Psychotropic self-medication among psychiatry residents in India: A cross-sectional study

ABSTRACT Background: Psychotropic self-medication among medical trainees is a high-risk behavior with important clinical, ethical, and patient-safety implications. While international studies have explored this practice, Indian data—particularly among psychiatry residents—remain scarce. Aim: To assess the frequency, patterns, correlates, and help-seeking attitudes related to psychotropic self-medication among psychiatry residents in India. Materials and Methods: A cross-sectional, anonymous, questionnaire-based study was conducted among 296 psychiatry residents across government, private, and deemed institutions from all five geographic zones of India. Data on sociodemographics, self-medication practices, psychological distress, coping strategies, stigma, and help-seeking were collected. Associations were analyzed using Chi-square tests and binary logistic regression. Results: A substantial proportion of residents (40.54%) reported self-medication for psychiatric symptoms, most commonly for anxiety and sleep disturbances. Benzodiazepines were the most frequently used drugs. Adverse effects were reported by 36.6%, yet only 11.3% sought professional consultation, and 45.8% delayed formal care. Male gender, prior psychiatric illness, and recent psychological distress were independently associated with self-medication. Informal prescribing to friends or relatives was reported by 87.5%. Stigma was highly prevalent, with 70.6% fearing career consequences of disclosure, while 93.9% believed that improved confidentiality would promote help-seeking. Conclusion: Psychotropic self-medication is common among Indian psychiatry residents and is closely linked to distress, stigma, confidentiality concerns, and professional overconfidence. These findings highlight urgent systemic needs for confidential, resident-centered mental health services, anti-stigma initiatives, and structured training in ethical self-care and prescribing.