Indian Journal of Mental Health and Neurosciences
Indian Journal of Mental Health and Neurosciences (IJMHNS) aims to promote and publish research related to mental health and associated neuro-science subjects from across the world. The Journal will be published biannually – in January and in July. The journal encourages clinical and translational research, with the focus on ameliorating the mental illness burden in the community and ensuring evidence based care.
Indian Psychiatric Society - Tamil Nadu Chapter
Copyright (c) 2025 Indian Journal of Mental Health and Neurosciences
The research interface between psychiatry and medicine: Evolving paradigms and their implications
ENCHANT - Enhancing Psychiatric History Taking: A Comprehensive Approach
Factors Affecting Adherence to Oral Medications in Chronic Psychiatric Patients at a Tertiary Care Hospital in Western India: A Cross-Sectional Study
Background: Adherence to Medications has been identified as an important factor in determining the course of psychiatric illness and future recovery. Despite this fact, lower adherence rates have been reported. Aim: To determine the level of adherence to oral medications in chronic psychiatric patients and to assess factors affecting adherence. Methods: A cross-sectional study was conducted on 225 patients diagnosed with and on treatment for Psychiatric Conditions for more than three months at the Outpatient Department of Psychiatry of a tertiary care hospital in Western India from September to October 2023. Data were collected using a Case Report Form and a standardized Adherence to Refills and Medications Score (ARMS) Questionnaire. Both bivariate and multivariate logistic regression were used. Variables with p-value < 0.05 were considered statistically significant. Results: Majority of the study population (87.6%) was found to be non-adherent. Through univariate logistic regression, it was found that the female gender (OR: 2.425; 95% CI: 1.020 – 5.766), higher education of head score (OR: 2.410; 95% CI: 1.063 – 4.758), and lesser number of class of medications (OR: 2.315; 95% CI: 1.037 – 5.166) were significant predictors of adherence. Multivariate logistic regression showed that higher education of head score (AOR: 2.705; 95% CI: 1.144 – 6.398) and lower frequency of consumption of medications (AOR: 0.335; 95% CI: 0.135 – 0.829) were associated with better adherence. Conclusion: The study showed that further improvements in adherence are required. Factors contributing to non-adherence should be assessed and intervened.
Assessment of association between pregnancy induced hypertension and cognitive function: Before and after one month of delivery: Cohort study
Introduction: Pre-eclampsia is a leading cause of morbidity and death in mother and baby. This also leads to endothelial dysfunction in large and small vessels, which leads to cognitive impairment. This is the first kind of study from India on the assessment of cognitive function in the Pregnancy-induced hypertension (PIH) group. Materials and Method: We recruited cases from the obstetric department’s antenatal care. We applied Socio-demographic data and a Cognitive assessment battery (Trail Making Test (TMT) A and B, PGI memory scale, Porteus maze, and Digit Symbol Substitution Test (DSST)) to collect information on cognitive function. The data was collected from May 2021 to November 2021. Assessment was done during pregnancy and one month after Delivery. Data was assessed using SPSS software. Results: The TMT A and B values were 27.32 & 57.08 predelivery and 23.34 & 48.74 post-delivery. In PGI memory scale (pre and post-delivery values), Remote memory (6.76 & 6.81), recent memory (4.99 & 5.00), mental balance (6.26 &6.75), attention and concentration(7.42 & 8.27), delayed recall (6.29 &6.9), immediate recall(5.13 & 5.70), verbal retention-dissimilar word (9.52 & 10.18) and recognition (6.75 & 7.62) & DSST (88.0 & 91.31), verbal retention for similar words (5.19 &5.34 &)and visual (2.19 & 2.22) retention. The Maze Test-1 (17.29 & 13.06) Maze Test-2 (21.44 & 16.83). Before Delivery, cognitive impairment was present in the Pregnancy Hypertension (PIH) group in trail making, MAZE test, and certain areas of the PGI memory scale, which were statistically significant (<0. 001) compared to the healthy control group. It continues even after one month of Delivery. Conclusion: This study has shown that there was an association between the pregnancy-induced hypertensive group and the healthy control group in certain domains of cognitive function before Delivery. The cognitive impairment persists even after one month of Delivery, which signifies microvascular damage persists for a longer duration.
A community based study in South India of the association between Common Mental Disorders(CMD) and Cognitive Impairment(CI) in urban elderly.
