79·3%), pain in the joins (33·4%), muscle (29·9%), hair loss (28·0%), headache (27·2%), breathlessness (25·3%), sleep disturbance (25·3%) and cough (24·9%). The prevalence of PCS was reduced to 12·8% at 12 weeks after positive test. Factor such as female gender, older age, oxygen supplementation during the acute illness, working in healthcare care facilities, the severity of acute illness, and pre-existing co-morbid were risk factors for PCS. Further, vaccination (second dose) reduced the odds of developing PCS by 45% compared to unvaccinated participants (aOR 0·65 95%CI 0·45-0·96). Finally, 8·3% of participants rated their overall health status was either poor or very poor following COVID-19 illness. The PCS involves almost all organ systems, regardless of the severity of acute COVID-19 illness. Two doses of vaccine help to reduce development of PCS. Although the evidence is mounting in prolonged COVID-19 symptoms among COVID-19 survivors, to date, the full range of such post-COVID-19 symptoms (PCS) is not yet fully understood. There is a lack of studies that assessed PCS comprehensively among persons who have recovered from the COVID-19illness. For ex le, limited data are available on psychosocial, behavioral, and oral manifestations related to PCS. Further, there is a paucity of studies that included a wide range of determinants of PCS and the association of vaccination with the development of PCS across the world. Our study is the first such study conducted among COVID-19 recovered persons who with a majority of them employed in a tertiary health care institute of north India. Our study, for the first time, investigated a wide range of post-COVID-19 manifestations among COVID-19 recovered persons in organ-specific and psychosocial behavioral aspects, making this the largest categorization of PCS currently (in total 16). The study included telephonic calls to each eligible candidate which helped in ensuring the COVID-19 status at the time of the study. Since the participants either were employees in the hospital or their dependents that enhance the accuracy of reporting PCS. The most prevalent symptom was unspecific PCS (85.6%), e.g., fatigue, followed by musculoskeletal manifestations (49·8%), Ear, Nose and Throat symptoms (47·5%), neurological (47·0%), cardio-respiratory (42·4%, gastrointestinal (36·2%), ocular symptoms (31·9%), dermatological symptoms (31·5%), and cardio-vascular (24·5%) symptoms, and mental health symptoms (23·7%). The rest of the organ specific symptoms were observed in less than 20% of the respondents. Older age, female gender, pre-existing co-morbid, oxygen supplementation during acute illness, the severity of illness, working in health care institutions were associated with PCS. Vaccination after the second dose was protective against PCS compared to non-vaccinated participants. Further, our study also reported a rating of the overall health status among COVID survivors, whereby around 8.3% of them reported being a poor or very poor health. PCS affects a multi-organ organ system, irrespective of the severity of acute-phase COVID-19 illness and hospitalization. Such persistent COVID-19 symptoms, compounded by its heterogeneity among COVID survivors can pose a substantial burden to the affected in iduals and their families and additional challenges for healthcare delivery and public health service. The current study shows that one in three in iduals experience persistent COVID-19 symptoms. Since the COVID pandemic is still ongoing across the world, therefore, the number of people experiencing PCS is likely to be increased substantially further. An integrated PCS care strategy, but not limited to organ-specific healthcare disciplines, others such as psychosocial support, including counseling and education, rehabilitation, community-based rehabilitation programs will be required for management. Prioritization of PCS care to elder and co-morbid patients should be recommended. Expediting the vaccination drive will be helpful to reduce the development of persistent COVID-19 symptoms. Research, collaborative and multidisciplinary, is required to understand the underlying pathophysiology mechanism for PCS.
Publisher: Medknow
Date: 2017
Publisher: Scientific Scholar
Date: 2018
Abstract: Substance use disorders are comparable to chronic medical illnesses and have a chronic relapsing course. Despite being significant contributors to morbidity and mortality, limited treatment options exist. The current narrative review was aimed at providing an overview of yoga therapy in substance-use disorders and discuss the relevant methodological issues. Articles published in English language till May 2017 indexed with PubMed, PubMed central, and Google Scholar were searched using search terms “Yoga,” “Substance use,” “Drug dependence,” “Nicotine,” “Tobacco,” “Alcohol,” “Opioids,” “Cannabis,” “Cocaine,” “Stimulants,” “Sedative hypnotics,” “Inhalants,” and “Hallucinogens” for inclusion in the review. A total of 314 studies were found fulfilling the stated criteria. Out of which, 16 studies were found to fulfill the inclusion and exclusion criteria and 12 were randomized control trials. The majority of studies were available on the role of yoga in management of nicotine dependence. S le size of these studies ranged from 18 to 624. The majority of studies suggested the role of yoga in reducing substance use as well as substance-related craving (especially in nicotine-use disorders) in short term. However, more studies are required for demonstrating the long-term effects of yoga therapy in substance-use disorder.
Publisher: Springer Science and Business Media LLC
Date: 07-2015
DOI: 10.1007/S40596-015-0379-9
Abstract: The authors aimed to assess and compare problematic internet use among medical students enrolled in a graduate degree course in one school each from Croatia, India, and Nigeria and to assess correlates of problematic use among these students. The questionnaire included a sociodemographic profile of participants and Young's Internet Addiction Test. The final analysis included 842 subjects. Overall, 38.7 and 10.5 % of respondents scored in the mild and moderate categories. Only a small fraction (0.5 %) of students scored in the severe category. Being male and spending more time on the internet were correlated with problematic internet use. Moreover, a significantly higher proportion of participants who scored above the cutoff used the Internet for browsing, social networking, chatting, gaming, shopping, and viewing pornography. However, there was no difference between the two groups with regard to using the internet for e-mailing or academic activities. It is important to address problematic internet use among medical students. The correlates can help identify those at increased risk.
Publisher: Informa UK Limited
Date: 30-11-2022
Publisher: Elsevier BV
Date: 09-2017
DOI: 10.1016/J.JSAT.2017.06.004
Abstract: Emerging adulthood (between the ages 18-25years) has been conceptualized as a specific developmental stage based on unique psychosocial characteristics. Opioids are commonly used drugs in this population. Few studies have reported predictors of retention in buprenorphine maintenance treatment among opioid-dependent emerging adults, particularly from India. Moreover, no study has examined outcomes with opioid maintenance treatment among emerging adults in non-clinical trial, naturalistic settings. The current study aimed to assess retention in buprenorphine maintenance treatment among emerging adults in a naturalistic setting. Also, it aimed to assess the factors associated with retention in treatment among these in iduals. The current study was a retrospective cohort study conducted at a substance use disorder treatment centre in northern part of India. The patients who received buprenorphine maintenance treatment between 1st January 2012 and 31st December 2014 were eligible for inclusion in the current study. The follow-up data of these subjects were assessed up to and including 31st March 2015. Information was retrieved on socio-demographic variables. The information related to substance use included type of substance, duration of use, age of onset, motive of use, route of administration and source of procurement. Additionally, details of buprenorphine dose, dispensing pattern, induction settings were recorded. Cox regression analysis was carried out to assess the predictors of retention in buprenorphine maintenance treatment. Of 68 emerging adults, 33.8% were retained in treatment at 90days, 19.1% at 6months and 11.7% at one year. After controlling for various covariates in adjusted Cox regression analysis, substance use in first degree relatives (AHR: 2.40, 95% CI 1.33-4.31), lower daily buprenorphine dose (AHR: 0.86, 95% CI 0.78-0.94) and past month injection drug use (AHR: 0.30, 95% CI 0.14-0.66) were found to be the significant predictors of treatment dropout. The findings of the current study help understand the predictors of retention in buprenorphine maintenance treatment among emerging adults in a real-world situation. These findings will help guide formulation of responsive and relevant buprenorphine maintenance treatment program for the emerging adults.
Publisher: Springer Science and Business Media LLC
Date: 14-02-2022
DOI: 10.1186/S43045-022-00180-6
Abstract: Problematic Internet gaming is an increasingly recognized global mental health problem. This multicultural cross-sectional study examined the association between Internet gaming disorder (IGD) symptoms and anxiety and depressive symptoms and substance use within a s le of young Internet users. In total, 3529 college/university students (1260 (35.7%) males mean age 21 ± 3 years) were surveyed online. We assessed online gaming patterns using the Internet Gaming Disorder Self-report for College/University Students (ICMH-IGD), symptoms of depression using the Patient Health Questionnaire-9, and symptoms of anxiety using the Generalized Anxiety Disorder scale-7. IGD symptoms were associated with symptoms of depression, anxiety, and substance use, independent of time spent online, psychiatric diagnosis, culture, or sociodemographic characteristics. For males, more significant IGD symptoms were associated with more extended Internet browsing per day time and higher levels of anxiety and depressive symptoms, while for females, with more extended Internet browsing per day time, marihuana use, and higher levels of depressive symptoms. Our study found that more overt symptoms of IGD were associated with higher levels of anxiety and depressive symptoms and substance use. Still, these associations differed among males and females, suggesting that gender differences should be considered when planning specific treatments.
