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Chronic obstructive pulmonary disease (COPD) patients often experience reduced physical activity, sleep disturbances, and cognitive impairment. However, reports on measurement of rest-activity rhythm and sleep-wake behavior and their impact on cognitive functions in COPD patients are limited. This study aimed to objectively measure circadian rhythms (rest-activity and ambient illuminance) and sleep behaviors in clinically stable COPD patients and their relationship with cognitive functions. The study involved 65 male COPD patients and 50 age-matched controls, monitored over 3–7 days using actigraphy. Cognitive status was assessed using the Montreal Cognitive Assessment (MoCA) followed by short interbal time estimation via time production and reproduction with reaction time measurement using TimeProd software. Findings indicated significant disruptions in circadian rhythms in COPD patients, characterized by lower mesor, amplitude, and autocorrelation coefficients compared to controls. Patients also reported poorer sleep quality and higher sleep fragmentation, with 85.7% displaying cognitive impairment. Notably, longer time estimations, increased variability in task performance, and slower reaction times suggested cognitive deterioration. Positive correlations emerged between rhythm parameters (amplitude and circadian quotient) and cognitive performance metrics. This highlights the relevance of circadian and sleep disturbances in COPD, suggesting that addressing these rhythms could help mitigate cognitive decline, potentially through chronotherapeutic strategies. [ABSTRACT FROM AUTHOR]

This article discusses the use of formative assessments in postgraduate medical education in India, specifically in General Hospital Psychiatry Units (GHPUs). Formative assessments are low-stakes evaluations that help students identify their strengths and weaknesses. The article describes various formative assessment strategies used in GHPUs, including logbooks, assessment of academic activities, work-based assessments, internal assessments exams, and 360° evaluations. These assessments are used to provide feedback to trainees and track their progress. The article also highlights the challenges and potential benefits of using graphical projections to visualize trainees' progress. [Extracted from the article]

Background: Substance use disorders (SUDs) are among the leading causes of morbidity in the population. In low- and medium-income countries like India, there is a wide treatment gap for SUD. A multicentric study on the care pathways for SUD in India can help to understand service provision, service utilization, and challenges to improve existing SUD care in India. Aim: We aimed to map pathways to care in SUD. We compared the clinical and demographic characteristics of patients who first consulted specialized services versus other medical services. Methods: This was a cross-sectional study of consecutive, consenting adults (18-65 years) with SUD registered to each of the nine participating addiction treatment services distributed across five Indian regions. We adapted the World Health Organization's pathway encounter form. Results: Of the 998 participants, 98% were males, 49.4% were rural, and 20% were indigenous population. Addiction services dominated initial (50%) and subsequent (60%) healthcare contacts. One in five contacted private for-profit healthcare. Primary care contact was rare (5/998). Diverse approaches included traditional healers (4-6%) and self-medication (2-8%). There was a 3-year delay in first contact; younger, educated individuals with opioid dependence preferred specialized services. Conclusion: There is a need to strengthen public healthcare infrastructure and delivery systems and integrate SUD treatment into public healthcare. [ABSTRACT FROM AUTHOR]

Introduction: Cannabis use disorders are global emerging problem nowadays, with high prevalence and morbidity. Cognitive impairments, and also corresponding genetic vulnerability, has been fairly replicated in individuals with cannabis dependence. However, there are few studies that assess cognitive functioning as an endophenotype or a trait marker for cannabis dependence. While the primary objective of this study was to assess the endophenotype pattern of cognitive dysfunction in cannabis dependence, assessing the association between the degree of cognitive functioning, and their socio‐demographic and clinical variables in the cannabis dependence patients and their first‐degree relatives was the secondary objective. Methodology: We compared cognitive functioning across three groups‐ patients with cannabis dependence syndrome, their 'non‐user' first‐degree relatives and healthy controls, with 30 participants in each group. Five cognitive domains‐ attention and concentration, verbal fluency, memory, visuospatial ability and executive functions were assessed. We assessed for endophenotype pattern of statistical significance in pairwise analyses of Kruskal‐Wallis test, which was corrected for multiple comparisons. Subsequently, correlation analysis to assess association of cognitive impairment with socio‐demographic and clinical variables was conducted. Results: Although impairment in attention and executive functions also was seen in patients with cannabis dependence, endophenotype pattern of statistical significance in pairwise analyses, with impairment in first‐degree relatives too, was seen in all sub‐scores of verbal fluency and verbal memory. None of the correlations were significant. Conclusion: 'Non‐user' first‐degree relatives of patients with cannabis dependence too show significant cognitive impairment. Verbal fluency and verbal memory are possible endophenotypes or trait markers for cannabis dependence syndrome. [ABSTRACT FROM AUTHOR]

