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   Table of Contents - Current issue
Coverpage
July-December 2022
Volume 27 | Issue 2
Page Nos. 71-137

Online since Friday, January 13, 2023

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EDITORIAL  

Mental health issues among medical students p. 71
Sandeep Grover
DOI:10.4103/jmhhb.jmhhb_297_22  
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PRESIDENTIAL ADDRESS Top

Can telepsychiatry bridge the treatment gap? p. 75
Sandeep Kumar Goyal
DOI:10.4103/jmhhb.jmhhb_157_22  
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ORIGINAL ARTICLES Top

Psychosocial roots of stress during pregnancy: A cross sectional study p. 82
KV Asha
DOI:10.4103/jmhhb.jmhhb_188_21  
Background: Pregnancy being an epoc of transition demanding heaps of remodeling and at the same time imbalance of which give rise to antenatal stress. As gestational stress is a considerable antecedent of detrimental pregnancy outcome, it is noteworthy to identify its contributing factors. The objective of the study was to determine the psychosocial factors associated with antenatal stress. Materials and Methods: Quantitative approach with a cross-sectional design was used to study the association between psychosocial factors and stress of pregnancy. Setting of the investigation was antenatal clinics of government hospitals at Thiruvananthapuram district of Kerala. The data were collected from 704 women in the gestational span of 20–24 weeks using Antenatal Psychosocial Stress Scale and structured interview schedule. Results: Bivariate analysis revealed that there is a statistically significant association between high stress and high fear of labor pain (odds ratio [OR] = 1.85, 95% confidence interval [CI]: 1.12–3.08) as well as anxiety regarding gender of baby (OR = 2.12, CI: 1.31–3.41). Conclusion: The present study revealed that heightened fear of labor pain and anxiety regarding gender of baby are the significant factors associated with antenatal stress. The study highlights the need of childbirth preparation classes attached to antenatal clinics. It also suggests the demand for abolishing gender preferences prevailing in the community.
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A study of impulsivity, compulsivity, and dysfunctional belief among medical undergraduate students with problematic internet use p. 87
Pallavi Abhilasha, Aneesha Haryal, Meha Malhotra, Mrinalini Reddy, Thenmozhi Moorthy, Mamta Singla
DOI:10.4103/jmhhb.jmhhb_201_21  
Background: Internet addiction has been described as an emerging behavior related to the development of new technologies. Impulsivity is a risk factor for addictive behaviors. Maladaptive use of the Internet has been coined as compulsive Internet use. Dysfunctional belief is an irrational thinking pattern where there is a negative view of self, the outer world, and future. Aim: The present study aims to assess the role of impulsivity, compulsivity, and dysfunctional belief leading to problematic Internet use. Materials and Methods: A total of 300 undergraduate medical students were assessed on this cross-sectional scale. Demographic details, Internet Addiction Test, Urgency Perseveration Premediation Sensation Seeking Positive Urgency Scale, Compulsive Internet Use Scale, and Dysfunctional Attitude Scale were filled by the participants using Google Forms. One hundred students could not be assessed due to nonresponse. Results: This study had a response rate of 66.6%, and of the respondents, 74.4% were mild, 25.2% were moderate, and 0.76% were severe in nature. A positive correlation was observed between Internet addiction and compulsive Internet use. There was a positive correlation between Internet addiction and lack of perseverance and positive urgency. There is an overall significance between level of dependency, achievement, and self-control in problematic and nonproblematic users. Conclusions: In the emerging era of Internet use, we must learn to differentiate excessive Internet use from addiction and be vigilant about psychopathology.
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Efficacy of online mental health program “EmoAid” during the COVID-19 pandemic Highly accessed article p. 95
Shilpa Gupta, Deepak Gupta, Eti Goel, Usama Rehman
DOI:10.4103/jmhhb.jmhhb_252_21  
Background: COVID-19 has triggered public health crises all around the globe. It has caused mental health issues not only in infected cases but also in uninfected cases. The world was put under strict/restricted lockdown to contain the transmission of COVID-19 diseases. All important aspects of life including therapies and counseling went online. “EmoAid” is one such online mental health program started during the COVID-19 to ease psychological distress. Aim: The current study assessed the efficacy of “EmoAid” program. Methods: One hundred and twenty-two participants completed depression, anxiety, and stress scale-21 online at three time periods; before the program (T1), after the program (T2), and 3 weeks after the program to study the maintenance effect (T3). Results: The results suggested that the program was successful in decreasing symptoms of depression, anxiety, and stress among participants. The maintenance effect of the program was also observed. Conclusion: The results highlight the importance of “EmoAid,” an online mental health program in lowering the levels of psychological distress during the pandemic, however, a randomized controlled study is required to validate the results.
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Effect of electronic media on adolescents' psychosocial health p. 100
Shailja Anand, Jyoti Khandekar, Sanjeev Kumar Rasania, Dinesh Kataria
DOI:10.4103/jmhhb.jmhhb_253_21  
Background: In the last decade, electronic media usage in world and India has seen dramatic increase. Electronic media is demonstrating potentially profound effects, especially on children and adolescents, like a double-edged sword. Electronic media is the media that uses electronics or electromechanical means for the audience to access the content. Many studies documenting relationship of electronic media on adolescents' physical and psychosocial health have been carried out in developed countries, in contrast; very few studies have been carried out in India. Therefore, this study was planned with the objective of finding out the extent and pattern of electronic media usage and its effect on psychosocial health of adolescents. Aims: The aim of the study is to assess the prevalence of electronic media usage among adolescents and to study the relationship of electronic media usage with psychosocial health of adolescents (10–17 years). Materials and Methods: This is a descriptive, community-based, cross-sectional study conducted in Mehrauli area of Delhi. Results: The mean age of 450 adolescents in the current study was a 13.85 ± 2.92 years, with majority (80%) belonging to nuclear families. Use of electronic media among study subjects was found to be 100%. Most of the psychosocial problems were reported more in subjects belonging to middle and late adolescent age groups. Aggression (42.89%), irritability (42.44%), and change in sleep pattern (39.33%) were commonly prevalent psychosocial problems among study subjects. Nearly 23% of adolescents reported with violent behavior, 17% feeling of loneliness, 13% peer problem, 10% had emotional problem, 10% were hyperactive, nearly 8% had conduct problem, nearly 7% reported with stress, anxiety, and low prosocial behavior, and 9% scored more than average for SDQ score. Only 4% had mild to moderate depression. Conclusion: Adolescents who spent the most overall time using electronic media had more behavioral problems. Duration of gadget use in our study was higher than the recommended, which is a matter of concern as it may have a detrimental effect on physical and psychosocial health of the adolescents.
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Nonsuicidal self-injury and family environment among college students in Kolkata, West Bengal: Mixed method explanatory sequential design p. 105
Arkita Pal, Paramita Roy
DOI:10.4103/jmhhb.jmhhb_11_22  
