Current Issue Highlights

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    Fifteen years and beyond on buprenorphine maintenance: A descriptive case series from a community opioid agonist treatment clinic in North India

    October 2026: 68(10):941-945

    Background:

    Long-term outcome data on buprenorphine maintenance treatment beyond 15 years remain scarce, particularly from community-based treatment settings in low- and middle-income countries.

    Cases:

    We present a case series of five males with opioid use disorder on sublingual buprenorphine for 15 to 19 years at a North India community clinic were reviewed. All remained employed and showed improvement across health, family, social, and financial domains. Three had treatment interruptions, with relapse or withdrawal prompting re-engagement. All wished to continue treatment, and two preferred lifelong maintenance.

    Conclusion:

    This case series suggests that a sustained recovery is observed among patients who adhere to opioid agonist treatment for a prolonged period.

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    Psychiatric facets of Wilson’s disease: A case series

    October 2026: 68(10):938-940

    Background:

    Wilson’s disease is a rare genetic syndrome characterised by multisystemic copper accumulation. Psychiatric symptoms are common and can present at any point in the course of the disease, often before clear neurological or hepatic signs are evident, thus creating diagnostic and therapeutic challenges.

    Cases:

    The following case series describes three male patients with a psychotic syndrome in the context of Wilson’s disease, highlighting the diversity in possible etiologies, outcomes, and pharmacotherapy.

    Conclusion:

    Psychiatrists must be aware of the differential diagnoses and safest treatment approaches as they often are the first point of contact for the patient with Wilson’s disease.

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    Impact of cognitive reserve on stress, affect, and general mental health in the rural population of Rajasthan – A cross-sectional study

    October 2026: 68(10):934-937

    Background:

    Cognitive reserve (CR) refers to the accumulation of cognitive capacities developed over a lifetime through one’s life experiences.

    Aim:

    To examine the impact of CR on perceived stress, negative affect, and general mental health in the rural population in Rajasthan.

    Methods:

    A total of 158 rural adults (aged 20–60 years) from Rajasthan (India) formed the sample. Cognitive impairment was screened using the Hindi Mini-Mental Status Examination (HVMMSE). Cognitive Reserve Index questionnaire (CRIq), Perceived Stress Scale-10 (PSS-10), Positive and Negative Affect Scale (PANAS), and General Health Questionnaire-12 (GHQ-12) were used to assess the variables.

    Results:

    The findings revealed a negative correlation between CR and adverse mental health outcomes (lower perceived stress, reduced negative affect, and better mental health). However, the effect size of CR on these variables was modest.

    Conclusion:

    The study highlights the protective role of CR against stress, negative affect, and poor mental health while underscoring gender-based disparities in CR.

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    Challenges faced by the nurses working in Child and Adolescent Psychiatry – A qualitative study

    October 2026: 68(10):930-933

    Background:

    Nurses working in Child and Adolescent Psychiatry (CAP) face many challenges. This article explores the experiences of nurses working in a specific area by using a qualitative research design.

    Methods:

    Twenty-six nursing officers were purposively selected and interviewed. The study was conducted and reported in accordance with the Consolidated Criteria for Reporting Qualitative Research checklist.

    Results:

    Various challenges related to parents, administration, safety, and security were identified. The participants also stated that working in CAP is entirely different from working in adult psychiatric settings, in terms of the physical setup and communication.

    Conclusion:

    The participants suggested that organising regular sensitization program, promoting higher education, and Continuing Nursing Education would be more helpful for better nursing care.

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    Mental health and workforce participation in India: A gendered analysis

    October 2026: 68(10):922-929

    Background:

    Depression adversely affects labor market outcomes globally. In low- and middle-income countries like India, where informal employment is prevalent and mental health services are limited, poor mental health may be associated with substantial economic disadvantages. However, large-scale empirical evidence remains limited, especially on gendered patterns.

    Aim:

    This study examines the association between depression and employment among midlife adults (ages 45–60) in India and explores how this relationship varies by gender and socio-economic status.

    Methods:

    Using nationally representative data from the Longitudinal Ageing Study in India (Wave 1), we analyze 27,092 individuals reporting current working status. Depression is measured using the Composite International Diagnostic Interview–Short Form via both continuous scores and threshold-based cutoffs. To account for potential endogeneity, we employ a control function approach and probit-2SLS models, with parental psychiatric history and number of confidants as instruments. Gender-disaggregated and subgroup analyses cover income and education levels.

    Results:

    Depression is associated with lower likelihood of employment, even at subclinical levels. The gender gap in employment is narrow among the depressed; the pattern is consistent with distress-driven employment and constrained agency.

    Conclusion:

    The counterintuitive narrower gender disparity among the depressed—largely driven by disadvantaged women—contrasts with conventional expectations about India’s labor market. Integrating gender-sensitive mental health support into employment and social protection programs, even for subclinical cases, may be relevant to protect vulnerable workers, reduce economic insecurity, and promote equitable workforce participation.