Background: Psychiatric disorders are among the leading contributors to disability in India and worldwide. The pattern, prevalence, and distribution of psychiatric disorders in the country and its regions need to be assessed to facilitate early diagnosis and treatment. No study on the epidemiology of psychiatric disorders has been conducted in the Chhattisgarh state. This paper, as part of the National Mental Health Survey (NMHS), discusses the prevalence and pattern of psychiatric disorders in Chhattisgarh state. Methods: A stratified random cluster sampling technique and random selection based on probability proportional to size (PPS) at each stage were adopted. Participants were from three selected districts of Chhattisgarh, such as Janjgir-Champa, Kabirdham, and Raipur. Adults (aged ≥18 years) residing in selected households were interviewed using Mini International Neuropsychiatric Interview (version 6.0), the Fagerstrom test for nicotine dependence, the WHO-SEARO screening questionnaire for generalized tonic-clonic seizures, and screening tools for intellectual disability and autism spectrum disorders. Results: A total of 2841 individuals were interviewed. The state's lifetime and current prevalence of psychiatric disorders for adults were 14.06% [95% confidence interval (CI) = 13.83–14.29] and 11.66% (95% CI = 11.45–11.87), respectively. Prevalence of substance use disorders, tobacco use disorders, schizophrenia and related disorders, and mood disorders was 32.4% (95% CI = 32.09–32.71), 29.86% (95% CI = 29.56–30.16), 0.8% (95% CI = 0.75–0.86), and 4.44% (95% CI = 4.31–4.58), respectively. High risk for suicide was detected in 0.28% (95% CI = 0.25–0.31). Psychiatric disorders were twice more common in males than in females. Conclusions: The study gives authentic data on the prevalence of psychiatric disorders in Chhattisgarh. This shall pave the way for policymakers and planners to design state-specific plans for dealing with mental disorders and related issues. [ABSTRACT FROM AUTHOR]

Background: There are more than 5 million people with dementia in India. Multicentre studies looking at details of treatment for people with dementia In India are lacking. Clinical audit is a quality improvement process which aims to systematically assess, evaluate, and improve patient care. Evaluating current practice is the key to a clinical audit cycle. Aim: This study aimed to assess the diagnostic patterns and prescribing practices of psychiatrists for patients with dementia in India. Method: A retrospective case file study was conducted across several centers in India. Results: Information from the case records of 586 patients with dementia was obtained. Mean age of the patients was 71.14 years (standard deviation = 9.42). Three hundred twenty one (54.8%) were men. Alzheimer's disease (349; 59.6%) was the most frequent diagnosis followed by vascular dementia (117; 20%). Three hundred fifty five (60.6%) patients had medical disorders and 47.4% patients were taking medications for their medical conditions. Eighty one (69.2%) patients with vascular dementia had cardiovascular problems. Majority of the patients (524; 89.4%) were on medications for dementia. Most frequently prescribed treatment was Donepezil (230; 39.2%) followed by Donepezil-Memantine combination (225; 38.4%). Overall, 380 (64.8%) patients were on antipsychotics. Quetiapine (213, 36.3%) was the most frequently used antipsychotic. Overall, 113 (19.3%) patients were on antidepressants, 80 (13.7%) patients were on sedatives/hypnotics, and 16 (2.7%) patients were on mood stabilizers. Three hundred nineteen (55.4%) patients and caregivers of 374 (65%) patients were receiving psychosocial interventions. Conclusions: Diagnostic and prescription patterns in dementia which emerged from this study are comparable to other studies both nationally and internationally. Comparing current practices at individual and national levels against accepted guidelines, obtaining feedback, identifying gaps and instituting remedial measures help to improve the standard of care provided. [ABSTRACT FROM AUTHOR]

Background: Internet use has spread across the world due to easy accessibility and affordability. However, it has been creating many problems at several levels. So, there is a need to identify the suitability of psychometric properties and the factor structure of the widely used Internet Addiction Test (IAT) in the Indian settings. Our objective was to perform an exploratory factor analysis on the IAT and to test the reliability of the scale. Methods: It was a cross-sectional study that included various professional groups. We used an online questionnaire that included sociodemographic details and Young's IAT. Exploratory factor analysis was used to identify the factor structure of Young's IAT in the Indian setup. Results: The mean age of the sample (N = 1,782) was 27.7 years (SD = 8.74) with a predominantly male population 1040 (58.4%). In total, 1.0% (17) of the sample had significant problems with internet usage, whereas 13% (232) were in the range of frequent/occasional problems, and the mean score on IAT was 32 (SD = 16.42). Exploratory factor analysis revealed two factors that explained 49% of the variance (Kaiser–Meyer–Olkin measure of sampling adequacy: 0.95, Bartlett's test of sphericity: P = 0.000). They were "mood and relationship issues" and "duration and productivity." Cronbach's α was 0.92, which indicates a high level of internal consistency. Conclusion: In Indian settings, IAT can be understood based on the two-factor structure. The scale has excellent reliability. Further studies are needed to replicate these results, by using confirmatory factor analysis and validity testing. [ABSTRACT FROM AUTHOR]

