Psychiatry_1

MD , PhD , Certified Sleep Physician

Sleep Disorders

Restless legs syndrome; Sleep-Psychiatry interface

DPM, MD, MPH

Mood Disorders

Social and Community Psychiatry

MD

Neurostimulation

r-TMS

MD, PDF

Neuropsychiatry

Dementia

MD

Sexual Disorders

Male Sexual Disorders

MD

Consultation-Liaison Psychiatry

Outpatients department:

• General OPD:
  • OPD is situated in hospital building C on Level 3
  • The General OPD provides services to the patients suffering disorders that represent in the form of alteration in behavior, emotions, perception, thoughts and cognitive functions like attention, concentration, memory, reasoning and judgment etc. To sum-up general OPD caters patients suffering from Depression, Anxiety, Bipolar Disorder, Schizophrenia, Substance use, Sexual Problems, Dementia, Sleep Disorders, Generalized Multisite Body Pains, Medically Unexplained Symptoms, Emotional and Behavioral symptoms co-occurring with other medical disorders etc.

In-patients department:

• 20 beds ward on third floor in Hospital building B, Level 4.
• Among these 20 beds, 6 beds are earmarked for DM (Addiction Psychiatry) program. In addition, two beds are available in Sleep Laboratory. 

Procedures (Diagnostic and/or Therapeutic) offered by the department:

• EEG facility: In collaboration with Department of Neurology and Department of Physiology is available in the department. This procedure helps in recognizing epilepsy and differentiating epilepsy from similar conditions seen in Psychiatry practice.
• Sleep Study: Polysomnography is the study of various physiological parameters during sleep that include but not limited to brain activity, muscle tone, respiration, body position, heart rhythm and movements. This information vital to diagnosie and treat a variety of sleep disorders.Central facility with two beds is available in the institute to diagnose and treat patients with sleep disorders. This is joint venture of Departments of Pulmonology, Psychiatry, Neurology, ENT, Pediatrics and Dental Surgery. We have facilities for state of art video-synchronized Level 1 polysomnography that help us to diagnose and treat a range of sleep disorders:
  • Chronic Insomnia
  • Hypersomnia
  • Sleep Related Breathing Disorders
  • Sleep Related Movement Disorders
  • Sleep Related Epilepsy
  • Circadian Rhythm Sleep Disorders
• NEUROMODULATION SERVICES: In the department of Psychiatry the latest clinical and therapeutic neuromodulation services are being provided to the needful suffering from varied range of neuropsychiatric disorders. Neuromodulation means trying to modify or change the dysfunctional neuronal activity to inflict the therapeutic effect in various psychiatric illnesses. Brain stimulation techniques to treat psychiatric disorders are being developed with interest as they ae more promising in refractory cases. These methods include electroconvulsive therapy (ECT), repetitive Transmagnetic stimulation (rTMS), transcranial direct current stimulation (tDCS), etc. At AIIMS Rishikesh ECT and tDCS services are available for public/Govt employees and is covered under Governmental health insurance scheme like Aushman Bharat and CGHS.
• Electroconvulsive Therapy (ECT): ECT services have recently been started at AIIMS Rishikesh. As per the prevailing mental health law, only the modified ECT (i.e. ECT under short general anesthesia) is provided to the needful patients. ECT is very much evident as the one of the efficacious treatment method in cases like severe depression with suicide risk, catatonia, suicidality, treatment resistance, etc. and has faster onset of action in comparison to medications. The modern techniques are used for giving ECT in the state of art operation theaters (OTs) at AIIMS Rishikesh, so as to have maximum benefits and least adverse effects. At present, the ECT services are available on IPD basis only and may be extended to the outpatients as a day care procedure.
• Transcranial direct current stimulation (tDCS): It is one of the important neuromodulation technique known for its uses in various neuro-psychiatric disorders. It is an OPD based treatment method which is brief, inexpensive, easy to administer, noninvasive and painless. tDCS is promising in patients with depression, neuropathic pain, Parkinsonism, stroke recovery, tinnitus (ringing in the ears), and other illnesses. A weak energy stimulus using ~9 volts’ battery is provided over the scalp, which is never painful or distressing during the procedure. Just to compare, a 9-volt battery is used in various home based equipment like infrared thermometer, torch light, smoke alarm, etc.
• Biofeedback: Biofeedback is a non-drug treatment that allows patients to gain awareness and control over their own physiological functions such as heart rate, body temperature, skin conductance, and muscular tension. The “autonomic nervous system” of our body is divided into two sub-systems: the “sympathetic” which is our fight or flight response to stress, and “parasympathetic” our relaxation response. When the body is under stress, a prolonged activation of the sympathetic nervous system can eventually lead to disorders and disease. Biofeedback treatment allows the patient to gain back control over these physiological changes that occur in their body during stress. It is a non-invasive treatment which uses sensors that attach to various parts of the body. These sensors help the patient to receive information about their bodily functions. The patient is then taught relaxation techniques and can simultaneously see real-time changes that indicate a relaxed state of being via machine-based feedback. It’s an effective treatment modality for anxiety, depression, chronic pain, headaches, and sleep-related problems.
• Drug Treatment Centre: Drug Treatment Centre (DTC) at AIIMS, Rishikesh is being run as part of a program that has been implemented by National Drug Dependence Treatment Centre, AIIMS, New Delhi under support and supervision of Drug De-addiction Program, Ministry of Health & Family Welfare, Government of India. Through this initiative, DTC provides drug treatment services for all types of drug users in keeping with the established standards of care and treatment. It has dedicated outpatient as well as inpatient services to provide care to patients with substance use problems by trained health professionals (counsellor, nurse, doctor). Most of the patients also require consultation from other specialists, which is also arranged. Additionally, our team is involved in various community based activities to improve awareness. We have laboratory facilities in collaboration with the department of Biochemistry to screen for addictive substances.Through this centre, we provide various treatment services including:
  • Psychosocial interventions- support and counselling services
  • Pharmacological treatment is also provided, most of the time cost is borne by the Government.
• Tele-psychiatry Unit: Tele-Psychiatry of the department is used for outreach clinical, academic as well as continuing training services. This facility has been established considering the difficult terrain of state and treatment gap for the patients with Psychiatric disorder.
  • Clinical: This facility is used to provide primary and emergency consultations to the physicians when they get patients with suspected Psychiatric disorder. In addition, department is providing tele-after care to the patients who have stabilized with the help of physicians posted in periphery.
  • Academic: This service is used to connect with other national institutes of importance and sharing departmental teaching programs. These programs are attended by students of all institutes that are involved. Thus, it bridges the gap of the expertise available at various institutes.
  • Continuing Training Services:
    • In Collaboration with NIMHANS, Bengaluru, this service is used to train doctors working in Uttarakhand and who have enrolled for Diploma in Primary Care Psychiatry Program.
    • Sleep Physicians of the institute also connect with Physicians interested in Sleep Medicine across the country once a week and discuss some common topic. This is an attempt to share knowledge and develop skills.