PROF. K C DUBE POSTER AWARD

Betting on Neuromodulation: Efficacy of Adjunctive Theta HD-tACS in Gambling Disorder Aaditya S., Sourav Khanra, Premaja Bhatt Joshi, Anshul Yadav, Justin Raj PC, Sanjay Kumar Munda. Central Institute of Psychiatry, Ranchi. Introduction: Recent years have witnessed an unprecedented growth in commercial gambling, fueled by ready online access. The relapsing nature of gambling disorder, with poor retention on current management protocols, requires novel treatment modalities to be explored. Aim: To investigate the efficacy of neuromodulation in the form of theta high-definition transcranial alternating current stimulation (HD-tACS) as an adjunctive intervention for patients with gambling disorder. Methodology: Three inpatients from a tertiary care hospital - Mr. X, a 38-year old male with a ten-year history of online sports betting, Mr. Y, a 31-year old who had incurred a loss of eight lakhs on offline card gambling and Mr. Z, a 24-year old with a history of online casino gambling - were included in the case series. Appropriate clinical scales were applied to assess gambling related cognitions, severity and craving, along with any comorbid anxiety and depression. This was followed by Stroop Task, Iowa Gambling Task, qEEG and resting state fMRI. 10 sessions of 6Hz theta HD-tACS of 20 minutes each were then administered to the left DLPFC over 5 days, after which assessments and imaging were repeated. Results: All subjects showed improvements in gambling related cognitions, severity and craving. They also displayed reduced risk-taking behaviour on Iowa Gambling Task, and reduced anxiety and depressive symptoms. qEEG and resting state fMRI findings will be reported at the time of presentation. Discussion: Prefrontal theta asymmetry between the right and left cortices has been hypothesised to underlie increased risk-taking behaviour. Exogenous theta HD-tACS to the left DLPFC leading to entrainment of theta oscillations, thereby reducing interhemispheric asymmetry, could increase cognitive control and risk aversiveness in gambling. Conclusion: The successful application of theta HD-tACS represents a possible breakthrough in our quest to treat gambling disorder, and warrants urgent further research to generalise these findings. Keywords: Gambling, Neuromodulation, tACS, DLPFC. Capturing Real-Time Moments: Exploring Ecological Momentary Assessment for Alcohol Dependence in India Ankita Chattopadhyay, Shalini Singh, Rakesh Lal Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India, National Drug Dependence Treatment Centre (NDDTC), All India Institute of Medical Sciences (AIIMS), New Delhi, India Aims/Objectives: Ecological momentary assessment (EMA) is emerging as a valuable method for real-time behavioural monitoring in substance-using population in natural settings. However, most EMA research has been conducted in developed countries and predominantly among non-dependent or non-treatment-seeking individuals, often with varied protocols and heterogeneous samples. This study aims to explore feasibility of EMA in treatment-seeking alcohol-dependent patients in India. Methods: A total of 102 males diagnosed with alcohol-dependence were recruited during outpatient detoxification phase. Ethical approval was obtained, and participants provided written informed consent. Participants completed a socio-demographic-clinical proforma, alongwith assessment of alcohol use severity, affective states (depression, anxiety, psychological stress), and alcohol craving using standardized clinical scales. EMA prompts addressing mood (sadness), anxiety, stress, and craving were sent to participants’ phones thrice daily for one week. Additionally, participants were required to self-initiate a response once daily. Results: Overall response rate was 24.47%, comprising 0.08% for self-initiated responses and 32.35% for random prompts. Acceptance rate for participation was high at 91.07%, but retention rate was low (34.31%). Compliance assessed by tracking response frequency revealed decline in responses over study duration. Feedback from participants indicated that both the length and frequency of assessments were perceived as “just right.” Notably, no significant clinical differences emerged between responders and non-responders. Reliability analysis showed moderate reliability for mood and stress measures, but poor reliability for anxiety and craving. Discussion: This study is pioneering in assessing EMA feasibility among treatment-seeking alcohol dependent patients in India, with findings suggesting that EMA can be useful for monitoring drinking behavior and related parameters, but challenges in compliance must be addressed. Conclusion: EMA studies involving larger samples and strategies to enhance adherence, such as incentivization and personalized interventions should be conducted in India. Additionally, developing tailored digital applications for alcohol-dependent patients in India could improve efficacy of EMA methodologies. Navigating the Aftermath: The Impact of Patient’s Suicide on Mental Health Professionals Akansha Bharadwaj, Shipra Singh, Yogender Malik AIIMS, New Delhi Introduction: The impact of patient suicides on mental health professionals (MHPs) is profound, affecting their emotional well-being and profession. This study explores MHPs’ experiences with patient suicides and their adequacy of managing such incidents. Aim/Objectives: The aim of the study is to explore the effect of patient suicides on MHPs. Objectives include evaluating the perceived psychological and professional impacts, understanding the support MHPs need and receive, and assessing