Background: Unprecedented aging in India has brought with it a host of difficulties for the elderly, including urbanization, breakdown of the joint family system, economic distress, poor nutrition and significant unpreparedness to manage their increasing needs. This urgent need was addressed through a formal research proposal aimed to study the prevalence of CMD and CI in community living elderly, their associations and sociodemographic correlates. This detailed analysis thus provides a framework to stimulate policy decisions for elder care in the country. Materials and methods: A prospective cross-sectional study was conducted across six old age homes in Chennai, India where 273 community living elderly aged 65 and older were assessed using the Clinical Interview Scale-Revised and the Mini Mental State Examination (Hindi version). Results: Most of the subjects were female (71.1%), had at least ten years of education and were of high socio-economic status; 52% were positive for CMD and 14.28% had CI. There was a statistically significant association between CMD and CI (t=5.115, p=0.000, 95%CI 8.453-19.034). Conclusions: The prevalence of CI is in keeping with the published literature. However, the prevalence of CMD in this population was found to be higher than that published in literature from India and low- and middle-income countries (LAMIC). Older age, female gender, low educational attainment and middle socio-economic status were factors associated with CI. This study validates the extensively reported finding that CMD and CI are important in the public health implications of human ageing that health planners and policy makers need to focus on.
The role of artificial intelligence in psychiatry
Copyright (c) 2024 https://creativecommons.org/licenses/by/4.0/
Manganese toxicity presenting as acute psychosis- A case report
Manganese poisoning is a toxic condition due to excessive exposure to manganese which can present with neurological or psychiatric symptoms. Here is a case report of a 51 years old male with occupational history, brought to the Emergency Room with two days history of acute onset behavioural disturbances. There was a history of taking Siddha medications for the last 4 months for polyarthralgia with minimal improvement. A diagnosis of organic psychotic disorder due to Manganese intoxication was made. MRI Brain plain and contrast were normal. The heavy metal screen was suggestive of high Manganese of 42 mg/ml and Cobalt of 4.4 ng/ml EEG was suggestive of generalized epileptiform abnormality. The patient was asked to refrain from further exposure to heavy metals and treated with Sodium valproate and neuro vitamins with gradual improvement in symptoms. This case report emphasizes the need for detailed evaluation and ruling out other medical conditions in a case presenting with the first episode of psychosis.
Copyright (c) 2024 Indian Journal of Mental Health and Neurosciences
Atropine induced delirium in young female with unknown snake bite : Case report
Venomous snakebites account for many deaths in developing countries. Administration of an Acetylcholinesterase Inhibitor (ACEI) has been recommended by WHO as a part of neurotoxic snakebite treatment. With atropine being used to reduce the undesirable muscarinic effects of ACEIs, adverse effects like delirium can occur. Delirium is characterized by acute decline in level of consciousness and cognition involving perceptual disturbances, abnormal psychomotor activity, and sleep cycle impairment. This case report describes a 17-year-old female with unknown snakebite who developed atropine induced delirium despite being under the cover of ACEIs and at a lower dose (4.5 mg) than usual for the drug to cause delirium. Though there are reports in literature about atropine induced delirium in organophosphate poisoning, to our knowledge none were reported snakebite cases. Hence, clinicians need to be cautious while encountering with such patients and should always consider the possibility of atropine induced delirium even in snakebite cases.
Prevalence and sociodemographic correlates of depression and anxiety among secondary school students in Chennai, South India: A cross-sectional study
Background: Anxiety and depression are common mental disorders affecting adolescents worldwide and in India. Various factors are associated with the prevalence of anxiety and depression among adolescents, which vary between geographic, socio-cultural, and economic backgrounds. Hence, the aim of the study was to estimate the prevalence of depression and anxiety and assess the socio-demographic factors associated with them among secondary school students in Chennai, south India. Materials and methods: A cross-sectional study was conducted among grade 9 students from four schools in Chennai. Written informed consent was obtained from the parents/guardian and assent from the students before recruitment into the study. The following tools were used to collect data: semi-structured proforma to collect the socio demographic details, perception of stress by Cohen’s Perceived Stress Scale, mental wellbeing by The World Health Organisation- Five Well-Being Index (WHO-5) and anxiety and depression assessed using General Anxiety Disorder (GAD-7) and Patient Health Questionnaire (PHQ-9), respectively. Results: A total of 569 students (323 (56.8%) boys, 246 (43.2%) girls) participated in the study. Prevalence of anxiety and depression among study participants was 46.3% and 39.6%, respectively. On the multivariate analysis, it was observed that students whose father had a blue-collar job and higher perceived stress were significantly more likely to have anxiety and depression.
depression, anxiety, prevalence, predictors, school, students, Chennai, south India
Impact of COVID-19 outbreak on mental health of undergraduate and postgraduate medical students.
