Indian Journal of Psychiatry (Indian J Psychiatr)

Publisher: Indian Psychiatric Society, Medknow Publications

Journal description

The Indian Journal of Psychiatry is an official publication of the Indian Psychiatric Society. It is published quarterly with one additional supplement (total 5 issues). The IJP publishes original work in all the fields of psychiatry. All papers are peer-reviewed before publication.

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Impact Factor Rankings

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5-year impact 0.00
Cited half-life 0.00
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Article influence 0.00
Website Indian Journal of Psychiatry website
ISSN 0019-5545
OCLC 226369857
Material type Series, Periodical
Document type Journal / Magazine / Newspaper

Publisher details

Medknow Publications

  • Pre-print
    • Author can archive a pre-print version
  • Post-print
    • Author can archive a post-print version
  • Conditions
    • Non-commercial
    • Publisher's version/PDF may be used
    • Creative Commons Attribution Non-Commercial Share Alike License
    • Published source must be acknowledged
    • All titles are open access journals
  • Classification
    ​ green

Publications in this journal

  • Indian Journal of Psychiatry 07/2016; 57(6(supplement)):286-95.
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    ABSTRACT: Response rates to first line antidepressant therapy are abysmally low, and more so in older adults. Ketamine has been used successfully in treatment‑resistant depression (TRD), and in nongeriatric population, with response rates at 24 and 72 h postinfusion being 25–85% and 14–72%, respectively.[1] The postulated mechanism of action is through antagonism of N‑methyl‑D‑aspartate receptors.[2] A 65‑year‑old retired civil servant, living with her husband had fourth episode of depressive illness. In the last 3 years, the illness showed increasing resistance to antidepressant medication(s) with each additional episode. The first episode remitted with escitalopram (10 mg/day), the second episode required higher dosage of escitalopram (40 mg/ day), and later, augmentation with amisulpride 25 mg/ day, and the third episode remitted with duloxetine (up to 60 mg/day) (as she had relapsed while on escitalopram) and amisulpride 100 mg/day. In the inter-episode period, the patient had attended all follow‑up appointments and continued with prescribed medication. In this episode, she had failed treatment with duloxetine + amisulpride, agomelatine, and agomelatine + amisulpride, respectively. Informed consent was obtained from the patient. Ketamine infusion (0.5 mg/kg diluted in 100 ml of normal saline) was given over 40 min, under the supervision of consultant anesthetist (RSG). Ratings of mood (Hamilton rating scale for depression [HAMD])[2] and side effects (Clinician Administered Dissociative States Scale)[3] were undertaken on morning of the infusion, and 1, 2, and 4 h following infusions, and on in between days of the infusion [labelled as postinfusion days in Table 1]. Four days after the 4th infusion (HAMD = 10), the patient feeling very much improved subjectively, the ketamine infusions were discontinued, with the provision that further infusions may be required if the depressive symptoms recurred. Agomelatine 50 mg/day was continued through the infusion period and in the follow‑up phase. Remission (HAMD <7) was maintained for another 1 year (HAMD administered biweekly for first 2 weeks, then weekly for 4 weeks, and then monthly) when the patient discontinued follow‑up visits. The side effects reported with the infusions were – alteration of passage of time (infusion 3, hours 1 and 2) and mild gaps in memory (infusion 4, hour 2). These symptoms disappeared in an hour of the infusion. The case illustrates several points of interest: From the first episode 3 years ago, subsequent episodes became more difficult to treat; amisulpride worked effectively as augmentation agent in the previous episodes when co‑administered with a selective serotonin reuptake inhibitor and serotonin and norepinephrine reuptake inhibitors, respectively, ketamine was well tolerated with minor and transient side effects; and the remission induced by ketamine infusions was maintained on the same antidepressant agomelatine. Contrary to previous literature, where ketamine has been used as a “last resort in pharmacotherapy” for TRD, it was used relatively early in the course of illness. The aim was to abort the depressive episode as longer unresolved episodes lead to poor prognosis.[5] To the best of our knowledge, this is the first report of use of ketamine in late onset depression, and illustrates therapeutic efficacy and safety of ketamine in an older adult, and conversion from treatment resistant to treatment responder on the same antidepressant.
    Indian Journal of Psychiatry 10/2015; 57(3):330-1.
