Siddharth Sarkar

• MD, DNB
• Additional Professor at All India Institute of Medical Sciences

Antidepressants hold the center stage in the treatment of depression in current clinical practice. However, it is also well-known that the treatment response and dosage requirement are influenced by ethnic variations. Although many efficacy studies have evaluated the efficacy of antidepressants, there is lack of systematic reviews and meta-analysis...

Lomotil (diphenoxylate atropine combination) has been in use as an antidiarrhoeal agent. Due to presence of opioid (diphenoxylate), there are chances of abuse. The reports of abuse of lomotil have been few in published literature. This chart review aimed to evaluate the characteristics of patients with dependence on lomotil coming to our centre. Th...

Factitious disorder can present with a wide variety of symptomatology. We present a case of a young girl presenting with spontaneous extrusion of wires from her limbs. These metallic wires were present in both her upper and lower limbs in the muscle bulk and were visible on X-ray. She sought repeated surgical removal of these wires, but the wires w...

Liver transplantation is a life saving surgical procedure that is associated with improved longevity and enhanced quality of life. The number of successful liver transplants is growing worldwide. The procedure requires a dedicated and trained team of experts. A psychiatrist plays an important role in such a team. Psychiatric and psychosocial assess...

The study was conducted to assess the occurrence of anxiety and depression in patients with recent myocardial infarction (MI) and also to assess the relationship of these symptoms with other relevant factors and clinical outcome. A total of 103 patients with recent MI attending the cardiology outpatient department (OPD) of a tertiary care centre in...

Naltrexone is an opioid antagonist that has clinical potential for use in patients with opioid dependence. While long-term use of opioid agonists such as buprenorphine and methadone has been well described, there is a lack of evidence of the long-term outcomes of patients being put on naltrexone. 1,2 We describe a patient with opioid dependence who...

Healthcare professionals face demanding jobs that significantly impact their physical and mental health. Indian physicians, in particular, encounter unique stressors and challenges compared to the general population, affecting both their personal and professional lives. Research on the prevalence and factors associated with substance use among Indi...

Drug courts are specialized programs from the courts that aim to offer a chance to individuals with substance-related problems encountering law enforcement to take treatment rather than face incarceration. The aim of this debate is to critically debate the utility, applicability, and feasibility of drug courts in India. This is a theoretical debate...

Aims To offer insights into various salient substance use and addictive behaviours related aspects as applicable to India. Methods We synthesised the published literature on addictive disorders from India. While not a systematic review of all available literature, the synthesis captures relevant themes including salient epidemiological findings, i...

Background: The association between somatic symptoms and psychiatric co-morbidities remains unexplored among patients with medically unexplained physical symptoms (MUPS) in Asian populations. This study aims to bridge this gap by investigating psychiatric morbidities and their determinants among patients presenting with MUPS in an Indian setup. Met...

Background: Naltrexone is a Food and Drug Administration (FDA)-approved anti-craving agent for the long-term treatment of alcohol dependence syndrome (ADS). However, it may not be equally effective in all patients. This study aims to assess naltrexone treatment response over four weeks in a national-level tertiary care setting. Methods: Male patien...

The health deficits of individuals with opioid use disorders have received considerable attention, especially in the context of risky behaviors, injection drug use, and HIV infection. Health-promoting behaviors and lifestyles play an important role in influencing numerous diseases in today's world, including substance use disorders. The present rev...

Background Nomophobia or no-mobile-phone phobia, defined as the fear of being unable to use or being unreachable via one’s mobile phone. The pervasive concern has varied bio-psychosocial and clinical implications in an individual’s life. Nomophobia is currently in an exploratory phase. Methods A scoping review was conducted to systematically map t...

Background and Aims Assessment of the severity of substance use disorders (SUDs) in a culture-sensitive manner can help gauge the current condition of the substance user and assess change with time. The present study aimed to develop a scale for the assessment of the severity of SUDs in the Indian clinical context. Methods Based upon the review of...

BACKGROUND Cognitive functions may play an important role in the management of obesity by promoting compliance towards lifestyle-related behaviours. This study aimed to identify cognitive deficits among adults and examine their association across different Body Mass Index (BMI) categories in an Indian setting. MATERIALS AND METHODS The study is a...

Background and Objectives Risky behaviors are common among patients with substance use disorders. Knowing the determinants of risky sexual behaviors can identify individuals who may benefit from targeted interventions. The primary aim of the study was to assess unprotected risky sexual behavior and its sociodemographic and clinical correlates in tr...

Introduction Adolescent opioid use in India has emerged as a critical public health concern, with a 2018 survey revealing 1.8% of adolescents aged 10–17 years as past-year opioid users. We present here the experiences of two cases of adolescent opioid users from a community-based drug treatment clinic in Delhi. Case Description Case 1 involved a 1...

