Official Journal of the Branch of Indian Psychiatric Society (Kerala)
Branch of Indian Psychiatric Society (Kerala)
Navigating the Demographic Shift and Solving the Elderly Mental Healthcare Needs-The Call for A Kerala State Senior Citizen Mental Health Policy
Copyright (c) 2026 Rajmohan Velayudhan (Author) https://creativecommons.org/licenses/by-nc/4.0
Writing Limitations in Research Manuscript: Recognizing the Study’s Constraints and their Implications
All research has certain limitations. Acknowledging these limitations, explaining how they were minimized, and discussing their impact on the findings are important for enhancing transparency in research. However, many papers either omit limitations altogether or address them only superficially. Researchers should clearly identify all major limitations, explain how they may affect the interpretation of the findings, describe the measures taken to mitigate their impact, and provide recommendations for future research. This will help readers, reviewers, and editors evaluate the research within the context of its constraints. All reporting guidelines emphasize inclusion of relevant study limitations in publications.
Column: Tips on Research and Publication
Copyright (c) 2026 Samir Kumar Praharaj, Shahul Ameen (Author) https://creativecommons.org/licenses/by-nc/4.0
Prevalence of Psychiatric Comorbidity with Alcohol Dependence and its Association with Quality of Life: A Cross-Sectional Study
Background Alcohol dependence and abuse are public health concerns associated with comorbidity and quality of life. Methods The study was done on patients diagnosed with alcohol dependence using the Mini International Neuropsychiatric Interview (MINI). The presence of psychiatric comorbidity was assessed using the MINI. Quality of life was assessed using the WHO QOL-BREF scale. Significance was calculated using unpaired Student's t-test and chi-square test, respectively, for continuous and categorical variables with SPSS version 26. Results Of the 121 persons with alcohol dependence, 52.1% had a psychiatric comorbidity. Bipolar affective disorder was the most common psychiatric comorbidity. The physical, psychological, social, and environmental domain mean scores of quality of life were significantly lower in patients with psychiatric comorbidity: 44.42 vs 50.69 (p=0.002), 37.65 vs 47.79 (p=0.001), 32.13 vs 41.97 (p=0.002), and 46.63 vs 54.02 (p=0.001). Conclusion In the current study, around 1 in 2 persons with alcohol dependence suffer from another psychiatric comorbidity. Quality of life is also lowered in persons with alcohol dependence having a psychiatric comorbidity. Routine screening of persons with alcohol dependence to detect psychiatric comorbidity should be done.
Copyright (c) 2026 Eapen Varghese , AnilkumarThekkethayyil Viswanathan (Author) https://creativecommons.org/licenses/by-nc/4.0
Emotional Intelligence in Alcohol Dependent Patients - A Comparative Study
Background Emotional intelligence (EI) is an important psychological construct influencing self-awareness, emotional regulation, and decision-making. Its role in alcohol dependence syndrome (ADS) is increasingly being recognized. Material and Methods This hospital-based cross-sectional comparative study was conducted in a tertiary care center and included 60 male patients with alcohol dependence syndrome and 60 age-matched healthy male controls. Emotional intelligence was assessed using the Schutte Self-Report Emotional Intelligence Test (SSEIT). Severity of alcohol dependence and craving were measured using the Severity of Alcohol Dependence Questionnaire (SADQ) and Alcohol Craving Questionnaire–Short Form Revised (ACQ-SF-R), respectively. Data were analyzed using SPSS version 22. Results The mean SSEIT score was significantly lower in the ADS group compared to controls (106.05 ± 17.45 vs. 141.33 ± 9.63; p < 0.001). Subdomains of EI, including emotion perception, self-regulation, and utilization of emotions, were significantly impaired in the ADS group. Family history of alcohol use was associated with lower EI scores (p = 0.004). No significant correlation was found between EI and alcohol craving or severity of dependence. Conclusion Emotional intelligence is significantly lower in individuals with alcohol dependence syndrome. EI was t may represent a potentially modifiable factor relevant to long-term recovery.
Copyright (c) 2026 Surabhi Surendran, Nikhil UG (Author) https://creativecommons.org/licenses/by-nc/4.0
Domestic Violence, Depressive And Anxiety Symptoms Among Pregnant Women - A Cross-Sectional Study
Background Domestic violence (DV) is widespread across countries and cultures. DV can lead to various psychiatric problems in pregnant women. This study aims to assess the prevalence of domestic violence among pregnant women and to determine the anxiety and depression among them. Materials and Methods A cross-sectional study was conducted by recruiting 232 pregnant women attending a tertiary care teaching hospital. Their socio-demographic and clinical parameters were recorded using a proforma. Domestic violence, depression, and anxiety were assessed using the Domestic Violence Questionnaire, Patient Health Questionnaire-9, and Generalized Anxiety Disorder-7 questionnaires, respectively. Data were analyzed using Jamovi version 2.3. Results The prevalence of DV among pregnant women was estimated to be 11.2% (95% CI = 7.8% to 15.9%). Depressive symptoms were found in 63.8% (95% CI =57.4% to 69.7%) and anxiety symptoms in 63.3% (95% CI = 57.0% to 69.3%) of the study population. A significant association was observed between domestic violence and depression and anxiety (p < 0.001). Conclusion A significant proportion of pregnant women experience DV. Pregnant women who experience DV show significantly higher levels of depression and anxiety.