Background: The COVID-19 pandemic, the largest crisis of modern era has subjected medical students and healthcare workers to immense amount of stress due to myriad problems like exposure risk, health concerns and subsequent economic repercussions. Aim: The aim of this study was to estimate the prevalence of depressive symptoms among medical students studying in the sub-continent and in foreign medical universities during the height of the COVID-19 pandemic. Setting and design: This was a cross sectional study. Materials and methods: A web-based survey was conducted using a specially constructed questionnaire pertaining to COVID-19 pandemic. Depressive symptoms were assessed using DASS-21 questionnaire and sleep quality with Pittsburgh Sleep quality index (PSQI), respectively. Statistical analysis: Chi-square tests was used for proportions. Pearson’s correlation analysis was done to evaluate the correlation between study DASS-21 subscales and PSQI. Multiple logistic regression was done to assess the association between study variables and the likelihood of having depressive symptoms. Results: Postgraduate medical students and those studying in foreign universities had a significantly higher prevalence of depression than undergraduates and students studying in Indian universities, respectively. These two sub-groups also had poorer sleep quality (P<0.001). A statistically significant correlation (P<0.001) was observed between depressive symptoms and sleep quality. On multiple logistic regression, post-graduate medical students (OR=3.4), lockdown duration (OR=4.3), poorer PSQI(OR=1.2) and female gender (OR=4.1) had significantly higher odds to exhibit depression. Conclusion: Post-graduate medical students and those studying in foreign medical universities had significantly higher prevalence of depression during the COVID-19 lockdown.
COVID-19; lockdown duration; depression; post-graduates; foreign universities.
Economic burden in patients with dementia attending a geriatric care clinic in Chennai: A cost of illness study
Background: Dementia is one of the major causes of dependency and disability among the elderly. With an increase in life expectancy, the burden of dementia is also on the rise especially in countries like India. There are economic concerns to the family as health expenses are majorly borne by them. There are few cost of illness studies for dementia from low- and middle-income countries. Our study aims to estimate the burden of costs of dementia in patients attending a geriatric clinic in a private hospital setting. Methods: This retrospective observational study assessed the economic burden of dementia by estimating both direct and indirect costs of illness from the caregiver's perspective. Results: Direct costs from medical services and social costs are higher when compared to indirect costs. Not all people have incurred social costs as many are provided care by the families and their inputs are not paid or accounted. The costs of informal care were under evaluated in the study. Conclusion: The direct health care cost of illness of Dementia from caregiver perspective is more than one seventh of the per-capita income of Indian population provided indirect costs and direct social costs are not included. Evaluating various costs incurred in various health care settings is important to understand the economic burden of Dementia. There is a need for well-designed prospective studies to inform policy decisions towards better service development for persons with dementia.
Direct medical costs, Social costs, Indirect costs, LMIC nation
First-episode psychosis research in India: A review
Background: With the growth of early intervention services for psychosis worldwide, it is imperative to understand the current knowledge on first-episode psychosis (FEP) from Indian context. Hence, the purpose of this review is to comprehensively examine the research studies on FEP from India. This would help to compare and contrast with other countries, develop specialist early intervention services and enlist research priorities pertaining to FEP. Methods: A Boolean search of articles published from January 1990 to March 2018 in electronic database of PubMed and Google Scholar was carried out and original research studies done on first-episode psychosis in India were incorporated in the current review. Case reports and review articles were excluded. Results: A total of 31 research studies were included for the review and classified into different subheadings of convenience. Conclusion: Even though the number of studies in Indian context pertaining to FEP is comparatively less than other western literature, the available results indicate certain characteristic similarities and differences in FEP from other parts of the world. We have also discussed on the importance of early intervention in FEP and the necessity for the creation of specialist early intervention services for mental health disorders.
Copyright (c) 2018 Indian Journal of Mental Health and Neurosciences
The Principles and Practice of Psychiatric Rehabilitation
People with severe mental disorders experience difficulty in functioning in several domains of life that are all not related to the illness and the symptoms. Medical management for severe mental disorders leads to improvement in symptoms and distress that may not always correlate with functional improvement. A comprehensive rehabilitative care is necessary to reengage the person in life activities and full participation in mainstream life. The Rehabilitation interventions are to be person centered with supports from the environment and removal of barriers to progress recovery. Rehabilitative care should be enhanced by integrated recovery-orientated practices that sustain hope, promote self-agency. This paper discusses the definition of psychiatric rehabilitation and a model of the processes involved.