their views on training related to dealing with patient suicides. Methodology: A mixed-methods approach was employed, utilizing a semi-structured online survey, following Institutional Ethical approval. The questionnaire, validated by professionals, covered demographics, details of incidents, emotional and professional impacts and support systems. The survey was open for 8 weeks, and responses from 96 MHPs were analysed using descriptive statistics and thematic analysis to derive insights from both quantitative and qualitative data. Results: Among 96 MHPs surveyed, 51% had treated patients who died by suicide, with a majority being males aged 20-40 years, primarily diagnosed with psychotic or affective disorders. The emotional impact varied: 49% reported mild, 28% moderate effects, with sadness, regret, and guilt being common responses. Support-seeking behaviours were prevalent, with 52.2% of respondents finding support from colleagues, family, or professional communities helpful, but formal training on managing patient suicides was found lacking. Discussion: The impact of patient suicides on MHPs is multifaceted, affecting personal and professional aspects. A significant portion of MHPs experienced patient suicides after completing their training. Majority of suicides occurred outside controlled environments, highlighting need for stronger follow-up and community support. Conclusion: The emotional and professional consequences of patient suicides underscores importance of a supportive environment, integrating enhanced psychiatry training and fostering open dialogue. Addressing these needs can help mitigate adverse effects and promote resilience among MHPs, ultimately benefiting practitioners and quality of mental health services. A comparative study on Cognitive impairment among patients with chronic skin inflammatory disorder (Psoriasis and Vitiligo) Tarun Narang, Anupama Arora, Rahul Chakravarty, Aseem Mehra PGIMER, Chandigarh, Dr YS Parmar Government Medical College, Nahan Background: A limited number of studies have associated the prevalence of cognitive impairment among patient with chronic inflammatory skin disorders. Aim and objectives: To evaluate and compare the presence of cognitive impairment among patients with psoriasis and vitiligo. Methods: This was a cross-sectional study with a convenient sampling technique. A total of 200 patient with a diagnosis of Psoriasis and Vitiligo (100 each) were included. Participants were evaluated on the Hindi version of the Montreal Cognitive Assessment for cognitive impairment, Patient Health Questionnaire- 9 for depression, Generalized Anxiety Disorder-7 for anxiety disorder and Metabolic syndrome as per the consensus criteria given by World Health Organization. Results: A total of 200 patients were recruited. Those with Psoriasis were significantly older (p<0.001), had notably fewer years of education (p=0.006), and were from rural areas (p=0.007). Those with psoriasis had a higher age of onset of illness (p-0.043), with a longer duration of illness (p-0.013) and reported significantly more presence of substance abuse (p-0.001). Overall, 68.5% had a presence of cognitive impairment. Those with psoriasis (75%) had a significantly higher frequency of cognitive impairment compared to those with vitiligo (62%). Those with psoriasis scored significantly low on the overall score of MOCA and all the domains of MOCA except orientation. These significant differences persisted even after controlling factors such as the age of the patient, number of years of education, locality, age of onset of illness, duration of illness, substance use, alcohol use, tobacco use, Hypertension, and central obesity. Conclusion: The prevalence of cognitive impairment was very high in patients with Psoriasis and vitiligo. It is recommended to evaluate patients with psoriasis and vitiligo for cognitive impairment for early identification, and treatment to prevent the further deterioration of cognitive functions. Keywords: Chronic inflammatory Skin Disorder, Psoriasis, Vitiligo Cardiovascular risk estimation in women on antipsychotics: Findings from a cross- sectional study Bandita Abhijita, Ilambaridhi Balasubramanian, Chinu Patra, Shree Mishra, Susanta Kumar Padhy JIPMER, Puducherry, NIMHANS, Bengaluru, AIIMS, Bhubaneswar Background: Patients with severe mental illness (SMI) are vulnerable to metabolic derangements, owing to lifestyle and genetic risk factors.1,2impaired fasting glucose (IFG Evidence suggests that females on antipsychotics are at higher risk for metabolic dysfunction and cardiovascular problems.3 However, studies on this are scant. Aims/Objectives: This cross-sectional study aimed to explore cardiovascular risk in women with SMI on antipsychotics and to look for potential association with various clinical variables. Methodology: The study was conducted at a tertiary institute in India. Eligible females aged 25- 65 years identified from hospital records were contacted telephonically and explained about the study. Consent was taken over text message. Participants were assessed using semistructured interview, Cardiovascular Risk Score (QRISK-3) and International Physical Activity Questionnaire (IPAQ). Institute ethical clearance was obtained. Results: Total of 261 consecutive participants were recruited with mean age of 37.53±14.48 years. Around half of study population were obese (55.6%). According to IPAQ, majority (79.3%) were minimally active, 16.1% were inactive and 4.6% were HEPA active (health enhancing physical activity; i.e., high active). Total of 15.3% of the population were at high cardiovascular risk in next 10 years (QRISK-3 >10). Cardiovascular risk was significantly higher in inactive (6.36 ± 8.5, p =0 .015) group compared to HEPA active group (1.92 ± 4.0). There was no significant difference between HEPA and minimally active groups (p =0 .291). Age, but not duration of illness or antipsychotic exposure was positively associated with QRISK-3 score. Among antipsychotics, clozapine was significantly associated with increased BMI (p<0.001) but not with QRISK-3. Discussion: This aligns with previous research indicating that individuals with SMI, especially those on antipsychotics, are at increased cardiovascular risk due to adverse effects compounded with lifestyle factors such as physical inactivity and obesity.4 Conclusion: There is a need to emphasise lifestyle modifications and regular cardiovascular monitoring in women on antipsychotics. A patient presenting with acute vision loss having visual hallucinations: A case report Devang borisagarl, Vinod M. Darji, Bhaveshkumar M. Lakdawala, Vaishal D. Chokshi Narendra Modi Medical and Introduction: The in which visual with visual visual loss or visual loss is a syndrome The patient has or no control over the which are A old patient was to from as was has in right days, developed loss of vision in left reported and and a was was reported those to be more on and all was to higher mental were showed in left and and more in was on and was after patient was patient reported in of Patient for and on for regular and was in Conclusion: should be in all patient who have acute onset of visual by onset of visual as are or with time antipsychotics. in antipsychotic should be Keywords: A study to explore the prevalence and of of among the patients with substance use disorder in AIIMS, and and have been to have abuse aimed at evaluating the prevalence and clinical of in patients treatment for substance use and Methods: Patients with diagnosis for various in the age of years who for participation in this study were evaluated for of of and Results: of a total was being for the of from to enhance the effect of from anxiety or a of these Majority were to by from to increased the of over time more half not the effect with had effects and found to the use of high of were in patients in rural areas (p<0.001), more 10 years and with an use disorder was also significantly higher in patients years with a age of onset of substance use disorder years and with duration of substance abuse Conclusion: These high for of in our study are an early of of which not be to and the need to explore this and in disorder in and objectives: and in the of and impact on and quality of However, of each of these especially in disorder. This study aimed to assess and association with clinical quality of and in patients with disorder who are in Methods: subjects with disorder in were recruited from the in a tertiary care in The clinical of were using scales. Results: patients reported high of which was associated with a history of illness, higher of poor quality of and a report of in This was higher of the qualitative assessment the most reported experiences of were of about and experienced of and a in was found to be significant of Conclusion: The risk of a patient more as as is a of even are should to look for even after clinical and Keywords: quality of disorder of in with A from in India AIIMS, AIIMS, Background: the of follow-up in with Disorder is for the Aim: To factors that in with Methods: A was conducted tertiary care in India from to consecutive aged years diagnosed with to the and of Mental were included. and clinical were from records for with were was as at follow-up in Results: records of could be were and were The overall rate was of included higher and factors associated with higher were on to behavior and poor Conclusion: and clinical factors can in with Addressing on and support to improve and in These findings can in tailored interventions and in India. Keywords: Disorder clinical follow-up in treatment analysis of and in to in National Drug Dependence Treatment Centre (NDDTC), of Psychiatry, AIIMS, India Introduction: Chronic use is to the reducing stress with However, the effects of on the and objectives: This study aims to evaluate the effect of on and in individuals, especially stress Methods: This study recruited male participants and subjects on for over was using the assessing and at and 20 and scales were for stress and mood Patients with significant or comorbid substance use were analysis was using Results: The group had and compared to both and in both to by The in stress was with no significant were between stress and mood at were on for an of with a of which is as a high with efficacy to as an to for management of To evaluate compared to and to in the management of to in use, and the following to and Alcohol Central of Alcohol and Drug of Drug Centre for Education and on and of of identified studies and controlled and Conclusion: significantly the stress as by reduced and study to assess in which are to This suggests that being a have more effects on the especially at a higher These findings open for further research and stress Disorder A case report Raj Medical and Introduction: disorder significantly a to control their This can increase mood and impact their with for can and from to leading to and emotional They also have significantly higher rate of and behaviour the A old to our with with of increased and low mood which were in onset and for According to the was history of of the patient from after with being the patient being that to There have been acute of very and in between which on about of in of There was also history of 10 had was old which