Copyright (c) 2026 Shafeequ Ahammed, Anithakumari Ayirolimeethal, Biju George (Author) https://creativecommons.org/licenses/by-nc/4.0
Effectiveness of Video-Based Learning versus Role Play for Teaching Family Education in Depression to Phase III Medical Students
Background: Family education is an essential component of comprehensive care in depression. Innovative and effective teaching methods are required to equip medical students with the necessary skills to deliver family psycho education. This study compares the effectiveness of video-based learning and role play in teaching family education in depression. Objectives: To compare the effectiveness of video-based learning versus role play in teaching family education in depression among Phase 3 MBBS students, assessed using an Objective Structured Clinical Examination (OSCE). Methods: A total of 127 Phase 3 MBBS students were divided into two groups. One group (n = 66) received psycho education training through video-based learning, while the other group (n = 61) received training through role play. Post-intervention, students were assessed using an OSCE designed to evaluate psycho education skills. The mean OSCE scores and the number of students who passed the OSCE (based on predefined passing criteria) were compared between the two groups using appropriate statistical methods. Results: The video-based learning group had a mean OSCE score of 12.62 ± 3.732, while the role play group scored 11.41 ± 3.509. A total of 47 students (72.3%) passed the OSCE in the video group, compared to 39 students (62.9%) in the role play group. The difference in mean scores was not statistically significant (p < 0.05) Conclusion: Video-based learning was found to be slightly more effective than role play in teaching family education, as reflected by higher OSCE scores and pass rates. Incorporating structured video modules into the undergraduate psychiatry curriculum may enhance learning outcomes in communication and psycho education skills.
Copyright (c) 2026 Harish M Tharayil, Anu Padmanabhan, Nishanth J Haridas, Tom Varghese, Afeefa Moidu, Varsha Vidyadharan (Author) https://creativecommons.org/licenses/by-nc/4.0
A Fractured Self: AN's Journey Through Borderline Personality Disorder and Therapeutic Resilience
AN, a 28-year-old female artist, presented with a complex constellation of symptoms indicative of borderline personality disorder (BPD), including intense emotional dysregulation, unstable interpersonal relationships, a distorted self-image, and chronic feelings of emptiness. Her history was a harrowing narrative of childhood trauma, weaving a tapestry of emotional wounds that profoundly impacted her adult life. This case report details her journey through a multifaceted therapeutic approach encompassing Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), Supportive Therapy, Behavioral Therapy, and intensive Arts-Based Therapy (ABT). It explores the challenges and triumphs encountered during her treatment, highlighting the importance of a well-tailored, integrative approach in addressing the unique complexities of BPD. It also examines the nuanced dynamics of the therapist-client relationship, emphasizing the crucial role of consistent support and the gradual development of self-efficacy in facilitating AN's path toward healing and stability.
Copyright (c) 2026 Sureshkumar Pattath Narayanan, Niva Das (Author) https://creativecommons.org/licenses/by-nc/4.0
Psychiatric Sequelae of Genital Dermatoses: A Two-Year Follow-up Study
Background: Genital dermatoses are a group of cutaneous disorders that affect the skin of the external genitalia. Individuals suffering from genital dermatoses may be reluctant to seek treatment because of fear, cultural taboos, and reticence to undergo an examination of the genitalia. This can worsen their dermatological condition and can also cause varying psychological distress. This study aimed to assess the anxiety and depression in patients diagnosed with genital dermatoses and to follow up with them after two years. Methods: This longitudinal observational study was conducted at a tertiary care center in Southern India. The study participants were persons diagnosed with genital dermatoses. The Hamilton Anxiety Rating Scale (HAM-A) and Hamilton Depression Rating Scale (HAM-D) were used to assess anxiety and depressive symptoms, respectively. We provided all participants with anxiety and depression with either pharmacological or psychological intervention. A follow-up was done two years after the initial evaluation to reassess the clinical status of their dermatological condition and anxiety and depressive symptoms. Results: Of the 60 participants with genital dermatoses, 51 participants completed a two-year follow-up. Among them, only 13 (25.5%) of the participants had persistent genital dermatoses after two years. Compared with the initial assessment values (Mean HAM-A =13.22 (Standard Deviation (SD) = 6.97) (Mean HAM-D = 11.07) (SD = 6.52), there was a significant reduction in both mean HAM-A (5.49) (SD=6.57) (P<0.001) and mean HAM-D (4.46) (SD=5.45) (P<0.001) scores after two years. Conclusion: Genital dermatoses can cause significant anxiety and depression. As the dermatological symptoms improve, the anxiety and depressive symptoms also improve.
