ABSTRACTS FOR SYMPOSIA

Opioid substitution therapy: A boon or bane: Experience from 4 sites in India Abdul Majid, Sandeep Bola1, Gojendra Singh2, Amar Shinde3 SKIMS Medical College, Srinagar, Jammu and Kashmir, 1Punjab, 2Manipur, 3Pune, Maharashtra, India Introduction: Opioid dependence remains a major public health concern worldwide, with significant medical, psychological, and social consequences. In recent years, Opioid Substitution Therapy (OST) has emerged as a cornerstone in the management of opioid dependence, aiming to reduce harm, prevent relapse, and restore functionality. However, its implementation continues to generate debate — is it truly a boon that rehabilitates, or a bane that merely replaces one addiction with another?. The symposium would help in enhancing our knowledge by sharing experiences which would help in better management of patients who need OST as treatment. Background: Definition: OST involves the administration of a long-acting opioid agonist (e. g., Buprenorphine or Methadone) as a substitute for the abused opioid, under medical supervision. Objectives: - To prevent withdrawal symptoms and cravings - To reduce illicit opioid use and associated risk behaviors - To improve psychosocial functioning and quality of life - In India: Initiated under the National AIDS Control Programme (NACP) and National Drug Dependence Treatment Centre (NDDTC), AIIMS, OST is now an integral part of harm-reduction strategies. Conclusion: Our experience supports OST as a boon when implemented with proper monitoring, psychosocial support, and community education. The potential risks can be mitigated through strict supervision, counseling, and periodic evaluation. OST should not be viewed as substituting addiction, but as a bridge to rehabilitation and recovery. Suicide and its Prevention: Clinical Insights, Risk stratification and evidence based interventions Abhinit Kumar, Kunal Kumar1, Nikhil Nayar1, Praneta Swarup1 SMS and R, Sharda Hospital, Sharda University, 1SMS and R, Sharda Hospital, Greater Noida, Uttar Pradesh, India Suicide is a leading global public health challenge, causing more than 700,000 deaths annually, with adolescents and young adults bearing a disproportionate burden. Contemporary research highlights suicide as a multidimensional phenomenon shaped by neurobiological vulnerability, psychosocial stressors, and sociocultural context. Despite advances in understanding, gaps persist in early identification and timely intervention. This symposium integrates updated evidence on epidemiology, risk stratification, and prevention strategies, aiming to equip clinicians with a structured and practical approach. Key themes include theoretical models of suicidal behavior, validated screening tools, and evidence-based treatments such as Cognitive Behavioral Therapy for Suicide Prevention, Dialectical Behavior Therapy, safety planning interventions, and the anti-suicidal effects of lithium and clozapine. High-risk populations—including individuals with mood disorders, substance use disorders, and recent psychiatric discharge—will be explored with practical clinical algorithms. The session emphasizes communication skills, family involvement, documentation standards, and medico-legal considerations to improve outcomes. By synthesizing scientific insights with clinical application, this symposium seeks to strengthen suicide prevention efforts across healthcare settings. Keywords: Suicide, Risk Assessment, Prevention, Psychiatry, Safety Planning, Crisis Intervention References: 1. World Health Organization. Suicide worldwide in 2019: global health estimates. WHO; 2021. 2. Turecki G, Brent DA. Suicide and suicidal behaviour. Lancet.2016;387:1227 –39. 3. Oquendo MA et al. A risk assessment model for suicide. Am J Psychiatry. 2021. 4. Stanley B, Brown GK. Safety Planning Intervention. Cogn Behav Pract. 2012. 5. Zalsman G et al. Suicide prevention strategies revisited. Lancet Psychiatry. 2016. 6. Attention-deficit/hyperactivity disorder across the lifespan: Adult diagnosis, comorbidities and Indian practice challenges Abhinit Kumar, Pankaj Verma1, Nikhil Nayar2, Praneta Swarup2 SMS and R, Sharda Hospital, Sharda University, 2SMS and R, Sharda Hospital, Greater Noida, Uttar Pradesh, 1VMMC and Safdarjung Hospital, New Delhi, India Attention-Deficit/Hyperactivity Disorder (ADHD) is now firmly established as a lifelong neurodevelopmental disorder, with longitudinal data demonstrating persistence of symptoms into adulthood in approximately 60 –70%of childhood cases.[1] Although hyperactivity tends to diminish with age, impairments in attention, working memory, executive functioning, and emotional regulation frequently continue to cause significant occupational and interpersonal dysfunction across the lifespan.[2,3] Adult ADHD is further complicated by high rates of psychiatric comorbidity—including anxiety disorders, depressive disorders, and substance use disorders which often results in diagnostic overshadowing and delayed recognition in routine clinical settings.