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Objectives: According to the national mental health survey, substance use disorders (SUDs) are prevalent in 22.4% of the population above 18 years, whereas the same is 26% among the tribal population. The treatment gap is also high in substance-addictive disorders. Our study aimed to compare the severity of substance use, pathways to psychiatric care, and treatment-seeking behavior among the tribal and non-tribal populations. Materials and Methods: The study was conducted at a tertiary psychiatric teaching institute in India. It was a cross-sectional comparative study. Patients fulfilling the International Classification of Disease 10 diagnostic criteria of mental and behavioral disorders due to substance use, with active dependence, were taken without comorbidity. Forty patients in tribal and non-tribal groups were recruited with consecutive sampling. The samples were assessed with a semi-structured interview schedule, addiction severity index, attitudes toward help-seeking, and pathways-to-care. Results: Excessive substance use median was for 7.00 (± 5.00) years in tribal and 6.00 (± 4.00) years in non-tribal; in tribal, substance intake was younger than non-tribal (P = 0.167), and general health-care system more distance than the non-tribal (P < 0.001). Around 65% of the persons with SUD never consulted their general practitioner and primary health-care facilities. Alcohol severity was higher in the tribal population than in the non-tribal population. The cannabis and opioid severity was high in the non-tribal population. Help-seeking behavior was deficient in both groups. Conclusion: Most of the substance abuse tribal and non-tribal populations reach healthcare very late and do not consider it as a health issue initially. The major reason for the delayed pathway is a lack of awareness about mental health care facilities and stigma in both populations. The stigma is high in non-tribal communities compared to the tribal community. There is a need to improve the identification and treatment of alcohol morbidity in primary care.

Research has recognised the psychosocial impairments linked to Trichotillomania (TTM) and established a relationship between problematic hair-pulling and affective regulation. Significant relationships between pulling triggers, their severity, and emotional dysregulation have also been predicted. The current case focused on the efficacy of combined DBT (Dialectical Behaviour Therapy) and HRT (Habit Reversal Training) in a client with TTM and Impulsive Personality features. The client received 11 weekly sessions of DBT-enhanced HRT, which took 3 months to complete. Following the end of this acute treatment phase, four maintenance sessions (two sessions per month) were delivered. The maintenance of treatment benefits was assessed using self-report measures and therapist observations at four time points: at pre-treatment, after the acute treatment phase (at the end of 3 months), and then at a 3-month and a 6-month follow-up. The intervention results suggested a substantial reduction in hair-pulling, hair regrowth in affected parts of the scalp, and self-reported improvements in mood. The study also shows preliminary evidence of DBT-enhanced HRT’s efficacy in a client with TTM and Impulsive Personality features, suggesting the importance of addressing personality structures and distressing emotional regulation that cause functional impairment during TTM treatment.

Background: Persons with Obsessive Compulsive Disorder and individuals in conflict with law are prone to experience guilt and regret which can have significant implications on their lives. Guilt and regret are two very prominent emotions found in individuals with Obsessive Compulsive Disorder A question then arises whether the individuals who are in Conflict with Law experiences the same kind of guilt and regret, which is experienced by the persons suffering from obsessive compulsive disorder; another aspect that too seeks attention is how related is the coping strategy of the two distinguished population. Methods: The objective of this study was to aim assess and compare the guilt, regret and coping in individuals with obsessive compulsive disorder and individuals in conflict with law. The sample size consists 60 individuals (18-55years of age), of whom 30 individuals were with OCD taking treatment in the Institute of Psychiatry and 30 individuals in conflict with law, who were taken from the Presidency Correctional Home and Alipore Women Correctional Home. Participants were selected purposively. The Revised Mosher Guilt Inventory, Regret Scale and Brief Cope were administered of the participants of either group for the assessment guilt, regret and coping respectively. Data analysis was done by the SPSS-25 (Windows version). Descriptive statistics, independent samples t test and chi-square test were used. Results: In OCD group, majority of the participants were found to have higher educational qualifications, e.g. intermediate, graduation or more, whereas, in persons in conflict with law group, most of them were either illiterate or minimally educated, nearly equal participation of males and females was observed in either group, mean ages were 32.93±9.21 and 40.00±8.38 in OCD and persons in conflict with law groups respectively. No significant differences were noted between these two groups in coping and regret. In case of guilt, significant difference was noted in 'guilty conscience', where OCD patients reported significantly higher scores than that of persons in conflict with law. In other two forms of guilt, i.e., sexual guilt and hostility guilt no significant differences were noted. Conclusion: Difference in guilt between OCD patients' and the persons' in conflict with might be due to several reasons, ranging from core illness related factors to larger socio-cultural factors. Roles of personality might as well have some association with it. Giving conclusive remark about guilt, regret and coping about these two divergent populations might not be possible with this small size. In future, studies should be carried out on larger samples which should be selected through stratified sampling method for securing more accurate information about those issues. Factors like, family structure and functions, marital relationship, family support and personality disposition should also be studied.