Latest Articles

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    Telephone-based outreach and interventions for persons with suicide attempts – A randomized controlled trial

    Indian Journal of Psychiatry. May 02, 2025

    Background:

    Suicidal ideation and a history of suicide attempts (SAs) are risk factors for future suicide. Telephone outreaches as treatment augmentation strategies could address these risks.

    Aim:

    To compare the efficacy of manualized addon telephone-based psychosocial interventions (TBPIs) with telephone contacts (TCs) during follow-up on suicidal ideation in individuals with a recent SA.

    Methods:

    Using a parallel-group, rater-blind, two-arm, randomized controlled trial design at two general hospital settings, we recruited 390 individuals with recent SA. We excluded recent psychosis, substance dependence, and medically unstable conditions. The TBPI group (N = 194) received three sessions of manualized psychosocial intervention with reminders for treatment adherence. The TC group (n = 196) received three telephone reminders for treatment adherence. Both the outreaches were at weekly intervals. Primary outcomes were changes in Beck’s Scale for Suicide Ideation and rates of repeat suicidal behaviors at 6 months.

    Results:

    Using intent to treat analysis at trial completion, TBPI (N = 194, χ2 = 44.19, W = 0.14, P < 0.001) and TC (N = 196, χ2 = 20.26, W = 0.07, P < 0.001) significantly reduced suicidal ideation at 6 months. There were no significant differences between TBPI and TC on suicidal ideation (δ = -0.031(CI = -0.091-0.030), P < 0.323) nor on rates of repeat suicidal behaviors (TBPI, N = 3 [1.5%]; TC N = 5 [2.6%], χ =2.24, P < 0.329). Exploratory analyses revealed significantly reduced suicidal ideation in those who received TBPI irrespective of whether psychiatric disorders were present. Those who received TC and were without psychiatric disorder did not show significantly reduced suicidal ideation.

    Conclusions:

    Telephone outreaches - during follow-up - are potential treatment augmentation strategies in individuals at risk of suicide in Indian hospital settings.

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    Screening children and adolescents with mild to moderate intellectual disability for autistic symptoms with the Indian Autism Screening Questionnaire (IASQ)

    Indian Journal of Psychiatry. May 02, 2025

    Introduction:

    Intellectual disability (ID) is frequently associated with autistic symptoms. Considering the prevalence of ID and the large numbers involved, a simple easy-to-use screening instrument is required. The present study aimed to screen a group of children with ID using the Indian Autism Screening Questionnaire (IASQ), a screening instrument for identifying autism in the general population but not tested among children with ID.

    Objectives:

    To screen for the presence and prevalence of autistic symptoms among Indian children with ID and to evaluate IASQ scale properties in this group.

    Methods:

    In a cross-sectional observational study, 120 children/adolescents between the ages of 3 and 18 (both genders) with mild to moderate ID were assessed using the Vineland Social Maturity Scale for Social Quotient, IASQ, and the Indian Scale for Assessment of Autism (ISAA).

    Results:

    Using the ISAA, 37.2% of children with mild ID (mild symptoms 27, moderate 5) and 52.9% with moderate ID (mild 16, moderate 2) reported autistic symptoms. The sensitivity and specificity for IASQ against the ISAA were acceptable – high sensitivity at cutoffs 1 to 5 and high specificity at cutoffs 4 and 5.

    Conclusion:

    The IASQ can be used for screening for autistic symptoms among children with mild or moderate ID at cutoff 1, while the specificity is high at cutoff 4. Autistic features were reported among 1/3rd and 1/2nd of children with mild and moderate ID, respectively.

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    A qualitative exploration of the lived experiences and views of users of mental health services after self-harm

    Indian Journal of Psychiatry. May 02, 2025

    Background:

    Individuals at risk of suicide have low engagement with mental health services (MHS). Reasons for this include stigma about suicide, inadequate public awareness, and the difficulty in approaching MHS. Lived experiences of users of MHS might yield insights into this low engagement and improve the access to mental health interventions for users.

    Aim:

    To explore the lived experiences and views of individuals with self-harm who were users of specialist MHS in a tertiary general hospital setting.

    Methods:

    We used a qualitative study design with in-depth interviews. We included participants who had used inpatient or outpatient MHS for a self-harm attempt. We used a realist approach to thematic analysis and ATLAS ti qualitative software for coding.

    Results:

    We recruited 25 participants (16 women and nine men) between 18 and 43 years. All participants had completed a randomized controlled trial on the efficacy of telephone outreach in suicide prevention. The themes generated were the participants’ inherent attitudes toward self-harm and suicide, their experiences of MHS, their perspectives on treatments that helped with suicidal ideation, and the impact of their experiences with MHS on future help-seeking.

    Conclusions:

    The user perspectives of MHS appear to be influenced by their inherent pre-existing beliefs about suicide. Users find specific interventions for suicidal ideation beneficial and healthcare infrastructural problems as challenges. Individuals with persistent difficulties after self-harm were more likely to engage with healthcare services. The study limitation was the absence of perspectives from those individuals who dropped out from MHS and other settings.

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