Pratap Sharan

All India Institute of Medical Sciences | AIIMS · Department of Psychiatry

Introduction The Arizona Sexual Experiences Scale (ASEX) is a brief questionnaire that evaluates five major aspects of sexual function: sex drive, arousal, erectile function/vaginal lubrication, ability to reach orgasm, and satisfaction with orgasm. An advantage of the ASEX is its simplicity and brevity (five items), making it suitable for the scre...

This book is specifically designed for postgraduate students in psychiatry at all stages of their training, with particular emphasis on those in their first year. Chapters written by experts with a long clinical and postgraduate teaching experience offer insights into the fundamentals of clinical examination in psychiatry helping the trainee reside...

Aims 1. To study the neural correlates of OCD using functional MRI. 2. To compare the neural correlates of the pure washer dimension of OCD with other dimensions of OCD and healthy controls. Methods It was a cross-sectional, case-control study conducted from 2018 to 2021. OCD patients were recruited with purposive sampling from outpatient attendan...

The UPPS-P Impulsive Behavior Model and the various psychometric instruments developed and validated based on this model are well established in clinical and research settings. However, evidence regarding the psychometric validity, reliability, and equivalence across multiple countries of residence, languages, or gender identities, including gender...

Although COVID-19 vaccines have demonstrated efficacy, there is variability in health professionals’ attitudes towards these agents. Factors associated with mental health professionals’ attitudes towards COVID-19 vaccination are not well understood. We investigated these factors by administering a newly developed measure, the COVID-19 Vaccine Attit...

Background The classification of mental, behavioural and neurodevelopmental disorders in the World Health Organization's International Classification of Diseases 11th revision (ICD‐11) includes a comprehensive set of behavioural indicators (BIs) within the neurodevelopmental disorders grouping. BIs can be used to assess the severity of disorders of...

Background. Depression and anxiety are among the most prevalent mental health issues experienced worldwide. However, whereas cross-cultural studies utilize psychometrically valid and reliable scales, fewer can meaningfully compare these conditions across different groups. To address this gap, the current study aimed to psychometrically assess the B...

Objectives: This study aimed to examine the psychometric properties of the P4 suicide screener in a multinational sample. The primary goal was to evaluate the reliability and validity of the scale and investigate its convergent validity by analyzing its correlation with depression, anxiety, and substance use. Study design: The study design is a cro...

Background The three-item Sexual Distress Scale (SDS-3) has been frequently used to assess distress related to sexuality in public health surveys and research on sexual wellbeing. However, its psychometric properties and measurement invariance across cultural, gender and sexual subgroups have not yet been examined. This multinational study aimed to...

Background and aims Problematic pornography use (PPU) is a common manifestation of the newly introduced Compulsive Sexual Behavior Disorder diagnosis in the 11th edition of the International Statistical Classification of Diseases and Related Health Problems. Although cultural, gender‐ and sexual orientation‐related differences in sexual behaviors a...

Objective We analyzed adult ADHD symptoms in a cross-cultural context, including investigating the occurrence and potential correlates of adult ADHD and psychometric examination of the Adult ADHD Self-Report Scale (ASRS) Screener. Method Our analysis is based on a large-scale research project involving 42 countries (International Sex Survey, N=72,...

Background and aims: Problematic pornography use (PPU) is a common manifestation of the newly introduced Compulsive Sexual Behavior Disorder diagnosis in the 11th edition of the International Statistical Classification of Diseases and Related Health Problems. Although cultural, gender- and sexual orientation-related differences in sexual behaviors...

Background Obsessive-compulsive disorder (OCD) is a common psychiatric disorder whose underlying pathophysiology is insufficiently understood. The pathophysiology of OCD may be related to abnormalities in the biochemistry of neurotransmitters. Aim The aim of the present study was to measure the absolute concentration of various metabolites in the...

Background: The duration of untreated psychosis (DUP) impacts symptomatic and functional outcome in patients with psychosis. Objectives: This study assessed DUP, its association with sociodemographic and clinical factors and its impact on short-term clinical and functional outcome in patients with first episode psychosis. Methodology: Sixty-nine f...

Introduction: Despite being a widely used screening questionnaire, there is no consensus on the most appropriate measurement model for the Alcohol Use Disorders Identification Test (AUDIT). Furthermore, there have been limited studies on its measurement invariance across cross-cultural subgroups, genders, and sexual orientations. Aims: The present...

Background: Increased levels of occupational stress among health professionals during the COVID-19 pandemic have been documented. Few studies examined the effects of the pandemic on mental health professionals despite the heightened demand for their services. Method: A multilingual, longitudinal, global survey was conducted at three time points...

