No abstract

Background: First rank symptoms (FRSs) are seen frequently in mania. There has been a scarcity of data published in consideration with the Indian population on the prevalence of FRS in mania. Aim: The aim of this study is to explore the pattern of occurrence of FRS and assess association between the presence of FRS and severity of mania. Subjects and Methods: A cross-sectional study was conducted in the psychiatry department of tertiary care institution of North India. Fifty patients selected by convenient sampling, diagnosed with mania as per Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) classification. Informed consent taken, semi-structured per forma used, present state examination-9 Hindi version used for FRS, Young Mania Rating Scale (YMRS) to assess severity of mania. Descriptive statistics were used. The Chi-square test was used for the comparison between the groups. Mann–Whitney U-test was used for the comparison between individual FRS and YMRS score. Results: Mean age FRS + was 35.32 years (±13.85), 71% were males; majority belonged to urban locality, married, residing in nuclear family, educated up to matriculation, and unemployed. There was no significant association of these variables with FRS. The Presence of ≥1 FRS was 62%; voices commenting on one's action (83.9%), voices arguing (77.4%), thought broadcast (38.7%), delusional perception (23.8%), thought withdrawal and thought echo (both 12.9%), made volitional acts, somatic passivity, and thought insertion (in 3.2% each). None had the presence of made feelings and made impulse/drives. Mean YMRS was 40.16 ± 7.91. No statistical significance found between FRS and YMRS scoring, except for thought withdrawal. Conclusions: The present study confirms FRS in substantial cases of mania. FRS in mania can lead to misdiagnosis of schizophrenia, leading to inadequate management, delayed appropriate treatment, and poor prognosis.

Although modern technologies have made life simpler, it has also intensified the complexity of psychopathology. The adoption of the Internet and its numerous artificial intelligence software products into morbid delusions is gaining more momentum. Clinicians must be alert about patients with delusions getting ideas and feedback from the social context in which they live. Here, we discuss a case about a young, single, high-school graduated male, with schizoid personality traits, socially withdrawn, dependent, sexually inhibited with a poor level of occupational and social functioning, who has developed erotomanic delusion with Google Assistant.

Background: There are many unique features related to substance abuse in the elderly, which is an underestimated problem in society. Objectives: A cross-sectional exploratory study was conducted in a North Indian tertiary care setting to assess the pattern of substance use in the elderly. Materials and Methods: Fifty cases were included in the study via purposive sampling; a Drug Abuse Monitoring System pro forma and a semistructured pro forma designed to gather information on sociodemographic and substance use characteristics were used. Descriptive statistics were applied. Continuous variables were summarized as means and standard deviations and categorical variables as counts and percentages. Results: The mean age of the samples was 64.12 ± 4.54 years. Alcohol use was noted in 66% of the cases, tobacco use in 76%, opioid use in 16%, cannabinoid use in 4%, and sedative/hypnotic use in 4%. Majority of the cases were married, studied up to high school, self-employed, and living in joint family. Majority of the cases had initiation of substance use in young age due to peer pressure, and the reason for change in pattern were in majority mainly family issues and tolerance. Majority of the cases were brought by family members for treatment seeking. Conclusions: The issue of substance abuse in elderly population is underestimated, and studies are scarce in finding the exact prevalence in the society.