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Background: The proportion of patients attending the first follow-up appointment as an outpatient after being discharged from the inpatient setting is an outcome indicator of the quality of inpatient services provided. The objectives of this study were to determine the proportion of psychiatric inpatients with mental disorders and substance use disorders attending follow-up appointments after discharge and to determine the factors associated with attending follow-up appointments in these patients. Materials and Methods: A retrospective chart review (observational study) was conducted among the inpatients of psychiatry ward. The list of patients admitted to the psychiatry ward was obtained from the admission register. The discharge summaries and outpatient records of these patients were reviewed to obtain the following data: sociodemographic details, clinical details, and follow-up visit details. The primary outcome variable was follow-up attendance in the outpatient department within 30 days of discharge. Results: Ninety-eight patient records were included in the present study. The mean age of the participants was 37.81 (11.03) years and one-third of them were female. The mean duration of hospital stay was 11.32 (8.2) days. Sixty-six (67.35%) patients attended at least one outpatient follow-up visit within 30 days after discharge from the hospital. Patients with mood disorders had 4.25 higher odds of 30-FU when compared to patients with substance use disorders. Conclusions: Two-thirds of psychiatric inpatients with mental disorders and substance use disorders attended follow-up appointments within 30 days after discharge. Diagnostic category was associated with attending the follow-up appointments in these patients. [ABSTRACT FROM AUTHOR]

Background: Identification of barriers to mental healthcare seeking among medical students will help organize student mental health services in medical colleges across India. This study was conducted to estimate the prevalence of depression, anxiety disorders, and suicidal behavior among medical students and to identify the potential barriers to mental healthcare seeking among them. Methods: In this cross-sectional observational study, the medical students from a medical college in South India were asked to complete a structured pro forma for sociodemographic details, Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder Questionnaire (GAD-7),and Suicide Behaviors Questionnaire-Revised (SBQ-R). The barriers to mental healthcare seeking were assessed using the mental health subscale of Barriers to Healthcare Seeking Questionnaire for medical students. A cut-off of 15 was used for determining the presence of depression on PHQ-9. A cut-off of 10 on GAD-7 indicated the presence of anxiety disorder, and a cut-off of 7 on SBQ-R indicated suicidal risk. Results: Out of the 425 participants, 59 (13.9%) were found to have depression (moderately severe or severe) and 86 (20.2%) were found to have anxiety disorders (moderate or severe). A total of 126 (29.6%) students were found to have a suicidal risk. Preference for informal consultations, concerns about confidentiality, and preference for self-diagnosis were the most commonly reported barriers to mental healthcare seeking. Students with psychiatric disorders perceived more barriers to mental healthcare seeking than students without psychiatric disorders. Conclusions: One-fourth of the medical students were detected to have depression and/or anxiety disorders. Establishing student mental health services, taking into account the perceived barriers, will go a long way in improving medical students' mental well-being. [ABSTRACT FROM AUTHOR]

Background: Coronavirus disease 2019 (COVID-19) pandemic has induced serious threats to people’s mental health. There are increasing concerns about anxiety linked with COVID-19. There are very few studies conducted to understand the needs of the mentally ill during this pandemic. Aim: The study aimed to assess and compare the anxiety, knowledge, attitude, and preventive practices related to COVID-19 among people with and without psychiatric illnesses. Materials and Methods: A cross-sectional analytical study was conducted among patients with psychiatric illnesses and their caregivers in the psychiatry department of a tertiary hospital. All consenting adults with a diagnosed psychiatric illness and scoring < 3 in the Clinical Global Impression-Severity scale were included in the case group. All consenting adult caregivers who accompany the patients were included in the reference group. Coronavirus Anxiety Scale and Knowledge, Attitude, and Preventive Practices towards COVID-19 Questionnaire were administered. Data were analyzed using IBM SPSS (19.0 version). Results: Less than 10% of the participants in both the groups had COVID-related anxiety. 98.3% of the participants in both the groups knew that isolation and treatment of COVID‑19‑affected individuals can prevent the spread of the virus. Avoidance of handshaking (case – 85% and reference – 81.7%) and going out of home unnecessarily (case – 83.3% and reference – 81.7%) were the predominant preventive practices in both the groups. Only, the attitude had a statistically significant difference between both the groups (P < 0.05). Conclusion: Patients with psychiatric illness had fair knowledge, and they followed preventive practices toward COVID-19 that are comparable with healthy individuals. There were discrepancies between their knowledge and preventive practices. [ABSTRACT FROM AUTHOR]