Background and objectives: Dissociative convulsions represent complex biopsychosocial etiopathogenesis and have semiological similarities with epilepsy, which leads to delays in definitive diagnosis as well as treatment. We explored the neurobiological underpinnings of dissociative convulsions using a functional magnetic resonance imaging (fMRI) d...

Aims: Mental disorders characterized by preoccupation with distressing bodily symptoms and associated functional impairment have been a target of major reconceptualization in the ICD-11, in which a single category of Bodily Distress Disorder (BDD) with different levels of severity replaces most of the Somatoform Disorders in ICD-10. This study com...

Background In anxiety disorders, culture is important in symptom presentation and help-seeking. Most tools for anxiety disorders are not validated in India and thus might not capture culture-specific aspects of anxiety. This study aims to identify and generate culturally specific terms to describe symptoms of anxiety as part of the development of t...

A 26-year-old female was hospitalized with complaints of repeated vomiting and weight loss (18 kg in 8 months); and incessant belching and nausea/regurgitation for 30 days subsequent to her COVID-19 treatment. After all the normal medical radiological reports, appropriate psychological and psychiatric evaluations were done. Incessant belching warra...

psychiatric co-morbidity in patients recovering from Covid-19 infection

Examines psychiatric epidemiology's unique evolution, conceptually and socially, within and between diverse regions and cultures, underscoring its growing influence on the biopolitics of nations and worldwide health campaigns.

Background and Aims Breast cancer is the commonest cancer worldwide.(1) Multiple level paravertebral anaesthesia (PVA) provides excellent analgesia with minimal PONV (2); therefore, we wanted to ascertain if PVA would improve quality of life (QoL) at 2weeks postoperatively in these patients. Methods We included female patients of > 18 years, of AS...

Background and Aims Breast cancer is the commonest cancer worldwide.(1) Multiple level paravertebral anaesthesia (PVA) provides excellent analgesia with minimal PONV (2); therefore, we wanted to ascertain if PVA would improve quality of life (QoL) at 2weeks postoperatively in these patients. Methods We included female patients of > 18 years, of AS...

Students are often vulnerable to a variety of mental illnesses. Attending a school, college or university can be a stressful experience for some individuals and it might predispose some students to develop a mental illness. It is estimated that about 75% of those with mental disorders exhibit their first symptom in childhood and adolescence. Mental...

In this article, an anthropologist and a psychiatrist examine a Sufi shrine-based concept of affliction known as asrat (an “effect” in Hindi-Urdu, “difficulty” in Arabic) and related practices of healing in urban north India. Rather than being located in an individual body, asrat afflictions are shared, most often within a household or kinship grou...

Background: The World Health Organization (WHO) has approved the 11th Revision of the International Classification of Diseases (ICD-11). A version of the ICD-11 for Mental, Behavioural and Neurodevelopmental Disorders for use in clinical settings, called the Clinical Descriptions and Diagnostic Requirements (CDDR), has also been developed. The CDD...

Background COVID-19 has profoundly affected the work of mental health professionals with many transitioning to telehealth to comply with public health measures. This large international study examined the impact of the pandemic on mental health clinicians’ telehealth use. Methods This survey study was conducted with mental health professionals, pr...

Background/Objective: The most recent versions of the two main mental disorders classifications—the World Health Organization's ICD-11 and the American Psychiatric Association's DSM–5—differ substantially in their diagnostic categories related to transgender identity. ICD-11 gender incongruence (GI), in contrast to DSM-5 gender dysphoria (GD), is...

An estimated 197.3 million people have mental disorders in India, and majority of the population have either no or limited access to mental health services. Thus, the country has a huge burden of mental disorders, and there is a significant treatment gap. Public mental health measures have become a developmental priority so that sustainable gains m...

Background: People working in the health sector were being labelled, stereotyped, discriminated against, stigmatized, and treated indifferently in the early phase of coronavirus disease 2019 (COVID-19) pandemic. To assess social stigma, perceived stress, and psychological distress among hospital security guards during the COVID-19 pandemic.Methods:...

Background: We report results of an internet-based field study evaluating the diagnostic guidelines for ICD-11 mood disorders. Accuracy of clinicians' diagnostic judgments applying draft ICD-11 as compared to the ICD-10 guidelines to standardized case vignettes was assessed as well as perceived clinical utility. Methods: 1357 clinician members o...