Background: Nonsuicidal self-injury (NSSI) refers to intentional, deliberate, and socially unexpected harming acts to oneself without any intention to die. It is a growing concern among recent mental health professionals. NSSI behaviors have an impact primarily on the individual, family, and ultimately on society. This problem is prevalent among the clinical population, but it has also become a threat to the general population, specifically adolescents and the young population. Aim: In this present study, we have explored the relationship between family environment and NSSI and investigated the predictable family factor for NSSI. Materials and Methods: Mixed method sequential research design was used for this research work. First, we did quantitative data collection; a total of 535 college students aged 18–26 years were selected and assessed using the Family Environment Scale and Functional Assessment of Self-Mutilation Scale. Second, thematic analysis was performed, followed by interviews with six participants. Results: There is a significant relationship between family conflict and NSSI χ2 = 33.47 (P < 0.001). Family conflict can be most reliable to predict NSSI, χ2 (16, n = 499) = 57.78, P < 0.001. In addition, the Thematic Analysis highlighted family interpersonal relationship, lack of expressiveness, and lack of sense of belongingness in the role of NSSI. Conclusion: Family conflict can be a crucial factor in detecting NSSI. This study can be a good source of information for clinicians and social scientists, but more studies should be conducted to control and prevent NSSI.
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Impact of electroconvulsive education module on knowledge and attitude of caregivers of mentally ill patients toward electroconvulsive therapy p. 113
Renish Bhupendra Bhatt, Parveen Kumar, Disha Alkeshbhai Vasavada, Viral Ratnprakash Shah, Lubna Mohammedrafik Nerli, Deepak Sachidanand Tiwari
DOI:10.4103/jmhhb.jmhhb_36_22  
Background: Electroconvulsive therapy (ECT) is a process of passage of an electric current to the patient's brain which induces a grand mal seizure. It is an effective and safe treatment option for many psychiatric disorders. There are a lot of stigmas associated with the use of ECT, which further undermines its acceptance by the general public. Relatives of patients who have more knowledge about ECT and its process of administration have a more positive attitude. Aims and Objective: The current study was used to assess the impact of brief ECT education module on knowledge and attitude toward ECT. Material and Methods: An interventional study was carried out from November 2021 to January 2022 among caregivers of mentally ill patients at a tertiary care center in Jamnagar, Gujarat, India. Consenting caregivers of 18–60 years without any history of psychiatric illness were included in the study. All participants were approached and requested to fill a semistructured pro forma containing demographic details and “knowledge and attitude toward ECT”, before and after the completion of the oral education session. Results: A total of 400 participants participated in the study. Participant's age ranged from 18 to 60 years. Participants have poor knowledge about the mechanism of ECT, its efficacy, and side effects related to it (<50% response). A positive correlation was observed between knowledge and attitude (r = 0.625, P < 0.001). Education has a statistically significant impact on changing attitude. Conclusion: Participants having higher educational qualifications or those having previous history of ECT among close friends or relatives had a positive perception toward ECT. Educational or counseling sessions among caregivers are effective in changing attitude toward ECT.
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Comparative effects of clozapine and risperidone monotherapy on levels of immunoglobulins in patients with schizophrenia – A 12 weeks' longitudinal study p. 119
Sumeesha Jaswal, Ajeet Sidana, Shivangi Mehta, Seema Gupta, Gurjit Kaur
DOI:10.4103/jmhhb.jmhhb_24_22  
Background: Schizophrenia is among the most puzzling yet disabling of all brain diseases. The finding of immunity-related genes seems to vindicate theories about the involvement of neuroimmunological processes in the pathogenesis of schizophrenia. Moreover, antipsychotics used in the treatment of schizophrenia have been shown to have effects on serum immunoglobulin levels. Aim: The aim of this study was to assess and compare the effect of risperidone and clozapine on the immunoglobulins at 6 weeks and 12 weeks in patients with schizophrenia and its clinical correlation. Materials and Methods: It was an open-label, randomized, comparative, and prospective study. Patients with International Classification of Diseases-11th Revision diagnosis of schizophrenia who were not on any antipsychotic drug for more than 2 weeks, were randomized to two groups, i.e., A (risperidone) and B (clozapine) after baseline assessment of sociodemographic and clinical parameters on the Positive and Negative Syndrome Scale (PANSS). Baseline blood investigations (complete hemogram, liver and renal function tests, lipid profile, and fasting blood sugar) and immunoglobulin estimation were done. Patients were followed at 6 weeks and 12 weeks and levels of immunoglobulin were reassessed at 6 weeks and 12 weeks along with PANSS and Glasgow Antipsychotic Side-Effect checklist. Results: A total of 32 patients were inducted into the study – 16 in the risperidone group and 16 in the clozapine group. There was no statistically significant difference in terms of the duration of illness or period of exacerbation between the two groups though the baseline total PANSS score was significantly higher in the clozapine group. In both the groups, there was no statistically significant difference in the baseline immunoglobulin levels at baseline and over 12 weeks in terms of the immunoglobulin G (IgG), IgM, and IgE levels. Within the clozapine group, a significant difference over 12 weeks was noted in IgG level. Conclusion: It can be concluded from the index study that the immunoglobulin levels in the patients with schizophrenia do not differ much concerning the effect of risperidone and clozapine. Clozapine is associated with a significant increase in IgG levels indicating the immunologic response of clozapine in schizophrenia.
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Effectiveness of adjunctive telemode mindfulness-based cognitive therapy on symptom severity and quality of life in patients with depression p. 126
Diksha Sachdeva, Harprit Kaur, Ajit Avasthi, Sandeep Grover
DOI:10.4103/jmhhb.jmhhb_28_22  
Background: Mindfulness-based cognitive therapy (MBCT) is reported to improve depression. However, little information is available about the effectiveness of MBCT interventions online. The aim of this study was to evaluate the effect of adjunctive telemode MBCT on the symptom severity and quality of life in patients with depression. Methods: 15 adult patients aged 18–55 years diagnosed with depression received 8-week adjunctive MBCT intervention to the ongoing treatment as usual for all (TAU) delivered through online mode. 12 participants completed the therapy and were reassessed. Patients were assessed at the baseline on Beck Depression Inventory (BDI), Five Facet Mindfulness Questionnaire, and World Health Organization-Quality of life BREF scale. Results: There was statistically significant reduction in the severity of depressive symptoms (P < 0.003) as assessed on the BDI. It led to remission in two-thirds of the patients partially responding to antidepressants. On the World Health Organization Quality of Life, there was statistically significant improvement on the domains of physical (P < 0.002), psychological (P < 0.002), social (P < 0.002), and environment (P < 0.005) domains. There was a significant improvement in the total Five Facet Mindfulness Questionnaire score. Conclusions: Adjunctive online MBCT appears to be a feasible adjunct to TAU in reducing severity of depression, improving mindfulness, and improving quality of life in patients with depression.
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BRIEF REPORT Top