Publisher: SAGE Publications
Date: 07-2014
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 02-2013
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-2012
Publisher: SAGE Publications
Date: 05-2012
DOI: 10.2190/PM.43.4.B
Abstract: The current study aimed at assessing eating attitude and body shape concerns among Indian female healthcare students who had received some teaching/training in Psychiatry. The study was conducted at government medical and nursing college. All the undergraduate healthcare students enrolled with institute at the time of study constituted the s ling frame for the study. Survey-based methodology was used for data collection. Study scales included semi-structured proforma, Eating Attitudes Test-26 (EAT-26) (including the three sub-scales), and Body Shape Questionnaire (BSQ). Data were analyzed using Pearson's and Spearman's correlation statistics and ANOVA with post hoc analysis. A total of 498 students returned the completed study questionnaire. There was significant correlation between Body Mass Index (BMI) and EAT-26 scores) including the sub-scales score of EAT-26). Similarly, BMI and BSQ scores were also significantly correlated. The findings from current study help understand the body shape and eating attitudes of Indian female healthcare students who had received some teaching/training in Psychiatry.
Publisher: Informa UK Limited
Date: 12-11-2021
Publisher: SAGE Publications
Date: 10-2013
Publisher: Briefland
Date: 26-09-2016
DOI: 10.5812/IJHRBA.32501
Publisher: SAGE Publications
Date: 2017
Publisher: Weston Medical Publishing
Date: 05-2014
Abstract: Objective: The current study aimed at comparison of retention rates for daily dispensing (DD) and alternate-day dispensing (AD) regimens for buprenorphine over a 1-year period at a tertiary care treatment center for management of substance use disorders. Additionally, it aimed at comparison of prescription refill proportions for these two buprenorphine dispensing regimens over a 1-year period.Setting: The study was conducted at a tertiary level substance use disorder treatment center.Patients, participants: Case records of patients satisfying the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) criteria for opioid dependence syndrome were included in the study.Main outcome measures: Retention rates and prescription refill proportions were compared for the two buprenorphine dispensing regimens for different time intervals over a 52-week period.Results: Fifty-two subjects (45.61 percent) were started on DD regimen and 62 (54.38 percent) were put on AD regimen of buprenorphine. All subjects were opioid dependent. The two groups did not differ for prescription refill proportions as well as retention rates for any of the time intervals studied.Conclusion: The findings of the current study support feasibility and acceptance of alternate-day dosing strategy for buprenorphine dispensing for patients with opioid dependence.
Publisher: Oxford University Press (OUP)
Date: 05-11-2021
Abstract: We conducted a cross-sectional survey to estimate the prevalence and clinical manifestation of disulfiram ethanol reaction (DER) and isopropanol toxicity (IT) in patients with alcohol use disorders, on disulfiram. Alcohol-based hand rub contains either ethanol or isopropanol or both. COVID-19 pandemic has led to wide scale usage of sanitizers. Patients with alcohol use disorders, on disulfiram, might experience disulfiram ethanol like reactions with alcohol-based sanitizers. We telephonically contacted 339 patients, prescribed disulfiram between January 2014 and March 2020. The assessment pertained to the last 3 months (i.e. third week of March to third week of June 2020). The s le consisted of middle-aged men with a mean 16 years of alcohol dependence. Among the 82 (24%) patients adherent to disulfiram, 42 (12.3%) were using alcohol-based hand rubs. Out of these, a total of eight patients (19% 95% CI 9–33) had features suggestive of DER four of whom also had features indicative of IT. Five patients (62.5%) had mild and self-limiting symptoms. Severe systemic reactions were experienced by three (37.5%). Severe reactions were observed with exposure to sanitizers in greater amounts, on moist skin or through inhalation. Patients on disulfiram should be advised to use alternate methods of hand hygiene.
Publisher: Medknow
Date: 2019
Publisher: Medknow
Date: 2021
Publisher: SAGE Publications
Date: 11-07-2022
DOI: 10.1177/02537176221105529
Abstract: Although early maladaptive schemas (EMSs) have been suggested as potential vulnerability markers for alcohol dependence (AD), there is less emphasis on addressing these schemas in substance abuse treatment programs. We thus aimed to examine the change in schemas in response to cognitive therapy in in iduals with AD. In this an open-label randomized controlled study, in iduals with alcohol dependence syndrome (ADS, n = 84) were randomized to the intervention group ( n = 45), which received six cognitive therapy sessions combined with treatment as usual (TAU), or the control group ( n = 39), which was on TAU only. Participants were assessed on the measures of EMSs, alcohol use severity, and perceived stress at baseline and posttreatment. The intervention group showed significant improvement in 5 out of 18 EMSs, that is, emotional deprivation, defectiveness, self-sacrifice, unrelenting standard, and negativity, compared to the control group, at the end of the treatment. There was a significant between-group effect for perceived stress but not for alcohol use severity. EMSs can be changed with cognitive therapy in in iduals with AD and could be a crucial area to address in treatment programs. Further studies with long-term follow-up are warranted. The trial was registered with the Clinical Trials Registry—India (CTRI/2015/12/006441) on December 17, 2015.
Publisher: Medknow
Date: 2014
Publisher: Medknow
Date: 2012
Publisher: SAGE Publications
Date: 03-2012
Publisher: Cureus, Inc.
Date: 06-11-2021
DOI: 10.7759/CUREUS.19310
Publisher: SAGE Publications
Date: 04-2012
DOI: 10.1080/08897077.2011.630947
Abstract: Self-reported drug use is a principle measure in the evaluation of treatment outcome. As there have been concerns about the accuracy of self-reporting, it is necessary to establish its validity by an objective method. The aim of the study was to examine the concordance between urinary cotinine concentrations and self-reported tobacco use among drug dependents seeking treatment at National Drug Dependence Treatment Centre, AIIMS, New Delhi, India. Eighty consecutive male drug addicts attending the OPD at National Drug Dependence Treatment Centre were interviewed by the clinician. Their tobacco as well as drug use history was recorded, and thereafter their urine s le was analyzed for drug testing. Mean age of the subjects was found to be 33 years (SD: 10). Urinalysis showed high concentration of cotinine (mean ± SD: 586.40 ± 222.15 ng/ml) in 95% of the subjects. High concordance was observed between self-report of tobacco use and urinary cotinine. The quantity of tobacco consumption and FTND scores were also correlated with the urinary cotinine levels. Urinalysis also showed misuse of opioids, benzodiazepines and antihistaminics. The treatment for tobacco use has been given low priority in the de-addiction centers. Tobacco is highly prevalent among the drug abusers. The effectiveness of the treatment program may be increased by using the combination of urine analysis along with self-report.
Publisher: National Library of Serbia
Date: 2020
Abstract: The present study evaluated the psychometric properties of a self-report scale for assessing Internet Gaming Disorder (IGD) symptoms according to the DSM?5 and ICD?11 among 3270 college/university students (2095 [64.1%] females age mean 21.6 [3.1] years) from different countries worldwide. Croatian, English, Polish, Portuguese, Serbian, Turkish, and Vietnamese versions of the scale were tested. The study showed that symptoms of IGD could be measured as a single underlying factor among college/university students. A nine item symptom scale following DSM?5, and a short four-item scale representing the main ICD?11 symptoms, had sound internal consistency and construct validity. Three symptom-items were found non-invariant across the language s les (i.e., preoccupation with on-line gaming, loss of interests in previous hobbies and entertainment, and the use of gaming to relieve negative moods). This study provides initial evidence for assessing IGD symptoms among college/university students and will hopefully foster further research into gaming addiction in this population worldwide especially with taking into account language/cultural differences.