Psychiatric Rehabilitation-Recovery-Mental illness- Mental Health Services
Early intervention of Autism Spectrum Disorder: translating research into practice
Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder, with increasing prevalence globally. Early intervention has been shown to improve the core deficits and result in a favorable outcome in children with ASD. Various interventional methods, novel mechanisms, and approaches are being widely researched. Though accelerating interventional research in ASD is observed globally, evidence from Indian setting is sparse. Given the uniqueness of cultural, socio-economic conditions, population statistics, existing health care and referral system, it is pivotal to develop and test interventional methods that are applicable and acceptable to the indigenous population. This paper reviews the currently available evidence-based treatment modalities in the Indian settings, with a specific focus on the behavioral interventions. Early diagnosis is seldom seen to translate into early intervention. In the background of the existing challenges, strategies to translate research into practice in terms of developing sustainable methods of service delivery, capacity building, training of trainers, need for liaison between experts and role of health care policy makers are discussed. Improving awareness among parents, medical professionals and stakeholders is the first step forward, towards translating research into practice.
Keywords: autism, ASD, early intervention, research, India
A cross-sectional study of factors associated with anti-depressant medication adherence in women attending an out patient psychiatry department
Introduction: Treatment adherence and illness may not be related only by the severity of the illness but by so many other factors which impact on seeking and continuing treatment; yet severity of the illness will be one of the major factors influencing treatment adherence. Methods: Female patients attending the psychiatric OPD, diagnosed with depression as per ICD-10 guidelines and provided informed consent participated in this questionnaire-based study. A total of 135 patients who attended the OPD in 9 months were assessed for the severity of depression and medication adherence by administering scales to assess the severity of depression and medication adherence was assessed by questioning about the drug taking and hospital attending behaviour. Out of this, thirty-one were attending for the first episode and hence were excluded from the analysis. Results: Out of the 104 female patients diagnosed with depression of more than one episode, 44 (42.3%) had mild depression, 52 (50%) had moderate depression and 8 (7.7%) had severe depression. Twenty-nine women (27.9%) were on medications and 75 (72.1%) women were not taking their medications. While greater proportion of women with mild depression were adherent to medication (51.7%), more women with moderate depression didn’t adhere to medication (54.7%), even though such difference was statistically not significant. Older age, having a paid work and married status were significantly associated with medication (antidepressants) adherence. Conclusions: Our results indicate that medication adherence is associated with factors other than severity of depression. Work and marital status played a significant role in determining the adherence to antidepressant medications among women. Keywords: Depression, medication adherence, compliance, female patients
Depression, medication adherence, compliance, female patients
Copyright (c) 2021 Indian Journal of Mental Health and Neurosciences
The inaugural issue of Indian Journal of Mental Health and Neurosciences is being published. A brief overview of the journal's aspirations and goals along with an overview of the contents is being provided.
Elderly Mental Health in Developing Countries
Geriatric Psychiatry deals with specific issues and challenges that arise in the assessment and management of mental health problems in elderly. As a specialty it has not received much attention in developing countries until recently. Elderly will soon be major consumers of mental health care in developing countries. Common psycho-social issues among the elderly and their impact on the mental health in the developing regions of the world and the complex interplay between physical health and mental health in the elderly are described. Dementia and depression are described in some detail focussing on relevant research to highlight the challenges in developing countries. Potential solutions to address the challenges of elderly mental health in developing countries are discussed.