Copyright (c) 2026 Nimmy Chandran, Anupa Mary Job, Anirudh Balachandran, Ajithra Mary, Deepak KS (Author) https://creativecommons.org/licenses/by-nc/4.0
Good Research Begins in the Days of Postgraduate Training!
Copyright (c) 2026 Sujit Sarkhel (Author) https://creativecommons.org/licenses/by-nc/4.0
Strengthening of the Association Through Networking
The theme of the year is “Strengthening of association through networking.” Through increasing the number of life fellows and LOM in our IPS Kerala State branch. The membership drive will be continued in full strength with my team. I want to associate with IMA, IAP, other governmental agencies, and NGOs to build awareness of mental health and its relevance for early detection of cases. We want to conduct a workshop for our young psychiatrists on prospects here in India and Kerala, as well as abroad. We will put pressure on NMC to make Psychiatry a single theory paper and a small case during the medical practical.
Copyright (c) 2026 Anoop Vincent (Author) https://creativecommons.org/licenses/by-nc/4.0
Modafinil Induced Psychosis in a Patient with Recurrent Depressive Disorder: A Case Report
BACKGROUND: Modafinil is the first FDA-designated “wakefulness-promoting agent” and is approved for use as an adjuvant in mood disorders. In depressive disorders, it is reported to be effective in alleviating fatigue and related symptoms. The molecule is widely used today. Since it belongs to the group of stimulants, theoretically, it can cause psychosis. CASE REPORT: We report the case of a 48-year-old woman with recurrent depressive disorder who developed psychotic symptoms, including visual and auditory hallucinations, within two days of initiating modafinil (100 mg/day) for fatigue. Symptoms worsened following venlafaxine addition but entirely resolved within five days of modafinil discontinuation, with no recurrence over six months. CONCLUSION: This case highlights the risk of modafinil-induced psychosis, even at standard doses, and suggests a possible interaction with venlafaxine. Clinicians should monitor for psychotic symptoms in vulnerable patients, warranting further investigation into modafinil’s neurobiological effects.
Copyright (c) 2026 Diya P Albert, Gopika SS, Vidhukumar Karunakaran (Author) https://creativecommons.org/licenses/by-nc/4.0
Navigating the Digital Landscape: Understanding Cyberbullying, Its Impacts, and Strategies for Prevention
While the Internet has revolutionized modern communication and connectivity, it has also given rise to cyberbullying, a real type of misconduct among young people. With the development of technology, cyberbullying has become a widespread global problem. Cyberbullying is the act of repeatedly and purposely hurting using electronic means like the internet or mobile phones. Although research on the prevalence, predictors, and consequences of cyberbullying is growing, existing literature remains scattered and lacks a theoretical focus. This article provides a conceptual exploration of cyberbullying by reviewing current evidence, highlighting the research gaps, offering recommendations for further study, and providing practical solutions, with a particular emphasis on the Indian context. Understanding the complexities of cyberbullying requires defining the term, tracing its trends, identifying contributing factors and consequences, exploring the various ways that it occurs, and discussing effective ways to combat cyberbullying. Effective strategies to combat cyberbullying include reporting instances, monitoring online behavior, teaching digital skills, as well as seeking legal action. Future studies need to examine how education programs can alter reporting rates, how frequently cyberbullying occurs, and how it influences social media behavior.
Copyright (c) 2026 Bhaswatty Das, Nurnahar Ahmed (Author) https://creativecommons.org/licenses/by-nc/4.0
Neurosyphilis: Diagnostic Challenges and Public Health Relevance – A Case Report
Background: Syphilis, caused by Treponema pallidum, remains a diagnostic challenge due to its varied clinical manifestations. Neurosyphilis, a late-stage complication, can mimic psychiatric disorders and lead to misdiagnosis. Case Report: A middle-aged woman presented with progressive cognitive decline, personality changes, and psychotic symptoms. She was initially mistaken for a primary psychiatric illness. Serological testing confirmed neurosyphilis, and treatment with intravenous penicillin resulted in marked improvement in neuropsychiatric features. This case emphasizes the importance of considering syphilis in atypical psychiatric presentations, particularly given its global resurgence. Conclusion: Early recognition and timely therapy are essential to prevent irreversible neurological damage, underscoring the need for heightened clinical vigilance and routine screening in at-risk populations.