[4] Contemporary diagnostic frameworks such as DSM-5-TR and ICD-11 emphasize developmental continuity and incorporate adult-specific symptom descriptors to improve diagnostic clarity.[5,6] Despite this, adult ADHD remains markedly underdiagnosed in India due to limited clinician training, low awareness, stigma associated with neurodevelopmental disorders, and restricted access to stimulant formulations.[7] This symposium synthesises current evidence from Kaplan & Sadock’s Comprehensive Textbook of Psychiatry as well as major international studies to elucidate the developmental trajectory of ADHD, refine diagnostic strategies for adult presentations, and highlight India-specific challenges related to assessment and management[8] By integrating neurobiological, clinical, and public health perspectives, the session aims to improve diagnostic accuracy, enhance early identification, and support culturally informed, evidence-based interventions for adults with ADHD. Reference 1. Faraone SV, Biederman J, Mick E. The age-dependent decline of attention deficit hyperactivity disorder: A meta-analysis of follow-up. Psychol Med 2006;36:159-65. Mental health in school and college settings: Screening, prevention, crisis response Abhinit Kumar, Kunal Kumar1, Pankaj Verma2, Nikhil Nayar1, Praneta Swarup1 SMS and R, Sharda Hospital, Sharda University, 1SMS and R, Sharda Hospital, Greater Noida, Uttar Pradesh, 2VMMC and Safdarjung Hospital, New Delhi, India There is growing global concern regarding the rising burden of mental-health problems among students in school and college settings, with anxiety, depression, learning difficulties, substance use, and self-harm emerging as major contributors to academic decline and psychosocial impairment. Early identification through structured screening programs significantly improves detection of emotional and behavioural disorders, particularly when standardized tools such as the SDQ (Strengths and Difficulties Questionnaire) (1), PHQ-A for adolescent depression (2), GAD-7 for anxiety (3), and the Columbia Suicide Severity Rating Scale (C-SSRS) (4) are incorporated into institutional workflows. Preventive interventions—including social-emotional learning curricula (5), teacher gatekeeper training programs (6), peer-support networks, and evidence-based anti-bullying policies are associated with reduced psychological distress and improved resilience and academic outcomes. Despite these advances, crisis-response systems remain inadequately developed in most Indian educational settings. Timely and structured crisis management, including suicide-risk assessment guided by AACAP and international youth-suicide guidelines (7), safety planning, parental engagement, emergency referral pathways, and carefully designed postvention measures to reduce suicide contagion (8), is essential to preventing adverse outcomes. This symposium proposes a comprehensive model for integrating mental-health systems within and screening strategies to the Indian prevention frameworks with Mental Health guidelines and a structured crisis-response with The is to from to mental-health Key Crisis prevention, school suicide prevention in to clinical Abhinit Kumar, Pankaj Verma1, Kunal Nikhil Nayar2, SMS and R, Sharda Hospital, Sharda University, 2SMS and R, Sharda Hospital, Greater Noida, Medical College, Uttar Pradesh, 1VMMC and Safdarjung Hospital, New Delhi, India is the of with emerging as one of its most The of and data into health for early diagnosis, risk and tools results in depressive disorders, and disorders through and Suicide risk models has than clinical and are to bridge the psychiatric However, these significant and related to data and remain in such as of by continues to growing evidence that as a clinical than a for This symposium aims to a comprehensive of the scientific of its current clinical in and and By clinicians and and has the potential to enhance psychiatric the of health in to of Medical University, Uttar Pradesh, is as a of particularly within culturally such as and individuals with and with treatment. 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The Indian and In one in and adolescents a health remains programs and the Mental Health Programme integrating implementation remains and Indian are and on than health such as low health of and referral The To in a culturally is with support and referral This include for and across health and and evidence-based to Indian can for resilience and the health of The of clinical strategies Hospital, of and of This the of in health and clinicians with evidence-based strategies for integrating into as an essential of the seeks to enhance by psychological, and A comprehensive across and the and outcomes. including clinical studies and longitudinal studies and in with better psychological reduced depression and anxiety, and improved and as and to and psychosocial and associated with distress and outcomes. The emphasize and enhancing clinician on Conclusion: evidence that and into clinical can enhance practice and with and or for longitudinal research is to strengthen evidence for in health