Background Substance use disorder is a complex bio-psycho-social phenomenon affecting the intimate relationship of substance users with their wives. Marital adjustment may be affected due to the ongoing substance use involving the family unit. Aim The present study aimed to compare marital adjustment between alcohol- or opioid-dependent patients a...

BACKGROUND Brain-derived neurotrophic factor (BDNF) has considerable relevance in neural growth and differentiation. It has been evaluated as a biomarker for individuals with various psychiatric disorders such as substance-related disorders and psychotic disorders. OBJECTIVE The present study explored differences in the levels of BDNF (in serum) a...

Objective To estimate the prevalence of depression in people with limb amputation. Additionally, factors affecting the prevalence or pattern of depression following limb amputation were explored. Methods Systematic literature search to identify all relevant studies assessing prevalence of depression following limb amputations was conducted through...

A substantial portion of patients presenting to healthcare settings exhibit physical symptoms lacking clear, demonstrable organic causes. Accurate assessment of symptom severity is crucial for documenting outcomes and establishing treatment efficacy. This systematic review and narrative synthesis aims to provide researchers with insights into avail...

Dhat syndrome has been described as a culture-bound syndrome in the classificatory systems. The present chapter discusses the research pursuits undertaken for Dhat syndrome. Much of the research has been observational studies, and has originated from India. Phenomenological research has been primarily the focus while treatment focussed studies are...

Introduction Patients with medically unexplained physical symptoms (MUPS) account for a substantial proportion of patients visiting the outpatient department. Diagnosis of MUPS is a challenge for most physicians. An accurate diagnosis relies on obtaining a detailed history from patients regarding the nature of their symptoms, their onset, and any a...

The “Medically Unexplained Physical Symptoms Scale” is a self-reporting instrument consisting of 38 items, specifically developed to evaluate somatic symptoms and their perceived severity across various domains. Primarily designed for the Indian population, this scale encompasses parameters of anomalous and distressing bodily sensations, physical c...

Background People who use psychoactive substances that are illicit have increased chances of coming into contact with the law enforcement and criminal justice systems for different reasons. The problem statement in terms of the need for healthcare services for such people is yet to be defined and quantified in India. Methods We used the data colle...

Background Nomophobia is a situational phobia evoked by unavailability of smart phone or the thought of the possibility of not having it, not being able to use it and losing it. Currently used instruments for assessment of severity of nomophobia offers challenges of administration and have limited applicability in the Indian setting. Therefore, thi...

Addictions are an escalating public health concern in India. Mental health professionals and other healthcare workers must keep themselves updated about the developments in the field. The nosology has recently changed, the related laws have been amended, more and more substances and behaviors are being reported to be addictive, a steady stream of n...

Background and Aims Several outcome measures have been utilized in addiction psychiatry. This paper discusses the various aspects of consideration for utilization and critical scrutiny of outcome measures used for various purposes in addiction psychiatry. Methods We followed a narrative review methodology to describe the various facets of outcome...

Substance use often affect the family members of the individual with substance use disorder. Caregiver burden has been well described issue among the individuals with substance use disorders. Additionally, the reactions of family members towards the user has the potential to perpetuate the substance use disorder, or reduce it. In collectivistic soc...

Background Workplace violence (WPV) is a significant problem in both developed and developing countries, especially among healthcare workers. It has widespread implications for their overall health and well-being. Objective The study was conducted to assess the problem of violence among doctors and other healthcare workers in healthcare settings....

Background and Aims: Understanding the long-term outcomes of patients with substance use disorders can help to understand their course and prognosis. We aimed to find out the 10-year retention of patients who underwent short-term inpatient treatment at a tertiary care addiction psychiatry treatment facility. Methodology: This retrospective cohor...

Prolonged grief disorder (PGD) is a condition characterized by difficulty in coping effectively with the loss of loved ones. The proposed diagnostic criteria for PGD have been based predominantly on research from developed Western nations. The cultural variations associated with experience and expression of grief and associated mourning rituals hav...

Objective: Nonprescribed use of drugs is a clinical and public health challenge fueled by diversion of controlled opioids like buprenorphine. In this study, we report the nonprescription use of buprenorphine and buprenorphine-naloxone for the first time in India. Design: A cross-sectional observational study utilizing semistructured interviews....

Review article on sleep disturbance in older adults with comorbid substance use

Background and Aims Despite a large body of research linking caregiver burden and social support in substance dependence, positive aspects of caregiving in these disorders have received very minimal attention. This exploratory observational study aimed to assess the positive aspects of caregiving for opioid dependence and evaluate the association o...