Copyright (c) 2025 Merin Poulose, Sreedeepan Mangalam, Anand Shajan, Varghese P Punnoose, Joice James (Author) https://creativecommons.org/licenses/by-nc/4.0
How to Select and Report the Appropriate Study Design
A clear understanding of study designs is essential for planning research and critically evaluating evidence. The choice of design depends on the research question, with multiple designs often suitable for a single question. Misapplication or misreporting of study designs can threaten validity and mislead readers. This manuscript provides an overview of common quantitative study designs, including observational and experimental studies. Common reporting errors include omitting the study design, incorrect labelling, inappropriate causal claims, failure to identify confounders, and omitting details of randomisation and allocation concealment.
Proportion of Sexual Dysfunction in Patients with Alcohol Dependence Syndrome in a Tertiary Care Hospital: A Cross-sectional Study
Background: A fulfilling sexual life is vital for emotional intimacy, self-esteem, and overall well-being. However, alcohol dependence poses significant challenges to sexual health, often leading to various dysfunctions that adversely affect quality of life. Understanding the prevalence and pattern of these dysfunctions among alcohol-dependent males is essential for comprehensive clinical management and intervention. Methods: This cross-sectional study aimed to evaluate the prevalence of sexual dysfunction and its association with the severity of alcohol dependence among 80 adult male participants diagnosed with Alcohol Dependence Syndrome. The Severity of Alcohol Dependence Questionnaire (SADQ) and the Arizona Sexual Experience Scale (ASEX) were administered. Statistical analyses, including Chi-square tests, ANOVA, and descriptive statistics, were performed using SPSS. Results: The mean age of participants was 39 years [38.96 ± 4.77]. A majority (55%) resided in rural areas, 21% had received formal education, and most belonged to low socioeconomic backgrounds; 88% were married. Based on SADQ scores, 65% demonstrated severe alcohol dependence, 26.25% moderate, and 8.75% mild, with a mean score of 32.96. Overall, 70% of participants experienced sexual dysfunction. The most common issues included low sexual drive (51.2%), difficulty achieving orgasm (50%), erection difficulty (46.25%), difficulty in arousal (43.75%), and orgasmic dissatisfaction (32.5%). Multiple sexual dysfunctions were frequently observed in a single patient, and a highly significant association was found between the severity of alcohol dependence and each type of sexual dysfunction. Conclusion: The high prevalence of sexual dysfunction among alcohol-dependent males underscores the need for routine sexual health screening and integrated therapeutic approaches within de-addiction programs. Addressing sexual dysfunction as a comorbid concern may enhance motivation for recovery and improve overall psychosocial functioning.
Copyright (c) 2025 Abdul Raheman, Ashok Kumar K S, Bhagyavathi H D , Mohammed Irfan Sheikh, Sanjana K (Author) https://creativecommons.org/licenses/by-nc/4.0
Response to the "Letter to the Editor response to The Weight Beneath the White Coat: Professional Stress, Help-Seeking Barriers, and the Hidden Grief of Doctors"
We agree that supervision, when well organised and practised, could address several of the issues we raised in the paper. We would also like to point out that supervision that is unhelpful or absent could have adverse consequences on stress and help-seeking behaviours in doctors. At times, the focus of supervision is on the normative aspects to the neglect of its formative and restorative functions. Indeed, the concept of clinical supervision is often lacking in medical training in India. We agree that Balint groups and other reflective spaces can significantly help reduce professional stress. Like the authors, we hope that faculty and trainees in other specialties will also recognise the importance of initiatives that help lower stress levels and promote the well-being of doctors.
Copyright (c) 2025 Arun Kishore NR, Shaji KS, Jimmy Mathew (Author) https://creativecommons.org/licenses/by-nc/4.0
Proportion of Post-partum Depression and Anxiety Symptoms among Women in a Tertiary Care Setting - A Cross-sectional Study
Background: Postpartum depression (PPD) and anxiety are mental health problems in females, and many factors predispose the occurrence of this illness. The study assessed the prevalence of postpartum depression and anxiety among postnatal mothers. Materials and Methods: A hospital-based cross-sectional study was conducted among 200 women admitted to a tertiary care hospital in North India between March 2023 and April 2023. The Edinburgh Postnatal Depression Scale (EPDS) and the Patient Health Questionnaire-4 4 (Anxiety) were used to estimate the post-partum depression and anxiety, respectively. Results: The mean age of the study subjects was 26.41 (SD = 5.292), and most of them belonged to rural backgrounds (64%). The prevalence of postpartum depression and anxiety was 30.5% (EPDS score of 10 and above) and 24% (PHQ score of 3 and above), respectively. Younger age (less than 35 years), rural background, low family income, complications during pregnancy, and low birth weight of the child were significantly associated with post-partum depression and anxiety in this setting (p <0.05). Conclusion: The findings of the present study revealed that nearly 20%-30% of study subjects had postpartum psychological distress in this setting. Depression is often not diagnosed during postpartum, which emphasizes the need for similar screening practices in obstetrical and primary care.