Publisher: American Chemical Society (ACS)
Date: 07-05-2020
Publisher: Medknow
Date: 2017
Abstract: Depression and alcohol-use disorders frequently co-occur and the presence of one augments the adverse consequences of the other. This article reviews and synthesizes the available literature on depression and alcohol-use disorders from the World Health Organization (WHO) South-East Asia Region, with respect to epidemiology, screening instruments, interventions and services, and policy. In common with other low- and middle-income settings, data from this region on co-occurring depression and alcohol-use disorders are scarce. The wide variations in language and cultural ersity within the countries of this region further make the identification and management of people with co-occurring depression and alcohol-use disorders a major challenge. A range of interventions for in iduals with the two disorders have been studied. However, most of this work has been done in high-income countries, highlighting the need to explore the effectiveness and cost effectiveness of various pharmacological and non-pharmacological interventions in the WHO South-East Asia Region. Much of this region comprises low-resource settings, with a dearth of trained personnel and resources. Flexible transdiagnostic approaches, delivered by community health workers and integrated into primary health care may be a pragmatic approach. Such services should form part of strengthened national responses to alcohol-related public health problems across the region.
Publisher: Forum for Medical Ethics Society
Date: 2015
Publisher: Elsevier
Date: 2016
Publisher: American Psychiatric Association Publishing
Date: 2013
Publisher: Informa UK Limited
Date: 24-06-2021
Publisher: Elsevier BV
Date: 06-2018
Publisher: Elsevier BV
Date: 12-2021
DOI: 10.1016/J.JAD.2021.08.050
Abstract: We report results of an internet-based field study evaluating the diagnostic guidelines for ICD-11 mood disorders. Accuracy of clinicians' diagnostic judgments applying draft ICD-11 as compared to the ICD-10 guidelines to standardized case vignettes was assessed as well as perceived clinical utility. 1357 clinician members of the World Health Organization's Global Clinical Practice Network completed the study in English, Spanish, Japanese or Russian. Participants were randomly assigned to apply ICD-11 or ICD-10 guidelines to one of eleven pairs of case vignettes. Clinicians using the ICD-11 and ICD-10 guidelines achieved similar levels of accuracy in diagnosing mood disorders depicted in vignettes. Those using the ICD-11 were more accurate in identifying depressive episode in recurrent depressive disorder. There were no statistically significant differences detected across classifications in the accuracy of identifying dysthymic or cyclothymic disorder. Circumscribed problems with the proposed ICD-11 guidelines were identified including difficulties differentiating bipolar type I from bipolar type II disorder and applying revised severity ratings to depressive episodes. Clinical utility of ICD-11 bipolar disorders was found to be significantly lower than for ICD-10 equivalent categories. Standardized case vignettes were manipulated to evaluate specific changes. The degree of accuracy of clinicians' diagnostic judgments may not reflect clinical decision-making with patients. Alignment of the ICD-11 with current research appears to have been achieved without sacrificing diagnostic accuracy or clinical utility though specific training may be necessary as ICD-11 is implemented worldwide. Areas in which the ICD-11 guidelines did not perform as intended resulted in further revisions.
Publisher: Medknow
Date: 2014
Publisher: SAGE Publications
Date: 06-02-2023
Publisher: Medknow
Date: 2013
Abstract: Tobacco use has been associated with various carcinomas including lung, esophagus, larynx, mouth, throat, kidney, bladder, pancreas, stomach, and cervix. Biomarkers such as concentration of cotinine in the blood, urine, or saliva have been used as objective measures to distinguish nonusers and users of tobacco products. A change in the cut-off value of urinary cotinine to detect active tobacco use is associated with a change in sensitivity and sensitivity of detection. The current study aimed at assessing the impact of using different cut-off thresholds of urinary cotinine on sensitivity and specificity of detection of smoking and smokeless tobacco product use among psychiatric patients. All the male subjects attending the psychiatry out-patient department of the tertiary care multispecialty teaching hospital constituted the s le frame for the current study in a cross-sectionally. Quantitative urinary cotinine assay was done by using ELISA kits of Calbiotech. Inc., USA. We used the receiver operating characteristic (ROC) curve to assess the sensitivity and specificity of various cut-off values of urinary cotinine to identify active smokers and users of smokeless tobacco products. ROC analysis of urinary cotinine levels in detection of self-reported smoking provided the area under curve (AUC) of 0.434. Similarly, the ROC analysis of urinary cotinine levels in detection of self-reported smoking revealed AUC of 0.44. The highest sensitivity and specificity of 100% for smoking were detected at the urinary cut-off value greater than or equal to 2.47 ng/ml. The choice of cut-off value of urinary cotinine used to distinguish nonusers form active users of tobacco products impacts the sensitivity as well as specificity of detection.
Publisher: Weston Medical Publishing
Date: 07-2013
Abstract: No abstract
Publisher: Elsevier BV
Date: 12-2020
Publisher: Weston Medical Publishing
Date: 2012
Abstract: Objective: In view of increasing safety concerns, there is a need to assess benefits of use of dextropropoxyphene as opioid substitution treatment, if any. This study aims at urinalysis-based comparative evaluation of pattern of use of dextropropoxyphene and buprenorphine among opioid-dependent subjects.Setting: Laboratory of a tertiary care drug-dependence treatment center.Participants: Patients on buprenorphine and dextropropoxyphene therapy and their urinalysis records.Interventions: Nonexperimental chart review method.Main outcome measure(s): “Use,” “abuse,” and “prescribed but not used rates” for buprenorphine and dextropropoxyphene were compared, using χ2-test with level of significance at p 0.05.Results: Rate of “use” and “abuse” was significantly high for dextropropoxyphene. Rate of “prescribed but not used” was significantly high for buprenorphine (p 0.05).Conclusions: Despite apparent benefits of dextropropoxyphene use in terms of better rates of “use” and “prescribed but not used” as compared to buprenorphine, one needs to review the situation in light of recent reports of adverse effects with dextropropoxyphene and limited resources available.
Publisher: Informa UK Limited
Date: 21-04-2016
DOI: 10.3109/10826084.2016.1155615
Abstract: Perceptions of in iduals with opioid dependence regarding medications used for long-term management of the condition have been explored only by a handful of studies. Interestingly, no study had compared the perceptions regarding buprenorphine, buprenorphine-naloxone, and oral naltrexone in the opioid-dependent subjects from the same setting. The present study aimed to examine the perceptions related to treatment of opioid dependence with buprenorphine, buprenorphine-naloxone, and oral naltrexone among in iduals seeking help at a tertiary care center. This was a cross-sectional, observational study with consecutive s ling. Sociodemographic data, Drug Abuse Monitoring System questionnaire, perceptions questionnaire, clinical interview to elicit drug use history, treatment history and details of prior abstinence attempts were completed. Eighty-five subjects were recruited in the study. Fear of becoming dependent (35.3%) was the most common harm reported while withdrawal control (82.4%) was the most common benefit reported with buprenorphine preparations. Precipitated withdrawals (21.2%) were the most common harm reported and prevention of relapse (53%) was the most common benefit reported with oral naltrexone. While patients who believed that buprenorphine or naltrexone were harmful reported durations of treatment that were much shorter than those who did not so believe, there was no statistically significant difference in the actual duration and period of abstinence (p = .34 p = .62). Sociodemographic profile, perceptions related to dosing, nature of medication, expectations from treatment, and duration of illness were also described.
Publisher: Elsevier BV
Date: 2018
Publisher: SAGE Publications
Date: 27-11-2022
Abstract: One of the barriers to effective care in patients with depression is stigma associated with having a mental disorder, which also acts as a barrier to recovery and increases the disability. To study the stigma and disabilities experienced by the patients with depressive disorders seeking treatment in a tertiary care hospital. Fifty patients diagnosed to have depressive disorder as per ICD-10 were recruited by convenient s ling. To measure the stigma, the Discrimination and Stigma Scale -12 was applied. The severity of depression was determined by applying Hamilton Depression Rating Scale (HAMD). The disability was calculated by using WHO Disability Assessment Schedule 2.0. Fifty percentages of the participants reported unfair treatment and they experienced discrimination in at least one life domain. There was significant positive correlation between unfair treatment subscale of stigma and disability. Around one fourth of the participants reported to be treated unfairly by their own families. Seventy percent reported to have concealed their mental health problems, 54% have stopped themselves from having a close personal relationship and 32% didn't apply for work in anticipating discrimination. Experienced and anticipated discrimination were significantly associated with concealing the mental health problem. Stigma due to having depression acts as a barrier to vocational & social integration and functional recovery. Concealment of the diagnosis of depression is itself barrier for help seeking and to receiving appropriate treatment. Small s le size and adopting the purposive s ling method are the limitations of the study.
