Prevalence of adult attention deficit hyperactivity disorder in India: a systematic review and a cross-sectional study among young adults in Delhi-NCR.

PURPOSE: The epidemiology of adult attention deficit hyperactivity disorder (ADHD) is not well explored in India. The present study aims to systematically review the literature on the prevalence of adult ADHD in India and also estimate the prevalence and sociodemographic correlates of adult ADHD among the young adults in Delhi-NCR. METHODS: For the systematic review, 494 articles were identified of which 10 were included in the review. Simultaneously, a cross-sectional study was conducted involving 1665 adults (18-25 years; mean age 19.92) of both sexes (69.1% females) from different colleges in Delhi-NCR, India. Data was collected using structured interviews and standardized diagnostic tool ASRS V1.1 was used for screening of ADHD. RESULT: The systematic review revealed a high prevalence of adult ADHD ranging from 5.48 to 25.7% among general and specific populations of India. Further, in the cross-sectional study, 14% of participants were screened positive for ADHD. While factors like South Indian origin and higher maternal education were associated with an increased risk of adult ADHD, low socioeconomic status was found to be protective. CONCLUSION: Considering the high prevalence of adult ADHD in India, there is an urgent need to increase awareness regarding adult ADHD and identify vulnerable populations to facilitate informed interventions.

Adverse childhood experiences in mental health of young adults: An exploratory study from Delhi-NCR, India.

BACKGROUND: Despite the growing realization regarding the importance of adverse childhood experiences (ACEs) in adult health outcomes, this area of research has received little scientific attention in low- and middle-income countries, including India. AIMS: To understand the overall and domain-specific association of exposure to ACEs with current depression, anxiety, stress, and well-being among young adults of Delhi-NCR. METHODS: This cross-sectional study was carried out among 1,812 young adults (aged 18-25 years) of both sexes (68.7% females). Fieldwork was conducted on the campuses of the University of Delhi, Delhi, and Amity University, Noida, India. ACEs, depression, anxiety, stress, and well-being were screened using the Adverse Childhood Experiences International Questionnaire, Beck Depression Inventory-II, Beck Anxiety Inventory, Perceived Stress Scale, and WHO-5 Well-Being Index, respectively. RESULTS: Exposure to ACEs was found to increase the odds of moderate/severe depression, moderate/severe anxiety, and high stress and decreased the odds of good well-being in a dose-response manner. Being bullied, followed by emotional abuse, was associated with the highest odds of current moderate/severe depression, moderate/severe anxiety, and high stress and the lowest odds of good well-being. Further, while several domains of household dysfunction showed poor association with studied mental health outcomes, domains of abuse and violence were more consistently associated. CONCLUSIONS: The present study revealed the detrimental impact of ACEs on mental health outcomes among young adults of Delhi-NCR, India, and underscored the relevance of ACEs in the Indian context. Considering the lack of trauma awareness in Indian societies, there is an urgent need to create widespread awareness regarding ACEs and associated health implications.

Family Accommodation in Obsessive Compulsive Disorder and Its Association With Insight.

Background: Family accommodation (FA) is defined as a family members' involvement by doing certain behavior in response to the daily rituals of patients with obsessive-compulsive disorder (OCD). FA is associated with more severe symptoms of OCD. Similarly, poor insight is associated with high severity of OCD symptoms. FA and insight are also related to each other, as more accommodative behavior of family members is associated with poor insight. Methods: This cross-sectional observational study assessed 103 adult OCD patients with an illness duration of at least one year. Participants were assessed using Yale-Brown Obsessive Compulsive Scale (Y-BOCS) symptom checklist, Y-BOCS to assess severity, and Family Accommodation Scale-SR (Hindi) to evaluate FA. Insight was assessed with the 11th item of Y-BOCS. Results: FA was common in the families of our participants. The mean±SD Y-BOCS score was 28.72±5.09, and the mean FAS-SR score was 44.1±12.03. A significant positive correlation existed between the FA and YBOCS scores, that is, with the increase in FA, YBOCS scores also significantly increased. A considerable number reported poor insight, and had high scores on YBOCS and their caregiver had high FA scores. Conclusion: FA is indicative of high symptom severity of OCD and higher FA is associated with poor insight, so FA needs further research for its interplay with OCD symptomatology and role in the maintenance of symptoms.

Neurocysticercosis presenting as bipolar disorder: a case report.

Neurocysticercosis is the most common neuro-parasitosis caused by the larval stage of Taenia solium. The most common manifestations include seizures and hydrocephalus. Psychiatric abnormalities are relatively rare but depressive symptoms are frequent in patients with neurocysticercosis. However, mania as a presentation is relatively rare. Pregnancy and the postpartum period are relatively vulnerable times and they can lead to reactivation of existing neurocysterci lesions. We are discussing the case of a 23-year-old female patient with neurocysticercosis leading to the reactivation of lesions in the peripartum and postpartum period leading to bipolar affective disorder. Improvement in the patient was seen with a combination of antipsychotics, antihelmintics, antiepileptics and steroids, along with improved radiological signs of neurocysterci lesions. Although neurocysticercosis is a common illness, its prevalence presenting as a manic episode is merely 2.6% and, hence, missed easily. Therefore, it is important to rule out organic aetiology in patients even with a classic presentation of bipolar affective disorder and those having any other neurological symptoms and signs.

Cognitive Schemas among Mental Health Professionals and Other Health Professionals.

OBJECTIVE: Research has demonstrated that dysfunctional cognitive schemas among mental health professionals (MHPs) may influence the ability to process clients' information in an unbiased manner, may be a substantial source of error in psychotherapeutic ratings, hinder accurate reporting of clients' cognitive schemas, and have a detrimental effect on therapeutic alliance. The present study compared cognitive schemas among MHPs and other health professionals (OHPs). MATERIALS AND METHOD: A sample of 128 professionals (64 MHPs and 64 OHPs) was chosen using a purposive sampling technique. The study used a cross-sectional observational research design. The Young Schema Questionnaire Short Form 3rd version was administered on the consenting participants. RESULTS: OHPs had higher maladaptive schemas on the domains of abandonment and defectiveness. Overall, males had more maladaptive schemas in the domains of abandonment, mistrust, entitlement/superiority, admiration/recognition seeking, and emotional inhibition. Among MHPs, a weak positive correlation of years of experience with vulnerability to harm or illness was seen. Among other health professionals, a significant but weak positive correlation of age with admiration/recognition seeking was seen. CONCLUSION: This study highlights the presence of maladaptive schemas in health professionals and the need for incorporation of training modules to address these.