Geriatric, elderly, mental health, developing countries, dementia, depression
Suicidality in children with Mild Intellectual Disability and Autism Spectrum Disorders admitted in an inpatient tertiary care centre in India
Challenges in management of Major Depression in patients with co-morbid medical conditions
Depression is a heterogeneous illness and depression with co-morbid physical illness may represent a phenotype of depression. Concurrent medical illness in depression is associated with greater functional and social impairment and significantly higher health care costs. A variety of mechanisms including lifestyle factors, immune-inflammatory pathways, medications and psychological factors have been proposed to explain the association between depression and physical illness. However, each of these pathways engenders unique challenges in managing such patients. Of utmost importance is to establish the nature of the underlying medical or psychological cause(s) which will inform customized management plans. This article initially reviews the prevalence of depression in medical conditions and vice versa. Subsequently, we move on to discuss specific approaches to diagnosis of depression in the context of medical co-morbidity. Finally, we describe evidence based pharmacological and psychosocial intervention strategies with some recommendations for common clinical scenarios. Evidence based care models to manage depression with physical illness are described which may be adapted for use in low resource settings
Depression, depressive disorder, co-morbidity, psychosomatic medicine; consultation-liaison psychiatry; psychiatry
Psychosocial issues of a antenatal mother with Covid 19
Abstract This paper deals with the case report of an AN mother who was diagnosed with Covid 19. The psycho social stressors experienced by her and the psychological intervention provided to her through telephone has been documented. The importance of telepsychiatry during the pandemic has been elucidated in this paper. Keywords: COVID 19, antenatal mother, mental health,
Copyright (c) 2020 Indian Journal of Mental Health and Neurosciences
A study of factors affecting the health seeking behaviour of people with pre-existing mental illness during the COVID-10 pandemic
BACKGROUND: Health or care seeking behavior has been defined as any action undertaken by individuals who perceive themselves to have a health problem or to be ill for the purpose of finding an appropriate remedy. A little understanding exists concerning socio-ecological barriers experience when seeking mental health care. we aimed at determining the factors that affect health seeking behavior of people with preexisting mental illness during COVID19 pandemic. METHODOLOGY: A Cross sectional study done for three months duration at Department of psychiatry, Chengalpattu Medical College & Hospital with sample size of 105. Ethical committee clearance was obtained.105 patients (age >18 years) consecutive patients having an International Classification of Disease 10 (ICD-10) psychiatric diagnosis, were included. Informed consent was obtained. Data regarding Socio demographic and clinical profile was obtained. RESULTS: In our study,39% of the patients belonged to 30-45 and 46-60 years of age, 6.7% of patients were between the age of above 60. 60% of study participants were male and the rest were female.69.5 % of patients had financial crisis ,70.5% of patients had decrease in the monthly income of the family by 30%or more.60% of patients had difficulty in travel to the hospital due to lack of transport facility during COVID pandemic. DISCUSSION AND CONCLUSION; Factors determining health-seeking behavior can help address problems and delay in early identification and optimal management of mental disorders during pandemic. Implementing community-based strategies to support resilience and psychologically vulnerable individuals during the COVID-19 crisis is fundamental for any community.
Crossroads in postgraduate psychiatry training in India
The specialist training program for psychiatrists in India is in need of an overhaul to enhance the competenecy of trainees.This will help future psychiatrists to keep themselves uptodate with the growing demands of the expanding field and ensure unifrom standards of teaching and assessment during examinations across the country. While continuing to support the core strengths of the training program, a robust system for periodic reviews to addess the lacunae in training is the need of the hour.
Copyright (c) 2019 Indian Journal of Mental Health and Neurosciences
Lockdown: A Focus on Emotions & Coping in Adolescents
Abstract Objective: The COVID lockdown has been the most significant life-changing experience this year. The sudden implementation of measures such as social distancing, closure of institutions, and restriction of movement may have affected the psychological well-being of adolescents. Keeping this in mind the present exploratory pilot study is an attempt to study and determine the psychological impact on adolescents during the lockdown. Material and Method: Data was collected from a sample of 461 adolescent respondents aged 14 to 20 years through an online survey Statistical Analysis: Descriptive statistics and Spearman’s correlation in SPSS version 24 Results: The majority of the study population (85.7%) reported happiness or a relaxed state of mind, and the next common emotion was boredom. Amongst the 69% of participants also conveyed that stressful/negative thoughts, lack of direct contact with friends were the predominant stressor. Coping behaviors highlighted were spending time with family (93.6%), communicating with friends (96.1%), engaging in hobbies (88.7%), talking to relatives (79.6%), studying (72.7%), and exercising (70.9%). In contrast, the majority (73.3%) indulged in excessive sleep or increased usage of social media platforms or apps. Conclusion: This study is the only survey to document adolescents’ mental health in India during the Covid-19 lockdown. The study highlights that happiness and boredom reflected the young mind of these adolescents, and significantly only one third reported any physical or mental health impact with the lockdown. Keywords: adolescents, COVID-19, mental health, thoughts, emotions, coping mechanisms
Prevalence of physical comorbidities among long-term psychiatric inpatients: A single centre study from South India
Background: Physical comorbidities are the most common causes of early mortality among patients with mental disorders. Prevention and early treatment of physical comorbidities would lead to better outcomes. Hence, the aim to the study estimate the prevalence of physical health disorders present as comorbidities among long-term stay psychiatric inpatients and to examine the difference in the physical comorbidities among male and female patients. Materials and methods: The study was conducted at Institute of Mental Health, Madras Medical College, Chennai. It was a quantitative, descriptive study combining data from clinical files and nursing records related to the physical health of the long-term inpatients. The clinical records of the patients who were long-term psychiatric inpatients, defined as the duration of stay in the care facility for more than 5 continuous years, were accessed between 1 January and 30 June 2019. The statistical analysis was done using SPSS 16.0. Results: The estimated prevalence was 74.2% (95% CI: 69.5-78.6) for at least one physical disorder comorbidity and 38.8% (95% CI: 33.8-43.9) had more than one physical comorbidity. Female in-patients have 2.7 times higher risk than males to have diabetes mellitus, hypertension and thyroid disorders. They also have 0.92 times higher risk than males to have anaemia. Conclusion: There is a high prevalence of physical comorbidities among long term psychiatric inpatients. Systems for the early detection and better clinical management of these physical comorbidities are essential in any long-term psychiatric facility.