Publisher: Weston Medical Publishing
Date: 08-2021
Abstract: Opioid use disorder is a major public health problem, and opioid replacement therapy with buprenorphine (BPN) is a clinically effective and evidence-based treatment for it. To deter misuse of the tablet through the injecting route, BPN coformulated with naloxone (BNX) in 4:1 ratio is available in many countries. Despite this, significant ersion and injecting use of the BNX combination has been reported from across the world. In this article, the pharmacological properties of BPN and BNX and the evidence for their ersion are reviewed. Also, a critical examination is made of the evidence supporting the role of naloxone in reducing the agonist effects of BPN when used through the injecting route. Based on this evidence, a hypothesis explaining the continued ersion of BNX has been proposed.
Publisher: Hindawi Limited
Date: 17-06-2021
DOI: 10.1111/PPC.12558
Publisher: Medknow
Date: 2016
Publisher: American Psychiatric Association Publishing
Date: 2012
Publisher: Elsevier BV
Date: 2021
Publisher: Scientific Scholar
Date: 07-2018
Abstract: Opioids are one of the most common illicit psychoactive substances being used in India. In fact, opioid use disorders are the most common disorder presenting to the substance use disorder treatment centers across the country. Effective and evidence-based interventions are available for management of opioid use disorders. However, the treatment for opioid use disorders remains difficult to access for most of those in need in India. The current article presents the literature on the use of tramadol for the management of opioid use disorders. It also makes recommendations on the use of tramadol for the management of opioid use disorders. Tramadol offers a viable alternative to the existing options for the management of opioid use disorders. It has been found effective when used for this indication. It offers certain major advantages such as easy and wide availability and low abuse liability. It offers a good option to expand the treatment services for opioid use disorders across the country.
Publisher: SAGE Publications
Date: 2016
Publisher: Medknow
Date: 2018
Publisher: Informa UK Limited
Date: 05-11-2018
DOI: 10.1080/10826084.2018.1521427
Abstract: Certain limitations of the existing opioid substitution therapies necessitate exploration of other options for maintenance of patients with opioid dependence. This study aimed to present the experience of use of tramadol for long-term treatment of patients with opioid dependence. This was a cross-sectional interview-based observational study conducted in Uttar Pradesh state in India. Patients with opioid dependence who received oral tramadol treatment for a period of more than 6 months were recruited. Outcome was assessed in terms of self-reported abstinence on tramadol. A total of 102 participants were recruited in the study, with a mean age of 41.3 years. All the participants were males. Abstinence to extraneous opioids was reported by 58.8% of the s le, and the median dose of tramadol at which abstinence was achieved was 350 mg/d. Those who reported to be taking natural opioids (raw opium or poppy husk) at the time of seeking treatment had higher rates of achieving abstinence. Tramadol may be a possible option for the maintenance treatment among some opioid-dependent in iduals. Further studies are required to establish its efficacy vis-à-vis other medications used in opioid substitution treatment.
Publisher: SAGE Publications
Date: 05-2022
DOI: 10.1177/02537176221091673
Abstract: Dysfunctional basic cognitions have been suggested as potential vulnerability markers for alcohol dependence (AD). Although there is a growing body of research on the role of distal cognitive vulnerability factors such as early maladaptive schema in the development of AD, little is known about the role of proximal cognitive factors such as cognitive distortions, dysfunctional attitude, and negative automatic thoughts. This comparative cross-sectional study aimed to examine dysfunctional cognitions in in iduals with AD ( n = 84) in comparison with healthy in iduals ( n = 60). The dysfunctional cognitions were assessed on the Young Schema Questionnaire third version of Short Form, Cognitive Distortion Scale, Dysfunctional Attitude Scale-Form A, and Automatic Thought Questionnaire. Multivariate analysis of covariance was conducted to analyze the group differences in dysfunctional cognitions. After controlling for the group difference in employment status, 12 of 18 schemas were more prevalent in in iduals with AD than in healthy in iduals. In iduals with AD also scored higher on seven of 10 cognitive distortions, as well as in terms of dysfunctional attitude and negative automatic thoughts. Dysfunctional cognition may play a significant role in developing AD. The findings may enhance our understanding of the nature and severity of dysfunctional cognitions in the development of AD. The information may further assist the clinicians in implementing adequate intervention strategies to manage dysfunctional cognitions in in iduals with AD.
Publisher: Oxford University Press (OUP)
Date: 06-08-2022
Abstract: To assess recent changes in the extent and pattern of alcohol use in India using the National Family Health Survey (NFHS) data. We used unit-level data from both rounds of NFHS. The pattern of alcohol use was categorized as: 'almost every day', 'almost once a week' and 'less than once a week'. The information was segregated for the urban and rural settings. Information was also available on the type of alcoholic beverage used by the respondents. The z test for differences in proportions was carried out for the study variables. Findings suggest a 22.37 and 39.02% reduction in the proportion of men and women who reported alcohol use, respectively. The proportion of men reporting 'almost every day' and 'about once a week' consumption of alcohol increased by 24.19 and 7.14%, respectively. With the caveats of expected limitations of surveys, the findings suggest an overall decrease in alcohol use in India, though the proportion of men with more frequent alcohol has increased. There is a need to strengthen the investment in the initiatives targeted at the harms due to alcohol use.
Publisher: Elsevier BV
Date: 04-2021
Publisher: Hindawi Limited
Date: 2013
DOI: 10.1155/2013/316372
Abstract: Adolescents and young adults continue to remain the main focus of attention with regards to substance use related problems. There has been a limited focus on illicit substance use among middle aged and elderly population. The current study explored the changing trends of substance use among treatment seeking middle aged in iduals (aged 40–60 years) at a tertiary level drug dependence treatment centre. The questionnaire used to gather information for the study is a 19-item structured questionnaire. It includes information on various sociodemographic variables, “current,” and “ever” use of substance. Information is also collected on variables related to high risk injecting drug use and HIV status of the in iduals. There has been consistent increase in the population of treatment seekers over five years. Over the five-year period, the absolute percentage increase in treatment seeking population is approximately 21%. Polysubstance use was found to increase significantly over five-study years ( P Trend = 0.007).
Publisher: Elsevier BV
Date: 10-2019
DOI: 10.1016/J.AJP.2019.09.004
Abstract: Internet use has increased worldwide exponentially over the past two decades, with no up-to-date cross-country comparison of Problematic Internet Use (PIU) and its correlates available. The present study aimed to explore the pattern and correlates of PIU across different countries in the European and the Asian continent. Further, the stability of factors associated with PIU across different countries were assessed. An international, cross-sectional study with a total of 2749 participants recruited from universities/colleges of eight countries: Bangladesh, Croatia, India, Nepal, Turkey, Serbia, Vietnam, and United Arab Emirates (UAE). Participants completed the Generalized Problematic Internet Use Scale -2 (GPIUS2) assessing PIU, and the Patient Health Questionnaire Anxiety-Depression Scale (PHQ-ADS) assessing the depressive and anxiety symptoms. A total of 2643 participants (mean age 21.3 ± 2.6 63% females) were included in the final analysis. The overall prevalence of PIU for the entire s le was 8.4% (range 1.6% to 12.6%). The mean GPIUS2 standardized scores were significantly higher among participants from the five Asian countries when compared to the three European countries. Depressive and anxiety symptoms were the most stable and strongest factors associated with PIU across different countries and cultures. The PIU is an important emerging mental health condition among college/university going young adults, with psychological distress being the strongest and most stable correlate of PIU across different countries and cultures in this study. The present study highlighted the importance of screening university and college students for PIU.
Publisher: Elsevier BV
Date: 06-2018
Publisher: SAGE Publications
Date: 07-2016
Publisher: Elsevier BV
Date: 08-2019
DOI: 10.1016/J.AJP.2019.07.013
Abstract: Problematic internet use has been reported to be high among school students. An online course was developed with an aim to strengthen the capacity of school teachers and counsellors on early identification, detection and intervention for behavioral addictions involving use of internet. The current report presents the observation from the first batch of participants of this course. Of the 28 teachers and counselors who expressed interest by enrollment in the course, a total of 15 participants provided both the pre and post course evaluation forms. The preliminary findings suggest that the online course is feasible, acceptable and effective in strengthening the capacity of school teachers and counsellors on behavioral addictions involving use of internet.