Objective: ICD-11 clinical guidelines for mental and behavioral disorders must be tested in clinical settings to guarantee their usefulness worldwide. The purpose of this study was to evaluate interrater reliability and clinical utility of the ICD-11 guidelines for children and adolescents in assessing and diagnosing mood, anxiety, and fear-relate...

Background The diagnosis of paraphilic disorder is a complicated clinical judgment based on the integration of information from multiple dimensions to arrive at a categorical (present/absent) conclusion. The recent update of the guidelines for paraphilic disorders in ICD-11 presents an opportunity to investigate how mental health professionals use...

The challenge of producing a classificatory system that is truly representative of different regions and cultural variations is difficult. This can be conceptualized as an ongoing process, achievable by constant commitment in this regard from various stakeholders over successive generations of the classificatory systems. The objective of this artic...

Background: Quarantine has been used as a public health measure to contain the spread of communicable diseases. Its use in the current COVID-19 pandemic is based on experience from the past while handling other coronavirus infections. Objectives: The aim of this study is to synthesize the available literature focusing on the psychological and socia...

Purpose The Hijra community is a cultural and gender grouping in South Asia broadly similar to western transgender communities, but with literature suggesting some differences in gender experience and patterns of psychosocial adversity. The present study aims to describe patterns of mental illness and psychoactive substance use in Hijra subjects an...

Background There is little data on the prevalence and effects of eating disorders in patients with T2DM. Aims To evaluate the presence of eating disorders (ED) and their association with glycemic control and metabolic parameters in adult patients with type 2 diabetes mellitus (T2DM). Methods A cross-sectional study was conducted in the endocrinol...

Background Severe irritability has become an important topic in child and adolescent mental health. Based on the available evidence and on public health considerations, WHO classified chronic irritability within oppositional defiant disorder (ODD) in ICD‐11, a solution markedly different from DSM‐5’s (i.e. the new childhood mood diagnosis, disrupti...

Background: Women's experiences of female sexual difficulties are shaped by cultural expectations. Aim of the study: To investigate the cultural validity and clinical utility of the classification of female sexual dysfunctions (FSD) in the International Classification of Diseases - 11th Revision (ICD-11) among Indian Women. Methods: A purposiv...

Background. This article reports the results of one of a series of global field studies implemented by the World Health Organization (WHO) to evaluate the accuracy, clinical utility, and global applicability of the new diagnostic guidelines for Mental, Behavioural and Neurological Disorders included in the next version of WHO’s International Classi...

This book is for undergraduate medical students and is compliant with recently introduced competency based curriculum. The book is based on DSM-5. Key points at the end of the chapter help in quick revision. Case based questions help to understand the clinical presentation of the disorder.

Pairwise similarity judgments and card sorting methodologies are different ways of generating data for similarity matrices used in various analyses such as multidimensional scaling and cluster analysis. Pairwise similarity judgments are considered the gold standard methodology, but can be cumbersome for large numbers of stimuli given the geometric...

Developed in collaboration with WHO Department of Mental Health and Substance Abuse, this study (conducted in India, the UK, and the USA) integrated feedback from mental health service users into the development of the chapter on mental, behavioural, and neurodevelopmental disorders for ICD-11. The ICD-11 will be used for health reporting from Janu...

Background: The World Health Organization (WHO) International Classification of Diseases and Related Health Problems (ICD) is used globally by 194 WHO member nations. It is used for assigning clinical diagnoses, providing the framework for reporting public health data, and to inform the organization and reimbursement of health services. Guided by o...

Aim The purpose of this study, using ¹H‐Magnetic Resonance Spectroscopy (¹H‐MRS), was to examine the treatment related changes in the neurochemicals in 28 unmedicated obsessive compulsive disorder (OCD) patients Methods We included subjects diagnosed with OCD (n=28) with a total duration of illness <5 years as a study group and matched healthy con...

Following approval of the ICD‐11 by the World Health Assembly in May 2019, World Health Organization (WHO) member states will transition from the ICD‐10 to the ICD‐11, with reporting of health statistics based on the new system to begin on January 1, 2022. The WHO Department of Mental Health and Substance Abuse will publish Clinical Descriptions an...

Personality disorders have complex multifactorial etiology with social and cultural factors playing a significant role in their genesis. The prevalence and manifestations of personality disorders varies across different countries emphasizing the need for cross-cultural studies to understand these differences. The chapter describes various sociocult...

Classifications of psychotic disorders are moving towards utilizing dimensional symptom domains as the preferred mechanism for describing psychotic symptomatology. The ICD-11 has proposed six symptom domains (Positive symptoms, Negative symptoms, Depressive symptoms, Manic symptoms, Psychomotor symptoms, and Cognitive symptoms) that would be rated...

