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Background: Dhat syndrome is a culture-bound syndrome originating in the Indian subcontinent, primarily among men characterized by the fear of loss of semen. Objective: The article discusses the perceived impact of Dhat syndrome on the overall psychological well-being of the individual. Method: Four patients from hospitals in Kolkata, West Bengal, were screened using MINI and then interviewed using semi-structured interview to assess presenting concerns, interventions, psychological well-being, attitude toward sex and masturbation, and their sociodemographic details. The data were then categorized based on the dimensions of the questionnaire, which was then analyzed individually and separately based on the dimensions. The differences and commonalities between the dimensions as conveyed by the participants were then reported. Results: The analysis showed that the participants reported lower levels of psychological well-being based on the categories of Seligman's PERMA model and attributed it to the symptoms experienced by them. They traced the beginning of the hindrances to achieving optimal well-being to the onset of symptoms. Conclusion: This article proposes the incorporation of integrative therapeutic interventions and advocacy of sex education to address the psychological well-being over the current symptom reduction interventions used.

Objective To examine feasibility and acceptability of smartphone mental health app use for symptom, cognitive, and digital phenotyping monitoring among people with schizophrenia in India and the United States. Methods Participants in Boston, USA and Bhopal and Bangalore, India used a smartphone app to monitor symptoms, play cognitive games, access relaxation and psychoeducation resources and for one month, with an initial clinical and cognitive assessment and a one-month follow-up clinical assessment. Engagement with the app was compared between study sites, by clinical symptom severity and by cognitive functioning. Digital phenotyping data collection was also compared between three sites. Results By Kruskal-Wallis rank-sum test, we found no difference between app activities completed or digital phenotyping data collected across the three study sites. App use also did not correlate to clinical or cognitive assessment scores. When using the app for symptom monitoring, preliminary findings suggest app-based assessment correlate with standard cognitive and clinical assessments. Conclusions Smartphone app for symptom monitoring and digital phenotyping for individuals with schizophrenia appears feasible and acceptable in a global context. Clinical utility of this app for real-time assessments is promising, but further research is necessary to determine the long-term efficacy and generalizability for serious mental illness.

BackgroundDespite significant advancements in healthcare technology, digital health solutions – especially those for serious mental illnesses – continue to fall short of their potential across both clinical practice and efficacy. The utility and impact of medicine, including digital medicine, hinges on relationships, trust, and engagement, particularly in the field of mental health. This paper details results from Phase 1 of a two-part study that seeks to engage people with schizophrenia, their family members, and clinicians in co-designing a digital mental health platform for use across different cultures and contexts in the United States and India.MethodsEach site interviewed a mix of clinicians, patients, and their family members in focus groups (n = 20) of two to six participants. Open-ended questions and discussions inquired about their own smartphone use and, after a demonstration of the mindLAMP platform, specific feedback on the app's utility, design, and functionality.ResultsOur results based on thematic analysis indicate three common themes: increased use and interest in technology during coronavirus disease 2019 (COVID-19), concerns over how data are used and shared, and a desire for concurrent human interaction to support app engagement.ConclusionPeople with schizophrenia, their family members, and clinicians are open to integrating technology into treatment to better understand their condition and help inform treatment. However, app engagement is dependent on technology that is complementary – not substitutive – of therapeutic care from a clinician.

India has the world's largest number of suicides, but there is little research on the trends in suicidal thoughts, especially for individuals with psychosis. More research is necessary to develop preventive interventions. Smartphone-based ecological momentary assessments (EMAs) can assess dynamic symptoms, but most EMA studies are conducted in higher income settings and have shorter (≤1 month) follow-up periods. This study aimed to examine the duration of onset to offset of suicidal ideation (SI) in tertiary hospital outpatients with psychosis in India. This study is an exploratory, secondary analysis of smartphone EMA data nested within the ongoing \"Smartphone Health Assessment for Relapse Prevention (SHARP)\" project. Tertiary hospital outpatients (n=50) with early course schizophrenia at 2 socioculturally different sites in India were recruited and given the \"mindLAMP\" app for monitoring mood through daily EMA surveys. The mood survey matched the 9-item Patient Health Questionnaire; the ninth item was used to define an instance of SI (score ≥1). A total of 14 patients with ≥1 SI instances who met the site-specific EMA survey use cutoff were included. We examined the between- and within-person variability in SI and computed the timescale of \"episodic\" SI (sequences of consecutive daily observations of SI score ≥1). Positive and Negative Syndrome Scale (PANSS) was used to assess changes in psychosis symptoms and its relationship with the temporality of SI. Over approximately 11 (SD 2.1) months of EMA reporting on average, 3253 mood surveys were filled by the 14 participants (median 213, IQR 147-256). A total of 521 instances of SI were reported. Monthly SI instances showed substantial within- and between-person variations. Timescale summary statistics revealed episodic SI patterns in 11 patients, with an average of 5.9 episodes (SD 4.4; range:1-14; n=65) with an episode lasting on average 2.5 days (SD 1.5; range:1-5.3; n=27). There was an average lag of approximately 59, 66, and 81 days between the time of the first drop in PANSS positive, negative, and general psychopathology scores, respectively, and the last reported SI instance. Results after imputation of missing data showed an average of 12.1 episodes and 228 days (average lag) between the first drop in PANSS scores and last reported SI. This indicated that SI was an enduring vulnerability subsequent to the beginning of clinical improvement in psychosis. Our study adds to the much-needed evidence base in India to measure the dynamics of suicidal thinking within an individual, for more targeted preventive interventions. Further steps in EMA research are highlighted such as the use of higher frequency \"burst\" surveys to assess the duration of an SI episode in hours or minutes, and inclusion of both active and passive SI markers to measure the timescale of suicidal thinking.