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    ABSTRACT: The institution of marriage in Hindus is regulated by the prevailing social norms and the Hindu Marriage Act (HMA), 1955. Married women with mental illness are heavily discriminated. This paper examines the social and legal aspects of Hindu marriage in women with mental illness. The HMA, 1955 lays down the conditions for a Hindu marriage and also provides matrimonial reliefs: Nullity of marriage, restitution of conjugal rights, judicial separation and divorce. The application of the provisions of HMA in the setting mental illness is difficult and challenging. There is a wide gap between the legislative provisions of HMA, and societal value systems and attitudes towards marriage in Indian society. Societal norms are powerful and often override the legal provisions. The disparities are most glaring in the setting of mental illness in women. This is a reflection of social stigma for mental illness and patriarchal attitude towards women. Concerted efforts are needed to bridge the gap between the legislative provisions of HMA and societal value systems and attitudes toward marriage. Awareness programs regarding the nature and types of mental illness, advances in treatment and information about good outcome of severe mental illness will be helpful. Improvement in moral and religious values will overcome to some extent the negative attitudes and patriarchal mind set toward married women with mental illness.
    Indian Journal of Psychiatry 09/2015; 57(Suppl 2):S324-32. DOI:10.4103/0019-5545.161499
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    ABSTRACT: Suicide is a global public health problem. Asia accounts for 60% of the world's suicides, so at least 60 million people are affected by suicide or attempted suicide in Asia each year. The burden of female suicidal behavior, in terms of total burden of morbidity and mortality combined, is more in women than in men. Women's greater vulnerability to suicidal behavior is likely to be due to gender related vulnerability to psychopathology and to psychosocial stressors. Suicide prevention programmes should incorporate woman specific strategies. More research on suicidal behavior in women particularly in developing countries is needed.
    Indian Journal of Psychiatry 09/2015; 57(Suppl 2):S233-8. DOI:10.4103/0019-5545.161484
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    ABSTRACT: Untreated perinatal depression and anxiety disorders are known to have significant negative impact on both maternal and fetal health. Dilemmas still remain regarding the use and safety of psychotropics in pregnant and lactating women suffering from perinatal depression and anxiety disorders. The aim of the current paper was to review the existing evidence base on the exposure and consequences of antidepressants, anxiolytics, and hypnotics in women during pregnancy and lactation and to make recommendations for clinical decision making in management of these cases. We undertook a bibliographic search of Medline/PubMed (1972 through 2014), Science Direct (1972 through 2014), Archives of Indian Journal of Psychiatry databases was done. References of retrieved articles, reference books, and dedicated websites were also checked. The existing evidence base is extensive in studying multiple outcomes of the antidepressant or anxiolytic exposure in neonates, and some of the findings appear conflicting. Selective serotonin reuptake inhibitors are the most researched antidepressants in pregnancy and lactation. The available literature is criticized mostly on the lack of rigorous well designed controlled studies as well as lacunae in the methodologies, interpretation of statistical information, knowledge transfer, and translation of information. Research in this area in the Indian context is strikingly scarce. Appropriate risk-benefit analysis of untreated mental illness versus medication exposure, tailor-made to each patient's past response and preference within in the context of the available evidence should guide clinical decision making.
    Indian Journal of Psychiatry 07/2015; 57(Suppl 2):S354-71. DOI:10.4103/0019-5545.161504
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    ABSTRACT: Management of bipolar during pregnancy and postpartum is very challenging. The treating clinicians have to take into account various factors like current mental state, longitudinal history of the patient, past history of relapse while off medication, response to medication, time of pregnancy at which patient presents to the clinician, etc. The choice of drug should depend on the balance between safety and efficacy profile. Whenever patient is on psychotropic medication, close and intensive monitoring should be done. Among the various mood stabilizers, use of lithium during the second and third trimester appears to be safe. Use of valproate during first trimester is associated with major malformation and long-term sequalae in the form of developmental delay, lower intelligence quotient, and higher risk of development of autism spectrum disorder. Similarly use of carbamazepine in first trimester is associated with higher risk of major congenital malformation and its use in first trimester is contraindicated. Data for lamotrigine (LTG) appears to be more favorable than other antiepileptics. During lactation, use of valproate and LTG is reported to be safe. Use of typical and/atypical antipsychotic is a good option during pregnancy in women with bipolar disorder.
    Indian Journal of Psychiatry 07/2015; 57(Suppl 2):S308-23. DOI:10.4103/0019-5545.161498