the as Conclusion: This is a case of disorder validated for common that are in all treatment patients with are to of patients in a in an institute of A Background: India, and of a total population of and mental health This study aims to evaluate the clinical and of patients the and psychiatry in an institute of importance from India. Additionally, to explore the association of and clinical with in this and A of patients the and was conducted over a were to 10 of statistics were as Results: The study included with a mean age of years The majority were male and to were from age groups The most common diagnosis was and followed by mental psychotic and mood It was found that the number of females were higher in the group The study revealed a among treatment for with higher prevalence of stress related and disorders. The of in most were in with This study useful insights for tertiary and mental health services. disorders. The who case of and is a among women for chronic This case report a who developed a to The patient experienced chronic and was treated with by after imaging a and to a being and was to a was at per from per to daily. The increase in use to physical the was experienced and severe use to and of the The patient was then to our and diagnosed with use disorder as per The patient was on a that To To anxiety and symptoms. and support. To and potential mood The patient the use of is Conclusion: This case underscores the significant risk of with and the need for monitoring and management of use, in Addressing both and psychological is for with A case report Bhaveshkumar M. Lakdawala, Vinod M. Darji, Vaishal D. Chokshi Narendra Modi Medical and Introduction: is a syndrome in which is the of It is diagnosed as often with and symptoms. A old patient to the for and an of was to psychiatry reported was their often had one of on of and behavior and and findings were and on and 5 developed symptoms. which was was was to analysis was and found for Patient was on and which to moderate was after Patient was on and for regular Conclusion: of is and is due to in presenting and no findings on of should be in patients presenting with acute onset a Keywords: A of Patients Psoriasis Psoriasis is a presenting with with prevalence reported in population as of in psoriasis is to as per criteria and to to 10 and Objectives To study in patients of psoriasis the of of of with and quality of This study is a study. by convenient sampling by using the was The patients were then by the that for minutes with the help of The were and the study population for of as per total score with and quality of found a between p between p between quality of p This that due to was more and more quality of criteria for the prevalence of not as patients help in a tertiary were included The of this study high prevalence of in patients of It is for and to be about the with of early to the for patient A of The of in Medical College, Introduction: is a form of syndrome in which individuals have or are This disorder often and that the of the to of a with and in a of and both the and their with Methodology: A clinical assessment was conducted for a male patient presenting with and informed a case report was clinical and Results: The patient, old in rural of was diagnosed with by the of being and a and with the perceived and in to these 10 was to the psychotic symptoms. Discussion: This case a of and significantly the of and A and approach can help to the clinical of patients with and help to of of in the Drug and Rakesh Institute of and Sciences and This study aims to evaluate in the psychiatry of a tertiary care hospital using the World Health use and the National for and and are the challenges to psychiatry in with standardized The is to promote use, and improve to clinical Methodology: The study was conducted over a of at a tertiary care involving a analysis of outpatient and The use were to assess the number of per the use of and the frequency of were using the Results: A total of were and about patients and were in of an were per The diagnosis an was written in to patients duration of treatment follow-up and were of were of were with a from the The and frequency of were for all According to the of Discussion: the of regular and training are to and This approach to clinical due to challenges in patients to on which are often or written in Conclusion: This study insights about needs and these will be in overall quality of patient can be reduced by utilizing and regular on and to and quality in A study in population of of Institute of Medical Sciences is to the prevalence of various in patients with and to assess quality in patients with Methods: study was a hospital sectional study conducted over that included patients from psychiatry sampling was The patients the and criteria were assessed using a for the data. The International of was to the International to assess in all and was applied on the symptoms. quality was to the Results: The prevalence of depressive disorder, anxiety disorder, psychotic disorder, and disorder was and and and of the with no illness was of the among had with age and with duration age duration of illness and were higher among had higher among There is significant association of compliance with effects and number of per Conclusion: are significantly with disorder. It is that patients with should be for early intervention can be is an for poor of disorders. It is that is more in more severe is associated with poor of and also longer duration of with and poor also have poor compliance and quality improve the treatment of help in

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