Copyright (c) 2025 Gulshan Hooda, Jaison Joseph, Rajeshwari Devi (Author) https://creativecommons.org/licenses/by-nc/4.0
Letter to the editor in response to "The Weight Beneath the White Coat: Professional Stress, Help-Seeking Barriers, and the Hidden Grief of Doctors"
We write as psychiatry trainees working in Scotland in response to Kishore, Shaji & Mathew’s thought-provoking piece titled ‘The Weight Beneath the White Coat: Professional Stress, Help-Seeking Barriers, and the Hidden Grief of Doctors’. The article effectively draws attention to the significant issue of burnout within the medical profession, which we agree is largely unspoken and warrants greater scrutiny. We write to reflect on some of the points raised from the perspective of current psychiatry trainees.
Copyright (c) 2025 Fraser Walker, Graham Walker (Author) https://creativecommons.org/licenses/by-nc/4.0
Cognitive Behavior Therapy for Obsessive-Compulsive Disorder with Co-Morbid Personality Disorder: A Case Series
Background – There have been contrasting results regarding the influence of co-morbid personality disorder (PD) on cognitive behaviour therapy (CBT) outcomes for anxiety disorders. This case series examines the efficacy and challenges of CBT for patients with obsessive-compulsive disorder (OCD) and comorbid PD. Case Series: For the present case series, three individuals with the diagnosis of OCD were selected. They also presented with comorbid obsessive compulsive PD (OCPD), anxious avoidant PD, and dependent PD, respectively, as assessed by the ICD-10 International Personality Disorder Examination (IPDE). The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) was administered to assess the severity of OCD in the patients. They underwent a variable number of CBT sessions. Results: Pre- and post-intervention analyses showed reductions in Y-BOCS scores across the baseline, 2-month, and 4-month follow-ups, along with improvements in functioning, as evidenced by patient and informant feedback pre- and post-intervention. However, the patient with co-morbid OCPD had a fluctuating course of treatment outcome, and his poorer motivation and preoccupation with details interfered with the course of therapy. Conclusion: CBT treatment plans of such groups of patients should be individualized to address the issues posed by comorbidity.
Copyright (c) 2025 Susmita Halder, Arpita Roy Choudhury (Author) https://creativecommons.org/licenses/by-nc/4.0
Sensory Deprivation or Postictal Vulnerability? Psychosis Following Phenytoin-Induced Toxic Epidermal Necrolysis – A Case Report
Background: Acute cutaneous and mucosal manifestations of drug-induced toxic epidermal necrolysis are well recognized. Ocular complications lead to visual impairment and sensory deprivation and may predispose to psychosis. Case Report: A 59-year-old woman with epilepsy, previously stable on anti-seizure medications, in whom phenytoin was introduced for breakthrough seizures. Following this, she developed toxic epidermal necrolysis (TEN), resulting in bilateral vision loss and subsequently full-blown psychosis. While she had shown mild irritability earlier, it was only after the seizure and abrupt sensory deprivation that she developed vivid hallucinations, delusions, and poor insight. The clear temporal sequence highlights the role of both postictal vulnerability and sensory deprivation in precipitating organic psychosis. Conclusion: This case emphasizes the need to evaluate organic causes when elderly patients present with new-onset psychotic symptoms.