Publisher: Elsevier BV
Date: 06-2014
Publisher: Wiley
Date: 28-08-2013
DOI: 10.1111/ADD.12312
Publisher: Medknow
Date: 2020
Publisher: Wiley
Date: 13-03-2018
DOI: 10.1111/APPY.12317
Publisher: Elsevier BV
Date: 03-2012
Publisher: Informa UK Limited
Date: 13-05-2019
Publisher: SAGE Publications
Date: 2016
Publisher: SAGE Publications
Date: 27-05-2014
Abstract: Hikikomori, a form of social withdrawal first reported in Japan, may exist globally but cross-national studies of cases of hikikomori are lacking. To identify in iduals with hikikomori in multiple countries and describe features of the condition. Participants were recruited from sites in India, Japan, Korea and the United States. Hikikomori was defined as a 6-month or longer period of spending almost all time at home and avoiding social situations and social relationships, associated with significant distress/impairment. Additional measures included the University of California, Los Angeles (UCLA) Loneliness Scale, Lubben Social Network Scale (LSNS-6), Sheehan Disability Scale (SDS) and modified Cornell Treatment Preferences Index. A total of 36 participants with hikikomori were identified, with cases detected in all four countries. These in iduals had high levels of loneliness (UCLA Loneliness Scale M = 55.4, SD = 10.5), limited social networks (LSNS-6 M = 9.7, SD = 5.5) and moderate functional impairment (SDS M = 16.5, SD = 7.9). Of them 28 (78%) desired treatment for their social withdrawal, with a significantly higher preference for psychotherapy over pharmacotherapy, in-person over telepsychiatry treatment and mental health specialists over primary care providers. Across countries, participants with hikikomori had similar generally treatment preferences and psychosocial features. Hikikomori exists cross-nationally and can be assessed with a standardized assessment tool. In iduals with hikikomori have substantial psychosocial impairment and disability, and some may desire treatment.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 02-2017
Publisher: Royal College of Psychiatrists
Date: 12-2011
Publisher: Elsevier BV
Date: 08-2020
Publisher: SAGE Publications
Date: 07-2017
Publisher: Medknow
Date: 2019
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 02-2012
Publisher: Medknow
Date: 2018
Publisher: Wiley
Date: 04-08-2015
DOI: 10.1111/JORA.12218
Publisher: Scientific Scholar
Date: 12-06-2020
Abstract: Opioid use is a major problem in India and has high morbidity and mortality with a prevalence of 2.06%. There is a huge treatment gap for opioid use disorders (OUDs). Due to limited mental health resources and limited psychiatric training of medical practitioners in OUDs, a significant proportion of patients do not receive appropriate medical intervention. This article demonstrates how a primary care doctor working in a remote opioid substitution therapy (OST) clinic received assistance from the optional opioid module of clinical schedule for primary care psychiatry (CSP) and collaborative video consultation (CVC) module to address specific difficulties of patients already on Buprenorphine OST and improve the quality of care, thereby reducing chances of relapses. CVC module is a part of one-year digitally driven primary care psychiatry program designed by National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru. The opioid module was designed by NIMHANS, Bengaluru in collaboration with the All India Institute of Medical Sciences (AIIMS), New Delhi These observations warrant replication of this approach across erse settings and at a larger scale to explore and evaluate its impact and effectiveness.
Publisher: Emerald
Date: 05-02-2021
Abstract: There is a paucity of comparative literature on pathway to care among patients with co-occurring disorders and those with only substance use disorders. This paper aims to compare the pathways to care among patients with co-occurring disorder and those with only substance use disorders. A cross-sectional observational study was carried out on male treatment seekers at a tertiary care substance use disorder treatment center in India. Participants were recruited in two groups, those with co-occurring psychiatric and substance use disorders and those with only substance use disorders. The two groups were matched for age and socio-economic status. A total of 189 subjects with co-occurring psychiatric and substance use disorders and 197 subjects with substance use disorders only were recruited. Psychiatric services were the most common first point of care. However, a larger proportion of the subjects in the co-occurring disorder group received the first care from faith healers, while a greater proportion received first care from the therapeutic communities in substance use disorder only group. Initial care was sought mostly following suggestion from the family members in both the groups. The time to treatment for substance use disorders did not differ between the two groups, though the treatment seeking for substance use disorder was more delayed than that of psychiatric disorder in the co-occurring disorder group. The findings shed light on the pathway of care followed in India and is a matter of further research. Expansion of services and dissemination of information about psychiatric disorders and substance use disorders can provide timely care to patients with substance use disorders and co-occurring disorders. The findings have a social implication as well. More awareness is needed currently in India for timely treatment of dual disorders. The paper is an original research by the authors. The data were collected from the participants who reported to the dual diagnosis clinic. The findings are important as they tell us about the current understanding of dual diagnosis by the general public.
Publisher: Touch Medical Media, Ltd.
Date: 2018
Abstract: Euthymia, or optimal mood, is an integral part of health. A diagnosis of diabetes poses multiple challenges to mental and emotional health and may lead to psychological and psychiatric dysfunction. Such conditions influence glycaemic control negatively and may act as barriers to achievement of desired biomedical outcomes. This article describes the concept of euthymia in diabetes and calls for euthymia to be accepted as a target, as well as a tool, in modern diabetes care.
Publisher: Wiley
Date: 24-02-2014
DOI: 10.1111/JPM.12133
Abstract: Most studies examining adolescent alcohol and substance use or abuse hardly include s les from developing countries. To bridge some gap, the prevalence and associated social correlates of alcohol and substance use and abuse was examined among a cohort of school-going adolescents s led from seven developing countries. Alcohol and substance abuse was measured using the CRAFFT instrument, independent socio-demographic correlates were determined using regression models. A total of 2454 adolescents completed the study, among which 40.9% reported using either alcohol or at least one other substance during the previous 12 months. This was mostly alcohol (37.8%), followed by marijuana/hashish (8.6%) and other substances (8.1%). Among the adolescents who reported using at least one substance, 45% (18.3% of total s le) had CRAFFT scores indicative of problematic or hazardous substance use. Several personal and family factors were independently associated with use/abuse, and the modifiable nature of these factors calls for appropriate intervention strategies.
Publisher: Elsevier BV
Date: 10-2015
Publisher: Wiley
Date: 22-06-2020
DOI: 10.1111/PCN.13075
Publisher: Elsevier BV
Date: 05-2021
Publisher: Medknow
Date: 2017
Publisher: Touch Medical Media, Ltd.
Date: 2018
DOI: 10.17925/USE.2018.14.1.27
Abstract: Diabetes distress (DD) is a commonly encountered adjustment disorder among persons living with diabetes. This article discusses insulin distress, a subtype of DD, which has distinct characteristics. Insulin distress can be defined as an emotional response to a suggestion to use insulin characterized by extreme apprehension, discomfort, dejection, or denial due to a perceived inability to cope with the requirements of insulin therapy. We describe the etiopathogenesis, clinical features and management of insulin distress. They highlight the clinical challenges that insulin distress poses in some persons. Pragmatic suggestions are shared regarding the addressing of insulin distress before or in parallel with insulin prescription.
Publisher: Wiley
Date: 11-08-2020
DOI: 10.1111/PCN.13109
Publisher: SAGE Publications
Date: 19-08-2021
DOI: 10.1177/02537176211033004
Abstract: Studies and published reports have not commented on the change in the proportion of the Indian population that consumed alcohol over the years. We report the findings on changes in alcohol use in India over the past two decades, based on a secondary analysis of the data gathered over the successive National Family Health Surveys (NFHS-3 to 5). There was a significant decline (P 0.001) of around 8% and 45% for the current use of alcohol among men and women from NFHS-3 to NFHS-4. There was a decline in the proportion of men reporting alcohol use across all but one state in NFHS-5 compared to NFHS-3. The decline was statistically significant (P 0.001) for all but one state. There was a decline in the proportion of women reporting alcohol use in 12 states and an increase in three states. Also, there was a significant (P 0.001) decline in the proportion of men reporting alcohol use in all the states in NFHS-5 compared to NFHS-4. There was an increase in the proportion of women reporting alcohol use in nine states (statistically significant in six states) in NFHS-5 compared to NFHS-4. However, the proportions were more than NFHS-3 values in two states. These observations on changes in alcohol use in the country over the past two decades will help better understand the trends in alcohol consumption and help better plan the future strategy to address alcohol use and alcohol use disorders.