A survey of patient satisfaction with telepsychiatry services delivered at a tertiary care hospital in western punjab during the COVID-19 pandemic p. 132
Jitender Aneja, Gurpreet Kaur, Bharat Udey
DOI:10.4103/jmhhb.jmhhb_191_22  
Background: Previous research has shown promising results of telepsychiatry in the form of patient satisfaction. However, its utilization in the wake of the COVID-19 pandemic and with bare minimum resources in the Indian context is scarcely studied. Aim: To evaluate patient satisfaction with telepsychiatry services delivered at a tertiary care hospital in Western Punjab. Methods: This study was done among 114 patients who had availed of telepsychiatry services between September and November 2021. The patients were interviewed telephonically using a pretested semi-structured tool that measured patient satisfaction on a 5-point Likert Scale. Results: The satisfaction rate was very high for various aspects of telepsychiatry services such as ease of seeking appointments, video quality, attending doctor's concern for the patient, time given, ability to procure medicines using the e-prescription and so on. Conclusion: Telepsychiatry services delivered through an easy medium encourage us to further strengthen and undertake more research into this aspect of health-care delivery.
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BOOK REVIEW Top

Book Review: Izydorczyk, bernadetta (2022). body image in eating disorders: clinical diagnosis and integrative approach to psychological treatment. Oxon, UK: Routledge. pp. 157. £120 (Hard Cover). Doi: 10.4324/9781003251088 p. 136
Fung Kei Cheng
DOI:10.4103/jmhhb.jmhhb_96_22  
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