Background: The study was undertaken as there is very less literature related to sources of influence for sexual knowledge and attitude toward sex and sexual behaviors of youth in India. Aim: The objectives of the study were to explore sexual knowledge, attitudes, behaviors and the sources of influence and also to examine the relationship between sexual knowledge, attitude and behaviors in the youth. Method: The sample was selected from colleges using purposive sampling method and from the community using snowball method (n = 300). The tools used were sociodemographic data sheet, Sexual Knowledge and Attitude Questionnaire (SKAQ-II) and Sexual Behavior and Sources of Influence (SBSI) scale. Results: Descriptive statistics and correlation was done to analyze the data. The youth had poor sexual knowledge; there was positive relationship between sexual knowledge and attitudes. Sexual behaviors through media and with self or others were found to be low. Internet was found to be the major source for gathering information and was considered the most reliable source. Conclusion: Indian college youth continue to have poor sexual knowledge. Internet is a major source of information and is considered as the most reliable one among youth. More knowledge about sex is associated with liberal attitude toward sex.

Background for the Study: Informed consent is a process of obtaining permission from the participant to participate in research. Involving children in a research requires them to give their \"assent\" for participation. Informed assent is obtained from children even after their guardians have given consent for participation. Studies have shown that children have difficulty understanding the key elements of research process such as right to withdraw from the study or the meaning of \"harm\" involved in the research process. Further, the studies have also propounded that using child-friendly methods such as using pictures and simple language would facilitate children's understanding. Objectives: In this study, pictorial and verbal assent formats were compared find out which format is suitable for children's understanding of informed assent with respect to research. Methods: A sample of 389 school going children and adolescents of both the gender, ranging from 7 to 16 years were considered for the study. The sample was randomly divided into two groups, where for one group (n = 197), pictorial assent format was administered and another group (n = 192), verbal assent format was administered. The pictorial assent format was developed for the study by the corresponding author. Results and Conclusions: Analysis revealed that there was a significant level of interaction between gender and the two assent formats. Males were able to understand pictorial assent format better compared to the females, whereas females were able to understand verbal assent format better than the males, when age and education were considered as covariates. Further, it was found that as age increases there is better understanding of research processes in both the formats. Hence, while the process of obtaining assent for participation in research, age of child must be considered and with respect to gender differences males tend to prefer pictorial formats whereas females tend to prefer verbal formats.

Smartphone technology provides us with a more convenient and less intrusive method of detecting changes in behavior and symptoms that typically precede schizophrenia relapse. To take advantage of the aforementioned, this study examines the feasibility of predicting schizophrenia relapse by identifying statistically significant anomalies in patient data gathered through mindLAMP, an open-source smartphone app. Participants, recruited in Boston, MA in the United States, and Bangalore and Bhopal in India, were invited to use mindLAMP for up to a year. The passive data (geolocation, accelerometer, and screen state), active data (surveys), and data quality metrics collected by the app were then retroactively fed into a relapse prediction model that utilizes anomaly detection. Overall, anomalies were 2.12 times more frequent in the month preceding a relapse and 2.78 times more frequent in the month preceding and following a relapse compared to intervals without relapses. The anomaly detection model incorporating passive data proved a better predictor of relapse than a naive model utilizing only survey data. These results demonstrate that relapse prediction models utilizing patient data gathered by a smartphone app can warn the clinician and patient of a potential schizophrenia relapse.

Traditional cognitive assessments in schizophrenia are time-consuming and necessitate specialized training, making routine evaluation challenging. To overcome these limitations, this study investigates the feasibility and advantages of utilizing smartphone-based assessments to capture both cognitive functioning and digital phenotyping data and compare these results to gold standard measures. We conducted a secondary analysis of data from 76 individuals with schizophrenia, who were recruited across three sites (one in Boston, two in India) was conducted. The open-source mindLAMP smartphone app captured digital phenotyping data and Trails A/B assessments of attention / memory for up to 12 months. The smartphone-cognitive tasks exhibited potential for normal distribution and these scores showed small but significant correlations with the results from the Brief Assessment of Cognition in Schizophrenia, especially the digital span and symbol coding tasks (r2 = 0.21). A small but significant correlation (r2 = 0.29) between smartphone-derived cognitive scores and health-related behaviors such as sleep duration patterns was observed. Smartphone-based cognitive assessments show promise as cross-cultural tools that can capture relevant data on momentary states among individuals with schizophrenia. Cognitive results related to sleep suggest functional applications to digital phenotyping data, and the potential of this multimodal data approach in research.

Purpose of Review Schizophrenia presents a significant mental health challenge requiring innovative solutions for relapse prevention, self-management, and health promotion. Patients face an excess mortality gap, driven by increased rates of chronic health conditions, exacerbated in low-resource settings. Digital interventions are a promising avenue to address the multifaceted needs of individuals with schizophrenia. This narrative review synthesizes evidence from digital intervention trials for schizophrenia published from January 2020 to June 2023. Recent Findings 23 studies were identified, encompassing smartphone applications and web-based platforms to mitigate symptom severity, prevent relapse, and promote physical health. Key developments thus far have shown reduced symptom burden, and enhanced medication adherence and physical activity engagement. Despite more than a decade of research on digital interventions, many trials in this review continued to focus on acceptability and feasibility, with emphasis on patient uptake. This suggests the field has shown limited advancement in effectiveness studies of digital interventions. Summary As the field evolves, further fully powered effectiveness studies, greater emphasis on implementation studies for digital tools for schizophrenia, and attention on digital health equity and evidence generation among those in lower-income countries are warranted. These findings hold implications for clinicians, researchers, and policymakers towards optimizing digital care for individuals with schizophrenia.