Publisher: Elsevier BV
Date: 2021
DOI: 10.2139/SSRN.3937558
Publisher: Informa UK Limited
Date: 04-12-2018
DOI: 10.1080/10826084.2018.1517799
Abstract: Therapeutic adherence is one of the most important determinants of the outcome with OST. There are no published studies that have explored the impact of change in tablet formulation of buprenorphine-naloxone from one brand to another among patients receiving OST. The current study is aimed at evaluation of the impact of change in buprenorphine-naloxone formulation on prescription pattern, treatment adherence, and patient satisfaction with OST. Our study was a cross sectional study based on a cohort of patients who were receiving OST at the study setting. Changes in prescription pattern, reports of subjective opioid withdrawal symptoms, or observation of objective opioid withdrawal symptoms were noted from the case records. The satisfaction and concerns of the patients with buprenorphine-naloxone formulations were assessed using a semi-structured proforma. An increase in dose of buprenorphine-naloxone was noted in 22 participants, since formulation change. Twenty participants reported that the color of the formulation was different from the previous one, the intensity of effect was reported to be different by 87% participants. Seventy-three percent participants endorsed that increase in dose can be a possible solution to address the perceived differences in the effects of two formulations. Changes in physical attributes of the formulation, perception among treatment seeking peers regarding such changes in treatment, and lack of sense of autonomy regarding one's treatment play a more important role in determining response of the patients to changes in formulation of buprenorphine-naloxone.
Publisher: SAGE Publications
Date: 2013
Publisher: Informa UK Limited
Date: 12-09-2017
DOI: 10.1080/15332640.2017.1357158
Abstract: Internalized stigma among in iduals with substance use disorders is a major barrier for accessing mental health services. This study aimed to assess internalized stigma among in iduals with substance use disorders and to assess the relationship of internalized stigma with the quality of life. This cross-sectional study recruited 201 patients with a clinical diagnosis of at least opioid or alcohol use disorder according to
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2017
DOI: 10.1097/JAN.0000000000000155
Abstract: “Dual disorder” or “dual diagnosis” refers to the co-occurrence of substance use disorder and psychiatric disorders. Prospective studies have shown that treatment outcomes, such as symptom levels, hospitalization rates, housing stability, and functional status, are worse among the patients with dual disorders as compared with those who have either of these disorders. The current article is aimed at reviewing the current state of evidence on neurobiology of dual disorders. Given the high prevalence of co-occurrence of substance use disorder and psychiatric disorders, it is important to explore the various facets of this association. The current review assimilates the information on neurobiological research on dual disorders and helps the readers gain insights into the current understanding on this theme. The electronic database of PubMed was searched for relevant publications. The studies included in the review belonged to various domains of neurobiology including neuropathology, structural neuroimaging, functional neuroimaging, genetics, neurochemicals/neuroreceptors, and neuroendocrinology. Forty studies were included in the review. Most of the issues related to the neurobiology of dual disorders remain inadequately studied. However, the current evidence suggests that the in iduals with co-occurring disorders are likely to differ from those with either substance use disorders or psychiatric disorders alone on various neurobiological aspects. Hence, it is imperative to systematically study the various neurobiological aspects of dual disorders in the future.
Publisher: SAGE Publications
Date: 07-2017
Publisher: Wiley
Date: 30-10-2013
DOI: 10.1111/APPY.12107
Publisher: SAGE Publications
Date: 09-2016
Publisher: SAGE Publications
Date: 11-2018
Publisher: SAGE Publications
Date: 07-2013
Publisher: Touch Medical Media, Ltd.
Date: 2018
Abstract: Diabetes distress – commonly encountered as a part of life with diabetes mellitus – can be effectively managed by coping skills training. Systematic assessment and documentation of the existing coping skills (and lack thereof) is a pre-requisite for planning such coping skills training. A six-item tool, the GlucoCoper – which assesses two negative (resistance, blame) and four positive (acceptance, optimism, planning and action) coping mechanisms – was administered to English-literate adult participants with type 2 diabetes (T2DM) at an endocrine centre in India. Each item was graded on a 10-point Likert scale. The GlucoCoper was administered to 338 participants. The tool demonstrated high internal validity. Total score on the GlucoCoper correlated with fasting and postprandial glucose. The GlucoCoper is a valid tool which can be used to assess and rate coping in persons with T2DM. It has potential in helping plan, deliver and monitor coping skills training in persons with diabetes distress.
Publisher: Medknow
Date: 2012
Publisher: Informa UK Limited
Date: 12-09-2015
Publisher: Informa UK Limited
Date: 02-10-2021
Publisher: Oman Medical Journal
Date: 07-2016
DOI: 10.5001/OMJ.2016.59
Publisher: Elsevier BV
Date: 10-2021
Publisher: Elsevier BV
Date: 02-2020
Publisher: Elsevier BV
Date: 10-2018
DOI: 10.1016/J.AJP.2018.07.018
Abstract: Perceived stigma is related to the beliefs that members of stigmatized group have about the stigmatizing attitudes present in society. We present the data on perceived stigma in alcohol and opioid users seeking treatment. This study was conducted at a tertiary care de-addiction facility with recruitment of patients with substance use disorders (alcohol and opioid use). Perceived stigma was assessed using Perceived Stigma of Substance Abuse Scale (PSAS). The study included 201 participants, majority of whom were males (99.5%), educated up to 10 Stigma remains an important issue among patients with alcohol and opioid use disorders. Perceived stigma could affect participation in society and health seeking behavior in substance using population, thus needs further exploration.
Publisher: SAGE Publications
Date: 07-2012
Publisher: Informa UK Limited
Date: 08-2013
DOI: 10.3109/09540261.2013.812959
Abstract: Undergraduate psychiatric education has an important role in developing psychiatric knowledge, decreasing stigma towards mental illness, and promoting psychiatry as a career choice. The attitudes and beliefs of medical students towards psychiatry have not been well understood, especially in non-western countries. To clarify this aspect, we have conducted a cross-sectional study between India and Japan. This study, conducted at two centres, one each in India and Japan, used a semi-structured questionnaire to evaluate the attitudes and beliefs of third-year medical students towards mental illness and psychiatry such as emotions experienced dealing with psychiatric patients, aetiology and treatment of psychiatric disorders, and psychiatry as a career choice. A total of 79 medical students from India and 77 from Japan participated in the present study. Significant differences were observed in the emotions experienced by the medical students while dealing with psychiatric patients. Most medical students (> 90%) from both study sites favoured psychiatrists for treatment of psychiatric illness. Psychiatry as a carrier choice was significantly related to the nationality of the medical students. The findings of the current study provide insight in to the attitudes of third-year medical students from India and Japan towards psychiatric patients.
Publisher: Springer Science and Business Media LLC
Date: 08-06-2014
Publisher: Elsevier BV
Date: 08-2018
Publisher: SAGE Publications
Date: 07-2016
Publisher: Medknow
Date: 2016
Publisher: Wiley
Date: 26-07-2012
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 06-2012
Publisher: SAGE Publications
Date: 12-12-2022
Publisher: Royal College of Psychiatrists
Date: 02-2012
Publisher: SAGE Publications
Date: 04-2013
Publisher: Touch Medical Media, Ltd.
Date: 2019
Publisher: American Psychiatric Association Publishing
Date: 2012
Publisher: Elsevier BV
Date: 04-2020
Publisher: Springer Science and Business Media LLC
Date: 25-06-2011
Publisher: Informa UK Limited
Date: 2020
DOI: 10.1080/02791072.2019.1709000
Abstract: This article reviews the provisions of Indian national policy on narcotic drugs and psychotropic substances in context of the health sector services for (illicit) psychoactive substances and substance use disorders (SUD). For the the current review, a checklist was developed based on recommendations from various agencies and organizations. The document on Indian national policy on narcotic drugs and psychotropic substances was reviewed based on the checklist. Themes such as identification in the aims/objectives/vision of the policy, including those highlighting treatment-related needs for SUD establishment of minimum standards of care for treatment evaluation of treatment programs for SUD government regulation of public and private drug treatment services capacity building for treatment services and harm reduction services to reduce bloodborne infections were documented in the policy. Others such as transparency of the policy making process situation analysis implementation of substance abuse prevention and treatment programs that target key populations impetus on evidence-based programs and practices were inadequately documented. Finally, integration of treatment into existing health care systems services for co-occurring disorders (medical and psychiatric) monitoring and performance evaluation of prevention programs harm reduction services to reduce overdose budget allocations and provisions for implementation were not documented in the current policy.
Publisher: SAGE Publications
Date: 05-2017
Publisher: Turkish Association of Nervous and Mental Health
Date: 2013
DOI: 10.5080/U6897
Publisher: Royal College of Psychiatrists
Date: 04-2012
Publisher: Medknow
Date: 2017
Publisher: Medknow
Date: 2021
Publisher: Medknow
Date: 2020
Publisher: Wiley
Date: 12-2021
DOI: 10.1111/APPY.12492
Abstract: Addictive disorders are a significant contributor to the global burden of disease. The burden of addictive disorders in LMIC is expected to grow further over the coming years. In this article we present the observations from the existing literature on the current status of education and training on addiction psychiatry in LMIC and provide recommendation on way forward for this specialized field of psychiatry. We searched electronic databases of PubMed to access the literature on the current status of education and training on addiction psychiatry. Additional searches were also conducted in other database of Google Scholar for potential ‘grey’ literature. We were able to identify a total of 11 relevant articles. Currently there is limited published literature on education and training on addiction psychiatry from the LMICs. Strengthening of the training on addictive disorders shall not only help bridge the gap of the unmet need for the evidence‐based interventions of addictive disorders across these countries it shall also help enhance the research capacity on addictive disorders in these countries.
