Effect of Virtual Reality on Sleep-Deprived Individuals

Indian Journal of Psychological Medicine, Ahead of Print.
Background:Sleep deprivation (SD) refers to getting less than the required amount of sleep, which for adults ranges from 7 to 9 h of sleep per night and can be caused by social and biological factors. College students experience SD, which can affect their academic performance, health, and mood. Virtual Reality Therapy (VRT), an upcoming method of intervention, has been used in other psychological conditions with positive outcomes. The purpose of this study was to determine the effect of VRT on individuals with SD.Methods:This quasi-experimental study recruited 28 individuals based on the scores of the Pittsburgh Sleep Quality Index (PSQI), Athens Insomnia Scale, and Beck’s Depression Inventory, which were used as the inclusion and exclusion criteria. VRT sessions of 20 min were given twice a week for 2 weeks. PSQI was also used as an outcome measure, immediately and 2 weeks after the interventionResults:A significant difference was found between the baseline and post-intervention PSQI scores (p = 0.001, effect size = 1.2). There was not much difference between the PSQI scores immediately and 2 weeks after the intervention.Conclusion:VRT was effective in improving sleep in individuals with SD.

A Multisite Longitudinal Investigation of Psychological Outcomes Following Cataract Surgery in India

Indian Journal of Psychological Medicine, Ahead of Print.
Background:Systematic data on mental health issues among adults with cataracts are not available from India. This study explored the impact of cataract surgery on depressive and generalized anxiety (GA) symptoms in an adult Indian sample.Methods:A multicenter, prospective, longitudinal cohort study was conducted. Subjects were recruited from four tertiary eye hospitals to assess depression, GA, and associated risk factors. A follow-up survey was carried out at 6 (n = 273, group 1), 12 (n = 198, group 2), or 18 months (n = 105, group 3) post-cataract surgery. Variations in the intensity of depression and GA were assessed using multiple classification analysis (MCA).Results:A total of 576 patients completed both baseline and follow-up assessments. The mean (SD) depression score was 25.6 (8.5) before surgery and 8.6 (7.7), 9.9 (7), and 9.8 (6.8), respectively, post-surgery for the three groups on the Center for Epidemiologic Studies Depression scale (CES-D). The mean GA score was 6.7 (4.2) at baseline and 1.1 (2.3), 1 (1.8), and 0.6 (1.3) after surgery on the Generalized Anxiety Disorder scale (GAD-7). MCA showed that factors with the highest impact on the mean change scores for both depressive and GA symptoms were restoration of vision post-surgery (β = 0.381 and 0.185) in group 1, regaining functional independence and female sex in group 2 (β = 0.192 and 0.23), and the presence of ocular comorbidities in the fellow eye (β = 0.36 and 0.315) in group 3.Conclusion:Mental health symptoms improved significantly post-cataract surgery across the three groups. The urgent need to invest in strategies that enable early cataract case detection and treat ocular anomalies in the fellow eye is highlighted.

National Drug Laws, Policies, and Programs in India: A Narrative Review

Indian Journal of Psychological Medicine, Ahead of Print.
Background:Drug use is a major public health issue in India. Significant changes in the approach toward drug use have happened in the last few decades. Despite this, no systematic attempt has been made to document the same in the scientific literature. This narrative review attempts to discuss the major drug laws, policies, and national programs of the Government of India (GoI).Methods:A thorough search was conducted to look for policies, programs, acts, and notifications related to substance use/drug use on various websites of different ministries of the GoI. Acts, programs, and policies addressing substance use were identified.Results:Various drug laws, programs, and acts from the GoI provide a multipronged approach to curbing the procurement of drug use along with its prevention and cure. The Ministry of Social Justice and Empowerment (MoSJE) is the nodal ministry for drug demand reduction. The enactment of the Narcotic Drugs and Psychotropic Substances (NDPS) Act 1985 and Policy 2012 and the implementation of India’s Drug De-Addiction Program (DDAP) are important landmarks in this journey.Conclusion:The GoI initiatives for reducing the mental health burden in this country in general and substance use disorders (SUDs), in particular, are immense. The acts/statutes/laws/notifications are all interlinked. Stakeholders in mental health, public health, and policy-making need to upgrade themselves with the relevant statutes to curb the menace of drug use.

Narrative Exposure Therapy for Treating Post-Traumatic Stress Among Transgender Youth of Color With Selective Mutism

Clinical Case Studies, Ahead of Print.
Rates of post-traumatic stress (PTS) are greater among transgender and non-binary (TGNB) youth compared to their cisgender peers. This disparity has been linked to increased experiences of trauma among TGNB youth, including greater exposure to child abuse, discrimination, hate crimes, and familial and peer bullying and rejection. Few studies to date have examined the use of trauma-focused interventions with TGNB youth. Narrative Exposure Therapy (NET) has been identified as a potentially impactful treatment for PTS for communities who experience oppression and human rights violations given its social justice-oriented “testimonial” approach and focus on meaning-making around traumatic experiences. While narrative-based approaches are often considered “best practice” for trauma interventions, youth may present with comorbid conditions that present barriers or often preclude them from receiving trauma treatment, such as selective mutism (SM). In this case series, we describe the use of NET for treating PTS symptoms in two transgender youth with comorbid SM, as well as adaptations to support their engagement and progress in treatment. Treatment progress was observed in reduction of PTS symptoms, increase in self-reported resilience and positive well-being, and full remission of SM, with treatment gains observed 6-months post-discharge. From these cases, we identified that (1) NET is a brief treatment that can address PTS and SM symptoms among TGNB youth; (2) NET is able to be adapted to enhance engagement in a narrative-based, trauma-focused therapy for youth with PTS and SM; and (3) NET can also increase self-perceived resilience and a sense of positive well-being for TGNB youth.