Background: Recognizing the need for good quality, scientific and reliable information for strengthening mental health policies and programmes, the National Mental Health Survey (NMHS) of India was implemented by National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, in the year 2015–2016. Aim: To estimate the prevalence, socio-demographic correlates and treatment gap of mental morbidity in a representative population of India. Methods: NMHS was conducted across 12 Indian states where trained field investigators completed 34,802 interviews using tablet-assisted personal interviews. Eligible study subjects (18+ years) in households were selected by a multi-stage, stratified, random cluster sampling technique. Mental morbidity was assessed using MINI 6. Three-tier data monitoring system was adopted for quality assurance. Weighted and specific prevalence estimates were derived (current and lifetime) for different mental disorders. Mental morbidity was defined as those disorders as per the International Statistical Classification of Diseases, Tenth Revision Diagnostic Criteria for Research (ICD-10 DCR). Multivariate logistic regression was conducted to examine risk for mental morbidity by different socio-demographic factors. Survey was approved by central and state-level institutional ethical committees. Results: The weighted lifetime prevalence of 'any mental morbidity' was estimated at 13.67% (95% confidence interval (CI) = 13.61, 13.73) and current prevalence was 10.56% (95% CI = 10.51, 10.61). Mental and behavioural problems due to psychoactive substance use (F10–F19; 22.44%), mood disorders (F30–F39; 5.61%) and neurotic and stress-related disorders (F40–F48; 3.70%) were the most commonly prevalent mental morbidity in India. The overall prevalence was estimated to be higher among males, middle-aged individuals, in urban-metros, among less educated and in households with lower income. Treatment gap for overall mental morbidity was 84.5%. Conclusion: NMHS is the largest reported survey of mental morbidity in India. Survey estimated that nearly 150 million individuals suffer from one or the other mental morbidity in India. This information is to be used for planning, delivery and evaluating mental health programming in the country. [ABSTRACT FROM AUTHOR]

Background: Previous attempts of Mental Health Systems Assessment in India were restricted in scope and scale. Information on all aspects of mental health systems (leadership/governance, legislation, financing, service delivery, workforce, access to essential medicines, information systems, intersectoral activities, and monitoring and evaluation) was scarcely available. The National Mental Health Survey-Mental Health Systems Assessment (NMHS-MHSA), a unique endeavor, assessed the performance of mental health systems and services through health systems assessment framework. The present paper discusses the design and methodology adopted under NMHS-MHSA along with emphasizing its implication for India and other LMICs. Methods: NMHS-MHSA was undertaken in 12 Indian states by contextually adapting WHO-AIMS instrument. Data was collated from several secondary sources including interviews of key stakeholders. Utilizing the data a set of 15-quantitative, 5-morbidity and 10-qualitative indicators were developed to summarize the functional status of mental health systems in the surveyed states. This information was authenticated through state level stakeholder's consultation and consensus building workshops following which a state mental health systems report card with indicators was developed. Conclusion: The process and robust method of data compilation enabled NMHS-MHSA to be a reliable and comprehensive method for assessing mental health systems at the state level. It's envisaged that the assessment provides requisite impetus for strengthening mental health program and mental health systems in India. Being less resource intensive, low -and middle- income countries can adopt NMHS-MHSA tool and methodology to assess their mental health systems with contextual modifications. [ABSTRACT FROM AUTHOR]

Staying home is NOT "staying safe": A rapid 8-day online survey on spousal violence against women during the COVID-19 lockdown in India , the nationwide lockdown in India began on the 25 March 2020 in a quest to fight the COVID-19 pandemic. This survey was conducted between 11 and 18 May 2020 (lockdown Phase 3 ended 17 May 2020). [Extracted from the article]

In patients presenting with manic symptoms and history of opioid use, clinicians should consider the possibility of withdrawal emergent manic symptoms, which might rapidly resolve with opioid substitution alone. He was diagnosed as having opioids-dependence syndrome, with harmful use of sedatives or hypnotics, uncomplicated withdrawal state, and withdrawal emergent mania with psychotic symptoms. This association has been reported to be threefold to fourfold higher for opioid use disorders compared to other substances.[1] Both opioids-induced and withdrawal emergent mania are not reported frequently and, therefore, less understood. [Extracted from the article]