Copyright (c) 2025 Sthuthi Shireen, Aiswarya R Kamath, Bindu Menon (Author) https://creativecommons.org/licenses/by-nc/4.0
Proportion of Psychotic Features in Patients With Major Depression and Their Relationship With Depression Severity: A Cross-Sectional Study
Background: Psychotic features like delusions and hallucinations occur in a clinically meaningful subset of depressive episodes. While Western estimates place the prevalence of psychosis in depression at 15–30%, Indian data are limited. ICD-10 ties psychosis to severe depression, whereas DSM-5 decouples psychosis from severity, and ICD-11 introduces moderate depression with psychotic features. Contemporary, India-specific evidence is needed to inform classification and care. Methods: This cross-sectional study at a tertiary care center evaluated 170 consecutive adult persons with depression (including major depressive episodes in bipolar I/II) who were diagnosed per DSM-5 using SCID-5. Depression and psychosis severity were assessed with the Hamilton Depression Rating Scale (HAM-D) and the Brief Psychiatric Rating Scale (BPRS), respectively. The data were analyzed using ANOVA, the chi-square test, and Pearson's correlation. Results: Overall, 24.7% (42/170) had psychotic features. Prevalence rose with depression severity: 0% in mild, 8.6% (7/81) in moderate, and 47.9% (35/73) in severe depression, which was significant. (p=0.01) Mean BPRS scores increased across severity strata with significant between-group differences. (F=55.79, p<0.001) HAM-D scores correlated positively with BPRS scores(r= 0.77, p<0.001), indicating that higher depressive severity was associated with greater psychosis severity. Conclusion: Psychotic features occur in approximately one-quarter of persons with major depression and are not confined to severe episodes, with a notable proportion present in moderate depression. The graded increase in both prevalence and severity of psychosis with depressive severity supports DSM-5’s delinking and aligns with ICD-11’s category of moderate depression with psychotic features. These findings underscore the need for routine psychosis screening across all depression severities
Copyright (c) 2025 Amrutha C Madhu, Ashfaq U Rahman AM, Uvais NA, Chitra Dilip (Author) https://creativecommons.org/licenses/by-nc/4.0
Coping Strategies and Psychological Wellbeing Among Undergraduate Students Affected by Cyberbullying: A Cross-Sectional Study
Background: Cyberbullying is an emerging concern among undergraduate students, potentially affecting their mental health and academic life. Understanding how students cope with such experiences is crucial for designing effective support systems. This study aimed to identify coping strategies employed by undergraduate students experiencing cyberbullying and to examine the association between these strategies and psychological well-being. Methods: A cross-sectional study was conducted among 744 undergraduate students selected through multistage random sampling from colleges in Khammam city, Telangana, South India. Data were collected using validated instruments: The Cyberbullying and Cybervictimization Questionnaire, the Coping with Cyberbullying Questionnaire, and the Psychological Wellbeing Scale. Descriptive statistics summarized participant characteristics, and Chi-square tests assessed associations between cyberbullying status and psychological well-being subscales. Results: Among the participants, 40.3% reported being victims of cyberbullying and 25.5% admitted to perpetrating it; 32.3% were both victims and perpetrators. Technical coping strategies such as blocking or reporting perpetrators (mean = 20.52) and seeking close support from friends and family (mean = 17.94) were most frequently used, whereas retaliation was least common (mean = 15.03). No significant associations were found between experiences of cyberbullying or cybervictimization and any psychological well-being subscales (p > 0.05). Conclusion: Undergraduate students predominantly adopt practical coping strategies, notably technical measures and social support, when facing cyberbullying. The absence of a significant link between cyberbullying experiences and overall psychological well-being suggests that other factors, such as pre-existing mental health and social support, may play a more pivotal role. Strengthening institutional support systems and promoting healthy coping mechanisms remain essential to address the psychosocial impact of cyberbullying.
Copyright (c) 2025 Md Adil Faizan, Prashanth Challuri, Govindappagari Venkata Jithendra, Tejasvi Sakhamuri, M Raghuram, M Pramod kumar (Author) https://creativecommons.org/licenses/by-nc/4.0
Alcohol Use Disorders in Males who have Survived a Suicidal Attempt- A Cross-Sectional Study
Background: Alcohol use disorders could be a major risk factor for suicidal behaviour. Our study aimed to find out the proportion of adults with Alcohol Use Disorder (AUD) in males who have survived a suicidal attempt and to find out the association of AUD and alcohol use-related factors with high suicidal intent. Methods: This cross-sectional study of 230 consecutive male inpatients of age 18-70 years admitted with non-fatal suicidal attempt in consultation liaison psychiatry used a specifically designed proforma to get the socio-demographic, suicide, and alcohol use-related variables. The suicide intent was assessed using Beck’s Suicide Intent scale. The Alcohol Use Disorders Identification Test (AUDIT) was used to identify AUD. The severity of Alcohol Dependence Questionnaire (SADQ) was used to assess the severity of AUD. Results: 43.9 % of adult males with non-fatal suicidal attempt had AUD, and 15.2% had high suicidal intent, 63 (62.4%) had used alcohol on the day of the attempt, and 40 (39.6%) of them used alcohol before the attempt to facilitate the suicidal attempt. Of the patients with moderate or low suicidal intent, 75 (38.5%) had AUD, and 26 (74.3%) with high suicidal intent had AUD, which was found to be significant. (chi-square = 15.46, p = 0.001). Severity of alcohol dependence had a significant association with high suicidal intent (chi-square=4.46, p=0.03). Logistic regression after adjusting for confounders showed that AUD [Odds ratio= 4.18 (1.78-9.79); p=0.001] and severity of AUD [Odds ratio= 3.33 (1.33-8.30); p=0.01] remained significant risk factors for adult suicide attempts. Conclusions: AUD was found to be significantly associated with high suicidal intent among adult males who have survived a suicidal attempt. Early recognition of risk factors for suicide, including alcohol use disorders and various alcohol use-related factors, helps in preventing suicides.