Association between severity and repetitive behaviours among children with autism spectrum disorder and anxiety and depression among their primary caregivers
Background: Autism spectrum disorder (ASD) is one of the most common pervasive developmental disorder and present with varied severity and clinical presentation. The diagnosis of ASD in the children has a huge psychological impact among their primary caregivers, leading to distress and mental health issues. The aim of our study was to assess the association between the severity and repetitive behaviours in children with autism spectrum disorder and anxiety and depression levels among their primary caregivers. Materials and methods: Children with autism spectrum disorder and their primary caregivers were recruited from the child psychiatry unit of large tertiary children hospital in south India, after informed consent. Severity of ASD was assessed by Childhood Autism Rating Scale – 1 (CARS-1) and repetitive behaviour by Repetitive behaviour scale - Revised (RBS-R). Among the caregivers, anxiety levels were assessed by Hamilton rating scale for Anxiety (HAM-A) and depression levels were assessed by Hamilton rating scale for Depression (HAM-D). Results: We recruited 100 children with ASD and their mothers (primary caregivers) in the study. The prevalence of anxiety and depression among mothers of children with ASD was 44% and 30%. Statistically significant correlation was observed between CARS scores and HAM-A (p=0.002) and HAM-D (p<0.001) scores. Among the repetitive behaviours, self-injurious behaviour was found to be significantly associated with anxiety (p<0.001) and depression (p<0.001) scores, while stereotyped (P=0.002) and compulsive (p=0.004) behaviours were associated with depression scores. Conclusion: There is a significant association between severity of autism spectrum disorder and anxiety and depression among their mothers.
Epigenetics is defined as the changes in gene expression that lead to predictable, stable and possibly heritable alterations in cell function that are not due to changes in DNA sequence. It is of major relevance in psychiatry since environmental factors like stress or substance abuse, significant contribute in causing psychiatric pathologies like depression, anxiety, depression, etc. Epigenetics research in psychiatry would give an opportunity to extend the outlook and approach towards psychiatric pathologies. Hence timely interventions would be sought for. This would also allow gaining access to ‘brain tissue’ from live patients with mental illness and predicting occurrence of or vulnerability to psychiatric illnesses by evaluation of biomarkers, thus preventing, reversing or atleast curbing the progress at an initial stage. There are evidences of work done in the field of epigenetics both in pre-clinical as well as clinical settings. It is remarkable to see how the DNA methylation at various sites can result in alteration of the mental health of an individual and also how this can affect as early as during the first week of life. This is an exciting frontier in psychiatry, providing long sought biomarkers for predicting complex and devastating human behaviours as well as mental illnesses.
Epigenetics, psychiatry, gene-environmental interaction, vulnerability, psychiatric pathologies.
Early use of electroconvulsive therapy in individuals with first episode psychosis: A case series
The use of electroconvulsive therapy (ECT) in various neuropsychiatric disorders has been well accepted. ECT has been proven to be safe and effective in adolescents and in old age. However, only a handful of literature is available on its effectiveness in first episode psychosis (FEP). In this case series, individuals with FEP who received ECT in their 1st month of treatment for various indications were described. During follow-up, subjects showed considerable improvement in their psychopathology and functional outcomes. None of them had any adverse events during or after ECT sessions. Thus, the present case series highlights the usefulness and safety of early use of ECT in individuals with first episode psychosis and its effectiveness in reducing the acute symptoms leading to remission and better outcomes.
Keywords: electroconvulsive therapy, firstepisode psychosis, case series