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    ABSTRACT: Alcohol and substance use, until recently, were believed to be a predominantly male phenomenon. Only in the last few decades, attention has shifted to female drug use and its repercussions in women. As the numbers of female drug users continue to rise, studies attempt to understand gender-specific etiological factors, phenomenology, course and outcome, and issues related to treatment with the aim to develop more effective treatment programs. Research has primarily focused on alcohol and tobacco in women, and most of the literature is from the Western countries with data from developing countries like India being sparse. This review highlights the issues pertinent to alcohol and substance use in women with a special focus to the situation in India.
    Indian Journal of Psychiatry 07/2015; 57(Suppl 2):S275-85. DOI:10.4103/0019-5545.161491
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    ABSTRACT: Several reasons justify the need for nonpharmacological interventions for bipolar disorder (BD) in women. This review focuses on psychosocial therapies for BDs in women. The research evidence for a wide range of psychosocial interventions for the management of BDs in women has been presented. All the interventions have some common components like targeting disease management, information regarding illness, and coping skills. There also are distinctive features like cognitive restructuring and self-rated mood charts in cognitive behavior therapy, regulation of sleep/wake cycles and daily routines in interpersonal sleep regulation therapy, and communication skill training in family treatments. Many psychosocial interventions hold promise as adjunctive therapies for bipolar patients. In India, there is a considerable dearth of literature in this area due lack of skilled staff for psychosocial interventions. Future trials need to: Clarify which populations are most likely to benefit from which strategies; identify putative mechanisms of action; systematically evaluate costs, benefits, and generalizability of effects, and record adverse effects.
    Indian Journal of Psychiatry 07/2015; 57(Suppl 2):S264-74. DOI:10.4103/0019-5545.161490
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    ABSTRACT: Women's mental health is closely linked to their status in society. This paper outlines the clinical features of women with schizophrenia and highlights the interpersonal and social ramifications on their lives. There is no significant gender difference in the incidence and prevalence of schizophrenia. There is no clear trend in mortality, although suicides seem to be more in women with schizophrenia. In India, women face a lot of problems, especially in relation to marriage, pregnancy, childbirth, and menopause. Most studies have shown better premorbid functioning, and social adjustment for women compared with men. There is a great need to plan for gender-sensitive mental health services targeting the special needs of these women. Women caregivers also deserve due attention.
    Indian Journal of Psychiatry 07/2015; 57(Suppl 2):S246-51. DOI:10.4103/0019-5545.161487
  • Indian Journal of Psychiatry 07/2015; 57(Suppl 2):S201-4. DOI:10.4103/0019-5545.161478
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    ABSTRACT: Postpartum period is demanding period characterized by overwhelming biological, physical, social, and emotional changes. It requires significant personal and interpersonal adaptation, especially in case of primigravida. Pregnant women and their families have lots of aspirations from the postpartum period, which is colored by the joyful arrival of a new baby. Unfortunately, women in the postpartum period can be vulnerable to a range of psychiatric disorders like postpartum blues, depression, and psychosis. Perinatal mental illness is largely under-diagnosed and can have far reaching ramifications for both the mother and the infant. Early screening, diagnosis, and management are very important and must be considered as mandatory part of postpartum care.
    Indian Journal of Psychiatry 07/2015; 57(Suppl 2):S216-21. DOI:10.4103/0019-5545.161481
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    ABSTRACT: Women, the fair sex, are principal providers of care and support to families. But, they are considered to be the weaker sex and one of the most powerless and marginalized sections of our society. The provision of Rehabilitation for mentally ill women has been, and still is, one of the major challenges for mental health systems reform in the last decades, for various reasons. The present paper discusses the global and Indian scenario of rehabilitation of mentally ill women and goes on to detail the contribution of the state and voluntary agencies in this regard. It explores the need of recovery, multilayered strategy of Rehabilitation services and the availability of present services. The stigma attached and legal defects which interfere in good quality of life for the mentally ill women are reviewed. Strategies for changes in future are recommended.
    Indian Journal of Psychiatry 07/2015; 57(Suppl 2):S345-53. DOI:10.4103/0019-5545.161503