Copyright (c) 2025 Arathy Nathan A, Lekshmy Gupthan, Jaimon Plathottathil Michael (Author) https://creativecommons.org/licenses/by-nc/4.0
The Weight Beneath the White Coat: Professional Stress, Help-Seeking Barriers, and the Hidden Grief of Doctors
Doctors face disproportionately high rates of stress, burnout, and suicide compared to the general population. Yet, paradoxically, help-seeking among doctors remains exceptionally low. This article explores the systemic, cultural, and psychological barriers that prevent doctors from accessing support. Drawing on clinical experience, sociocultural analysis, and reflections from the field, we argue that medical culture and professional identity shape a unique and often isolating experience of stress. We call for institutional reforms and early educational interventions to normalise vulnerability, promote wellbeing, and support doctors in their dual identities as caregivers and human beings.
Navigating Parenting in the Digital World
Copyright (c) 2025 Rachna George, Varghese P Punnoose (Author) https://creativecommons.org/licenses/by-nc/4.0
Parenting is one of the significant challenges that every human being faces in their lifetime. There have been several fundamental changes in the lifestyle of children and adolescents in the twenty-first century compared to those of a previous generation. In today’s digital era, everything has become super fast to such an extent that you need to click your mobile a couple of times to get a sure ticket for a movie or to order your choicest delicacy, which would invariably be delivered straight to your doorstep. The time gap between the genesis of a desire and its realisation has dwindled to a few minutes or even a few seconds. The parent needs to be mindful of their children's digital behavior and ensure that they can guide them about healthy and unhealthy choices in digital encounters. Parents should be well-versed in the online friends of their kids and the nature and quality of the interaction their kids are having with them. Ensuring healthy screen time, which is age-appropriate, is another vital issue that should be considered seriously. According to the American Academy of Pediatrics' recommendation, children under 2 years of age should not have any screen time. Children between 3 and 5 years old may be permitted one hour of screen time daily, which does not need to be continuous. Parents should ensure that this screen time does not consist exclusively of cartoons or fast-moving visuals. The parent should understand that it is more important to allow the child to play and explore novel aspects of their life rather than restricting their freedom within the four walls of tuition centres, thereby ruining any chance for psychosocial development. Studies from various parts of the world have shown that physical inactivity, apart from increasing the chance for metabolic lifestyle-induced disorders, also paves the way for behavioral addiction, including online gaming disorders as well as substance use disorders in the future. As a parent, it is your primary responsibility to listen non-judgmentally to your child's concerns. Most importantly, it is not about moral policing your child, but about empowering them to differentiate between healthy and unhealthy choices in life, which defines the parent in you.
Copyright (c) 2025 Arun B Nair (Author) https://creativecommons.org/licenses/by-nc/4.0
Psychosocial Problems Among Healthcare Workers in a Tertiary Care Centre During the COVID-19 Pandemic - A Qualitative Study
Background: The COVID-19 pandemic has affected the mental health of healthcare workers (HCWs) engaged in fighting the pandemic, as reported by many quantitative studies. Only a few qualitative studies, mostly conducted online, have explored the psychosocial problems faced by them, especially the residents. This study was done to have an in-depth understanding of psychosocial problems experienced by the HCWs engaged in delivering care to COVID-19 cases in a tertiary care centre. Methods: A qualitative study was undertaken, comprising 11 In-depth Interviews (IDIs) and four Focus Group Discussions (FGDs) with various stakeholders, chosen purposively to ensure representativeness, after obtaining informed consent. Transcriptions of the recorded IDIs and FGDs and translation to English were done. Free-listing, domain identification, coding, and identification of categories and themes were undertaken. A conceptual model was developed. Triangulation of methods and data was ensured. Results: Physical, emotional, behavioral, interpersonal, and interdepartmental problems, worries, apprehensions, social issues, deficiencies, and occupational impairments were the identified themes. Almost all the participants reported emotional problems like anxiety, fear, depression, anger outbursts, etc. All stakeholders experienced physical problems, primarily related to the use of personal protective equipment, and were overwhelmed by the workload and deficiencies in various domains. Social stigma, discrimination, and ostracization were experienced mostly by the nurses, nursing assistants, and attenders. Deficiencies in their academic training were a major concern for the residents. Conclusion: Various psychosocial problems were common among HCWs engaged in delivering care to COVID-19 patients. The inadequacies of the system and the attitude of the community contributed to these issues.