Objectives: Effective interventions for cannabis use disorders are fairly limited. The present randomized controlled trial (RCT) aimed to compare the reduction in cannabis use (number of days cannabis used) with brief intervention and simple advice in patients with cannabis use disorder. Materials and Methods: This non-blinded and parallel two-grou...

Background: Approximately one-fourth of individuals who seek treatment in outpatient medical settings have Medically Unexplained Physical Symptoms (MUPS), a prevalent medical ailment. Patients with MUPS have a considerable functional impairment, and a lower quality of life, and may also have co-occurring psychiatric conditions. Materials and meth...

Bihar Excise (Amendment) Act, 2016 was promulgated in the state and a complete prohibition on alcohol was declared within the state of Bihar. We aimed to assess the impact of the prohibition on extent and pattern of alcohol use in the state of Bihar using the National Family Health Survey data. We also compared the data from Bihar with the data for...

Background Alcohol use disorder has a substantial impact on patients’ caregivers, leading to burden and adverse effects on their psychological health. Currently, there is limited literature which is available to suggest whether the burden and psychological distress of the family members change when patients with alcohol dependence undergo treatment...

Introduction All the resources that catalyze this recovery are known as recovery capital. This study aims at finding out the correlates which help increase the recovery capital of an individual and the extent to which it can affect them. Methodology Along with sociodemographic and clinical variables, we assessed recovery capital (Assessment of Rec...

Background Alcohol use disorders (AUD) contribute substantially to the global disease and disability burden. The Indian Disability Evaluation and Assessment Scale (IDEAS) has seldom been used to measure disability in those with AUDs. Objectives To assess the validity of IDEAS to quantify disability among persons with AUDs by measuring the level of...

Background and Aims Coronavirus has resulted in unique challenges to the healthcare professionals. The pandemic has affected the mental health of healthcare professionals, which may impact their ability to provide care to patients. We aimed to assess anxiety among healthcare professionals, and its relation to selected parameters. Methods This onli...

The study aimed to assess and compare the serum brain derived neurotrophic factor (BDNF) levels in patients with alcohol dependence, depression and alcohol dependence with comorbid depression. Three groups each of 30 alcohol-dependent, depressive and alcohol-dependent with comorbid depressive patients seeking treatment were included. BDNF levels we...

Background: Association between opioid use and sexual functioning is well-known. However, data evaluating the influence of treatment on different aspects of sexuality are lacking. Aim: To compare sexual behavior, functioning, relationship, satisfaction, and sexual quality of life (sQoL) among treatment naïve patients (GROUP-I) with Opioid (heroi...

Background Coronavirus disease 2019 (COVID-19) and related restrictions have affected individuals with opioid use disorders who are on treatment by affecting the opioid agonist treatment services worldwide. The study aimed to assess the changes in substance use patterns and associated behaviors among the patients on buprenorphine maintenance treatm...

BACKGROUND: The study was conducted to assess the different components of communication skills and barriers to practicing good communication skills among resident doctors in a health care setting. MATERIALS AND METHODS: A web‑based cross‑sectional survey was performed, and data were collected using a pre‑validated questionnaire with a Cronbach’s al...

Understanding the predictors of workplace violence amongst healthcare professionals is important to develop and implement prevention and mitigation strategies. We conducted a systematic review to synthesize the recent evidence on predictors of workplace violence across healthcare settings. The review has been done as per the Preferred Reporting Ite...

Gaming disorder is a health concern associated with significant impairment. Digital technology can be helpful for implementing preventive measures for gaming disorder. This randomized trial aimed to assess the effectiveness of an e-Health intervention to prevent gaming disorder among college students. This randomized trial compared an online interv...

Purpose This study aims to offer an overview of the models of clinical care of the patients with dual disorders in India. Design/methodology/approach All the members of the Dual Diagnosis India Network (DDIN) who shared the clinical care delivery at their center were invited to share the details of their model. In addition, an invite was also sent...

Background and Aims: In the process of treatment for substance use disorders, patients experience many barriers and facilitators related to treatment. This study aimed to ascertain the barriers and facilitators of addiction treatment in treatment‑seeking population of patients with substance use disorders. Methods: A defined questionnaire was devel...

Objective: This study aimed to ascertain the reasons why patients with opioid dependence leave treatment. Design: Prospective follow-up observational study. Setting: This study was carried out at a tertiary care substance use treatment facility in north India with both outpatient and inpatient services. The facility is a public-funded institution...

Aims To assess recent changes in the extent and pattern of alcohol use in India using the National Family Health Survey (NFHS) data. Methods We used unit-level data from both rounds of NFHS. The pattern of alcohol use was categorized as: ‘almost every day’, ‘almost once a week’ and ‘less than once a week’. The information was segregated for the ur...