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    ABSTRACT: Research on psychotropic medications during pregnancy and lactation is limited as often involves complex ethical issues. Information on safety of psychotropic drugs during these critical phases is either inconclusive or undetermined. Many women with severe mental illness have unplanned pregnancies and require antipsychotic medication during pregnancy and lactation. Multiple issues have to be considered while choosing safe treatments for pregnant and lactating women and the best approach is to individualize the treatment. Medication should be guided primarily by its safety data and by the psychiatric history of the patient. Important issues to be kept in mind include pre-pregnancy counseling for all women, including planning pregnancies; folate supplementation, discussion with patient and family regarding options, and active liaison with obstetricians, ultrasonologists and pediatricians. Whenever possible, non-pharmacological approaches should be used in addition.
    Indian Journal of Psychiatry 07/2015; 57(Suppl 2):S303-7. DOI:10.4103/0019-5545.161497
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    ABSTRACT: Gender is a critical determinant of mental health and mental illness. The patterns of psychological distress and psychiatric disorder among women are different from those seen among men. Women have a higher mean level of internalizing disorders while men show a higher mean level of externalizing disorders. Gender differences occur particularly in the rates of common mental disorders wherein women predominate. Differences between genders have been reported in the age of onset of symptoms, clinical features, frequency of psychotic symptoms, course, social adjustment, and long-term outcome of severe mental disorders. Women who abuse alcohol or drugs are more likely to attribute their drinking to a traumatic event or a stressor and are more likely to have been sexually or physically abused than other women. Girls from nuclear families and women married at a very young age are at a higher risk for attempted suicide and self-harm. Social factors and gender specific factors determine the prevalence and course of mental disorders in female sufferers. Low attendance in hospital settings is partly explained by the lack of availability of resources for women. Around two-thirds of married women in India were victims of domestic violence. Concerted efforts at social, political, economic, and legal levels can bring change in the lives of Indian women and contribute to the improvement of the mental health of these women.
    Indian Journal of Psychiatry 07/2015; 57(Suppl 2):S205-11. DOI:10.4103/0019-5545.161479
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    ABSTRACT: Menopause is one of the most significant events in a woman's life and brings in a number of physiological changes that affect the life of a woman permanently. There have been a lot of speculations about the symptoms that appear before, during and after the onset of menopause. These symptoms constitute the postmenopausal syndrome; they are impairing to a great extent to the woman and management of these symptoms has become an important field of research lately. This chapter attempts to understand these symptoms, the underlying pathophysiology and the management options available.
    Indian Journal of Psychiatry 07/2015; 57(Suppl 2):S222-32. DOI:10.4103/0019-5545.161483
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    ABSTRACT: Eating disorders, especially anorexia nervosa and bulimia nervosa have been classically described in young females in Western population. Recent research shows that they are also seen in developing countries including India. The classification of eating disorders has been expanded to include recently described conditions like binge eating disorder. Eating disorders have a multifactorial etiology. Genetic factor appear to play a major role. Recent advances in neurobiology have improved our understanding of these conditions and may possibly help us develop more effective treatments in future. Premorbid personality appears to play an important role, with differential predisposition for individual disorders. The role of cultural factors in the etiology of these conditions is debated. Culture may have a pathoplastic effect leading to non-conforming presentations like the non fat-phobic form of anorexia nervosa, which are commonly reported in developing countries. With rapid cultural transformation, the classical forms of these conditions are being described throughout the world. Diagnostic criteria have been modified to accommodate for these myriad presentations. Treatment of eating disorders can be quite challenging, given the dearth of established treatments and poor motivation/insight in these conditions. Nutritional rehabilitation and psychotherapy remains the mainstay of treatment, while pharmacotherapy may be helpful in specific situations.
    Indian Journal of Psychiatry 07/2015; 57(Suppl 2):S286-95. DOI:10.4103/0019-5545.161493
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    ABSTRACT: India has one of the fastest growing youth populations in the world. Girls below 19 years of age comprise one-quarter of India's rapidly growing population. In spite of India's reputation for respecting women, to an extent to treat her as a goddess, the moment a baby is born, the first thing comes to mind is "boy or girl?" as the differences are beyond just being biological. This article examines the significance of various psychological constructs and psychosocial issues that are important in the life of a "girl" baby born in our country.
    Indian Journal of Psychiatry 07/2015; 57(Suppl 2):S212-5. DOI:10.4103/0019-5545.161480
  • Indian Journal of Psychiatry 07/2015; 57(Suppl 2):S199-200. DOI:10.4103/0019-5545.161477