Copyright (c) 2025 Indu PV, Harish M Tharayil, Chitra Dilip, Anithakumari Ayirolimeethal, Harsha Vadakkechalil, Anu Padmanabhan, Afeefa Moidu, Rajula KP, Aysha Zabin Madathil, Varsha Vidyadharan (Author) https://creativecommons.org/licenses/by-nc/4.0
Aim, Research Questions, Objectives, and Hypotheses- Which One and How to Write in a Manuscript?
A well-defined research framework is fundamental to conducting effective and impactful studies. This article explores the distinct yet interconnected roles of key research components: the aim, objectives, research questions, and hypothesis. The aim outlines the broad purpose of a study, while objectives delineate the measurable steps necessary to achieve the aim. Research questions specify the inquiries that guide the investigation. A hypothesis provides a testable prediction based on an assumption. Clarifying these elements is crucial for designing a coherent and focused research plan. By distinguishing and articulating each component, researchers can improve the clarity, direction, and overall quality of their studies.
Copyright (c) 2025 Samir Kumar Praharaj, Shahul Ameen (Author) https://creativecommons.org/licenses/by-nc/4.0
Moonlight Over the History of Psychiatry In Kerala
This is a review of a fascinating and eminently readable book by Dr. K.A. Kumar, one of my teachers in psychiatry, who is well-known to the psychiatric fraternity in India. The book is titled “Novum Nilavum, which I am translating as Sufferings and Moonshine. Dr. Kumar has dedicated this book to his parents: his mother, who taught him the basics of kindness and caring, and his father, who instilled in him a sense of justice and duty. After this, there is a brief preface by him and a concise introduction by the famous Malayalam writer, Paul Zacharia. The book has twelve chapters and ends with an afterword by the author himself. Dr. Kumar offers a firsthand account of the mental health care scenario in the most literate state of the country. It is a gratifying experience for the reader to go through this well-written book. This book is a welcome addition to the very sparse list of books on the history of Psychiatry and mental health in Kerala. Reading it will be a delight to mental health professionals, and lay readers will also find the book engaging. Book: Novum Nilavum (Sufferings and Moonshines); Memoirs of a Psychiatrist Language: Malayalam Author: Professor K A Kumar Publisher: Chintha Publishers, Thiruvananthapuram, February 2025 Distributed by: Deshabhimani Book House, Thiruvananthapuram The book is available on Amazon.com [Link]
Copyright (c) 2025 Harish M Tharayil (Author) https://creativecommons.org/licenses/by-nc/4.0
A Comparative Study of Clinical Characteristics, Course of Illness, Substance Use Pattern and Quality Of Life between Patients with Bipolar and Unipolar Depression
Background: Distinguishing between unipolar and bipolar depression is critical for effective management. This study aims to compare the clinical characteristics, illness trajectory, substance use patterns, and quality of life in patients with unipolar and bipolar depression. Methods: A cross-sectional study including 140 patients diagnosed with unipolar or bipolar depression per DSM-5 criteriawas conducted. Participants were evaluated using the Hamilton Depression Rating Scale (HDRS), Brief Psychiatric Rating Scale (BPRS), WHO Quality of Life-BREF (WHOQOL-BREF), Alcohol Use Disorders Identification Test (AUDIT), and the Fagerstrom Test for Nicotine Dependence. Socio-demographic and clinical data were analysed using descriptive and inferential statistics. Results: Patients with Bipolar Depression (BD) had significantly higher symptom severity, with mean HDRS scores of 21.59 (SD = 5.05) compared to 17.64 (SD = 4.43) in Unipolar Depression (UD) (p < 0.001), and BPRS scores of 44.10 (SD = 7.99) vs. 37.91 (SD = 8.55), respectively (p < 0.001). Psychotic symptoms were more common in the BD group (64.3%) compared to the UD group (34.3%) (p< 0.001). Regarding the course of illness, BD patients had an earlier age of onset (mean = 25.61 years, SD = 7.31) than UD patients (mean = 36.23 years, SD = 8.04; p < 0.001), a greater number of depressive episodes (p < 0.001), longer average duration of episodes (p = 0.009), and more frequent hospitalizations (p < 0.001). In terms of quality of life, psychological domain scores were significantly lower in the BD group (mean = 41.63, SD = 13.47) compared to the UD group (mean = 48.71, SD = 13.34; p = 0.004). Conclusion: Bipolar depression presents with greater severity, recurrence, and psychotic symptoms, impacting overall psychological well-being.
Copyright (c) 2025 M Goutham Kiran , Roy Abraham Kallivayalil, Joice Geo (Author) https://creativecommons.org/licenses/by-nc/4.0