This study explored the profile of HIV positive patients seeking treatment at a tertiary care addiction treatment facility. A retrospective study was done to collet detailed information on clinical characteristics: drug use (type, age of initiation, duration), general medical condition and past treatment history. The study included 138 patients wit...

Background: Workplace violence (WPV) is a significant problem in both developed and developing countries among healthcare workers. The study aims to examine the perspective of resident doctors on various aspects of WPV to promote a better understanding of the complexity of the problem of WPV at a tertiary care center in India. Material and method...

The gradual move towards telemedicine for the care and service provided to patients with addictive disorders [1], has been accentuated during the pandemic [2-4]. Telemedicine facilitates expert medical care to those situated at distant locations, and reduces the indirect and direct healthcare costs. While the benefits of telemedicine have made it a...

Objective To develop and validate questionnaires to assess the behavioral, psychosocial, and environmental predictors of successful weight loss outcomes. Design Mixed method study. Questionnaires were developed using 5 steps: item generation by literature review and preexisting questionnaires, expert evaluation, pilot testing, factor analysis, and...

Weight gain is an independent risk factor for decline in cardiometabolic and overall health-related quality of life in midlife women. The AIIMS-DST initiative aims to develop and validate stepwise recommendations specific for weight management in midlife women. The key clinical questions specific to weight management in midlife women were finalized...

Background The ingestion of various animals with psychoactive properties has been observed since antiquity. Though unusual, lizard use has been reported in the literature as case reports. Yet the rarity of this phenomenon has not been explored through large-scale studies. This paper systematically reviews available case reports of individuals using...

Background and aims: Substance use among medical students may have consequences like poor academic performance and impaired patient care. There is a growing literature on substance use among medical students in India. This systematic review and meta-analysis were done to synthesize the literature on substance use among medical students in India....

Background: Workplace violence (WPV) against health-care professionals has been a concern worldwide as it strains the relationship between the patient and healthcare professionals. Implementing mitigation interventions to help the healthcare professionals to prevent and manage these violent episodes might make the workplaces more secure. Objectiv...

Addictive disorders affect a considerable proportion of the population worldwide and in India. Treatment-related barriers and facilitators play a role in the processes of how patients seek care. This study aimed to understand the barriers and facilitators of addiction treatment of patients reaching an addiction treatment facility in India. This qua...

Objective Individuals seeking treatment for physical symptoms having unknown etiology are common in the primary healthcare setup. Factors such as biomedical, environmental, social, and psychological ones are expected to play an important role in the treatment of Medically Unexplained Physical Symptoms (MUPS). Therefore, this systematic review and m...

Background: Recovery capital helps in the assessment of the personal strengths and challenges that exist in an individual with substance use which may have an impact on recovery process. This study aims at finding out the factors which help such individuals to sustain their recovery and how these factors differ across the two groups of people suffe...

Background Strict adherence to pharmacological dosage regimens is a prerequisite to the success of most treatments, particularly for patients in drug abuse programs. The compliance of tramadol, an atypical non-scheduled narcotic analgesic, using objective method has not been adequately studied in an Indian setting. Aim To evaluate the compliance a...

Behaviour change is the basic foundation in the management of obesity. Such behaviour change is difficult to achieve due to several psychosocial and behavioural barriers that often remain unidentified and unaddressed in a weight management programme. This is even more challenging in postpartum and midlife women because of several biopsychosocial fa...

Objective: This study aims to understand middle-aged perimenopausal women's perspectives and beliefs regarding their body weight status, and evaluate the barriers, and facilitators associated weight loss. Methods: Five focus group discussions were conducted with perimenopausal women (aged 40-55 y) who were recruited through convenience and snowb...

Background and aims Weight gain is an independent risk factor for decline in cardiometabolic and overall health related quality of life in midlife women. The AIIMS-DST initiative aims to develop and validate stepwise recommendations specific for weight management in midlife women. Methods The key clinical questions specific to weight management in...

Introduction Postpartum obesity is a public health concern. There is a need to counsel women about their postpartum weight management, accounting for various barriers they face. Limited literature in the Indian context underscored the need to develop the clinical practice guideline to be used by healthcare providers in Indian healthcare settings....

Background Comparative studies of the naturalistic course of patients of opioid dependence on naltrexone and buprenorphine are likely to be helpful for clinical decision-making. The article aimed to report on the three-months naturalistic outcomes of patients discharged on naltrexone or buprenorphine from the same center. Methods Patients with opi...

Background and Aims Relapse is a major clinical concern in alcohol use disorders. The magnitude of the problem, poor access and availability of treatment, and changing social milieu placed India in a challenging position. This was a systematic review of Indian studies on rates and determinants of relapse to alcohol. Methods Systematic search (Janu...