Publisher: SAGE Publications
Date: 2012
Publisher: Springer International Publishing
Date: 07-07-2018
Publisher: Medknow
Date: 2011
Publisher: Medknow
Date: 2017
Abstract: Depression is globally the third-leading cause of disability in terms of disability-adjusted life-years. Depression in patients with diseases such as cancer, diabetes mellitus, stroke or cardiovascular disease is 2-4-fold more prevalent than in people who do not have physical noncommunicable diseases, and may have a more prolonged course. The significant burden due to depression that is comorbid with chronic physical disease, coupled with limited resources, makes it a major public health challenge for low- and middle-income countries. Given the bidirectional relation between depression and chronic physical disease, the clear way forward in managing this population of patients is via a system in which mental health care is integrated with primary care. Central to this integrated approach is the Collaborative Care Model, adapted to the local sociocultural context. In this model, care is jointly led by the primary care physician, supported by a case manager and a mental health professional. Various successful initiatives in low- and middle-income countries may be used as templates for collaborative care in other low-resource settings. The model involves a range of interwoven components, such as capacity-building, task-sharing, task-shifting, developing good referral and linkage systems, anti-stigma initiatives and lifestyle modifications. Policies based on adoption of this approach would not only directly address depression that is comorbid with physical noncommunicable disease but also facilitate achievement of Sustainable Development Goal 3, to "ensure healthy lives and promote well-being for all at all ages".
Publisher: SAGE Publications
Date: 2012
Publisher: Elsevier BV
Date: 04-2018
DOI: 10.1016/J.AJP.2018.04.010
Abstract: The student population is likely to be vulnerable to problems associated with increased online activity. We present the findings on extent and pattern of problematic internet use based on observations from a cyber awareness initiative undertaken in national capital city of New Delhi. A total of 25 schools were enrolled in the first phase of the initiative. The students in the middle, high, secondary and senior secondary grades were eligible for inclusion in the initiative. The Generalized Problematic Internet Use Scale 2 was used to assess problematic internet use. Correlation analysis was done using Pearson's correlation. A binary logistic regression was carried to see how various variables predicted the GPIUS scores. The level of statistical significance was kept at p < 0.05 for all the tests. A total of 6291 students participated in first phase. Around 19% of study participants reported problematic internet use and 37% used internet for mood regulation. Male gender, older age, studying in senior grades, and owning a personal device were associated with higher rates of problematic internet use. Use of internet for accessing social media, online gaming, and recreational surfing is associated with problematic internet use, while use of internet for educational activities was associated with lesser problems. There is a need to cover all students under cyber awareness program in order to facilitate safe and healthy use of internet.
Publisher: SAGE Publications
Date: 10-2012
Publisher: Medknow
Date: 2018
Publisher: Scientific Scholar
Date: 07-2018
Abstract: Trihexyphenidyl is an anticholinergic medication that is routinely used for the management of extrapyramidal symptoms in patients who receive antipsychotic medications. Trihexyphenidyl has been reported to be abused by some patients, who start to take it in increasing doses and tend to report a sensation of relaxation or pleasure with this medication. Hence, whether trihexyphenidyl should be considered a psychoactive substance and whether nonprescription misuse of this medication should be considered under the purview of substance use disorders need further clarity. We present here two cases of trihexyphenidyl misuse which developed in the context of persistent delusional disorders and highlight the challenges in diagnosis in such a situation.
Publisher: Medknow
Date: 2017
Publisher: Cambridge University Press (CUP)
Date: 30-04-2014
DOI: 10.1017/S2045796014000201
Abstract: This study evaluated the measurement invariance of the strengths and difficulties questionnaire (SDQ) self-report among adolescents from seven different nations. Data for 2367 adolescents, aged 13–18 years, from India, Indonesia, Nigeria, Serbia, Turkey, Bulgaria and Croatia were available for a series of factor analyses. The five-factor model including original SDQ scales emotional symptoms, conduct problems, hyperactivity–inattention problems, peer problems and prosocial behaviour generated inadequate fit degree in all countries. A bifactor model with three factors (i.e., externalising, internalising and prosocial) and one general problem factor yielded adequate degree of fit in India, Nigeria, Turkey and Croatia. The prosocial behaviour, emotional symptoms and conduct problems factor were found to be common for all nations. However, originally proposed items loaded saliently on other factors besides the proposed ones or only some of them corresponded to proposed factors in all seven countries. Due to the lack of a common acceptable model across all countries, namely the same numbers of factors (i.e., dimensional invariance), it was not possible to perform the metric and scalar invariance test, what indicates that the SDQ self-report models tested lack appropriate measurement invariance across adolescents from these seven nations and it needs to be revised for cross-country comparisons.
Publisher: Weston Medical Publishing
Date: 09-2017
Abstract: Background and aims: Tramadol is an opioid agonist which can be potentially used for maintenance treatment of patients with opioid use disorders. This chart review presents the characteristics of in iduals with an ICD 10 diagnosis of opioid dependence who were maintained on tramadol for a period of at least 6 months.Methods: Records of patients seeking treatment for opioid dependence from the outpatient clinic of the National Drug Dependence Treatment Centre, Ghaziabad, India were screened. One hundred consecutive patients who received tramadol for more than 6 months were included.Results: The s le comprised exclusively of males and had a mean age of 40.9 years. The median dose of tramadol at initiation and continuation was 300 mg/ day. Sixty-two patients achieved complete abstinence during the course of treatment. Greater age, longer duration of opioid use, and better follow-up adherence were associated with abstinent status. The rates of abstinence were higher among those presenting with natural opioid use as compared to others (prescription opioid use or heroin use).Conclusion: Tramadol can be an alternative medication for harm reduction in select group of patients with opioid dependence. Further research is required to strengthen the evidence base of rational use of tramadol for maintenance treatment of patients with opioid dependence.
Publisher: Medknow
Date: 2014
Publisher: Briefland
Date: 28-02-2016
DOI: 10.5812/IJHRBA.30342
Publisher: SAGE Publications
Date: 16-10-2020
Publisher: Informa UK Limited
Date: 10-2016
DOI: 10.1080/15504263.2016.1254309
Abstract: This article overviews training, clinical services, and research on dual disorders across four countries: France, India, Israel, and Spain. The current dual disorders systems in each of the four countries were reviewed, with a focus on strengths and limitations of each. In France, psychiatric care occurs within the public health care system and involves little training of medical graduates for managing dual disorders. Special courses and forums for specialists have recently started to meet the growing interest of physicians in learning how to manage dual disorders. The Indian health care system grapples with a large treatment gap for mental disorders, and while some treatment services for dual disorders exist, specific research and training efforts on dual disorders are just beginning. Israel has both public- and private sector services for patients with dual disorders, with specialized inpatient and emergency care for the acutely ill as well as day care and therapeutic communities for long-term management. Interest by researchers is growing, but training and education efforts in dual disorders are, however, minimal. Similar to the other countries, addiction and psychiatry disciplines are governed by separate isions within the National Health System in Spain. There are some dual disorders services available, but they are limited in scope. While medical professionals clearly recognize the importance of dual disorders, there is no such recognition by the national and regional governing bodies. The common thread in various aspects of dual disorder management in each of these four countries is that there is a lower-than-desirable level of attention to dual disorders in terms of care, policy, research, and training. There are growing opportunities for training and continuing education in dual disorders management. We suggest that nations could learn from each other's experiences on how to address the issue of dual disorders.