In this paper we report the clinical utility of the diagnostic guidelines for ICD‐11 mental, behavioural and neurodevelopmental disorders as assessed by 339 clinicians in 1,806 patients in 28 mental health settings in 13 countries. Clinician raters applied the guidelines for schizophrenia and other primary psychotic disorders, mood disorders (depre...

Background/Objective: The World Health Organization's diagnostic guidelines for ICD-11 mental and behavioural disorders must be tested in clinical settings around the world to ensure that they are clinically useful and genuinely global. The objective is evaluate the inter-rater reliability and clinical utility of ICD-11 guidelines for psychotic, mo...

Tacrolimus is one of the mainstays for post-transplant immunosuppression. A variety of neuropsychiatric adverse effects have been reported above the levels of its therapeutic use. Manic symptoms associated with its use have been rarely reported. We report possibly the first such case in a child post-renal transplantation and discuss the potential n...

Background/Objective: Collaborative teamwork in global mental health presents unique challenges, including the formation and management of international teams composed of multicultural and multilingual professionals with different backgrounds in terms of their training, scientific expertise, and life experience. The purpose of the study was to anal...

Reliable, clinically useful, and globally applicable diagnostic classification of mental disorders is an essential foundation for global mental health. The World Health Organization (WHO) is nearing completion of the 11th revision of the International Classification of Diseases and Related Health Problems (ICD-11). The present study assessed inter-...

Background: Dhat syndrome is regarded by many as a culture bound syndrome of the Indian sub-continent. However the nosological status, conceptual understanding of the condition as well as the diagnostic guidelines are all mired in controversy. Aims: The current study aims to study the psychopathology of Dhat syndrome in men by using a qualitativ...

Patients with many psychiatric disorders have considerable internalized stigma. The current study intended to examine the level and impact of internalized stigma in patients with bipolar affective disorder (BPAD). 60 patients with BPAD, 33 patients with schizophrenia and 30 patients with anxiety disorders were compared on Internalized Stigma of Men...

Contemporary mental health practice primarily centers around the neurobiological and psychological processes at the individual level. However, a more careful consideration of interpersonal and other group-level attributes (e.g., interpersonal relationship, mutual trust/hostility, interdependence, and cooperation) and a better grasp of their patholo...

Aim and methods: The aim of this article is to provide a narrative literature review of the 'third gender' phenomenon in Brazil ( Travestis), India ( Hijras) and Mexico ( Muxes), considering the social stigma, the legal and health aspects of these identities. Results: These three groups share similar experiences of stigmatisation, marginalisatio...

The World Health Organization (WHO) South-East Asia Region, which contributes one quarter of the world’s population, has a significant burden due to mental illnesses. Mental health has been a low priority in most countries of the region. Although most of these countries have national mental health policies, implementation at ground level remains a...

Aim: To compare white matter structural changes in specific tracts by diffusion tensor imaging (DTI) tractography in patients of bipolar disorder I, non-ill first degree relatives of the patients, and healthy controls. Methods: In a cross sectional study, we studied right-handed subjects consisting of 16 euthymic bipolar disorder I patients, 15...

Introduction OCD is a complex disorder with multiple aetiological theories. Recent research points to role of autoimmunity as well as hyperactivity of glutaminergic pathways in aetiopathogenesis of the disorder. It is possible that autoimmune mechanisms may modulate excitatory neurotransmission resulting in OCD. Aims/objectives This study aimed to...

Prevention of mental disorders offers opportunities for decreasing enormous health, economic, and social burden attributable to them. Substantial evidence exist showing effectiveness of prevention strategies in reducing risk factors, strengthening protective factors, and decreasing psychiatric symptoms and disability. The government and various sta...

Context: Previous studies have reported high psychiatric comorbidity with physical illness. However, referral rate to consultation-liaison (C-L) psychiatry from other departments is very low. There is a paucity of literature from India in this subspecialty of psychiatry. Aims: This study was conducted to assess the sociodemographic profile and psyc...

Background/Objectives: Eating disorders are rarely encountered in the Indian subcontinent. Surprisingly, there is sparse literature related to eating attitude distortions and body dissatisfaction in the Indian population. The objective of this study was to explore the eating attitudes and body shape concerns in medical students, with the objectives...

Globally, more than 350 million people of all ages suffer from depression. In spite of the high burden, depression is often unrecognized and undertreated. Inaccurate assessment is one of the important barriers for effective care. Clinical diagnosis is considered as the gold standard for the diagnosis of depression. However, the available instrument...