settings. of The of emotional and clinical is self-harm Medical and Hospital, India 1. to Background: are to emotional and self-harm and to the self-harm and reduced but and distress and strengthen regulation and reduce on 2. and Background: and often in individuals with emotional and through and or to its on 3. Risk in Background: self-harm safety with and strategies or safety but can or emphasize and safety and with for safety with Mental health Kumar1, and Hospital, of Psychiatry, Uttar Pradesh, Maharashtra, India and individuals in India often healthcare due to and of This to delayed and through In this emerged as and for and health and This symposium aims to highlight the health of individuals and experiences from psychiatric functioning across and healthcare settings. of The the psychosocial health among on and healthcare the functioning of the Medical culturally and psychiatric The on a in medico-legal and with community and to comprehensive The insights from a institutional and strategies to within public health Conclusion: significantly reduce healthcare and improve health for and By this symposium aims to health and in and psychiatric across healthcare in to A on rehabilitation and leading to is now through the which emphasizes and social a social symptom to include and access to community The psychosocial rehabilitation a Key social and be for on and outcomes. of rehabilitation such as training, and family be The on implementation of psychosocial rehabilitation in on models including support and the is and gaps be to the of and the need to rehabilitation to Indian The the health and rehabilitation A the Mental and the of with highlight support such as limited access to and stigma in and be with for rehabilitation within public health By integrating clinical with social and the from merely to social from Hospital, India such as the the psychological and burden not by but by and The of and the of insights significant for the Indian and the Indian This symposium psychiatric emerging from the including the of depression, and substance among are the effects on family of and community The the of mental-health psychosocial interventions, and continuity of to the Indian the symposium these can enhance mental-health resilience in the through improved psychiatric peer-support and it strategies for and including psychological community resilience and mental-health for crisis settings. By synthesizing global evidence with the symposium aims to strengthen and mental-health and into and in the mental-health of India: and the to Medical College, of Psychiatry, India is an that the has for as in the of more in the recent an be with the of one Psychiatry as a is emerging as a with of from Despite the in the of has not in of in with data in a when it to be it be in the of or the academic in or in The for this are and can be which in to this and it a more that and can be in the This symposium aims to on the current of of in of and the that with its and can in its advances in management of suicide in India: and policies Singh2, AIIMS, Pradesh, Maharashtra, India Suicide management in Indian India significantly high of suicide deaths has on on epidemiology, risk and current suicide prevention strategies to challenges and for suicide India has developed a suicide prevention Suicide a of measures in preventing a of strategies be more than a The low of suicide in the community it to and for suicide prevention is to the practice in of the interventions are in Suicide research suicidal in patients and more are and of suicide in young health and are for further suicide Suicide and Indian India has its National Suicide By systems suicide prevention in through the Mental Health Programme The an implementation for a of including and health and and the social and potential for health AIIMS, Pradesh, and of Psychiatry, New and Mental health of Health New Delhi, India and is a to and to that has with and the most for is or a of of including more a into and Mental a significant on diagnosis, health and the public and to who from health problems can be by is in when it to and of can be and However, the of health and the treatments are and Mental the of on Mental In to the and with health now access to learning through and and the that among in and is an that to and proper of and its of substance use and associated among medical students in A of Mental India Background: use among medical students is a growing public health and to However, particularly from are This the and associated with substance use among medical students in To the and associated with substance use among medical students in A with a and the and to the and the most by and use among and students significantly substance students of use, as a Conclusion: use is among medical students in by academic and in The insights for policies and including management programs and to support the of healthcare and National Drug Treatment India of Medical New Delhi, India is a of withdrawal of of in patients with and use of is a medical emergency by of that is in and with in the of