We should also keep in mind that these patients were sensitive to the side effects of other antipsychotics as well. Can Isolated Head Tremors Be an Extrapyramidal Symptom Associated with Lurasidone? The patient was discharged against medical advice as he was unwilling to stay due to repeated conflicts with other patients and staff, with an early follow-up date. [Extracted from the article]

Sir, Despite several criticisms, adjustment disorder (AD) continues to be a commonly diagnosed condition in several clinical settings.[1] A wide variety of pharmacological and psychological interventions have been tested in patients with AD.[2] Not surprisingly, antidepressants and benzodiazepines are the most widely studied psychotropic medications in patients with AD.[2],[3] The previous studies on the prescription pattern of psychotropic medications did not report the findings on AD as a separate category. The present study highlights the current prescription pattern and the drop-out rate in patients with AD, thus filling the existing knowledge gap in the Indian literature. A total of 880 outpatient records were screened, 39 (4.43%) patients had a documented diagnosis of AD, out of them, 16 (41%) had an education of graduate level or above and 10 (25.6%) were unemployed. [Extracted from the article]

Optimal cut-off score for diagnosing depression with the Patient Health Questionnaire (PHQ-9): a meta-analysis. The appropriateness of using a cutoff of 15 on Patient Health Questionnaire-9 (PHQ-9) for determining the presence of depression and the wisdom of classifying the participants scoring 10-14 as normal has been questioned. [Extracted from the article]

The article focuses on the important aspects of confidentiality are nondisclosure, disclosure, and legal obligations. It mentions the Medical Council of India has implemented a new competency-based curriculum known as "Attitude, Ethics and Communication Model". It also mentions that medical institutes have the onus to implement ethical training for their students.

Background: Globally, about half the patients with alcohol dependence syndrome have a comorbid personality disorder (PD). Indian studies that have explored this are sparse., Objectives: The present study was conducted to estimate the prevalence of personality disorders in individuals with alcohol dependence syndrome undergoing inpatient treatment and to determine the sociodemographic and clinical correlates of PDs in these patients., Methods: This cross-sectional observational study was conducted among the inpatients of the psychiatry department in a tertiary care teaching hospital. Adult male patients with DSM-IV TR diagnosis of alcohol dependence were evaluated for the presence of PDs using Structured Clinical Interview for DSM IV Axis II Personality disorders. The severity of alcohol dependence was assessed using the Severity of Alcohol Dependence Questionnaire., Results: One hundred male inpatients with alcohol dependence syndrome were recruited. Of them, 48 (48%) participants had at least one PD with a 95% confidence interval of 0.38-0.58. Antisocial and avoidant PDs were found in 26 (26%) and 13 (13%) patients, respectively. The mean age at first drink was lower in participants with PD when compared to those without any PD (18.13 ± 4.46 vs. 20.79 ± 4.61 years, respectively). Also, the amount of alcohol consumption per day was significantly higher in those with PD when compared to those without any PD (15.9 ± 6.81 vs. 13.17 ± 4.34 units per day)., Conclusion: About half of males with alcohol dependence syndrome undergoing inpatient treatment had at least one PD. Antisocial and avoidant PDs were the most common PDs in this population. Individuals with comorbid PD had a lower age at first drink and higher daily alcohol consumption., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Indian Journal of Psychiatry.)