Publisher: SAGE Publications
Date: 04-2014
Publisher: Scientific Scholar
Date: 2015
Publisher: Informa UK Limited
Date: 11-01-2020
DOI: 10.1080/15332640.2018.1542528
Abstract: Drug use, including opioid use disorder, is one of the rapidly rising and serious problems affecting populations globally. There is a treatment gap and delay in presentation of drug users to treatment centers. The present study aimed at assessing the pathways to care among opioid-dependent in iduals seeking treatment from a community-based treatment center in India. In a cross-sectional observational study conducted at a community clinic of the National Drug Dependence Treatment Centre (NDDTC), New Delhi, India, a total of 100 treatment-seeking drug users (age 18-60 years) fulfilling DSM IV TR criteria for opioid dependence were recruited. The data were collected using a semistructured pro forma based on patient self-report and the encounter form used in the World Health Organization (WHO) Pathway Study. All participants were male, were mostly married, were employed, and belonged to nuclear families. Ninety-eight percent of participants has ever used heroin in a dependent fashion and 20% were using it currently. Mean age of the participants was 40.83 years (SD 12.7). Median age of onset of heroin use was 22 years (IQR 12). Median duration of heroin use was 138 months (IQR 132). Only 21% of participants visited the community deaddiction clinic at the first contact with care. The median time for first treatment-seeking attempt was 9.5 years (IQR 7). The study findings suggest significant delay between onset of drug-related problems and first treatment contact. There is a need to increase the availability and accessibility of treatment services to reduce the delay in treatment seeking.
Publisher: Medknow
Date: 2015
Publisher: SAGE Publications
Date: 03-2014
Publisher: Elsevier BV
Date: 09-2019
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 09-2012
Publisher: American Diabetes Association
Date: 14-08-2017
DOI: 10.2337/DC16-2599
Publisher: Medknow
Date: 2014
Publisher: SAGE Publications
Date: 17-09-2019
Abstract: We reviewed the literature for preventive programs against illicit drug use that specifically target adults aged 18–25 (i.e. emerging adults). Narrative review of preventive programs that have a high strength of recommendation according to the US Preventive Services Task Force (USPSTF) grading system. Prevention programs that met the criteria are school and college based, family-based, community based, peer-led, workplace-based, and technology-based interventions. They target the known modifiable risk factors associated with illicit drug use among adolescents and young adults. The preventive programs we reviewed are utilizing evidence-based strategies for the prevention of illicit drug use. Further research is needed to formulate new and effective preventive strategies for the reduction of illicit drug use by emerging adults.
Publisher: SAGE Publications
Date: 08-05-2022
DOI: 10.1177/02537176221082897
Abstract: Distance learning techniques are gaining popularity as the internet today is a faster and more convenient source of spreading exhaustive information. We aim at conducting a scoping review on the utility of internet-based learning in addiction psychiatry. We performed a systematic search of databases such as Google Scholar, PubMed, and Cochrane using the following keywords: Distance education, substance related disorder, teaching, internet, along with the MeSH terms (“Internet” AND “Teaching” AND “Substance Related Disorders”) OR (“Distance Education” AND “Substance Related Disorders”). The reference lists of articles were searched for other relevant literature. A total of 34 studies were included. Most of the courses offered online were on specific therapies, for ex le, training on motivational interviewing, twelve-step facilitation, cognitive behavioral therapy, alcohol screening, and brief intervention. They were based on various aspects of distance learning such as the acquisition of knowledge or skills, feasibility, level of satisfaction of the trainees/students, the cost-effectiveness of the techniques, and the type of trainees who have access to the course. The majority of the studies showed positive findings in terms of the parameter being studied. However, the level of satisfaction among the students is questionable. Internet-based teaching programs provide a good alternative to traditional educational methods in terms of effectiveness, feasibility, and acquisition of knowledge and skills. We emphasize the use of internet-based training in addiction psychiatry reinforced by actual practical experiences.
Publisher: Oxford University Press (OUP)
Date: 29-01-2015
DOI: 10.1093/NTR/NTV023
Publisher: Medknow
Date: 2019
Abstract: Behavioural addictions have been identified as an emerging public health problem. The unprecedented pace of the digital revolution, resulting in an ever-increasing use of internet-based technologies, provides the opportunity to create a unique resource to assist in offering public health interventions in the World Health Organization South-East Asia Region. The ability to deliver evidence-based treatment and preventive programmes that can be accessed by mobile phones, for ex le, increases access to a wide range of populations, including hidden or hard-to-reach populations. BehavioR (the Behavioral addictions Resource hub) has been established with the aim of offering a one-stop resource centre for behavioural addictions. The expected end-users of this digital platform include patients, caregivers, the general public, health-care providers, academics, researchers and policy-makers. The platform can be used to offer digital health interventions to patients strengthen the capacity of health-care providers for early detection of, screening for, intervention in and management of behavioural addictions and serve as an online repository for reliable information on behavioural addictions for the general public.
Publisher: Informa UK Limited
Date: 21-08-2014
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2017
Publisher: Touch Medical Media, Ltd.
Date: 2017
DOI: 10.17925/USE.2017.13.02.55
Abstract: Alexithymia is a personality trait that refers to the inability to express emotions in words. Medical professionals have been criticized for being “alexithymic” by many observers. From a clinician’s perspective, an alexithymic diabetes care professional is one who is unable to empathize with the patient, or to understand the patient’s emotional status and needs. In overzealous attempts at being “patientcentric,” one often tends to undermine the importance of the fact that diabetes care is a two-way process. The diabetes care professional is as important a component of diabetology as the person with diabetes. Balanced models and constructs are available which highlight the equal importance of the physician and other stakeholders of the healthcare system as well. The term we propose is “eulexithymia,” which we define as a balanced ability to express one’s emotions and understand others’ feelings. When used to describe a diabetes care professional, a “eulexithymic” professional is one who understands and responds to a patient’s feelings in a balanced manner, without letting oneself be unduly and inappropriately affected by them.
Publisher: Weston Medical Publishing
Date: 2013
Abstract: Aim/background: Tramadol is a synthetic opiate and a centrally acting weak µ-opioid receptor agonist. The potential advantages of tramadol include ease of administration, low abuse potential, and being nonscheduled. This study compared tramadol and buprenorphine for controlling withdrawal symptoms in patients with opioid dependence syndrome. Methods: Consenting male subjects between 20 and 45 years of age who fulfilled the ICD-10-DCR criteria for opiate dependence syndrome were randomly assigned in a double-blind, double-dummy placebo-controlled trial for detoxification. Those with multiple drug dependence, abnormal cardiac, renal and hepatic functions, psychosis, or organic mental illness were excluded. Assessments included Subjective Opiate Withdrawal Scale (SOWS), Objective Opiate Withdrawal Scale (OOWS), Visual Analog Scale (VAS), and Side Effect Check List. Subjects were evaluated daily and study duration was 10 days. Results: Sixty two subjects were enrolled. The mean SOWS and OOWS and VAS were significantly lower in the buprenorphine group on second and third day of detoxification as compared to the tramadol group. Although the retention rate was higher for buprenorphine group throughout the study, when compared with tramadol the difference was not significant on any day. Three subjects in the tramadol group had seizures. Conclusions: Tramadol was found to have limited detoxification efficacy in moderate to severe opioid withdrawal and substantial risk of seizures as compared to buprenorphine. Further studies are warranted to examine its efficacy in mild opioid withdrawal symptoms and its potential use in outpatient settings where its administration advantages may be valuable. Keywords: tramadol, buprenorphine, detoxification, opioids, heroin, randomized DOI:10.5055/jom.2013.0145
Publisher: Elsevier BV
Date: 02-2022
DOI: 10.1016/J.AJP.2021.102955
Abstract: We aimed to study the attributes of the digital media reports on death due to suicide attributed to gaming. We also aimed to assess the overlap between the 'gaming' and 'gambling' activities in these media reports. The online media reports on the theme of deaths due to suicides attributed to digital gaming in India were retrieved using the Google News online platform. The news reports were searched in the tor browser using the keywords "gaming suicide India" or "gaming death India". Gaming was identified as the direct reason for death due to suicide in an overwhelming majority (94.8%) of news reports. A large proportion of the reports failed to report death due to suicide in a responsible manner following the guidelines for responsible media reporting of suicide given by the World Health Organization (WHO). Stakeholders' views and opinions mentioned in the news reports included parents, caregivers or friends (17.5%), other gamers (3.1%), gaming industry (8.3%), and mental health professionals (5.2%). Around 24 per cent reports advocated a ban on 'gaming'. Based on our observations we recommend responsible reporting on death due to suicide in the online news. Also, there should be a more rigorous and systematic attempt before reaching at the conclusion while attributing these deaths to gaming. Finally, the news reports should ensure that the boundaries between 'gaming' and 'gambling' do not get blurred.
Publisher: SAGE Publications
Date: 09-2014
Publisher: Elsevier BV
Date: 2018
Publisher: Informa UK Limited
Date: 05-10-2017
Publisher: Informa UK Limited
Date: 13-01-2015
No related grants have been discovered for YATAN PAL SINGH BALHARA.